Search results for: percent mortality
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2410

Search results for: percent mortality

2140 Need Assessments of Midwives in Public's Health Center (Puskesmas) at Sukabumi Municipal, Province of Jawa Barat, Indonesia

Authors: Al Asyary, Meita Veruswati, Dian Ayyubi

Abstract:

Sukabumi municipal has highest rank for maternal mortality in Indonesia with 102 by 100,000 live birth with almost 80% of birth were not attended by skilled birth attendant (SBA). Although universal health coverage has been implemented, availability and sufficiency of SBA, such as midwife in this developing country, are problematic agenda for the quality of public healthcare as well as decreasing maternal mortality rate. This study aims to describe the equal distribution of midwives in Sukabumi municipal as support of government’s program named Millennium Development Goals (MDGs) that suppressed maternal mortality rate in Indonesia. We conducted an observational study with Workload Indicator of Staffing Need (WISN) analysis to present the dispersion of midwives by their activities and workloads in 37 Puskesmas. We also generated in-depth interview with several executive chief of health sections, including chief of health offices in Sukabumi municipal. It resulted inferentially that several activities in midwives’ program were differed at once of existing than needed condition ideally (ρ value = 0.002 < 0.05). Meanwhile, decision for midwives’ procurement and placement were held by un-systematically procedure such as based on where the midwife was staying, and it also progressed by neighborhood issue priorities. The absence of formal regulation in local government is a serious problem that indicated poor political commitment, while access to SBA shall be focused carefully.

Keywords: developing country, health professional resources, health policy, need assessment

Procedia PDF Downloads 139
2139 Pyrethroid and Organophosphate Susceptibility Status of Aedesaegypti (Linnaeus), Aedes albopictus (Skuse) and Culex quinquefasciatus (Say) in Penang, Malaysia

Authors: Hadura Abu Hasan, Zairi Jaal, P. J. McCall

Abstract:

Dengue is a serious problem in Malaysia, particularly in high-density urban communities with lower socio-economic levels. This study evaluated the susceptibility of local populations of Aedesaegypti (Linnaeus), Aedesalbopictus (Skuse) and Culexquinquefasciatus (Say) from the traditional community of BaganDalam, Penang, Malaysia to lambdacyhalothrin and pirimiphos-methyl using standard World Health Organization (WHO) adult bioassay test. Unfed female mosquitoes aged 3-5 days were exposed to WHO recommended dosages of insecticides over fixed time periods with results presented as knock-down time (KT50) for each strain.The insecticide susceptible VCRU laboratory strain was usedas control. All three specieswere highly resistant to lambda-cyhalothrin with less than 10% mortality at 24 hours after treatment. In contrast, Ae.aegypti and Ae. albopictus were susceptible to pirimiphos-methyl, showing 100% mortality recorded 24 hoursafter treatment. Cx. quinquefasciatuswasclassed as ‘suspected resistant’ to pirimiphos-methyl as mortality recorded 24 hours after treatment was 94-96%. The results indicate that organophosphates such as pirimiphos-methyl might be used as alternative to pyrethroid for dengue vector control in this dengue-prone area.

Keywords: vector control, aedes aegypti, aedes albopictus, dengue, culex quinquefasciatus, residuals insecticides, pyrethroid, organophosphate, resistant, mosquito

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2138 Effect of Sowing Dates on Incidence of Sorghum Head Bug Eurystylus Sp (Hemiptera; Miridae) at Rainfed Sector, Blue Nile State, Sudan

Authors: Eisa Y. Adam, Anas A. Fadlelmula, Ali E. Ali

Abstract:

Sorghum head bug is a key insect pest of sorghum, and it is important to pay attention to the peak time of the pest abundance. The objective of this study was to study the effect of planting date on head bugs population. Field experiment was conducted during 2007/08 – 2008/09 and 2013/14 - 2014/15 cropping seasons at the Damazine Research Station Farm, Blue Nile State to determine sorghum head bugs incidence and abundance through the sowing date. Different sowing dates (early, mid and late sowing) and a susceptible sorghum variety known as Wad Ahmed variety were used the experiment. The experimental design used was randomized complete block design (RCBD). Data were collected on the number of head bug adults and nymphs/panicle, damage percent, coloration and a puncture due to bug feeding and oviposition, 1000 seeds weight and yield. The results showed that significantly (P<0.05) higher number of bugs and damage percent were recorded on the late sowing date for the four seasons followed by the mid sowing, while the early sowing gave low number of bugs, damage percent and high1000 weight. There were significant differences between protected and unprotected heads. The late sowing (August) is a critical sorghum planting time because it coincided with highest numbers of the head bugs.

Keywords: abundance, damage, headbugs, panicle

Procedia PDF Downloads 235
2137 Attributable Mortality of Nosocomial Infection: A Nested Case Control Study in Tunisia

Authors: S. Ben Fredj, H. Ghali, M. Ben Rejeb, S. Layouni, S. Khefacha, L. Dhidah, H. Said

Abstract:

