Search results for: hematology–oncology ward
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 411

Search results for: hematology–oncology ward

231 Improving the Patient Guidance Satisfaction and Integrity of Patients Hospitalized in Iodine-131 Isolation Rooms

Authors: Yu Sin Syu

Abstract:

Objective: The study aimed to improve the patient guidance satisfaction of patients hospitalized in iodine-131 isolation rooms, as well as the patient guidance completion rate for such patients. Method: A patient care guidance checklist and patient care guidance satisfaction questionnaire were administered to 29 patients who had previously been hospitalized in iodine-131 isolation rooms. The evaluation was conducted on a one-on-one basis, and its results showed that the patients’ satisfaction with patient guidance was only 3.7 points and that the completion rate for the patient guidance performed by nurses was only 67%. Therefore, various solutions were implemented to create a more complete patient guidance framework for nurses, including the incorporation of regular care-related training in in-service education courses; the establishment of patient care guidance standards for patients in iodine-131 isolation rooms; the establishment of inpatient care standards and auditing processes for iodine-131 isolation rooms; the creation of an introductory handbook on ward environment; Invite other the care team the revision of iodine-131 health education brochures; the creation of visual cards and videos covering equipment operation procedures; and introduction of QR codes. Results: Following the implementation of the above measures, the overall satisfaction of patients hospitalized in iodine-131 isolation rooms increased from 3.7 points to 4.6 points, and the completion rate for patient guidance rose from 67% to 100%. Conclusion: Given the excellent results achieved in this study, it is hoped that this nursing project can serve as a benchmark for other relevant departments.

Keywords: admission care guidance, guidance satisfaction, integrity, Iodine131 isolation

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230 Elemental and Magnetic Properties of Bed Sediment of Siang River, a Major River of Brahmaputra Basin

Authors: Abhishek Dixit, Sandip S. Sathe, Chandan Mahanta

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The Siang river originates in Angsi glacier in southern Tibet (there known as the Yarlung Tsangpo). After traveling through Indus-Tsangpo suture zone and deep gorges near Namcha Barwa peak, it takes a south-ward turn and enters India, where it is known as Siang river and becomes a major tributary of the Brahmaputra in Assam plains. In this study, we have analyzed the bed sediment of the Siang river at two locations (one at extreme upstream near the India-China border and one downstream before Siang Brahmaputra confluence). We have also sampled bed sediment at the remote location of Yammeng river, an eastern tributary of Siang. The magnetic hysteresis properties show the combination of paramagnetic and weak ferromagnetic behavior with a multidomain state. Moreover, curie temperature analysis shows titanomagnetite solid solution series, which is causing the weak ferromagnetic signature. Given that the magnetic mineral was in a multidomain state, the presence of Ti, Fe carrying heave mineral, may be inferred. The Chemical index of alteration shows less weathered sediment. However, the Yammeng river sample being close to source shows fresh grains subjected to physical weathering and least chemically alteration. Enriched Ca and K and depleted Na and Mg with respect to upper continental crust concentration also points toward the less intense chemical weathering along with the dominance of calcite weathering.

Keywords: bed sediment, magnetic properties, Siang, weathering

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229 Malnutrition of the Cancer Patients under Chemotherapy and Influence of Learned Food Aversions

Authors: Hafsa Chergui

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Malnutrition is a very common problem for hospitalized patients in general but it happens most to those who have a chronic disease such as cancer. Learned food aversions are defined as aversions which form toward foods after their ingestion has been temporally paired with illness (nausea or emesis). Learned food aversion may exert a negative impact on nutritional status and quality of life. The present review evaluates the literature derived both from laboratory animals and humans. Also, a questionnaire has been filled by patients under chemotherapy to assess the level of food aversions. This study evaluated the current research for avoiding the formation of aversions to dietary items in 200 cancer patients treated with chemotherapy. A scapegoat food or beverage can be used just before treatment to reduce the incidence of treatment-related aversions to foods in the individual s usual diet. The goal of this work is to inform the nurses and dieticians because they play a vital role in the daily assessment of the patients' nutritional status. Being aware of all the causes of malnutrition may help to suggest solutions to improve the health condition of the patient and avoid severe malnutrition.

Keywords: chemotherapy, oncology, food aversion, taste aversion

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228 Effect of Dietary Spirulina Powder on Growth Performance, Body Composition, Hematological, Biological and Immunological Parameters of Oscar Fish, Astronotus ocellatus

Authors: Negar Ghotbeddin

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In this study, the changes in survival, growth, body composition, hematological, biochemical and immunological parameters of oscar fish (Astronotus ocellatus) have been investigated with dietary spirulina powder supplementation. Total of 300 fish with an initial weight of 8.37 ± 0.36 was distributed to three treatments and one control (0%). The fish were fed 8 weeks with diets containing different concentrations of S. powder: (control (0%), 2.5%, 5%, and 10%). Then sampling was done, and different parameters were measured by standard methods. Growth performance such as weight gain (%), specific growth rate (SGR) and feed conversion ratio (FCR) significantly improved in fish fed with S. powder (p < 0.5). Crude protein significantly increased in the S. powder supplemented groups (p < 0.5). However, crude lipid decreased with the increasing of dietary S. powder levels. Total protein increased in fish fed with 10% S. powder. Triglycerides and cholesterol decreased with the increasing of dietary S. powder levels. Immunological parameters including C3 and C4 increased significantly with the increasing of dietary S. powder levels, and lysozyme was improved in 10% S. powder. Results of this study indicated that S. powder had positive effects on Oscar fish and the best values were observed at 10 % S. powder.

