Search results for: baby infant formula
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 894

Search results for: baby infant formula

294 Alteration of Placental Development and Vascular Dysfunction in Gestational Diabetes Mellitus Has Impact on Maternal and Infant Health

Authors: Sadia Munir

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The aim of this study is to investigate changes in placental development and vascular dysfunction which subsequently affect feto-maternal health in pregnancies complicated by gestational diabetes mellitus (GDM). Fetal and postnatal adverse health outcomes of GDM are shown to be associated with disturbances in placental structure and function. Children of women with GDM are more likely to be obese and diabetic in childhood and adulthood. GDM also increases the risk of adverse pregnancy outcomes, including preeclampsia, birth injuries, macrosomia and neonatal hypoglycemia, respiratory distress syndrome, neonatal cardiac dysfunction and stillbirth. Incidences of type 2 diabetes in the MENA region are growing at an alarming rate which is estimated to become more than double by 2030. Five of the top 10 countries for diabetes prevalence in 2010 were in the Gulf region. GDM also increases the risk of development of type 2 diabetes. Interestingly, more than half of the women with GDM develop diabetes later in their life. The human placenta is a temporary organ located at the interface between mother and fetal blood circulation. Placenta has a central role as both a producer as well as a target of several molecules that are involved in placental development and function. We have investigated performed a Pubmed search with key words placenta, GDM, placental villi, vascularization, cytokines, growth factors, inflammation, hypoxia, oxidative stress and pathophysiology. We have investigated differences in the development and vascularization of placenta, their underlying causes and impact on feto-maternal health through literature review. We have also identified gaps in the literature and research questions that need to be answered to completely understand the central role of placenta in the GDM. This study is important in understanding the pathophysiology of placenta due to changes in the vascularization of villi, surface area and diameter of villous capillaries in pregnancies complicated by GDM. It is necessary to understand these mechanisms in order to develop treatments to reverse their effects on placental malfunctioning, which in turn, will result in improved mother and child health.

Keywords: gestational diabetes mellitus, placenta, vasculature, villi

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293 Novel Inference Algorithm for Gaussian Process Classification Model with Multiclass and Its Application to Human Action Classification

Authors: Wanhyun Cho, Soonja Kang, Sangkyoon Kim, Soonyoung Park

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In this paper, we propose a novel inference algorithm for the multi-class Gaussian process classification model that can be used in the field of human behavior recognition. This algorithm can drive simultaneously both a posterior distribution of a latent function and estimators of hyper-parameters in a Gaussian process classification model with multi-class. Our algorithm is based on the Laplace approximation (LA) technique and variational EM framework. This is performed in two steps: called expectation and maximization steps. First, in the expectation step, using the Bayesian formula and LA technique, we derive approximately the posterior distribution of the latent function indicating the possibility that each observation belongs to a certain class in the Gaussian process classification model. Second, in the maximization step, using a derived posterior distribution of latent function, we compute the maximum likelihood estimator for hyper-parameters of a covariance matrix necessary to define prior distribution for latent function. These two steps iteratively repeat until a convergence condition satisfies. Moreover, we apply the proposed algorithm with human action classification problem using a public database, namely, the KTH human action data set. Experimental results reveal that the proposed algorithm shows good performance on this data set.

Keywords: bayesian rule, gaussian process classification model with multiclass, gaussian process prior, human action classification, laplace approximation, variational EM algorithm

Procedia PDF Downloads 308
292 Trade Policy Incentives and Economic Growth in Nigeria

Authors: Emmanuel Dele Balogun

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This paper analyzes, using descriptive statistics and econometrics data which span the period 1981 to 2014 to gauge the effects of trade policy incentives on economic growth in Nigeria. It argues that the provided incentives penalize economic growth during pre-trade liberalization eras, but stimulated a rapid increase in total factor productivity during the post-liberalization period of 2000 to 2014. The trend analysis shows that Nigeria maintained high tariff walls in economic regulation eras which became low in post liberalization era. The protections were in favor of infant industries, which were mainly appendages of multinationals but against imports of competing food and finished consumer products. The trade openness index confirms the undue exposure of Nigeria’s economy to the vagaries of international market shocks; while banking sector recapitalization and new listing of telecommunications companies deepened the financial markets in post-liberalization era. The structure of economic incentives was biased in favor of construction, trade and services, but against the real sector despite protectionist policies. Total Factor Productivity (TFP) estimates show that the Nigerian economy suffered stagnation in pre-liberalization eras, but experienced rapid growth rates in post-liberalization eras. The regression results relating trade policy incentives to TFP growth rate yielded a significant but negative intercept suggesting that a non-interventionist policy could be detrimental to economic progress, while protective tariff which limits imports of competing products could spur productivity gains in domestic import substitutes beyond factor growth with market liberalization. The main constraint to the effectiveness of trade policy incentives is the failure of benefiting industries to leverage on the domestic factor endowments of the nation. This paper concludes that there is the need to review the current economic transformation strategies urgently with a view to provide policymakers with a better understanding of the most viable options that could make for rapid success.

Keywords: economic growth, macroeconomic incentives, total factor productivity, trade policies

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291 The Third Level Digital Divide: Millennials and Post-Millennials Online Activities in South Africa

Authors: Ayanda Magida, Brian Armstrong

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The study aimed to assess the third level of the digital divide among the millennials and post-millennials in South Africa. The millennials are people born from 1981-to 1996, that is, people between the ages of 25-40 years old and post-millennials are people born from 1997 to date. For the study, only post-millennials born between 1997-2003 were included as they were old enough to consent to participation in the study. Data was collected as part of the Ph.D. project that focuses on the relationship between income inequality, the digital divide, and social cohesion in South Africa. The digital divide has three main levels, namely the first, second and third. The first and second focus on access and usage, respectively. The third-level digital divide can be defined as the differences in the benefits associated with being online. The current paper focuses on the third level: the benefits derived by being online using four domains: economic, educational, social, and personal benefits. The economic benefits include income, employment and finance-related activities; the social benefits include socializing belonging, identity, and informal networks. The personal benefits include personal wellbeing and self-actualization. A total of 763 participants completed the survey, and 61.3% were post-millennials between the ages of 18-24 and s 38.6 % were millennials between 25 and 40. The majority of the respondents were female (62%), male (34%) and nonbinary (1%), respectively. Most of the respondents were black, followed by whites, Indians and colored, respectively. Thus, they represented the status of the demographics of the country. Most of the respondents had access to the internet and smartphone. Most expressed that they use laptops (68%) or mobile (71%) to access the internet and 54 % access the internet using wireless/Wi-Fi. There were no differences between the millennial and post-millennial economic and educational benefits of being online. However, the post-millennials were more inclined to use the internet for social and personal benefits than the millennials. This could be attributed to many factors, such as age. The post-millennials are still discovering themselves and therefore would derive social and personal benefits associated with being online. The findings confirm studies that argue that younger generations derive more benefits from being online than the older generation. Based on the findings, it is evident that the post-millennials are not using the internet or online activities for social networks and socializing but can derive economic benefits such as job looking and education benefits from being online. It can be inferred that there are no significant differences between the two groups, and it seems like the third-level digital divide is not evident among the two groups as they both have been able to derive meaningful benefits from being online. Further studies should focus on the third-level divide between the baby boomers and Generation X.

