Search results for: clinical outcome

Authors: Ojo Oo, Akinde S. B., Kiilani A. O., Jayeola Jo, Jogbodo T. M., Ajani Ka, Olaniyan So, Adeagbo Oy, Bolarinwa Ra, Durosomo Ha, Sule W. F.

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Lockdown imposed to control SARS-CoV-2 transmission hampered malaria control services in Nigeria. Considering COVID-19 vaccination, we assessed Plasmodium falciparum (Pf) antigen and SARS-CoV-2 immunoglobulin-G (IgG) positivity among adults in Osogbo, Osun State, Nigeria. Consenting attendees of four Healthcare Centres were consecutively enrolled for blood sampling; relevant socio-demographic/behavioral/clinical/environmental data were collected with a questionnaire. Samples were tested, using commercial rapid test kits, for Pf antigen and SARS-CoV-2 IgG and results were analyzed using logistic regression. Participants' mean age was 40.99 years (n=200), and they were predominantly females (84.5%), traders/businessmen/women (86.0%), with self-reported receipt of COVID-19 vaccine from 123 (61.5%). Pf antigen positivity was 17.5% (95% CI: 12.23–22.77%) with age (p=0.004), marital status (p=0.004), report of stagnant water around the workplace (p=0.041) and bush around homes (p=0.008) being associated. SARS-CoV-2 IgG positivity was 56.5% (95% CI: 49.63–63.37%) with age (p=0.012) and receipt of COVID-19 vaccination (p=0.001) being associated. Although the vaccinated had a 22.8 times higher likelihood of IgG positivity, no factor was predictive of COVID-19 vaccine receipt. We report 17.5% Pf antigen positivity with four predictors, and 56.5% SARS-CoV-2 IgG positivity with two predictors.

Keywords: COVID-19, vaccine, IgG, Plasmodium falciparum, SARS-CoV-2

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Authors: A. Bhattacharya, Sanjay Gupta, S. H. Bodakhe

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HbA1c is form of the haemoglobin that is used to measure the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose. In diabetes mellitus, higher amounts of glycated hemoglobin, indicating poorer control of blood glucose levels, have been associated with cardiovascular disease, nephropathy, and retinopathy. Guraku’s basic components are nicotine and jaggery, jaggery is made up of sugarcane so can have a diabetogenic potential which is exacerbated in presence of nicotine. This work had done with the aim to find correlation between Diabetic cataract, HbA1c and Guraku. Subjects were enrolled according to the inclusion and exclusion criteria. In this study total 75 subjects were included. In the study it was found that people consuming Guraku had a high level of HbA1c thus are more prone to the development of diabetic cataract. Male subjects are the more than female subjects. Most of the subjects belong to the lower socioeconomical class and not very educated. It could be concluded that this type of study could be useful in indentifying number of subjects suffering from diabetic cataract whose condition get worse by use of nicotine product like Guraku and preventive measure to be taken in prevention of this type of diabetic complication.

Keywords: diabetic cataract, HbA1c, Guraku, diabetogenic potential

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Authors: Grange Sylvain, Plancher Ronan, Reurink Guustav, Croisille Pierre, Edouard Pascal

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The primary objective of this study was to analyze the potential correlation between the pain experienced at the time of a hamstring muscle injury and the volume of the lesion measured on MRI. The secondary objectives were to analyze a correlation between this pain and the lesion grade as well as the affected hamstring muscle. We performed a retrospective analysis of the data collected in a prospective, multicenter, non-interventional cohort study (HAMMER). Patients with suspected hamstring muscle injury had an MRI after the injury and at the same time were evaluated for their pain intensity experienced at the time of the injury with a Numerical Pain Rating Scale (NPRS) from 0 to 10. A total of 61 patients were included in the present analysis. MRIs were performed in an average of less than 8 days. There was a significant correlation between pain and the injury volume (r=0.287; p=0.025). There was no significant correlation between the pain and the lesion grade (p>0.05), nor between the pain and affected hamstring muscle (p>0.05). Pain at the time of injury appeared to be correlated with the volume of muscle affected. These results confirm the value of a clinical approach in the initial evaluation of hamstring injuries to better select patients eligible for further imaging.

Keywords: hamstring muscle injury, MRI, volume lesion, pain

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Authors: Amberly Brigden, Ali Heawood, Emma C. Anderson, Richard Morris, Esther Crawley

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Background: Paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is characterised by persistent, disabling fatigue. Health services see patients below the age of 12. This age group experience high levels of disability, with low levels of school attendance, high levels of fatigue, anxiety, functional disability and pain. CFS/ME interventions have been developed for adolescents, but the developmental needs of younger children suggest treatment should be tailored to this age group. Little is known about how intervention should be delivered to this age group, and further work is needed to explore this. Qualitative research aids patient-centered design of health intervention. Methods: Five to 11-year-olds and their parents were recruited from a specialist CFS/ME service. Semi-structured interviews explored the families’ experience of the condition and perspectives on treatment. Interactive and arts-based methods were used. Interviews were audio-recorded, transcribed and analysed thematically. Qualitative Results: 14 parents and 7 children were interviewed. Early analysis of the interviews revealed the importance of the social-ecological setting of the child, which led to themes being developed in the context of Systems Theory. Theme one relates to the level of the child, theme two the family system, theme three the organisational and societal systems, and theme four cuts-across all levels. Theme1: The child’s capacity to describe, understand and manage their condition. Younger children struggled to describe their internal experiences, such as physical symptoms. Parents felt younger children did not understand some concepts of CFS/ME and did not have the capabilities to monitor and self-regulate their behaviour, as required by treatment. A spectrum of abilities was described; older children (10-11-year-olds) were more involved in clinical sessions and had more responsibility for self-management. Theme2: Parents’ responsibility for managing their child’s condition. Parents took responsibility for regulating their child’s behaviour in accordance with the treatment programme. They structured their child’s environment, gave direct instructions to their child, and communicated the needs of their child to others involved in care. Parents wanted their child to experience a 'normal' childhood and took steps to shield their child from medicalization, including diagnostic labels and clinical discussions. Theme3: Parental isolation and the role of organisational and societal systems. Parents felt unsupported in their role of managing the condition and felt negative responses from primary care health services and schools were underpinned by a lack of awareness and knowledge about CFS/ME in younger children. This sometimes led to a protracted time to diagnosis. Parents felt that schools have the potential important role in managing the child’s condition. Theme4: Complexity and uncertainty. Many parents valued specialist treatment (which included activity management, physiotherapy, sleep management, dietary advice, medical management and psychological support), but felt it needed to account for the complexity of the condition in younger children. Some parents expressed uncertainty about the diagnosis and the treatment programme. Conclusions: Interventions for younger children need to consider the 'systems' (family, organisational and societal) involved in the child’s care. Future research will include interviews with clinicians and schools supporting younger children with CFS/ME.

