Search results for: mood repair
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 770

Search results for: mood repair

590 Immunomodulation by Interleukin-10 Therapy in Mouse Airway Transplantation

Authors: Mohammaad Afzal Khan, Ghazi Abdulmalik Ashoor , Fatimah Alanazi, Talal Shamma, Abdullah Altuhami, Hala Abdalrahman Ahmed, Abdullah Mohammed Assiri, Dieter Clemens Broering

Abstract:

Microvascular injuries during inflammation are key causes of transplant malfunctioning and permanent failure, which play a major role in the development of chronic rejection of the transplanted organ. Inflammation-induced microvascular loss is a promising area to investigate the decisive roles of regulatory and effector responses. The present study was designed to investigate the impact of IL-10 on immunotolerance, in particular, the microenvironment of the allograft during rejection. Here, we investigated the effects of IL-10 blockade/ reconstitution and serially monitored regulatory T cells (Tregs), graft microvasculature, and airway epithelium in rejecting airway transplants. We demonstrated that the blocking/reconstitution of IL-10 significantly modulates CD4+FOXP3+ Tregs, microvasculature, and airway epithelium during rejection. Our findings further highlighted that blockade of IL-10 upregulated proinflammatory cytokines, IL-2, IL-1β, IFN-γ, IL-15, and IL-23, but suppressed IL-5 secretion during rejection; however, reconstitution of IL-10 significantly upregulated CD4+FOXP3+ Tregs, tissue oxygenation/blood flow and airway repair. Collectively, these findings demonstrate a potential reparative modulation of IL-10 during microvascular and epithelial repair, which could provide a vital therapeutic window to rejecting transplants in clinical practice.

Keywords: interleukin -10, regulatory T cells, allograft rejection, immunotolerance

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589 Fill Rate Window as a Criterion for Spares Allocation

Authors: Michael Dreyfuss, Yahel Giat

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Limited battery range and long recharging times are the greatest obstacles to the successful adoption of electric cars. One of the suggestions to overcome these problems is that carmakers retain ownership of batteries and provide battery swapping service so that customers exchange their depleted batteries for recharged batteries. Motivated by this example, we consider the problem of optimal spares allocation in an exchangeable-item, multi-location repair system. We generalize the standard service measures of fill rate and average waiting time to reflect the fact that customers penalize the service provider only if they have to wait more than a ‘tolerable’ time window. These measures are denoted as the window fill rate and the truncated waiting time, respectively. We find that the truncated waiting time is convex and therefore a greedy algorithm solves the spares allocation problem efficiently. We show that the window fill rate is generally S-shaped and describe an efficient algorithm to find a near-optimal solution and detail a priori and a posteriori upper bounds to the distance from optimum. The theory is complemented with a large scale numerical example demonstrating the spare battery allocation in battery swapping stations.

Keywords: convex-concave optimization, exchangeable item, M/G/infinity, multiple location, repair system, spares allocation, window fill rate

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588 A Concept to Assess the Economic Importance of the On-Site Activities of ETICS

Authors: V. Sulakatko, F. U. Vogdt, I. Lill

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Construction technology and on-site construction activities have a direct influence on the life cycle costs of energy efficiently renovated apartment buildings. The systematic inadequacies of the External Thermal Insulation Composite System (ETICS) which occur during the construction phase increase the risk for all stakeholders, reduce mechanical durability and increase the life cycle costs of the building. The economic effect of these shortcomings can be minimised if the risk of the most significant on-site activities is recognised. The objective of the presented ETICS economic assessment concept is to evaluate the economic influence of on-site shortcomings and reveal their significance to the foreseeable future repair costs. The model assembles repair techniques, discusses their direct cost calculation methods, argues over the proper usage of net present value over the life cycle of the building, and proposes a simulation tool to evaluate the risk of on-site activities. As the technique is dependent on the selected real interest rate, a sensitivity analysis is anticipated to determine the validity of the recommendations. After the verification of the model on the sample buildings by the industry, it is expected to increase economic rationality of resource allocation and reduce high-risk systematic shortcomings during the construction process of ETICS.

Keywords: activity-based cost estimating, cost estimation, ETICS, life cycle costing

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587 Traumatic Brachiocephalic Artery Pseudoaneurysm

Authors: Sally Shepherd, Jessica Wong, David Read

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Traumatic brachiocephalic artery aneurysm is a rare injury that typically occurs as a result of a blunt chest injury. A 19-year-old female sustained a head-on, high speed motor vehicle crash into a tree. Upon release after 45 minutes of entrapment, she was tachycardic but normotensive, with a significant seatbelt sign across her chest and open deformed right thigh with weak pulses in bilateral lower limbs. A chest XR showed mild upper mediastinal widening. A CT trauma series plus gated CT chest revealed a grade 3a aortic arch transection with brachiocephalic pseudoaneurysm. Endovascular repair of the brachiocephalic artery was attempted post-presentation but was unsuccessful as the first stent migrated to the infrarenal abdominal aorta and the second stent across the brachiocephalic artery origin had a persistent leak at the base. She was transferred to Intensive Care for strict blood pressure control. She returned to theatre 5 hours later for a median sternotomy, aortic arch repair with an 8mm graft extraction, and excision of the innominate artery pseudoaneurysm. She had an uncomplicated post-operative recovery. This case highlights that brachiocephalic artery injury is a rare but potentially lethal injury as a result of blunt chest trauma. Safe management requires a combined Vascular and Cardiothoracic team approach, as stenting alone may be insufficient.

Keywords: blunt chest injury, Brachiocephalic aneurysm, innominate artery, trauma

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586 Executive Deficits in Non-Clinical Hoarders

Authors: Thomas Heffernan, Nick Neave, Colin Hamilton, Gill Case

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Hoarding is the acquisition of and failure to discard possessions, leading to excessive clutter and significant psychological/emotional distress. From a cognitive-behavioural approach, excessive hoarding arises from information-processing deficits, as well as from problems with emotional attachment to possessions and beliefs about the nature of possessions. In terms of information processing, hoarders have shown deficits in executive functions, including working memory, planning, inhibitory control, and cognitive flexibility. However, this previous research is often confounded by co-morbid factors such as anxiety, depression, or obsessive-compulsive disorder. The current study adopted a cognitive-behavioural approach, specifically assessing executive deficits and working memory in a non-clinical sample of hoarders, compared with non-hoarders. In this study, a non-clinical sample of 40 hoarders and 73 non-hoarders (defined by The Savings Inventory-Revised) completed the Adult Executive Functioning Inventory, which measures working memory and inhibition, Dysexecutive Questionnaire-Revised, which measures general executive function and the Hospital Anxiety and Depression Scale, which measures mood. The participant sample was made up of unpaid young adult volunteers who were undergraduate students and who completed the questionnaires on a university campus. The results revealed that, after observing no differences between hoarders and non-hoarders on age, sex, and mood, hoarders reported significantly more deficits in inhibitory control and general executive function when compared with non-hoarders. There was no between-group difference on general working memory. This suggests that non-clinical hoarders have a specific difficulty with inhibition-control, which enables you to resist repeated, unwanted urges. This might explain the hoarder’s inability to resist urges to buy and keep items that are no longer of any practical use. These deficits may be underpinned by general executive function deficiencies.