Background: The Intensive Care Unit (ICU) provides continuous care and uses a high level of treatment technologies. Although developed country hospitals allocate only 5–10% of beds in critical care areas, approximately 20% of nosocomial infections (NI) occur among patients treated in ICUs. Whereas in the developing countries the situation is still less accurate. The aim of our study is to assess mortality rates in ICUs and to determine its predictive factors. Methods: We carried out a nested case-control study in a 630-beds public tertiary care hospital in Eastern Tunisia. We included in the study all patients hospitalized for more than two days in the surgical or medical ICU during the entire period of the surveillance. Cases were patients who died before ICU discharge, whereas controls were patients who survived to discharge. NIs were diagnosed according to the definitions of ‘Comité Technique des Infections Nosocomiales et les Infections Liées aux Soins’ (CTINLIS, France). Data collection was based on the protocol of Rea-RAISIN 2009 of the National Institute for Health Watch (InVS, France). Results: Overall, 301 patients were enrolled from medical and surgical ICUs. The mean age was 44.8 ± 21.3 years. The crude ICU mortality rate was 20.6% (62/301). It was 35.8% for patients who acquired at least one NI during their stay in ICU and 16.2% for those without any NI, yielding an overall crude excess mortality rate of 19.6% (OR= 2.9, 95% CI, 1.6 to 5.3). The population-attributable fraction due to ICU-NI in patients who died before ICU discharge was 23.46% (95% CI, 13.43%–29.04%). Overall, 62 case-patients were compared to 239 control patients for the final analysis. Case patients and control patients differed by age (p=0,003), simplified acute physiology score II (p < 10-3), NI (p < 10-3), nosocomial pneumonia (p=0.008), infection upon admission (p=0.002), immunosuppression (p=0.006), days of intubation (p < 10-3), tracheostomy (p=0.004), days with urinary catheterization (p < 10-3), days with CVC ( p=0.03), and length of stay in ICU (p=0.003). Multivariate analysis demonstrated 3 factors: age older than 65 years (OR, 5.78 [95% CI, 2.03-16.05] p=0.001), duration of intubation 1-10 days (OR, 6.82 [95% CI, [1.90-24.45] p=0.003), duration of intubation > 10 days (OR, 11.11 [95% CI, [2.85-43.28] p=0.001), duration of CVC 1-7 days (OR, 6.85[95% CI, [1.71-27.45] p=0.007) and duration of CVC > 7 days (OR, 5.55[95% CI, [1.70-18.04] p=0.004). Conclusion: While surveillance provides important baseline data, successful trials with more active intervention protocols, adopting multimodal approach for the prevention of nosocomial infection incited us to think about the feasibility of similar trial in our context. Therefore, the implementation of an efficient infection control strategy is a crucial step to improve the quality of care.

Keywords: intensive care unit, mortality, nosocomial infection, risk factors

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2136 Supply Chain of Energy Resources and Its Alternatives Due to the Arab Spring: The Case of Egyptian Natural Gas Flow to Jordan

Authors: Moh’d Anwer Al-Shboul

Abstract:

The year 2011 was a challenging year for Jordanian economy, which felt a variety of effects from the Arab Spring which took place in neighboring countries. Since February, 5th 2012, the Arab Gas Supply Pipeline, which carries natural gas from Egypt through the Sinai Peninsula and to Jordan and Israel, has been attacked more than 39 times. Jordan imported about 80 percent of its necessity of natural gas (about 250 million cubic feet of natural gas per day) from Egypt to generate particularly electricity, with the reminder of being produced locally. Jordan has utilized multiple alternatives to address the interruption of available natural gas supply from Egypt. The Jordanian distributed power plants now rely on the use of heavy fuel oil and diesel for electricity generation, in this case, it costs Jordan about four times than natural gas. The substitution of Egyptian natural gas supplies by fuel oil and diesel, coupled with the 32 percent rise in global fuel prices, has increased Jordan’s energy import bill by over 50 percent in 2011, reaching more than 16 percent of the 2011 GDP. The increase in the cost of electricity generation pushed the Jordanian economy to borrow from multiple internal and external resource channels, thus increasing the public debt. The Jordanian government’s short-term solution to the reduced natural gas supply from Egypt was alternatively purchasing the necessary quantities from some Gulf countries such as Qatar and/or Saudi Arabia, which can be imported with two possible methods. The first method is to rent a ship equipped with a liquefied natural gas (LNG) terminal, which is currently operating. The second method requires equipping the Aqaba port with an LNG terminal, which also currently is operating. In the long-term, a viable solution to depending on importing expensive and often unreliable natural gas supplies from surrounding countries is to depend more heavily on renewable supply energy, including solar, wind, and water energy.

Keywords: energy supply resources, Arab spring, liquefied natural gas, pipeline, Jordan

Procedia PDF Downloads 113
2135 Predictor Factors in Predictive Model of Soccer Talent Identification among Male Players Aged 14 to 17 Years

Authors: Muhamad Hafiz Ismail, Ahmad H., Nelfianty M. R.

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The longitudinal study is conducted to identify predictive factors of soccer talent among male players aged 14 to 17 years. Convenience sampling involving elite respondents (n=20) and sub-elite respondents (n=20) male soccer players. Descriptive statistics were reported as frequencies and percentages. The inferential statistical analysis is used to report the status of reliability, independent samples t-test, paired samples t-test, and multiple regression analysis. Generally, there are differences in mean of height, muscular strength, muscular endurance, cardiovascular endurance, task orientation, cognitive anxiety, self-confidence, juggling skills, short pass skills, long pass skills, dribbling skills, and shooting skills for 20 elite players and sub-elite players. Accordingly, there was a significant difference between pre and post-test for thirteen variables of height, weight, fat percentage, muscle strength, muscle endurance, cardiovascular endurance, flexibility, BMI, task orientation, juggling skills, short pass skills, a long pass skills, and dribbling skills. Based on the first predictive factors (physical), second predictive factors (fitness), third predictive factors (psychological), and fourth predictive factors (skills in playing football) pledged to the soccer talent; four multiple regression models were produced. The first predictive factor (physical) contributed 53.5 percent, supported by height and percentage of fat in soccer talents. The second predictive factor (fitness) contributed 63.2 percent and the third predictive factors (psychology) contributed 66.4 percent of soccer talent. The fourth predictive factors (skills) contributed 59.0 percent of soccer talent. The four multiple regression models could be used as a guide for talent scouting for soccer players of the future.