Keywords: chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), pediatric, qualitative, treatment

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Authors: Susanne Fridsten, Kristina Hellman, Anders Sundin, Lennart Blomqvist

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Background: Patients diagnosed with locally advanced cervical carcinoma are treated with definitive concomitant chemo-radiotherapy. Treatment failure occurs in 30-50% of patients with very poor prognoses. The treatment is standardized with risk for both over-and undertreatment. Consequently, there is a great need for biomarkers able to predict therapy outcomes to allow for individualized treatment. Aim: To explore the role of T2- and diffusion-weighted magnetic resonance imaging (MRI) for early prediction of therapy outcome and the optimal time point for assessment. Methods: A pilot study including 15 patients with cervical carcinoma stage IIB-IIIB (FIGO 2009) undergoing definitive chemoradiotherapy. All patients underwent MRI four times, at baseline, 3 weeks, 5 weeks, and 12 weeks after treatment started. Tumour size, size change (∆size), visibility on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and change of ADC (∆ADC) at the different time points were recorded. Results: 7/15 patients relapsed during the study period, referred to as "poor prognosis", PP, and the remaining eight patients are referred to "good prognosis", GP. The tumor size was larger at all time points for PP than for GP. The ∆size between any of the four-time points was the same for PP and GP patients. The sensitivity and specificity to predict prognostic group depending on a remaining tumor on DWI were highest at 5 weeks and 83% (5/6) and 63% (5/8), respectively. The combination of tumor size at baseline and remaining tumor on DWI at 5 weeks in ROC analysis reached an area under the curve (AUC) of 0.83. After 12 weeks, no remaining tumor was seen on DWI among patients with GP, as opposed to 2/7 PP patients. Adding ADC to the tumor size measurements did not improve the predictive value at any time point. Conclusion: A large tumor at baseline MRI combined with a remaining tumor on DWI at 5 weeks predicted a poor prognosis.

Keywords: chemoradiotherapy, diffusion-weighted imaging, magnetic resonance imaging, uterine cervical carcinoma

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Authors: Singh Baljinder, Sharma Navneet

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Microalbuminuria is the earliest detectable marker of diabetic nephropathy. We planned to evaluate the prevalence of microalbuminuria in type 1 diabetics and correlate with various risk factor. We randomly selected 100 type 1 diabetic patients after inclusion and exclusion criteria from DCRC, S. P. Medical College, Bikaner. Clinical examinations for anthropometeric parameters, hypertension, retinopathy, glycaemic status, lipid profile were done and microalbuminuria was estimated by micral test. Microalbuminuria was seen in 38% patients. The mean urinary albumin concentration was 96.61 mg/l in microalbuminuria positive cases, 134 mg/L in hypertensive patients while 74.5 mg/L in normal patients. Mean diabetic duration was 6.43 years in microalbuminurics. Albumin excretion increased significantly with age at onset of 10-18 years and declined thereafter. Microalbuminuria cases exhibited mean cholesterol 181.63 mg%, TG 130.94 mg%, LDL 109.87 mg%, HDL 57.5 mg% and VLDL 30.64 mg%. Mean urinary albumin concentration in patients with retinopathy was 160.52 mg/L while 78.66 mg/L without retinopathy. In multiple stepwise logistic regression analysis, a strong positive association was seen between microalbuminuria and hypertension (OR=5.087, CI=2.1319-12.101), fasting blood sugar (OR=3. 491, CI=1.138-10.70), duration of diabetes (OR=3.41, CI=1.360-8.55) and HbA1c (OR=2.381, CI-=1.1-5.64). The present study indicates that microalbuminuria is a common complication of type 1 diabetes mellitus and can be prevented by careful management of risk factors.

Keywords: type 1 diabetes, microalbuminuria, diabetic nephropathy, retinopathy, hypertension

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Authors: Isabel Medina, Mario Duran

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Although Problem-based learning provides students with multiple opportunities for rigorous instructional experiences in which students are challenged to address problems in the community; there are still gaps in connecting community leaders to the PBL process. At a south Texas high school, community participation serves as an integral component of the PBL process. Problem-based learning (PBL) has recently gained momentum due to the increase in global communities that value collaboration and critical thinking. As an instructional approach, PBL engages high school students in meaningful learning experiences. Furthermore, PBL focuses on providing students with a connection to real-world situations that require effective peer collaboration. For PBL leaders, providing students with a meaningful process is as important as the final PBL outcome. To achieve this goal, STEM high school strategically created a space for community involvement to be woven within the PBL fabric. This study examines the impact community members had on PBL students attending a STEM high school in South Texas. At STEM High School, community members represent a support system that works through the PBL process to ensure students receive real-life mentoring from business and industry leaders situated in the community. A phenomenological study using a semi-structured approach was used to collect data about students’ perception of community involvement within the PBL process for one South Texas high school. In our proposed presentation, we will discuss how community involvement in the PBL process academically impacted the educational experience of high school students at STEM high school. We address the instructional concerns PBL critics have with the lack of direct instruction, by providing a representation of how STEM high school utilizes community members to assist in impacting the academic experience of students.