Keywords: hoarding, memory, executive, deficits

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585 The Strategies and Mediating Processes of Learning the Inflectional Morphology in English: A Case Study for Taiwanese English Learners

Authors: Hsiu-Ling Hsu, En-Minh (John) Lan

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Pronunciation has received more and more language researchers’ and teachers’ attention because it is important for effective or even successful communication. How to consistently and correctly orally produce verbal morphology, such as English regular past tense inflection, has been a big challenge and troublesome for FL learners. The research aims to explore EFL (English as a foreign language) learners’ developmental trajectory of the inflectional morphology, that is, what mediating processes and strategies EFL learners use, to attain native-like prosodic structure of inflectional morphemes (e.g., –ed and –s suffixes) by comparing the differences among EFL learners at different English levels. This research adopted a self-repair analysis and Prosodic Transfer Hypothesis with three developmental stages as a theoretical framework. To answer the research questions, we conducted two experiments, grammatical tense test written production (Experiment 1) and read-aloud oral production (Experiment 2), and recruited 30 participants who were divided into three groups, low-, middle-, and advanced EFL learners. Experiment 1 was conducted to ensure that participants had learned the knowledge of forming the English regular past tense rules and Experiment 2 was carried out to compare the data across FL English learner groups at different English levels. The EFL learners’ self-repair data showed at least four interesting findings. First, low achievers were more sensitive to the plural suffix -s than the past tense suffix -ed. Middle achievers exhibited a greater responsiveness to the past tense suffix, while high achievers demonstrated equal sensitivity to both suffixes. Additionally, two strategies used by EFL English learners to produce verbs and nouns with inflectional morphemes were to delete internal syllable and to divide a four-syllable verb (e.g., ‘graduated’) into two prosodic structures (e.g., ‘gradu’ and ‘ated’ or ‘gradua’ and ‘ted’). Third, true vowel epenthesis was found only in the low EFL achievers. Moreover fortition (native-like sound) was observed in the low and middle EFL achievers. These findings and self-repair data disclosed mediating processes between the developmental stages and provided insight on how Taiwan EFL learners attained the adjunction prosodic structures of inflectional Morphemes in English.

Keywords: inflectional morphology, prosodic structure, developmental trajectory, strategies and mediating processes, English as a foreign language

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584 Evaluation of the Impact of Neuropathic Pain on the Quality of Life of Patients

Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani

Abstract:

Introduction: Neuropathic pain (NP) is chronic pain; it can be observed in a large number of clinical situations. This pain results from a lesion of the peripheral or central nervous system. It is a frequent reason for consultations in rheumatology. This pain being chronic, can become disabling for the patient, thereby altering his quality of life. Objective: The objective of this study was to evaluate the impact of neuropathic pain on the quality of life of patients followed-up for chronic neuropathic pain. Material and Method: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the hospital anxiety, and depression scale (HAD) score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. Results: A total of 1528 patient data were collected; the average age of the patients was 57 years (standard deviation: 13 years) with extremes ranging from 17 years to 94 years, 91% were women and 9% men with a sex ratio man/woman equal to 0.10. 67% of our patients were married, and 63% of our patients were housewives. 43% of patients were followed-up for degenerative pathology. The NP was cervical radiculopathy in 26%, lumbosacral radiculopathy in 51%, and carpal tunnel syndrome in 20%. 23% of our patients had poor sleep quality, and 54% had average sleep quality. The pain was very intense in 5% of patients; 33% had severe pain, and 58% had moderate pain. The function was limited in 55% of patients. The average HAD score for anxiety and depression was 4.39 (standard deviation: 2.77) and 3.21 (standard deviation: 2.89), respectively. Conclusion: Our data clearly illustrate that neuropathic pain has a negative impact on the quality of sleep and function, as well as the mood of patients, thus influencing their quality of life.

Keywords: neuropathic pain, sleep, quality of life, chronic pain

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583 Torsional Behavior of Reinforced Concrete (RC) Beams Strengthened by Fiber Reinforced Cementitious Materials– a Review

Authors: Sifatullah Bahij, Safiullah Omary, Francoise Feugeas, Amanullah Faqiri

Abstract:

Reinforced concrete (RC) is commonly used material in the construction sector, due to its low-cost and durability, and allowed the architectures and designers to construct structural members with different shapes and finishing. Usually, RC members are designed to sustain service loads efficiently without any destruction. However, because of the faults in the design phase, overloading, materials deficiencies, and environmental effects, most of the structural elements will require maintenance and repairing over their lifetime. Therefore, strengthening and repair of the deteriorated and/or existing RC structures are much important to extend their life cycle. Various techniques are existing to retrofit and strengthen RC structural elements such as steel plate bonding, external pre-stressing, section enlargement, fiber reinforced polymer (FRP) wrapping, etc. Although these configurations can successfully improve the load bearing capacity of the beams, they are still prone to corrosion damage which results in failure of the strengthened elements. Therefore, many researchers used fiber reinforced cementitious materials due to its low-cost, corrosion resistance, and result in improvement of the tensile and fatigue behaviors. Various types of cementitious materials have been used to strengthen or repair structural elements. This paper has summarized to accumulate data regarding on previously published research papers concerning the torsional behaviors of RC beams strengthened by various types of cementitious materials.

