Search results for: neon signs
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 620

Search results for: neon signs

140 Human Identification Using Local Roughness Patterns in Heartbeat Signal

Authors: Md. Khayrul Bashar, Md. Saiful Islam, Kimiko Yamashita, Yano Midori

Abstract:

Despite having some progress in human authentication, conventional biometrics (e.g., facial features, fingerprints, retinal scans, gait, voice patterns) are not robust against falsification because they are neither confidential nor secret to an individual. As a non-invasive tool, electrocardiogram (ECG) has recently shown a great potential in human recognition due to its unique rhythms characterizing the variability of human heart structures (chest geometry, sizes, and positions). Moreover, ECG has a real-time vitality characteristic that signifies the live signs, which ensure legitimate individual to be identified. However, the detection accuracy of the current ECG-based methods is not sufficient due to a high variability of the individual’s heartbeats at a different instance of time. These variations may occur due to muscle flexure, the change of mental or emotional states, and the change of sensor positions or long-term baseline shift during the recording of ECG signal. In this study, a new method is proposed for human identification, which is based on the extraction of the local roughness of ECG heartbeat signals. First ECG signal is preprocessed using a second order band-pass Butterworth filter having cut-off frequencies of 0.00025 and 0.04. A number of local binary patterns are then extracted by applying a moving neighborhood window along the ECG signal. At each instant of the ECG signal, the pattern is formed by comparing the ECG intensities at neighboring time points with the central intensity in the moving window. Then, binary weights are multiplied with the pattern to come up with the local roughness description of the signal. Finally, histograms are constructed that describe the heartbeat signals of individual subjects in the database. One advantage of the proposed feature is that it does not depend on the accuracy of detecting QRS complex, unlike the conventional methods. Supervised recognition methods are then designed using minimum distance to mean and Bayesian classifiers to identify authentic human subjects. An experiment with sixty (60) ECG signals from sixty adult subjects from National Metrology Institute of Germany (NMIG) - PTB database, showed that the proposed new method is promising compared to a conventional interval and amplitude feature-based method.

Keywords: human identification, ECG biometrics, local roughness patterns, supervised classification

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139 Ecophysiological Features of Acanthosicyos horridus (!Nara) to Survive the Namib Desert

Authors: Jacques M. Berner, Monja Gerber, Gillian L. Maggs-Kolling, Stuart J. Piketh

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The enigmatic melon species, Acanthosicyos horridus Welw. ex Hook. f., locally known as !nara, is endemic to the hyper-arid Namib Desert, where it thrives in sandy dune areas and dry river banks. The Namib Desert is characterized by extreme weather conditions which include high temperatures, very low rainfall, and extremely dry air. Plant and animals that have made the Namib Dessert their home are dependent on non-rainfall water inputs, like fog, dew and water vapor, for survival. Fog is believed to be the most important non-rainfall water input for most of the coastal Namib Desert and is a life line to many Namib plants and animals. It is commonly assumed that the !nara plant is adapted and dependent upon coastal fog events. The !nara plant shares many comparable adaptive features with other organisms that are known to exploit fog as a source of moisture. These include groove-like structures on the stems and the cone-like structures of thorns. These structures are believed to be the driving forces behind directional water flow that allow plants to take advantage of fog events. The !nara-fog interaction was investigated in this study to determine the dependence of !nara on these fog events, as it would illustrate strategies to benefit from non-rainfall water inputs. The direct water uptake capacity of !nara shoots was investigated through absorption tests. Furthermore, the movement and behavior of fluorescent water droplets on a !nara stem were investigated through time-lapse macrophotography. The shoot water potential was measured to investigate the effect of fog on the water status of !nara stems. These tests were used to determine whether the morphology of !nara has evolved to exploit fog as a non-rainfall water input and whether the !nara plant has adapted physiologically in response to fog. Chlorophyll a fluorescence was used to compare the photochemical efficiency of !nara plants on days with fog events to that on non-foggy days. The results indicate that !nara plants do have the ability to take advantage of fog events as commonly believed. However, the !nara plant did not exhibit visible signs of drought stress and this, together with the strong shoot water potential, indicates that these plants are reliant on permanent underground water sources. Chlorophyll a fluorescence data indicated that temperature stress and wind were some of the main abiotic factors influencing the plants’ overall vitality.

Keywords: Acanthosicyos horridus, chlorophyll a fluorescence, fog, foliar absorption, !nara

Procedia PDF Downloads 126
138 Utilization of Standard Paediatric Observation Chart to Evaluate Infants under Six Months Presenting with Non-Specific Complaints

Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes

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Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.

Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart

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137 Intersubjectivity of Forensic Handwriting Analysis

Authors: Marta Nawrocka

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In each of the legal proceedings, in which expert evidence is carried out, a major concern is the assessment of the evidential value of expert reports. Judicial institutions, while making decisions, rely heavily on the expert reports, because they usually do not possess 'special knowledge' from a certain fields of science which makes it impossible for them to verify the results presented in the processes. In handwriting studies, the standards of analysis are developed. They unify procedures used by experts in comparing signs and in constructing expert reports. However, the methods used by experts are usually of a qualitative nature. They rely on the application of knowledge and experience of expert and in effect give significant range of margin in the assessment. Moreover, the standards used by experts are still not very precise and the process of reaching the conclusions is poorly understood. The above-mentioned circumstances indicate that expert opinions in the field of handwriting analysis, for many reasons, may not be sufficiently reliable. It is assumed that this state of affairs has its source in a very low level of intersubjectivity of measuring scales and analysis procedures, which consist elements of this kind of analysis. Intersubjectivity is a feature of cognition which (in relation to methods) indicates the degree of consistency of results that different people receive using the same method. The higher the level of intersubjectivity is, the more reliable and credible the method can be considered. The aim of the conducted research was to determine the degree of intersubjectivity of the methods used by the experts from the scope of handwriting analysis. 30 experts took part in the study and each of them received two signatures, with varying degrees of readability, for analysis. Their task was to distinguish graphic characteristics in the signature, estimate the evidential value of the found characteristics and estimate the evidential value of the signature. The obtained results were compared with each other using the Alpha Krippendorff’s statistic, which numerically determines the degree of compatibility of the results (assessments) that different people receive under the same conditions using the same method. The estimation of the degree of compatibility of the experts' results for each of these tasks allowed to determine the degree of intersubjectivity of the studied method. The study showed that during the analysis, the experts identified different signature characteristics and attributed different evidential value to them. In this scope, intersubjectivity turned out to be low. In addition, it turned out that experts in various ways called and described the same characteristics, and the language used was often inconsistent and imprecise. Thus, significant differences have been noted on the basis of language and applied nomenclature. On the other hand, experts attributed a similar evidential value to the entire signature (set of characteristics), which indicates that in this range, they were relatively consistent.

Keywords: forensic sciences experts, handwriting analysis, inter-rater reliability, reliability of methods

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136 Effect of Vitamin D3 on Polycystic Ovary Syndrome Prognosis, Anthropometric and Body Composition Parameters of Overweight Women: A Randomized, Placebo-Controlled Clinical Trial

Authors: Nahla Al-Bayyari, Rae’d Hailat

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Vitamin D deficiency and overweight are common in women suffering from polycystic ovary syndrome (PCOS). Weight gain in PCOS is an important factor for the development of menstrual dysfunction and signs of hyperandrogenism and alopecia. Features of PCOS such as oligomenorrhea can be predicted by anthropometric measurements as body mass index (BMI). Therefore, the aim of this trial was to study the effect of 50,000 IU/week of vitamin D₃ supplementation on the body composition and on the anthropometric measurements of overweight women with PCOS and to examine the impact of this effect on ovaries ultrasonography and menstrual cycle regularity. The study design was a prospective randomized, double-blinded placebo-controlled clinical trial conducted on 60 overweight Jordanian women aged (18-49) years with PCOS and vitamin D deficiency. The study participants were divided into two groups; vitamin D group (n = 30) who were assigned to receive 50,000 IU/week of vitamin D₃ and placebo group (n = 30) who were assigned to receive placebo tablets orally for 90 days. The anthropometric measurements and body composition were measured at baseline and after treatment for the PCOS and vitamin D deficient women. Also, assessment of the participants’ picture of ovaries by ultrasound and menstrual cycle regulatory were performed before and after treatment. Results showed that there were no significant (p > 0.05) differences between the placebo and vitamin D group basal 25(OH)D levels, body composition and anthropometric parameters. After treatment, vitamin D group serum levels of 25(OH)D increased (12.5 ± 0.61 to 50.2 ± 2.04 ng/mL, (p < 0.001), and decreased (50.2 ± 2.04 to 48.2 ± 2.03 ng/mL, p < 0.001) after 14 days of vitamin D₃ treatment cessation. There were no significant changes in the placebo group. In the vitamin D group, there were significant (p < 0.001) decreases in body weight, BMI, waist, and hip circumferences and fat mass. In addition, there were significant increases (p < 0.05) in fat free mass and total body water. These improvements in both anthropometric and body composition as well as in 25(OH)D concentrations, resulted in significant improvements in the picture of PCOS women ovaries ultrasonography and in menstrual cycle regularity, where nearly most of them (93%) had regular cycles after vitamin D₃ supplementation. In the placebo group, there were only significant decreases (p < 0.05) in waist and hip circumferences. It can be concluded that vitamin D supplementation improving serum 25(OH)D levels and PCOS prognosis by reducing body weight of overweight PCOS women and regulating their menstrual cycle.