Keywords: spirulina powder, growth performance, body composition, hematology, immunity, Astronotus ocellatus

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227 Classification of Business Models of Italian Bancassurance by Balance Sheet Indicators

Authors: Andrea Bellucci, Martina Tofi

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The aim of paper is to analyze business models of bancassurance in Italy for life business. The life insurance business is very developed in the Italian market and banks branches have 80% of the market share. Given its maturity, the life insurance market needs to consolidate its organizational form to allow for the development of non-life business, which nowadays collects few premiums but represents a great opportunity to enlarge the market share of bancassurance using its strength in the distribution channel while the market share of independent agents is decreasing. Starting with the main business model of bancassurance for life business, this paper will analyze the performances of life companies in the Italian market by balance sheet indicators and by main discriminant variables of business models. The study will observe trends from 2013 to 2015 for the Italian market by exploiting a database managed by Associazione Nazionale delle Imprese di Assicurazione (ANIA). The applied approach is based on a bottom-up analysis starting with variables and indicators to define business models’ classification. The statistical classification algorithm proposed by Ward is employed to design business models’ profiles. Results from the analysis will be a representation of the main business models built by their profile related to indicators. In that way, an unsupervised analysis is developed that has the limit of its judgmental dimension based on research opinion, but it is possible to obtain a design of effective business models.

Keywords: bancassurance, business model, non life bancassurance, insurance business value drivers

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226 Efficacy of Cool's and Rhythmic Stabilization Exercises on Scapular up Ward Rotation and Ut/Sa Ratio in Patients with Shoulder Impingement Syndrome

Authors: Mohammed Moustafa, Khaled Ayad, Waleed Reda

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Shoulder impingement syndrome is the most common disorder of the shoulder, resulting in functional loss and disability. Objective: This study was designed to compare between the effects of scapular muscle training versus rhythmic stabilization exercises in treatment of shoulder impingement syndrome. Methods: Thirty patients participated in this study; they were assigned randomly into two experimental groups. The first experimental group (A) consisted of 15 patients with a mean age (21.87±2.72) years; they received graduated rhythmic stabilization exercises and stretching of the posterior capsule. The second experimental group (B) consisted of 15 patients with a mean age (22.27±2.94) years; they received scapular muscle training exercises in addition to stretching of the posterior capsule. Treatment was given three times per week, every other day, for four consecutive weeks. Patients have been evaluated pretreatment and post treatment for shoulder pain severity and functional disability. Results: Both groups showed highly statistical significant reduction in pain severity and functional disability measured post-treatment when compared with their corresponding values in pretreatment assessment. Conclusion: Both of rhythmic stabilization exercises and scapular muscle training are effective interventions to reduce shoulder pain severity and functional disability.

Keywords: impingement syndrome, scapular exercises, rhythmic stabilization exercises, posterior capsule stretch

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225 A Comparative Analysis Of Da’wah Methodology Applied by the Two Variant Factions of Jama’atu Izalatil Bid’ah Wa-Iqamatis Sunnah in Nigeria

Authors: Aminu Alhaji Bala

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The Jama’atu Izalatil Bid’ah Wa-Iqamatis Sunnah is a Da’wah organization and reform movement launched in Jos - Nigeria in 1978 as a purely reform movement under the leadership of late Shaykh Ismai’la Idris. The organization started a full fledge preaching sessions at National, State and Local Government levels immediately after its formation. The contributions of this organization to da'wah activities in Nigeria are paramount. The organization conducted its preaching under the council of preaching with the help of the executives, elders and patrons of the movement. Teaching and preaching have been recognized as the major programs of the society. Its preaching activities are conducted from ward, local, state and national levels throughout the states of Nigeria and beyond. It also engaged itself in establishing Mosques, schools and offers sermons during Friday congregation and Eid days throughout its mosques where its sermon is translated into vernacular language, this attracted many Muslims who don’t understand Arabic to patronize the its activities. The organization however split into two faction due to different approaches to Da’wah methodology and some seemingly selfish interests among its leaders. It is upon this background that this research was conducted using analytical method to compare and contrast the da’wah methodology applied by the two factions of the organization. The research discussed about the formation, Da’wah activities of the organization. It also compared and contrast the Da’wah approach and methodology of the two factions. The research finding reveals that different approach and methods applied by these factions is one of the main reason of their split in addition to other selfish interest among its leaders.

Keywords: activities, Da’wah, methodology, organization

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224 Quantum Dot Biosensing for Advancing Precision Cancer Detection

Authors: Sourav Sarkar, Manashjit Gogoi

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In the evolving landscape of cancer diagnostics, optical biosensing has emerged as a promising tool due to its sensitivity and specificity. This study explores the potential of CdS/ZnS core-shell quantum dots (QDs) capped with 3-Mercaptopropionic acid (3-MPA), which aids in the linking chemistry of QDs to various cancer antibodies. The QDs, with their unique optical and electronic properties, have been integrated into the biosensor design. Their high quantum yield and size-dependent emission spectra have been exploited to improve the sensor’s detection capabilities. The study presents the design of this QD-enhanced optical biosensor. The use of these QDs can also aid multiplexed detection, enabling simultaneous monitoring of different cancer biomarkers. This innovative approach holds significant potential for advancing cancer diagnostics, contributing to timely and accurate detection. Future work will focus on optimizing the biosensor design for clinical applications and exploring the potential of QDs in other biosensing applications. This study underscores the potential of integrating nanotechnology and biosensing for cancer research, paving the way for next-generation diagnostic tools. It is a step forward in our quest for achieving precision oncology.

