Search results for: mini nutritional assessment score
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7969

Search results for: mini nutritional assessment score

7819 Nutritional Supplementation in the Management of Childhood/Youth Aggression: A Systematic Review

Authors: Sabrina M. Wang, Rameen Qamar, Fahad Manzar Qureshi, Laura La Chance, Nathan J. Kolla, Barna Konkolÿ Thege

Abstract:

Elevated level of aggressive behaviour in children and youth can lead to impairments in family, social or academic functioning. The aim of the present study was to critically review the evidence on the effectiveness of nutritional supplements in reducing aggression in children and youth. The Cochrane Library, EMBASE, MEDLINE, ProQuest Dissertations & Theses, PsycINFO, and PubMed data bases were searched for relevant studies. Altogether, 22 studies met inclusion criteria; 13 investigated the effect of macronutrients (fatty acids and amino acids), 6 studies investigated the effect of micronutrients (vitamins and minerals), while 3 studies investigated a combination of macro and micronutrients. Out of the 22 studies, 7 reported a beneficial effect of nutritional supplementation (vitamins and minerals, essential fatty acids, or a certain combination of these). Eight studies did not report a significant beneficial effect of nutritional supplementation (essential fatty acids, vitamin D, and L-tryptophan), while 7 studies reported mixed effects (vitamin B6, essential fatty acids alone and in combination with vitamins and minerals, and carnitine). The results overall suggest that there may be a role for broad-range vitamin and mineral supplements in the treatment of aggression in youth and children.

Keywords: aggression, children, youth, nutritional supplementation, micronutrient, macronutrient

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7818 Feasibility of Risk Assessment for Type 2 Diabetes in Community Pharmacies Using Two Different Approaches: A Pilot Study in Thailand

Authors: Thitaporn Thoopputra, Tipaporn Pongmesa, Shuchuen Li

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Aims: To evaluate the application of non-invasive diabetes risk assessment tool in community pharmacy setting. Methods: Thai diabetes risk score was applied to assess individuals at risk of developing type 2 diabetes. Interactive computer-based risk screening (IT) and paper-based risk screening (PT) tools were applied. Participants aged over 25 years with no known diabetes were recruited in six participating pharmacies. Results: A total of 187 clients, mean aged (+SD) was 48.6 (+10.9) years. 35% were at high risk. The mean value of willingness-to-pay for the service fee in IT group was significantly higher than PT group (p=0.013). No significant difference observed for the satisfaction between groups. Conclusions: Non-invasive risk assessment tool, whether paper-based or computerized-based can be applied in community pharmacy to support the enhancing role of pharmacists in chronic disease management. Long term follow up is needed to determine the impact of its application in clinical, humanistic and economic outcomes.

Keywords: community pharmacy, intervention, prevention, risk assessment, type 2 diabetes

Procedia PDF Downloads 476
7817 Nutritional Management of Polycystic Ovary Syndrome Using a Mediterranean Diet

Authors: Mohamed Radwan

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Introduction: Polycystic ovary syndrome is becoming very common among girls from ages 14 to 21 years old, alongside women in their childbearing period. A combination of menstrual irregularities, overweight or obesity, insulin resistance (type 2 diabetes), and symptoms of virilization are characteristics of these cases. Background: A multidisciplinary team should be involved in managing these cases and may consist of A gynecologist, endocrinologist, nutritionist, and psychologist. The role of nutritionists is crucial in these cases in weight reduction and nutritional management. It is mandatory to present some questions that may help in expanding further our understanding of the nutritional management of this syndrome, such as it is not an easy process to reduce the weight of PCO patients (2) we need to know what suitable nutritional plans for these cases are. Methodology: It is not successful to use one diet plan for all patients or a specific plan, but we need to give tailored plans for each patient. We will summarize the medical, nutritional therapy and weight management in polycystic ovary patients and highlight the best eating plan and dietary composition in the treatment of these women. We will also discuss the role of dieticians in treating polycystic ovary cases and overcoming the challenges these women face. Conclusion: All diet plans would decrease the weight of Polycystic ovary cases as low calory diet, low glycemic index diet, high protein diet, as well as Dash diet, but the most suitable diet plan to improve hormones and lead to spontaneous pregnancy is the Mediterranean diet.

Keywords: obesity, PCO mediteranian diet, dash diet, high protein diet

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7816 Error Analysis in Academic Writing of EFL Learners: A Case Study for Undergraduate Students at Pathein University

Authors: Aye Pa Pa Myo

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Writing in English is accounted as a complex process for English as a foreign language learners. Besides, committing errors in writing can be found as an inevitable part of language learners’ writing. Generally, academic writing is quite difficult for most of the students to manage for getting better scores. Students can commit common errors in their writings when they try to write academic writing. Error analysis deals with identifying and detecting the errors and also explains the reason for the occurrence of these errors. In this paper, the researcher has an attempt to examine the common errors of undergraduate students in their academic writings at Pathein University. The purpose of doing this research is to investigate the errors which students usually commit in academic writing and to find out the better ways for correcting these errors in EFL classrooms. In this research, fifty-third-year non-English specialization students attending Pathein University were selected as participants. This research took one month. It was conducted with a mixed methodology method. Two mini-tests were used as research tools. Data were collected with a quantitative research method. Findings from this research pointed that most of the students noticed their common errors after getting the necessary input, and they became more decreased committing these errors after taking mini-test; hence, all findings will be supportive for further researches related to error analysis in academic writing.