Keywords: anthropometric, overweight, polycystic ovary syndrome, vitamin D₃

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135 Needs of Omani Children in First Grade during Their Transition from Kindergarten to Primary School: An Ethnographic Study

Authors: Zainab Algharibi, Julie McAdam, Catherine Fagan

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The purpose of this paper is to shed light on how Omani children in the first grade experience their needs during their transition to primary school. Theoretically, the paper was built on two perspectives: Dewey's concept of continuity of experience and the boundary objects introduced by Vygotsky (CHAT). The methodology of the study is based on the crucial role of children’s agency which is a very important activity as an educational tool to enhance the child’s participation in the learning process and develop their ability to face various issues in their life. Thus, the data were obtained from 45 children in grade one from 4 different primary schools using drawing and visual narrative activities, in addition to researcher observations during the start of the first weeks of the academic year for the first grade. As the study dealt with children, all of the necessary ethical laws were followed. This paper is considered original since it seeks to deal with the issue of children's transition from kindergarten to primary school in Oman, if not in the Arab region. Therefore, it is expected to fill an important gap in this field and present a proposal that will be a door for researchers to enter this research field later. The analysis of drawing and visual narrative was performed according to the social semiotics approach in two phases. The first is to read out the surface message “denotation,” while the second is to go in-depth via the symbolism obtained from children while they talked and drew letters and signs. This stage is known as “signified”; a video was recorded of each child talking about their drawing and expressing themself. Then, the data were organised and classified according to a cross-data network. Regarding the researcher observation analyses, the collected data were analysed according to the model was developed for the "grounded theory". It is based on comparing the recent data collected from observations with data previously encoded by other methods in which children were drawing alongside the visual narrative in the current study, in order to identify the similarities and differences, and also to clarify the meaning of the accessed categories and to identify sub-categories of them with a description of possible links between them. This is a kind of triangulation in data collection. The study came up with a set of findings, the most vital being that the children's greatest interest goes to their social and psychological needs, such as friends, their teacher, and playing. Also, their biggest fears are a new place, a new teacher, and not having friends, while they showed less concern for their need for educational knowledge and skills.

Keywords: children’s academic needs, children’s social needs, transition, primary school

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134 Morphological and Molecular Evaluation of Dengue Virus Serotype 3 Infection in BALB/c Mice Lungs

Authors: Gabriela C. Caldas, Fernanda C. Jacome, Arthur da C. Rasinhas, Ortrud M. Barth, Flavia B. dos Santos, Priscila C. G. Nunes, Yuli R. M. de Souza, Pedro Paulo de A. Manso, Marcelo P. Machado, Debora F. Barreto-Vieira

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The establishment of animal models for studies of DENV infections has been challenging, since circulating epidemic viruses do not naturally infect nonhuman species. Such studies are of great relevance to the various areas of dengue research, including immunopathogenesis, drug development and vaccines. In this scenario, the main objective of this study is to verify possible morphological changes, as well as the presence of antigens and viral RNA in lung samples from BALB/c mice experimentally infected with an epidemic and non-neuroadapted DENV-3 strain. Male BALB/c mice, 2 months old, were inoculated with DENV-3 by intravenous route. After 72 hours of infection, the animals were euthanized and the lungs were collected. Part of the samples was processed by standard technique for analysis by light and transmission electronic microscopies and another part was processed for real-time PCR analysis. Morphological analyzes of lungs from uninfected mice showed preserved tissue areas. In mice infected with DENV-3, the analyzes revealed interalveolar septum thickening with presence of inflammatory infiltrate, foci of alveolar atelectasis and hyperventilation, bleeding foci in the interalveolar septum and bronchioles, peripheral capillary congestion, accumulation of fluid in the blood capillary, signs of interstitial cell necrosis presence of platelets and mononuclear inflammatory cells circulating in the capillaries and/or adhered to the endothelium. In addition, activation of endothelial cells, platelets, mononuclear inflammatory cell and neutrophil-type polymorphonuclear inflammatory cell evidenced by the emission of cytoplasmic membrane prolongation was observed. DEN-like particles were seen in the cytoplasm of endothelial cells. The viral genome was recovered from 3 in 12 lung samples. These results demonstrate that the BALB / c mouse represents a suitable model for the study of the histopathological changes induced by DENV infection in the lung, with tissue alterations similar to those observed in human cases of DEN.

Keywords: BALB/c mice, dengue, histopathology, lung, ultrastructure

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133 Music in Religion Culture of the Georgian Pentecostals

Authors: Nino Naneishvili

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The study of religious minorities and their musical culture has attracted scant academic attention in Georgia. Within wider Georgian society, it would seem that the focus of discourse to date has been on the traditional orthodox religion and its musical expression, with other forms of religious expression regarded as intrinsically less valuable. The goal of this article is to study Georgia's different religious and musical picture which, this time, is presented on the example of the Pentecostals. The first signs of the Pentecostal movement originated at the end of the 19th Century in the USA, and first appeared in Georgia as early as 1914. An ethnomusicological perspective allows the use of anthropological and sociological approaches. The basic methodology is an ethnographic method. This involved attending religious services, observation, in-depth interviews and musical material analysis. This analysis, based on a combined use of various theoretical and methodological approaches, reveals that Georgian Pentecostals, apart from polyphonic singing, are characterised by “ bi-musicality.“ This phenomenon together with Georgian three part polyphony combines vocalisation within “social polyphony.“ The concept of back stage and front stage is highlighted. Chanters also try to express national identity. In some cases however it has been observed that they abandon or conceal certain musical forms of expression which are considered central to Georgian identity. The famous hymn “Thou art a Vineyard” is a case in point. The reason given for this omission within the Georgian Pentecostal church is that within Pentecostal doctrine, God alone is the object of worship. Therefore there is no veneration of Saints as representatives of the Divine. In some cases informants denied the existence of this hymn, and others explain that the meaning conveyed to the Vineyard is that of Jesus Christ and not the Virgin Mary. Others stated that they loved Virgin Mary and were therefore free to sing this song outside church circles. The results of this study illustrates that one of the religious minorities in Georgia, the Pentecostals, are characterised by a deviation in musical thinking from Homo Polyphonicus. They actively change their form of musical worship to secondary ethno hearing – bi-musicality. This outcome is determined by both new religious thinking and the process of globalization. A significant principle behind this form of worship is the use of forms during worship which are acceptable and accessible to all. This naturally leads to the development of modern forms. Obtained material does not demonstrate a connection between traditional religious music in general. Rather, it constitutes an independent domain.