Keywords: third-level digital divide, millennials, post-millennials, online activities

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290 The Scientific Phenomenon Revealed in the Holy Quran - an Update

Authors: Arjumand Warsy

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The Holy Quran was revealed to Prophet Mohammad (May Peace and Blessings of Allah be upon Him) over fourteen hundred years ago, at a time when majority of the people in Arabia were illiterate and very few could read or write. Any knowledge about medicine, anatomy, biology, astronomy, physics, geology, geophysics or other sciences were almost non-existent. Many superstitious and groundless believes were prevalent and these believes were passed down through past generations. At that time, the Holy Quran was revealed and it presented several phenomenon that have been only currently unveiled, as scientists have worked endlessly to provide explanation for these physical and biological phenomenon applying scientific technologies. Many important discoveries were made during the 20th century and it is interesting to note that many of these discoveries were already present in the Holy Quran fourteen hundred years ago. The Scientific phenomenon, mentioned in the Holy Quran, cover many different fields in biological and physical sciences and have been the source of guidance for a number of scientists. A perfect description of the creation of the universe, the orbits in space, the development process, development of hearing process prior to sight, importance of the skin in sensing pain, uniqueness of fingerprints, role of males in selection of the sex of the baby, are just a few of the many facts present in the Quran that have astonished many scientists. The Quran in Chapter 20, verse 50 states: قَالَ رَبُّنَا الَّذِيۤ اَعْطٰى كُلَّ شَيْءٍ خَلْقَهٗ ثُمَّ هَدٰى ۰۰ (He said "Our Lord is He, Who has given a distinctive form to everything and then guided it aright”). Explaining this brief statement in the light of the modern day Molecular Genetics unveils the entire genetic basis of life and how guidance is stored in the genetic material (DNA) present in the nucleus. This thread like structure, made of only six molecules (sugar, phosphate, adenine, thymine, cytosine and guanine), is so brilliantly structured by the Creator that it holds all the information about each and every living thing, whether it is viruses, bacteria, fungi, plants, animals or humans or any other living being. This paper will present an update on some of the physical and biological phenomena’ presented in the Holy Quran, unveiled using advanced technologies during the last century and will discuss how the need to incorporate this information in the curricula.

Keywords: The Holy Quran, scientific facts, curriculum, Muslims

Procedia PDF Downloads 335
289 Assessing the Resilience of the Insurance Industry under Solvency II

Authors: Vincenzo Russo, Rosella Giacometti

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The paper aims to assess the insurance industry's resilience under Solvency II against adverse scenarios. Starting from the economic balance sheet available under Solvency II for insurance and reinsurance undertakings, we assume that assets and liabilities follow a bivariate geometric Brownian motion (GBM). Then, using the results available under Margrabe's formula, we establish an analytical solution to calibrate the volatility of the asset-liability ratio. In such a way, we can estimate the probability of default and the probability of breaching the undertaking's Solvency Capital Requirement (SCR). Furthermore, since estimating the volatility of the Solvency Ratio became crucial for insurers in light of the financial crises featured in the last decades, we introduce a novel measure that we call Resiliency Ratio. The Resiliency Ratio can be used, in addition to the Solvency Ratio, to evaluate the insurance industry's resilience in case of adverse scenarios. Finally, we introduce a simplified stress test tool to evaluate the economic balance sheet under stressed conditions. The model we propose is featured by analytical tractability and fast calibration procedure where only the disclosed data available under the Solvency II public reporting are needed for the calibration. Using the data published regularly by the European Insurance and Occupational Pensions Authority (EIOPA) in an aggregated form by country, an empirical analysis has been performed to calibrate the model and provide the related results at the country level.

Keywords: Solvency II, solvency ratio, volatility of the asset-liability ratio, probability of default, probability to breach the SCR, resilience ratio, stress test

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288 Numerical Modeling of Determination of in situ Rock Mass Deformation Modulus Using the Plate Load Test

Authors: A. Khodabakhshi, A. Mortazavi

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Accurate determination of rock mass deformation modulus, as an important design parameter, is one of the most controversial issues in most engineering projects. A 3D numerical model of standard plate load test (PLT) using the FLAC3D code was carried to investigate the mechanism governing the test process. Five objectives were the focus of this study. The first goal was to employ 3D modeling in the interpretation of PLT conducted at the Bazoft dam site, Iran. The second objective was to investigate the effect of displacements measuring depth from the loading plates on the calculated moduli. The magnitude of rock mass deformation modulus calculated from PLT depends on anchor depth, and in practice, this may be a cause of error in the selection of realistic deformation modulus for the rock mass. The third goal of the study was to investigate the effect of testing plate diameter on the calculated modulus. Moreover, a comparison of the calculated modulus from ISRM formula, numerical modeling and calculated modulus from the actual PLT carried out at right abutment of the Bazoft dam site was another objective of the study. Finally, the effect of plastic strains on the calculated moduli in each of the loading-unloading cycles for three loading plates was investigated. The geometry, material properties, and boundary conditions on the constructed 3D model were selected based on the in-situ conditions of PLT at Bazoft dam site. A good agreement was achieved between numerical model results and the field tests results.

Keywords: deformation modulus, numerical model, plate loading test, rock mass

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287 Rational Memory Therapy: The Counselling Technique to Control Psychological and Psychosomatic Illnesses

Authors: Sachin Deshmukh

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Mind and body synchronization occurs through memory and sensation production. Sensations are the guiding language of subconscious mind for conscious mind to take a proper action. Mind-mechanism is based upon memories collected so far since intrauterine life. There are three universal triggers for memory creation; they are persons, situations and objects. Memory is created as sensations experienced by special senses. Based upon experiencing comfort or discomfort, the triggers are categorized as safe or unsafe triggers. A memory comprises of ‘safe or unsafe feeling for triggers, and actions taken for that feeling’. Memories for triggers are created slowly, thoughtfully and consciously by the conscious mind, and archived in the subconscious mind for future references. Later on, similar triggers can come in contact with the individual. Subconscious mind uses these stored feelings to decide whether these triggers are safe or unsafe. It produces comfort or discomfort sensations as emotions accordingly and reacts in the same way as has been recorded in memory. Speed of sensing and processing the triggers, and reacting by subconscious mind is that of the speed of bioelectricity. Hence, formula for human emotions has been designed in this paper as follows: Emotion (Stress or Peace) = Trigger (Person or Situation or object) x Mass of feelings (stressful or peaceful) associated with the Trigger x Speed of Light². We also establish modern medical scientific facts about relationship between reflex activity and memory. This research further develops the ‘Rational Memory Therapy’ focusing on therapeutic feelings conversion techniques, for stress prevention and management.