Keywords: academic writing, error analysis, EFL learners, mini-tests, mixed methodology

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7815 Development of an Interactive Display-Control Layout Design System for Trains Based on Train Drivers’ Mental Models

Authors: Hyeonkyeong Yang, Minseok Son, Taekbeom Yoo, Woojin Park

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Human error is the most salient contributing factor to railway accidents. To reduce the frequency of human errors, many researchers and train designers have adopted ergonomic design principles for designing display-control layout in rail cab. There exist a number of approaches for designing the display control layout based on optimization methods. However, the ergonomically optimized layout design may not be the best design for train drivers, since the drivers have their own mental models based on their experiences. Consequently, the drivers may prefer the existing display-control layout design over the optimal design, and even show better driving performance using the existing design compared to that using the optimal design. Thus, in addition to ergonomic design principles, train drivers’ mental models also need to be considered for designing display-control layout in rail cab. This paper developed an ergonomic assessment system of display-control layout design, and an interactive layout design system that can generate design alternatives and calculate ergonomic assessment score in real-time. The design alternatives generated from the interactive layout design system may not include the optimal design from the ergonomics point of view. However, the system’s strength is that it considers train drivers’ mental models, which can help generate alternatives that are more friendly and easier to use for train drivers. Also, with the developed system, non-experts in ergonomics, such as train drivers, can refine the design alternatives and improve ergonomic assessment score in real-time.

Keywords: display-control layout design, interactive layout design system, mental model, train drivers

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7814 The Play Translator’s Score Developing: Methodology for Intercultural Communication

Authors: Akhmylovskaia Larisa, Barysh Andriana

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The present paper is introducing the translation score developing methodology and methods in the cross-cultural communication. The ideas and examples presented by the authors illustrate the universal character of translation score developing methods under analysis. Personal experience in the international theatre-making projects, opera laboratories, cross-cultural master-classes, movie and theatre festivals give more opportunities to single out the conditions, forms, means and principles of translation score developing as well as the translator/interpreter’s functions as cultural liaison for multiethnic collaboration.

Keywords: methodology of translation score developing, pre-production, analysis, production, post-production, ethnic scene theory, theatre anthropology, laboratory, master-class, educational project, academic project, Stanislavski terminology meta-language, super-objective, participant observation

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7813 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

Procedia PDF Downloads 274
7812 The Effects of Music Therapy on Positive Negative Syndrome Scale, Cognitive Function, and Quality of Life in Female Schizophrenic Patients

Authors: Elmeida Effendy, Mustafa M. Amin, Nauli Aulia Lubis, P. J. Sirait

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Music therapy may have an effect on mental illnesses. This is a comparative, quasi-experimental study to examine the effect of music therapy added to standard care on Positive Negative Syndrome Scale, Cognitive Function and Quality of Life in female schizophrenic patients. 50 schizophrenic participants who were diagnosed with semistructured MINI ICD-X, were assigned into two groups received pharmacotherapy. Participants were assigned into each group of therapy by using matched allocation method. Music therapy added on to the first group. They received music therapy, using Mozart Sonata four times a week, over a period of six week. Positive and negative symptoms were measured by using Positive and Negative Syndrome Scale (PANSS). Cognitive function were measured by using Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA). All rating scale were administrated by certified skill residents every week after music therapy session. The participants who were received pharmaco-and-music therapy significantly showed greater response than who received pharmacotherapy only. The mean difference of response were -6,6164 (p=0,001) for PANNS, 2,911 (p=0,004) for MMSE, 3,618 (p=0,001) for MOCA, 4,599 (p=0,001) for SF-36. Music therapy have beneficial effects on PANSS, Cognitive Function and Quality of Life in schizophrenic patients.

Keywords: music therapy, rating scale, schizophrenia, symptoms

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7811 Functional Performance Needs of Individuals with Intellectual and Developmental Disabilities

Authors: Noor Taleb Ismael, Areej Abd Al Kareem Al Titi, Ala'a Fayez Jaber

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Objectives: To investigate self-perceived functional performance among adults with IDD who are Jordanian residential care and rehabilitation centers residents. Also, to investigate their functional abilities (i.e., motor, and cognitive). In addition, to determine the motor and cognitive predictors of their functional performance. Methods: The study utilized a cross-sectional descriptive design; the sample included 180 individuals with IDD (90 males and 90 females) aged 18 to 75 years. The inclusion criteria encompassed: 1) Adults with a confirmed IDD by their physician’s professional and 2) residents in Jordanian Residential Care and Rehabilitation Centers affiliated with the Jordanian Ministry of Social Development. The exclusion criteria were: 1) bedridden or totally dependent on their care providers; 2) who had an accident or acquired neurological conditions. Researchers conducted semi-structured interviews to complete the outcome measures that include the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), the Montreal Cognitive Assessment (MoCA), the Mini-Mental Status Examination (MMSE), and the sociodemographic questionnaire. Data analyses consisted of descriptive statistics, analysis of frequencies, correlation, and regression analyses. Result: Individuals with IDD showed low functional performance in all daily life areas, including self-care, productivity, and leisure; there was severe cognitive impairment and poor independence and functional performance. (COPM Performance M= 1.433, SD±.57021, COPM Satisfaction M= 1.31, SD±.54, FIM M= 3.673, SD± 1.7918). Two predictive models were validated for the COPM performance and FIM total scores. First, significant predictors of high self-perceived functional performance on COPM were high scores on FIM Motor sub scores, FIM cognitive sub scores, young age, and having a high school educational level (R2=0.603, p=0.012). Second, significant predictors of high functional capacity on FIM were a high score on the COPM performance subscale, a high MMSE score, and having a cerebral palsy (CP) diagnosis (R2=0.671, p<0.001). Conclusions: Evaluating functional performance and associated factors is important in rehabilitation to provide better services and improve health and QoL for individuals with IDD. This study suggested conducting future studies targeting integrated individuals with IDD who live with their families in the communities.