Keywords: Georgia, globalization, music, pentecostal

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132 Exploring the Correlation between Body Constitution of an Individual as Per Ayurveda and Gut Microbiome in Healthy, Multi Ethnic Urban Population in Bangalore, India

Authors: Shalini TV, Gangadharan GG, Sriranjini S Jaideep, ASN Seshasayee, Awadhesh Pandit

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Introduction: Prakriti (body-mind constitution of an individual) is a conventional, customized and unique understanding of which is essential for the personalized medicine described in Ayurveda, Indian System of Medicine. Based on the Doshas( functional, bio humoral unit in the body), individuals are categorized into three major Prakriti- Vata, Pitta, and Kapha. The human gut microbiome hosts plenty of highly diverse and metabolically active microorganisms, mainly dominated by the bacteria, which are known to influence the physiology of an individual. Few researches have shown the correlation between the Prakriti and the biochemical parameters. In this study, an attempt was made to explore any correlation between the Prakriti (phenotype of an individual) with the Genetic makeup of the gut microbiome in healthy individuals. Materials and methods: 270 multi-ethnic, healthy volunteers of both sex with the age group between 18 to 40 years, with no history of antibiotics in the last 6 months were recruited into three groups of Vata, Pitta, and Kapha. The Prakriti of the individual was determined using Ayusoft, a software designed by CDAC, Pune, India. The volunteers were subjected to initial screening for the assessment of their height, weight, Body Mass Index, Vital signs and Blood investigations to ensure they are healthy. The stool and saliva samples of the recruited volunteers were collected as per the standard operating procedure developed, and the bacterial DNA was isolated using Qiagen kits. The extracted DNA was subjected to 16s rRNA sequencing using the Illumina kits. The sequencing libraries are targeting the variable V3 and V4 regions of the 16s rRNA gene. Paired sequencing was done on the MiSeq system and data were analyzed using the CLC Genomics workbench 11. Results: The 16s rRNA sequencing of the V3 and V4 regions showed a diverse pattern in both the oral and stool microbial DNA. The study did not reveal any specific pattern of bacterial flora amongst the Prakriti. All the p-values were more than the effective alpha values for all OTUs in both the buccal cavity and stool samples. Therefore, there was no observed significant enrichment of an OTU in the patient samples from either the buccal cavity or stool samples. Conclusion: In healthy volunteers of multi-ethnicity, due to the influence of the various factors, the correlation between the Prakriti and the gut microbiome was not seen.

Keywords: gut microbiome, ayurveda Prakriti, sequencing, multi-ethnic urban population

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131 Spontaneous Rupture of Splenic Artery Pseudoaneurysm; A Rare Presentation of Acute Abdominal Pain in the Emergency Department: Case Report

Authors: Zainab Elazab, Azhar Aziz

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Background: Spontaneous Splenic artery pseudoaneurysm rupture is a rare condition which is potentially life threatening, if not detected and managed early. We report a case of abdominal pain with intraperitoneal free fluid, which turned out to be spontaneous rupture of a splenic artery pseudoaneurysm, and was treated with arterial embolization. Case presentation: A 28-year old, previously healthy male presented to the ED with a history of sudden onset upper abdominal pain and fainting attack. The patient denied any history of trauma or prior similar attacks. On examination, the patient had tachycardia and a low-normal BP (HR 110, BP 106/66) but his other vital signs were normal (Temp. 37.2, RR 18 and SpO2 100%). His abdomen was initially soft with mild tenderness in the upper region. Blood tests showed leukocytosis of 12.3 X109/L, Hb of 12.6 g/dl and lactic acid of 5.9 mmol/L. Ultrasound showed trace of free fluid in the perihepatic and perisplenic areas, and a splenic hypoechoic lesion. The patient remained stable; however, his abdomen became increasingly tender with guarding. We made a provisional diagnosis of a perforated viscus and the patient was started on IV fluids and IV antibiotics. An erect abdominal x-ray did not show any free air under the diaphragm so a CT abdomen was requested. Meanwhile, bedside ultrasound was repeated which showed increased amount of free fluid, suggesting intra-abdominal bleeding as the most probable etiology for the condition. His CT abdomen revealed a splenic injury with multiple lacerations, a focal intrasplenic enhancing area on venous phase scan (suggesting a pseudoaneurysm with associated splenic intraparenchymal, sub capsular and perisplenic hematomas). Free fluid in the subhepatic and intraperitoneal regions along the small bowel was also detected. Angiogram was done which confirmed a diagnosis of pseudoaneurysm of intrasplenic arterial branch, and angio-embolization was done to control the bleeding. The patient was later discharged in good condition with a surgery follow-up. Conclusion: Splenic artery pseudoaneurysm rupture is a rare cause of abdominal pain which should be considered in any case of abdominal pain with intraperitoneal bleeding. Early management is crucial as it carries a high mortality. Bedside ultrasound is a useful tool to help for early diagnosis of such cases.

Keywords: abdominal pain, pseudo aneurysm, rupture, splenic artery

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130 Change of Bone Density with Treatments of Intravenous Zoledronic Acid in Patients with Osteoporotic Distal Radial Fractures

Authors: Hong Je Kang, Young Chae Choi, Jin Sung Park, Isac Kim

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Purpose: Osteoporotic fractures are an important among postmenopausal women. When osteoporotic distal radial fractures occur, osteoporosis must be treated to prevent the hip and spine fractures. Intravenous injection of Zoledronic acid is expected to improve preventing osteoporotic fractures. Many articles reported the effect of intravenous Zoledronic acid to BMD of the hip and spine fracture or non-fracture patients with low BMD. However, that with distal radial fractures has rarely been reported. Therefore, the authors decided to study the effect of Zoledronic acid in BMD score, bone union, and bone turnover markers in the patients who underwent volar plating due to osteoporotic distal radial fractures. Materials: From April 2018 to May 2022, postmenopausal women aged 55 years or older who had osteoporotic distal radial fractures and who underwent surgical treatment using volar plate fixation were included. Zoledronic acid (5mg) was injected intravenously between 3 and 5 days after surgery. BMD scores after 1 year of operation were compared with the initial scores. Bone turnover markers were measured before surgery, after 3 months, and after 1 year. Radiological follow-up was performed every 2 weeks until the bone union and at 1 year postoperatively. Clinical outcome indicators were measured one year after surgery, and the occurrence of side effects was observed. Result: Total of 23 patients were included, with a lumbar BMD T score of -2.89±0.2 before surgery to -2.27±0.3 one year after surgery (p=0.012) and a femoral neck BMD T score of -2.45±0.3 before surgery to -2.36±0.3 (p=0.041) after one year, and all were statistically significant. Measured as bone resorption markers, serum CTX-1 was 337.43±10.4 pg/mL before surgery, 160.86±8.7 pg/mL (p=0.022) after three months, and 250.12±12.7 pg/mL (p=0.031) after one year. Urinary NTX-1 was 39.24±2.2 ng/mL before surgery, 24.46±1.2 ng/mL (p=0.014) after three months and 30.35±1.6 ng/mL (p=0.042) after one year. Measured as bone formation markers, serum osteocalcin was 13.04±1.1 ng/mL before surgery, 8.84±0.7 ng/mL (p=0.037) after 3 months and 11.1±0.4 ng/mL (p=0.026) after one year. Serum bone-specific ALP was 11.24±0.9 IU/L before surgery, 8.25±0.9 IU/L (p=0.036) after three months, and 10.2±0.9 IU/L (p=0.027) after one year. All were statistically significant. All cases showed bone union within an average of 6.91±0.3 weeks without any signs of failure. Complications were found in 5 out of 23 cases (21.7%), such as headache, nausea, muscle pain, and fever. Conclusion: When Zoledronic acid was used, BMD was improved in both the spine and femoral neck. This may reduce the likelihood and subsequent morbidity of additional osteoporotic fractures. This study is meaningful in that there was no difference in the duration of bone union and radiological characteristics in patients with distal radial fractures administrated with intravenous BP early after the fractures, and improvement in BMD and bone turnover indicators was measured.

Keywords: zeoldreonic acid, BMD, osteoporosis, distal radius

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129 Intensive Neurophysiological Rehabilitation System: New Approach for Treatment of Children with Autism