Keywords: reinforced concrete beams, strengthening techniques, cementitious materials, torsional strength, twisting angle

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582 Comet Assay: A Promising Tool for the Risk Assessment and Clinical Management of Head and Neck Tumors

Authors: Sarim Ahmad

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The Single Cell Gel Electrophoresis Assay (SCGE, known as comet assay) is a potential, uncomplicated, sensitive and state-of-the-art technique for quantitating DNA damage at individual cell level and repair from in vivo and in vitro samples of eukaryotic cells and some prokaryotic cells, being popular in its widespread use in various areas including human biomonitoring, genotoxicology, ecological monitoring and as a tool for research into DNA damage or repair in different cell types in response to a range of DNA damaging agents, cancer risk and therapy. The method involves the encapsulation of cells in a low-melting-point agarose suspension, lysis of the cells in neutral or alkaline (pH > 13) conditions, and electrophoresis of the suspended lysed cells, resulting in structures resembling comets as observed by fluorescence microscopy; the intensity of the comet tail relative to the head reflects the number of DNA breaks. The likely basis for this is that loops containing a break lose their supercoiling and become free to extend towards the anode. This is followed by visual analysis with staining of DNA and calculating fluorescence to determine the extent of DNA damage. This can be performed by manual scoring or automatically by imaging software. The assay can, therefore, predict an individual’s tumor sensitivity to radiation and various chemotherapeutic drugs and further assess the oxidative stress within tumors and to detect the extent of DNA damage in various cancerous and precancerous lesions of oral cavity.

Keywords: comet assay, single cell gel electrophoresis, DNA damage, early detection test

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581 Use of 3D Printed Bioscaffolds from Decellularized Umbilical Cord for Cartilage Regeneration

Authors: Tayyaba Bari, Muhammad Hamza Anjum, Samra Kanwal, Fakhera Ikram

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Osteoarthritis, a degenerative condition, affects more than 213 million individuals globally. Since articular cartilage has no or limited vessels, therefore, after deteriorating, it is unable to rejuvenate. Traditional approaches for cartilage repair, like autologous chondrocyte implantation, microfracture and cartilage transplantation are often associated with postoperative complications and lead to further degradation. Decellularized human umbilical cord has gained interest as a viable treatment for cartilage repair. Decellularization removes all cellular contents as well as debris, leaving a biologically active 3D network known as extracellular matrix (ECM). This matrix is biodegradable, non-immunogenic and provides a microenvironment for homeostasis, growth and repair. UC derived bioink function as 3D scaffolding material, not only mediates cell-matrix interactions but also adherence, proliferation and propagation of cells for 3D organoids. This study comprises different physical, chemical and biological approaches to optimize the decellularization of human umbilical cord (UC) tissues followed by the solubilization of these tissues to bioink formation. The decellularization process consisted of two cycles of freeze thaw where the umbilical cord at -20˚C was thawed at room temperature followed by dissection in small sections from 0.5 to 1cm. Similarly decellularization with ionic and non-ionic detergents Sodium dodecyl sulfate (SDS) and Triton-X 100 revealed that both concentrations of SDS i.e 0.1% and 1% were effective in complete removal of cells from the small UC tissues. The results of decellularization was further confirmed by running them on 1% agarose gel. Histological analysis revealed the efficacy of decellularization, which involves paraffin embedded samples of 4μm processed for Hematoxylin-eosin-safran and 4,6-diamidino-2-phenylindole (DAPI). ECM preservation was confirmed by Alcian Blue, and Masson’s trichrome staining on consecutive sections and images were obtained. Sulfated GAG’s content were determined by 1,9-dimethyl-methylene blue (DMMB) assay, similarly collagen quantification was done by hydroxy proline assay. This 3D bioengineered scaffold will provide a typical atmosphere as in the extracellular matrix of the tissue, which would be seeded with the mesenchymal cells to generate the desired 3D ink for in vitro and in vivo cartilage regeneration applications.

Keywords: umbilical cord, 3d printing, bioink, tissue engineering, cartilage regeneration

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580 A Systematic Review Examining the Experimental methodology behind in vivo testing of hiatus hernia and Diaphragmatic Hernia Mesh

Authors: Whitehead-Clarke T., Beynon V., Banks J., Karanjia R., Mudera V., Windsor A., Kureshi A.

Abstract:

Introduction: Mesh implants are regularly used to help repair both hiatus hernias (HH) and diaphragmatic hernias (DH). In vivo studies are used to test not only mesh safety but increasingly comparative efficacy. Our work examines the field of in vivo mesh testing for HH and DH models to establish current practices and standards. Method: This systematic review was registered with PROSPERO. Medline and Embase databases were searched for relevant in vivo studies. 44 articles were identified and underwent abstract review, where 22 were excluded. 4 further studies were excluded after full text review – leaving 18 to undergo data extraction. Results: Of 18 studies identified, 9 used an in vivo HH model and 9 a DH model. 5 studies undertook mechanical testing on tissue samples – all uniaxial in nature. Testing strip widths ranged from 1-20mm (median 3mm). Testing speeds varied from 1.5-60mm/minute. Upon histology, the most commonly assessed structural and cellular factors were neovascularization and macrophages, respectively (n=9 each). Structural analysis was mostly qualitative, where cellular analysis was equally likely to be quantitative. 11 studies assessed adhesion formation, of which 8 used one of four scoring systems. 8 studies measured mesh shrinkage. Discussion: In vivo studies assessing mesh for HH and DH repair are uncommon. Within this relatively young field, we encourage surgical and materials testing institutions to discuss its standardisation.

Keywords: hiatus, diaphragmatic, hernia, mesh, materials testing, in vivo

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579 Compensatory Articulation of Pressure Consonants in Telugu Cleft Palate Speech: A Spectrographic Analysis

Authors: Indira Kothalanka

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For individuals born with a cleft palate (CP), there is no separation between the nasal cavity and the oral cavity, due to which they cannot build up enough air pressure in the mouth for speech. Therefore, it is common for them to have speech problems. Common cleft type speech errors include abnormal articulation (compensatory or obligatory) and abnormal resonance (hyper, hypo and mixed nasality). These are generally resolved after palate repair. However, in some individuals, articulation problems do persist even after the palate repair. Such individuals develop variant articulations in an attempt to compensate for the inability to produce the target phonemes. A spectrographic analysis is used to investigate the compensatory articulatory behaviours of pressure consonants in the speech of 10 Telugu speaking individuals aged between 7-17 years with a history of cleft palate. Telugu is a Dravidian language which is spoken in Andhra Pradesh and Telangana states in India. It is a language with the third largest number of native speakers in India and the most spoken Dravidian language. The speech of the informants is analysed using single word list, sentences, passage and conversation. Spectrographic analysis is carried out using PRAAT, speech analysis software. The place and manner of articulation of consonant sounds is studied through spectrograms with the help of various acoustic cues. The types of compensatory articulation identified are glottal stops, palatal stops, uvular, velar stops and nasal fricatives which are non-native in Telugu.