Keywords: functional performance, intellectual and developmental disabilty, cognitive abilities, motor abilities

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7810 Biimodal Biometrics System Using Fusion of Iris and Fingerprint

Authors: Attallah Bilal, Hendel Fatiha

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This paper proposes the bimodal biometrics system for identity verification iris and fingerprint, at matching score level architecture using weighted sum of score technique. The features are extracted from the pre processed images of iris and fingerprint. These features of a query image are compared with those of a database image to obtain matching scores. The individual scores generated after matching are passed to the fusion module. This module consists of three major steps i.e., normalization, generation of similarity score and fusion of weighted scores. The final score is then used to declare the person as genuine or an impostor. The system is tested on CASIA database and gives an overall accuracy of 91.04% with FAR of 2.58% and FRR of 8.34%.

Keywords: iris, fingerprint, sum rule, fusion

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7809 Developing of Attitude towards Using Complementary Treatments Scale in Turkey

Authors: Ayşegül Bilge, Merve Uğuryol, Şeyda Dülgerler, Mustafa Yıldız

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The purpose of this research is to prove the Attitude towards Using Complementary Treatments Scale reliability and validity. The research is a methodological type of research that has been planned to determine the validity and reliability of the Attitude towards Using Complementary Treatments Scale. The scale has been developed by the researchers. In the scale, there are 23 questions including complementary and modern therapies individuals apply when they have health problems 4-item Likert-type evaluation has been carried out in preparing the questionnaire. High score obtained from the scale indicates a positive attitude towards complementary therapies. In the course of validity assessment of the scale, expert opinion has been received, and the content validity of the scale has been determined by using Kendall coefficient correlation test (Wa=0.200, p = 0.460). In the course of the reliability assessment of the scale, total score correlations of 23 materials have been examined, and those under 0.20 correlation limit has been removed from the scale correlation. As a result, the scale was left to be 13 items. In the internal consistency tests of the analyses, Cronbach's alpha value has been found to be 0.79. As a result, of the validity analyses of the Attitude towards Using Complementary Treatments Scale, the content and language validity analyses has been found to be at the expected level. It has been determined to be a highly reliable scale as the result of the reliability analyses. In conclusion, Attitude towards Using Complementary Treatments Scale is a valid and reliable scale.

Keywords: alternative health care, complementary treatment, instrument development, nursing practice

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7808 Physiotherapy Program for Frozen Shoulder on Pain, Onset of Symptom and Obtaining Modalities

Authors: Narupon Kunbootsri, J. Kraipoj, K. Phandech, P. Sirasaporn

Abstract:

Physiotherapy is one of the treatments for frozen shoulder but there was no data about the treatment of physiotherapy. Moreover, it is question about onset of symptom before physiotherapy program and obtaining physical modalities and delayed start physiotherapy program lead to delayed improvement. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder on pain score, onset of symptom and obtaining physical modalities. A retrospective study design was conducted. 182 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of onset of symptom, pain score and obtaining physical modalities were recorded. There was a statistically significant improve in pain score, pretreatment score mean 7.24±1.52 and the last follow up pain score mean 3.88± 1.0 [mean difference 3.18 with 95%CI were [2.45- 3.92]. In addition, the onset of symptoms was 145 days before obtaining physiotherapy program. The physical modalities used frequently were hot pack 14.8% and ultrasound diathermy 13.7%. In conclusion, the retrospective study show physiotherapy program including, hot pack and ultrasound diathermy seem to be useful for frozen shoulder in term of pain score. But onset of symptom is too long to start physiotherapy programs.

Keywords: frozen shoulder, physiotherapy, pain score, onset of symptom, physical modality

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7807 Correlation between Clinical Measurements of Static Foot Posture in Young Adults

Authors: Phornchanok Motantasut, Torkamol Hunsawong, Lugkana Mato, Wanida Donpunha

Abstract:

Identifying abnormal foot posture is important for prescribing appropriate management in patients with lower limb disorders and chronic non-specific low back pain. The normalized navicular height truncated (NNHt) and the foot posture index-6 (FPI-6) have been recommended as the common, simple, valid, and reliable static measures for clinical application. The NNHt is a single plane measure while the FPI-6 is a triple plane measure. At present, there is inadequate information about the correlation between the NNHt and the FPI-6 for categorizing foot posture that leads to a difficulty of choosing the appropriate assessment. Therefore, the present study aimed to determine the correlation between the NNHt and the FPI-6 measures in adult participants with asymptomatic feet. Methods: A cross-sectional descriptive study was conducted in 47 asymptomatic individuals (23 males and 24 females) aged 28.89 ± 7.67 years with body mass index 21.73 ± 1.76 kg/m². The right foot was measured twice by the experienced rater using the NNHt and the FPI-6. A sequence of the measures was randomly arranged for each participant with a 10-minute rest between the tests. The Pearson’s correlation coefficient (r) was used to determine the relationship between the measures. Results: The mean NNHt score was 0.23 ± 0.04 (ranged from 0.15 to 0.36) and the mean FPI-6 score was 4.42 ± 4.36 (ranged from -6 to +11). The Pearson’s correlation coefficient among the NNHt score and the FPI-6 score was -0.872 (p < 0.01). Conclusion: The present finding demonstrates the strong correlation between the NNHt and FPI-6 in adult feet and implies that both measures could be substituted for each other in identifying foot posture.