Authors: V. I. Kozyavkin, L. F. Shestopalova, T. B. Voloshyn

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Introduction: Rehabilitation of children with Autism is the issue of the day in psychiatry and neurology. It is attributed to constantly increasing quantity of autistic children - Autistic Spectrum Disorders (ASD) Existing rehabilitation approaches in treatment of children with Autism improve their medico- social and social- psychological adjustment. Experience of treatment for different kinds of Autistic disorders in International Clinic of Rehabilitation (ICR) reveals the necessity of complex intensive approach for healing this malady and wider implementation of a Kozyavkin method for treatment of children with ASD. Methods: 19 children aged from 3 to 14 years were examined. They were diagnosed ‘Autism’ (F84.0) with comorbid neurological pathology (from pyramidal insufficiency to para- and tetraplegia). All patients underwent rehabilitation in ICR during two weeks, where INRS approach was used. INRS included methods like biomechanical correction of the spine, massage, physical therapy, joint mobilization, wax-paraffin applications. They were supplemented by art- therapy, ergotherapy, rhythmical group exercises, computer game therapy, team Olympic games and other methods for improvement of motivation and social integration of the child. Estimation of efficacy was conducted using parent’s questioning and done twice- on the onset of INRS rehabilitation course and two weeks afterward. For efficacy assessment of rehabilitation of autistic children in ICR standardized tool was used, namely Autism Treatment Evaluation Checklist (ATEC). This scale was selected because any rehabilitation approaches for the child with Autism can be assessed using it. Results: Before the onset of INRS treatment mean score according to ATEC scale was 64,75±9,23, it reveals occurrence in examined children severe communication, speech, socialization and behavioral impairments. After the end of the rehabilitation course, the mean score was 56,5±6,7, what indicates positive dynamics in comparison to the onset of rehabilitation. Generally, improvement of psychoemotional state occurred in 90% of cases. Most significant changes occurred in the scope of speech (16,5 before and 14,5 after the treatment), socialization (15.1 before and 12,5 after) and behavior (20,1 before and 17.4 after). Conclusion: As a result of INRS rehabilitation course reduction of autistic symptoms was noted. Particularly improvements in speech were observed (children began to spell out new syllables, words), there was some decrease in signs of destructiveness, quality of contact with the surrounding people improved, new skills of self-service appeared. The prospect of the study is further, according to evidence- based medicine standards, deeper examination of INRS and assessment of its usefulness in treatment for Autism and ASD.

Keywords: intensive neurophysiological rehabilitation system (INRS), international clinic od rehabilitation, ASD, rehabilitation

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128 Hematological Changes in the Hydatidosed Male Sheep after Experimental Inoculation of Echinococcus granulosus Eggs

Authors: M. Younus, Muhammad Shafique, M. Athar Khan, Tanveer Akhtar , M. Moeen Athar

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A total of 48 apparently healthy weaned sheep lambs (Ovis aries) of 8-10 weeks old weighing 7-10 Kg were purchased from the contractors, maintained in the experimental station of University of the Punjab, Quaid-e-Azam Campus at Lahore, Pakistan. They were dewormed against nematodes with levamisole (ICI) at recommended dose rates. The feces were tested against the parasitic eggs, no helminths ova were seen. All the 48 sheep lambs were divided into two groups i.e. group A & group B. Group 'A' comprising of 40 sheep, kept as infected groups whereas group 'B' comprising of 08 sheep & kept as a new infected control group. Each sheep lamb of group A was given 3-4 fresh gravid segments contains 2-3 thousand eggs of Echinococcus granulosus. These were collected from experimentally infected dogs by feeding fresh hydrated cysts collected from liver & lungs of sheep after slaughtering. Each lamb was fed with fresh gravid segments for a total period of 5 days or each alternate day. Coagulated blood was collected before the start of infected diet and after every month by jugular phlebotomy of each sheep lamb from the infected & new infected control group. One lamb each from group A & group B was slaughtered at the end of each month for the presence of macroscopic hydatid cyst in viscera & abdominal cavity. After 180 days of the experiment, hydatid cysts were confirmed in the abdominal cavity. Hematological parameters of zero days & then at the end of every month revealed that there was a gradual increase (PL 0.05) in the White Blood Cell (WBC), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin Concentration (MCHC) and Erythrocyte Sedimentation Rates (ESR). The increasing trend was probably due to inflammatory response and lytic effect of the newly developing E. granulosus hydatid cysts. The red blood cell (RBC), Hemoglobin (HB), Packed Cell Volume (PCV) and Mean Corpuscular Hemoglobin (MCH) infected groups were decreased significantly as compared to the control group (PL 0.05). The experiment was terminated at the end of the 7th month. It can be concluded that Echinococcus granulosus can damage livestock and other intermediate hosts such as horses, the development of hydatid cysts affect the organs due to the growing cysts pressuring the organ tissues. Parts of the tissue die, which impairs the functioning of the affected organ. The clinical signs depend on the affected organ. The major damage for livestock is organ condemnation at slaughter.

Keywords: echinococcus granulosus, hydatidosis, sheep, hematology

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127 Safety Evaluation of Intramuscular Administration of Zuprevo® Compared to Draxxin® in the Treatment of Swine Respiratory Disease at Weaning Age

Authors: Josine Beek, S. Agten, R. Del Pozo, B. Balis

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The objective of the present study was to compare the safety of intramuscular administration of Zuprevo® (tildipirosin, 40 mg/mL) with Draxxin® (tulathromycin, 100 mg/mL) in the treatment of swine respiratory disease at weaning age. The trial was carried out in two farrow-to-finish farms with 300 sows (farm A) and 500 sows (farm B) in a batch-production system. Farm A had no history of respiratory problems, whereas farm B had a history of respiratory outbreaks with increased mortality ( > 2%) in the nursery. Both farms were positive to Pasteurella multocida, Bordetella bronchiseptica, Actinobacillus pleuropneumoniae and Haemophilus parasuis. From each farm, one batch of piglets was included (farm A: 644 piglets; farm B: 963 piglets). One day before weaning (day 0; 18-21 days of age), piglets were identified by an individual ear tag and randomly assigned to a treatment group. At day 0, Group 1 was treated with a single intramuscular injection with Zuprevo® (tildipirosin, 40 mg/mL; 1 mL/10 kg) and group 2 with Draxxin® (tulathromycin, 100 mg/mL; 1 mL/40 kg). For practical reasons, dosage of the product was adjusted according to three weight categories: < 4 kg, 4-6 kg and > 6 kg. Within each farm, piglets of both groups were comingled at weaning and subsequently managed and located in the same facilities and with identical environmental conditions. Our study involved the period from day 0 until 10 weeks of age. Safety of treatment was evaluated by 1) visual examination for signs of discomfort directly after treatment and after 15 min, 1 h and 24 h and 2) mortality rate within 24 h after treatment. Efficacy of treatment was evaluated based on mortality rate from day 0 until 10 weeks of age. Each piglet that died during the study period was necropsied by the herd veterinarian to determine the probable cause of death. Data were analyzed using binary logistic regression and differences were considered significant if p < 0.05. The pig was the experimental unit. In total, 848 piglets were treated with tildipirosin and 759 piglets with tulathromycin. In farm A, one piglet with retarded growth ( < 1 kg at 18 days of age) showed an adverse reaction after injection of tildipirosin: lateral recumbence and dullness for ± 30 sec. The piglet recovered after 1-2 min. This adverse reaction was probably due to overdosing (12 mg/kg). No adverse effect of treatment was observed in any other piglet. There was no mortality within 24 h after treatment. No significant difference was found in mortality rate between both groups from day 0 until 10 weeks of age. In farm A, overall mortality rate was 0.3% (2/644). In farm B, mortality rate was 0.2% (1/502) in group 1 (tildipirosin) and 0.9% (4/461) in group 2 (tulathromycin)(p=0.60). The necropsy of piglets that died during the study period revealed no macroscopic lesions of the respiratory tract. In conclusion, Zuprevo® (tildipirosin, 40 mg/mL) was shown to be a safe and efficacious alternative to Draxxin® (tulathromycin, 100 mg/mL) for the early treatment of swine respiratory disease at weaning age.

Keywords: antibiotic treatment, safety, swine respiratory disease, tildipirosin

Procedia PDF Downloads 365
126 Implementing Peer Mediated Interventions with Visual Supports for Social Skills Development in a School-Based Work Setting with Secondary Students with Autism

Authors: Karen Eastman

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More youths and young adults with autism spectrum disorder (ASD) have been entering the workforce in recent years. Historically, students with ASD struggle after leaving high school and experience lower rates of employment, with social skills continuing to be the most problematic area of concern. Special education teachers may find it challenging to identify effective combinations of evidence-based practices (EBPs) and supports to best guide these students. One EBP, Peer Mediated Instruction and Intervention (PMII) has been well documented in the literature as being effective for younger students with autism but not researched as much with older students and adults, particularly in work settings. A need to combine PMII with other EBPs has been identified as a way to achieve a greater positive impact rather than any practice alone. A multiple baseline across skills design was used in this research project with two participants in different settings. PMII was combined with Visual Supports, with typical peers being trained in both practices. PMII is an evidence-based practice used to address social concerns by training peers without disabilities as to how they can provide feedback to and support, the student with ASD with social interactions in structured settings. The peers without disabilities were the instructors, while the adults facilitated the social situations and provided support to both the peers and students with ASD when needed. Because many individuals with ASD learn best with visual input, rather than using only the spoken word (verbal directions and feedback), Visual Supports were used in conjunction with PMII. Visual Supports can include written words, pictures, symbols, videos, or objects. In this project, the Visual Supports used were written social scripts, videos, Stop and Think signs, written reminder cards, a school map, and a pictorial task analysis of work tasks. Variables that may affect intervention outcomes in this project included attendance at school and school-based work settings for both the students with ASD and the peers without disabilities and behaviors and responses from others in the settings. Qualitative data was also collected from observations and surveys with peers about the process and their role. Data indicated that the students with ASD responded more positively to redirection and support from their peers than to teachers and staff and showed an increase in positive interactions with others. Those surveyed indicated a positive attitude toward and response to the use of peer interventions with visual supports.