Keywords: quantum dots, biosensing, cancer, device

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223 Scanning Electron Microscopy of the Erythrocytes of Channa punctatus (Bloch) Exposed to Mercuric Chloride

Authors: Shweta Maheshwari, Anish Dua

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Hematological changes reflect the adverse effects of heavy metals on fish. Hematology is a valuable tool to evaluate pathological condition of the fish. It helps in diagnosing the structural and functional status of fish exposed to toxicants. Morphological alteration in erythrocytes due to environmental stress can be studied through ultra-structural analysis. The aim of the present study was to assess the toxicity of mercuric chloride on red blood cells of an air breathing fish, Channa punctatus. Fish were subjected to chronic experiments using three sublethal concentration of mercuric chloride (0.020mg/L, 0.027mg/L, 0.040mg/L) for a period of 15, 30 and 60 days. Exposed fish of all the three concentrations were subjected to a recovery period of 30 days. A control was maintained in tap water simultaneously. For SEM analysis, blood from caudal vein of fish was taken and examined at an accelerating voltage of 20kV. Scanning electron micrographs revealed elliptical shaped erythrocytes of control fish. Alterations in the erythrocyte morphology such as presence of spherocytes, membrane internalization, crenation of membrane and development of lobopodial projections were observed in the exposed fish. The study revealed that ultra-structural analysis appears to be a sensitive method to evaluate the toxicity of various toxicants to fish.

Keywords: Channa punctatus, erythrocytes, mercuric chloride, scanning electron microscopy

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222 Isolation, Screening and Identification of Frog Cutaneous Bacteria for Anti-Batrachochytrium dendrobatidis Activity

Authors: Adria Rae Abigail R. Eda, Arvin C. Diesmos, Vance T. Vredenburg, Merab A. Chan

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Mitigating strategies using symbiotic cutaneous bacteria is one of the major concerns in the conservation of amphibian population. Batrachochytrium dendrobatidis is the causative agent of chytridiomycosis associated with mass mortality and amphibian extinctions worldwide. In the Philippines, there is a lack of study on the cutaneous bacteria of Philippine amphibians that may have beneficial effects to ward off the deadly fungal infection. In this study, cutaneous bacteria from frogs were isolated and examined for anti-B. dendrobatidis activity. Eight species of frogs were collected at Mt. Palay-palay Mataas na Gulod National Park in Cavite, a site positive for the presence of B. dendrobatidis. Bacteria were isolated from the skin of frogs by swabbing the surfaces of the body and inoculated in Reasoner´s 2A (R2A) agar. Isolated bacteria were tested for potential inhibitory properties against B. dendrobatidis through zoospore inhibition assay. Results showed that frog cutaneous bacteria significantly inhibited the growth of B. dendrobatidis in vitro. By means of 16S rRNA gene primers, the anti-B. dendrobatidis bacteria were identified to be Enterobacter sp., Alcaligenes faecalis and Pseudomonas sp. Cutaneous bacteria namely Enterobacter sp. (isolates PLd33 and PCv4) and Pseudomonas (isolate PLd31) remarkably cleared the growth of B. dendrobatidis zoospore in 1% tryptone agar. Therefore, frog cutaneous bacteria inhibited B. dendrobatidis in vitro and could possibly contribute to the immunity and defense of frogs against the lethal chytridiomycosis.

Keywords: Batrachochytrium dendrobatidis, cutaneous bacteria, frogs, zoospore inhibition assay

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221 The Relationship between Trace Elements in Groundwater Linked to a History of Volcanic Activity in La Pampa and Buenos Aires Provinces, Argentina

Authors: Maisarah Jaafar, Neil I. Ward

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Volcanic and geothermal activity can result in the release of arsenic (As), manganese (Mn), iron, selenium (Se), molybdenum (Mo) and uranium (U) into natural waters. Several studies have reported high levels of these elements in surface and groundwater in Argentina. The main focus has been on As associated with volcanic ash deposits. This study reports the trace element levels of groundwater from an agricultural region of south-eastern La Pampa and southern Buenos Aires provinces, Argentina which have reported high levels of human health problems (bone/teeth disorders, depression, arthritis, etc). Fifty-eight groundwater samples were collected from wells adjacent to Ruta 35 and an Agilent 7700x inductively coupled plasma mass spectrometer (ICP-MS) were used for total elemental analysis. Physicochemical analysis confirmed pH range of 7.05-8.84 and variable conductivity (988-3880 µS/cm) with total dissolved solid content of 502-1989 mg/l. The majority water samples are in an oxidizing environment (Eh= 45-146 mV). Total As levels ranged from (µg/l): 13.08 – 319.4 for La Pampa (LP) and 39.6 – 189.4 for Buenos Aires (BA); all above the WHO Guideline for Drinking Water, 10 µg/l As. Interestingly, Mo (LP: 1.85 – 85.39 µg/l; BA: 4.61– 55.55 µg/l;), Se (LP: 1.2 – 16.59 µg/l; BA: 0.3– 6.94 µg/l;) and U (LP: 1.85 – 85.39 µg/l; BA: 4.61– 55.55 µg/l;) levels are lower than reported values for northern La Pampa. Inter-elemental correlation displayed positive statistically significant between As-Mo, A-Se, As-U while negative statistically significant between As-Mn and As-Fe. This confirms that the source of the trace element is similar to that reported for other region of Argentina, namely volcanic ash deposition.