Keywords: memory, sensations, feelings, emotions, rational memory therapy

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286 Hybrid Equity Warrants Pricing Formulation under Stochastic Dynamics

Authors: Teh Raihana Nazirah Roslan, Siti Zulaiha Ibrahim, Sharmila Karim

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A warrant is a financial contract that confers the right but not the obligation, to buy or sell a security at a certain price before expiration. The standard procedure to value equity warrants using call option pricing models such as the Black–Scholes model had been proven to contain many flaws, such as the assumption of constant interest rate and constant volatility. In fact, existing alternative models were found focusing more on demonstrating techniques for pricing, rather than empirical testing. Therefore, a mathematical model for pricing and analyzing equity warrants which comprises stochastic interest rate and stochastic volatility is essential to incorporate the dynamic relationships between the identified variables and illustrate the real market. Here, the aim is to develop dynamic pricing formulations for hybrid equity warrants by incorporating stochastic interest rates from the Cox-Ingersoll-Ross (CIR) model, along with stochastic volatility from the Heston model. The development of the model involves the derivations of stochastic differential equations that govern the model dynamics. The resulting equations which involve Cauchy problem and heat equations are then solved using partial differential equation approaches. The analytical pricing formulas obtained in this study comply with the form of analytical expressions embedded in the Black-Scholes model and other existing pricing models for equity warrants. This facilitates the practicality of this proposed formula for comparison purposes and further empirical study.

Keywords: Cox-Ingersoll-Ross model, equity warrants, Heston model, hybrid models, stochastic

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285 Effective Slab Width for Beam-End Flexural Strength of Composite Frames with Circular-Section Columns

Authors: Jizhi Zhao, Qiliang Zhou, Muxuan Tao

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The calculation of the ultimate loading capacity of composite frame beams is an important step in the design of composite frame structural systems. Currently, the plastic limit theory is mainly used for this calculation in the codes adopted by many countries; however, the effective slab width recommended in most codes is based on the elastic theory, which does not accurately reflect the complex stress mechanism at the beam-column joints in the ultimate loading state. Therefore, the authors’ research group put forward the Compression-on-Column-Face mechanism and Tension-on-Transverse-Beam mechanism to explain the mechanism in the ultimate loading state. Formulae are derived for calculating the effective slab width in composite frames with rectangular/square-section columns under ultimate lateral loading. Moreover, this paper discusses the calculation method of the effective slab width for the beam-end flexural strength of composite frames with circular-section columns. The proposed design formula is suitable for exterior and interior joints. Finally, this paper compares the proposed formulae with available formulae in other literature, current design codes, and experimental results, providing the most accurate results to predict the effective slab width and ultimate loading capacity.

Keywords: composite frame structure, effective slab width, circular-section column, design formulae, ultimate loading capacity

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284 Performance of Bored Pile on Alluvial Deposit

Authors: K. Raja Rajan, D. Nagarajan

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Bored cast in-situ pile is a popular choice amongst consultant and contractor due to the ability to adjust the pile length suitably in case if any variation found in the actual geological strata. Bangladesh geological strata are dominated by silt content. Design is normally based on field test such as Standard Penetration test N-values. Initially, pile capacity estimated through static formula with co-relation of N-value and angle of internal friction. Initial pile load test was conducted in order to validate the geotechnical parameters assumed in design. Initial pile load test was conducted on 1.5m diameter bored cast in-situ pile. Kentledge method is used to load the pile for 2.5 times of its working load. Initially, safe working load of pile has been estimated as 570T, so test load is fixed to 1425T. Max load applied is 777T for which the settlement reached around 155mm which is more than 10% of diameter of piles. Pile load test results was not satisfactory and compelled to increase the pile length approximately 20% of its total length. Due to unpredictable geotechnical parameters, length of each pile has been increased which is having a major impact on the project cost and as well as in project schedule. Extra bore holes have been planned along with lab test results in order to redefine the assumed geotechnical parameters. This article presents detailed design assumptions of geotechnical parameters in the design stage and the results of pile load test which made to redefine the assumed geotechnical properties.

Keywords: end bearing, pile load test, settlement, shaft friction

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283 Case Study Approach Using Scenario Analysis to Analyze Unabsorbed Head Office Overheads

Authors: K. C. Iyer, T. Gupta, Y. M. Bindal

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Head office overhead (HOOH) is an indirect cost and is recovered through individual project billings by the contractor. Delay in a project impacts the absorption of HOOH cost allocated to that particular project and thus diminishes the expected profit of the contractor. This unabsorbed HOOH cost is later claimed by contractors as damages. The subjective nature of the available formulae to compute unabsorbed HOOH is the difficulty that contractors and owners face and thus dispute it. The paper attempts to bring together the rationale of various HOOH formulae by gathering contractor’s HOOH cost data on all of its project, using case study approach and comparing variations in values of HOOH using scenario analysis. The case study approach uses project data collected from four construction projects of a contractor in India to calculate unabsorbed HOOH costs from various available formulae. Scenario analysis provides further variations in HOOH values after considering two independent situations mainly scope changes and new projects during the delay period. Interestingly, one of the findings in this study reveals that, in spite of HOOH getting absorbed by additional works available during the period of delay, a few formulae depict an increase in the value of unabsorbed HOOH, neglecting any absorption by the increase in scope. This indicates that these formulae are inappropriate for use in case of a change to the scope of work. Results of this study can help both parties in deciding on an appropriate formula more objectively, considering the events on a project causing the delay and contractor's position in respect of obtaining new projects.