Keywords: soccer talent identification, fitness and physical test, soccer skills test, psychological test

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2134 Breast Cancer Incidence Estimation in Castilla-La Mancha (CLM) from Mortality and Survival Data

Authors: C. Romero, R. Ortega, P. Sánchez-Camacho, P. Aguilar, V. Segur, J. Ruiz, G. Gutiérrez

Abstract:

Introduction: Breast cancer is a leading cause of death in CLM. (2.8% of all deaths in women and 13,8% of deaths from tumors in womens). It is the most tumor incidence in CLM region with 26.1% from all tumours, except nonmelanoma skin (Cancer Incidence in Five Continents, Volume X, IARC). Cancer registries are a good information source to estimate cancer incidence, however the data are usually available with a lag which makes difficult their use for health managers. By contrast, mortality and survival statistics have less delay. In order to serve for resource planning and responding to this problem, a method is presented to estimate the incidence of mortality and survival data. Objectives: To estimate the incidence of breast cancer by age group in CLM in the period 1991-2013. Comparing the data obtained from the model with current incidence data. Sources: Annual number of women by single ages (National Statistics Institute). Annual number of deaths by all causes and breast cancer. (Mortality Registry CLM). The Breast cancer relative survival probability. (EUROCARE, Spanish registries data). Methods: A Weibull Parametric survival model from EUROCARE data is obtained. From the model of survival, the population and population data, Mortality and Incidence Analysis MODel (MIAMOD) regression model is obtained to estimate the incidence of cancer by age (1991-2013). Results: The resulting model is: Ix,t = Logit [const + age1*x + age2*x2 + coh1*(t – x) + coh2*(t-x)2] Where: Ix,t is the incidence at age x in the period (year) t; the value of the parameter estimates is: const (constant term in the model) = -7.03; age1 = 3.31; age2 = -1.10; coh1 = 0.61 and coh2 = -0.12. It is estimated that in 1991 were diagnosed in CLM 662 cases of breast cancer (81.51 per 100,000 women). An estimated 1,152 cases (112.41 per 100,000 women) were diagnosed in 2013, representing an increase of 40.7% in gross incidence rate (1.9% per year). The annual average increases in incidence by age were: 2.07% in women aged 25-44 years, 1.01% (45-54 years), 1.11% (55-64 years) and 1.24% (65-74 years). Cancer registries in Spain that send data to IARC declared 2003-2007 the average annual incidence rate of 98.6 cases per 100,000 women. Our model can obtain an incidence of 100.7 cases per 100,000 women. Conclusions: A sharp and steady increase in the incidence of breast cancer in the period 1991-2013 is observed. The increase was seen in all age groups considered, although it seems more pronounced in young women (25-44 years). With this method you can get a good estimation of the incidence.

Keywords: breast cancer, incidence, cancer registries, castilla-la mancha

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2133 Sentiment Analysis of Consumers’ Perceptions on Social Media about the Main Mobile Providers in Jamaica

Authors: Sherrene Bogle, Verlia Bogle, Tyrone Anderson

Abstract:

In recent years, organizations have become increasingly interested in the possibility of analyzing social media as a means of gaining meaningful feedback about their products and services. The aspect based sentiment analysis approach is used to predict the sentiment for Twitter datasets for Digicel and Lime, the main mobile companies in Jamaica, using supervised learning classification techniques. The results indicate an average of 82.2 percent accuracy in classifying tweets when comparing three separate classification algorithms against the purported baseline of 70 percent and an average root mean squared error of 0.31. These results indicate that the analysis of sentiment on social media in order to gain customer feedback can be a viable solution for mobile companies looking to improve business performance.

Keywords: machine learning, sentiment analysis, social media, supervised learning

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2132 Early Versus Delayed Antiretroviral Therapy in HIV‐positive People with Tuberculosis

Authors: Mohhamed El Habib Labdouni

Abstract:

Introduction: Co-infection with VIH and tuberculosis poses one of the major ongoing challenges for global TB and AIDS prevention and control. The objective of this study is to raise the issue of the resurgence of TB, in People living with VIH supported in a referent center in western Algeria. Its epidemiological, clinical, biological and radiological new trends, and to compare the mortality rate between early and delayed ART. Methods: It was a prospective study, during 36 months from the 01st/01/2012 to 31st/12/2014, by identifying and analyzing cases of TB-VIH co-infection. Our population was devised in two groups/ early ART and delayed ART. The primary and secondary endpoints were analyzed with Kaplan-Meier curves and log-rank test the period of follow up, which was fixed at 300 weeks. Results: Sixty cases of co-infection TB -VIH were enrolled in our study: 78.3% had pulmonary tuberculosis associated with extra-pulmonary, 13.3% had only pulmonary tuberculosis and 08.3% presented strictly extra-pulmonary TB. The clinical particularity of this co-infection is the frequency of serious localization such us: pleural 23.3%, peritoneal 31.7%, and meningeal suffusion 13.3%.y-.biologicaly we notice the predominance both of pancytopenia and leucoanemia, hyponatremia in 38,6% and hypokalemia in 19,3%. By analyzing Kaplan-Meier survival curves, we notice that early ART initiation is associated with a significant reduction of all-cause mortality (p = 0,000), and we have identified several prognostic factors such as hypokalemia hyponatremia, leukocytosis thrombopenemia leucothrombopenia (p = 0,005). Conclusion: Our study confirms most of the results reported in the literature. Early ART initiation reduces the rate of all-cause mortality, despite the probability of the occurrence of TB-IRIS.

Keywords: TB-HIV co-infection, early ART, hyponatremia, extrapulmonary tuberculosis

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2131 Effects of Some Factors Affecting Optimum Reproductive Capacity of Local Breeds of Sheep in Nigeria

Authors: D. Zahraddeen, N. M. Lemu, P. P. Barje, I. S. R. Butswat

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This study was conducted to investigate some of the factors affecting the optimum reproductive capacity of the indigenous breeds of sheep in Nigeria. A total of 767 sheep of different breeds were investigated. The reproductive indices considered were birth/weaning weights, litter size, parity, mortality, reproductive problems/disorders, body condition score (BCS), as well as growth traits. The results showed that litter size, parity, and BCS had significant (p < 0.05) effects on birth/weaning weights, mortality rates and growth traits of the sheep breeds studied. Similarly, the rearing method/system significantly (p < 0.05) influenced other reproductive traits such as birth/weaning weights, mortality, growth performance of lambs. However, the major reproductive problems/disorders in the ewes were dystocia (30.94%), retained placenta (16.91%), mastitis (15.83), pregnancy toxaemia (11.51%), uterine prolapse (6.48%) and vaginal prolapse (3.24%). In the rams, the incidence of reproductive problems included cryptorchidism (1.08%), orchitis (2.87%) and scrotal dermatophilosis (1.79%), among others. This study concludes that the four breeds of sheep (Balami, Yankasa, Uda, and West African Dwarf sheep) and their crosses exhibited varied genetic make-up and potentials. However, the large number of sheep farmers practicing the extensive production system might be responsible for the low reproductive performance of this species in the country. It is, therefore, recommended that significant improvement could be achieved through enhanced management practices of these animals.