Keywords: cleft palate, compensatory articulation, spectrographic analysis, PRAAT

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578 Bio-Functionalized Silk Nanofibers for Peripheral Nerve Regeneration

Authors: Kayla Belanger, Pascale Vigneron, Guy Schlatter, Bernard Devauchelle, Christophe Egles

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A severe injury to a peripheral nerve leads to its degeneration and the loss of sensory and motor function. To this day, there still lacks a more effective alternative to the autograft which has long been considered the gold standard for nerve repair. In order to overcome the numerous drawbacks of the autograft, tissue engineered biomaterials may be effective alternatives. Silk fibroin is a favorable biomaterial due to its many advantageous properties such as its biocompatibility, its biodegradability, and its robust mechanical properties. In this study, bio-mimicking multi-channeled nerve guidance conduits made of aligned nanofibers achieved by electrospinning were functionalized with signaling biomolecules and were tested in vitro and in vivo for nerve regeneration support. Silk fibroin (SF) extracted directly from silkworm cocoons was put in solution at a concentration of 10wt%. Poly(ethylene oxide) (PEO) was added to the resulting SF solution to increase solution viscosity and the following three electrospinning solutions were made: (1) SF/PEO solution, (2) SF/PEO solution with nerve growth factor and ciliary neurotrophic factor, and (3) SF/PEO solution with nerve growth factor and neurotrophin-3. Each of these solutions was electrospun into a multi-layer architecture to obtain mechanically optimized aligned nanofibrous mats. For in vitro studies, aligned fibers were treated to induce β-sheet formation and thoroughly rinsed to eliminate presence of PEO. Each material was tested using rat embryo neuron cultures to evaluate neurite extension and the interaction with bio-functionalized or non-functionalized aligned fibers. For in vivo studies, the mats were rolled into 5mm long multi-, micro-channeled conduits then treated and thoroughly rinsed. The conduits were each subsequently implanted between a severed rat sciatic nerve. The effectiveness of nerve repair over a period of 8 months was extensively evaluated by cross-referencing electrophysiological, histological, and movement analysis results to comprehensively evaluate the progression of nerve repair. In vitro results show a more favorable interaction between growing neurons and bio-functionalized silk fibers compared to pure silk fibers. Neurites can also be seen having extended unidirectionally along the alignment of the nanofibers which confirms a guidance factor for the electrospun material. The in vivo study has produced positive results for the regeneration of the sciatic nerve over the length of the study, showing contrasts between the bio-functionalized material and the non-functionalized material along with comparisons to the experimental control. Nerve regeneration has been evaluated not only by histological analysis, but also by electrophysiological assessment and motion analysis of two separate natural movements. By studying these three components in parallel, the most comprehensive evaluation of nerve repair for the conduit designs can be made which can, therefore, more accurately depict their overall effectiveness. This work was supported by La Région Picardie and FEDER.

Keywords: electrospinning, nerve guidance conduit, peripheral nerve regeneration, silk fibroin

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577 A Case Study of Building Behavior Damaged during 26th Oct, 2015 Earthquake in Northern Areas of Pakistan

Authors: Rahmat Ali, Amjad Naseer, Abid A. Shah

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This paper is an attempt to presents the performance of building observed during 26th Oct, 2015 earthquake in District Swat and Shangla region. Most of the buildings in the earthquake hit areas were built with Rubble stone masonry, dress Stone Masonry, brick masonry with and without RC column, Brick masonry with RC beams and column, Block Masonry with and without RC column. It was found that most of the buildings were built without proper supervision and without following any codes. A majority of load bearing masonry walls were highly affected during the earthquake. The load bearing walls built with rubble stone masonry were collapsed resulting huge damages and loss of property and life. Load bearing bricks masonry walls were also affected in most of the region. In some residential buildings the bricks were crushed in a single brick walls. Severe cracks were also found in double brick masonry walls. In RC frame structure beams and columns were also seriously affected. A majority of building structures were non-engineered. Some buildings designed by unskilled local consultants were also affected during the earthquake. Several architectural and structural mistakes were also found in various buildings designed by local consultant. It was found that the structures were collapsed prematurely either because of unskillful labor and using substandard materials or avoiding delicate repair, maintenance, and health monitoring activities because of lack of available sophisticated technology in our country.

Keywords: cracks, collapse, earthquake, masonry, repair

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576 The Impact of Floods and Typhoons on Housing Welfare: Case Study of Thua Thien Hue Province, Vietnam

Authors: Seyeon Lee, Suyeon Lee, Julia Rogers

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This research investigates and records post-flood and typhoon conditions of low income housing in the Thua Thien Hue Province, Vietnam; area prone to extreme flooding in Central Vietnam. The cost of rebuilding houses after flood and typhoon has been always a burden for low income households. These costs often lead to the elimination of essential construction practices for disaster resistance. Despite relief efforts from international non-profit organizations and Vietnam government, the impacts of flood and typhoon damages to residential construction has been reoccurring to the same neighborhood annually. Notwithstanding its importance, this topic has not been systematically investigated. The study is limited to assistance provided to low income households documenting existing conditions of low income homes impacted by post flood and typhoon conditions in the Thua Thien Hue Province. The research identifies leading causes of the building failure from the natural disasters. Relief efforts and progress made since the last typhoon is documented. The quality of construction and repairs are assessed based on Home Builders Guide to Coastal Construction by Federal Emergency Management Agency. Focus group discussions and individual interviews with local residents from four different communities were conducted to get incites on repair effort by the non-profit organizations and Vietnam government, and their needs post flood and typhoon. The findings from the field study informed that many of the local people are now aware of the importance of improving housing conditions as one of the key coping strategies to withstand flood and typhoon events as it makes housing and community more resilient to future events. While there has been a remarkable improvement of housing and infrastructure with the support from the local government as well as the non-profit organizations, many households in the study areas are found to still live in weak and fragile housing conditions without gaining access to the aid to repair and strengthen the houses. Given that the major immediate recovery action taken by the local people tends to focus on repairing damaged houses, and on this ground, low-income households spend a considerable amount of their income on housing repair, providing proper and applicable construction practices will not only improve the housing condition, but also contribute to reducing poverty in Vietnam.