Keywords: phenomenological, STEM education, student engagement, community involvement

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Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

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In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

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Authors: Jodie Hughes

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Endometriosis affects 1 in 10 individuals that were born female globally. Endometriosis incidence rates peak between 30-40 year of age, in young women and adolescents it is a rarely suspected and often ill-diagnosed. The average cost of endometriosis is €9,579 per woman. More than 75% of women have reported being absent from work due to endometriosis, with 40% of women becoming unemployed due to the disease. 46% of patients with endometriosis need to have appointments with upward of five doctors to gain a correct diagnosis. Quantitative data were collected by way of an online PSS-10 survey that included demographic questions from two sample groups of females, group 1 was females with endometriosis, group 2 were healthy women. The data were scored using Cohens scoring system, overall scores were input to SPSS. A non-parametric Mann-Whitney U test and ANOVA was used to ascertain any differences between the PSS-10 scores of the two groups. A significance level of P<0.05 was adopted. Four women were invited to take part in a semi structured interview that was recorded, transcribed and coded using interpretive phenomenological analysis (IPA) using NVivo 12. Results showed that the PSS-10 scores were significantly higher in women with endometriosis compared to healthy women with a p=<0.005. Endometriosis affects all aspects of a patient’s life, to adequately diagnose and treat the condition and improve HRQoL there needs to be better understanding of the clinical symptoms and how they impact the lives of patients.

Keywords: endometriosis, HRQoL, perceived stress, women

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Authors: Nuhi Arslani, Stojan Potrc, Timotej Mikuljan

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Background: In Department of Abdominal and General Surgery of University Medical Centre Maribor, we treated 578 patients for rectal cancer between 2004 and 2014. During and after treatment we especially concentrated on monitoring local and systemic complications. Methods: For analysis, we used data gathered from preoperative diagnostic tests, reports gathered during operation, reports from the pathohistologic review, and reports on complications after surgery and follow up. Results: In the case of 573 (out of 578) patients (99.1%) we performed resection. R0 was achieved in 551 patients (96,1%). R1 was achieved in 8 patients (1,4%). R2 was achieved in 14 patients (2,4%). Local complications were reported in 78 (13.5%) patients and systemic complications were reported in 68 (11.7%). We would like to point out the low number of local and systemic complications. Conclusions: With advances in surgical techniques, with a multimodal-multidisciplinary approach and with the use of total mesorectal excision we experienced a significant improvement in reducing the number of local and systemic complications in patients with rectal cancer. However, there still remains the question for truly optimal care for each patient with rectal cancer and his quality of life after surgical treatment.

Keywords: local complications, rectal cancer, resection, systemic complications

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Authors: C. van den Berg, C. Pokpas

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Popular discourse touts entrepreneurship as a universal solution for underdevelopment, unemployment, and poverty. Moreover, claims are made that women and other disadvantaged groups can achieve material and personal success through digital entrepreneurship. This paper examines the potential of digital technology in entrepreneurial ventures to stimulate economic growth for marginalized groups and communities. Although digital entrepreneurship is hailed as a means to empower under-resourced and socially marginalized people, these opportunities still exist within the confines of existing social and cultural practices. The perspectives of female digital entrepreneurs in developing countries are sorely understudied, particularly concerning an understanding of the complex underlying socio-cultural factors impeding women’s entrepreneurial behaviors. This qualitative study, guided by a feminist phenomenological perspective, focused on the experiences of digital female entrepreneurs in the Western Cape of South Africa. Data were collected via semi-structured interviews and analyzed through the interpretative phenomenological analysis (IPA) approach to determine the relationships between digital entrepreneurship and structural and agential enabling conditions. Findings show that digital entrepreneurship is not a panacea for economic growth in marginalized groups and communities and highlight the importance of addressing socio-cultural gender inequality to enable successful entrepreneurial activity. The paper concludes with recommendations for specialized training initiatives aimed at female entrepreneurs that address internalized constraints and barriers that keep women subservient and measures to shift gender and power beliefs. The outcome will benefit the stimulation of gender-specific public policies to develop a successful digital start-up ecosystem further.

Keywords: digital innovation, female digital entrepreneurs, feminist phenomenology, gender, marginalised communities

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Authors: Gabriel Sepulveda Navarro

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Traditional interventions for young offenders are necessary but not sufficient to tackle the multiple causes of juvenile crime. For instance, interventions offered to young offenders often are verbally mediated and dialogue based, requiring important metacognitive abilities as well as abstract thinking, assuming average performance in a wide variety of skills. It seems necessary to assess a broader set of abilities and functions in order to increase the efficiency of interventions while addressing offending. In order to clarify these assumptions, Stroop Test, as well as Rey-Osterrieth Complex Figure Test were applied to juvenile offenders tried and sentenced for violent crimes in Santiago de Chile. A random sample was drawn from La Cisterna Half-Open Program, consisting of 50 young males between 18 and 24 years old, residing in different districts of Santiago de Chile. The analysis of results suggests a disproportionately elevated incidence of impairments in executive functions and visuospatial skills. As an outcome, over 40% of the sample shows a significant low performance in both assessments, exceeding four times the same prevalence rates among young people in the general population. While executive functions entail working memory (being able to keep information and use it in some way), cognitive flexibility (to think about something in more than one way) and inhibitory control (being able to self-control, ignore distractions and delay immediate gratification), visuospatial skills permit to orientate and organize a planned conduct. All of these abilities are fundamental to the skill of avoiding violent behaviour and abiding by social rules. Understanding the relevance of neurodevelopmental impairments in the onset of violent and criminal behaviour, as well as recidivism, eventually may guide the deployment of a more comprehensive assessment and treatment for juvenile offenders.