Keywords: foot posture index, foot type, measurement of foot posture, navicular height

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7806 Clinical Prediction Score for Ruptured Appendicitis In ED

Authors: Thidathit Prachanukool, Chaiyaporn Yuksen, Welawat Tienpratarn, Sorravit Savatmongkorngul, Panvilai Tangkulpanich, Chetsadakon Jenpanitpong, Yuranan Phootothum, Malivan Phontabtim, Promphet Nuanprom

Abstract:

Background: Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to developed the prediction score to determine the likelihood of ruptured appendicitis in an Asian population. Methods: This study was diagnostic, retrospectively cross-sectional and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between March 2016 and March 2018. The inclusion criteria were age >15 years and an available pathology report after appendectomy. Clinical factors included gender, age>60 years, right lower quadrant pain, migratory pain, nausea and/or vomiting, diarrhea, anorexia, fever>37.3°C, rebound tenderness, guarding, white blood cell count, polymorphonuclear white blood cells (PMN)>75%, and the pain duration before presentation. The predictive model and prediction score for ruptured appendicitis was developed by multivariable logistic regression analysis. Result: During the study period, 480 patients met the inclusion criteria; of these, 77 (16%) had ruptured appendicitis. Five independent factors were predictive of rupture, age>60 years, fever>37.3°C, guarding, PMN>75%, and duration of pain>24 hours to presentation. A score > 6 increased the likelihood ratio of ruptured appendicitis by 3.88 times. Conclusion: Using the Ramathibodi Welawat Ruptured Appendicitis Score. (RAMA WeRA Score) developed in this study, a score of > 6 was associated with ruptured appendicitis.

Keywords: predictive model, risk score, ruptured appendicitis, emergency room

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7805 The FINDRISC Score for Prediabetes and Diabetes Screening in Adult Libyan Males

Authors: Issam M Hajjaji, Adel Tajoury, Salah R Benhamid

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The MENA region has the highest prevalence of diabetes in the world. Various risk scores were developed, not all appropriate locally. The objective of this study is to apply the FINDRISC Score to adult Libyan males to determine its significance, sensitivity, specificity and Positive Predictive Values as an initial screening tool for type 2 diabetes, and suggest a cut-off point. Methods: 600 subjects answered the questionnaire at their place of work, and their waist, weight, height & BP were measured. Thereafter, after excluding those with known diabetes, an Oral Glucose Tolerance Test was done. Results: 414 subjects aged 19-78 completed the questionnaire and tests. 35 (8.4%) had impaired glucose tolerance (IGT) and 13 (3.1%) had diabetes (DM). The AUC-ROC for IGT was 0.614 (95% CI: 0.527-0.701), for DM 0.810 (95% CI: 0.709-0.911) and for both 0.689 (95% CI: 0.609-0.769). The Positive Predictive Value for a cut-off score of 5 were 15.5%, 11.7% & 5.7% for both conditions combined, prediabetes & diabetes respectively. The equivalent values for a cut-off score of 8 were 16.1%, 9.0% & 7.7%. The Negative Predictive Values were uniformly above 90%. Conclusions & Recommendations: The FINDRISC Score had a low predictive value for dysglycaemia in this sample and performed at a level of significance for IGT that is similar to other MENA countries, but did better for DM. A larger sample that included women is suggested, with a view of adjusting the Score to suit the local population.

Keywords: diabetes, FINDRISK, Libya, prediabetes

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7804 Level of Gross Motor Development and Age Equivalents of Children 9 Years

Authors: Masri Baharom

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The purpose of the study is to identify the age group of children 9 who have experienced delays in gross motor development. Instrument used in this study is Test Gross Motor Development / TGMD-2 (Ulrich, 2000) which was adopted at the international level. Gross motor development data were obtained by video recording (Sony (DRC-SR42 with a 40x optical zoom capability, and software Ultimate Studio 14) on locomotor and manipulative skills. A total n = 192 persons, children of 9 years (9.30 ± .431) at Sekolah Kebangsaan Mutiara Perdana, Bayan Lepas, Penang were involved as subjects. Children age 9 years experienced delays AELS (4.61 ± .69), AEMS (5:52 ± .62) and GMDQ (7.26 ± .2.14). The findings based on descriptive rating indicated that the performance of children age 9 years acquired low levels of AELS, MSS, AEMS and very low in LSS and GMDS.

Keywords: gross motor development score, locomotor standard score, age equivalent locomotor score, manipulative standard score, age equivalent manipulative score

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7803 Addressing the Oracle Problem: Decentralized Authentication in Blockchain-Based Green Hydrogen Certification

Authors: Volker Wannack

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The aim of this paper is to present a concept for addressing the Oracle Problem in the context of hydrogen production using renewable energy sources. The proposed approach relies on the authentication of the electricity used for hydrogen production by multiple surrounding actors with similar electricity generation facilities, which attest to the authenticity of the electricity production. The concept introduces an Authenticity Score assigned to each certificate, as well as a Trust Score assigned to each witness. Each certificate must be attested by different actors with a sufficient Trust Score to achieve an Authenticity Score above a predefined threshold, thereby demonstrating that the produced hydrogen is indeed "green."

