Search results for: implicit versus explicit CSR
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1609

Search results for: implicit versus explicit CSR

1369 Effect of Sr-Doping on Multiferroic Properties of Ca₁₋ₓSrₓMn₇O₁₂

Authors: Parul Jain, Jitendra Saha, L. C. Gupta, Satyabrata Patnaik, Ashok K. Ganguli, Ratnamala Chatterjee

Abstract:

This study shows how sensitively and drastically multiferroic properties of CaMn₇O₁₂ get modified by isovalent Sr-doping, namely, in Ca₁₋ₓSrₓMn₇O₁₂ for x as small as 0.01 and 0.02. CaMn₇O₁₂ is a type-II multiferroic, wherein polarization is caused by magnetic spin ordering. In this report magnetic and ferroelectric properties of Ca₁₋ₓSrₓMn₇O₁₂ (0 ≤ x ≤ 0.1) are investigated. Samples were prepared by wet sol gel technique using their respective nitrates; powders thus obtained were calcined and sintered in optimized conditions. The X-ray diffraction patterns of all samples doped with Sr concentrations in the range (0 ≤ x ≤ 10%) were found to be free from secondary phases. Magnetization versus temperature and magnetization versus field measurements were carried out using Quantum Design SQUID magnetometer. Pyroelectric current measurements were done for finding the polarization in the samples. Findings of the measurements are: (i) increase of Sr-doping in CaMn₇O₁₂ lattice i.e. for x ≤ 0.02, increases the polarization, whereas decreases the magnetization and the coercivity of the samples; (ii) the material with x = 0.02 exhibits ferroelectric polarization Ps which is more than double the Ps in the un-doped material and the magnetization M is reduced to less than half of that of the pure material; remarkably (iii) the modifications in Ps and M are reversed as x increases beyond x = 0.02 and for x = 0.10, Ps is reduced even below that for the pure sample; (iv) there is no visible change of the two magnetic transitions TN1 (90 K) and TN2 (48 K) of the pure material as a function of x. The strong simultaneous variations of Ps and M for x = 0.02 strongly suggest that either a basic modification of the magnetic structure of the material or a significant change of the coupling of P and M or possibly both.

Keywords: ferroelectric, isovalent, multiferroic, polarization, pyroelectric

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1368 Investigating Visual Statistical Learning during Aging Using the Eye-Tracking Method

Authors: Zahra Kazemi Saleh, Bénédicte Poulin-Charronnat, Annie Vinter

Abstract:

This study examines the effects of aging on visual statistical learning, using eye-tracking techniques to investigate this cognitive phenomenon. Visual statistical learning is a fundamental brain function that enables the automatic and implicit recognition, processing, and internalization of environmental patterns over time. Some previous research has suggested the robustness of this learning mechanism throughout the aging process, underscoring its importance in the context of education and rehabilitation for the elderly. The study included three distinct groups of participants, including 21 young adults (Mage: 19.73), 20 young-old adults (Mage: 67.22), and 17 old-old adults (Mage: 79.34). Participants were exposed to a series of 12 arbitrary black shapes organized into 6 pairs, each with different spatial configurations and orientations (horizontal, vertical, and oblique). These pairs were not explicitly revealed to the participants, who were instructed to passively observe 144 grids presented sequentially on the screen for a total duration of 7 min. In the subsequent test phase, participants performed a two-alternative forced-choice task in which they had to identify the most familiar pair from 48 trials, each consisting of a base pair and a non-base pair. Behavioral analysis using t-tests revealed notable findings. The mean score for the first group was significantly above chance, indicating the presence of visual statistical learning. Similarly, the second group also performed significantly above chance, confirming the persistence of visual statistical learning in young-old adults. Conversely, the third group, consisting of old-old adults, showed a mean score that was not significantly above chance. This lack of statistical learning in the old-old adult group suggests a decline in this cognitive ability with age. Preliminary eye-tracking results showed a decrease in the number and duration of fixations during the exposure phase for all groups. The main difference was that older participants focused more often on empty cases than younger participants, likely due to a decline in the ability to ignore irrelevant information, resulting in a decrease in statistical learning performance.

Keywords: aging, eye tracking, implicit learning, visual statistical learning

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1367 Role of Preoperative and Postoperative Endovaginal Ultrasound and 24-Hour Pad Test in Evaluation of Efficacy of Various Treatment Modalities for Stress Urinary Incontinence

Authors: J. B. Sharma, Vivek Kakkar, Sunesh Kumar, K. K. Roy, Rajesh Kumari, Kavita Pandey, Smriti Hari

Abstract:

Background: Stress urinary incontinence (SUI) is a common problem affecting the quality of life of women. Methods: It is a prospective study conducted over 40 women of SUI by endovaginal ultrasound on rest and Valsalva preoperatively and six months postoperatively for levator hiatus, pubovisceral thickness, urethral length, and bladder neck position. A 24-hour pad test was also performed on all women at the same time for grading of SUI. Treatment given was medical in 4 (10%), Burch colposuspension in 18 (45%), and tension-free obturator tape in 18 (45%). Results: Mean age, parity, and body mass index in the study were 41.60 years, 2.73, and 24.2 kg/m², respectively. All 40 (100%) patients had SUI, with the mean duration of symptoms being 4.04 years. On the 24-hour pad test, mild SUI was in 4 (10%), moderate SUI in 33 (82.5%), and severe SUI in 3 (7.5%), with mean preoperative 24-hour pad test being 36.69 gm which significantly reduced to 9.79 gm postoperatively (p 0.001). There was a significant change in levator hiatus and pubovisceral thickness with the treatment of SUI. Overall urethral length increased, but there was a significant decrease in urethral length on Valsalva after the treatment (0.40 versus 0.28 cm, p 0.04) and a significant reduction in bladder neck descent after Valsalva after treatment (0.41 cm versus 0.27 cm, p 0.001). Conclusion: Endovaginal ultrasound and 24-hour pad test are useful diagnostic modalities for SUI diagnosis and to see the impact of treatment.

Keywords: stress urinary incontinence, endovaginal ultrasound, 24-hours pad test, pubovisceral muscle thickness

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1366 A Posteriori Analysis of the Spectral Element Discretization of Heat Equation

Authors: Chor Nejmeddine, Ines Ben Omrane, Mohamed Abdelwahed

Abstract:

In this paper, we present a posteriori analysis of the discretization of the heat equation by spectral element method. We apply Euler's implicit scheme in time and spectral method in space. We propose two families of error indicators, both of which are built from the residual of the equation and we prove that they satisfy some optimal estimates. We present some numerical results which are coherent with the theoretical ones.

