Search results for: payback period
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5480

Search results for: payback period

1190 Trends in Endoscopic Versus Open Treatment of Carpal Tunnel Syndrome in Rheumatoid Arthritis Patients

Authors: Arman Kishan, Sanjay Kubsad, Steve Li, Mark Haft, Duc Nguyen, Dawn Laporte

Abstract:

Objective: Carpal tunnel syndrome can be managed surgically with endoscopic or open carpal tunnel release (CTR). Rheumatoid arthritis (RA) is a known risk factor for Carpal Tunnel Syndrome (CTS) and is believed to be related to compression of the median nerve secondary to inflammation. We aimed to analyze national trends, outcomes, and patient-specific comorbidities associated with ECTR and OCTR in patients with RA. Methods: A retrospective cohort study was conducted using the PearlDiver database, identifying 683 RA patients undergoing ECTR and 4234 undergoing OCTR between 2010 and 2014. Demographic data, comorbidities, and complication rates were analyzed. Univariate and multivariable analyses assessed differences between the treatment methods. Results:  Patients with RA undergoing ECTR in comparison to OCTR had no significant differences in medical comorbidities such as hypertension, obesity, chronic kidney disease, hypothyroidism and diabetes mellitus. Patients in the ECTR group reported a risk ratio of 1.44 (95%CI: 1.10-1.89, p=0.01) of requiring repeat procedures within 90 days of the initial procedure. Five-year trends in ECTR and OCTR procedures reported a combined annual growth rate of 5.6% and 13.15, respectively. Conclusion: Endoscopic and open approaches to CTR are important considerations in surgical planning. RA and ECTR have previously been identified as independent risk factors for revision CTR. Our study has identified the 90-day risk of repeat procedures to be elevated in the ECTR group in comparison to the OCTR group. Additionally, the growth of OCTR procedures has outpaced the growth of ECTR procedures in the same period, likely in response to the trend of ECTR leading to higher rates of repeat procedures. The need for revision following ECTR in patients with RA could be related to chronic inflammation leading to transverse carpal ligament thickening and concomitant tenosynovitis. Future directions could include further characterization of repeat procedures performed in this subset of patients. 

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, rheumatoid arthritis, trends analysis, carpal tunnel syndrome

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1189 An Investigation into the Views of Gifted Children on the Effects of Computer and Information Technologies on Their Lives and Education

Authors: Ahmet Kurnaz, Eyup Yurt, Ümit Çiftci

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In this study, too, an attempt was made to reveal the place and effects of information technologies on the lives and education of gifted children based on the views of gifted. To this end, the effects of information technologies on gifted are general skills, technology use, academic and social skills, and cooperative and personal skills were investigated. These skills were explored depending on whether or not gifted had their own computers, had internet connection at home, or how often they use the internet, average time period they spent at the computer, how often they played computer games and their use of social media. The study was conducted using the screening model with a quantitative approach. The sample of the study consisted of 129 gifted attending 5-12th classes in 12 provinces in different regions of Turkey. 64 of the participants were female while 65 were male. The research data were collected using the using computer of gifted and information technologies (UCIT) questionnaire which was developed by the researchers and given its final form after receiving expert view. As a result of the study, it was found that UCIT use improved foreign language speaking skills of gifted, enabled them to get to know and understand different cultures, and made use of computer and information technologies while they study. At the end of the study these result were obtained: Gifted have positive idea using computer and communication technology. There are differences whether using the internet about the ideas UCIT. But there are not differences whether having computer, inhabited city, grade level, having internet at home, daily and weekly internet usage durations, playing the computer and internet game, having Facebook and Twitter account about the UCIT. UCIT contribute to the development of gifted vocabulary, allows knowing and understand different cultures, developing foreign language speaking skills, gifted do not give up computer when they do their homework, improve their reading, listening, understanding and writing skills in a foreign language. Gifted children want to have transition to the use of tablets in education. They think UCIT facilitates doing their homework, contributes learning more information in a shorter time. They'd like to use computer-assisted instruction programs at courses. They think they will be more successful in the future if their computer skills are good. But gifted students prefer teacher instead of teaching with computers and they said that learning can be run from home without going to school.

Keywords: gifted, using computer, communication technology, information technologies

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1188 Polygenetic Iron Mineralization in the Baba-Ali and Galali Deposits, Further Evidences from Stable (S, O, H) Isotope Data, NW Hamedan, Iran

Authors: Ghodratollah Rostami Paydar

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The Baba-Ali and Galali iron deposits are located in northwest Hamedan and the Iranian Sanandaj-Sirjan geological structural zone. The host rocks of these deposits are metavolcanosedimentary successions of Songhor stratigraphic series with permo-trriassic age. Field investigation, ore geometry, textures and structures and paragenetic sequence of minerals, all indicate that the ore minerals are crystallized in four stages: primary volcanosedimentary stage, secondary regional metamorphism with formation of ductile shear zones, contact metamorphism and metasomatism stage and the finally late hydrothermal mineralization within uplift and exposure. Totally 29 samples of sulfide, oxide-silicate and carbonate minerals of iron orees and gangue has been purified for stable isotope analysis. The isotope ratio data assure that occurrence of dynamothermal metamorphism in these areas typically involves a lengthy period of time, which results in a tendency toward isotopic homogenization specifically in O and H stable isotopes and showing the role of metamorphic waters in mineralization process. Measurement of δ34S (CDT) in first generation of pyrite is higher than another ones, so it confirms the volcanogenic origin of primary iron mineralization. δ13C data measurements in Galali carbonate country rocks show a marine origin. δ18O in magnetite and skarn forming silicates, δ18O and δ13C in limestone and skarn calcite and δ34S in sulphides are all consistent with the interaction of a magmatic-equilibrated fluid with Galali limestone, and a dominantly magmatic source for S. All these data imply skarn formation and mineralisation in a magmatic-hydrothermal system that maintained high salinity to relatively late stages resulting in the formation of the regional Na metasomatic alteration halo. Late stage hydrothermal quartz-calcite veinlets are important for gold mineralization, but the economic evaluation is required to detailed geochemical studies.

Keywords: iron, polygenetic, stable isotope, BabaAli, Galali

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1187 Parametrical Analysis of Stain Removal Performance of a Washing Machine: A Case Study of Sebum

Authors: Ozcan B., Koca B., Tuzcuoglu E., Cavusoglu S., Efe A., Bayraktar S.