Keywords: absorbed and unabsorbed overheads, head office overheads, scenario analysis, scope variation

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282 Development of Antimicrobial Properties Nutraceuticals: Gummy Candies with Addition of Bovine Colostrum, Essential Oils and Probiotics

Authors: E. Bartkiene, M. Ruzauskas, V. Lele, P. Zavistanaviciute, J. Bernatoniene, V. Jakstas, L. Ivanauskas, D. Zadeike, D. Klupsaite, P. Viskelis, J. Bendoraitiene, V. Navikaite-Snipaitiene, G. Juodeikiene

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In this study, antimicrobial nutraceuticals; gummy candies (GC) from bovine colostrum (BC), essential oils (EOs), probiotic lactic acid bacteria (PLAB), and their combinations, were developed. For antimicrobial GC preparation, heteropolysaccharide (agar) was used. The antimicrobial properties of EOs (Eugenia caryophyllata, Thymus vulgaris, Citrus reticulata L., Citrus paradisi L.), BC, L. paracasei LUHS244, L. plantarum LUHS135, and their combinations against pathogenic bacteria strains (Streptococcus mutans, Enterococcus faecalis, Staphylococcus aureus, Salmonella enterica, Escherichia coli, Proteus mirabilis, and Pseudomonas aeruginosa) were evaluated. The highest antimicrobial properties by EO’s (Eugenia caryophyllata and Thymus vulgaris) were established. The optimal ingredients composition for antimicrobial GC preparation was established, which incorporate the BC fermented with L. paracasei LUHS244 in combination with Thymus vulgaris or Eugenia caryophyllata. These ingredients showed high inhibition properties of all tested pathogenic strains (except Pseudomonas aeruginosa). Antimicrobial GC formula consisting of thyme EO (up to 0.2%) and fermented BC (up to 3%), and for taste masking, mandarin or grapefruit EOs (up to 0.2%) was used. Developed GC high overall acceptability and antimicrobial properties, thus, antimicrobial GC could be a preferred form of nutraceuticals. This study was fulfilled with the support of the LSMU-KTU joint project.

Keywords: antimicrobial activity, bovine colostrum, essential oil, gummy candy, probiotic

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281 Integrated Imaging Management System: An Approach in the Collaborative Coastal Resource Management of Bagac, Bataan

Authors: Aljon Pangan

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The Philippines being an archipelagic country, is surrounded by coastlines (36,289 km), coastal waters (226,000 km²), oceanic waters (1.93 million km²) and territorial waters (2.2 million km²). Studies show that the Philippine coastal ecosystems are the most productive and biologically diverse in the world, however, plagued by degradation problems due to over-exploitation and illegal activities. The existence of coastal degradation issues in the country led to the emergence of Coastal Resource Management (CRM) as an approach to both national and local government in providing solutions for sustainable coastal resource utilization. CRM applies the idea of planning, implementing and monitoring through the lens of collaborative governance. It utilizes collective action and decision-making to achieve sustainable use of coastal resources. The Municipality of Bagac in Bataan is one of the coastal municipalities in the country who crafts its own CRM Program as a solution to coastal resource degradation and problems. Information and Communications Technology (ICT), particularly Integrated Imaging Management System (IIMS) is one approach that can be applied in the formula of collaborative governance which entails the Government, Private Sector, and Civil Society. IIMS can help policymakers, managers, and citizens in managing coastal resources through analyzed spatial data describing the physical, biological, and socioeconomic characteristics of the coastal areas. Moreover, this study will apply the qualitative approach in deciphering possible impacts of the application of IIMS in the Coastal Resource Management policy making and implementation of the Municipality of Bagac.

Keywords: coastal resource management, collaborative governance, integrated imaging management system, information and communication technology

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280 A Comparative Study on Behavior Among Different Types of Shear Connectors using Finite Element Analysis

Authors: Mohd Tahseen Islam Talukder, Sheikh Adnan Enam, Latifa Akter Lithi, Soebur Rahman

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Composite structures have made significant advances in construction applications during the last few decades. Composite structures are composed of structural steel shapes and reinforced concrete combined with shear connectors, which benefit each material's unique properties. Significant research has been conducted on different types of connectors’ behavior and shear capacity. Moreover, the AISC 360-16 “Specification for Steel Structural Buildings” consists of a formula for channel shear connectors' shear capacity. This research compares the behavior of C type and L type shear connectors using Finite Element Analysis. Experimental results from published literature are used to validate the finite element models. The 3-D Finite Element Model (FEM) was built using ABAQUS 2017 to investigate non-linear capabilities and the ultimate load-carrying potential of the connectors using push-out tests. The changes in connector dimensions were analyzed using this non-linear model in parametric investigations. The parametric study shows that by increasing the length of the shear connector by 10 mm, its shear strength increases by 21%. Shear capacity increased by 13% as the height was increased by 10 mm. The thickness of the specimen was raised by 1 mm, resulting in a 2% increase in shear capacity. However, the shear capacity of channel connectors was reduced by 21% due to an increase of thickness by 2 mm.

Keywords: finite element method, channel shear connector, angle shear connector, ABAQUS, composite structure, shear connector, parametric study, ultimate shear capacity, push-out test

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279 Development of a Multi-User Country Specific Food Composition Table for Malawi

Authors: Averalda van Graan, Joelaine Chetty, Malory Links, Agness Mwangwela, Sitilitha Masangwi, Dalitso Chimwala, Shiban Ghosh, Elizabeth Marino-Costello

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Food composition data is becoming increasingly important as dealing with food insecurity and malnutrition in its persistent form of under-nutrition is now coupled with increasing over-nutrition and its related ailments in the developing world, of which Malawi is not spared. In the absence of a food composition database (FCDB) inherent to our dietary patterns, efforts were made to develop a country-specific FCDB for nutrition practice, research, and programming. The main objective was to develop a multi-user, country-specific food composition database, and table from existing published and unpublished scientific literature. A multi-phased approach guided by the project framework was employed. Phase 1 comprised a scoping mission to assess the nutrition landscape for compilation activities. Phase 2 involved training of a compiler and data collection from various sources, primarily; institutional libraries, online databases, and food industry nutrient data. Phase 3 subsumed evaluation and compilation of data using FAO and IN FOODS standards and guidelines. Phase 4 concluded the process with quality assurance. 316 Malawian food items categorized into eight food groups for 42 components were captured. The majority were from the baby food group (27%), followed by a staple (22%) and animal (22%) food group. Fats and oils consisted the least number of food items (2%), followed by fruits (6%). Proximate values are well represented; however, the percent missing data is huge for some components, including Se 68%, I 75%, Vitamin A 42%, and lipid profile; saturated fat 53%, mono-saturated fat 59%, poly-saturated fat 59% and cholesterol 56%. A multi-phased approach following the project framework led to the development of the first Malawian FCDB and table. The table reflects inherent Malawian dietary patterns and nutritional concerns. The FCDB can be used by various professionals in nutrition and health. Rising over-nutrition, NCD, and changing diets challenge us for nutrient profiles of processed foods and complete lipid profiles.