Keywords: heat equation, spectral elements discretization, error indicators, Euler

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1365 Satellite Data to Understand Changes in Carbon Dioxide for Surface Mining and Green Zone

Authors: Carla Palencia-Aguilar

Abstract:

In order to attain the 2050’s zero emissions goal, it is necessary to know the carbon dioxide changes over time either from pollution to attenuations in the mining industry versus at green zones to establish real goals and redirect efforts to reduce greenhouse effects. Two methods were used to compute the amount of CO2 tons in specific mining zones in Colombia. The former by means of NPP with MODIS MOD17A3HGF from years 2000 to 2021. The latter by using MODIS MYD021KM bands 33 to 36 with maximum values of 644 data points distributed in 7 sites corresponding to surface mineral mining of: coal, nickel, iron and limestone. The green zones selected were located at the proximities of the studied sites, but further than 1 km to avoid information overlapping. Year 2012 was selected for method 2 to compare the results with data provided by the Colombian government to determine range of values. Some data was compared with 2022 MODIS energy values and converted to kton of CO2 by using the Greenhouse Gas Equivalencies Calculator by EPA. The results showed that Nickel mining was the least pollutant with 81 kton of CO2 e.q on average and maximum of 102 kton of CO2 e.q. per year, with green zones attenuating carbon dioxide in 103 kton of CO2 on average and 125 kton maximum per year in the last 22 years. Following Nickel, there was Coal with average kton of CO2 per year of 152 and maximum of 188, values very similar to the subjacent green zones with average and maximum kton of CO2 of 157 and 190 respectively. Iron had similar results with respect to 3 Limestone sites with average values of 287 kton of CO2 for mining and 310 kton for green zones, and maximum values of 310 kton for iron mining and 356 kton for green zones. One of the limestone sites exceeded the other sites with an average value of 441 kton per year and maximum of 490 kton per year, eventhough it had higher attenuation by green zones than a close Limestore site (3.5 Km apart): 371 kton versus 281 kton on average and maximum 416 kton versus 323 kton, such vegetation contribution is not enough, meaning that manufacturing process should be improved for the most pollutant site. By comparing bands 33 to 36 for years 2012 and 2022 from January to August, it can be seen that on average the kton of CO2 were similar for mining sites and green zones; showing an average yearly balance of carbon dioxide emissions and attenuation. However, efforts on improving manufacturing process are needed to overcome the carbon dioxide effects specially during emissions’ peaks because surrounding vegetation cannot fully attenuate it.

Keywords: carbon dioxide, MODIS, surface mining, vegetation

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1364 Tranexamic Acid in Orthopedic Surgery in Children

Authors: K. Amanzoui, A. Erragh, M. Elharit, A. Afif, K. Elfakhr, S. Kalouch, A. Chlilek

Abstract:

Orthopedic surgery is a provider of pre and postoperative bleeding; patients are exposed to several risks, and different measures are proposed to reduce bleeding during surgery, called the transfusion-sparing method, including tranexamic acid, which has shown its effectiveness in numerous studies. A prospective analytical study in 50 children was carried out in the orthopedic traumatology operating room of the EL HAROUCHI hospital of the CHU IBN ROCHD in Casablanca over a period of six months (April to October 2022). Two groups were randomized: one receiving tranexamic acid (Group A) and a non-receiving control group (Group B). The average age was 10.3 years, of which 58.8% were female. The first type of surgery was thoracolumbar scoliosis (52%). The average preoperative hemoglobin was 12.28 g/dl in group A, against 12.67 g/dl in the control group. There was no significant difference between the two groups (p=0.148). Mean intraoperative bleeding was 396.29 ml in group A versus 412 ml in the control group. No significant difference was observed for this parameter (p=0.632). The average hemoglobin level in the immediate postoperative period in our patients is 10.2 g/dl. In group A, it was 10.95 g/dl versus 10.93 g/dl in group B. At H24 postoperative, the mean hemoglobin value was 10.29 g/dl in group A against 9.5 g/dl in group B. For group A, the blood loss recorded during the first 24 hours was 209.43 ml, against 372 ml in group B, with a significant difference between the two groups (p=0.001). There is no statistically significant difference between the 2 groups in terms of the use of fillers, ephedrine or intraoperative transfusion. While for postoperative transfusion, we note the existence of a statistically significant difference between group A and group B. It is suggested that the use of tranexamic acid is an effective, simple, and low-cost way to limit postoperative blood loss and the need for transfusion.

Keywords: tranexamic acid, blood loss, orthopedic surgery, children

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1363 Reconceptualizing Evidence and Evidence Types for Digital Journalism Studies

Authors: Hai L. Tran

Abstract:

In the digital age, evidence-based reporting is touted as a best practice for seeking the truth and keeping the public well-informed. Journalists are expected to rely on evidence to demonstrate the validity of a factual statement and lend credence to an individual account. Evidence can be obtained from various sources, and due to a rich supply of evidence types available, the definition of this important concept varies semantically. To promote clarity and understanding, it is necessary to break down the various types of evidence and categorize them in a more coherent, systematic way. There is a wide array of devices that digital journalists deploy as proof to back up or refute a truth claim. Evidence can take various formats, including verbal and visual materials. Verbal evidence encompasses quotes, soundbites, talking heads, testimonies, voice recordings, anecdotes, and statistics communicated through written or spoken language. There are instances where evidence is simply non-verbal, such as when natural sounds are provided without any verbalized words. On the other hand, other language-free items exhibited in photos, video footage, data visualizations, infographics, and illustrations can serve as visual evidence. Moreover, there are different sources from which evidence can be cited. Supporting materials, such as public or leaked records and documents, data, research studies, surveys, polls, or reports compiled by governments, organizations, and other entities, are frequently included as informational evidence. Proof can also come from human sources via interviews, recorded conversations, public and private gatherings, or press conferences. Expert opinions, eye-witness insights, insider observations, and official statements are some of the common examples of testimonial evidence. Digital journalism studies tend to make broad references when comparing qualitative versus quantitative forms of evidence. Meanwhile, limited efforts are being undertaken to distinguish between sister terms, such as “data,” “statistical,” and “base-rate” on one side of the spectrum and “narrative,” “anecdotal,” and “exemplar” on the other. The present study seeks to develop the evidence taxonomy, which classifies evidence through the quantitative-qualitative juxtaposition and in a hierarchical order from broad to specific. According to this scheme, data, statistics, and base rate belong to the quantitative evidence group, whereas narrative, anecdote, and exemplar fall into the qualitative evidence group. Subsequently, the taxonomical classification arranges data versus narrative at the top of the hierarchy of types of evidence, followed by statistics versus anecdote and base rate versus exemplar. This research reiterates the central role of evidence in how journalists describe and explain social phenomena and issues. By defining the various types of evidence and delineating their logical connections it helps remove a significant degree of conceptual inconsistency, ambiguity, and confusion in digital journalism studies.

Keywords: evidence, evidence forms, evidence types, taxonomy

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1362 Effect of Manual Progressive Ischemic Pressure versus Post Isometric Facilitation in the Treatment of Latent Myofascial Trigger Points in Mechanical Neck Pain

Authors: Mohamed M. Diab, Fahmy E. Mohamed, Alaa Balbaa

Abstract:

Background: Myofascial pain syndrome a common type of non-articular musculoskeletal pain, is a condition associated with regional pain and muscle tenderness characterized by the presence of hypersensitive nodules. Objectives: the purpose of this study is to compare between the effects of manual progressive ischemic pressure versus the effect of post isometric facilitation in the treatment of Rhomboid latent myofascial trigger points. Methods: six patients had participated in this study. Patients divided into two groups. Group A treated by manual progressive ischemic pressure and traditional physical therapy program. Group B treated by post isometric facilitation and traditional physical therapy program. Treatment program was for 6 sessions over two week’s period. Result: Statistical analysis revealed that there is no significant difference in post treatment from pretreatment in pain severity (VAS) in myofascial trigger points with Rhomboid muscles) and Pain pressure threshold (PPT) for tenderness at both groups (A,B). Conclusion: ischemic pressure technique appear to be no more effective than post isometric facilitation in treatment of rhomboids latent myofacial trigger point.