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A washing machine is mainly used for removing any types of dirt and stains and also eliminating malodorous substances from textile surfaces. Stains originate from various sources from the human body to environmental contamination. Therefore, there are various methods for removing them. They are roughly classified into four different groups: oily (greasy) stains, particulate stains, enzymatic stains and bleachable (oxidizable) stains. Oily stains on clothes surfaces are a common result of being in contact with organic substances of the human body (e.g. perspiration, skin shedding and sebum) or by being exposed to an oily environmental pollutant (e.g. oily foods). Studies showed that human sebum is major component of oily soil found on the garments, and if it is aged under the several environmental conditions, it can generate obstacle yellow stains on the textile surface. In this study, a parametric study was carried out to investigate the key factors affecting the cleaning performance (specifically sebum removal performance) of a washing machine. These parameters are mechanical agitation percentage of tumble, consumed water and total washing period. A full factorial design of the experiment is used to capture all the possible parametric interactions using Minitab 2021 statistical program. Tests are carried out with commercial liquid detergent and 2 different types of sebum-soiled cotton and cotton + polyester fabrics. Parametric results revealed that for both test samples, increasing the washing time and the mechanical agitation could lead to a much better removal result of sebum. However, for each sample, the water amount had different outcomes. Increasing the water amount decreases the performance of cotton + polyester fabrics, while it is favorable for cotton fabric. Besides this, it was also discovered that the type of textile can greatly affect the sebum removal performance. Results showed that cotton + polyester fabrics are much easier to clean compared to cotton fabric

Keywords: laundry, washing machine, low-temperature washing, cold wash, washing efficiency index, sustainability, cleaning performance, stain removal, oily soil, sebum, yellowing

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1186 Assessing the Effect of Urban Growth on Land Surface Temperature: A Case Study of Conakry Guinea

Authors: Arafan Traore, Teiji Watanabe

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Conakry, the capital city of the Republic of Guinea, has experienced a rapid urban expansion and population increased in the last two decades, which has resulted in remarkable local weather and climate change, raise energy demand and pollution and treating social, economic and environmental development. In this study, the spatiotemporal variation of the land surface temperature (LST) is retrieved to characterize the effect of urban growth on the thermal environment and quantify its relationship with biophysical indices, a normalized difference vegetation index (NDVI) and a normalized difference built up Index (NDBI). Landsat data TM and OLI/TIRS acquired respectively in 1986, 2000 and 2016 were used for LST retrieval and Land use/cover change analysis. A quantitative analysis based on the integration of a remote sensing and a geography information system (GIS) has revealed an important increased in the LST pattern in the average from 25.21°C in 1986 to 27.06°C in 2000 and 29.34°C in 2016, which was quite eminent with an average gain in surface temperature of 4.13°C over 30 years study period. Additionally, an analysis using a Pearson correlation (r) between (LST) and the biophysical indices, normalized difference vegetation index (NDVI) and a normalized difference built-up Index (NDBI) has revealed a negative relationship between LST and NDVI and a strong positive relationship between LST and NDBI. Which implies that an increase in the NDVI value can reduce the LST intensity; conversely increase in NDBI value may strengthen LST intensity in the study area. Although Landsat data were found efficient in assessing the thermal environment in Conakry, however, the method needs to be refined with in situ measurements of LST in the future studies. The results of this study may assist urban planners, scientists and policies makers concerned about climate variability to make decisions that will enhance sustainable environmental practices in Conakry.

Keywords: Conakry, land surface temperature, urban heat island, geography information system, remote sensing, land use/cover change

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1185 Distribution of Malaria-Infected Anopheles Mosquitoes in Kudat, Ranau and Tenom of Sabah, Malaysia

Authors: Ahmad Fakhriy Hassan, Rohani Ahmad, Zurainee Mohamed Nor, Wan Najdah Wan Mohamad Ali

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In Malaysia, it was realized that while the incidence of human malaria is decreasing, the incidence of Plasmodium knowlesi malaria appears to be on the rise, especially in rural areas of Sabah, East Malaysia. The primary vector for P. knowlesi malaria in Sabah is An. balabacensis a species found abundant in rural areas, shown to rest and feed outdoor throughout the night, which makes its control very challenging. This study aims to examine the distribution of malaria-infected Anopheles mosquitoes in three areas in Sabah, namely Kudat, Ranau, and Tenom, known as areas in Sabah that presented high number of malaria cases. Briefly, mosquitoes were caught every 6 weeks for the period of 18 months using Human Landing Catching (HLC) technique from May 2016 to November 2017. Identification of species was done using microscopy and molecular methods. Molecular method is also used to detect malaria parasite in all mosquito collected. An. balabacensis was present in all the study areas. In Kudat, six other Anopheles species were also detected, namely, An. barumbrosus, An. latens, An. letifer, An. maculatus, An. sundaicus and An. tesselatus. In Ranau five other Anopheles species were detected, namely, An. barumbrosus, An. donaldi., An. hodgkini, An. maculatus, and An. tesselatus while in Tenom seven more species An. donaldi, An. umbrosus, An. barumbrosus, An.latens, An. hodgkini, An. maculatus, and An. tesselatus were detected. This study showed 24% out of 259, 39% out of 127, and 26% out of 265 Anopheles mosquito collected in Kudat, Ranau, and Tenom were detected positive for malaria parasite respectively. In Kudat An. balabacensis, An. barumbrosus, An. latens, An. maculatus, An. sundaicus and An. tesselatus were the six out of eight Anopheles species that were found infected with malaria parasite. All Anopheles species collected in Ranau were positive for malaria while In Tenom, only five out of eight species; An. balabacensus, An. donaldi, An. hodgkini, An. maculatus, and An. latens were detected positive for malaria parasite. Interestingly, for all study areas An. balabacensis was shown to be the only species infected with four malaria species; P. falciparum, P. knowlesi, P. vivax, and Plasmodium sp. This finding clearly indicates that An. balabacensis is the dominant malaria vector in Kudat, Ranau, and Tenom.

Keywords: Anopheles balabacensis, human landing catching technique, nested PCR, Plasmodium knowlesi, Simian malaria

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1184 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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1183 Cooling With Phase-Change-Material in Vietnam: Outcomes at 18 Months

Authors: Hang T. T. Tran, Ha T. Le, Hanh T. P. Tran, Hung V. Cao, Giang T. H. Nguyen, Dien M. Tran, Tobias Alfvén, Linus Olson

Abstract:

Background: Hypoxic Ischemic Encephalopathy is one of the major causes of neonatal death and those who survive with severe encephalopathy are more likely to develop adverse long-term outcomes such as neurocognitive impairment and cerebral palsy, which is a huge burden, especially in low-middle income countries. It is important to have a long-term follow-up for early detection and promote early intervention for these groups of high-risk infants. Aim: To determine the neurological outcome of cooling infants at 18 months and identify an optimized neurological examination scale for Hypoxic Ischemic Encephalopathy infants in Vietnam. Method: Descriptive study of neurodevelopmental outcomes at 18 months of HIE infants who underwent therapeutic hypothermia treatment in Vietnam. All survived cooling infants were assessed at discharge and at 6, 12, and 18 months by a pediatric physical therapist and a neurologist using two assessment tools: Ages and Stages Questionnaires and the Hammersmith Infant Neurological Examination scale to detect impairments and promote early intervention for those who require it. Results: During a 3-year period, a total of 130 neonates with moderate to severe HIE underwent therapeutic hypothermia treatment using Phase change material mattress (65% moderate, 35% severe – Sarnat). 43 (33%) died during hospitalization and infancy; among survivors, 69 (79%) completed 3 follow-ups at 18 months. At 18 months, 25 had cerebral palsy, 11 had mild delayed neurodevelopment. At each time-point, infants with a normal/mildly delayed neurodevelopment had significantly higher Ages and Stages Questionnaires and Hammersmith Infant Neurological Examination scores (p<0.05) than those with cerebral palsy. Conclusion: The study showed that the Ages and Stages Questionnaires and Hammersmith Infant Neurological Examination is a helpful tool in the process of early diagnosis of infants at low and high neurological risk and identifying those infants needing specific rehabilitation programme.