Keywords: analytical data, dietary pattern, food composition data, multi-phased approach

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278 Fluoranthene Removal in Wastewater Using Biological and Physico-Chemical Methods

Authors: Angelica Salmeron Alcocer, Deifilia Ahuatzi Chacon, Felipe Rodriguez Casasola

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Polycyclic aromatic hydrocarbons (PAHs) are produced naturally (forest fires, volcanic eruptions) and human activity (burning fossil fuels). Concern for PAHs is due to their toxic, mutagenic and carcinogenic effects and so pose a potential risk to human health and ecology. Therefore these are considered the most toxic components of oil, they are highly hydrophobic, making them easily depositable on the floor, air and water. One method of removing PAHs of contaminated soil used surfactants such as Tween 80, which it has been reported as less toxic and also increases the solubility of the PAH compared to other surfactants, fluoranthene is a PAH with molecular formula C16H10, its name derives from the fluorescence which presents to UV light. In this paper, a study of the fluoranthene removal solubilized with Tween 80 in synthetic wastewater using a microbial community (isolated from soil of coffee plantations in the state of Veracruz, Mexico) and Fenton oxidation method was performed. The microbial community was able to use both tween 80 and fluoranthene as carbon sources for growth, when the biological treatment in batch culture was applied, 100% of fluoranthene was mineralized, this only occurred at an initial concentration of 100 ppm, but by increasing the initial concentration of fluoranthene the removal efficiencies decay and degradation time increases due to the accumulation of byproducts more toxic or less biodegradable, however when the Fenton oxidation was previously applied to the biological treatment, it was observed that removal of fluoranthene improved because it is consumed approximately 2.4 times faster.

Keywords: fluoranthene, polycyclic aromatic hydrocarbons, biological treatment, fenton oxidation

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277 Tablet Computer Based Cognitive Rehabilitation Program, Injini, for Children with Cognitive Impairment

Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

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Cognitive impairment is commonly encountered problem in children with various clinical diseases, including Down syndrome, autism spectrum disorder, brain injury, and others. Cognitive impairment limits participation in education and society, and this further hinders development in cognition. However, young children with cognitive impairment tend not to respond well to traditional cognitive treatments, therefore alternative treatment choices are need. As a cognitive training program, touch screen technology can easily be applied to very young children by involving visual and auditory support. Injini was developed as tablet computer based cognitive rehabilitation program for young children or individuals with severe cognitive impairment, which targeted on cognitive ages of 18 to 36 months. The aim of this study was to evaluate the efficacy of a tablet computer based cognitive rehabilitation program (Injini) for children with cognitive impairment. 38 children between cognitive ages of 18 to 36 months confirmed by cognitive evaluations were recruited and randomly assigned to the intervention group (n=20) and the control group (n=18). The intervention group received tablet computer based cognitive rehabilitation program (Injini) for 30 minutes per session, twice a week, over a period of 12 weeks, in addition to the traditional rehabilitation program. The control group received traditional rehabilitation program only. Mental score of Bayley Scales of Infant Development II (BSID II), Pediatric Evaluation of Disability Inventory (PEDI), Laboratory Temperament Assessment Battery (Lab-TAB), Early Childhood Behavior Questionnaire (ECBQ), and Goal Attainment Scale (GAS) were evaluated before and after 12 weeks of therapeutic intervention. When comparing the baseline characteristics, there was no significant difference between the two groups in the measurements of cognitive function. After 12 weeks of treatment, both group showed improvements in all measurements. However, in comparison of improvements after treatment, the intervention group showed more improvements in the mental score of BSID II, social function domain of PEDI, observation domain of Lab-TAB, and GAS, as compared to the control group. Application of the tablet computer based cognitive rehabilitation program (Injini) would be beneficial for improvement of cognitive function in young children with cognitive impairment.

Keywords: cognitive therapy, computer-assisted therapy, early intervention, tablets

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276 Sea-Level Rise and Shoreline Retreat in Tainan Coast

Authors: Wen-Juinn Chen, Yi-Phei Chou, Jou-Han Wang

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Tainan coast is suffering from beach erosion, wave overtopping, and lowland flooding; though most of the shoreline has been protected by seawalls, they still threatened by sea level rise. For coastal resources developing, coastal land utilization, and to draft an appropriate mitigate strategy. Firstly; we must assess the impact of beach erosion under a different scenario of climate change. Here, we have used the meteorological data since 1898 to 2012 to prove that the Tainan area did suffer the impact of climate change. The result shows the temperature has been raised to about 1.7 degrees since 1989. Also, we analyzed the tidal data near the Tainan coast (Anpin site and Junjunn site), it shows sea level rising with a rate about 4.1~4.8 mm/year, this phenomenon will have serious impacts on Tainan coastal area, especially it will worsen coastal erosion. So we have used Bruun rule to calculate the shoreline retreated rate at every two decade period since 2012. Wave data and bottom sand diameter D50 were used to calculate the closure depth that will be used in Bruun formula and the active length of the profile is computed by the beach slope and Dean's equilibrium concept. After analysis, we found that in 2020, the shoreline will be retreated about 3.0 to 12 meters. The maximum retreat is happening at Chigu coast. In 2060, average shoreline retreated distance is 22m, but at Chigu and Tsenwen, shoreline may be backward retreat about 70m and will be reached about 130m at 2100, this will cause a lot of coastal land loss to the sea, protect and mitigate project must be quickly performed.

Keywords: sea level rise, shoreline, coastal erosion, climate change

Procedia PDF Downloads 381
275 Modified Side Plate Design to Suppress Lateral Torsional Buckling of H-Beam for Seismic Application

Authors: Erwin, Cheng-Cheng Chen, Charles J. Salim

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One of the method to solve the lateral torsional buckling (LTB) problem is by using side plates to increased the buckling resistance of the beam. Some modifications in designing the side plates are made in this study to simplify the construction in the field and reduce the cost. At certain region, side plates are not added: (1) At the beam end to preserve some spaces for bolt installation, but the beam is strengthened by adding cover plate at both flanges and (2) at the middle span of the beam where the moment is smaller. Three small scale full span beam specimens are tested under cyclic loading to investigate the LTB resistant and the ductility of the proposed design method. Test results show that the LTB deformation can be effectively suppressed and very high ductility level can be achieved. Following the test, a finite element analysis (FEA) model is established and is verified using the test results. An intensive parametric study is conducted using the established FEA model. The analysis reveals that the length of side plates is the most important parameter determining the performance of the beam and the required side plates length is determined by some parameters which are (1) beam depth to flange width ratio, (2) beam slenderness ratio (3) strength and thickness of the side plates, (4) compactness of beam web and flange, and (5) beam yield strength. At the end of the paper, a design formula to calculate the required side plate length is suggested.