Keywords: disaster coping mechanism, housing welfare, low-income housing, recovery reduction

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575 Impact of Expressive Writing on Creativity

Authors: Małgorzata Osowiecka

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Negative emotions are rather seen as creativity inhibitor. On the other hand, it is worth noting that negative emotions may be good for our functioning. Negative emotions enhance cognitive resources and improve evaluative processes. Moreover maintaining a negative emotional state allow for cognitive reinterpretation of the emotional stimuli, what is good for our creativity, especially cognitive flexibility. Writing a diary or writing about difficult emotional experiences in general can be the way to not only improve psychical health, but also – enhance creative behaviors. Thanks to translating difficult emotions to the verbal level and giving them ‘a name’ or ‘a label’, we can get easier access to both emotional content of an experience and to the semantic content, without the need of speaking out loud. Expressive writing improves academic results and the efficiency of working memory. The classical method of writing about emotions consists in a long-term process of describing negative experiences. Present research demonstrate the efficiency of this process over a shorter period of time - one writing session, on school children sample. Participants performed writing task. Writing task had two different topics: emotions connected with their negative emotions (expressive writing) and content not connected with negative emotional state (writing about one’s typical day). Creativity was measured by Guilford’s Alternative Uses Task. Results have shown that writing about negative emotions results in the higher level of divergent thinking in all three parameters: fluency, flexibility and originality. After the writing task mood of expressive writing participants remained negative more than the mood of the controls. Taking an expressive action after a difficult emotional experience can support functioning, which can be observed in enhancement of divergent thinking. Writing about emotions connected with negative experience makes one more creative, than writing about something unrelated with difficult emotional moments. Research has shown that young people should not demonize negative emotions. Sometimes, properly applied, negative emotions can be the basis of creation. Preparation was supported by a The Young Scientist University grant titled ‘Dynamics of emotions in the creative process’ from The Polish Ministry of Science and Higher Education.

Keywords: creativity, divergent thinking, emotions, expressive writing

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574 Corrective Feedback and Uptake Patterns in English Speaking Lessons at Hanoi Law University

Authors: Nhac Thanh Huong

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New teaching methods have led to the changes in the teachers’ roles in an English class, in which teachers’ error correction is an integral part. Language error and corrective feedback have been the interest of many researchers in foreign language teaching. However, the techniques and the effectiveness of teachers’ feedback have been a question of much controversy. This present case study has been carried out with a view to finding out the patterns of teachers’ corrective feedback and their impact on students’ uptake in English speaking lessons of legal English major students at Hanoi Law University. In order to achieve those aims, the study makes use of classroom observations as the main method of data collection to seeks answers to the two following questions: 1. What patterns of corrective feedback occur in English speaking lessons for second- year legal English major students in Hanoi Law University?; 2. To what extent does that corrective feedback lead to students’ uptake? The study provided some important findings, among which was a close relationship between corrective feedback and uptake. In particular, recast was the most commonly used feedback type, yet it was the least effective in terms of students’ uptake and repair, while the most successful feedback, namely meta-linguistic feedback, clarification requests and elicitation, which led to students’ generated repair, was used at a much lower rate by teachers. Furthermore, it revealed that different types of errors needed different types of feedback. Also, the use of feedback depended on the students’ English proficiency level. In the light of findings, a number of pedagogical implications have been drawn in the hope of enhancing the effectiveness of teachers’ corrective feedback to students’ uptake in foreign language acquisition process.

Keywords: corrective feedback, error, uptake, speaking English lesson

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573 Assessment, Diagnosis and Treatment, Simulation for the Nurse Practitioner Student

Authors: Helen Coronel, Will Brewer, Peggy Bergeron, Clarissa Hall, Victoria Casson

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Simulation-based training provides the nurse practitioner (NP) student with a safe and controlled environment in which they can practice a real-life scenario. This type of learning fosters critical thinking skills essential to practice. The expectation of this study was that students would have an increase in their competency and confidence after performing the simulation. Approximately 8.4% of Americans suffer from depression. The state of Alabama is ranked 47th out of 50 for access to mental health care. As a result of this significant shortage of mental health providers, primary care providers are frequently put in the position of screening for and treating mental health conditions, such as depression. Family nurse practitioners are often utilized as primary care providers, making their ability to assess, diagnose and treat these disorders a necessary skill. The expected outcome of this simulation is an increase in confidence, competency and the empowerment of the nurse practitioner student’s ability to assess, diagnose and treat a common mood disorder they may encounter in practice. The Kirkpatrick Module was applied for this study. A non-experimental design using descriptive statistical analysis was utilized. The simulation was based on a common psychiatric mood disorder frequently observed in primary care and mental health clinics. Students were asked to watch a voiceover power point presentation prior to their on-campus simulation. The presentation included training on the assessment, diagnosis, and treatment of a patient with depression. Prior to the simulation, the students completed a pre-test, then participated in the simulation, and completed a post-test when done. Apple iPads were utilized to access a simulated health record. Major findings of the study support an increase in students’ competency and confidence when assessing, diagnosing, and treating an adult patient with depression.

Keywords: advanced practice, nurse practitioner, simulation, primary care, depression

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572 Comparative Stem Cells Therapy for Regeneration of Liver Fibrosis

Authors: H. M. Imam, H. M. Rezk, A. F. Tohamy

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Background: Human umbilical cord blood (HUCB) is considered as a unique source for stem cells. HUCB contain different types of progenitor cells which could differentiate into hepatocytes. Aims: To investigate the potential of rat's liver damage repair using human umbilical cord mesenchymal stem cells (hUCMSCs). We investigated the feasibility for hUCMSCs in recovery from liver damage. Moreover, investigating fibrotic liver repair and using the CCl4-induced model for liver damage in the rat. Methods: Rats were injected with 0.5 ml/kg CCl4 to induce liver damage and progressive liver fibrosis. hUCMSCs were injected into the rats through the tail vein; Stem cells were transplanted at a dose of 1×106 cells/rat after 72 hours of CCl4 injection without receiving any immunosuppressant. After (6 and 8 weeks) of transplantation, blood samples were collected to assess liver functions (ALT, AST, GGT and ALB) and level of Procollagen III as a liver fibrosis marker. In addition, hepatic tissue regeneration was assessed histopathologically and immunohistochemically using antihuman monoclonal antibodies against CD34, CK19 and albumin. Results: Biochemical and histopathological analysis showed significantly increased recovery from liver damage in the transplanted group. In addition, HUCB stem cells transdifferentiated into functional hepatocytes in rats with hepatic injury which results in improving liver structure and function. Conclusion: Our findings suggest that transplantation of hUCMSCs may be a novel therapeutic approach for treating liver fibrosis. Therefore, hUCMSCs are a potential option for treatment of liver cirrhosis.