Keywords: encephalopathy, phase-change-material, neurodevelopment, cerebral palsy

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1182 Music, Politics and Modernisation in China: An Analysis of 'Red Detachment of Women'

Authors: Lei Ping

Abstract:

The Western discourse of ‘modernity’ along with its objects, ideologies, and culture are brought to Imperial China by force of arms which confronted Chinese traditions. The struggle and conflicts between ‘Zhong’ (Chinese) and ‘Wai' (foreign), ‘Jiu’(Old) and ‘Xin’(New) are continuous during the turbulent times of 19th Century China. Since the foundation of the People’s Republic in 1949, China has gone through radical social, economic and cultural reform under the Communist Party’s highly centralised and autocratic political regime. The regime and Chairman Mao’s eagerness to identify the new China and establish a revolutionary mono-culture have increased political influence on the modernisation process. The ten years of Cultural Revolution (1966-76) have commonly been neglected and separated from China’s modern history due to its political, emotional and various other associations. Its cultural productions which dictated the Chinese stages during this period, namely the yangbanxi (Model Works), are largely viewed as political propaganda material with little or no artistic value in the nation’s cultural development. This paper argues that far from being anti modernisation of culture, the yangbanxi carry continuities that originate from before the cultural revolution and influence later cultural productions up till today. The focus of the paper is on Hongse Niangzijun (The Red Detachment of Women), a ballet yangbanxi (Model Works) which was performed to President Nixon during his visit to China in 1972. It depicts the female soldier Wu Qionghua’s life story: a transformation from a peasant girl to a mature communist soldier. The first part of the paper begins with an introduction to the cultural, social and political contexts under which the ballet was created and made a yangbanxi (Model work). The second part examines the application of musical devices (e.g. instrumentation, leitmotif), ranging from typical Western techniques to Chinese musical and theatrical traditions. By analysing, connecting and comparing these musical devices of various origins, the paper illustrates that the yangbanxi (Model Works) largely contributes to the ever-present, continuing and evolving modernisation of contemporary Chinese culture.

Keywords: cultural revolution, Hongse Niangzijun (Red Detachment of Women), modern China, music, Yangbanxi (model works)

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1181 Increase of Quinoa Tolerance to High Salinity Involves Agrophysiological Parameters Improvement by Soil Amendments

Authors: Bourhim Mohammad Redouane, Cheto Said, Qaddoury Ahmed, Hirich Abdelaziz, Ghoulam Cherki

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Several abiotic stresses cause disruptions in the properties of agricultural soils and hence their loss worldwide. Among these abiotic stresses, Salinity to which most crops were exposed caused an important reduction in their productivity. Therefore, in order to deal with this challenging problem, we rely on cultivating alternative plants that can tolerate the adverse salinity stress, such as quinoa (Chenopodium quinoa). Although even it was qualified as tolerant to Salinity, the quinoa’s performance could be negatively affected under high salinity levels. Thus, our study aims to assess the effects of the application of soil amendments to improve quinoa tolerance levels under high Salinity. Thus, three quinoa varieties (Puno, ICBA-Q5, and Titicaca) were grown on agricultural soil under a greenhouse with five amendments; Biochar “Bc,” compost “Cp,” black soldier insect frass “If,” cow manure “Fb” and phosphogypsum “Pg.” Two controls without amendment were adopted consisting of the salinized negative one “T(-)” and the non-salinized positive one “T(+).” After 20 days from sowing, the plants were irrigated with a saline solution of 16 dS/m prepared with NaCl for a period of 60 days. Then plant tolerance was assessed based on agrophysiological parameters. The results showed that salinity stress negatively affected the quinoa plants for all the analyzed agrophysiological parameters in the three varieties compared to their corresponding controls “T(+).” However, most of these parameters were significantly enhanced by the application of soil amendments compared to their negative controls “T(-).” For instance, the biomass was improved by 91.8% and 69.4%, respectively, for Puno and Titicaca varieties amended with “Bc.” The total nitrogen amount was increased by 220% for Titicaca and ICBA-Q5 plants cultivated in the soil amended with “If.” One of the most important improvements was noted for potassium content in Titicaca amended with “Pg,” which was six times higher compared to the negative control. Besides, the plants of Puno amended with “Cp” showed an improvement of 75.9% for the stomatal conductance and 58.5% for nitrate reductase activity. Nevertheless, the pronounced varietal difference was registered between Puno and Titicaca, presenting the highest performances mainly for the soil amended with “If,” “Bc,” and “Pg.”

Keywords: chenopodium quinoa, salinity, soil amendments, growth, nutrients, nitrate reductase

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1180 The Effects of Extreme Precipitation Events on Ecosystem Services

Authors: Szu-Hua Wang, Yi-Wen Chen

Abstract:

Urban ecosystems are complex coupled human-environment systems. They contain abundant natural resources for producing natural assets and attract urban assets to consume natural resources for urban development. Urban ecosystems provide several ecosystem services, including provisioning services, regulating services, cultural services, and supporting services. Rapid global climate change makes urban ecosystems and their ecosystem services encountering various natural disasters. Lots of natural disasters have occurred around the world under the constant changes in the frequency and intensity of extreme weather events in the past two decades. In Taiwan, hydrological disasters have been paid more attention due to the potential high sensitivity of Taiwan’s cities to climate change, and it impacts. However, climate change not only causes extreme weather events directly but also affects the interactions among human, ecosystem services and their dynamic feedback processes indirectly. Therefore, this study adopts a systematic method, solar energy synthesis, based on the concept of the eco-energy analysis. The Taipei area, the most densely populated area in Taiwan, is selected as the study area. The changes of ecosystem services between 2015 and Typhoon Soudelor have been compared in order to investigate the impacts of extreme precipitation events on ecosystem services. The results show that the forest areas are the largest contributions of energy to ecosystem services in the Taipei area generally. Different soil textures of different subsystem have various upper limits of water contents or substances. The major contribution of ecosystem services of the study area is natural hazard regulation provided by the surface water resources areas. During the period of Typhoon Soudelor, the freshwater supply in the forest areas had become the main contribution. Erosion control services were the main ecosystem service affected by Typhoon Soudelor. The second and third main ecosystem services were hydrologic regulation and food supply. Due to the interactions among ecosystem services, fresh water supply, water purification, and waste treatment had been affected severely.

Keywords: ecosystem, extreme precipitation events, ecosystem services, solar energy synthesis

Procedia PDF Downloads 119
1179 Bioproduction of L(+)-Lactic Acid and Purification by Ion Exchange Mechanism