Keywords: cover plate, earthquake resistant design, lateral torsional buckling, side plate, steel structure

Procedia PDF Downloads 146
274 The Language of Risk: Pregnancy and Childbirth in the COVID-19 Era

Authors: Sarah Holdren, Laura Crook, Anne Drapkin Lyerly

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Objective: The COVID-19 Pandemic has drawn new attention to long-existing bioethical questions around pregnancy, childbirth, and parenthood. Due to the increased risk of severe COVID-19, pregnant individuals may experience anxiety regarding medical decision-making. Especially in the case of hospital births, questions around the ethics of bringing healthy pregnant individuals into a high-risk environment for viral transmission illuminate gaps in the American maternal and child healthcare system. Limited research has sought to understand the experiences of those who gave birth outside hospitals during this time. This study aims to understand pregnant individuals’ conceptualization of risk during the COVID-19 pandemic. Methods: Individuals who gave birth after March 2020 were recruited through advertisements on social media. Participants completed a 1-hour semi-structured interview and a demographic questionnaire. Interviews were transcribed and coded by members of the research team using thematic narrative analysis. Results: A total of 18 participants were interviewed and completed the demographic questionnaire. The language of risk was utilized in birth narratives in three different ways, which highlighted the multileveled and nuanced ways in which risk is understood and mitigated by pregnant and birthing individuals. These included: 1. The risk of contracting COVID-19 before, during, and after birth, 2. The risk of birth complications requiring medical interventions dependent on selected birthing space (home, birthing center, hospital), and 3. The overall risk of creating life in the middle of a pandemic. The risk of contracting COVID-19 and risk of birth complications were often weighed in paradoxical ways throughout each individual’s pregnancy, while phrases such as “pandemic baby” and “apocalypse” appeared throughout narratives and highlighted the broader implications of pregnancy and childbirth during this momentous time. Conclusions: Healthcare professionals should consider the variety of ways that pregnant and birthing individuals understand the risk when counseling patients on healthcare decisions, especially during times of healthcare crisis such as COVID-19. Future work should look to understand how the language of risk fits into a broader understanding of the human experience of growing life in times of crisis.

Keywords: maternal and child health, thematic narrative analysis, COVID-19, risk mitigation

Procedia PDF Downloads 140
273 Barriers and Challenges to a Healthy Lifestyle for Postpartum Women and the Possibilities in an Information Technology-Based Intervention: A Qualitative Study

Authors: Pernille K. Christiansen, Mette Maria Skjøth, Line Lorenzen, Eva Draborg, Christina Anne Vinter, Trine Kjær, Mette Juel Rothmann

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Background and aims: Overweight and obesity are an increasing challenge on a global level. In Denmark, more than one-third of all pregnant women are overweight or obese, and many women exceed the gestational weight gain recommendations from the Institute of Medicine. Being overweight or obese, is associated with a higher risk of adverse maternal and fetal outcomes, including gestational diabetes and childhood obesity. Thus, it is important to focus on the women’s lifestyles between their pregnancies to lower the risk of gestational weight retention in the long run. The objective of this study was to explorer what barriers and challenges postpartum women experience with respect to healthy lifestyles during the postpartum period and to access whether an Information Technology based intervention might be a supportive tool to assist and motivate postpartum women to a healthy lifestyle. Materials and methods: The method is inspired by participatory design. A systematic text condensation was applied to semi-structured focus groups. Five focus group interviews were carried out with a total of 17 postpartum women and two interviews with a total of six health professionals. Participants were recruited through the municipality in Svendborg, Denmark, and at Odense University Hospital in Odense, Denmark, during a four-month period in early 2018. Results: From the women’s perspective, better assistance is needed from the health professionals to obtain or maintain a healthy lifestyle. The women need tools that inform and help them understand and prioritise their own health-related risks, and to motivate them to plan and take care of their own health. As the women use Information Technology on a daily basis, the solution could be delivered through Information Technology. Finally, there is room for engaging the partner more in the communication related to the baby and family’s lifestyle. Conclusion: Postpartum women need tools that inform and motivate a healthy lifestyle postpartum. The tools should allow access to high-quality information from health care professionals, when the information is needed, and also allow engagement from the partner. Finally, Information Technology is a potential tool for delivering tools.

Keywords: information technology, lifestyle, overweight, postpartum

Procedia PDF Downloads 117
272 Assessing the Quality of Maternity Care in Sub-Saharan Africa Using the Donabedian Quality of Care Framework: A Systematic Scoping Review

Authors: Bernice Boafoaa Gyapong, Anne Jones, Sam Bassett, Janet Anderson

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Background: Maternal mortality and morbidity are global concerns, especially in sub-Saharan Africa (SSA). Most maternal mortalities occur at the time of birth. Quality intrapartum care is essential for improving maternal and newborn health outcomes. This scoping review aimed to assess and describe the quality of care during childbirth in SSA to provide an overview of the regional trend of the quality of intrapartum care, the challenges to quality care provision, and identify research gaps. Methods: A scoping review based on Arksey and O’Malley’s scoping review framework was conducted. Medline, CINAHL, PsycINFO, and maternal-infant databases were searched to identify the relevant studies for this review. A narrative summary was presented using themes based on the Donabedian structure, process, and outcome quality of care model. Results: A total of five hundred and forty-seven (547) publications were identified. Fifty-six (56) studies conducted in twenty (20) countries were included in the review. Thirty-four (34) were quantitative, sixteen (16) were qualitative, and six (6) were mixed methods. Most of the studies were related to the process component of quality of care. The provision of emergency obstetric care services, infrastructure, and availability of essential staff and equipment for perinatal care was inadequate in many facilities, particularly rural and peripheral health facilities. Many women experienced disrespectful care during childbirth. Routine care during labour and delivery was observed to be sub-optimal, yet some women reported high satisfaction with care. The use of health facilities for delivery was lower in health centres compared to hospitals. Conclusion: There are variations in the quality of maternity care provided in SSA. Intrapartum care quality is generally deficient in SSA, particularly in peripheral health facilities, health centres, and community clinics. Many of the quality-of-care issues identified are related to the structure component. Stakeholders must develop interventions that comprehensively address these interrelated issues to improve maternal healthcare quality, especially in primary healthcare facilities.