Keywords: sheep, breeds, reproduction, disorders

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2130 San Francisco Public Utilities Commission Headquarters "The Greenest Urban Building in the United States"

Authors: Charu Sharma

Abstract:

San Francisco Public Utilities Commission’s Headquarters was listed in the 2013-American Institute of Architects Committee of the Environment (AIA COTE) Top Ten Green Projects. This 13-story, 277,000-square-foot building, housing more than 900 of the agency’s employees was completed in June 2012. It was designed to achieve LEED Platinum Certification and boasts a plethora of green features to significantly reduce the use of energy and water consumption, and provide a healthy office work environment with high interior air quality and natural daylight. Key sustainability features include on-site clean energy generation through renewable photovoltaic and wind sources providing $118 million in energy cost savings over 75 years; 45 percent daylight harvesting; and the consumption of 55 percent less energy and a 32 percent less electricity demand from the main power grid. It uses 60 percent less water usage than an average 13-story office building as most of that water will be recycled for non-potable uses at the site, running through a system of underground tanks and artificial wetlands that cleans and clarifies whatever is flushed down toilets or washed down drains. This is one of the first buildings in the nation with treatment of gray and black water. The building utilizes an innovative structural system with post tensioned cores that will provide the highest asset preservation for the building. In addition, the building uses a “green” concrete mixture that releases less carbon gases. As a public utility commission this building has set a good example for resource conservation-the building is expected to be cheaper to operate and maintain as time goes on and will have saved rate-payers $500 million in energy and water savings. Within the anticipated 100-year lifespan of the building, our ratepayers will save approximately $3.7 billion through the combination of rental savings, energy efficiencies, and asset ownership.

Keywords: energy efficiency, sustainability, resource conservation, asset ownership, rental savings

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2129 Application of Hydrogen Peroxide and Polialuminum Chloride to Treat Palm Oil Mill Wastewater by Electrocoagulation

Authors: M. Nasrullah, Siti Norsita, Lakhveer Singh, A. W. Zulrisam, Mimi Sakinah

Abstract:

The purposes of this study were to investigate the effects of polyaluminum chloride (PAC) and hydrogen peroxide on COD removal by electrocoagulation. The current density was varied between 30-80 mA cm−2, polyaluminum chloride (1-3 g L-1) as coagulant aid and 1 and 2 percent of hydrogen peroxide as an oxidizing agent. It has been shown that 86.67% of COD was removed by the iron electrode in 180 min while 81.11% of COD was removed by the aluminum electrode in 210 min which indicate that iron was more effective than aluminum. As much as 88.25% COD was removed by using 80 mA cm−2 as compared to 72.86% by using 30 mA cm−2 in 240 min. When PAC and H2O2 increased, the percent of COD removal was increasing as well. The highest removal efficiency of 95.08% was achieved by adding 2% of H2O2 in addition of 3 g L−1 PAC. The general results demonstrate that electrocoagulation is very efficient and able to achieve more than 70% COD removal in 180 min at current density 30-80 mAcm-2 depending on the concentration of H2O2 and coagulant aid.

Keywords: electrocaogulation, palm oil mill effluent, hydrogen peroxide, polialuminum chloride, chemical oxygen demand

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2128 Environmental Related Mortality Rates through Artificial Intelligence Tools

Authors: Stamatis Zoras, Vasilis Evagelopoulos, Theodoros Staurakas

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The association between elevated air pollution levels and extreme climate conditions (temperature, particulate matter, ozone levels, etc.) and mental consequences has been, recently, the focus of significant number of studies. It varies depending on the time of the year it occurs either during the hot period or cold periods but, specifically, when extreme air pollution and weather events are observed, e.g. air pollution episodes and persistent heatwaves. It also varies spatially due to different effects of air quality and climate extremes to human health when considering metropolitan or rural areas. An air pollutant concentration and a climate extreme are taking a different form of impact if the focus area is countryside or in the urban environment. In the built environment the climate extreme effects are driven through the formed microclimate which must be studied more efficiently. Variables such as biological, age groups etc may be implicated by different environmental factors such as increased air pollution/noise levels and overheating of buildings in comparison to rural areas. Gridded air quality and climate variables derived from the land surface observations network of West Macedonia in Greece will be analysed against mortality data in a spatial format in the region of West Macedonia. Artificial intelligence (AI) tools will be used for data correction and prediction of health deterioration with climatic conditions and air pollution at local scale. This would reveal the built environment implications against the countryside. The air pollution and climatic data have been collected from meteorological stations and span the period from 2000 to 2009. These will be projected against the mortality rates data in daily, monthly, seasonal and annual grids. The grids will be operated as AI-based warning models for decision makers in order to map the health conditions in rural and urban areas to ensure improved awareness of the healthcare system by taken into account the predicted changing climate conditions. Gridded data of climate conditions, air quality levels against mortality rates will be presented by AI-analysed gridded indicators of the implicated variables. An Al-based gridded warning platform at local scales is then developed for future system awareness platform for regional level.

Keywords: air quality, artificial inteligence, climatic conditions, mortality

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2127 Outcome of Naive SGLT2 Inhibitors Among ICU Admitted Acute Stroke with T2DM Patients a Prospective Cohort Study in NCMultispecialty Hospital, Biratnagar, Nepal

Authors: Birendra Kumar Bista, Rhitik Bista, Prafulla Koirala, Lokendra Mandal, Nikrsh Raj Shrestha, Vivek Kattel