Authors: Zelal Polat, Şebnem Harsa, Semra Ülkü

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Lactic acid exists in nature optically in two forms, L(+), D(-)-lactic acid, and has been used in food, leather, textile, pharmaceutical and cosmetic industries. Moreover, L(+)-lactic acid constitutes the raw material for the production of poly-L-lactic acid which is used in biomedical applications. Microbially produced lactic acid was aimed to be recovered from the fermentation media efficiently and economically. Among the various downstream operations, ion exchange chromatography is highly selective and yields a low cost product recovery within a short period of time. In this project, Lactobacillus casei NRRL B-441 was used for the production of L(+)-lactic acid from whey by fermentation at pH 5.5 and 37°C that took 12 hours. The product concentration was 50 g/l with 100% L(+)-lactic acid content. Next, the suitable resin was selected due to its high sorption capacity with rapid equilibrium behavior. Dowex marathon WBA, weakly basic anion exchanger in OH form reached the equilibrium in 15 minutes. The batch adsorption experiments were done approximately at pH 7.0 and 30°C and sampling was continued for 20 hours. Furthermore, the effect of temperature and pH was investigated and their influence was found to be unimportant. All the adsorption/desorption experiments were applied to both model lactic acid and biomass free fermentation broth. The ion exchange equilibria of lactic acid and L(+)-lactic acid in fermentation broth on Dowex marathon WBA was explained by Langmuir isotherm. The maximum exchange capacity (qm) for model lactic acid was 0.25 g La/g wet resin and for fermentation broth 0.04 g La/g wet resin. The equilibrium loading and exchange efficiency of L(+)-lactic acid in fermentation broth were reduced as a result of competition by other ionic species. The competing ions inhibit the binding of L(+)-lactic acid to the free sites of ion exchanger. Moreover, column operations were applied to recover adsorbed lactic acid from the ion exchanger. 2.0 M HCl was the suitable eluting agent to recover the bound L(+)-lactic acid with a flowrate of 1 ml/min at ambient temperature. About 95% of bound L(+)-lactic acid was recovered from Dowex marathon WBA. The equilibrium was reached within 15 minutes. The aim of this project was to investigate the purification of L(+)-lactic acid with ion exchange method from fermentation broth. The additional goals were to investigate the end product purity, to obtain new data on the adsorption/desorption behaviours of lactic acid and applicability of the system in industrial usage.

Keywords: fermentation, ion exchange, lactic acid, purification, whey

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1178 The Evolution of Deformation in the Southern-Central Tunisian Atlas: Parameters and Modelling

Authors: Mohamed Sadok Bensalem, Soulef Amamria, Khaled Lazzez, Mohamed Ghanmi

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The southern-central Tunisian Atlas presents a typical example of external zone. It occupies a particular position in the North African chains: firstly, it is the eastern limit of atlassicstructures; secondly, it is the edges between the belts structures to the north and the stable Saharan platform in the south. The evolution of deformation studyis based on several methods such as classical or numerical methods. The principals parameters controlling the genesis of folds in the southern central Tunisian Atlas are; the reactivation of pre-existing faults during later compressive phase, the evolution of decollement level, and the relation between thin and thick-skinned. One of the more principal characters of the southern-central Tunisian Atlas is the variation of belts structures directions determined by: NE-SW direction named the attlassic direction in Tunisia, the NW-SE direction carried along the Gafsa fault (the oriental limit of southern atlassic accident), and the E-W direction defined in the southern Tunisian Atlas. This variation of direction is the result of an important variation of deformation during different tectonics phases. A classical modeling of the Jebel ElKebar anticline, based on faults throw of the pre-existing faults and its reactivation during compressive phases, shows the importance of extensional deformation, particular during Aptian-Albian period, comparing with that of later compression (Alpine phases). A numerical modeling, based on the software Rampe E.M. 1.5.0, applied on the anticline of Jebel Orbata confirms the interpretation of “fault related fold” with decollement level within the Triassic successions. The other important parameter of evolution of deformation is the vertical migration of decollement level; indeed, more than the decollement level is in the recent series, most that the deformation is accentuated. The evolution of deformation is marked the development of duplex structure in Jebel AtTaghli (eastern limit of Jebel Orbata). Consequently, the evolution of deformation is proportional to the depth of the decollement level, the most important deformation is in the higher successions; thus is associated to the thin-skinned deformation; the decollement level permit the passive transfer of deformation in the cover.

Keywords: evolution of deformation, pre-existing faults, decollement level, thin-skinned

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1177 Management of Third Stage Labour in a Rural Ugandan Hospital

Authors: Brid Dinnee, Jessica Taylor, Joseph Hartland, Michael Natarajan

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Background:The third stage of labour (TSL) can be complicated by Post-Partum Haemorrhage (PPH), which can have a significant impact on maternal mortality and morbidity. In Africa, 33.9% of maternal deaths are attributable to PPH1. In order to minimise this figure, current recommendations for the developing world are that all women have active management of the third stage of labour (AMTSL). The aim of this project was to examine TSL practice in a rural Ugandan Hospital, highlight any deviation from best practice and identify barriers to change in resource limited settings as part of a 4th year medical student External Student Selected Component field trip. Method: Five key elements from the current World Health Organisation (WHO) guidelines on AMTSL were used to develop an audit tool. All daytime vaginal deliveries over a two week period in July 2016 were audited. In addition to this, a retrospective comparison of PPH rates, between 2006 (when ubiquitous use of intramuscular oxytocin for management of TSL was introduced) and 2015 was performed. Results: Eight vaginal deliveries were observed; at all of which intramuscular oxytocin was administered and controlled cord traction used. Against WHO recommendation, all umbilical cords were clamped within one minute, and no infants received early skin-to-skin contact. In only one case was uterine massage performed after placental delivery. A retrospective comparison of data rates identified a 40% reduction in total number of PPHs from November 2006 to November 2015. Maternal deaths per delivery reduced from 2% to 0.5%. Discussion: Maternal mortality and PPH are still major issues in developing countries. Maternal mortality due to PPH can be reduced by good practices regarding TSL, but not all of these are used in low-resource settings. There is a notable difference in outcomes between the developed and developing world. At Kitovu Hospital, there has been a reduction in maternal mortality and number of PPHs following introduction of IM Oxytocin administration. In order to further improve these rates, staff education and further government funding is key.

Keywords: post-partum haemorrhage, PPH, third stage labour, Uganda

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1176 Morphological Interaction of Porcine Oocyte and Cumulus Cells Study on in vitro Oocyte Maturation Using Electron Microscopy

Authors: M. Areekijseree, W. Pongsawat, M. Pumipaiboon, C. Thepsithar, S. Sengsai, T. Chuen-Im

Abstract:

Morphological interaction of porcine cumulus-oocyte complexes (pCOCs) was investigated on in vitro condition using electron microscope (SEM and TEM). The totals of 1,923 oocytes were round in shape, surrounded by zona pellucida with layer of cumulus cells ranging between 59.29-202.14 µm in size. They were classified into intact-, multi-, partial cumulus cell layer oocyte, and completely denuded oocyte, at the percentage composition of 22.80% 32.70%, 18.60%, and 25.90 % respectively. The pCOCs classified as intact- and multi cumulus cell layer oocytes were further culturing at 37°C with 5% CO2, 95% air atmosphere and high humidity for 44 h in M199 with Earle’s salts supplemented with 10% HTFCS, 2.2 mg/mL NaHCO3, 1 M Hepes, 0.25 mM pyruvate, 15 µg/mL porcine follicle-stimulating hormone, 1 µg/mL LH, 1µg/mL estradiol with ethanol, and 50 µg/mL gentamycin sulfate. On electron microscope study, cumulus cells were found to stick their processes to secrete substance from the sac-shape end into zona pellucida of the oocyte and also communicated with the neighboring cells through their microvilli on the beginning of incubation period. It is believed that the cumulus cells communicate with the oocyte by inserting the microvilli through this gap and embedded in the oocyte cytoplasm before secreting substance, through the sac-shape end of the microvilli, to inhibit primary oocyte development at the prophase I. Morphological changes of the complexes were observed after culturing for 24-44 h. One hundred percentages of the cumulus layers were expanded and cumulus cells were peeling off from the oocyte surface. In addition, the round-shape cumulus cells transformed themselves into either an elongate shape or a columnar shape, and no communication between cumulus neighboring cells. After 44 h of incubation time, diameter of oocytes surrounded by cumulus cells was larger than 0 h incubation. The effect of hormones in culture medium is exerted by their receptors present in porcine oocyte. It is likely that all morphological changes of the complexes after hormone treatment were to allow maturation of the oocyte. This study demonstrated that the association of hormones in M199 could promote porcine follicle activation in 44 h in vitro condition. This culture system should be useful for studying the regulation of early follicular growth and development, especially because these follicles represent a large source of oocytes that could be used in vitro for cell technology.