Keywords: Rhmoiboid trigger point, myofacila trigger point, ischemic pressure, post isometric facilitation

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1361 Evaluation of the Power Generation Effect Obtained by Inserting a Piezoelectric Sheet in the Backlash Clearance of a Circular Arc Helical Gear

Authors: Barenten Suciu, Yuya Nakamoto

Abstract:

Power generation effect, obtained by inserting a piezo- electric sheet in the backlash clearance of a circular arc helical gear, is evaluated. Such type of screw gear is preferred since, in comparison with the involute tooth profile, the circular arc profile leads to reduced stress-concentration effects, and improved life of the piezoelectric film. Firstly, geometry of the circular arc helical gear, and properties of the piezoelectric sheet are presented. Then, description of the test-rig, consisted of a right-hand thread gear meshing with a left-hand thread gear, and the voltage measurement procedure are given. After creating the tridimensional (3D) model of the meshing gears in SolidWorks, they are 3D-printed in acrylonitrile butadiene styrene (ABS) resin. Variation of the generated voltage versus time, during a meshing cycle of the circular arc helical gear, is measured for various values of the center distance. Then, the change of the maximal, minimal, and peak-to-peak voltage versus the center distance is illustrated. Optimal center distance of the gear, to achieve voltage maximization, is found and its significance is discussed. Such results prove that the contact pressure of the meshing gears can be measured, and also, the electrical power can be generated by employing the proposed technique.

Keywords: circular arc helical gear, contact problem, optimal center distance, piezoelectric sheet, power generation

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1360 Landfill Failure Mobility Analysis: A Probabilistic Approach

Authors: Ali Jahanfar, Brajesh Dubey, Bahram Gharabaghi, Saber Bayat Movahed

Abstract:

Ever increasing population growth of major urban centers and environmental challenges in siting new landfills have resulted in a growing trend in design of mega-landfills some with extraordinary heights and dangerously steep slopes. Landfill failure mobility risk analysis is one of the most uncertain types of dynamic rheology models due to very large inherent variabilities in the heterogeneous solid waste material shear strength properties. The waste flow of three historic dumpsite and two landfill failures were back-analyzed using run-out modeling with DAN-W model. The travel distances of the waste flow during landfill failures were calculated approach by taking into account variability in material shear strength properties. The probability distribution function for shear strength properties of the waste material were grouped into four major classed based on waste material compaction (landfills versus dumpsites) and composition (high versus low quantity) of high shear strength waste materials such as wood, metal, plastic, paper and cardboard in the waste. This paper presents a probabilistic method for estimation of the spatial extent of waste avalanches, after a potential landfill failure, to create maps of vulnerability scores to inform property owners and residents of the level of the risk.

Keywords: landfill failure, waste flow, Voellmy rheology, friction coefficient, waste compaction and type

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1359 Prognostic Value of Serum Matrix Metalloproteinase (MMP-9) in Critically Ill Septic Patients

Authors: Sherif Sabri, Nael Samir, Mohamed Ali, Ahmed ElSakhawy

Abstract:

Introduction: There is growing evidence to support the hypothesis that serum matrix metalloproteinase -9 in could be an early predictor of mortality in septic patients. Aim of the work: Study the relationship of matrix metalloproteinase 9 in patients with SIRS in comparison to septic patients in day 0 and day 2. Patients and Methods: This is a prospective observational study conducted on 40 adult critically ill patients staying more than 24 hours in ICU either surgical or medical department, El Fayoum General Hospital in the period from November 2014 to March 2015. Patients met at least two of the criteria for severe inflammatory response syndrome (SIRS). Diagnostic criteria include several clinical and laboratory findings of sepsis induced tissue hypoperfusion or organ dysfunction. Samples were grouped as drawn either at admission, or at day 2 after admission. Results: Patients were divided into two groups: The non-sepsis (SIRS) group, which included 15 (37.5%) patients with no later evidence of sepsis were enrolled as controls. The Sepsis group, which included 25 patients diagnosed to have SIRS with later evidence of sepsis with positive culture. Exploring serum level of MMP-9 in non-survivors and survivors, there was significant increase in non-survivors if compared to survivors at admission p-value 0.001 (mean value in survivors 4.4mg/dl±4.1mg/dl at admission versus mean value in non-survivors 11.9mg/dl±5.8mg/dl) and after two days of admission was also significant increase p-value 0.001 (mean value in survivors 10.9mg/dl ±9.4mg/dl versus mean value in non-survivors 22.6mg/dl±10.4). Conclusion: MMP-9 levels in septic patients have a beneficial role in ICU for high-risk stratification as it is an independent marker of mortality in severe sepsis.

Keywords: matrix metalloproteinase (MMP-9), sepsis, septic shock, systemic inflamatory response syndrome

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1358 Hydro-Chemical Characterization of Glacial Melt Waters Draining from Shaune Garang Glacier, Himachal Himalaya

Authors: Ramesh Kumar, Rajesh Kumar, Shaktiman Singh, Atar Singh, Anshuman Bhardwaj, Ravindra Kumar Sinha, Anupma Kumari

Abstract:

A detailed study of the ion chemistry of the Shaune Garnag glacier meltwater has been carried out to assess the role of active glacier in the chemical denudation rate. The chemical compositions of various ions in meltwater of the Shaune Garang glacier were analyzed during the melting period 2015 and 2016. Total 112 of melt water samples twice in a day were collected during ablation season of 2015 and 2016. To identify various factors controlling the dissolved ionic strength of Shaune Garang Glacier meltwater statistical analysis such as correlation matrix, Principle Component Analysis (PCA) and factor analysis were applied to deduce the result. Cation concentration for Ca²⁺ > Mg²⁺ > Na⁺ > K⁺ in the meltwater for both the years can be arranged in the order as Ca²⁺ > Mg²⁺ > Na⁺ > K⁺. Study showed that Ca²⁺ and HCO₃⁻ found to be dominant on the both melting period. Carbonate weathering identified as the dominant process controlling the dissolved ion chemistry of meltwater due to the high ratios of (Ca²⁺ + Mg²⁺) versus TZ+ and (Ca²⁺ + Mg²⁺) versus (Na⁺ + K⁺) in the study area. The cation denudation rate of the Shaune Garnag catchment is 3412.2 m⁻² a⁻¹, i.e. higher than the other glacierised catchment in the Himalaya, indicating intense chemical erosion in this catchment.