Keywords: autism, social skills, vocational training, peer interventions

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125 Poultry in Motion: Text Mining Social Media Data for Avian Influenza Surveillance in the UK

Authors: Samuel Munaf, Kevin Swingler, Franz Brülisauer, Anthony O’Hare, George Gunn, Aaron Reeves

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Background: Avian influenza, more commonly known as Bird flu, is a viral zoonotic respiratory disease stemming from various species of poultry, including pets and migratory birds. Researchers have purported that the accessibility of health information online, in addition to the low-cost data collection methods the internet provides, has revolutionized the methods in which epidemiological and disease surveillance data is utilized. This paper examines the feasibility of using internet data sources, such as Twitter and livestock forums, for the early detection of the avian flu outbreak, through the use of text mining algorithms and social network analysis. Methods: Social media mining was conducted on Twitter between the period of 01/01/2021 to 31/12/2021 via the Twitter API in Python. The results were filtered firstly by hashtags (#avianflu, #birdflu), word occurrences (avian flu, bird flu, H5N1), and then refined further by location to include only those results from within the UK. Analysis was conducted on this text in a time-series manner to determine keyword frequencies and topic modeling to uncover insights in the text prior to a confirmed outbreak. Further analysis was performed by examining clinical signs (e.g., swollen head, blue comb, dullness) within the time series prior to the confirmed avian flu outbreak by the Animal and Plant Health Agency (APHA). Results: The increased search results in Google and avian flu-related tweets showed a correlation in time with the confirmed cases. Topic modeling uncovered clusters of word occurrences relating to livestock biosecurity, disposal of dead birds, and prevention measures. Conclusions: Text mining social media data can prove to be useful in relation to analysing discussed topics for epidemiological surveillance purposes, especially given the lack of applied research in the veterinary domain. The small sample size of tweets for certain weekly time periods makes it difficult to provide statistically plausible results, in addition to a great amount of textual noise in the data.

Keywords: veterinary epidemiology, disease surveillance, infodemiology, infoveillance, avian influenza, social media

Procedia PDF Downloads 73
124 Subjectivity in Miracle Aesthetic Clinic Ambient Media Advertisement

Authors: Wegig Muwonugroho

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Subjectivity in advertisement is a ‘power’ possessed by advertisements to construct trend, concept, truth, and ideology through subconscious mind. Advertisements, in performing their functions as message conveyors, use such visual representation to inspire what’s ideal to the people. Ambient media is advertising medium making the best use of the environment where the advertisement is located. Miracle Aesthetic Clinic (Miracle) popularizes the visual representation of its ambient media advertisement through the omission of face-image of both female mannequins that function as its ambient media models. Usually, the face of a model in advertisement is an image commodity having selling values; however, the faces of ambient media models in Miracle advertisement campaign are suppressed over the table and wall. This face concealing aspect creates not only a paradox of subjectivity but also plurality of meaning. This research applies critical discourse analysis method to analyze subjectivity in obtaining the insight of ambient media’s meaning. First, in the stage of textual analysis, the embedding attributes upon female mannequins imply that the models are denoted as the representation of modern women, which are identical with the identities of their social milieus. The communication signs aimed to be constructed are the women who lose their subjectivities and ‘feel embarrassed’ to flaunt their faces to the public because of pimples on their faces. Second, in the stage of analysis of discourse practice, it points out that ambient media as communication media has been comprehensively responded by the targeted audiences. Ambient media has a role as an actor because of its eyes-catching setting, and taking space over the area where the public are wandering around. Indeed, when the public realize that the ambient media models are motionless -unlike human- stronger relation then appears, marked by several responses from targeted audiences. Third, in the stage of analysis of social practice, soap operas and celebrity gossip shows on the television become a dominant discourse influencing advertisement meaning. The subjectivity of Miracle Advertisement corners women by the absence of women participation in public space, the representation of women in isolation, and the portrayal of women as an anxious person in the social rank when their faces suffered from pimples. The Ambient media as the advertisement campaign of Miracle is quite success in constructing a new trend discourse of face beauty that is not limited on benchmarks of common beauty virtues, but the idea of beauty can be presented by ‘when woman doesn’t look good’ visualization.

Keywords: ambient media, advertisement, subjectivity, power

Procedia PDF Downloads 293
123 The Relationship between Self-Injurious Behavior and Manner of Death

Authors: Sait Ozsoy, Hacer Yasar Teke, Mustafa Dalgic, Cetin Ketenci, Ertugrul Gok, Kenan Karbeyaz, Azem Irez, Mesut Akyol

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Self-mutilating behavior or self-injury behavior (SIB) is defined as: intentional harm to one’s body without intends to commit suicide”. SIB cases are commonly seen in psychiatry and forensic medicine practices. Despite variety of SIB methods, cuts in the skin is the most common (70-97%) injury in this group of patients. Subjects with SIB have one or more other comorbidities which include depression, anxiety, depersonalization, and feeling of worthlessness, borderline personality disorder, antisocial behaviors, and histrionic personality. These individuals feel a high level of hostility towards themselves and their surroundings. Researches have also revealed a strong relationship between antisocial personality disorder, criminal behavior, and SIB. This study has retrospectively evaluated 6,599 autopsy cases performed at forensic medicine institutes of six major cities (Ankara, Izmir, Diyarbakir, Erzurum, Trabzon, Eskisehir) of Turkey in 2013. The study group consisted of all cases with SIB findings (psychopathic cuts, cigarette burns, scars, and etc.). The relationship between causes of death in the study group (SIB subjects) and the control group was investigated. The control group was created from subjects without signs of SIB. Mann-Whitney U test was used for age variables and Chi-square test for categorical variables. Multinomial logistic regression analysis was used in order to analyze group differences in respect to manner of death (natural, accident, homicide, suicide) and analysis of risk factors associated with each group was determined by the Binomial logistic regression analysis. This study used SPSS statistics 15.0 for all its statistical and calculation needs. The statistical significance was p <0.05. There was no significant difference between accidental and natural death among the groups (p=0.737). Also there was a unit increase in number of cuts in psychopathic group while number of accidental death decreased (95% CI: 0.941-0.993) by 0.967 times (p=0.015). In contrast, there was a significant difference between suicidal and natural death (p<0.001), and also between homicidal and natural death (p=0.025). SIB is often seen with borderline and antisocial personality disorder but may be associated with many psychiatric illnesses. Studies have shown a relationship between antisocial personality disorders with criminal behavior and SIB with suicidal behavior. In our study, rate of suicide, murder and intoxication was higher compared to the control group. It could be concluded that SIB can be used as a predictor of possibility of one’s harm to him/herself and other people.

Keywords: autopsy, cause of death, forensic science, self-injury behaviour

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122 Long Term Survival after a First Transient Ischemic Attack in England: A Case-Control Study

Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

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Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.

Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model

Procedia PDF Downloads 122
121 Studies on Effect of Nano Size and Surface Coating on Enhancement of Bioavailability and Toxicity of Berberine Chloride; A p-gp Substrate

Authors: Sanjay Singh, Parameswara Rao Vuddanda

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The aim of the present study is study the factual benefit of nano size and surface coating of p-gp efflux inhibitor on enhancement of bioavailability of Berberine chloride (BBR); a p-gp substrate. In addition, 28 days sub acute oral toxicity study was also conducted to assess the toxicity of the formulation on chronic administration. BBR loaded polymeric nanoparticles (BBR-NP) were prepared by nanoprecipitation method. BBR NP were surface coated (BBR-SCNP) with the 1 % w/v of vitamin E TPGS. For bioavailability study, total five groups (n=6) of rat were treated as follows first; pure BBR, second; physical mixture of BBR, carrier and vitamin E TPGS, third; BBR-NP, fourth; BBR-SCNP and fifth; BBR and verapamil (widely used p-gp inhibitor). Blood was withdrawn at pre-set timing points in 24 hrs study and drug was quantified by HPLC method. In oral chronic toxicity study, total four groups (n=6) were treated as follows first (control); water, second; pure BBR, third; BBR surface coated nanoparticles and fourth; placebo BBR surface coated nanoparticles. Biochemical levels of liver (AST, ALP and ALT) and kidney (serum urea and creatinine) along with their histopathological studies were also examined (0-28 days). The AUC of BBR-SCNP was significantly 3.5 folds higher compared to all other groups. The AUC of BBR-NP was 3.23 and 1.52 folds higher compared to BBR solution and BBR with verapamil group, respectively. The physical mixture treated group showed slightly higher AUC than BBR solution treated group but significantly low compared to other groups. It indicates that encapsulation of BBR in nanosize form can circumvent P-gp efflux effect. BBR-NP showed pharmacokinetic parameters (Cmax and AUC) which are near to BBR-SCNP. However, the difference in values of T1/2 and clearance indicate that surface coating with vitamin E TPGS not only avoids the P-gp efflux at its absorption site (intestine) but also at organs which are responsible for metabolism and excretion (kidney and liver). It may be the reason for observed decrease in clearance of BBR-SCNP. No toxicity signs were observed either in biochemical or histopathological examination of liver and kidney during toxicity studies. The results indicate that administration of BBR in surface coated nanoformulation would be beneficial for enhancement of its bioavailability and longer retention in systemic circulation. Further, sub acute oral dose toxicity studies for 28 days such as evaluation of intestine, liver and kidney histopathology and biochemical estimations indicated that BBR-SCNP developed were safe for long use.

Keywords: bioavailability, berberine nanoparticles, p-gp efflux inhibitor, nanoprecipitation method

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120 Technology for Good: Deploying Artificial Intelligence to Analyze Participant Response to Anti-Trafficking Education

Authors: Ray Bryant

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3Strands Global Foundation (3SGF), a non-profit with a mission to mobilize communities to combat human trafficking through prevention education and reintegration programs, launched a groundbreaking study that calls out the usage and benefits of artificial intelligence in the war against human trafficking. Having gathered more than 30,000 stories from counselors and school staff who have gone through its PROTECT Prevention Education program, 3SGF sought to develop a methodology to measure the effectiveness of the training, which helps educators and school staff identify physical signs and behaviors indicating a student is being victimized. The program further illustrates how to recognize and respond to trauma and teaches the steps to take to report human trafficking, as well as how to connect victims with the proper professionals. 3SGF partnered with Levity, a leader in no-code Artificial Intelligence (AI) automation, to create the research study utilizing natural language processing, a branch of artificial intelligence, to measure the effectiveness of their prevention education program. By applying the logic created for the study, the platform analyzed and categorized each story. If the story, directly from the educator, demonstrated one or more of the desired outcomes; Increased Awareness, Increased Knowledge, or Intended Behavior Change, a label was applied. The system then added a confidence level for each identified label. The study results were generated with a 99% confidence level. Preliminary results show that of the 30,000 stories gathered, it became overwhelmingly clear that a significant majority of the participants now have increased awareness of the issue, demonstrated better knowledge of how to help prevent the crime, and expressed an intention to change how they approach what they do daily. In addition, it was observed that approximately 30% of the stories involved comments by educators expressing they wish they’d had this knowledge sooner as they can think of many students they would have been able to help. Objectives Of Research: To solve the problem of needing to analyze and accurately categorize more than 30,000 data points of participant feedback in order to evaluate the success of a human trafficking prevention program by using AI and Natural Language Processing. Methodologies Used: In conjunction with our strategic partner, Levity, we have created our own NLP analysis engine specific to our problem. Contributions To Research: The intersection of AI and human rights and how to utilize technology to combat human trafficking.

Keywords: AI, technology, human trafficking, prevention

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119 Cardiac Pacemaker in a Patient Undergoing Breast Radiotherapy-Multidisciplinary Approach

Authors: B. Petrović, M. Petrović, L. Rutonjski, I. Djan, V. Ivanović

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Objective: Cardiac pacemakers are very sensitive to radiotherapy treatment from two sources: electromagnetic influence from the medical linear accelerator producing ionizing radiation- influencing electronics within the pacemaker, and the absorption of dose to the device. On the other hand, patients with cardiac pacemakers at the place of a tumor are rather rare, and single clinic hardly has experience with the management of such patients. The widely accepted international guidelines for management of radiation oncology patients recommend that these patients should be closely monitored and examined before, during and after radiotherapy treatment by cardiologist, and their device and condition followed up. The number of patients having both cancer and pacemaker, is growing every year, as both cancer incidence, as well as cardiac diseases incidence, are inevitably growing figures. Materials and methods: Female patient, age 69, was diagnozed with valvular cardiomyopathy and got implanted a pacemaker in 2005 and prosthetic mitral valve in 1993 (cancer was diagnosed in 2012). She was stable cardiologically and came to radiation therapy department with the diagnosis of right breast cancer, with the tumor in upper lateral quadrant of the right breast. Since she had all lymph nodes positive (28 in total), she had to have irradiated the supraclavicular region, as well as the breast with the tumor bed. She previously received chemotherapy, approved by the cardiologist. The patient was estimated to be with the high risk as device was within the field of irradiation, and the patient had high dependence on her pacemaker. The radiation therapy plan was conducted as 3D conformal therapy. The delineated target was breast with supraclavicular region, where the pacemaker was actually placed, with the addition of a pacemaker as organ at risk, to estimate the dose to the device and its components as recommended, and the breast. The targets received both 50 Gy in 25 fractions (where 20% of a pacemaker received 50 Gy, and 60% of a device received 40 Gy). The electrode to the heart received between 1 Gy and 50 Gy. Verification of dose planned and delivered was performed. Results: Evaluation of the patient status according to the guidelines and especially evaluation of all associated risks to the patient during treatment was done. Patient was irradiated by prescribed dose and followed up for the whole year, with no symptoms of failure of the pacemaker device during, or after treatment in follow up period. The functionality of a device was estimated to be unchanged, according to the parameters (electrode impedance and battery energy). Conclusion: Patient was closely monitored according to published guidelines during irradiation and afterwards. Pacemaker irradiated with the full dose did not show any signs of failure despite recommendations data, but in correlation with other published data.

Keywords: cardiac pacemaker, breast cancer, radiotherapy treatment planning, complications of treatment

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118 Anti-Arthritic Effect of a Herbal Diet Formula Comprising Fruits of Rosa Multiflora and Flowers of Lonicera Japonica

Authors: Brian Chi Yan Cheng, Hui Guo, Tao Su, Xiu‐qiong Fu, Ting Li, Zhi‐ling Yu

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Rheumatoid arthritis (RA) affects around 1% of the globe population. Yet, there is still no cure for RA. Toll-like receptor 4 (TLR4) signalling has been found to be involved in the pathogenesis of RA, making it a potential therapeutic target for RA treatment. A herbal formula (RL) consisting of fruits of Rosa Multiflora (Eijitsu rose) and flowers of Lonicera Japonica (Japanese honeysuckle) has been used in treating various inflammatory disorders for more than a thousand year. Both of them are rich sources of nutrients and bioactive phytochemicals, which can be used in producing different food products and supplements. In this study, we would evaluate the anti-arthritic effect of RL on collagen-induced arthritis (CIA) in rats and investigate the involvement of TLR4 signaling in the mode of action of RL. Anti-arthritic efficacy was evaluated using CIA rats induced by bovine type II collagen. The treatment groups were treated with RL (82.5, 165, and 330 mg/kg bw per day, p.o.) or positive control indomethacin (0.25 mg/kg bw per day, p.o.) for 35 days. Clinical signs (hind paw volume and arthritis severity scores), changes in serum inflammatory mediators, pro-/antioxidant status, histological and radiographic changes of joints were investigated. Spleens and peritoneal macrophages were used to determine the effects of RL on innate and adaptive immune responses in CIA rats. The involvement of TLR4 signalling pathways in the anti-arthritic effect of RL was examined in cartilage tissue of CIA rats, murine RAW264.7 macrophages and human THP-1 monocytic cells. The severity of arthritis in the CIA rats was significantly attenuated by RL. Antioxidant status, histological score and radiographic score were efficiently improved by RL. RL could also dose-dependently inhibit pro-inflammatory cytokines in serum of CIA rats. RL significantly inhibited the production of various pro-inflammatory mediators, the expression and/or activity of the components of TLR4 signalling pathways in animal tissue and cell lines. RL possesses anti-arthritic effect on collagen-induced arthritis in rats. The therapeutic effect of RL may be related to its inhibition on pro-inflammatory cytokines in serum. The inhibition of the TAK1/NF-κB and TAK1/MAPK pathways participate in the anti-arthritic effects of RL. This provides a pharmacological justification for the dietary use of RL in the control of various arthritic diseases. Further investigation should be done to develop RL into a anti-arthritic food products and/or supplements.