Keywords: Argentina, groundwater, trace element, volcanic activity

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220 Epidemiological Profile of Acute Respiratory Infections Hospitalized in Infants and Children Under 15 Years of Age, Hospital Immaculée, Cayes, Haiti, 2019-2021

Authors: Edna Ariste, Richard Standy Coqmar

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Background: Acute respiratory infections are a major public health problem in the world, mainly in vulnerable populations such as newborns, children under five years of age, and the elderly. The objective of this study was to Characterize the cases of acute respiratory infections in infants and under 15 years old hospitalized at the Immaculée Conception Hospital in Cayes from January 1, 2019, to December 31, 2021. Methods: A retrospective descriptive study was conducted on the epidemiology profile of acute respiratory infections hospitalized in the pediatric ward at Immaculée Conception Hospital in Les Cayes from January 2019 to December 2021. The study population consisted of all newborns, infants, and children under 15 years of age diagnosed with respiratory infections at the pediatric service. Data were collected from the hospitalization registers and patient records of this unit. A database was created and used for data collection. Excel and Epi info 7.2 were used for data analysis. Results: A total of 588 cases were identified during the 2019-2021 year. 43.5% (256) were female, and 56.5% (332) were male. The average age was 4, 3. The most affected age group was 1-4 years. The male/female sex ratio was 1.2. The most frequent respiratory infections were respectively pneumonia 44.9%, bronchitis 16.5%, and respiratory distress 10.5%. The mortality rate recorded during this period was 4.4%. Conclusion: Acute respiratory infections are more frequent in young children. It is, therefore, necessary to practice hand hygiene. Reinforce the surveillance of severe acute respiratory infections.

Keywords: acute respiratory infections, pediatrics, cayes, haiti

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219 High-Throughput, Purification-Free, Multiplexed Profiling of Circulating miRNA for Discovery, Validation, and Diagnostics

Authors: J. Hidalgo de Quintana, I. Stoner, M. Tackett, G. Doran, C. Rafferty, A. Windemuth, J. Tytell, D. Pregibon

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We have developed the Multiplexed Circulating microRNA assay that allows the detection of up to 68 microRNA targets per sample. The assay combines particle­based multiplexing, using patented Firefly hydrogel particles, with single­ step RT-PCR signal. Thus, the Circulating microRNA assay leverages PCR sensitivity while eliminating the need for separate reverse transcription reactions and mitigating amplification biases introduced by target­-specific qPCR. Furthermore, the ability to multiplex targets in each well eliminates the need to split valuable samples into multiple reactions. Results from the Circulating microRNA assay are interpreted using Firefly Analysis Workbench, which allows visualization, normalization, and export of experimental data. To aid discovery and validation of biomarkers, we have generated fixed panels for Oncology, Cardiology, Neurology, Immunology, and Liver Toxicology. Here we present the data from several studies investigating circulating and tumor microRNA, showcasing the ability of the technology to sensitively and specifically detect microRNA biomarker signatures from fluid specimens.

Keywords: biomarkers, biofluids, miRNA, photolithography, flowcytometry

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218 Endocrine Therapy-Induced Alopecia in Patients with Breast Cancer in Tunisia

Authors: Aref Zribi, Sonia Ben Nasr, Sana Fendri, Mahdi Balti, Abderazzek Haddaoui

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Background: Despite their benefit, Endocrine therapies (ET) are known to have substantial adverse events (AEs) such as hot flashes, mood disorders and osteoarticular pain. ET induced alopecia(EIA) is less frequently noted by patients and is less reported in the literature. The aim of our study was to report ET alopecia characteristics and their influence on patient and treatment observance. Method: We conducted a retrospective study including luminal BC patients treated in the oncology department of the military hospital of Tunis between January 2015 and December 2020. Patients treated with previous chemotherapy-inducing alopecia were excluded. Results: 145 female patients were included. The median age was 59 years. EIA was reported in 44% of cases. Alopecia was attributed to aromatase inhibitors in 53% and tamoxifen in 21%. Severity was grade 1 in 80% and grade 2 in the remaining cases. ET discontinuation because of alopecia was noted in 6.5 % of patients. Moderate improvement of alopecia was observed with topical minoxidil and Thallium metallicum 9CH homeopathy during ET in 60% of patients. Conclusions: EIA is frequent in BC patients and should be considered to improve treatment observance and patients’ quality of life.

Keywords: endocrine therapy, alopecia, breast cancer, Tunisia

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217 A Single Cell Omics Experiments as Tool for Benchmarking Bioinformatics Oncology Data Analysis Tools

Authors: Maddalena Arigoni, Maria Luisa Ratto, Raffaele A. Calogero, Luca Alessandri