Keywords: hydrogen, blockchain, sustainability, structural change

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7802 Knowledge, Attitude, and Practice of Medical Ethics amongst Paediatric Surgeons and Trainees in Malaysia

Authors: Salehah Tahkin, Norlaila Mustafa, Dayang Anita Abdul Aziz

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Knowledge of medical ethics is important to all practitioners so the best care can be delivered to all patients through safe practice. Surgeons are not exceptions to this. Knowledge, attitude, and practice (KAP) of medical ethics among paediatric surgeons and trainees in Malaysia has not been evaluated before. This study aims to determine the level of KAP regarding medical ethics among these groups. This was a cross-sectional study involving three groups of samples, i.e., paediatric surgeons (PS), paediatric surgical trainees (PST), and medical officers with a special interest in paediatric surgery (MO). A validated KAP questionnaire was used. Standard formulas were used to calculate objective indexes for measuring KAP, which were then compared for statistical significance across different sample groups; p less than 0.05 is taken as significant. The index is rated into 5 classes using a score of 0 to 10, i.e., poor (1-2.99), fair (3-4.99), good (5-6.99), very good (7-8.99), and excellent (9-10). There were 117 samples, i.e., PS n=45 (38.5%), PST n=25 (21.3%), and MO n=47 (40.2%). For knowledge, all three groups display a good index score (mean score of 5.44). For attitude, PS and MO also display an index score of good (mean score of 5.81), while the PST index score was fair (4.82). For practice, our study shows a highest score of 7.14 (very good) among PST. However, these differences were not statistically significant (p> 0.05). Conclusion: Training in paediatric surgery must continue to emphasize professionalism and medical ethics education to deliver the best health care services.

Keywords: KAP, medical ethics, paediatric, surgeons, trainees

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7801 Numerical Analysis of Mandible Fracture Stabilization System

Authors: Piotr Wadolowski, Grzegorz Krzesinski, Piotr Gutowski

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The aim of the presented work is to recognize the impact of mini-plate application approach on the stress and displacement within the stabilization devices and surrounding bones. The mini-plate osteosynthesis technique is widely used by craniofacial surgeons as an improved replacement of wire connection approach. Many different types of metal plates and screws are used to the physical connection of fractured bones. Below investigation is based on a clinical observation of patient hospitalized with mini-plate stabilization system. Analysis was conducted on a solid mandible geometry, which was modeled basis on the computed tomography scan of the hospitalized patient. In order to achieve most realistic connected system behavior, the cortical and cancellous bone layers were assumed. The temporomandibular joint was simplified to the elastic element to allow physiological movement of loaded bone. The muscles of mastication system were reduced to three pairs, modeled as shell structures. Finite element grid was created by the ANSYS software, where hexahedral and tetrahedral variants of SOLID185 element were used. A set of nonlinear contact conditions were applied on connecting devices and bone common surfaces. Properties of particular contact pair depend on screw - mini-plate connection type and possible gaps between fractured bone around osteosynthesis region. Some of the investigated cases contain prestress introduced to the mini-plate during the application, what responds the initial bending of the connecting device to fit the retromolar fossa region. Assumed bone fracture occurs within the mandible angle zone. Due to the significant deformation of the connecting plate in some of the assembly cases the elastic-plastic model of titanium alloy was assumed. The bone tissues were covered by the orthotropic material. As a loading were used the gauge force of magnitude of 100N applied in three different locations. Conducted analysis shows significant impact of mini-plate application methodology on the stress distribution within the miniplate. Prestress effect introduces additional loading, which leads to locally exceed the titanium alloy yield limit. Stress in surrounding bone increases rapidly around the screws application region, exceeding assumed bone yield limit, what indicate the local bone destruction. Approach with the doubled mini-plate shows increased stress within the connector due to the too rigid connection, where the main path of loading leads through the mini-plates instead of plates and connected bones. Clinical observations confirm more frequent plate destruction of stiffer connections. Some of them could be an effect of decreased low cyclic fatigue capability caused by the overloading. The executed analysis prove that the mini-plate system provides sufficient support to mandible fracture treatment, however, many applicable solutions shifts the entire system to the allowable material limits. The results show that connector application with the initial loading needs to be carefully established due to the small material capability tolerances. Comparison to the clinical observations allows optimizing entire connection to prevent future incidents.

Keywords: mandible fracture, mini-plate connection, numerical analysis, osteosynthesis

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7800 Diagnostic Yield of CT PA and Value of Pre Test Assessments in Predicting the Probability of Pulmonary Embolism

Authors: Shanza Akram, Sameen Toor, Heba Harb Abu Alkass, Zainab Abdulsalam Altaha, Sara Taha Abdulla, Saleem Imran

Abstract:

Acute pulmonary embolism (PE) is a common disease and can be fatal. The clinical presentation is variable and nonspecific, making accurate diagnosis difficult. Testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly CT and D-dimer measurement, may not improve care while potentially leading to patient harm and unnecessary expense. CTPA is the investigation of choice for PE. Its easy availability, accuracy and ability to provide alternative diagnosis has lowered the threshold for performing it, resulting in its overuse. Guidelines have recommended the use of clinical pretest probability tools such as ‘Wells score’ to assess risk of suspected PE. Unfortunately, implementation of guidelines in clinical practice is inconsistent. This has led to low risk patients being subjected to unnecessary imaging, exposure to radiation and possible contrast related complications. Aim: To study the diagnostic yield of CT PA, clinical pretest probability of patients according to wells score and to determine whether or not there was an overuse of CTPA in our service. Methods: CT scans done on patients with suspected P.E in our hospital from 1st January 2014 to 31st December 2014 were retrospectively reviewed. Medical records were reviewed to study demographics, clinical presentation, final diagnosis, and to establish if Wells score and D-Dimer were used correctly in predicting the probability of PE and the need for subsequent CTPA. Results: 100 patients (51male) underwent CT PA in the time period. Mean age was 57 years (24-91 years). Majority of patients presented with shortness of breath (52%). Other presenting symptoms included chest pain 34%, palpitations 6%, collapse 5% and haemoptysis 5%. D Dimer test was done in 69%. Overall Wells score was low (<2) in 28 %, moderate (>2 - < 6) in 47% and high (> 6) in 15% of patients. Wells score was documented in medical notes of only 20% patients. PE was confirmed in 12% (8 male) patients. 4 had bilateral PE’s. In high-risk group (Wells > 6) (n=15), there were 5 diagnosed PEs. In moderate risk group (Wells >2 - < 6) (n=47), there were 6 and in low risk group (Wells <2) (n=28), one case of PE was confirmed. CT scans negative for PE showed pleural effusion in 30, Consolidation in 20, atelactasis in 15 and pulmonary nodule in 4 patients. 31 scans were completely normal. Conclusion: Yield of CT for pulmonary embolism was low in our cohort at 12%. A significant number of our patients who underwent CT PA had low Wells score. This suggests that CT PA is over utilized in our institution. Wells score was poorly documented in medical notes. CT-PA was able to detect alternative pulmonary abnormalities explaining the patient's clinical presentation. CT-PA requires concomitant pretest clinical probability assessment to be an effective diagnostic tool for confirming or excluding PE. . Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Combining Wells scores with clinical and laboratory assessment may reduce the need for CTPA.