Keywords: carbon tetra chloride, liver fibrosis, mesenchymal stem cells, rat

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571 Budget Optimization for Maintenance of Bridges in Egypt

Authors: Hesham Abd Elkhalek, Sherif M. Hafez, Yasser M. El Fahham

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Allocating limited budget to maintain bridge networks and selecting effective maintenance strategies for each bridge represent challenging tasks for maintenance managers and decision makers. In Egypt, bridges are continuously deteriorating. In many cases, maintenance works are performed due to user complaints. The objective of this paper is to develop a practical and reliable framework to manage the maintenance, repair, and rehabilitation (MR&R) activities of Bridges network considering performance and budget limits. The model solves an optimization problem that maximizes the average condition of the entire network given the limited available budget using Genetic Algorithm (GA). The framework contains bridge inventory, condition assessment, repair cost calculation, deterioration prediction, and maintenance optimization. The developed model takes into account multiple parameters including serviceability requirements, budget allocation, element importance on structural safety and serviceability, bridge impact on network, and traffic. A questionnaire is conducted to complete the research scope. The proposed model is implemented in software, which provides a friendly user interface. The framework provides a multi-year maintenance plan for the entire network for up to five years. A case study of ten bridges is presented to validate and test the proposed model with data collected from Transportation Authorities in Egypt. Different scenarios are presented. The results are reasonable, feasible and within acceptable domain.

Keywords: bridge management systems (BMS), cost optimization condition assessment, fund allocation, Markov chain

Procedia PDF Downloads 264
570 The Long-Term Effects of Immediate Implantation, Early Implantation and Delayed Implantation at Aesthetics Area

Authors: Xing Wang, Lin Feng, Xuan Zou, Hongchen liu

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Immediate Implantation after tooth extraction is considered to be the ideal way to retain the alveolar bone, but some scholars believe the aesthetic effect in the Early Implantation case are more reliable. In this study, 89 patients were added to this retrospective study up to 5 years. Assessment indicators was including the survival of the implant (peri-implant infection, implant loosening, shedding, crowns and occlusal), aesthetics (color and fullness gums, papilla height, probing depth, X-ray alveolar crest height, the patient's own aesthetic satisfaction, doctors aesthetics score), repair defects around the implant (peri-implant bone changes in height and thickness, whether the use of autologous bone graft, whether to use absorption/repair manual nonabsorbable material), treatment time, cost and the use of antibiotics.The results demonstrated that there is no significant difference in long-term success rate of immediate implantation, early implantation and delayed implantation (p> 0.05). But the results indicated immediate implantation group could get get better aesthetic results after two years (p< 0.05), but may increase the risk of complications and failures (p< 0.05). High-risk indicators include gingival recession, labial bone wall damage, thin gingival biotypes, planting position and occlusal restoration bad and so on. No matter which type of implanting methods was selected, the extraction methods and bone defect amplification techniques are observed as a significant factors on aesthetic effect (p< 0.05).

Keywords: immediate implantation, long-term effects, aesthetics area, dental implants

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569 Lime Based Products as a Maintainable Option for Repair And Restoration of Historic Buildings in India

Authors: Adedayo Jeremiah Adeyekun, Samuel Oluwagbemiga Ishola

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This research aims to study the use of traditional building materials for the repair and refurbishment of historic buildings in India and to provide an authentic treatment of historical buildings that will be highly considered by taking into consideration the new standards of rehabilitating process. This can be proven to be an effective solution over modern impervious material due to its compatibility with traditional building methods and materials. For example, their elastoplastic properties allow accommodating movement due to settlement or moisture/temperature changes without cracking. The use of lime also enhances workability, water retention and bond characteristics. Lime is considered to be a natural, traditional material, but it is also sustainable and energy-efficient, with production powered by biomass and emissions up to 25% less than cementitious materials. However, there is a lack of comprehensive data on the impact of lime‐based materials on the energy efficiency and thermal properties of traditional buildings and structures. Although lime mortars, renders and plasters were largely superseded by cement-based products in the first half of the 20th century, lime has a long and proven track record dating back to ancient times. This was used by the Egyptians in 4000BC to construct the pyramids. This doesn't mean that lime is an outdated technology, nor is it difficult to be used as a material. In fact, lime has a growing place in modern construction, with increasing numbers of designers choosing to use lime-based products because of their special properties. To carry out this research, some historic buildings will be surveyed and information will be derived from the textbooks and journals related to Architectural restoration.

Keywords: lime, materials, historic, buildings, sustainability

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568 Effect of Natural and Urban Environments on the Perception of Thermal Pain – Experimental Research Using Virtual Environments

Authors: Anna Mucha, Ewa Wojtyna, Anita Pollak

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The environment in which an individual resides and observes may play a meaningful role in well-being and related constructs. Contact with nature may have a positive influence of natural environments on individuals, impacting mood and psychophysical sensations, such as pain relief. Conversely, urban settings, dominated by concrete elements, might lead to mood decline and heightened stress levels. Similarly, the situation may appear in the case of the perception of virtual environments. However, this is a topic that requires further exploration, especially in the context of relationships with pain. The aforementioned matters served as the basis for formulating and executing the outlined experimental research within the realm of environmental psychology, leveraging new technologies, notably virtual reality (VR), which is progressively gaining prominence in the domain of mental health. The primary objective was to investigate the impact of a simulated virtual environment, mirroring a natural setting abundant in greenery, on the perception of acute pain induced by thermal stimuli (high temperature) – encompassing intensity, unpleasantness, and pain tolerance. Comparative analyses were conducted between the virtual natural environment (intentionally constructed in the likeness of a therapeutic garden), virtual urban environment, and a control group devoid of virtual projections. Secondary objectives aimed to determine the mutual relationships among variables such as positive and negative emotions, preferences regarding virtual environments, sense of presence, and restorative experience in the context of the perception of presented virtual environments and induced thermal pain. The study encompassed 126 physically healthy Polish adults, distributing 42 individuals across each of the three comparative groups. Oculus Rift VR technology and the TSA-II neurosensory analyzer facilitated the experiment. Alongside demographic data, participants' subjective feelings concerning virtual reality and pain were evaluated using the Visual Analogue Scale (VAS), the original Restorative Experience in the Virtual World questionnaire (Doświadczenie Regeneracji w Wirtualnym Świecie), and an adapted Slater-Usoh-Steed (SUS) questionnaire. Results of statistical and psychometric analyses, such as Kruskal-Wallis tests, Wilcoxon tests, and contrast analyses, underscored the positive impact of the virtual natural environment on individual pain perception and mood. The virtual natural environment outperformed the virtual urban environment and the control group without virtual projection, particularly in subjective pain components like intensity and unpleasantness. Variables such as restorative experience, sense of presence and virtual environment preference also proved pivotal in pain perception and pain tolerance threshold alterations, contingent on specific conditions. This implies considerable application potential for virtual natural environments across diverse realms of psychology and related fields, among others as a supportive analgesic approach and a form of relaxation following psychotherapeutic sessions.