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The presence of tumor heterogeneity, where distinct cancer cells exhibit diverse morphological and phenotypic profiles, including gene expression, metabolism, and proliferation, poses challenges for molecular prognostic markers and patient classification for targeted therapies. Understanding the causes and progression of cancer requires research efforts aimed at characterizing heterogeneity, which can be facilitated by evolving single-cell sequencing technologies. However, analyzing single-cell data necessitates computational methods that often lack objective validation. Therefore, the establishment of benchmarking datasets is necessary to provide a controlled environment for validating bioinformatics tools in the field of single-cell oncology. Benchmarking bioinformatics tools for single-cell experiments can be costly due to the high expense involved. Therefore, datasets used for benchmarking are typically sourced from publicly available experiments, which often lack a comprehensive cell annotation. This limitation can affect the accuracy and effectiveness of such experiments as benchmarking tools. To address this issue, we introduce omics benchmark experiments designed to evaluate bioinformatics tools to depict the heterogeneity in single-cell tumor experiments. We conducted single-cell RNA sequencing on six lung cancer tumor cell lines that display resistant clones upon treatment of EGFR mutated tumors and are characterized by driver genes, namely ROS1, ALK, HER2, MET, KRAS, and BRAF. These driver genes are associated with downstream networks controlled by EGFR mutations, such as JAK-STAT, PI3K-AKT-mTOR, and MEK-ERK. The experiment also featured an EGFR-mutated cell line. Using 10XGenomics platform with cellplex technology, we analyzed the seven cell lines together with a pseudo-immunological microenvironment consisting of PBMC cells labeled with the Biolegend TotalSeq™-B Human Universal Cocktail (CITEseq). This technology allowed for independent labeling of each cell line and single-cell analysis of the pooled seven cell lines and the pseudo-microenvironment. The data generated from the aforementioned experiments are available as part of an online tool, which allows users to define cell heterogeneity and generates count tables as an output. The tool provides the cell line derivation for each cell and cell annotations for the pseudo-microenvironment based on CITEseq data by an experienced immunologist. Additionally, we created a range of pseudo-tumor tissues using different ratios of the aforementioned cells embedded in matrigel. These tissues were analyzed using 10XGenomics (FFPE samples) and Curio Bioscience (fresh frozen samples) platforms for spatial transcriptomics, further expanding the scope of our benchmark experiments. The benchmark experiments we conducted provide a unique opportunity to evaluate the performance of bioinformatics tools for detecting and characterizing tumor heterogeneity at the single-cell level. Overall, our experiments provide a controlled and standardized environment for assessing the accuracy and robustness of bioinformatics tools for studying tumor heterogeneity at the single-cell level, which can ultimately lead to more precise and effective cancer diagnosis and treatment.

Keywords: single cell omics, benchmark, spatial transcriptomics, CITEseq

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216 Motor Vehicle Accidents During Pregnancy: Analysis of Maternal and Fetal Outcome at a University Hospital

Authors: Manjunath Attibele, Alsawafi Manal, Al Dughaishi Tamima

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Introduction: The purpose of this study was to describe the clinical characteristics and types of mechanisms of injuries caused by Motor vehicle accidents (MVA) during pregnancy. To analyze the patterns of accidents during pregnancy and its adverse consequences on both maternal and fetal outcome. Methods: This was a retrospective cohort study on pregnant patients who met with MVAs The study period was from January 1, 2010, to December 31, 2019. All relevant data were retrieved from electronic patients’ records from the hospital information system and from the antenatal ward admission register Results: Out of 168 women who had motor vehicle accidents during the study period, of which, 39 (23.2%) women during pregnancy. Twenty-one (53.8%) women were over 30 years old. Thirty-five (89.7%) women were Omanis, and 27 (69.2%) were in their third trimester. Twenty-three (59%) of accidents happened at night, and 31 (79.5%) of them happened on a weekday. Twenty-two (56.4%) of women were driving themselves, and 24 (61.5%) of them were not using any seatbelt. Accident related abdominal & back pain was seen in 23(59%) women. Regarding the outcome of pregnancy, 23 (74.2%) had a normal vaginal delivery. The mean accident to delivery interval was 7 weeks. Thirty (96.7%) of involved newborns were relatively healthy. One woman (3.2%) had a ruptured uterusleading to fetal death (3.2%). Conclusion: This study showed that the incidence of motor vehicle accidents during pregnancy is around 23.2% . Majority had trauma-associated pain. One serious injury to a woman causing a ruptured uterus which lead to fetal death. Majority of involved newborns were relatively healthy. No reported maternal death.

Keywords: motor vehicle accidents, pregnancy, maternal outcome, fetal outcome

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215 Surgical Collaboration in Managing Spinal Cord Compression Due to a Pre-Vertebral Chordoma: A Case Report

Authors: Rose Virginy S. Bautista, Ida Marie Tabangay-Lim, Helen Bongalon-Amo, Jose Modesto B. Abellera

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Chordomas, particularly those of the spine and the head and neck region, represent a rare and locally aggressive group of malignancies. The complexity of these tumors -given the rarity, location, and involvement of neurovascular structures- imposes a challenge in the diagnosis and management. We herein report a case of spinal cord compression due to a prevertebral cervical chordoma. The patient presented with a gradually enlarging lateral neck mass, with progressive bilateral extremity weakness and urinary incontinence; preoperative biopsy showed chordoma. A multidisciplinary approach for the management of this case was made, involving neurosurgery, head and neck surgery, and radiation oncology services. Surgical collaboration between the two cutting services was done to have a radical excision of the tumor and spinal cord decompression. The patient was then referred for adjuvant radiation therapy. With this collaborative treatment strategy, more comprehensive and quality care could be provided to our patients.

Keywords: chordoma, surgical collaboration, spinal cord compression, neurosurgery, head and neck surgery

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214 Disease Level Assessment in Wheat Plots Using a Residual Deep Learning Algorithm

Authors: Felipe A. Guth, Shane Ward, Kevin McDonnell

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The assessment of disease levels in crop fields is an important and time-consuming task that generally relies on expert knowledge of trained individuals. Image classification in agriculture problems historically has been based on classical machine learning strategies that make use of hand-engineered features in the top of a classification algorithm. This approach tends to not produce results with high accuracy and generalization to the classes classified by the system when the nature of the elements has a significant variability. The advent of deep convolutional neural networks has revolutionized the field of machine learning, especially in computer vision tasks. These networks have great resourcefulness of learning and have been applied successfully to image classification and object detection tasks in the last years. The objective of this work was to propose a new method based on deep learning convolutional neural networks towards the task of disease level monitoring. Common RGB images of winter wheat were obtained during a growing season. Five categories of disease levels presence were produced, in collaboration with agronomists, for the algorithm classification. Disease level tasks performed by experts provided ground truth data for the disease score of the same winter wheat plots were RGB images were acquired. The system had an overall accuracy of 84% on the discrimination of the disease level classes.