Keywords: cumulus cells, electron microscopy, in vitro, porcine oocyte

Procedia PDF Downloads 358
1175 Outcome of Emergency Response Team System in In-Hospital Cardiac Arrest

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

Abstract:

Introduction: To improve early detection and mortality rate of In- Hospital Cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditions and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90mmHg, respiratory rate <8 or > 28 breaths per minute, O2 saturation < 90%, acute change in conscious state, acute chest pain or worried about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in In-Hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in In-Hospital cardiac arrest and overall hospital mortality rate. We conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed Chi -square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010 ,139 calls in 2011 and 245 calls in 2012.The number of ERT calls per 1000 admissions in year 2009-10 was 7.69, 5.61 in 2011 and 9.38 in 2013. The number of Code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, But we have not found difference in overall hospital mortality rate.

Keywords: emergency response team, ERT, cardiac arrest, emergency medicine

Procedia PDF Downloads 282
1174 Effectiveness of Psychosocial Interventions in Preventing Postpartum Depression among Teenage Mothers: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Lebeza Alemu Tenaw, Fei Wan Ngai

Abstract:

Background: Postpartum depression is the most common mental health disorder that occurs after childbirth, and it is more prevalent among teenage mothers compared to adults. Although there is emerging evidence suggesting psychosocial interventions can decrease postpartum depression, there are no consistent findings regarding the effectiveness of these interventions, especially for teenage mothers. The current review aimed to investigate the effectiveness of psychosocial interventions in preventing postpartum depression among teenage mothers. Methods: The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) manual was implemented to select articles from online databases. The articles were searched using the Population, Intervention, Control, and Outcome (PICO) model. The quality of the articles was assessed using the Cochrane Collaboration Risk of Bias assessment tool. The statistical analyses were performed using Stata 17, and the effect size was estimated using the standard mean difference score of depression between the intervention and control groups. Heterogeneity between the studies was assessed through the I2 statistic and Q statistic, while the publication bias was evaluated using the asymmetry of the funnel plot and Egger's test. Results: In this systematic review, a total of nine articles were included. While psychosocial interventions demonstrated in reducing the risk of postpartum depression compared to usual maternal care, it is important to note that the mean difference score of depression was significant in only three of the included studies. The overall meta-analysis finding revealed that psychosocial interventions were effective in preventing postpartum depression, with a pooled effect size of -0.5 (95% CI: -0.95, -0.06) during the final time postpartum depression assessment. The heterogeneity level was found to be substantial, with an I2 value of 82.3%. However, no publication bias was observed. Conclusion: The review findings suggest that psychosocial interventions initiated during the late antenatal and early postnatal periods effectively prevent postpartum depression. The interventions were found to be more beneficial during the first three months of the postpartum period. However, this review also highlighted that there is a scarcity of interventional studies conducted in low-income countries, indicating the need for further studies in diverse communities.

Keywords: teenage pregnancy, postpartum depression, review

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1173 Management as a Proxy for Firm Quality

Authors: Petar Dobrev

Abstract:

There is no agreed-upon definition of firm quality. While profitability and stock performance often qualify as popular proxies of quality, in this project, we aim to identify quality without relying on a firm’s financial statements or stock returns as selection criteria. Instead, we use firm-level data on management practices across small to medium-sized U.S. manufacturing firms from the World Management Survey (WMS) to measure firm quality. Each firm in the WMS dataset is assigned a mean management score from 0 to 5, with higher scores identifying better-managed firms. This management score serves as our proxy for firm quality and is the sole criteria we use to separate firms into portfolios comprised of high-quality and low-quality firms. We define high-quality (low-quality) firms as those firms with a management score of one standard deviation above (below) the mean. To study whether this proxy for firm quality can identify better-performing firms, we link this data to Compustat and The Center for Research in Security Prices (CRSP) to obtain firm-level data on financial performance and monthly stock returns, respectively. We find that from 1999 to 2019 (our sample data period), firms in the high-quality portfolio are consistently more profitable — higher operating profitability and return on equity compared to low-quality firms. In addition, high-quality firms also exhibit a lower risk of bankruptcy — a higher Altman Z-score. Next, we test whether the stocks of the firms in the high-quality portfolio earn superior risk-adjusted excess returns. We regress the monthly excess returns on each portfolio on the Fama-French 3-factor, 4-factor, and 5-factor models, the betting-against-beta factor, and the quality-minus-junk factor. We find no statistically significant differences in excess returns between both portfolios, suggesting that stocks of high-quality (well managed) firms do not earn superior risk-adjusted returns compared to low-quality (poorly managed) firms. In short, our proxy for firm quality, the WMS management score, can identify firms with superior financial performance (higher profitability and reduced risk of bankruptcy). However, our management proxy cannot identify stocks that earn superior risk-adjusted returns, suggesting no statistically significant relationship between managerial quality and stock performance.

Keywords: excess stock returns, management, profitability, quality

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1172 Bank Liquidity Creation in a Dual Banking System: An Empirical Investigation

Authors: Lianne M. Q. Lee, Mohammed Sharaf Shaiban

Abstract:

The importance of bank liquidity management took center stage as policy makers promoted a more resilient global banking system after the market turmoil of 2007. The growing recognition of Islamic banks’ function of intermediating funds in the economy warrants the need to investigate its balance sheet structure which is distinct from its conventional counterparts. Given that asymmetric risk, transformation is inevitable; Islamic banks need to identify the liquidity risk within their distinctive balance sheet structure. Thus, there is a strong need to quantify and assess the liquidity position to ensure proper functioning of a financial institution. It is vital to measure bank liquidity because liquid banks face less liquidity risk. We examine this issue by using two alternative quantitative measures of liquidity creation “cat fat” and “cat nonfat” constructed by Berger and Bouwman (2009). “Cat fat” measures all on balance sheet items including off balance sheet, whilst the latter measures only on balance sheet items. Liquidity creation is measured over the period 2007-2014 in 14 countries where Islamic and conventional commercial banks coexist. Also, separately by bank size class as empirical studies have shown that liquidity creation varies by bank size. An interesting and important finding shows that all size class of Islamic banks, on average have increased creation of aggregate liquidity in real dollar terms over the years for both liquidity creation measures especially for large banks indicating that Islamic banks actually generates more liquidity to the economy compared to its conventional counterparts, including from off-balance sheet items. The liquidity creation for off-balance sheets by conventional banks may have been affected by the global financial crisis when derivatives markets were severely hit. The results also suggest that Islamic banks have the higher volume of assets and deposits and that borrowing/issues of bonds are less in Islamic banks compared to conventional banks because most products are interest-based. As Islamic banks appear to create more liquidity than conventional banks under both measures, it translates that the development of Islamic banking is significant over the decades since its inception. This finding is encouraging as, despite Islamic banking’s overall size, it represents growth opportunities for these countries.