Keywords: Shaune Garang glacier, Hydrochemistry, chemical composition, cation denudation rate, carbonate weathering

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1357 Translating Creativity to an Educational Context: A Method to Augment the Professional Training of Newly Qualified Secondary School Teachers

Authors: Julianne Mullen-Williams

Abstract:

This paper will provide an overview of a three year mixed methods research project that explores if methods from the supervision of dramatherapy can augment the occupational psychology of newly qualified secondary school teachers. It will consider how creativity and the use of metaphor, as applied in the supervision of dramatherapists, can be translated to an educational context in order to explore the explicit / implicit dynamics between the teacher trainee/ newly qualified teacher and the organisation in order to support the super objective in training for teaching; how to ‘be a teacher.’ There is growing evidence that attrition rates among teachers are rising after only five years of service owing to too many national initiatives, an unmanageable curriculum and deteriorating student discipline. The fieldwork conducted entailed facilitating a reflective space for Newly Qualified Teachers from all subject areas, using methods from the supervision of dramatherapy, to explore the social and emotional aspects of teaching and learning with the ultimate aim of improving the occupational psychology of teachers. Clinical supervision is a formal process of professional support and learning which permits individual practitioners in frontline service jobs; counsellors, psychologists, dramatherapists, social workers and nurses to expand their knowledge and proficiency, take responsibility for their own practice, and improve client protection and safety of care in complex clinical situations. It is deemed integral to continued professional practice to safeguard vulnerable people and to reduce practitioner burnout. Dramatherapy supervision incorporates all of the above but utilises creative methods as a tool to gain insight and a deeper understanding of the situation. Creativity and the use of metaphor enable the supervisee to gain an aerial view of the situation they are exploring. The word metaphor in Greek means to ‘carry across’ indicating a transfer of meaning form one frame of reference to another. The supervision support was incorporated into each group’s induction training programme. The first year group attended fortnightly one hour sessions, the second group received two one hour sessions every term. The existing literature on the supervision and mentoring of secondary school teacher trainees calls for changes in pre-service teacher education and in the induction period. There is a particular emphasis on the need to include reflective and experiential learning, within training programmes and within the induction period, in order to help teachers manage the interpersonal dynamics and emotional impact within a high pressurised environment

Keywords: dramatherapy supervision, newly qualified secondary school teachers, professional development, teacher education

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1356 Conservative Treatment Versus Percutaneous Wire Fixation in treatment of Distal Radial Fracture in Elderly

Authors: Abdelfatah Elsenosy, Mahmoud Ebrahim

Abstract:

Background: Distal radius fractures are commonly encountered in orthopedic practice, especially in elderly patients. A number of clinical papers have supported the idea that anatomic restoration of the distal end of the radius is essential to gain superior results. Aim and objectives: The aim of the study is to systematically review the literature for the management of distal end radius in elderly persons (conservative treatment versus percutaneous wire fixation) as regards radiological and functional outcomes. Subjects and methods: Studies were identified from the Medline, Cochrane, EMBASE, and Google Scholar databases were searched until 2019 using combinations of the following search terms: distal radius fracture, conservative treatment, non-operative treatment, and nonsurgical treatment, surgical treatment, operative, elderly, and older. Reference lists of relevant studies were manually searched. Results: There was no statistical significance difference between CI and PKF groups’ frequency of complication in all of the selected studies. Based on the results, we recommend more analysis regarding every parameter of the radiographic and functional results and specific complications related to each fixation need to be accomplished, which requires more Randomized controlled trials (RCTs) with high quality. Conclusion: Surgical treatment seems to be more effective distal radius fracture compared with conservative treatment when the radiographic outcomes were analyzed, and no significant differences were detected in the functional outcomes and complication rate.

Keywords: radius, fracture, surgical, RCTs, conservative, radiographic, outcomes, orthopedic

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1355 Comparison of the Effect of Semi-Rigid Ankle Bracing Performance among Ankle Injured Versus Non-Injured Adolescent Female Hockey Players

Authors: T. J. Ellapen, N. Acampora, S. Dawson, J. Arling, C. Van Niekerk, H. J. Van Heerden

Abstract:

Objectives: To determine the comparative proprioceptive performance of injured versus non-injured adolescent female hockey players when wearing an ankle brace. Methods: Data were collected from 100 high school players who belonged to the Highway Secondary School KZN Hockey league via voluntary parental informed consent and player assent. Players completed an injury questionnaire probing the prevalence and nature of hockey injuries (March-August 2013). Subsequently players completed a Biodex proprioceptive test with and without an ankle brace. Probability was set at p≤ 0.05. Results: Twenty-two players sustained ankle injuries within the six months (p<0.001). Injured players performed similarly without bracing Right Anterior Posterior Index (RAPI): 2.8±0.9; Right Medial Lateral Index (RMLI): 1.9±0.7; Left Anterior Posterior Index (LAPI) LAPI: 2.7; Left Medial Lateral Index (LMLI): 1.7±0.6) as compared to bracing (RAPI: 2.7±1.4; RMLI: 1.8±0.6; LAPI: 2.6±1.0; LMLI: 1.5±0.6) (p>0.05). However, bracing (RAPI: 2.2±0.8; RMLI: 1.5±0.5; LAPI: 2.4±0.9; MLI: 1.5±0.5) improved the ankle stability of the non-injured group as compared to their unbraced performance (RAPI: 2.5±1.0; RMLI: 1.8±0.8; LAPI: 2.8±1.1; LMLI: 1.8±0.6) (p<0.05). Conclusion: Ankle bracing did not enhance the stability of injured ankles. However ankle bracing has an ergogenic effect enhancing the stability of healthy ankles.

Keywords: hockey, proprioception, ankle, bracing

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1354 Clinician's Perspective of Common Factors of Change in Family Therapy: A Cross-National Exploration

Authors: Hassan Karimi, Fred Piercy, Ruoxi Chen, Ana L. Jaramillo-Sierra, Wei-Ning Chang, Manjushree Palit, Catherine Martosudarmo, Angelito Antonio

Abstract:

Background: The two psychotherapy camps, the randomized clinical trials (RCTs) and the common factors model, have competitively claimed specific explanations for therapy effectiveness. Recently, scholars called for empirical evidence to show the role of common factors in therapeutic outcome in marriage and family therapy. Purpose: This cross-national study aims to explore how clinicians, across different nations and theoretical orientations, attribute the contribution of common factors to therapy outcome. Method: A brief common factors questionnaire (CFQ-with a Cronbach’s Alpha, 0.77) was developed and administered in seven nations. A series of statistical analyses (paired-samples t-test, independent sample t-test, ANOVA) were conducted: to compare clinicians perceived contribution of total common factors versus model-specific factors, to compare each pair of common factors’ categories, and to compare clinicians from collectivistic nations versus clinicians from individualistic nation. Results: Clinicians across seven nations attributed 86% to common factors versus 14% to model-specific factors. Clinicians attributed 34% of therapeutic change to client’s factors, 26% to therapist’s factors, 26% to relationship factors, and 14% to model-specific techniques. The ANOVA test indicated each of the three categories of common factors (client 34%, therapist 26%, relationship 26%) showed higher contribution in therapeutic outcome than the category of model specific factors (techniques 14%). Clinicians with psychology degree attributed more contribution to model-specific factors than clinicians with MFT and counseling degrees who attributed more contribution to client factors. Clinicians from collectivistic nations attributed larger contributions to therapist’s factors (M=28.96, SD=12.75) than the US clinicians (M=23.22, SD=7.73). The US clinicians attributed a larger contribution to client’s factors (M=39.02, SD=1504) than clinicians from the collectivistic nations (M=28.71, SD=15.74). Conclusion: The findings indicate clinicians across the globe attributed more than two thirds of therapeutic change to CFs, which emphasize the training of the common factors model in the field. CFs, like model-specific factors, vary in their contribution to therapy outcome in relation to specific client, therapist, problem, treatment model, and sociocultural context. Sociocultural expectations and norms should be considered as a context in which both CFs and model-specific factors function toward therapeutic goals. Clinicians need to foster a cultural competency specifically regarding the divergent ways that CFs can be activated due to specific sociocultural values.