Keywords: crop disease assessment, deep learning, precision agriculture, residual neural networks

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213 Fabrication and Analysis of Simplified Dragonfly Wing Structures Created Using Balsa Wood and Red Prepreg Fibre Glass for Use in Biomimetic Micro Air Vehicles

Authors: Praveena Nair Sivasankaran, Thomas Arthur Ward, Rubentheren Viyapuri

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Paper describes a methodology to fabricate a simplified dragonfly wing structure using balsa wood and red prepreg fibre glass. These simplified wing structures were created for use in Biomimetic Micro Air Vehicles (BMAV). Dragonfly wings are highly corrugated and possess complex vein structures. In order to mimic the wings function and retain its properties, a simplified version of the wing was designed. The simplified dragonfly wing structure was created using a method called spatial network analysis which utilizes Canny edge detection method. The vein structure of the wings were carved out in balsa wood and red prepreg fibre glass. Balsa wood and red prepreg fibre glass was chosen due to its ultra- lightweight property and hence, highly suitable to be used in our application. The fabricated structure was then immersed in a nanocomposite solution containing chitosan as a film matrix, reinforced with chitin nanowhiskers and tannic acid as a crosslinking agent. These materials closely mimic the membrane of a dragonfly wing. Finally, the wings were subjected to a bending test and comparisons were made with previous research for verification. The results had a margin of difference of about 3% and thus the structure was validated.

Keywords: dragonfly wings, simplified, Canny edge detection, balsa wood, red prepreg, chitin, chitosan, tannic acid

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212 Retrospective Casenote Audit of Venous Thromboembolism Prophylaxis in Maxillofacial Patients

Authors: Joshua Abraham, Craig Wales

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Abstract—SIGN Guideline 122 recommends that all patients who are admitted to hospital are assessed for venous thromboembolism risk within 24 hours of admission. NHS Greater Glasgow and Clyde provide guidance on this in the form of a proforma. Patients are then subsequently prescribed either thrombo-embolic-deterrent stockings (TEDS)/low molecular weight heparin (LMWH) for the prevention of VTE based on their score. A retrospective casenote audit of a random sample of fifty oncology and trauma inpatients at the QEUH in December 2019 was performed. 90% of patients had a risk assessment conducted as evidenced by a completed proforma. In 78% of these patients, the proforma fully completed. Overall 94% of patients had some for of thromboprophylaxis prescribed in the form of TEDS or LMWH. A lack of 100% compliance against the given standards highlighted potential implications for patient safety, but also medico-legal ramifications for staff. Clinical judgement can only be relied upon if there is written documentation as evidence. Further staff education and the suggestion of a written prompt to the clerk-in documentation will hopefully improve compliance, whilst a repeat audit should demonstrate any improvement.

Keywords: Maxillofacial , Thromboembolism, Thromboprophylaxis , Prescription

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211 Effect of the Endotracheal Care Nursing Guideline Utilization on the Incidence of Endotracheal Tube Displacement, Oxygen Deficiency after Extubation, Re-intubation, and Nurses Satisfaction

Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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210 Peg@GDF3:TB3+ – Rb Nanocomposites for Deep-Seated X-Ray Induced Photodynamic Therapy in Oncology

Authors: E.A. Kuchma

Abstract:

Photodynamic therapy (PDT) is considered an alternative and minimally invasive cancer treatment modality compared to chemotherapy and radiation therapy. PDT includes three main components: a photosensitizer (PS), oxygen, and a light source. PS is injected into the patient's body and then selectively accumulates in the tumor. However, the light used in PDT (spectral range 400–700 nm) is limited to superficial lesions, and the light penetration depth does not exceed a few cm. The problem of PDT (poor visible light transmission) can be solved by using X-rays. The penetration depth of X-rays is ten times greater than that of visible light. Therefore, X-ray radiation easily penetrates through the tissues of the body. The aim of this work is to develop universal nanocomposites for X-ray photodynamic therapy of deep and superficial tumors using scintillation nanoparticles of gadolinium fluoride (GdF3), doped with Tb3+, coated with a biocompatible coating (PEG) and photosensitizer RB (Rose Bengal). PEG@GdF3:Tb3+(15%) – RB could be used as an effective X-ray, UV, and photoluminescent mediator to excite a photosensitizer for generating reactive oxygen species (ROS) to kill tumor cells via photodynamic therapy. GdF3 nanoparticles can also be used as contrast agents for computed tomography (CT) and magnetic resonance imaging (MRI).

Keywords: X-ray induced photodynamic therapy, scintillating nanoparticle, radiosensitizer, photosensitizer

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209 The Frequency of Q Fever Among Hospitalized Patients with Pyrexia

Authors: Hassan Ali Abood Nassrullah, Jabbar Fadeel Mahdi, Mohammed Salih Mahdi Alkurdi, Ali Al Mousawi, Saad Ibrahim Al-Ghabban, Abdul Amir H. Kadhum, Ahmed Al-Amiery

Abstract:

Background: Q fever is a zoonotic disease characterized by its clinical polymorphism and can present acutely as fever, pneumonia, hepatitis, and chronically as infective endocarditis, arthritis, osteomyelitis, or hepatitis. Objective: The aim of this study is To estimate the prevalence of cases of Q fever in hospitalized febrile patients in Imam Al Hussain Teaching Medical City in Karbala. Methods: One hundred patients with pyrexia were admitted to the medical ward from 1st August to 31st December 2019. Serological procedures fortified by Enzyme-linked Immunosorbent Assay test. Patients were considered to have acute Q fever when the specific antibodies (IgM and IgG) of phase II of Coxiella burnetii were positive. Results: The mean age of the patients was 35.05±12.93 years; females constituted 60% of them. Eighteen patients (18%) showed positive results for IgM, a lower proportion (13% n=13) had positive IgG levels, and 9% showed equivocal results. Statistical analysis revealed a significant association between positive IgM levels of the female gender and in patients consuming unpasteurized milk. One patient (female aged 60 years) died in the hospital, while all other patients were discharged well. Two female patients were pregnant, and one of them had an abortion. Conclusions: Q fever is more common in febrile patients. The study indicates that this disease should not be overlooked in the differential diagnosis of acute fever. Serological testing should be performed in all patients with acute febrile illness with an unsettling diagnosis.