Keywords: japanese honeysuckle, rheumatoid arthritis, rosa multiflora, rosehip

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117 Clinicians' and Nurses' Documentation Practices in Palliative and Hospice Care: A Mixed Methods Study Providing Evidence for Quality Improvement at Mobile Hospice Mbarara, Uganda

Authors: G. Natuhwera, M. Rabwoni, P. Ellis, A. Merriman

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Aims: Health workers are likely to document patients’ care inaccurately, especially when using new and revised case tools, and this could negatively impact patient care. This study set out to; (1) assess nurses’ and clinicians’ documentation practices when using a new patients’ continuation case sheet (PCCS) and (2) explore nurses’ and clinicians’ experiences regarding documentation of patients’ information in the new PCCS. The purpose of introducing the PCCS was to improve continuity of care for patients attending clinics at which they were unlikely to see the same clinician or nurse consistently. Methods: This was a mixed methods study. The cross-sectional inquiry retrospectively reviewed 100 case notes of active patients on hospice and palliative care program. Data was collected using a structured questionnaire with constructs formulated from the new PCCS under study. The qualitative element was face-to-face audio-recorded, open-ended interviews with a purposive sample of one palliative care clinician, and four palliative care nurse specialists. Thematic analysis was used. Results: Missing patients’ biogeographic information was prevalent at 5-10%. Spiritual and psychosocial issues were not documented in 42.6%, and vital signs in 49.2%. Poorest documentation practices were observed in past medical history part of the PCCS at 40-63%. Four themes emerged from interviews with clinicians and nurses-; (1) what remains unclear and challenges, (2) comparing the past with the present, (3) experiential thoughts, and (4) transition and adapting to change. Conclusions: The PCCS seems to be a comprehensive and simple tool to be used to document patients’ information at subsequent visits. The comprehensiveness and utility of the PCCS does paper to be limited by the failure to train staff in its use prior to introducing. The authors find the PCCS comprehensive and suitable to capture patients’ information and recommend it can be adopted and used in other palliative and hospice care settings, if suitable introductory training accompanies its introduction. Otherwise, the reliability and validity of patients’ information collected by this PCCS can be significantly reduced if some sections therein are unclear to the clinicians/nurses. The study identified clinicians- and nurses-related pitfalls in documentation of patients’ care. Clinicians and nurses need to prioritize accurate and complete documentation of patient care in the PCCS for quality care provision. This study should be extended to other sites using similar tools to ensure representative and generalizable findings.

Keywords: documentation, information case sheet, palliative care, quality improvement

Procedia PDF Downloads 120
116 Causes of Road Crashes Among Students Attending Schools in Huye District and Kigali City

Authors: Ami Nkumbuye

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Background: Every year 1.3 million people die due to Road crashes, according to the Global status report. Road crashes remain the greatest killer aged between 15-29 years. Young people are paying an unacceptable price for their own safer mobility. 23,498 students attending class daily from home crossing the roads of 3 districts Kigali and Southern province is showing a similar trend with 40320 cross road daily. As most of them don't have any idea about the safety, they should have when they are crossing roads and traffic rules and signs as well. Despite the high number of mortality related to road crashes in Rwanda, we don't have any approved calendar to teach young people road safety as the most affected age group. Objective: The objective of this study was to identify the causes of road crashes and the outcome of victims after being involved in road crashes over a period of two years, from January 2020 to December 2021, in Huye district and Kigali City. Methods: A retrospective descriptive study with open questions and then data analysis, students were identified from 15 schools in Kigali City and Southern Province and through the Local Action Project supported by Global Youth Coalition for Road Safety and Youth for Road Safety (YOURS), students asked about the cause of road crashes through open and closed question and data analyzed. Result: There were 354 students from 15 schools: 198 males and 156 females. Their age ranged from 10 to 25 years. The commonest cause of road crashes among students attending schools daily was: high speed, lack of education on safe behavior on the road, drinking and driving, and poor road infrastructures, with 47%, 32%, 13% and 8 %, respectively. The hospital admission after road crashes for the victims was 32.3%. In most scenes where road crashes occur, students report that they didn't see any person who could provide post-crash care until the ambulance came, in some cases, resulted in bad outcomes for the victims after road crashes. Conclusion: This study revealed that high speed and lack of education n road safety are the major cause of road crashes among young people in Rwanda. If local Non-Governmental Organization and Decision makers work on these issues like never before, we can see a decrease in road crash among young people and adult as well. We would like to give a recommendation to two institutions: the first is the Rwanda National Police Traffic department to set 30km/m as the maximum speed limit in City and near schools. The second is for the Ministry of Education to put Road Safety and Post Crash Care curricula in both Primary and Secondary schools.

Keywords: road safety, post-crash care, young people, students

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115 Constructivist Grounded Theory of Intercultural Learning

Authors: Vaida Jurgile

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Intercultural learning is one of the approaches taken to understand the cultural diversity of the modern world and to accept changes in cultural identity and otherness and the expression of tolerance. During intercultural learning, students develop their abilities to interact and communicate with their group members. These abilities help to understand social and cultural differences, to form one’s identity, and to give meaning to intercultural learning. Intercultural education recognizes that a true understanding of differences and similarities of another culture is necessary in order to lay the foundations for working together with others, which contributes to the promotion of intercultural dialogue, appreciation of diversity, and cultural exchange. Therefore, it is important to examine the concept of intercultural learning, revealed through students’ learning experiences and understanding of how this learning takes place and what significance this phenomenon has in higher education. At a scientific level, intercultural learning should be explored in order to uncover the influence of cultural identity, i.e., intercultural learning should be seen in a local context. This experience would provide an opportunity to learn from various everyday intercultural learning situations. Intercultural learning can be not only a form of learning but also a tool for building understanding between people of different cultures. The research object of the study is the process of intercultural learning. The aim of the dissertation is to develop a grounded theory of the process of learning in an intercultural study environment, revealing students’ learning experiences. The research strategy chosen in this study is a constructivist grounded theory (GT). GT is an inductive method that seeks to form a theory by applying the systematic collection, synthesis, analysis, and conceptualization of data. The targeted data collection was based on the analysis of data provided by previous research participants, which revealed the need for further research participants. During the research, only students with at least half a year of study experience, i.e., who have completed at least one semester of intercultural studies, were purposefully selected for the research. To select students, snowballing sampling was used. 18 interviews were conducted with students representing 3 different fields of sciences (social sciences, humanities, and technology sciences). In the process of intercultural learning, language expresses and embodies cultural reality and a person’s cultural identity. It is through language that individual experiences are expressed, and the world in which Others exist is perceived. The increased emphasis is placed on the fact that language conveys certain “signs’ of communication and perception with cultural value, enabling the students to identify the Self and the Other. Language becomes an important tool in the process of intercultural communication because it is only through language that learners can communicate, exchange information, and understand each other. Thus, in the process of intercultural learning, language either promotes interpersonal relationships with foreign students or leads to mutual rejection.