Keywords: common factors, model-specific factors, cross-national survey, therapist cultural competency, enhancing therapist efficacy

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1353 Effect of Fatty Acids in Feed on Levels of Antibody Titers and CD4 and CD8 T-Lymphocyte against Newcastle Disease Virus of Vaccinated Broiler Chicken

Authors: Alaa A. Shamaun Al-Abboodi, Yunis A. A. Bapeer

Abstract:

400 one-day-old male broiler chicks (Ross-308) randomly divided to 2 main groups, 1st main group (GA) was feeding basal diet with medium chain fatty acid (MCFA) at rate of 0.15% and divided to four subgroups, 3 subgroups vaccinated with different routes with Newcastle Disease Virus (NDV) and non-vaccinated group. The 2nd main group (GB) feeding basal diet without MCFA and divided the same as 1st main group. The parameters used in this study included: ND antibody titers at 1, 10, 21, 28, 35 and 42 days of age and values of CD4 and CD8 at 1, 20, 30 and 42 days of age. This experiment detected increase in ND antibodies titers in (G1, G2, G3) groups were fed on basal diet MCFA comparing to groups were fed without adding MCFA (G5, G6, G7) and control groups (G4, G8). The results of cellular immune response (CD4 and CD8) T-cells in broiler chicks indicated that there was obviously significant relationship between dietary Fatty Acid (FA) versus the diet without FA on the level of CD4 parameter, for the entire experimental period. The effect of different ages was statistically significant in creating different values of CD4 level, whereas the CD4 level decreases markedly with age. However, analyzing the data of different vaccination methods, oculonasal method of vaccination led to the highest value of CD4 compared with the oral, S/C and control groups. There were statistical differences in CD8 values due to supplementation of FA versus the basal diet and due to the effect of different age periods. As for the age effect, the CD8 value at 20 days of age was significantly higher than at 42 and 30 days.

Keywords: broiler, CD4 and CD8, fatty acids, Newcastle Disease

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1352 Rhizobia-Containing Rhizobacterial Consortia and Intercropping Improved Faba Bean and Wheat Performances Under Stress Combining Drought and Phosphorus Deficiency

Authors: Said Cheto, Khawla Oukaltouma, Imane Chamkhi, Ammar Ibn Yasser, Bouchra Benmrid, Ahmed Qaddoury, Lamfeddal Kouisni, Joerg Geistlinger, Youssef Zeroual, Adnane Bargaz, Cherki Ghoulam

Abstract:

Our study aimed to assess, the role of inoculation of faba bean/wheat intercrops with selected rhizobacteria consortia gathering one rhizobia and two phosphate solubilizing bacteria “PSB” to alleviate the effects of combined water deficit and P limitation on Faba bean/ wheat intercrops versus monocrops under greenhouse conditions. One Vicia faba L variety (Aguadulce “Ag”), and one Triticum durum L. variety (Karim “K”) were grown as sole crops or intercrop in pots containing sterilized substrate (sand: peat 4:1v/v) added either with rock phosphate (RP) as the alone P source (P limitation) or with KH₂PO₄ in nutrient solution (P sufficient control). Plant inoculation was done using rhizobacterial consortia composed; C1(Rhizobium laguerreae, Kocuria sp, and Pseudomonas sp) and C2 (R. laguerreae, Rahnella sp, and Kocuria sp). Two weeks after inoculation, the plants were submitted to water deficit consisting of 40% of substrate water holding Capacity (WHC) versus 80% WHC for well-watered plants. At the flowering stage, the trial was assessed, and the results showed that inoculation with both consortia (C1 and C2) improved faba bean biomass in terms of shoots, roots, and nodules compared to inoculation with rhizobia alone, particularly C2 improved these parametres by 19.03, 78.99, and 72.73%, respectively. Leaf relative water content decreased under combined stress, particularly in response to C1 with a significant improvement of this parameter in wheat intercrops. For faba bean under P limitation, inoculation with C2 increased stomatal conductance (gs) by 35.73% compared to plants inoculated with rhizobia alone. Furthermore, the same inoculum C2 improved membrane stability by 44,33% versus 16,16% for C1 compared to inoculation with rhizobia alone under P deficit. For sole cropped faba bean plants, inoculation with both consortia improved N accumulation compared to inoculation with rhizobia alone with an increase of 70.75% under P limitation. Moreover, under the combined stress, intercropping inoculation with C2 improved plant biomass and N content (112.98%) in wheat plants, compared to the sole crop. Our finding revealed that consortium C2 might offer an agronomic advantage under water and P deficit and could be used as inoculum for enhancing faba bean and wheat production under both monocropping and intercropping systems.

Keywords: drought, phosphorus, intercropping, PSB, rhizobia, vicia faba, Triticum durum

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1351 Propranalol is Not Effective in Preventing the Progression to Severe Portal Hypertensive Gastropathy in Cirrhotic Patients who Had Undergone Variceal Eradication: A Randomised Controlled Trial

Authors: Jeffey George, Varghese Thomas

Abstract:

Background and Objectives: PHG is an important source of gastrointestinal bleeding in patients with portal hypertension. Aim: To assess the progression to severe portal hypertensive gastropathy(PHG) in patients with cirrhosis who were treated with maximum tolerated dose of propranalol, after variceal eradication to grade II or below. Methods: Cirrhotic patients(child A and B) presenting with upper gastrointestinal bleeding with endoscopic findings of mild or no PHG were followed up over 6 months after variceal eradication to assess the progression to severe PHG. Included patients were randomised to either maximum tolerated doses of propranalol (group A) or to no treatment (group B). Primary end point of the study were the development of gastrointestinal bleed, evidence of hepatic decompensation and death. Progression to severe PHG were compared between the two groups. Results: 56 patients (49 males) were enrolled (group A = 28, group B = 28). 8 patients were excluded from final analysis (gi bleed=5, encephalopathy=2,HCC=1 including 4 deaths).3 patients were lost to follow-up, and 1 developed intolerance to propranalol. Mean dose of propranalol used was 60 mg per day. Progression to severe PHG in the fundus over 6 months was 23.8% in group A versus 15.8 % in group B (p = 0.52). Severe PHG was noted in body in 14.3% in group A versus 21.1% in group B (p = 0.57). 23.8 % in group A had progression to severe PHG compared with 15.8 % in group B (p =0.52). There was no statistically significant difference in the progression of PHG between the two groups(p=0.43). Conclusion: In this short term study propranalol was found not to prevent the progression to severe portal hypertensive gastropathy in cirrhotic patients who had undergone endotherapy for esophageal varices.