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Introduction: Poorly controlled diabetes is associated with cause and poor outcome of stroke. High blood sugar reduces cerebral blood flow, increases intracranial pressure, cerebral edema and neuronal death, especially among patients with poorly controlled diabetes.1 SGLT2 inhibitors are associated with 50% reduction in hemorrhagic stroke compared with placebo. SGLT2 inhibitors decrease cardiovascular events via reducing glucose, blood pressure, weight, arteriosclerosis, albuminuria and reduction of atrial fibrillation.2,3 No study has been documented in low income countries to see the role of post stroke SGLT2 inhibitors on diabetic patients at and after ICU admission. Aims: The aim of the study was to measure the 12 months outcome of diabetic patients with acute stroke admitted in ICU set up with naïve SGLT2 inhibitors add on therapy. Method: It was prospective cohort study carried out in a 250 bedded tertiary neurology care hospital at the province capital Biratnagar Nepal. Diabetic patient with acute stroke admitted in ICU from 1st January 2022 to 31st December 2022 who were not under SGLT2 inhibitors were included in the study. These patients were managed as per hospital protocol. Empagliflozin was added to the alternate enrolled patients. Empagliflozin was continued at the time of discharged and during follow up unless contraindicated. These patients were followed up for 12 months. Outcome measured were mortality, morbidity requiring readmission or hospital visit other than regular follow up, SGLT2 inhibitors related adverse events, neuropsychiatry comorbidity, functional status and biochemical parameters. Ethical permission was taken from hospital administration and ethical board. Results: Among 147 diabetic cases 68 were not treated with empagliflozin whereas 67 cases were started the SGLT2 inhibitors. HbA1c level and one year mortality was significantly low among patients on empaglifozin arm. Over a period of 12 months 427 acute stroke patients were admitted in the ICU. Out of them 44% were female, 61% hypertensive, 34% diabetic, 57% dyslipidemia, 26% smoker and with median age of 45 years. Among 427 cases 4% required neurosurgical interventions and 76% had hemorrhagic CVA. The most common reason for ICU admission was GCS<8 (51%). The median ICU stay was 5 days. ICU mortality was 21% whereas 1 year mortality was 41% with most common reason being pneumonia. Empaglifozin related adverse effect was seen in 11% most commonly lower urinary tract infection in 6%. Conclusion: Empagliflozin can safely be started among acute stroke with better Hba1C control and low mortality outcome compared to treatment without SGLT2 inhibitor.

Keywords: diabetes, ICU, mortality, SGLT2 inhibitors, stroke

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2126 The Toxicity Effects of HICIDE VD-9 on the Mortality of Lucilia cuprina under Laboratory Conditions

Authors: Mehdi Shahmoradi Moghadam, Saba Kavian, Mehdi Zabihzadeh, Amir Mohammad Alborzi, Reza Sadeghi

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Cypermethrin is one of the most widely used synthetic insecticides to control pests in veterinary, industrial and agricultural environments. In the present study, the mortalities of Lucilia Cuprina as the key pest of meat were studied after being exposed to HICIDE VD-9 (a ready-to-use disinfectant/insecticide containing cypermethrin, polyhexanide and quaternary ammonium compounds produced by Dana pharmed lotus Co., Iran) within 15 minutes. The experimental results showed that moralities percentage of egg, larvae and adults of Lucilia Cuprina were 48%, 81% and 70%, respectively. Based on the obtained results, it can be predicted that in addition to controlling the insect pests of blow flies, HICIDE VD-9, as a cost-effective and environmentally friendly disinfectant/insecticide, can be effective against other insects, e.g., biting flies, fleas, midges, mosquitoes and ticks.

Keywords: cypermethrin, HICIDE VD-9, Lucilia cuprina, mortality, toxicity

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2125 Improving the Electrical Conductivity of Epoxy Coating Using Carbon Nanotube by Electrodeposition Method

Authors: Mahla Zabet, Navid Zanganeh, Hafez Balavi, Farbod Sharif

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Electrodeposition is a method for applying coatings with uniform thickness on complex objects. A conductive surface can be produced using the electrical current in this method. Carbon nanotubes are known to have high electrical conductivity and mechanical properties. In this report, NH2-multiwalled carbon nanotubes (MWCNTs) were used in epoxy resin with different weight percent. The weight percent of incorporated MWCNTS into the matrix was changed in the range of 0.6-3.6 wt% to obtain a series of electrocoatings. The electrocoats were then applied on steel substrates by a cathodic electrodeposition technique. Scanning electron microscopy (SEM) and optical microscopy were used to characterize the electrocoated films. The results illustrated the increase in conductivity by increasing of MWCNT load. However, at the percolation threshold, throwing power was dropped with increase in recoating ability.

Keywords: electrodeposition, carbon nanotube, electrical conductivity, throwing power

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2124 Prospects of Agroforestry Products in the Emergency Situation: A Case Study of Earthquake of 2015 in Central Nepal

Authors: Raju Chhetri

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Agroforestry is one of the main sources of livelihood among the people of Nepal. In particular, this is the only one mode of livelihood among the Chepangs. The monster earthquake (7.3 MW) that hit the country on the 25th of April in 2015 and many of its aftershocks had devastating effects. As a result, not only the big structures collapsed, it incurred great losses on fabrication, collection centers, schools, markets and other necessary service centers. Although there were a large number of aftershocks after the monster earthquake, the most devastating aftershock took place on 12th May, 2015, which measured 6.3 richter scale. Consequently, it caused more destruction of houses, further calamity to the lives of people, and public life got further perdition. This study was mainly carried out to find out the food security and market situation of Agroforestry product of the Chepang community in Raksirang VDC (one of the severely affected VDCs of Makwanpur district) due to the earthquake. A total of 40 households (12 percent) were randomly selected as a sample in ward number 7 only. Questionnaires and focus groups were used to gather primary data. Additional, two Focus Group Discussions (FGD) were convened in the study area to get some descriptive information on this study. Estimated 370 hectares of land, which was full of Agroforestry plantation, ruptured by the earthquake. It caused severe damages to the households, and a serious loss of food-stock, up to 60-80 percent (maize, millet, and rice). Instead of regular cereal intake, banana (Muas Paradisca) consumption was found ‘high scale’ in the emergency period. The market price of rice (37-44 NRS/Kg) increased by 18.9 percent. Some difference in the income range before and after the earthquake was observed. Before earthquake, sale of Agroforestry, and livestock products were continuing, but after the earthquake, Agroforestry product sale is the only one means of livelihood among Chepangs. Nearly 50-60 percent Agroforestry production of banana (Mass Paradisca), citrus (Citrus Lemon), pineapple (Ananus comosus) and broom grass (Thysanolaena maxima) declined, excepting for cash income from the residual. Heavy demands of Agroforestry product mentioned above lay high farm gate prices (50-100 percent) helps surveyed the community to continue livelihood from its sale. Out of the survey samples, 30 households (75 percent) respondents migrated to safe location due to land rupture, ongoing aftershocks, and landslides. Overall food security situation in this community is acute and challenging for the days to come. Immediate and long term both response from a relief agency concerning food, shelter and safe stocking of Agroforestry product is required to keep secured livelihood in Chepang community.