Keywords: quality of care, maternity health, Sub-Saharan Africa, intrapartum

Procedia PDF Downloads 39
271 A Non-Invasive Neonatal Jaundice Screening Device Measuring Bilirubin on Eyes

Authors: Li Shihao, Dieter Trau

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Bilirubin is a yellow substance that is made when the body breaks down old red blood cells. High levels of bilirubin can cause jaundice, a condition that makes the newborn's skin and the white part of the eyes look yellow. Jaundice is a serial-killer in developing countries in Southeast Asia such as Myanmar and most parts of Africa where jaundice screening is largely unavailable. Worldwide, 60% of newborns experience infant jaundice. One in ten will require therapy to prevent serious complications and lifelong neurologic sequelae. Limitations of current solutions: - Blood test: Blood tests are painful may largely unavailable in poor areas of developing countries, and also can be costly and unsafe due to the insufficient investment and lack of access to health care systems. - Transcutaneous jaundice-meter: 1) can only provide reliable results to caucasian newborns, due to skin pigmentations since current technologies measure bilirubin by the color of the skin. Basically, the darker the skin is, the harder to measure, 2) current jaundice meters are not affordable for most underdeveloped areas in Africa like Kenya and Togo, 3) fat tissue under the skin also influences the accuracy, which will give overestimated results, 4) current jaundice meters are not reliable after treatment (phototherapy) because bilirubin levels underneath the skin will be reduced first, while overall levels may be quite high. Thus, there is an urgent need for a low-cost non-invasive device, which can be effective not only for caucasian babies but also Asian and African newborns, to save lives at the most vulnerable time and prevent any complications like brain damage. Instead of measuring bilirubin on skin, we proposed a new method to do the measurement on the sclera, which can avoid the difference of skin pigmentations and ethnicities, due to the necessity for the sclera to be white regardless of racial background. This is a novel approach for measuring bilirubin by an optical method of light reflection off the white part of the eye. Moreover, the device is connected to a smart device, which can provide a user-friendly interface and the ability to record the clinical data continuously A disposable eye cap will be provided avoiding contamination and fixing the distance to the eye.

Keywords: Jaundice, bilirubin, non-invasive, sclera

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270 Factors Affecting Cesarean Section among Women in Qatar Using Multiple Indicator Cluster Survey Database

Authors: Sahar Elsaleh, Ghada Farhat, Shaikha Al-Derham, Fasih Alam

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Background: Cesarean section (CS) delivery is one of the major concerns both in developing and developed countries. The rate of CS deliveries are on the rise globally, and especially in Qatar. Many socio-economic, demographic, clinical and institutional factors play an important role for cesarean sections. This study aims to investigate factors affecting the prevalence of CS among women in Qatar using the UNICEF’s Multiple Indicator Cluster Survey (MICS) 2012 database. Methods: The study has focused on the women’s questionnaire of the MICS, which was successfully distributed to 5699 participants. Following study inclusion and exclusion criteria, a final sample of 761 women aged 19- 49 years who had at least one delivery of giving birth in their lifetime before the survey were included. A number of socio-economic, demographic, clinical and institutional factors, identified through literature review and available in the data, were considered for the analyses. Bivariate and multivariate logistic regression models, along with a multi-level modeling to investigate clustering effect, were undertaken to identify the factors that affect CS prevalence in Qatar. Results: From the bivariate analyses the study has shown that, a number of categorical factors are statistically significantly associated with the dependent variable (CS). When identifying the factors from a multivariate logistic regression, the study found that only three categorical factors -‘age of women’, ‘place at delivery’ and ‘baby weight’ appeared to be significantly affecting the CS among women in Qatar. Although the MICS dataset is based on a cluster survey, an exploratory multi-level analysis did not show any clustering effect, i.e. no significant variation in results at higher level (households), suggesting that all analyses at lower level (individual respondent) are valid without any significant bias in results. Conclusion: The study found a statistically significant association between the dependent variable (CS delivery) and age of women, frequency of TV watching, assistance at birth and place of birth. These results need to be interpreted cautiously; however, it can be used as evidence-base for further research on cesarean section delivery in Qatar.

Keywords: cesarean section, factors, multiple indicator cluster survey, MICS database, Qatar

Procedia PDF Downloads 94
269 A Comparative Study of Substituted Li Ferrites Sintered by the Conventional and Microwave Sintering Technique

Authors: Ibetombi Soibam

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Li-Zn-Ni ferrite having the compositional formula Li0.4-0.5xZn0.2NixFe2.4-0.5xO4 where x = 0.02 ≤ x ≤0.1 in steps of 0.02 was fabricated by the citrate precursor method. In this method, metal nitrates and citric acid was used to prepare the gel which exhibit self-propagating combustion behavior giving the required ferrite sample. The ferrite sample was given a pre-firing at 650°C in a programmable conventional furnace for 3 hours with a heating rate of 5°C/min. A series of the sample was finally given conventional sintering (CS) at 1040°C after the pre-firing process. Another series was given microwave sintering (MS) at 1040°C in a programmable microwave furnace which uses a single magnetron operating at 2.45 GHz frequency. X- ray diffraction pattern confirmed the spinel phase structure for both the series. The theoretical and experimental density was calculated. It was observed that densification increases with the increase in Ni concentration in both the series. However, samples sintered by microwave technique was found to be denser. The microstructure of the two series of the sample was examined using scanning electron microscopy (SEM). Dielectric properties have been investigated as a function of frequency and composition for both series of samples sintered by CS and MS technique. The variation of dielectric constant with frequency show dispersion for both the series. It was explained in terms of Koop’s two layer model. From the analysis of dielectric measurement, it was observed that the value of room temperature dielectric constant decreases with the increase in Ni concentration for both the series. The microwave sintered samples show a lower dielectric constant making microwave sintering suitable for high-frequency applications. The possible mechanisms contributing to all the above behavior is being discussed.

Keywords: citrate precursor, dielectric constant, ferrites, microwave sintering

Procedia PDF Downloads 379
268 Impacts of Sociological Dynamics on Entomophagy Practice and Food Security in Nigeria

Authors: O. B. Oriolowo, O. J. John

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Empirical findings have shown insects to be nutritious and good source of food for man. However, human food preferences are not only determined by nutritional values of food consumed but, more importantly, by sociology and economic pressure. This study examined the interrelation between science and sociology in sustaining the acceptance of entomophagy among college students to combat food insecurity. A twenty items five Likert scale, College Students Entomophagy Questionnaire (CSEQ), was used to elucidate information from the respondents. The reliability coefficient was obtained to be 0.91 using Spearman-Brown Prophecy formula. Three research questions and three hypotheses were raised. Also, quantitative nutritional analysis of few insects and some established conventional protein sources were undertaking in order to compare their nutritional status. The data collected were analyzed using descriptive statistics of percentages and inferential statistics of correlation and Analysis of Variance (ANOVA). The results obtained showed that entomophagy has cultural heritage among different tribes in Nigeria and is an acceptable practice; it cuts across every social stratum and is practiced among both major religions. Moreover, insects compared favourably in term of nutrient contents when compared with the conventional animal protein sources analyzed. However, there is a gradual decline in the practice of entomophagy among students, which may be attributed to the influence of western civilization. This study, therefore, recommended an intensification of research and enlightenment of people on the usefulness of entomophagy so as to preserve its cultural heritage as well as boost human food security.