Keywords: propranalol, portal hypertensive gastropathy, cirrhotic patients, gastroenterology

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1350 The Effects of L2 Storybook Reading and Interactive Vocabulary Instruction on Vocabulary Acquisition

Authors: Lenore Van Den Berg

Abstract:

Vocabulary development is positively associated with reading development, reading comprehension, and academic achievement. It is frequently stated that South Africa is in the midst of a literacy crisis. The past 24 years since the first democratically elected government have not revolutionised the education system; rather, after various curriculum changes and continued struggles to incorporate all 11 official languages as languages of instruction, research shows that 78 per cent of South African Grade 4 learners are functionally illiterate. The study sets out to find solutions to this problem and to add to the research base on vocabulary acquisition by assessing the effect of integrating the principles of explicit, interactive vocabulary instruction, within the context of storybook reading, on Grade 1 vocabulary acquisition. Participants comprised of 69 Grade 1 English second language learners from three classes in two government primary schools. The two schools differ in socio-economic status (SES), with School A having a lower SES than School B. One Grade 1 class was randomly assigned to be the Experimental Group, while two other classes served as control groups. The intervention took place for a period of 18 weeks and consisted of 30-minute storybook reading sessions, accompanied by interactive vocabulary instruction, twice a week. The Peabody Picture Vocabulary Test IV (PPVT-IV) was the diagnostic test administered to all learners before the intervention, as a pre-test, and after the interventions as a post-test. Data regarding excising vocabulary instruction practices and approaches were also collected through classroom observations and individual, semi-structured interviews with the Experimental Group’s teacher. Findings suggest that second language storybook reading, accompanied by explicit, interactive vocabulary instruction, have a positive impact on Grade 1 vocabulary acquisition but that vocabulary teaching practices and socio-economic status also play a key role in vocabulary acquisition.

Keywords: interactive vocabulary instruction, second language vocabulary, storybook reading, vocabulary acquisition, reading development, PPVT

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1349 Study of Contrast Induced Nephropathy in Patients Undergoing Cardiac Catheterization: Upper Egypt Experience

Authors: Ali Kassem, Sharf Eldeen-Shazly, Alshemaa Lotfy

Abstract:

Introduction: Contrast-induced nephropathy (CIN) has been the third leading cause of hospital-acquired renal failure. Patients with cardiac diseases are particularly at risk especially with repeated injections of contrast media. CIN is generally defined as an increase in serum creatinine concentration of > 0.5 mg/dL or 25% above baseline within 48 hours after contrast administration. Aim of work: To examine the frequency of CIN for patients undergoing cardiac catheterization at Sohag University Hospital (Upper Egypt) and to identify possible risk factors for CIN in these patients. Material and methods: The study included 104 patients with mean age 56.11 ±10.03, 64(61.5%) are males while 40(38.5%) are females. 44(42.3%) patients are diabetics, 43(41%) patients are hypertensive, 6(5.7%) patients have congestive heart failure, 69(66.3%) patients on statins, 74 (71.2 %) are on ACEIs or ARBs, 19(15.4%) are on metformin, 6 (5.8%) are on NSAIDs, 30(28.8%) are on diuretics. RESULTS: Patients were classified at the end of the study into two groups: Group A: Included 91 patients who did not develop CIN. Group B: Included 13 patients who developed CIN, of which serum creatinine raised > 0.5mg/dl in 6 patients and raised > 25% from the baseline after the procedure in 13 patients. The overall incidence of CIN was 12.5%. CIN increased with older age. There was an increase in the incidence of CIN in diabetic versus non-diabetic patients (20.5% and 6.7%) respectively. (p< 0.03). There was a highly significant increase in the incidence of CIN in patients with CHF versus those without CHF (100% and 71%) respectively, (P<0001). Patients on diuretics showed a significant increase in the incidence of CIN representing 61.5% of all patients who developed CIN. Conclusion: Older patients, diabetic patients, patients with CHF and patients on diuretics have higher risk of developing CIN during coronary catheterization and should receive reno-protective measures before contrast exposure.

Keywords: cardiac diseases, contrast-induced nephropathy, coronary catheterization, CIN

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1348 MicroRNA Drivers of Resistance to Androgen Deprivation Therapy in Prostate Cancer

Authors: Philippa Saunders, Claire Fletcher

Abstract:

INTRODUCTION: Prostate cancer is the most prevalent malignancy affecting Western males. It is initially an androgen-dependent disease: androgens bind to the androgen receptor and drive the expression of genes that promote proliferation and evasion of apoptosis. Despite reduced androgen dependence in advanced prostate cancer, androgen receptor signaling remains a key driver of growth. Androgen deprivation therapy (ADT) is, therefore, a first-line treatment approach and works well initially, but resistance inevitably develops. Abiraterone and Enzalutamide are drugs widely used in ADT and are androgen synthesis and androgen receptor signaling inhibitors, respectively. The shortage of other treatment options means acquired resistance to these drugs is a major clinical problem. MicroRNAs (miRs) are important mediators of post-transcriptional gene regulation and show altered expression in cancer. Several have been linked to the development of resistance to ADT. Manipulation of such miRs may be a pathway to breakthrough treatments for advanced prostate cancer. This study aimed to validate ADT resistance-implicated miRs and their clinically relevant targets. MATERIAL AND METHOD: Small RNA-sequencing of Abiraterone- and Enzalutamide-resistant C42 prostate cancer cells identified subsets of miRs dysregulated as compared to parental cells. Real-Time Quantitative Reverse Transcription PCR (qRT-PCR) was used to validate altered expression of candidate ADT resistance-implicated miRs 195-5p, 497-5p and 29a-5p in ADT-resistant and -responsive prostate cancer cell lines, patient-derived xenografts (PDXs) and primary prostate cancer explants. RESULTS AND DISCUSSION: This study suggests a possible role for miR-497-5p in the development of ADT resistance in prostate cancer. MiR-497-5p expression was increased in ADT-resistant versus ADT-responsive prostate cancer cells. Importantly, miR-497-5p expression was also increased in Enzalutamide-treated, castrated (ADT-mimicking) PDXs versus intact PDXs. MiR-195-5p was also elevated in ADT-resistant versus -responsive prostate cancer cells, while there was a drop in miR-29a-5p expression. Candidate clinically relevant targets of miR-497-5p in prostate cancer were identified by mining AGO-PAR-CLIP-seq data sets and may include AVL9 and FZD6. CONCLUSION: In summary, this study identified microRNAs that are implicated in prostate cancer resistance to androgen deprivation therapy and could represent novel therapeutic targets for advanced disease.

Keywords: microRNA, androgen deprivation therapy, Enzalutamide, abiraterone, patient-derived xenograft

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1347 Effects of the Food Colour Erythrosine on Thyroid Gland Function in Experimental Rats

Authors: Maha M.Saber, Eitedal Daoud, Moetazza M. Alshafei, Lobna M. Abd El-Latif

Abstract:

Children in the third world consumes many food products colored red like sweets and soft drink without knowing its effect on health or the type of color used in these products Erythrosine (ER,FD & C Red No.3) is one of the most common coloring agent used in these products and in coloring cherry in compotes. The possible adverse effect of erythrosine ER on the thyroid gland function is investigated in albino rats. Forty-five adult male albino rats were divided to three groups two groups will receive ER orally in doses 68 and I36mg/kg respectively. Third group will receive distilled water for three months Sections of thyroid glands were examined for histopathological, morphometric analysis and MIB-I Ki67 (proliferative marker). Serum concentration of triiodothyronine (T3), Thyroxin (T4) and thyrotrophin (TSH) were determined, results showed histological changes in the two treatment groups versus control group in the group with 68mg/kg dose show vaculation of the cytoplasm of follicular cells and pleomorphism of their nuclei. While the other treated group {136mg /kg} showed congestion of blood vessels, hyperplasia of the interstitial cells and increased multilayer of the follicular cells. Highly significant increase in the mean area of the thyroid follicles in both treated groups compared to control group.Erythrosine treated groups showed a very highly significant decrease (P < 0.001) in serum concentration of T3 and T 4 while TSH showed a very highly significant increase versus control.