Keywords: antibodies, frequency, immunoglobulin IgM, Q fever

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208 Knowledge and Preventive Practice of Occupational Health Hazards among Nurses Working in Various Hospitals in Kathmandu

Authors: Sabita Karki

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Occupational health hazards are recognized as global problems for health care workers, it is quiet high in developing countries. It is increasing day by day due to change in science and technology. This study aimed to assess the knowledge and practice of occupational health hazards among the nurses. A descriptive, cross sectional study was carried out among 339 nurses working in three different teaching hospitals of the Kathmandu from February 28, 2016 to March 28, 2016. A self-administered questionnaire was used to collect the data. The study findings revealed that out of 339 samples of all 80.5% were below 30 years; 51.6% were married; 57.5% were graduates and above; 91.4% respondents were working as staff nurse; 56.9% were working in general ward; 56.9% have work experience of 1 to 5 years; 79.1% respondents were immunized against HBV; only 8.6% have received training/ in-service education related to OHH and 35.4% respondents have experienced health hazards. The mean knowledge score was 26.7 (SD=7.3). The level of knowledge of occupational health hazards among the nurses was 68.1% (adequate knowledge). The knowledge was statistically significant with education OR = 0.288, CI: 0.17-0.46 and p value 0.00 and immunization against HBV OR= 1.762, CI: 0.97-0.17 and p value 0.05. The mean practice score was 7.6 (SD= 3.1). The level of practice on prevention of OHH was 74.6% (poor practice). The practice was statistically significant with age having OR=0.47, CI: 0.26-0.83 and p value 0.01; designation OR= 0.32, CI: 0.14-0.70 and p value 0.004; working department OR=0.61, CI: 0.36-1.02 and p value 0.05; work experience OR=0.562, CI: 0.33-0.94 and p value 0.02; previous in-service education/ training OR=2.25; CI: 1.02-4.92 and p value 0.04. There was no association between knowledge and practice on prevention of occupational health hazards which is not statistically significant. Overall, nurses working in various teaching hospitals of Kathmandu had adequate knowledge and poor practice of occupational health hazards. Training and in-service education and availability of adequate personal protective equipments for nurses are needed to encourage them adhere to practice.

Keywords: occupational health hazard, nurses, knowledge, preventive practice

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207 Setting up Model Hospitals in Health Care Waste Management in Madagascar

Authors: Sandrine Andriantsimietry, Hantanirina Ravaosendrasoa

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Madagascar, in 2018, set up the first best available technology, autoclave, to treat the health care waste in public hospitals according the best environmental practices in health care waste management. Incineration of health care waste, frequently through open burning is the most common practice of treatment and elimination of health care waste across the country. Autoclave is a best available technology for non-incineration of health care waste that permits recycling of treated waste and prevents harm in environment through the reduction of unintended persistent organic pollutants from the health sector. A Global Environment Fund project supported the introduction of the non-incineration treatment of health care waste to help countries in Africa to move towards Stockholm Convention objectives in the health sector. Two teaching hospitals in Antananarivo and one district hospital in Manjakandriana were equipped respectively with 1300L, 250L and 80L autoclaves. The capacity of these model hospitals was strengthened by the donation of equipment and materials and the training of the health workers in best environmental practices in health care waste management. Proper segregation of waste in the wards to collect the infectious waste that was treated in the autoclave was the main step guaranteeing a cost-efficient non-incineration of health care waste. Therefore, the start-up of the switch of incineration into non-incineration treatment was carried out progressively in each ward with close supervision of hygienist. Emissions avoided of unintended persistent organic pollutants during these four months of autoclaves use is 9.4 g Toxic Equivalent per year. Public hospitals in low income countries can be model in best environmental practices in health care waste management but efforts must be made internally for sustainment.

Keywords: autoclave, health care waste management, model hospitals, non-incineration

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206 Improving Effectiveness of Students' Learning during Clinical Rotations at a Teaching Hospital in Rwanda

Authors: Nanyombi Lubimbi, Josette Niyokindi

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Background: As in many other developing countries in Africa, Rwanda suffers from a chronic shortage of skilled Health Care professionals including Clinical Instructors. This shortage negatively affects the clinical instruction quality therefore impacting student-learning outcomes. Due to poor clinical supervision, it is often noted that students have no structure or consistent guidance in their learning process. The Clinical Educators and the Rwandan counterparts identified the need to create a favorable environment for learning. Description: During orientation the expectations of the student learning process, collaboration of the clinical instructors with the nurses and Clinical Educators is outlined. The ward managers facilitate structured learning by helping the students identify a maximum of two patients using the school’s objectives to guide the appropriate selection of patients. Throughout the day, Clinical Educators with collaboration of Clinical Instructors when present conduct an ongoing assessment of learning and provide feedback to the students. Post-conference is provided once or twice a week to practice critical thinking skills of patient cases that they have been taking care of during the day. Lessons Learned: The students are found to be more confident with knowledge and skills gained during rotations. Clinical facility evaluations completed by students at the end of their rotations highlight the student’s satisfaction and recommendation for continuation of structured learning. Conclusion: Based on the satisfaction of both students and Clinical Instructors, we have identified need for structured learning during clinical rotations. We acknowledge that more evidence-based practice is necessary to effectively address the needs of nursing and midwifery students throughout the country.