Keywords: executive functions, half-open program, juvenile offenders, neurodisabilities, visuospatial skills

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Authors: Wenxiao Liu, Kun Zhang, Yongqing Li

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Bovine herpesvirus 1, a member of the genus Variellovirus of the subfamily Alphaherpesvirinae, has caused severe economic cost to the bovine industry. In this study, BoHV-1 glycerol protein gD was expressed in insect cells, and the purified gD was immunized in the Balb/C mice to generate monoclonal antibodies. Based on hybridoma cell fusion techniques, 20 monoclonal antibodies against Bovine herpesvirus 1 have been obtained. Further, mAb 3F8 with neutralizing activity and gD were applied to develop a blocking enzyme-linked immunosorbent assay (Elisa) for detecting neutralizing antibodies against BoHV-1, which shows a significant correlation between the blocking Elisa and VNT. The sensitivity and specificity of the test were estimated to be 94.59% and 93.42%, respectively. Furthermore, antibody pairing tests revealed that mAb 1B6 conjugated to fluorescence microspheres was used as the capture antibody, and mAb 3F9 was used as the detectable antibody to establish the immunochromatographic assay (ICS). The ICS was conducted to detect BoHV-1 in bovine samples with high sensitivity, specificity, and good stability. Clinical sample testing revealed that the results of ICS and real-time PCR have a coincidence rate of 95.42%. Our research confirmed that the ICS is a rapid and reliable method for the diagnosis of BoHV-1. In conclusion, our results lay a solid foundation for the prevention and control of BoHV-1 infection.

Keywords: bovine disease, BoHV-1, ELISA, ICS assay

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Authors: Kashima Arora, Monika Tomar, Vinay Gupta

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Biosensors have found potential applications ranging from environmental testing and biowarfare agent detection to clinical testing, health care, and cell analysis. This is driven in part by the desire to decrease the cost of health care and to obtain precise information more quickly about the health status of patient by the development of various biosensors, which has become increasingly prevalent in clinical testing and point of care testing for a wide range of biological elements. Uric acid is an important byproduct in human body and a number of pathological disorders are related to its high concentration in human body. In past few years, rapid growth in the development of new materials and improvements in sensing techniques have led to the evolution of advanced biosensors. In this context, metal oxide thin film based matrices due to their bio compatible nature, strong adsorption ability, high isoelectric point (IEP) and abundance in nature have become the materials of choice for recent technological advances in biotechnology. In the past few years, wide band-gap metal oxide semiconductors including ZnO, SnO₂ and CeO₂ have gained much attention as a matrix for immobilization of various biomolecules. Tin oxide (SnO₂), wide band gap semiconductor (Eg =3.87 eV), despite having multifunctional properties for broad range of applications including transparent electronics, gas sensors, acoustic devices, UV photodetectors, etc., it has not been explored much for biosensing purpose. To realize a high performance miniaturized biomolecular electronic device, rf sputtering technique is considered to be the most promising for the reproducible growth of good quality thin films, controlled surface morphology and desired film crystallization with improved electron transfer property. Recently, iron oxide and its composites have been widely used as matrix for biosensing application which exploits the electron communication feature of Fe, for the detection of various analytes using urea, hemoglobin, glucose, phenol, L-lactate, H₂O₂, etc. However, to the authors’ knowledge, no work is being reported on modifying the electronic properties of SnO₂ by implanting with suitable metal (Fe) to induce the redox couple in it and utilizing it for reagentless detection of uric acid. In present study, Fe implanted SnO₂ based matrix has been utilized for reagentless uric acid biosensor. Implantation of Fe into SnO₂ matrix is confirmed by energy-dispersive X-Ray spectroscopy (EDX) analysis. Electrochemical techniques have been used to study the response characteristics of Fe modified SnO₂ matrix before and after uricase immobilization. The developed uric acid biosensor exhibits a high sensitivity to about 0.21 mA/mM and a linear variation in current response over concentration range from 0.05 to 1.0 mM of uric acid besides high shelf life (~20 weeks). The Michaelis-Menten kinetic parameter (Km) is found to be relatively very low (0.23 mM), which indicates high affinity of the fabricated bioelectrode towards uric acid (analyte). Also, the presence of other interferents present in human serum has negligible effect on the performance of biosensor. Hence, obtained results highlight the importance of implanted Fe:SnO₂ thin film as an attractive matrix for realization of reagentless biosensors towards uric acid.

Keywords: Fe implanted tin oxide, reagentless uric acid biosensor, rf sputtering, thin film

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Authors: Tahra AlMahmoud, Sameeha Mohamed Al Hadhrami, Mohamed Elhanan, Hanan Naser Alshamsi, Fikri Abu-Zidan

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Background: To the best of the author(s)’ knowledge there are no epidemiological studies for traumatic eye injuries in UAE, neither data on groups at risk or mechanisms for ocular trauma. Purpose: To report the epidemiology of eye injuries that required hospital admission and surgery at a referral center at the eastern part of Abu Dhabi. Method: Retrospective charts review of all patients who had suffered an eye injury that required surgical intervention between 2012 and 2017 at Al Ain Hospital. Demographic data, place of occurrence, the cause of injury, visual acuity (VA) before and after treatment, number of admission days and follow up were extracted. Data were tabulated and presented as number (%), mean (SD), or median (range) as appropriate. Wilcoxon signed rank test was used for VA outcome. Results: One hundred forty-one patients were identified, 96 eyes with open-globe and 48 other types of injuries. The mean age of the patients was 26±15.5 years, and 89% were male. Majority of injuries occurred at the workplace (50.4%) followed by home (31.2%). Trauma with a sharp object (24.1%), blunt object (16.3%), nail (11.3%), and hammer on metal (7.8%) were the most common etiologies of injury. Corneas injuries (48.2%) was the most frequent cause for visual acuity limitation followed by lens/cataract (23.4%). Among the traumatized eyes, 30 eyes (21.3%) retained intraocular foreign body, Mean admission days was 3.16± 2.81days (1-16) and a number of follow up visit was 3.17± 4.11times (0-26). Conclusion: Ocular trauma requiring surgical intervention is an area of concern in particular for occupations involving work with metals. This work may give insight into the value and necessity of implementing preventive measures.