Keywords: erythrosine, thyroid, morphometrics, proliferative marker

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1346 Numerical Simulation of Filtration Gas Combustion: Front Propagation Velocity

Authors: Yuri Laevsky, Tatyana Nosova

Abstract:

The phenomenon of filtration gas combustion (FGC) had been discovered experimentally at the beginning of 80’s of the previous century. It has a number of important applications in such areas as chemical technologies, fire-explosion safety, energy-saving technologies, oil production. From the physical point of view, FGC may be defined as the propagation of region of gaseous exothermic reaction in chemically inert porous medium, as the gaseous reactants seep into the region of chemical transformation. The movement of the combustion front has different modes, and this investigation is focused on the low-velocity regime. The main characteristic of the process is the velocity of the combustion front propagation. Computation of this characteristic encounters substantial difficulties because of the strong heterogeneity of the process. The mathematical model of FGC is formed by the energy conservation laws for the temperature of the porous medium and the temperature of gas and the mass conservation law for the relative concentration of the reacting component of the gas mixture. In this case the homogenization of the model is performed with the use of the two-temperature approach when at each point of the continuous medium we specify the solid and gas phases with a Newtonian heat exchange between them. The construction of a computational scheme is based on the principles of mixed finite element method with the usage of a regular mesh. The approximation in time is performed by an explicit–implicit difference scheme. Special attention was given to determination of the combustion front propagation velocity. Straight computation of the velocity as grid derivative leads to extremely unstable algorithm. It is worth to note that the term ‘front propagation velocity’ makes sense for settled motion when some analytical formulae linking velocity and equilibrium temperature are correct. The numerical implementation of one of such formulae leading to the stable computation of instantaneous front velocity has been proposed. The algorithm obtained has been applied in subsequent numerical investigation of the FGC process. This way the dependence of the main characteristics of the process on various physical parameters has been studied. In particular, the influence of the combustible gas mixture consumption on the front propagation velocity has been investigated. It also has been reaffirmed numerically that there is an interval of critical values of the interfacial heat transfer coefficient at which a sort of a breakdown occurs from a slow combustion front propagation to a rapid one. Approximate boundaries of such an interval have been calculated for some specific parameters. All the results obtained are in full agreement with both experimental and theoretical data, confirming the adequacy of the model and the algorithm constructed. The presence of stable techniques to calculate the instantaneous velocity of the combustion wave allows considering the semi-Lagrangian approach to the solution of the problem.

Keywords: filtration gas combustion, low-velocity regime, mixed finite element method, numerical simulation

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1345 Regional Trade Integration: Empirical Investigation of Trade within the European Union versus Association for South East Asian Nations

Authors: Sarina Zainab Shirazi

Abstract:

Abstract— With the advent of globalization, different countries have liberalized their trade policies to enhance economic integration and developmental processes but the advantages accrued vary greatly from region to region. This study specifically examines European Union (EU) and Association for South East Asian Nations (ASEAN), two regions that show contrasting integration patterns. EU shows most successful integrations versus the slower paced integration in the ASEAN region. A comprehensive panel data empirical investigation of EU and ASEAN in the context of economy size, geographical distances, language, ethnicity, common border and regional trade agreements (RTA) is conducted for a period of 1985 – 2015. The empirical investigation through the augmented gravity equation shows that the real effectiveness for enhanced intra-regional trade is significant when specific examination of export and import components is conducted in the presence of non-tariff barriers. These barriers surface in the form of terms of trade openness, inflation, exchange rate, common borders, common language, ethnic similarity, and presence of a formal regional trade agreement (RTA). Thus, these factors can be utilized by the EU and ASEAN regions in order to formulate effective policy tools to enhance trade within their respective spheres of influence.

Keywords: Association for South East Asian Nations, European Union, Gravity Model, Regional Trade

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1344 Review of Studies on Agility in Knowledge Management

Authors: Ferdi Sönmez, Başak Buluz

Abstract:

Agility in Knowledge Management (AKM) tries to capture agility requirements and their respective answers within the framework of knowledge and learning for organizations. Since it is rather a new construct, it is difficult to claim that it has been sufficiently discussed and analyzed in practical and theoretical realms. Like the term ‘agile learning’, it is also commonly addressed in the software development and information technology fields and across the related areas where those technologies can be applied. The organizational perspective towards AKM, seems to need some more time to become scholarly mature. Nevertheless, in the literature one can come across some implicit usages of this term occasionally. This research is aimed to explore the conceptual background of agility in KM, re-conceptualize it and extend it to business applications with a special focus on e-business.

Keywords: knowledge management, agility requirements, agility, knowledge

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1343 Maternal, Fetal and Neonatal Outcomes of Elective Versus Emergency Cesarean Deliveries

Authors: Poonam Chouhan, Rama Thakur, R. J. Mahajan, Kushla Pathania, Mehnaz Kumar

Abstract:

Background: Cesarean sections are associated with short- and long-term risks and affect the health of the woman, her child, and future pregnancies. We conducted a study to compare Maternal, fetal, and neonatal elective versus emergency cesarean deliveries in a tertiary care center. Material & Methods: This was a cross-sectional comparative hospital-based study conducted at Kamla Nehru State Hospital for the mother and Child, Department of Obstetrics and Gynecology, Indira Gandhi Medical College, Shimla, from June 1, 2020, to May 31ˢᵗ, 2021). A total of 200 consenting participants (100 participants undergoing elective cesarean section & 100 participants undergoing emergency cesarean section) were enrolled. The analysis was performed using the statistical package for social sciences (SPSS) version 21. Results: Antenatal complications were more in women who had an emergency cesarean section (95%) as compared to those who had an elective cesarean section (46%) (p=0.0076). 26.5% of women had fetal complications, and out of them, 92.4% (49/53) underwent emergency cesarean section. IUGR was diagnosed in 8% of women, out of them, 56.2% had elective cesarean section & 43.8% had an emergency cesarean section. Malpresentation other than breech presentation were present in 3.5% (7/200) of women. Six (3%) women had cesarean section for macrosomia. Of these, 66.7% (4/6) had elective cesarean section & 33.3% had emergency cesarean section. 23% (46/200) neonates required NICU admission, and 5% (10/200) had transient tachypnoea of new-born (TTNB). Conclusion: Our study concluded that maternal and fetal Complications of an emergency cesarean are more as compared to a planned elective cesarean. An elective cesarean conducted well in time will prevent an emergency cesarean delivery and its related complications.