Keywords: CT PA, D dimer, pulmonary embolism, wells score

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7799 Regional Disparities in the Level of Education in West Bengal

Authors: Nafisa Banu

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The present study is an attempt to analyze the regional disparities in the level of education in West Bengal. The data based on secondary sources obtained from a census of India. The study is divided into four sections. The first section presents introductions, objectives and brief descriptions of the study area, second part discuss the methodology and data base, while third and fourth comprise the empirical results, interpretation, and conclusion respectively. For showing the level of educational development, 8 indicators have been selected and Z- score and composite score techniques have been applied. The present study finds out there are large variations of educational level due to various historical, economical, socio-cultural factors of the study area.

Keywords: education, regional disparity, literacy rate, Z-score, composite score

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7798 Immunity Boosting and Balanced Diet Prevents Viral Infections with Special Emphasis on COVID-19

Authors: K. R. Padma, K. R. Don

Abstract:

Background and aims: A balanced nutritional diet is essential in maintaining immunity and for deterrence as well as desisting of viral infections. Nevertheless, currently, very less information is available online regarding nutrition consumption during the period of coronavirus infection, i.e. (COVID-19). In our systematic review article, we portrayed and aimed to evaluate evidence from various previous clinical trials, which was based on nutritional interventions for viral diseases and given a concise overview. Methods: A systematic search was carried out employing 3 key medical databases: PubMed®, Web of Science®, and SciVerse Scopus®. Studies were performed and evaluated suitable if clinical trials in humans, appropriate immunological parameters on viral and respiratory infections, need to perform. Basic Clinical trials on nutritional vitamins, minerals, nutraceuticals as well as probiotics were included. Results: We have explored 10 review articles and extracted data for our study. A total of > 2000 participants were included and excluded several other trace elements as well as various vitamins, but in inclusion criteria mainly concentrated on those who have shown propitious immune-modulatory effects against viral respiratory infections. Conclusions: We have encapsulated the potential health benefits of some minerals, vitamins, as well as certain designer foods, nutraceuticals, and probiotics in viral infections. Based on this nutritional interventional strategy available from our present data, it could be promising to abstain and reduce the COVID-19 infection replication and boost our immunity to fight against the virus.

Keywords: COVID-19, immunity, vitamins, nutritional intervention strategy

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7797 Italian Central Guarantee Fund: An Analysis of the Guaranteed SMEs’ Default Risk

Authors: M. C. Arcuri, L. Gai, F. Ielasi

Abstract:

Italian Central Guarantee Fund (CGF) has the purpose to facilitate Small and Medium-sized Enterprises (SMEs)’ access to credit. The aim of the paper is to study the evaluation method adopted by the CGF with regard to SMEs requiring its intervention. This is even more important in the light of the recent CGF reform. We analyse an initial sample of more than 500.000 guarantees from 2012 to 2018. We distinguish between a counter-guarantee delivered to a mutual guarantee institution and a guarantee directly delivered to a bank. We investigate the impact of variables related to the operations and the SMEs on Altman Z’’-score and the score consistent with CGF methodology. We verify that the type of intervention affects the scores and the initial condition changes with the new assessment criterions. 

Keywords: banks, default risk, Italian guarantee fund, mutual guarantee institutions

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7796 Nutrition Role in the Management of Psychiatric Disorders

Authors: Abeer Mohammed, Nevein Mustafa Elashery, Mona Hassan Abdel Aal, Ereny Wilson Nagib

Abstract:

The Aim of the current study is to investigate nutrition role in the management of psychiatric disorders. Research Design: A quasi- experimental research design was utilized for this study. Setting The study was conducted at outpatient clinic at Institute of Psychiatry affiliated to Ain Shams University hospitals, using a convenient sample of 50 psychiatric patients with depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders. Tools: data were collected through; first, an interview questionnaire covering socio-demographic characteristics, second, nutrition assessment tools Third, nutrition risk assessment. Fourth, nutrition management program Results showed that there were highly statistically significant improvements in modified nutritional supplements for patients with depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders' patients after conducting the nutrition management program. Regarding psychiatric patients’ knowledge about healthy food, healthy nutritional habits, and patients’ awareness & readiness for change, there were highly statistically significant improvements. Concerning signs and symptoms of psychiatric disorders, there were highly statistically significant improvements for depression, schizophrenia, bipolar disorders, and obsessive-compulsive patients after conducting the management program. In conclusion, the nutrition management program was effective in improving symptoms associated with, depression, schizophrenia, bipolar disorders, and obsessive compulsive disorders. The study recommended that nurses should have more contribution in counseling psychiatric patients, and their families about healthy diet and healthy habits. Further research should recommend studying the effectiveness of herbs on enhancing mental health for psychiatric patients.