Keywords: epidemiology, Middle Eastern area, occupational injury, ocular traumas

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Authors: Ibeku Bernadine Ezenwanyi

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Hospital-Acquired Infections (HAI), also called ‘Nosocomial Infection’ is an infection you get while in the hospital for another reason. They are an important cause of morbidity and mortality. This study examined the epidemiology, clinical outcomes of some instruments used on patients especially catheter that was passed on them during their stay in the hospital. It was discovered that they had catheter–associated urinary tract infection (CAUTI). An observational study was carried out from January to March, 2022, on 180 patients (80 males and 100 females) admitted in the surgical wards, medical wards, dialysis unit and intensive care unit (ICU) of the hospital. The patient’s urine samples were collected for urine culture and the isolation was carried out using plate count agar medium and macconkey agar. Among the 80 males, 45 had Urinary Tract Infections (UTI) mostly proteus infection and among the 100 females, 70 also had (UTI) and the most common was caused by Escherichia coli. Other strain of microorganisms such as Klebsiella, Staphylococcus aureus and Pseudomonas aeruginosa. It is important to follow up patients that these devices were used on with antibiotics to make sure that these infections are not developed because the rate of these infections (UTI) are high especially in females.

Keywords: catheter, urinary tract infection, nosocomial infection, microorganisms

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Authors: Fryanto Anugrah Rhamdhani Rhamdhani, Hana Riana Permatasari

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The aim of this study analyzes the inclusive of economic growth and analyzes the inclusive of economic growth determinant in regency and city (West Java Province). The background this study Economic Growth can do not afford to reduce poverty, Disparity and expand The Workforce. Referring Central Bureau Of Statistic West Java Province report in 2015 recorded only 5 regions able reduce poverty, 3 regions able reduce Gini Ratio and 7 regions able Workforce Absorption, meanwhile, 11 regions was improved Economic Growth. The Inclusive of Economic Growth definition based on various literature means the quality Economic Growth able reduce Poverty, Gini Ratio, and Workforce absorption. This study adopted the measurement Inclusive Economic of Growth Klassen and analyzes factor in Term Reducing Poverty, Gini Ratio, and the workforce Absorption. Data used panels data composite time series and cross-section including 25 regency and cities regions from Central Bureau Of Statistic West Java Province during 2014-2015. As a result, the measurement inclusive economic of growth Klassen 2014-2015 from 25 regency and cities shows all region does not inclusive reducing Poverty, only 2 regions able reduce Gini Ratio and 3 regions able increase Workforce absorption. Different from the result the measurement Inclusive Economic of Growth for workforce absorption, several regions shows a negative coefficient indicates Economic Growth decline Workforce absorption. The outcome of this study analyzes factor of Inclusive economic of Growth, so that give recommendations for government achieve inclusive economic of growth toward Sustainable Economic. Can be Concluded above low-quality Economic Growth, that due to all region does not inclusive Economic of Growth.

Keywords: inclusive economic growth, Gini ratio, poverty, workforce

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Authors: A. Hoppe, T. Kagele, B. Hall, A. Nichols, B. Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to members of Spokane, Washington, experiencing homelessness. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to the underserved homeless population. In this analysis, clinical charts from street and shelter encounters made by the Spokane Street Medicine Program in early 2021 were reviewed in order to better understand the healthcare inequities prevalent among people experiencing homelessness in Spokane, WA. Pain, wound-care, and follow-up efforts were predominant concerns among the homeless population. More than half of the conditions addressed were acute, and almost a quarter of all chief complaints involved chronic unmanaged conditions. This analysis gives reason for the priorities of the SSM Program to be focused on pain, wound-care, and follow-up efforts. Understanding the specific medical needs of this population will allow for better resource allocation and improved health outcomes among people experiencing homelessness.

Keywords: equity issues in public health, health disparities, health services accessibility, medical public health, street medicine

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Authors: Ankita Baidya, Vanishri Ganakumar, Ranveer S. Jadon, Piyush Ranjan, Rita Sood

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Septic embolism can have varied presentations and clinical considerations. Infected central venous catheters are commonly associated with septic emboli but peripheral vascular catheters are rarely implicated. We describe a rare case of septic pulmonary emboli related to infected peripheral venous cannulation caused by an unusual etiological agent. A young male presented with complaints of fever, productive cough, sudden onset shortness of breath and cellulitis in both the upper limbs. He was recently hospitalised for dengue fever and administered intravenous fluids through peripheral venous line. The patient was febrile, tachypneic and in respiratory distress, there were multiple pus filled bullae in left hand alongwith swelling and erythema involving right forearm that started at the site of cannulation. Chest examination showed active accessory muscles of respiration, stony dull percussion at the base of right lung and decreased breath sounds at right infrascapular, infraaxillary and mammary area. Other system examination was within normal limits. Chest X-ray revealed bilateral multiple patchy heterogenous peripheral opacities and infiltrates with right-sided pleural effusion. Contrast-enhanced computed tomography (CECT) chest showed feeding vessel sign confirming the diagnosis as septic emboli. Venous Doppler and 2D-echocardiogarm were normal. Laboratory findings showed marked leucocytosis (22000/mm3). Pus aspirate, blood sample, and sputum sample were sent for microbiological testing. The patient was started empirically on ceftriaxone, vancomycin, and clindamycin. The Pus culture and sputum culture showed Klebsiella pneumoniae sensitive to cefoperazone-sulbactum, piperacillin-tazobactum, meropenem and amikacin. The antibiotics were modified accordingly to antimicrobial sensitivity profile to Cefoperazone-sulbactum. Bronchoalveolar lavage (BAL) was done and sent for microbiological investigations. BAL culture showed Klebsiella pneumoniae with same antimicrobial resistance profile. On day 6 of starting cefoperazone-sulbactum, he became afebrile. The skin lesions improved significantly. He was administered 2 weeks of cefoperazone–sulbactum and discharged on oral faropenem for 4 weeks. At the time of discharge, TLC was 11200/mm3 with marked radiological resolution of infection and healed skin lesions. He was kept in regular follow up. Chest X-ray and skin lesions showed complete resolution after 8 weeks. Till date, only couple of case reports of septic emboli through peripheral intravenous line have been reported in English literature. This case highlights that a simple procedure of peripheral intravenous cannulation can lead to catastrophic complication of septic pulmonary emboli and widespread cellulitis if not done with proper care and precautions. Also, the usual pathogens in such clinical settings are gram positive bacteria, but with the history of recent hospitalization, empirical therapy should also cover drug resistant gram negative microorganisms. It also emphasise the importance of appropriate healthcare practices to be taken care during all procedures.