Keywords: maternal, fetal, neonatal, complications, cesareans

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1342 Time-Interval between Rectal Cancer Surgery and Reintervention for Anastomotic Leakage and the Effects of a Defunctioning Stoma: A Dutch Population-Based Study

Authors: Anne-Loes K. Warps, Rob A. E. M. Tollenaar, Pieter J. Tanis, Jan Willem T. Dekker

Abstract:

Anastomotic leakage after colorectal cancer surgery remains a severe complication. Early diagnosis and treatment are essential to prevent further adverse outcomes. In the literature, it has been suggested that earlier reintervention is associated with better survival, but anastomotic leakage can occur with a highly variable time interval to index surgery. This study aims to evaluate the time-interval between rectal cancer resection with primary anastomosis creation and reoperation, in relation to short-term outcomes, stratified for the use of a defunctioning stoma. Methods: Data of all primary rectal cancer patients that underwent elective resection with primary anastomosis during 2013-2019 were extracted from the Dutch ColoRectal Audit. Analyses were stratified for defunctioning stoma. Anastomotic leakage was defined as a defect of the intestinal wall or abscess at the site of the colorectal anastomosis for which a reintervention was required within 30 days. Primary outcomes were new stoma construction, mortality, ICU admission, prolonged hospital stay and readmission. The association between time to reoperation and outcome was evaluated in three ways: Per 2 days, before versus on or after postoperative day 5 and during primary versus readmission. Results: In total 10,772 rectal cancer patients underwent resection with primary anastomosis. A defunctioning stoma was made in 46.6% of patients. These patients had a lower anastomotic leakage rate (8.2% vs. 11.6%, p < 0.001) and less often underwent a reoperation (45.3% vs. 88.7%, p < 0.001). Early reoperations (< 5 days) had the highest complication and mortality rate. Thereafter the distribution of adverse outcomes was more spread over the 30-day postoperative period for patients with a defunctioning stoma. Median time-interval from primary resection to reoperation for defunctioning stoma patients was 7 days (IQR 4-14) versus 5 days (IQR 3-13 days) for no-defunctioning stoma patients. The mortality rate after primary resection and reoperation were comparable (resp. for defunctioning vs. no-defunctioning stoma 1.0% vs. 0.7%, P=0.106 and 5.0% vs. 2.3%, P=0.107). Conclusion: This study demonstrated that early reinterventions after anastomotic leakage are associated with worse outcomes (i.e. mortality). Maybe the combination of a physiological dip in the cellular immune response and release of cytokines following surgery, as well as a release of endotoxins caused by the bacteremia originating from the leakage, leads to a more profound sepsis. Another explanation might be that early leaks are not contained to the pelvis, leading to a more profound sepsis requiring early reoperations. Leakage with or without defunctioning stoma resulted in a different type of reinterventions and time-interval between surgery and reoperation.

Keywords: rectal cancer surgery, defunctioning stoma, anastomotic leakage, time-interval to reoperation

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1341 A Nutrient Formulation Affects Brain Myelination in Infants: An Investigative Randomized Controlled Trial

Authors: N. Schneider, M. Bruchhage, M. Hartweg, G. Mutungi, J. O Regan, S. Deoni

Abstract:

Observational neuroimaging studies suggest differences between breast-fed and formula-fed infants in developmental myelination, a key brain process for learning and cognitive development. However, the possible effects of a nutrient formulation on myelin development in healthy term infants in an intervention study have not been investigated. Objective was, therefore, to investigate the efficacy of a nutrient formulation with higher levels of myelin-relevant nutrients as compared to a control formulation with lower levels of the same nutrients on brain myelination and cognitive development in the first 6 months of life. The study is an ongoing randomized, controlled, double-blind, two-center, parallel-group clinical trial with a nonrandomized, non-blinded arm of exclusively breastfed infants. The current findings result from a staged statistical analysis at 6 months; the recruitment and intervention period has been completed for all participants. Follow-up visits at 12, 18 and 24 months are still ongoing. N= 81 enrolled full term, neurotypical infants of both sexes were randomized into either the investigational (N= 42) or the control group (N= 39), and N= 108 children in the breast-fed arm served as a natural reference group. The effect of a blend of docosahexaenoic acid, arachidonic acid, iron, vitamin B12, folic acid as well as sphingomyelin from a uniquely proceed whey protein concentrate enriched in alpha-lactalbumin and phospholipids in an infant nutrition product matrix was investigated. The main outcomes for the staged statistical analyses at 6 months included brain myelination measures derived from MRI. Additional outcomes were brain volume, cognitive development and safety. The full analyses set at 6 months comprised N= 66 infants. Higher levels of myelin-relevant nutrients compared to lower levels resulted in significant differences in myelin structure, volume, and rate of myelination as early as 3 and 6 months of life. The cross-sectional change of means between groups for whole-brain myelin volume was 8.4% for investigational versus control formulation (3.5% versus the breastfeeding reference) group at 3 months and increased to 36.4% for investigational versus control formulation (14.1% versus breastfeeding reference) at 6 months. No statistically significant differences were detected for early cognition scores. Safety findings were largely similar across groups. This is the first pediatric nutritional neuroimaging study demonstrating the efficacy of a myelin nutrient blend on developmental myelination in well-nourished term infants. Myelination is a critical process in learning and development. The effects were demonstrated across the brain, particularly in temporal and parietal regions, known to be functionally involved in sensory, motor and language skills. These first results add to the field of nutritional neuroscience by demonstrating early life nutrition benefits for brain architecture which may be foundational for later cognitive and behavioral outcomes. ClinicalTrials.gov Identifier: NCT03111927 (Infant Nutrition and Brain Development - Full-Text View - ClinicalTrials.gov).

Keywords: brain development, infant nutrition, MRI, myelination

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1340 Earthquake Forecasting Procedure Due to Diurnal Stress Transfer by the Core to the Crust

Authors: Hassan Gholibeigian, Kazem Gholibeigian

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In this paper, our goal is determination of loading versus time in crust. For this goal, we present a computational procedure to propose a cumulative strain energy time profile which can be used to predict the approximate location and time of the next major earthquake (M > 4.5) along a specific fault, which we believe, is more accurate than many of the methods presently in use. In the coming pages, after a short review of the research works presently going on in the area of earthquake analysis and prediction, earthquake mechanisms in both the jerk and sequence earthquake direction is discussed, then our computational procedure is presented using differential equations of equilibrium which govern the nonlinear dynamic response of a system of finite elements, modified with an extra term to account for the jerk produced during the quake. We then employ Von Mises developed model for the stress strain relationship in our calculations, modified with the addition of an extra term to account for thermal effects. For calculation of the strain energy the idea of Pulsating Mantle Hypothesis (PMH) is used. This hypothesis, in brief, states that the mantle is under diurnal cyclic pulsating loads due to unbalanced gravitational attraction of the sun and the moon. A brief discussion is done on the Denali fault as a case study. The cumulative strain energy is then graphically represented versus time. At the end, based on some hypothetic earthquake data, the final results are verified.

Keywords: pulsating mantle hypothesis, inner core’s dislocation, outer core’s bulge, constitutive model, transient hydro-magneto-thermo-mechanical load, diurnal stress, jerk, fault behaviour

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