Keywords: Rwanda, clinical rotation, structured learning, critical thinking skills, post-conference

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205 Study of Large-Scale Atmospheric Convection over the Tropical Indian Ocean and Its Association with Oceanic Variables

Authors: Supriya Manikrao Ovhal

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In India, the summer monsoon rainfall occurs owing to large scale convection with reference to continental ITCZ. It was found that convection over tropical ocean increases with SST from 26 to 28 degree C, and when SST is above 29 degree C, it sharply decreases for warm pool areas of Indian and for monsoon areas of West Pacific Ocean. The reduction in convection can be influenced by large scale subsidence forced by nearby or remotely generated deep convection, thus it was observed that under the influence of strong large scale rising motion, convection does not decreases but increases monotonically with SST even if SST value is higher than 29.5 degree C. Since convection is related to SST gradient, that helps to generate low level moisture convergence and upward vertical motion in the atmosphere. Strong wind fields like cross equatorial low level jet stream on equator ward side of the warm pool are produced due to convection initiated by SST gradient. Areas having maximum SST have low SST gradient, and that result in feeble convection. Hence it is imperative to mention that the oceanic role (other than SST) could be prominent in influencing large Scale Atmospheric convection. Since warm oceanic surface somewhere or the other contributes to penetrate the heat radiation to the subsurface of the ocean, and as there is no studies seen related to oceanic subsurface role in large Scale Atmospheric convection, in the present study, we are concentrating on the oceanic subsurface contribution in large Scale Atmospheric convection by considering the SST gradient, mixed layer depth (MLD), thermocline, barrier layer. The present study examines the probable role of subsurface ocean parameters in influencing convection.

Keywords: sst, d20, olr, wind

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204 The Effects of Kinesio Tape® and No Tape for Muscle Facilitation and Inhibition, for Collegiate Athletes with Self-Reported Shoulder Pain

Authors: Gregory Chown, Benjamin Infantolino, Christopher Wise, Rachel Holmes, Samantha O'Donnell, Katelyn Pfeiffer, Victoria Ward

Abstract:

Background: There is a lack of understanding of how Kinesio Tape® physiologically works. Furthermore, few studies compare Kinesio Tape® to other forms of taping. The research question is: Does Kinesio Tape® cause a difference in muscle facilitation, inhibition, and pain, between Kinesio Tape® and no tape for collegiate athletes with self-reported shoulder pain? Method: This quantitative non-randomized design used a convenience sampling method. There were eleven participants with self-reported shoulder pain who were athletes on the men’s and women’s lacrosse and tennis teams. Participants attended one 30-45 minute session for data collection. Each participant received all three taping conditions and performed four repetitions of 120 degrees of active shoulder flexion for the three separate trials (no tape, Kinesio Tape® inhibition, and Kinesio Tape® facilitation). Surface electromyography (sEMG) electrodes were placed on the anterior deltoid, supraspinatus, and lower trapezius to measure muscle facilitation and inhibition. Each participant completed the visual analogue scale (VAS) before and after each trial to measure pain. Results: No statistical significance was found for pain scores on the VAS between the taping methods of facilitation, inhibition, and no tape (p = .118). No statistical significance was found for the percentage of change in muscle function for each taping method; Anterior deltoid (p = .993), supraspinatus (p = .997) and lower trapezius (p = .922). Conclusion: Based on the results, Kinesio Tape® appears to not have an effect on muscle function or pain when utilizing the facilitation or inhibition taping method when compared to no tape.

Keywords: Kinesio tape, muscle facilitation, muscle inhibition, pain

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203 Title: Real World Evidence a Tool to Overcome the Lack of a Comparative Arm in Drug Evaluation in the Context of Rare Diseases

Authors: Mohamed Wahba

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Objective: To build a comparative arm for product (X) in specific gene mutated advanced gastrointestinal cancer using real world evidence to fulfill HTA requirements in drug evaluation. Methods: Data for product (X) were collected from phase II clinical trial while real world data for (Y) and (Z) were collected from US database. Real-world (RW) cohorts were matched to clinical trial base line characteristics using weighting by odds method. Outcomes included progression-free survival (PFS) and overall survival (OS) rates. Study location and participants: Internationally (product X, n=80) and from USA (Product Y and Z, n=73) Results: Two comparisons were made: trial cohort 1 (X) versus real-world cohort 1 (Z), trial cohort 2 (X) versus real-world cohort 2 (Y). For first line, the median OS was 9.7 months (95% CI 8.6- 11.5) and the median PFS was 5.2 months (95% CI 4.7- not reached) for real-world cohort 1. For second line, the median OS was 10.6 months (95% CI 4.7- 27.3) for real-world cohort 2 and the median PFS was 5.0 months (95% CI 2.1- 29.3). For OS analysis, results were statistically significant but not for PFS analysis. Conclusion: This study provided the clinical comparative outcomes needed for HTA evaluation.

Keywords: real world evidence, pharmacoeconomics, HTA agencies, oncology

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202 Outcomes of Educating Care Giver in Tracheostomy Wound Care for Discharge Planning of Tracheostomy Patients at the Ear, Nose, Throat, and Eye Ward of Songkhla Hospital Thailand

Authors: Kingkan Chumjamras

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There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

Procedia PDF Downloads 400