Keywords: environmental psychology, nature, acute pain, emotions, vitrual reality, virtual environments

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567 Optimal Sequential Scheduling of Imperfect Maintenance Last Policy for a System Subject to Shocks

Authors: Yen-Luan Chen

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Maintenance has a great impact on the capacity of production and on the quality of the products, and therefore, it deserves continuous improvement. Maintenance procedure done before a failure is called preventive maintenance (PM). Sequential PM, which specifies that a system should be maintained at a sequence of intervals with unequal lengths, is one of the commonly used PM policies. This article proposes a generalized sequential PM policy for a system subject to shocks with imperfect maintenance and random working time. The shocks arrive according to a non-homogeneous Poisson process (NHPP) with varied intensity function in each maintenance interval. As a shock occurs, the system suffers two types of failures with number-dependent probabilities: type-I (minor) failure, which is rectified by a minimal repair, and type-II (catastrophic) failure, which is removed by a corrective maintenance (CM). The imperfect maintenance is carried out to improve the system failure characteristic due to the altered shock process. The sequential preventive maintenance-last (PML) policy is defined as that the system is maintained before any CM occurs at a planned time Ti or at the completion of a working time in the i-th maintenance interval, whichever occurs last. At the N-th maintenance, the system is replaced rather than maintained. This article first takes up the sequential PML policy with random working time and imperfect maintenance in reliability engineering. The optimal preventive maintenance schedule that minimizes the mean cost rate of a replacement cycle is derived analytically and determined in terms of its existence and uniqueness. The proposed models provide a general framework for analyzing the maintenance policies in reliability theory.

Keywords: optimization, preventive maintenance, random working time, minimal repair, replacement, reliability

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566 Microstructure and Hardness Changes on T91 Weld Joint after Heating at 560°C

Authors: Suraya Mohamad Nadzir, Badrol Ahmad, Norlia Berahim

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T91 steel has been used as construction material for superheater tubes in sub-critical and super critical boiler. This steel was developed with higher creep strength property as compared to conventional low alloy steel. However, this steel is also susceptible to materials degradation due to its sensitivity to heat treatment especially Post Weld Heat Treatment (PWHT) after weld repair process. Review of PWHT process shows that the holding temperature may different from one batch to other batch of samples depending on the material composition. This issue was reviewed by many researchers and one of the potential solutions is the development of weld repair process without PWHT. This process is possible with the use of temper bead welding technique. However, study has shown the hardness value across the weld joint with exception of PWHT is much higher compare to recommended hardness value. Based on the above findings, a study to evaluate the microstructure and hardness changes of T91 weld joint after heating at 560°C at varying duration was carried out. This study was carried out to evaluate the possibility of self-tempering process during in-service period. In this study, the T91 weld joint was heat-up in air furnace at 560°C for duration of 50 and 150 hours. The heating process was controlled with heating rate of 200°C/hours, and cooling rate about 100°C/hours. Following this process, samples were prepared for the microstructure examination and hardness evaluation. Results have shown full tempered martensite structure and acceptance hardness value was achieved after 50 hours heating. This result shows that the thin component such as T91 superheater tubes is able to self-tempering during service hour.

Keywords: T91, weld-joint, tempered martensite, self-tempering

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565 Development of Earthquake and Typhoon Loss Models for Japan, Specifically Designed for Underwriting and Enterprise Risk Management Cycles

Authors: Nozar Kishi, Babak Kamrani, Filmon Habte

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Natural hazards such as earthquakes and tropical storms, are very frequent and highly destructive in Japan. Japan experiences, every year on average, more than 10 tropical cyclones that come within damaging reach, and earthquakes of moment magnitude 6 or greater. We have developed stochastic catastrophe models to address the risk associated with the entire suite of damaging events in Japan, for use by insurance, reinsurance, NGOs and governmental institutions. KCC’s (Karen Clark and Company) catastrophe models are procedures constituted of four modular segments: 1) stochastic events sets that would represent the statistics of the past events, hazard attenuation functions that could model the local intensity, vulnerability functions that would address the repair need for local buildings exposed to the hazard, and financial module addressing policy conditions that could estimates the losses incurring as result of. The events module is comprised of events (faults or tracks) with different intensities with corresponding probabilities. They are based on the same statistics as observed through the historical catalog. The hazard module delivers the hazard intensity (ground motion or wind speed) at location of each building. The vulnerability module provides library of damage functions that would relate the hazard intensity to repair need as percentage of the replacement value. The financial module reports the expected loss, given the payoff policies and regulations. We have divided Japan into regions with similar typhoon climatology, and earthquake micro-zones, within each the characteristics of events are similar enough for stochastic modeling. For each region, then, a set of stochastic events is developed that results in events with intensities corresponding to annual occurrence probabilities that are of interest to financial communities; such as 0.01, 0.004, etc. The intensities, corresponding to these probabilities (called CE, Characteristics Events) are selected through a superstratified sampling approach that is based on the primary uncertainty. Region specific hazard intensity attenuation functions followed by vulnerability models leads to estimation of repair costs. Extensive economic exposure model addresses all local construction and occupancy types, such as post-linter Shinand Okabe wood, as well as concrete confined in steel, SRC (Steel-Reinforced Concrete), high-rise.