Keywords: earthquake, rupture, agroforestry, livelihood, indigenous, food security

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2123 Physiological Assessment for Straightforward Symptom Identification (PASSify): An Oral Diagnostic Device for Infants

Authors: Kathryn Rooney, Kaitlyn Eddy, Evan Landers, Weihui Li

Abstract:

The international mortality rate for neonates and infants has been declining at a disproportionally low rate when compared to the overall decline in child mortality in recent decades. A significant portion of infant deaths could be prevented with the implementation of low-cost and easy to use physiological monitoring devices, by enabling early identification of symptoms before they progress into life-threatening illnesses. The oral diagnostic device discussed in this paper serves to continuously monitor the key vital signs of body temperature, respiratory rate, heart rate, and oxygen saturation. The device mimics an infant pacifier, designed to be easily tolerated by infants as well as orthodontically inert. The fundamental measurements are gathered via thermistors and a pulse oximeter, each encapsulated in medical-grade silicone and wired internally to a microcontroller chip. The chip then translates the raw measurements into physiological values via an internal algorithm, before outputting the data to a liquid crystal display screen and an Android application. Additionally, a biological sample collection chamber is incorporated into the internal portion of the device. The movement within the oral chamber created by sucking on the pacifier-like device pushes saliva through a small check valve in the distal end, where it is accumulated and stored. The collection chamber can be easily removed, making the sample readily available to be tested for various diseases and analytes. With the vital sign monitoring and sample collection offered by this device, abnormal fluctuations in physiological parameters can be identified and appropriate medical care can be sought. This device enables preventative diagnosis for infants who may otherwise have gone undiagnosed, due to the inaccessibility of healthcare that plagues vast numbers of underprivileged populations.

Keywords: neonate mortality, infant mortality, low-cost diagnostics, vital signs, saliva testing, preventative care

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2122 An Economic Analysis of Bottled Drinking Water Industry in India

Authors: Swadhin Mondal

Abstract:

While safe drinking water is an effective defense against the infection of water borne diseases, a large number of populations suffering from these diseases do not have access to safe drinking water due inadequacy of supply. Private entrepreneurs entered this sector and made bottled drinking water available by supplying various kinds of bottled water. In this study we found that the bottled drinking water industry has experienced a spectacular growth over the past two decades and it has a huge growth potential because of rising demand for safe drinking. High profit margin (217 %) is the main attraction to the entrepreneur to invest in this industry. Health awareness, lack of safe drinking water facilities, rising income, urbanization, migration and rising trend in tourism industries are the major influencing factors of demand for bottled drinking water (BDW). This industry also partially fulfills the demand for drinking water. More than 2 percent of household’s demands were met by this industry and many more households (additional 4 percent) coping with BDW during water crisis. Poor households spend around 4 percent of their total monthly household’s consumption expenditure on BDW which may have an adverse impact on household because households could have spent this for purchasing other goods. Like other developed counties, a large section of Indian households are shifting from their traditional sources of water to BDW. However, there are some concerns about the quality of BDW. Many cases, BDW contains chemical toxins at more than permissible level that can be harmful for health. Hence, there is an urgent need for appropriate intervention to regulate price, reduce potential harm and improve the quality of water provided by this industry.

Keywords: drinking water, public health public failure, privatization, development, public policy

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2121 Assessing the Impact of Frailty in Elderly Patients Undergoing Emergency Laparotomies in Singapore

Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

Abstract:

Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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2120 Biocontrol Potential of Trichoderma longibrachiatum as an Entomopathogenic Fungi against Bemisia tabaci

Authors: Waheed Anwar, Kiran Nawaz, Muhammad Saleem Haider, Ahmad Ali Shahid, Sehrish Iftikhar

Abstract:

The whitefly, Bemisia tabaci (Gennadius), is a complex insect species, including many cryptic species or biotypes. Whitefly causes damage to many ornamental and horticultural crops through directly feeding on phloem sap, resulting in sooty mould and critically decreases the rate of photosynthesis of many host plants. Biological control has emerged as one of the most important methods for the management of soil-borne plant pathogens. Among the natural enemies of insects different entomopathogenic fungi are mostly used as biological control of the pest. The purpose of this research was to find indigenous insect-associated fungi and their virulence against Bemisia tabaci. A detailed survey of cotton fields in sample collection was conducted during July and August 2013 from the central mixed zone of Punjab, Pakistan. For the isolation of T. longibrachiatum, sabouraud dextrose peptone yeast extract agar (SDAY) media was used and morphological characterization of isolated T. longibrachiatum was studied using different dichotomous keys. Molecular Identification of the pathogen was confirmed by amplifying the internal transcribed spacer region. Blastn analysis showed 100% homology with already reported sequences on the database. For these bioassays, two conidial concentrations 4 × 108/mL & 4 × 104/mL of T. longibrachiatum was sprayed in clip cages for nymph and adult B. tabaci respectively under controlled environmental conditions. The pathogenicity of T. longibrachiatum was tested on nymph and adult whitefly to check mortality. Mortality of B. tabaci at nymphal and adult stages were observed after 24-hour intervals. Percentage mortality of nymphs treated with 4 x 104/mL conidia of T. longibrachiatum was 20, 24, 36 and 40% after 48, 72, 96, 72, 96, 120 and 144 hours respectively. However, no considerable difference was recorded in percentage mortality of whitefly after 120 and 144 hours. There were great variations after 24, 48, 72 and 96 hours in the rate of mortality. The efficacy of T. longibrachiatum as entomopathogenic fungi was evaluated in adult and nymphal stages of whitefly. Trichoderma longibrachiatum showed maximum activity on nymphal stages of whitefly as compared to adult stages. The percentage of conidial germination was also recorded on the outer surface of adult and nymphal stages of B. tabaci. The present findings indicated that T. longibrachiatum is an entomopathogenic fungus against B. tabaci and many species of Trichoderma were already reported as an antagonistc organism against a wide range of bacterial and fungal pathogens.