Keywords: intercultural learning, grounded theory, students, other

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114 Comparative Hematological Analysis of Blood Profile in Experimentally Infected with Trichinella spiralis, Trichinella britovi and Trichinella pseudospiralis Mice

Authors: Valeria T. Dilcheva, Svetlozara L. Petkova, Ivelin Vladov

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Trichinellosis is a food-borne parasitic disease caused by nematodes of the genus Trichinella which are zoonotic parasites with cosmopolitan distribution and major socio-economic importance. Human infection is acquired through consumption of undercooked meat from domestic or wild animal. Penetration of Trichinella larvae into striated skeletal muscle cells results in ultrastructural and metabolic changes. Migration of larvae causes the typical symptoms and signs of the disease. The severity of the symptoms depends on the number of ingested Trichinella larvae and the immune response of the host. Eosinophilia is present, with few exceptions, in most cases of human trichinellosis, inasmuch as it is the earliest and most important host response. Even in human asymptomatic cases, increases in eosinophilia of up to 15% have been observed. Eosinophilia appears at an early stage of infection between the second and fifth weeks of infection. By 2005 it was considered that only two species of Trichinella genus were found in the country. After routine trichinelloscopy procedure disseminated single muscle larvae in samples of wild boars and badger were PCR-identified as T. pseudospiralis. The study aimed to observed hematological changes occurring during experimentally induced infection with Trichinella spiralis, T. britovi and T. pseudospiralis in mice. We performed hematological blood profile, tracking 15 blood indicators. In statistical analysis made by Two-way ANOVA, there were significant differences of HGB, MCHC, PLT, Lymph%, Gran% in all three types of trichinellosis compared to control animals. Capsule-forming T. spiralis showed statistically significant differences in HGB, MCHC, Lymph% and PLT compared to the other two species. Non capsule-forming T. pseudospiralis showed statistically significant differences in Lymph%, Gran% relative to the control and in Gran% relative to T. spiralis. It appears rather substantial the process of capsule formation for prolonged immune response and retention of high content of percentage of lymphocytes(Lymph%) and low of granulocyte(Gran%) in T. pseudospiralis, which is contrary to studies for T. spiralis and eosinophilia. Studies and analyzes of some specific blood profile parameters can provide additional data in favor of early diagnosis and adequate treatment as well as provide a better understanding of acute and chronic trichinosis.

Keywords: hematological test, T. britovi, T. spiralis, T. pseudospiralis

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113 Mechanisms of Atiulcerogenic Activity of Costus speciosus Rhizome Extract in Ethanol-Induced Gastric Mucosal Injury in Rats

Authors: Somayeh Fani, Mahmood Ameen Abdulla

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Costus speciosus is an important Malaysian medicinal plant commonly used traditionally in the treatment of many aliments. The present investigation is designed to elucidate preventive effects of ethanolic extracts of C. speciosus rhizome against absolute ethanol-induced gastric mucosal injury in Sprague-Dawley rats. Five groups of rats were orally pre-treated with vehicle, carboxymethylcellulose (CMC) as normal control group (Group 1), ethanol as ulcer control group (Group 2), omeprazole 20 mg/kg (reference group) (Group 3), and 250 and 500 mg/kg of C. speciosus extract (experimental groups) (Group 4 and 5), respectively. An hour later, CMC was given orally to Group 1 rats and absolute ethanol was given orally to Group 2-5 rats to generate gastric mucosal injury. After an additional hour, the rats were sacrificed. Grossly, ulcer control group exhibited severe of gastric mucosal hemorrhagic injury and increased in ulcer area, whereas groups pre-treated with omeprazole or plant’s rhizomes exhibited the significant reduction of gastric mucosal injury. Significant increase in the pH and mucous of gastric content was observed in rats re-treated with C. speciosus rhizome. Histology, ulcer control rats, demonstrated remarkable disruption of gastric mucosa, increased in edema and inflammatory cells infiltration of submucosal layer compared to rats pre-treated with rhizomes extract. Periodic acid Schiff staining for glycoprotein, rats pre-fed with C. speciosus C. displayed remarkably intense uptake of magenta color by glandular gastric mucosa compared with ulcer control rats. Immunostaining of gastric epithelium, rats pre-treatment with rhizome extract provide evidence of up-regulation of HSP70 and down-regulation of Bax proteins compared to ulcer control animals. Gastric tissue homogenate, C. speciosus significantly increased the activity of superoxide dismutase (SOD), and catalase (CAT), increased the level of non-protein sulfhydryl (NP-SH) and decreased the level of lipid peroxidation after ethanol administration. Acute toxicity test did not show any signs of toxicity. The mechanisms implicated the gasrtoprotective property of C. speciosus depend upon the antisecretory activity, increased in gastric mucus glycoprotein, up-regulation of HSP70 protein and down-regulation of Bax proteins, reduction in the lipid peroxidation and increase in the level of NP-SH and antioxidant enzymes activity in gastic homogenate.

Keywords: antioxidant, Costus speciosus, gastric ulcer, histology, omeprazole

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112 Assessing the Impact of Additional Information during Motor Preparation in Lane Change Task

Authors: Nikita Rajendra Sharma, Jai Prakash Kushvah, Gerhard Rinkenauer

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Driving a car is a discrete aiming movement in which drivers aim at successful extraction of relevant information and elimination of potentially distracting one. It is the motor preparation which enables one to react to certain stimuli onsite by allowing perceptual process for optimal adjustment. Drivers prepare their responses according to the available resources of advanced and ongoing information to drive efficiently. It requires constant programming and reprogramming of the motor system. The reaction time (RT) is shorter when a response signal is preceded by a warning signal. The reason behind this reduced time in responding to targets is that the warning signal causes the participant to prepare for the upcoming response by updating the motor program before the execution. While performing the primary task of changing lanes while driving, the simultaneous occurrence of additional information during the presentation of cues (congruent or incongruent with respect to target cue) might impact the motor preparation and execution. The presence of additional information (other than warning or response signal) between warning signal and imperative stimulus influences human motor preparation to a reasonable extent. The present study was aimed to assess the impact of congruent and incongruent additional information (with respect to imperative stimulus) on driving performance (reaction time, steering wheel amplitude, and steering wheel duration) during a lane change task. implementing movement pre-cueing paradigm. 22 young valid car-drivers (Mage = 24.1+/- 3.21 years, M = 10, F = 12, age-range 21-33 years) participated in the study. The study revealed that additional information influenced the overall driving performance as potential distractors and relevant information. Findings suggest that the events of additional information relatively influenced the reaction time and steering wheel angle as potential distractor or irrelevant information. Participants took longer to respond, and higher steering wheel angles were reported for targets coupled with additional information in comparison with warning signs preceded by potential distractors and the participants' response time was more for a higher number of lanes (2 Lanes > 1 Lane). The same additional information appearing interchangeably at warning signals and targets worked as relevant information facilitating the motor programming in the trails where they were congruent with the direction of lane change direction.

Keywords: additional information, lane change task, motor preparation, movement pre-cueing, reaction time, steering wheel amplitude

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111 Multicollinearity and MRA in Sustainability: Application of the Raise Regression

Authors: Claudia García-García, Catalina B. García-García, Román Salmerón-Gómez

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Much economic-environmental research includes the analysis of possible interactions by using Moderated Regression Analysis (MRA), which is a specific application of multiple linear regression analysis. This methodology allows analyzing how the effect of one of the independent variables is moderated by a second independent variable by adding a cross-product term between them as an additional explanatory variable. Due to the very specification of the methodology, the moderated factor is often highly correlated with the constitutive terms. Thus, great multicollinearity problems arise. The appearance of strong multicollinearity in a model has important consequences. Inflated variances of the estimators may appear, there is a tendency to consider non-significant regressors that they probably are together with a very high coefficient of determination, incorrect signs of our coefficients may appear and also the high sensibility of the results to small changes in the dataset. Finally, the high relationship among explanatory variables implies difficulties in fixing the individual effects of each one on the model under study. These consequences shifted to the moderated analysis may imply that it is not worth including an interaction term that may be distorting the model. Thus, it is important to manage the problem with some methodology that allows for obtaining reliable results. After a review of those works that applied the MRA among the ten top journals of the field, it is clear that multicollinearity is mostly disregarded. Less than 15% of the reviewed works take into account potential multicollinearity problems. To overcome the issue, this work studies the possible application of recent methodologies to MRA. Particularly, the raised regression is analyzed. This methodology mitigates collinearity from a geometrical point of view: the collinearity problem arises because the variables under study are very close geometrically, so by separating both variables, the problem can be mitigated. Raise regression maintains the available information and modifies the problematic variables instead of deleting variables, for example. Furthermore, the global characteristics of the initial model are also maintained (sum of squared residuals, estimated variance, coefficient of determination, global significance test and prediction). The proposal is implemented to data from countries of the European Union during the last year available regarding greenhouse gas emissions, per capita GDP and a dummy variable that represents the topography of the country. The use of a dummy variable as the moderator is a special variant of MRA, sometimes called “subgroup regression analysis.” The main conclusion of this work is that applying new techniques to the field can improve in a substantial way the results of the analysis. Particularly, the use of raised regression mitigates great multicollinearity problems, so the researcher is able to rely on the interaction term when interpreting the results of a particular study.

Keywords: multicollinearity, MRA, interaction, raise

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