Keywords: antibiotics, cannula, Klebsiella pneumoniae, septic emboli

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Authors: Osamah S. Alanazi, Mohammad G. Kotbi, Mohammed O. AlFadil

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While renewable energy technology is developing in Saudi Arabia, and the ambitious 2030 vision encourages the shift towards more efficient and clean energy usage. The research on the application of geothermal resources in residential use for the Saudi Arabian context will contribute towards a more sustainable environment. This paper is a part of an ongoing master's thesis, which its main goal is to investigate the possibility of achieving a zero-carbon house in Riyadh by applying a ground-coupled system into a current sustainable house that uses a grid-tied solar system. The current house was built and designed by King Saud University for the 2018 middle east solar decathlon competition. However, it failed to reach zero-carbon operation due to the high cooling demand. This study will redesign and validate the house using Revit and Carriers Hourly Analysis 'HAP' software with the use of ordinary least square 'OLS' regression. After that, a ground source ventilation system will be designed using the 'GCV Tool' to reduce cooling loads. After the application of the ground source system, the new electrical loads will be compared with the current house. Finally, a simple economic analysis that includes the cost of applying a ground source system will be reported. The findings of this study will indicate the possibility and feasibility of reaching a zero-carbon house in Riyadh, Saudi Arabia, using a ground-coupled ventilation system. While cooling in the residential sector is the dominant energy consumer in the Gulf region, this work will certainly help in moving towards using renewable sources to meet those demands. This paper will be limited to highlight the literature review, the methodology of the research, and the expected outcome.

Keywords: renewable energy, zero-carbon houses, sustainable buildings, geothermal energy, solar PV, GCV Tool

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Authors: Narin Ozturk, Xiao-Mei Li, Sylvie Giachetti, Francis Levi, Alper Okyar

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P-glycoprotein (P-gp, MDR1, ABCB1) is a transmembrane protein acting as an ATP-dependent efflux pump and functions as a biological barrier by extruding drugs and xenobiotics out of cells in healthy tissues especially in intestines, liver and brain as well as in tumor cells. The circadian timing system controls a variety of biological functions in mammals including xenobiotic metabolism and detoxification, proliferation and cell cycle events, and may affect pharmacokinetics, toxicity and efficacy of drugs. Selective mTOR (mammalian target of rapamycin) inhibitor everolimus is an immunosuppressant and anticancer drug that is active against many cancers, and its pharmacokinetics depend on P-gp. The aim of this study was to investigate the dosing time-dependent toxicity of everolimus with respect to the intestinal P-gp expression rhythms in mdr1a::Luc mice using Real Time-Biolumicorder (RT-BIO) System. Mdr1a::Luc male mice were synchronized with 12 h of Light and 12 h of Dark (LD12:12, with Zeitgeber Time 0 – ZT0 – corresponding Light onset). After 1-week baseline recordings, everolimus (5 mg/kg/day x 14 days) was administered orally at ZT1-resting period- and ZT13-activity period- to mdr1a::Luc mice singly housed in an innovative monitoring device, Real Time-Biolumicorder units which let us monitor real-time and long-term gene expression in freely moving mice. D-luciferin (1.5 mg/mL) was dissolved in drinking water. Mouse intestinal mdr1a::Luc oscillation profile reflecting P-gp gene expression and locomotor activity pattern were recorded every minute with the photomultiplier tube and infrared sensor respectively. General behavior and clinical signs were monitored, and body weight was measured every day as an index of toxicity. Drug-induced body weight change was expressed relative to body weight on the initial treatment day. Statistical significance of differences between groups was validated with ANOVA. Circadian rhythms were validated with Cosinor Analysis. Everolimus toxicity changed as a function of drug timing, which was least following dosing at ZT13, near the onset of the activity span in male mice. Mean body weight loss was nearly twice as large in mice treated with 5 mg/kg everolimus at ZT1 as compared to ZT13 (8.9% vs. 5.4%; ANOVA, p < 0.001). Based on the body weight loss and clinical signs upon everolimus treatment, tolerability for the drug was best following dosing at ZT13. Both rest-activity and mdr1a::Luc expression displayed stable 24-h periodic rhythms before everolimus and in both vehicle-treated controls. Real-time bioluminescence pattern of mdr1a revealed a circadian rhythm with a 24-h period with an acrophase at ZT16 (Cosinor, p < 0.001). Mdr1a expression remained rhythmic in everolimus-treated mice, whereas down-regulation was observed in P-gp expression in 2 of 4 mice. The study identified the circadian pattern of intestinal P-gp expression with an unprecedented precision. The circadian timing depending on the P-gp expression rhythms may play a crucial role in the tolerability/toxicity of everolimus. The circadian changes in mdr1a genes deserve further studies regarding their relevance for in vitro and in vivo chronotolerance of mdr1a-transported anticancer drugs. Chronotherapy with P-gp-effluxed anticancer drugs could then be applied according to their rhythmic patterns in host and tumor to jointly maximize treatment efficacy and minimize toxicity.

Keywords: circadian rhythm, chronotoxicity, everolimus, mdr1a::Luc mice, p-glycoprotein

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Authors: Jean-Francois Feller

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The analysis of the volatolome emitted by the human body with a sensor array (e-nose) is a method for clinical applications full of promises to make an olfactive fingerprint characteristic of people's health state. But the amount of volatile organic compounds (VOC) to detect, being in the range of parts per billion (ppb), and their diversity (several hundred) justifies developing ever more sensitive and selective vapor sensors to improve the discrimination ability of the e-nose, is still of interest. Quantum resistive vapour sensors (vQRS) made with nanostructured conductive polymer nanocomposite transducers have shown a great versatility in both their fabrication and operation to detect volatiles of interest such as cancer biomarkers. However, it has been shown that their chemo-resistive response was highly dependent on the quality of the inter-particular junctions in the percolated architecture. The present work investigates the effectiveness of poly(hedral oligomeric silsesquioxane) acting as a nanospacer to amplify the disconnectability of the conducting network and thus maximize the vQRS's sensitivity to VOC.