Keywords: financial institution, liquidity creation, liquidity risk, policy and regulation

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1171 Evaluation of Associated Risk Factors and Determinants of near Miss Obstetric Cases at B.P. Koirala Institute of Health Sciences, Dharan

Authors: Madan Khadka, Dhruba Uprety, Rubina Rai

Abstract:

Background and objective: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of the level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near-miss obstetric cases and maternal death. Material and Methods A Prospective Observational Study was done from August 1, 2014, to June 30, 2015, in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by the 5-factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, and a complication of abortion, ruptured uterus, medical/surgical condition and sepsis. Results: A total of 9,727 delivery were attended during the study period from August 2014 to June 2014. There were 6307 (71.5%) vaginal delivery and 2777(28.5%) caesarean section and 181 perinatal death with a total of 9,546 live birth. A total of 162 near miss was identified, and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions (WLTC) of 172, Severe maternal outcome ratio of 18.64 per 1000 live birth, Maternal near-miss mortality ratio (MNM: 1 MD) 10.1:1, Mortality index (MI) of 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9%. 19.75% were prim gravidae, with mean age 25.66 yrs, and cardiovascular and coagulation dysfunction as a major life threatening condition and sepsis (25%) was the major cause of mortality. Conclusion: Hemorrhage and hypertensive disorders are the leading causes of near miss event and sepsis as a leading cause of mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.

Keywords: abortion, eclampsia, hemorrhage, maternal mortility, near miss

Procedia PDF Downloads 174
1170 Improving the Digestibility of Agro-Industrial Co-Products by Treatment with Isolated Fungi in the Meknes-Morocco Region

Authors: Mohamed Benaddou, Mohammed Diouri

Abstract:

country, such as Morocco, generates a high quantity of agricultural and food industry residues. A large portion of these residues is disposed of by burning or landfilling. The valorization of this waste biomass as feed is an interesting alternative because it is therefore considered among the best sources of cheap carbohydrates. However, its nutritional yield without any pre-treatment is very low because lignin protects cellulose, the carbohydrate used as a source of energy by ruminants. Fungal treatment is an environmentally friendly, easy and inexpensive method. This study investigated the treatment of wheat straw (WS), cedar sawdust (CS) and olive pomace (OP) with fungi selected according to the source of Carbon for improving its digestibility. Two were selected in a culture medium in which cellulose was the only source of Carbon: Cosmospora Viridescens (C.vir) and Penicillium crustosum (P.crus), two were selected in a culture medium in which lignin is the only source of Carbon: Fusarium oxysporum (F.oxy) and Fusarium sp. (F. Sp), and two in a culture medium where cellulose and lignin are the two sources of Carbon at the same time: Fusarium solani (F. solani) and Penicillium chrysogenum (P.chryso). P.chryso degraded more CS cellulose. It is very important to notice that the delignification by F. Solani reached 70% after 12 weeks of treatment of wheat straw. Ligninase enzymatic was detected in F.solani, F.sp, F.oxysporum, which made it possible to delignify the treated substrates. Delignification by C.vir is negligible in all three substrates after 12 weeks of treatment. P.crus and P.chryso degraded the lignin very slightly in WC (it did not exceed 12% after 12 weeks of treatment) but in OP this delignification is slight reaching 25% and 13% for P.chryso and P.crus successively. P.chryso allowed 30% degradation of lignin from 4 weeks of treatment. The degradation of the lignin was able to reach the maximum within 8 weeks of treatment for most of the fungi except F. solani who continued the treatment after this period. Digestibility variation (IVTD.variation) is highly very significant from fungus to fungi, duration to time, substrate to substrate and its interactions (P <0.001). indeed, all the fungi increased digestibility after 12 weeks of treatment with a difference in the degree of this increase. F.solani and F.oxy increased digestibility more than the others. this digestibility exceeded 50% in CS and O.P but did not exceed 20% for WS after treatment with F.oxy. IVTD.Var was not exceeded 20% in W.S.cedar treated with P.chryso but reached 45% after 8 weeks of treatment in W.straw.

Keywords: lignin, cellulose, digestibility, fungi, treatment, lignocellulosic biomass

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1169 An Unusual Cause of Electrocardiographic Artefact: Patient's Warming Blanket

Authors: Sanjay Dhiraaj, Puneet Goyal, Aditya Kapoor, Gaurav Misra

Abstract:

In electrocardiography, an ECG artefact is used to indicate something that is not heart-made. Although technological advancements have produced monitors with the potential of providing accurate information and reliable heart rate alarms, despite this, interference of the displayed electrocardiogram still occurs. These interferences can be from the various electrical gadgets present in the operating room or electrical signals from other parts of the body. Artefacts may also occur due to poor electrode contact with the body or due to machine malfunction. Knowing these artefacts is of utmost importance so as to avoid unnecessary and unwarranted diagnostic as well as interventional procedures. We report a case of ECG artefacts occurring due to patient warming blanket and its consequences. A 20-year-old male with a preoperative diagnosis of exstrophy epispadias complex was posted for surgery under epidural and general anaesthesia. Just after endotracheal intubation, we observed nonspecific ECG changes on the monitor. At a first glance, the monitor strip revealed broad QRs complexes suggesting a ventricular bigeminal rhythm. Closer analysis revealed these to be artefacts because although the complexes were looking broad on the first glance there was clear presence of normal sinus complexes which were immediately followed by 'broad complexes' or artefacts produced by some device or connection. These broad complexes were labeled as artefacts as they were originating in the absolute refractory period of the previous normal sinus beat. It would be physiologically impossible for the myocardium to depolarize so rapidly as to produce a second QRS complex. A search for the possible reason for the artefacts was made and after deepening the plane of anaesthesia, ruling out any possible electrolyte abnormalities, checking of ECG leads and its connections, changing monitors, checking all other monitoring connections, checking for proper grounding of anaesthesia machine and OT table, we found that after switching off the patient’s warming apparatus the rhythm returned to a normal sinus one and the 'broad complexes' or artefacts disappeared. As misdiagnosis of ECG artefacts may subject patients to unnecessary diagnostic and therapeutic interventions so a thorough knowledge of the patient and monitors allow for a quick interpretation and resolution of the problem.