Keywords: efficacy, Trichoderma, virulence, bioassay

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2119 Internal Combustion Engine Fuel Composition Detection by Analysing Vibration Signals Using ANFIS Network

Authors: M. N. Khajavi, S. Nasiri, E. Farokhi, M. R. Bavir

Abstract:

Alcohol fuels are renewable, have low pollution and have high octane number; therefore, they are important as fuel in internal combustion engines. Percentage detection of these alcoholic fuels with gasoline is a complicated, time consuming, and expensive process. Nowadays, these processes are done in equipped laboratories, based on international standards. The aim of this research is to determine percentage detection of different fuels based on vibration analysis of engine block signals. By doing, so considerable saving in time and cost can be achieved. Five different fuels consisted of pure gasoline (G) as base fuel and combination of this fuel with different percent of ethanol and methanol are prepared. For example, volumetric combination of pure gasoline with 10 percent ethanol is called E10. By this convention, we made M10 (10% methanol plus 90% pure gasoline), E30 (30% ethanol plus 70% pure gasoline), and M30 (30% Methanol plus 70% pure gasoline) were prepared. To simulate real working condition for this experiment, the vehicle was mounted on a chassis dynamometer and run under 1900 rpm and 30 KW load. To measure the engine block vibration, a three axis accelerometer was mounted between cylinder 2 and 3. After acquisition of vibration signal, eight time feature of these signals were used as inputs to an Adaptive Neuro Fuzzy Inference System (ANFIS). The designed ANFIS was trained for classifying these five different fuels. The results show suitable classification ability of the designed ANFIS network with 96.3 percent of correct classification.

Keywords: internal combustion engine, vibration signal, fuel composition, classification, ANFIS

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2118 Functional Neurocognitive Imaging (fNCI): A Diagnostic Tool for Assessing Concussion Neuromarker Abnormalities and Treating Post-Concussion Syndrome in Mild Traumatic Brain Injury Patients

Authors: Parker Murray, Marci Johnson, Tyson S. Burnham, Alina K. Fong, Mark D. Allen, Bruce McIff

Abstract:

Purpose: Pathological dysregulation of Neurovascular Coupling (NVC) caused by mild traumatic brain injury (mTBI) is the predominant source of chronic post-concussion syndrome (PCS) symptomology. fNCI has the ability to localize dysregulation in NVC by measuring blood-oxygen-level-dependent (BOLD) signaling during the performance of fMRI-adapted neuropsychological evaluations. With fNCI, 57 brain areas consistently affected by concussion were identified as PCS neural markers, which were validated on large samples of concussion patients and healthy controls. These neuromarkers provide the basis for a computation of PCS severity which is referred to as the Severity Index Score (SIS). The SIS has proven valuable in making pre-treatment decisions, monitoring treatment efficiency, and assessing long-term stability of outcomes. Methods and Materials: After being scanned while performing various cognitive tasks, 476 concussed patients received an SIS score based on the neural dysregulation of the 57 previously identified brain regions. These scans provide an objective measurement of attentional, subcortical, visual processing, language processing, and executive functioning abilities, which were used as biomarkers for post-concussive neural dysregulation. Initial SIS scores were used to develop individualized therapy incorporating cognitive, occupational, and neuromuscular modalities. These scores were also used to establish pre-treatment benchmarks and measure post-treatment improvement. Results: Changes in SIS were calculated in percent change from pre- to post-treatment. Patients showed a mean improvement of 76.5 percent (σ= 23.3), and 75.7 percent of patients showed at least 60 percent improvement. Longitudinal reassessment of 24 of the patients, measured an average of 7.6 months post-treatment, shows that SIS improvement is maintained and improved, with an average of 90.6 percent improvement from their original scan. Conclusions: fNCI provides a reliable measurement of NVC allowing for identification of concussion pathology. Additionally, fNCI derived SIS scores direct tailored therapy to restore NVC, subsequently resolving chronic PCS resulting from mTBI.

Keywords: concussion, functional magnetic resonance imaging (fMRI), neurovascular coupling (NVC), post-concussion syndrome (PCS)

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2117 The Resistance Reader Program Based on Image Processing

Authors: Janpen Srijan, Nahathai Tanmang, Thanit Purathanang, Anun Dowchern, Saksit Summart, Seangduan Kampimpa

Abstract:

This paper presents the resistance reader program based on image processing by using MATLAB. The proposed program is divided into six parts; the first part is the web camera; the second part is a watt selection before shooting the resistor; the third part is a part of finding the position of the color on the mid-point of resistor; the fourth part is a part of identifying color code of the resistor; the fifth part is a part of taking the number of values for each color for resistance calculation and the last part is a part of displaying result of resistance value. The experimental result of the resistance reader program based on image processing was able to display the resistance value of resistor. The accuracy of proposed program is 85 percent for 1 watt resistor. It has 15 percent of reading error because a problem with the color code of some resistor was too bright.

Keywords: resistance reader program, image processing, resistor, MATLAB

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2116 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

Abstract:

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

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2115 Religiosity and Customer Loyalty in Islamic Banking: An Evidence from Pakistan

Authors: Muhammad Taimoor Hassan, Kausar Abbas

Abstract:

The Islamic Banking Services is one of the growing businesses in financial sector around the globe with 15 to 18 percent growth all over the world and 10-12 percent growth rate in Pakistan. This research study is aimed at measuring the impact of religiosity on the customer loyalty of Islamic Banking in Pakistan. The study has utilized cause and effect research design to assess the impact of religiosity on Islamic Banking. Data from 350 respondents have been collected to meet the purpose of the study. The results revealed that the religiosity has a significant impact on the customer loyalty of Islamic Banking through the customer attitude and customer trust on the sequential model. The results suggest that the religiosity, customer attitude, and customer trust are the interconnected variables which lead to customer loyalty in Islamic Banking of Pakistan. The study is useful in the setting of Pakistan to further increase the customer loyalty for Islamic Banks.