Keywords: entomophagy, food security, malnutrition, poverty alleviation, sociology

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267 Multilevel Modelling of Modern Contraceptive Use in Nigeria: Analysis of the 2013 NDHS

Authors: Akiode Ayobami, Akiode Akinsewa, Odeku Mojisola, Salako Busola, Odutolu Omobola, Nuhu Khadija

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Purpose: Evidence exists that family planning use can contribute to reduction in infant and maternal mortality in any country. Despite these benefits, contraceptive use in Nigeria still remains very low, only 10% among married women. Understanding factors that predict contraceptive use is very important in order to improve the situation. In this paper, we analysed data from the 2013 Nigerian Demographic and Health Survey (NDHS) to better understand predictors of contraceptive use in Nigeria. The use of logistics regression and other traditional models in this type of situation is not appropriate as they do not account for social structure influence brought about by the hierarchical nature of the data on response variable. We therefore used multilevel modelling to explore the determinants of contraceptive use in order to account for the significant variation in modern contraceptive use by socio-demographic, and other proximate variables across the different Nigerian states. Method: This data has a two-level hierarchical structure. We considered the data of 26, 403 married women of reproductive age at level 1 and nested them within the 36 states and the Federal Capital Territory, Abuja at level 2. We modelled use of modern contraceptive against demographic variables, being told about FP at health facility, heard of FP on TV, Magazine or radio, husband desire for more children nested within the state. Results: Our results showed that the independent variables in the model were significant predictors of modern contraceptive use. The estimated variance component for the null model, random intercept, and random slope models were significant (p=0.00), indicating that the variation in contraceptive use across the Nigerian states is significant, and needs to be accounted for in order to accurately determine the predictors of contraceptive use, hence the data is best fitted by the multilevel model. Only being told about family planning at the health facility and religion have a significant random effect, implying that their predictability of contraceptive use varies across the states. Conclusion and Recommendation: Results showed that providing FP information at the health facility and religion needs to be considered when programming to improve contraceptive use at the state levels.

Keywords: multilevel modelling, family planning, predictors, Nigeria

Procedia PDF Downloads 392
266 The Effect of Musical Mobile Usage on the Physiological Parameters and Pain Level During Intestinal Stomaterapy Procedure in Infants

Authors: Hilal Keskin, Gülzade Uysal

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This study was conducted to determine the effect of bedside music mobile use on physiological parameters and pain level during intestinal stomaterapy in infants. The study was carried out with 66 babies (music mobile group: 33, Control group: 33) who were followed in the pediatric surgery and urology unit of Kanuni Sultan Süleyman Training and Research Hospital between December 2018- October 2019. Data were collected using the “Data Collection Form” and “FLACC Pain Scale.” They were evaluated using the appropriate statistical methods in the SPSS 22.0 program. The difference between the descriptive features of music mobile and control group was not significant (p> 0.05) groups are distributed homogeneously. When the in-group results were examined; There was no significant change in the mean values of Hearth Peak Beat (HPB), SpO2 and blood pressure of the infants in the music mobile group during stomaterapy (p>0.05). Body temperature and Face, Leg, Activity, Cry, Consolability (FLACC) Pain Scale scores were found to increase immediately after stomaterapy (p<0.05). It was found that the mean scores of KTA, body temperature and FLACC pain of the babies in the control group increased significantly after the stomaterapy and SpO2 value decreased (p <0,05). After 15 minutes from stomatherapy, KTA, blood pressure, body temperature and FLACC pain scores averaged; although SpO2 value increased, it was determined that it could not reach pre-stomaterapy value. Results between groups; KTA, SpO2, systolic/diastolic blood pressure, body temperature, and FLACC pain score mean values between groups were homogeneous before stomaterapy (p> 0.05). In the control group, a significant increase was found in the mean scores of KTA, body temperature and FLACC pain after stomaterapy compared to the bedside music mobile group, and a significant decrease in SpO2 values (p <0.05). In the control group, the mean body temperature and FLACC pain scores of the infants 15 minutes after stomaterapy were significantly increased and the SpO2 values were significantly lower than the bedside music group (p <0.05). According to the results of the research; The use of bedside music mobile during intestinal stomaterapy was found to be effective in decreasing the physiological parameters and pain level. It can be recommended for use in infants during painful interventions.

Keywords: intestinal stomatherapy, infant, musical mobile, pain, physiological parameters

Procedia PDF Downloads 159
265 Pregnancy and Birth Outcomes of Single versus Multiple Embryo Transfer in Gestational Surrogacy Arrangements: A Systematic Review

Authors: Jutharat Attawet, Alex Y. Wang, Cindy M. Farquhar, Elizabeth A. Sullivan

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Background: Adverse maternal and perinatal outcomes of multiple pregnancies resulting from multiple embryo transfers (ET) has become significant concerns. This is particularly relevant for gestational carriers since they usually do not have infertility issues. Single embryo transfer (SET) therefore has been encouraged to assist reproductive technology (ART) practice in order to reduce multiple pregnancies. Objectives: This systematic review aims to investigate the pregnancy and birth outcomes of SET and multiple ET in surrogacy arrangements. Search methods: This study is a systematic review. Electronic databases were searched from CINAHL, Medline, Embase, Scopus and ProQuest for studies from 1980 to 2017. Cross-references and national ART reports were also manual searchings. Articles without restriction of English language and study types were accessed. Carrier cycles involving in SET and multiple ET were identified in database searching. The main outcome measures including clinical pregnancy, live delivery and multiple deliveries per gestational carrier cycle were compared between SET and multiple ET. Mantel-Haenzel risk ratios (RRs) with 95% confidence intervals (CIs), using the numbers of outcome events in SET and multiple ET of each study were calculated suing RevMan5.3. Outcomes: The search returned 97 articles of which 5 met the inclusion criteria. Approximately 50% of carrier cycles were transferred a single embryo and 50% were transferred more than one embryo. The clinical pregnancy rate (CPR) was 39% for SET and 53% for multiple ET, which was not significantly different with RR = 0.83 (95% CI: 0.67-1.03). The live delivery rate was 33% for SET and 57% for multiple ET which was not significantly different with RR = 0.78 (95% CI: 0.61-1.00). The multiple delivery rate per carrier was greater risks in the multiple ET carrier cycles (RR =0.4, 95% CI: 0.01-0.26). There were 104 sets of twins (including one set of twins selectively reduced from triplets to twins) and 1 set of triples in the multiple ET carrier cycle. In the SET carrier cycles, there were 2 sets of twins. Significance of the study: SET should be advocated among surrogate carriers to prevent multiple pregnancies and subsequent adverse outcomes for both carrier and baby. Surrogacy practice should be reviewed and surrogate carriers should be fully informed of the risk of adverse maternal and birth outcome of multiple pregnancies due to multiple embryo transfers.

Keywords: assisted reproduction, birth outcomes, carrier, gestational surrogacy, multiple embryo transfer, multiple pregnancy, pregnancy outcomes, single embryo transfer, surrogate mother, systematic review

Procedia PDF Downloads 376