Keywords: ECG artefacts, patient warming blanket, peri-operative arrhythmias, mobile messaging services

Procedia PDF Downloads 242
1168 Evaluation of Existence of Antithyroid Antibodies, Anti-Thyroid Peroxidase and Anti-Thyroglobulin in Patients with Hepatitis C Viral Infections

Authors: Junaid Mahmood Alam, Sana Anwar, Sarah Sughra Asghar

Abstract:

Chronic hepatitis or Hepatitis C viral (HCV) infection has been identified as one of the factors that could elicit autoimmune disease resulting in the development of auto-antibodies. Furthermore, HCV is implicated in contravening of forbearance to antigens, therefore, inciting auto-reactivity. In this regard, several near and past studies noted the prevalence of thyroid dysfunction and production of anti-thyroid antibodies (ATAb) such as anti-thyroid peroxidase (AntiTPO) and anti-thyroglobulin (AntiTG) in patients with HCV. Likewise, one of the etiologies of augmentation of thyroid disease is basically interferon therapy for HCV infections, for which a number of autoimmune diseases have been noted including Grave’s disease, Hishimoto thyroiditis. A prospectively case-control study was therefore carried out at department of clinical biochemistry lab services and chemical pathology in collaboration with department of clinical microbiology, at Liaquat National Hospital and Medical College, Karachi Pakistan for the period January 2015 to December 2017. Two control groups were inducted for comparison purpose, control group 1 = without HCV infection and with thyroid disorders (n = 20), control group 2 = with HCV infection and without thyroid disorders (n = 20), whereas HCV infected were n = 40 where more than half were noted to be positive for either of HCV IgG and Ag. In HCV group, patients with existing sub-clinical hypothyroidism and clinical hyperthyroidism were less than 5%. Analysis showed the presence of AntiTG in 12 HCV patients (30%), AntiTPO in 15 (37.5%) and both AntiTG and antiTPO in 10 patients (25%). Only 3 patients were found with the history of anti-thyroid auto-antibodies (7.5%) and one with parents and relatives with auto-immune disorders (2.5%). Patients that remained untreated were 12 (30%), under treatment 18 (45%) and with complete-course of treatment 10 (25%). As per review of the literature, meta-analysis of evident data and cross-sectional studies of selective cohorts (as studied in presented research), thyroid connection is designated as one of the most recurrent endocrine ailment associated with chronic HCV infection. Moreover, it also represents an extrahepatic disease in the continuum of HCV syndrome. In conclusion, HCV patients were more likely to encompass thyroid disorders especially related to development of either of ATAb or both antiTG and AntiTPO.

Keywords: Hepatitis C viral (HCV) infection, anti-thyroid antibodies, anti-thyroid peroxidase antibodies, anti-thyroglobulin antibodies

Procedia PDF Downloads 132
1167 Long-Term Outcome of Emergency Response Team System in In-Hospital Cardiac Arrest

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

Abstract:

Introduction: To improve early detection and mortality rate of in-hospital cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditons and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90 mmHg, respiratory rate <8 or >28 breaths per minute, O2 saturation <90%, acute change in conscious state, acute chest pain or worry about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in in-hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in in-hospital cardiac arrest and overall hospital mortality rate, we conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed chi-square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010, 139 calls in 2011 and 245 calls in 2012. The number of ERT calls per 1000 admissions in year 2009-10 was 7.69; 5.61 in 2011 and 9.38 in 2013. The number of code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001 ). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, but we have not found difference in overall hospital mortality rate.

Keywords: cardiac arrest, outcome, in-hospital, ERT

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1166 Effect of Resistance Training on BDNF and Inflammatory Markers in Healthy Older Adults

Authors: Obinna Afamefuna Echi

Abstract:

Background: The global increase in the elderly population is anticipated to reach significant levels by 2050, presenting extensive economic, social, and healthcare challenges. Age-related cognitive decline, alterations in brain anatomy, and systemic inflammation are profound concerns that diminish the quality of life and increase susceptibility to diseases like Alzheimer's and cardiovascular diseases. Resistance training is presently studied for its potential neuroprotective and anti-inflammatory benefits in older adults. Objectives: This study aimed to explore the effects of different resistance training modalities on neurotrophic factors, inflammatory markers, and cognitive functions in the elderly. Methods: A controlled trial was conducted with 60 male participants aged 60-75, assigned to either 12 weeks of high-intensity blood flow restriction training (BFRT), muscle damaging resistance training (MDRT), or a non-exercising control group. Cognitive function, neurotrophic factors such as BDNF, and inflammatory markers including IL-6 and TNF were measured before and after the intervention period. Setting: Participants were recruited from Kaunas, Lithuania, with sessions facilitated at the Lithuanian Sports University and health assessments conducted at the Lithuanian University of Health Sciences. Results: Preliminary data suggested did not show significant improvements in BDNF levels and cognitive functions in the BFRT and MDRT groups compared to controls. However, there was a notable reduction in inflammatory markers, indicating potential health benefits beyond cognitive enhancement. Conclusion: The incorporation of resistance training can be a strategic intervention to mitigate age-associated cognitive decline and systemic inflammation, thereby enhancing overall health and quality of life in older adults. The results advocate for wider adoption and further study of resistance training as a preventive measure in ageing populations. Funding: The Lithuanian Sports University, the Research Council of Lithuania and the Lithuanian University of Health Sciences.

Keywords: ageing, resistance training, BDNF, cognitive function

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1165 Development of Biodegradable Wound Healing Patch of Curcumin

Authors: Abhay Asthana, Shally Toshkhani, Gyati Shilakari

Abstract:

The objective of the present research work is to develop a topical biodegradable dermal patch based formulation to aid accelerated wound healing. It is always better for patient compliance to be able to reduce the frequency of dressings with improved drug delivery and overall therapeutic efficacy. In present study optimized formulation using biodegradable components was obtained evaluating polymers and excipients (HPMC K4M, Ethylcellulose, Povidone, Polyethylene glycol and Gelatin) to impart significant folding endurance, elasticity, and strength. Molten gelatin was used to get a mixture using ethylene glycol. Chitosan dissolved in acidic medium was mixed with stirring to Gelatin mixture. With continued stirring to the mixture Curcumin was added with the aid of DCM and Methanol in an optimized ratio of 60:40 to get homogenous dispersion. Polymers were dispersed with stirring in the final formulation. The mixture was sonicated casted to get the film form. All steps were carried out under strict aseptic conditions. The final formulation was a thin uniformly smooth textured film with dark brown-yellow color. The film was found to have folding endurance was around 20 to 21 times without a crack in an optimized formulation at RT (23°C). The drug content was in range 96 to 102% and it passed the content uniform test. The final moisture content of the optimized formulation film was NMT 9.0%. The films passed stability study conducted at refrigerated conditions (4±0.2°C) and at room temperature (23 ± 2°C) for 30 days. Further, the drug content and texture remained undisturbed with stability study conducted at RT 23±2°C for 45 and 90 days. Percentage cumulative drug release was found to be 80% in 12h and matched the biodegradation rate as tested in vivo with correlation factor R2>0.9. In in vivo study administration of one dose in equivalent quantity per 2 days was applied topically. The data demonstrated a significant improvement with percentage wound contraction in contrast to control and plain drug respectively in given period. The film based formulation developed shows promising results in terms of stability and in vivo performance.