Keywords: volatolome, quantum resistive vapour sensor, nanostructured conductive polymer nanocomposites, olfactive diagnosis

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Authors: Fateme Hadadian, Behnam Khaledi Paveh, Hosein Feizi

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Background: High number of patients with end-stage renal disease worldwide, and Iran and the patients required hemodialysis, As well as symptoms and treatment process and its impact on quality of life The researcher had to take a step towards solving these problems. Methods: In randomized clinical trial in 60 hemodialysis patients admitted to hospital hemodialysis Imam Reza (AS) were studied. Using questionnaires dialysis patients' QOL, quality of life was measured in patients and controls were divided randomly into two groups. Benson's relaxation method for the experimental group and two months at home, once per day, respectively and the control group received no special action. Immediately after the end of the period with was used for evaluating the quality of life in both the experimental and control groups were survey and data using independent t-test were used for statistical analysis. Results: The general dimensions of quality of life scores before and after intervention, there was significant difference (P=0/001). But this difference was not significant after QOL (P=0/2). Between QOL scores before and after treatment between the two groups was statistically significant (P=0/02). Conclusion: Benson relaxation has the desired effect on quality of life in hemodialysis patients and can be used as a useful method to enhance the quality of life in hemodialysis patients, implementation and training will be given.

Keywords: hemodialysis, quality of life, Benson muscle relaxation, biomedicine

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Authors: Krishna Dahiya

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Introduction: Labour pain has been described as the most severe pain experienced by women in their lives. Pain management in labour is one of the most important challenges faced by the obstetrician. The opioids are the primary treatment for patients with moderate and severe pain but these drugs are not always tolerated and are associated with dose-dependent side effects. Nonsteroidal anti-inflammatory drugs, too, are associated with variable adverse effects. Considering these factors, our study compared the efficacy and side effect of intravenous tramadol and paracetamol. Objective: To evaluate the efficacy and adverse effects of an intravenous infusion of 1000 mg of paracetamol as compared with an intravenous injection of 50mg of tramadol for intrapartum analgesia. Methods: In a randomized prospective study at Pt. BDS PGIMS, 200 women in active labor were allocated to received either paracetamol (n=100) or tramadol (n=100). The primary outcome was the efficacy of the drug to supply adequate analgesia as measured by a change in the visual analog scale (VAS) pain intensity score at various times after drug administration. The secondary outcomes included the need for additional rescue analgesia and the presence of adverse maternal or fetal events. Results: The mean age of cases were 25.55 ± 3.849 years and 25.60 ± 3.655 years respectively As recorded by the VAS score, there was significant pain reduction at 30 minutes, and at 1 and 2 hours in both groups (P<0.01). In comparison, between group I and II, a significantly higher rate of nausea and vomiting in tramadol group (14% vs 8%; P < 0.03) patients. Similarly, drowsiness (0% vs 11%; P<0.01), dry mouth (0% vs 8%; P<0.04) and dizziness (0% vs 9%; P<0.02) was also significant in group II. Conclusion: Due to difficulty in administering epidural analgesia to all parturients, administration of paracetamol and tramadol infusion for analgesia is simple and less invasive alternative. In the present study, both paracetamol and tramadol were equally effective for labour analgesia but paracetamol has emerged as safe alternative as compared to tramadol due to a low incidence of side effects.

Keywords: paracetamol, tramadol, labor, analgesia

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Authors: Ji Wen Sun, Nan Ping Shen, Yi Bei Wu

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This study used Nursing Interventions Classification (NIC-6th) to identify the interventions performed in a pediatric cardiology unit, and then to analysis its frequency, time and difficulty, so as to give a brief review on what our nurses have done. The research team selected a 35 beds pediatric cardiology unit, and drawn all the nursing interventions in the nursing record from our hospital information system (HIS) from 1 October 2015 to 30 November 2015, using NIC-6th to do the matching and then counting their frequencies. Then giving each intervention its own time and difficulty code according to NIC-6th. The results showed that nurses in pediatric cardiology unit performed totally 43 interventions from 5394 statements, and most of them were in RN(basic) education level needed and less than 15 minutes time needed. There still had some interventions just needed by a nursing assistant but done by nurses, which should call for nurse managers to think about the suitable staffing. Thus, counting the summary of the product of frequency, time and difficulty for each intervention of each nurse can know one's performance. Acknowledgement Clinical Management Optimization Project of Shanghai Shen Kang Hospital Development Center (SHDC2014615); Hundred-Talent Program of Construction of Nursing Plateau Discipline (hlgy16073qnhb).

Keywords: nursing interventions, nursing interventions classification, nursing record, pediatric cardiology

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Authors: Hyunjung Lim, Jeonghun Nam, Hyuk Choi

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High-throughput separation is an essential technique for cancer research and diagnosis. Here, we propose a viscoelastic microfluidic device for sheathless, high-throughput isolation of circulating tumor cells (CTCs) from white blood cells. Here, we demonstrate a viscoelastic method for separation and concentration of CTCs using closed-loop microfluidics. Our device is a rectangular straight channel with a low aspect ratio. Also, to achieve high-efficiency, high-throughput processing, we used a polymer solution with low viscosity. At the inlet, CTCs and white blood cells (WBCs) were randomly injected into the microchannel. Due to the viscoelasticity-induced lateral migration to the equilibrium positions, large CTCs could be collected from the side outlet while small WBCs were removed at the center outlet. By recirculating the collected CTCs from the side outlet back to the sample reservoir, continuous separation and concentration of CTCs could be achieved with high separation efficiency (~ 99%). We believe that our device has the potential to be applied in resource-limited clinical settings.