Keywords: typhoon, earthquake, Japan, catastrophe modelling, stochastic modeling, stratified sampling, loss model, ERM

Procedia PDF Downloads 238
564 Mitochondrial Apolipoprotein A-1 Binding Protein Promotes Repolarization of Inflammatory Macrophage by Repairing Mitochondrial Respiration

Authors: Hainan Chen, Jina Qing, Xiao Zhu, Ling Gao, Ampadu O. Jackson, Min Zhang, Kai Yin

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Objective: Editing macrophage activation to dampen inflammatory diseases by promoting the repolarization of inflammatory (M1) macrophages to anti-inflammatory (M2) macrophages is highly associated with mitochondrial respiration. Recent studies have suggested that mitochondrial apolipoprotein A-1 binding protein (APOA1BP) was essential for the cellular metabolite NADHX repair to NADH, which is necessary for the mitochondrial function. The exact role of APOA1BP in the repolarization of M1 to M2, however, is uncertain. Material and method: THP-1-derived macrophages were incubated with LPS (10 ng/ml) or/and IL-4 (100 U/ml) for 24 hours. Biochemical parameters of oxidative phosphorylation and M1/M2 markers were analyzed after overexpression of APOA1BP in cells. Results: Compared with control and IL-4-exposed M2 cells, APOA1BP was downregulated in M1 macrophages. APOA1BP restored the decline in mitochondrial function to improve metabolic and phenotypic reprogramming of M1 to M2 macrophages. Blocking oxidative phosphorylation by oligomycin blunts the effects of APOA1BP on M1 to M2 repolarization. Mechanistically, LPS triggered the hydration of NADH and increased its hydrate NADHX which inhibit cellular NADH dehydrogenases, a key component of electron transport chain for oxidative phosphorylation. APOA1BP decreased the level of NADHX via converting R-NADHX to biologically useful S-NADHX. The mutant of APOA1BP aspartate188, the binding site of NADHX, fail to repair oxidative phosphorylation, thereby preventing repolarization. Conclusions: Restoring mitochondrial function by increasing mitochondrial APOA1BP might be useful to improve the reprogramming of inflammatory macrophages into anti-inflammatory cells to control inflammatory diseases.

Keywords: inflammatory diseases, macrophage repolarization, mitochondrial respiration, apolipoprotein A-1 binding protein, NADHX, NADH

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563 A Method of Manufacturing Low Cost Utility Robots and Vehicles

Authors: Gregory E. Ofili

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Introduction and Objective: Climate change and a global economy mean farmers must adapt and gain access to affordable and reliable automation technologies. Key barriers include a lack of transportation, electricity, and internet service, coupled with costly enabling technologies and limited local subject matter expertise. Methodology/Approach: Resourcefulness is essential to mechanization on a farm. This runs contrary to the tech industry practice of planned obsolescence and disposal. One solution is plug-and-play hardware that allows farmer to assemble, repair, program, and service their own fleet of industrial machines. To that end, we developed a method of manufacturing low-cost utility robots, transport vehicles, and solar/wind energy harvesting systems, all running on an open-source Robot Operating System (ROS). We demonstrate this technology by fabricating a utility robot and an all-terrain (4X4) utility vehicle. Constructed of aluminum trusses and weighing just 40 pounds, yet capable of transporting 200 pounds of cargo, on sale for less than $2,000. Conclusions & Policy Implications: Electricity, internet, and automation are essential for productivity and competitiveness. With planned obsolescence, the priorities of technology suppliers are not aligned with the farmer’s realities. This patent-pending method of manufacturing low-cost industrial robots and electric vehicles has met its objective. To create low-cost machines, the farmer can assemble, program, and repair with basic hand tools.

Keywords: automation, robotics, utility robot, small-hold farm, robot operating system

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562 Congenital Diaphragmatic Hernia Outcomes in a Low-Volume Center

Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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561 Cognitive Performance and Physiological Stress during an Expedition in Antarctica

Authors: Andrée-Anne Parent, Alain-Steve Comtois

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The Antarctica environment can be a great challenge for human exploration. Explorers need to be focused on the task and require the physical abilities to succeed and survive in complete autonomy in this hostile environment. The aim of this study was to observe cognitive performance and physiological stress with a biomarker (cortisol) and hand grip strength during an expedition in Antarctica. A total of 6 explorers were in complete autonomous exploration on the Forbidden Plateau in Antarctica to reach unknown summits during a 30 day period. The Stroop Test, a simple reaction time, and mood scale (PANAS) tests were performed every week during the expedition. Saliva samples were taken before sailing to Antarctica, the first day on the continent, after the mission on the continent and on the boat return trip. Furthermore, hair samples were taken before and after the expedition. The results were analyzed with SPSS using ANOVA repeated measures. The Stroop and mood scale results are presented in the following order: 1) before sailing to Antarctica, 2) the first day on the continent, 3) after the mission on the continent and 4) on the boat return trip. No significant difference was observed with the Stroop (759±166 ms, 850±114 ms, 772±179 ms and 833±105 ms, respectively) and the PANAS (39.5 ±5.7, 40.5±5, 41.8±6.9, 37.3±5.8 positive emotions, and 17.5±2.3, 18.2±5, 18.3±8.6, 15.8±5.4 negative emotions, respectively) (p>0.05). However, there appears to be an improvement at the end of the second week. Furthermore, the simple reaction time was significantly lower at the end of the second week, a moment where important decisions were taken about the mission, vs the week before (416±39 ms vs 459.8±39 ms respectively; p=0.030). Furthermore, the saliva cortisol was not significantly different (p>0.05) possibly due to important variations and seemed to reach a peak on the first day on the continent. However, the cortisol from the hair pre and post expedition increased significantly (2.4±0.5 pg/mg pre-expedition and 16.7±9.2 pg/mg post-expedition, p=0.013) showing important stress during the expedition. Moreover, no significant difference was observed on the grip strength except between after the mission on the continent and after the boat return trip (91.5±21 kg vs 85±19 kg, p=0.20). In conclusion, the cognitive performance does not seem to be affected during the expedition. Furthermore, it seems to increase for specific important events where the crew seemed to focus on the present task. The physiological stress does not seem to change significantly at specific moments, however, a global pre-post mission measure can be important and for this reason, for long-term missions, a pre-expedition baseline measure is important for crewmembers.

Keywords: Antarctica, cognitive performance, expedition, physiological adaptation, reaction time

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