Keywords: wound healing, biodegradable, polymers, patch

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1164 Submicron Laser-Induced Dot, Ripple and Wrinkle Structures and Their Applications

Authors: P. Slepicka, N. Slepickova Kasalkova, I. Michaljanicova, O. Nedela, Z. Kolska, V. Svorcik

Abstract:

Polymers exposed to laser or plasma treatment or modified with different wet methods which enable the introduction of nanoparticles or biologically active species, such as amino-acids, may find many applications both as biocompatible or anti-bacterial materials or on the contrary, can be applied for a decrease in the number of cells on the treated surface which opens application in single cell units. For the experiments, two types of materials were chosen, a representative of non-biodegradable polymers, polyethersulphone (PES) and polyhydroxybutyrate (PHB) as biodegradable material. Exposure of solid substrate to laser well below the ablation threshold can lead to formation of various surface structures. The ripples have a period roughly comparable to the wavelength of the incident laser radiation, and their dimensions depend on many factors, such as chemical composition of the polymer substrate, laser wavelength and the angle of incidence. On the contrary, biopolymers may significantly change their surface roughness and thus influence cell compatibility. The focus was on the surface treatment of PES and PHB by pulse excimer KrF laser with wavelength of 248 nm. The changes of physicochemical properties, surface morphology, surface chemistry and ablation of exposed polymers were studied both for PES and PHB. Several analytical methods involving atomic force microscopy, gravimetry, scanning electron microscopy and others were used for the analysis of the treated surface. It was found that the combination of certain input parameters leads not only to the formation of optimal narrow pattern, but to the combination of a ripple and a wrinkle-like structure, which could be an optimal candidate for cell attachment. The interaction of different types of cells and their interactions with the laser exposed surface were studied. It was found that laser treatment contributes as a major factor for wettability/contact angle change. The combination of optimal laser energy and pulse number was used for the construction of a surface with an anti-cellular response. Due to the simple laser treatment, we were able to prepare a biopolymer surface with higher roughness and thus significantly influence the area of growth of different types of cells (U-2 OS cells).

Keywords: cell response, excimer laser, polymer treatment, periodic pattern, surface morphology

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1163 Change through Stillness: Mindfulness Meditation as an Intervention for Men with Self-Perceived Problematic Pornography Use

Authors: Luke Sniewski, Pante Farvid, Phil Carter, Rita Csako

Abstract:

Background and Aims: Self-Perceived Problematic Porn Use (SPPPU) refers to individuals who identify as or perceive themselves to be addicted to porn. These individuals feel they are unable to regulate their porn consumption and experience adverse consequences as a result of their use in everyday life. To the author’s best knowledge, this research represents the first study to intervene with pornography use with mindfulness meditation, and aims to investigate the experiences and challenges of men with SPPPU as they engage in a mindfulness meditation intervention. As meditation is commonly characterized by sitting and observing one’s internal experience with non-reaction and acceptance, the study’s principal hypothesis was that consistent practice of meditation would develop the participant’s capacity to respond to cravings, urges, and unwanted thoughts in less reactive, more productive ways. Method: This 12-mixed method research utilised Single Case Experimental Design (SCED) methodology, with a standard AB design. Each participant was randomly assigned to an initial baseline time period between 2 to 5 weeks before learning the meditation technique and practicing it for the remainder of the 12-week study. The pilot study included 3 participants, while the intervention study included 12. The meditation technique used for the study involved a 15-minute guided breathing exercise in the morning, along with a 15-minute guided concentration meditation in the evening. Results: At the time of submission, only pilot study results were available. Results from the pilot study indicate an improved capacity for self-awareness of the uncomfortable mental and emotional states that drove their participants’ pornography use. Statistically significant reductions were also observed in daily porn use, total weekly time spent viewing porn, as well as lowered Pornography Craving Questionnaire (PCQ) and Problematic Pornography Use Scale (PPUS) scores. Conclusion: Pilot study results suggest that meditation could serve as a complementary tool for health professionals to provide clients in conjunction with therapeutic interventions. Study limitations, directions for future research, and clinical implications to be discussed as well.

Keywords: meditation, behavioural change, pornography, mindfulness

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1162 Identification and Antibiotic Resistance Rates of Acinetobacter baumannii Strains Isolated from the Respiratory Tract Samples, Obtained from the Different Intensive Care Units

Authors: Recep Kesli, Gulşah Asik, Cengiz Demir, Onur Turkyilmaz

Abstract:

Objective: Acinetobacter baumannii (A. baumannii) can cause health-care associated infections, such as bacteremia, urinary tract and wound infections, endocarditis, meningitis, and pneumonia, particularly in intensive care unit patients. In this study, we aimed to evaluate A. baumannii production in sputum and bronchoalveolar lavage and susceptibilities for antibiotics in a 24 months period. Methods: Between October 2013 and September 2015, Acinetobacter baumannii isolated from respiratory tract speciments were evaluated retrospectively. The strains were isolated from the different intensive care units patients. A. baumannii strains were identified by both the conventional methods and aoutomated identification system -VITEK 2 (bio-Merieux, Marcy l’etoile, France). Antibiotic resistance testing was performed by Kirby-Bauer disc diffusion method according to CLSI criteria. Results: All the ninety isolates included in the study were from respiratory tract specimens. While of all the isolated 90 Acinetobacter baumannii strains were found to be resistant (100%), against ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam, resistance rates against other tested antibiotics found as follows; meropenem 77, 86%, imipenem 75, 83%, trimethoprim-sulfamethoxazole (TMP-STX) 69, 76,6%, gentamicin 51, 56,6% and amikacin 48, 53,3%. Colistin was found as the most effective antibiotic against Acinetobacter baumannii, and there were not found any resistant (0%) strain against colistin. Conclusion: This study demonstrated that the no resistance was found in Acinetobacter baumannii against to colistin. High rates of resistance to carbapenems (imipenem and meropenem) and other tested antibiotics (ceftiaxone, ceftazidime, ciprofloxacine, piperacilline-tazobactam, TMP-STX gentamicin and amikacin) also have remarkable resistance rates. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay with resistance rates. High resistance rates against antibiotics require implementation of the infection control program and rational use of antibiotics. In the present study, while there were not found colistin resistance, panresistance were found against to ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam.

Keywords: acinetobacter baumannii, antibiotic resistance, multi drug resistance, intensive care unit

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1161 Effectiveness of Medication and Non-Medication Therapy on Working Memory of Children with Attention Deficit and Hyperactivity Disorder

Authors: Mohaammad Ahmadpanah, Amineh Akhondi, Mohammad Haghighi, Ali Ghaleiha, Leila Jahangard, Elham Salari

Abstract:

Background: Working memory includes the capability to keep and manipulate information in a short period of time. This capability is the basis of complicated judgments and has been attended to as the specific and constant character of individuals. Children with attention deficit and hyperactivity are among the people suffering from deficiency in the active memory, and this deficiency has been attributed to the problem of frontal lobe. This study utilizes a new approach with suitable tasks and methods for training active memory and assessment of the effects of the trainings. Participants: The children participating in this study were of 7-15 year age, who were diagnosed by the psychiatrist and psychologist as hyperactive and attention deficit based on DSM-IV criteria. The intervention group was consisted of 8 boys and 6 girls with the average age of 11 years and standard deviation of 2, and the control group was consisted of 2 girls and 5 boys with an average age of 11.4 and standard deviation of 3. Three children in the test group and two in the control group were under medicinal therapy. Results: Working memory training meaningfully improved the performance in not-trained areas as visual-spatial working memory as well as the performance in Raven progressive tests which are a perfect example of non-verbal, complicated reasoning tasks. In addition, motional activities – measured based on the number of head movements during computerized measuring program – was meaningfully reduced in the medication group. The results of the second test showed that training similar exercise to teenagers and adults results in the improvement of cognition functions, as in hyperactive people. Discussion: The results of this study showed that the performance of working memory is improved through training, and these trainings are extended and generalized in other areas of cognition functions not receiving any training. Trainings resulted in the improvement of performance in the tasks related to prefrontal. They had also a positive and meaningful impact on the moving activities of hyperactive children.

Keywords: attention deficit hyperactivity disorder, working memory, non-medical treatment, children

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