Keywords: nutrition, role, management, psychiatric disorders

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7795 Level Of Gross Motor Development And Age Equivalents Of 9-Year-Old Children

Authors: Ahmad Hashim, Masri Baharom

Abstract:

The purpose of the study is to identify the age group of children 9 who have experienced delays in gross motor development. Instrument used in this study is Test Gross Motor Development / TGMD-2 (Ulrich, 2000) which was adopted at the international level. Gross motor development data were obtained by video recording (Sony (DRC-SR42 with a 40x optical zoom capability, and software Ultimate Studio 14) on locomotor and manipulative skills. A total n = 192 persons, children of 9 years (9.30 ± .431) at Sekolah Kebangsaan Mutiara Perdana, Bayan Lepas, Penang were involved as subjects. Children age 9 years experienced delays AELS (4.61 ± .69), AEMS (5:52 ± .62) and GMDQ (7.26 ± .2.14). The findings based on descriptive rating indicated that the performance of children age 9 years acquired low levels of AELS, MSS, AEMS and very low in LSS and GMDS.

Keywords: gross motor development score, locomotor standard score, age equivalent locomotor score, manipulative standard score, age equivalent manipulative score

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7794 Effect of Golden Oyster Mushroom (Pleurotus citrinopileatus) Powder on Physiochemical, Antioxidative, and Sensory Properties of Noodles

Authors: Giap Pham Ngoc Tram, Tran Hong Quan, Tran Tieu Yen, Nguyen Phung Tien

Abstract:

The use of natural ingredients to enhance the nutritional and sensory properties of food products has gained significant interest in recent years. This study focuses on the effect of Golden oyster mushroom powder (GOMP) on the physiochemical, antioxidative, and sensory properties of noodles. The aim of this study is to investigate the influence of GOMP on the nutritional, antioxidant, and sensory properties of noodles. The study determined the color, moisture, total ash, protein, total phenolic, flavonoid contents, water activity, and antioxidant activity of GOMP and noodles. The incorporation of GOMP at levels of 5-15% increased the ash, protein, flavonoid, and total phenolic contents of the noodles. It also enhanced their antioxidant activities, as evidenced by improved DPPH radical scavenging activity and metal chelating activity. However, the incorporation of GOMP resulted in a decrease in the L* and b* values of the noodles. Furthermore, the GOMP-enriched noodles exhibited a lower cutting force compared to the control. This study highlights the potential of GOMP as a nutritional and antioxidant ingredient in noodle preparation. It adds to the existing literature by providing evidence of the positive effects of GOMP on the nutritional and functional properties of noodles. The researchers collected data on the physiochemical properties, nutritional contents, and antioxidant activities of GOMP and noodles. Statistical analysis was then performed to assess the differences between the control and GOMP-enriched noodles. The results of this study demonstrate that the inclusion of GOMP at the amount of 5-15% can increase the nutritional and antioxidant properties of noodles without significantly impacting sensory attributes.

Keywords: oyster mushroom, noodles, antioxidant activity, phytochemical, sensory property

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7793 Development of a Novel Score for Early Detection of Hepatocellular Carcinoma in Patients with Hepatitis C Virus

Authors: Hatem A. El-Mezayen, Hossam Darwesh

Abstract:

Background/Aim: Hepatocellular carcinoma (HCC) is often diagnosed at advanced stage where effective therapies are lacking. Identification of new scoring system is needed to discriminate HCC patients from those with chronic liver disease. Based on the link between vascular endothelial growth factor (VEGF) and HCC progression, we aimed to develop a novel score based on combination of VEGF and routine laboratory tests for early prediction of HCC. Methods: VEGF was assayed for HCC group (123), liver cirrhosis group (210) and control group (50) by Enzyme Linked Immunosorbent Assay (ELISA). Data from all groups were retrospectively analyzed including α feto protein (AFP), international normalized ratio (INR), albumin and platelet count, transaminases, and age. Areas under ROC curve were used to develop the score. Results: A novel index named hepatocellular carcinoma-vascular endothelial growth factor score (HCC-VEGF score)=1.26 (numerical constant) + 0.05 ×AFP (U L-1)+0.038 × VEGF(ng ml-1)+0.004× INR –1.02 × Albumin (g l-1)–0.002 × Platelet count × 109 l-1 was developed. HCC-VEGF score produce area under ROC curve of 0.98 for discriminating HCC patients from liver cirrhosis with sensitivity of 91% and specificity of 82% at cut-off 4.4 (ie less than 4.4 considered cirrhosis and greater than 4.4 considered HCC). Conclusion: Hepatocellular carcinoma-VEGF score could replace AFP in HCC screening and follow up of cirrhotic patients.

Keywords: Hepatocellular carcinoma, cirrhosis, HCV, diagnosis, tumor markers

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7792 Assessment of Proximate Composition and Heavy Metal in Vigna unguculata (White Beans) Sold in Kazaure Market, Jigawa State, Nigeria

Authors: Abdu Umar Adamu, Saidu Akun Abdullahi, Al-Hassan Muhammed, Hamisu Abdu

Abstract:

Leguminous plants such as beans have been considered as a source of protein in this present work. The proximate analysis on beans (Vigna unguiculata) were determined in order to identify the nutritional content as well as presence of some heavy metals accumulation in washed and unwashed beans (white Beans) sold in Kazaure market Jigawa State Nigeria. On the average comparative analysis, the result has indicated that, the Vigna unguiculata had protein content of 61.1%, fibre 4.5%, ash 10.4%, moisture 5%, carbohydrate 15.8% and total lipid 4.9%, therefore it could be suggested that beans has enough nutritional content that helps the people health. The heavy metal analysis of unwashed white beans showed that Fe (17.37 ± 6.71)mg/kg had the highest concentration followed by Zn (6.41 ± 3.09), Cu (5.69 ± 2.42), Cd (0.46 ± 0.65) and Pb (0.57 ± 0.94)mg/kg , while the washed beans shows that Zn (0.11 ± 0.17), Fe (0.01 ± 0.006), Cd (0.02 ± 0.01), Cu (0.03 ± 0.021), Pb (0.01 ± 0.006)mg/kg. The washed white beans are safe for consumption and also the concentration of heavy metal are negligible and of nontoxic effect to human health.