Keywords: circulating tumor cell, closed-loop microfluidics, concentration, separation, viscoelastic fluid

Procedia PDF Downloads 153

Authors: Hubert Feiglstorfer

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Due to its location in a transition zone from the Pannonian to the pre-Alpine region, the east of Austria shows a small-scale diversity in the regional development of certain vernacular building techniques. In this article the relationship between natural building material resources, topography and climate will be examined. Besides environmental preconditions, social and economic historical factors have developed different construction techniques within certain regions in the Weinviertel and Burgenland, the two eastern federal states of Austria. But even within these regions, varying building techniques were found, due to the locally different use of raw materials like wood, stone, clay, lime, or organic fibres. Within these small-scale regions, building traditions were adapted over the course of time due to changes in the use of the building material, for example from wood to brick or from wood to earth. The processing of the raw materials varies from region to region, for example as rammed earth, cob, log, or brick construction. Environmental preconditions cross national borders. For that reason, developments in the neighbouring countries, the Czech Republic, Slovakia, Hungary and Slovenia are included in this analysis. As an outcome of this research a map was drawn which shows the interrelation between locally available building materials, topography, climate and local building techniques? As a result of this study, which covers the last 300 years, one can see how the local population used natural resources very sensitively adapted to local environmental preconditions. In the case of clay, for example, changes of proportions of lime and particular minerals cause structural changes that differ from region to region. Based on material analyses in the field of clay mineralogy, on ethnographic research, literature and archive research, explanations for certain local structural developments will be given for the first time over the region of East Austria.

Keywords: European crafts, material culture, architectural history, earthen architecture, earth building history

Procedia PDF Downloads 238

Authors: Mehak Masood

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This paper aims to design an integrated solid waste management plan for industrial estates taking Sundar Industrial Estate as case model. The issue of solid waste management is on the rise in Pakistan especially in the industrial sector. In this regard, the concept of development and establishment of industrial estates is gaining popularity nowadays. Without proper solid waste management plan it is very difficult to manage day to day affairs of industrial estates. An industrial estate contains clusters of different types of industrial units. It is necessary to identify different types of solid waste streams from each industrial cluster within the estate. In this study, Sundar Industrial Estate was taken as a case model. Primary and secondary data collection, waste assessment, waste segregation and weighing and field surveys were essential elements of the study. Wastes from each industrial process were identified and quantified. Currently 130 industries are in production but after full colonization of industries this number would reach 385. Elaborated process flow diagrams were made to characterize the recyclable and non-recyclables waste. From the study it was calculated that about 12354.1 kg/captia/day of solid waste is being generated in Sundar Industrial Estate. After the full colonization of the industrial estate, the estimated quantity will be 4756328.5 kg/captia/day. Furthermore, solid waste generated from each industrial sector was estimated. Suggestions for collection and transportation are given. Environment friendly solid waste management practices are suggested. If an effective integrated waste management system is developed and implemented it will conserve resources, create jobs, reduce poverty, conserve natural resources, protect the environment, save collection, transportation and disposal costs and extend the life of disposal sites. A major outcome of this study is an integrated solid waste management plan for the Sundar Industrial Estate which requires immediate implementation.

Keywords: integrated solid waste management plan, industrial estates, Sundar Industrial Estate, Pakistan

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Authors: Adamu S. Salawu, Ibrahim O. Isah

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Direct solution to several forms of fourth-order ordinary differential equations is not easily obtained without first reducing them to a system of first-order equations. Thus, numerical methods are being developed with the underlying techniques in the literature, which seeks to approximate some classes of fourth-order initial value problems with admissible error bounds. Multistep methods present a great advantage of the ease of implementation but with a setback of several functions evaluation for every stage of implementation. However, hybrid methods conventionally show a slightly higher order of truncation for any k-step linear multistep method, with the possibility of obtaining solutions at off mesh points within the interval of solution. In the light of the foregoing, we propose the continuous form of a hybrid multistep method with Chebyshev polynomial as a basis function for the numerical integration of fourth-order initial value problems of ordinary differential equations. The basis function is interpolated and collocated at some points on the interval [0, 2] to yield a system of equations, which is solved to obtain the unknowns of the approximating polynomial. The continuous form obtained, its first and second derivatives are evaluated at carefully chosen points to obtain the proposed block method needed to directly approximate fourth-order initial value problems. The method is analyzed for convergence. Implementation of the method is done by conducting numerical experiments on some test problems. The outcome of the implementation of the method suggests that the method performs well on problems with oscillatory or trigonometric terms since the approximations at several points on the solution domain did not deviate too far from the theoretical solutions. The method also shows better performance compared with an existing hybrid method when implemented on a larger interval of solution.

Keywords: Chebyshev polynomial, collocation, hybrid multistep method, initial value problems, interpolation

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Authors: Amira Ben Rabeh, Faouzi Benzarti, Hamid Amiri, Mouna Bouaziz

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Alzheimer is a disease that affects the brain. It causes degeneration of nerve cells (neurons) and in particular cells involved in memory and intellectual functions. Early diagnosis of Alzheimer Diseases (AD) raises ethical questions, since there is, at present, no cure to offer to patients and medicines from therapeutic trials appear to slow the progression of the disease as moderate, accompanying side effects sometimes severe. In this context, analysis of medical images became, for clinical applications, an essential tool because it provides effective assistance both at diagnosis therapeutic follow-up. Computer Assisted Diagnostic systems (CAD) is one of the possible solutions to efficiently manage these images. In our work; we proposed an application to detect Alzheimer’s diseases. For detecting the disease in early stage we used the three sections: frontal to extract the Hippocampus (H), Sagittal to analysis the Corpus Callosum (CC) and axial to work with the variation features of the Cortex(C). Our method of classification is based on Support Vector Machine (SVM). The proposed system yields a 90.66% accuracy in the early diagnosis of the AD.

Keywords: Alzheimer Diseases (AD), Computer Assisted Diagnostic(CAD), hippocampus, Corpus Callosum (CC), cortex, Support Vector Machine (SVM)

Procedia PDF Downloads 384