Keywords: white beans, protein, proximate composition, heavy metal

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7791 Shoulder-Arm Mobility and Upper and Lower Extremity Muscle Function are Impaired in Patients with Systemic Sclerosis

Authors: F. Bringby, A. Nordin, L. Björnådal, E. Svenungsson, C. Boström, H Alexanderson

Abstract:

Patients with systemic sclerosis (SSc) have reduced hand function and self-reported limitations in daily activities. Few studies have explored limitations in shoulder-arm mobility and muscle function, or if there are differences in physical function between diffuse cutaneous (dcSSc) and limited cutaneous (lcSSc) SSc. The purpose of this study was to describe objectively assessed shoulder-arm mobility, lower extremity muscle function and muscle endurance in SSc and evaluate possible differences between lcSSc and dcSSc. 121 patients with SSc were included in this cross sectional study. Shoulder-arm mobility were examined using the Shoulder Function Assessment Scale (SFA) including 5 tasks ,lower extremity muscle function was measured by Timed stands test (TST) and muscle endurance in shoulder- and hip flexors were assessed by the Functional Index 2 (FI-2). Patients with dcSSc had median SFA hand to back score 5 (4-6) and median “hand to seat” score of 5 (4-6) compared to patients with lcSSc with corresponding median values of 6 (4-6) and 6 (5-6) respectively (p<0.01-p<0.05). 50% of both patientsgroups had lower muscle function assessed by the TST compared to age- and gender matched reference values but there were no differences in TST between the two patient groups. There was no difference in FI-2 scores between dcSSc and lcSSc. The whole group had 40 (28-83) % and 38 (32-72) % of maximal FI-2 shoulder flexion score on the right and left sides, and 40 (23-63) % and 37 (23-62) % of maximal FI-2 hip flexion score on the right and left sides. Reference values for the FI-2 indicate that healthy individuals perform in mean 100 % of maximal score. Patients with dcSSc were more limited than patients with lcSSc. Patients with SSc have reduced muscle function compared to reference values. These results highlights the importance of assessing shoulder-arm mobility and muscle function as well as a need for further research to identify exercise interventions to target these limitations.

Keywords: diffuse, limited, mobility, muscle function, physical therapy, systemic sclerosis

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7790 Effectively Improving Cognition, Behavior, and Attitude of Diabetes Inpatients through Nutritional Education

Authors: Han Chih Feng, Yi-Cheng Hou, Jing-Huei Wu

Abstract:

Diabetes is a chronic disease. Nutrition knowledge and skills enable individuals with type 2 diabetes to optimize metabolic self-management and quality of life. This research studies the effect of nutritional education on diabetes inpatients in terms of their cognition, behavior, and attitude. The participants are inpatients diagnosed with diabetes at Taipei Tzu Chi Hospital. A total of 103 participants, 58 male, and 45 females, enrolled in the research between January 2018 and July 2018. The research evaluates cognition, behavior, and attitude level before and after nutritional education conducted by dietitians. The result shows significant improvement in actual consumption (2.5 ± 1.4 vs 3.8 ± 0.7; p<.001), diet control motivation (2.7 ± 0.8 vs 3.4 ± 0.6; p<.001), correct nutrition concept (1.2± 0.4 vs 2.4 ± 0.5; p<.001), learning willingness (2.7± 0.9 vs 3.4 ± 0.6; p<.001), cognitive behaviors (1.4 ± 0.5 vs 2.9 ± 0.7; p<.001). AC sugar (278.5 ± 321.5 vs 152.2 ± 49.1; p<.001) and HbA1C (10.3 ± 2.6 vs 8.6 ± 1.9; p<.001) are significant improvement after nutritional education. After nutritional education, participants oral hypoglycemic agents increased from 16 (9.2%) to 33 (19.0%), insulin decreased from 75 (43.1%) to 68 (39.1%), and hypoglycemic drugs combined with insulin decreased from 83 (47.7%) to 73 (42.0%).Further analysis shows that female inpatients have significant improvement in diet control motivation (3.91 ± 0.85 vs 4.44 ± 0.59; p<0.000), correct nutrition concept (3.24± 0.48 vs 4.47± 0.51; p<0.000), learning willingness (3.89 ± 0.86 vs 4.44 ± 0.59; p<0.000) and cognitive behaviors (2.42 ± 0.58 vs 4.02 ± 0.69; p<0.000); male inpatients have significant improvement in actual food intake (4.41± 0.92 vs 3.97 ± 0.42; p<0.000), diet control motivation (3.62 ± 0.86 vs 4.29 ± 0.62; p<0.000), correct nutrition concept (3.26 ± 0.44 vs 4.36 ± 0.49; p<0.000), learning willingness (3.72± 0.93 vs 4.33± 0.63; p<0.000) and cognitive behaviors (2.45± 0.54 vs 4.03± 0.77; p<0.000). In conclusion, nutritional education proves effective, regardless of gender, in improving an inpatient’s cognition, behavior, and attitude toward diabetes self-management.

Keywords: diabetes, nutrition education, actual consumption, diet control motivation, nutrition concept, learning willingness, cognitive behaviors

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