Keywords: Islamic banks, customer loyalty, attitude, Pakistan

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2114 Reducing Pressure Drop in Microscale Channel Using Constructal Theory

Authors: K. X. Cheng, A. L. Goh, K. T. Ooi

Abstract:

The effectiveness of microchannels in enhancing heat transfer has been demonstrated in the semiconductor industry. In order to tap the microscale heat transfer effects into macro geometries, overcoming the cost and technological constraints, microscale passages were created in macro geometries machined using conventional fabrication methods. A cylindrical insert was placed within a pipe, and geometrical profiles were created on the outer surface of the insert to enhance heat transfer under steady-state single-phase liquid flow conditions. However, while heat transfer coefficient values of above 10 kW/m2·K were achieved, the heat transfer enhancement was accompanied by undesirable pressure drop increment. Therefore, this study aims to address the high pressure drop issue using Constructal theory, a universal design law for both animate and inanimate systems. Two designs based on Constructal theory were developed to study the effectiveness of Constructal features in reducing the pressure drop increment as compared to parallel channels, which are commonly found in microchannel fabrication. The hydrodynamic and heat transfer performance for the Tree insert and Constructal fin (Cfin) insert were studied using experimental methods, and the underlying mechanisms were substantiated by numerical results. In technical terms, the objective is to achieve at least comparable increment in both heat transfer coefficient and pressure drop, if not higher increment in the former parameter. Results show that the Tree insert improved the heat transfer performance by more than 16 percent at low flow rates, as compared to the Tree-parallel insert. However, the heat transfer enhancement reduced to less than 5 percent at high Reynolds numbers. On the other hand, the pressure drop increment stayed almost constant at 20 percent. This suggests that the Tree insert has better heat transfer performance in the low Reynolds number region. More importantly, the Cfin insert displayed improved heat transfer performance along with favourable hydrodynamic performance, as compared to Cfinparallel insert, at all flow rates in this study. At 2 L/min, the enhancement of heat transfer was more than 30 percent, with 20 percent pressure drop increment, as compared to Cfin-parallel insert. Furthermore, comparable increment in both heat transfer coefficient and pressure drop was observed at 8 L/min. In other words, the Cfin insert successfully achieved the objective of this study. Analysis of the results suggests that bifurcation of flows is effective in reducing the increment in pressure drop relative to heat transfer enhancement. Optimising the geometries of the Constructal fins is therefore the potential future study in achieving a bigger stride in energy efficiency at much lower costs.

Keywords: constructal theory, enhanced heat transfer, microchannel, pressure drop

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2113 Debating the Role of Patriarchy in the Incidence of Gender-Based Violence in Jordan: Systematic Review of the Literature

Authors: Nour Daoud

Abstract:

Patriarchy continues to thrive in Jordan where male-controlled values are still entrenched in a society that is suffering from upsetting percentages of Gender-based Violence (GBV). This paper is a systematic review of the literature with an attempt to evaluate and interpret all available research evidence relevant to determining the extent to which patriarchy contributes to the occurrence, re-occurrence, and continuation of GBV in Jordan. Twenty-one (21) full-text articles were selected for the in-depth review due to meeting the established criteria for inclusion. 81 percent of articles included primary data while 19 percent included secondary data. Analysis of data was based on a specific extraction form that was developed using the ‘Excel’ to respond to the main goal of the paper. Interpretation of data was in light of the theorization of different feminism schools on the relationship between patriarchy and gender-based violence. Findings show that 33 percent of the selected articles affirm that the patriarchal standpoint best explains the role of patriarchy in the incidence of gender-based violence in Jordan under its three main themes (Honor-based Violence, Intimate Partner Violence and Street Harassment). Apart from the limited number of articles that were found debating this argument and the low percentage of articles that acknowledged the role of patriarchy in the incidence of gender-based violence in Jordan, this paper breaks the ice to implement future empirical studies on this subject. Also, it is an invitation for all Jordanian women to unite their efforts in order to eradicate all forms of victimization against them.

Keywords: honor-based violence, intimate partner violence, middle-east, street harassment

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2112 Comparison of Maternal and Perinatal Outcomes of Obstetric Population Diagnosed with Covid-19 in Reference to Influenza A/H1N1: A Systematic Review and Meta-Analysis

Authors: Maria Vargas Hernandez, Jose Rojas Suarez, Carmelo Dueñas Castell, Sandra Contreras, Camilo Bello, Diana Borre, Walter Anichiarico, Harold Vasquez, Eduard Perez, Jose Santacruz

Abstract:

In the last two decades, there have been outbreaks of emerging infectious diseases, with an impact on both the general population and the obstetric population. These infections, which affect the general population, pose a high risk for adverse maternal and perinatal outcomes, taking into account that physiological and immunological changes that occur during pregnancy can increase their risk or severity. Among these, the pandemics of viral infections, Influenza A/H1N1 and SARS-CoV-2/COVID-19, stand out. In 2009, Influenza A/H1N1 infection (H1N1 2009pdm) affected approximately 3,110 obstetric patients, with data reported from 29 countries, including 1,625 (52.3%) cases that were hospitalized, 378 (23.3%) admissions to ICU and 130 (8%) deaths; and since the end of 2019, the Severe Acute Respiratory Syndrome - 2 (SARS-CoV-2) has been identified, causing the COVID-19 pandemic, with global mortality that is around 2-4% for the general population, and higher mortality in patients requiring admission to the intensive care unit. Its impact on the obstetric population is still unknown. Objectives: To evaluate the impact on maternal and perinatal outcomes of COVID-19 infection in reference to influenza A/H1N1 infection in the obstetric population. Methodology: Systematic review of the literature and meta-analysis. Results: Mortality from maternal infection with influenza A/H1N1 appears to be higher (8%) than mortality due to maternal infection with COVID-19 (3%). The rates of ICU admission, hospitalization, the requirement for invasive mechanical ventilation, and fetal death also appear to be higher in the maternal population with A/H1N1 infection, in reference to the maternal population with COVID-19 infection. Within perinatal outcomes, the admission to the neonatal ICU appears to be higher in the infants born to mothers with COVID-19 infection (28% vs. 15% for COVID-19 and A/H1N1, respectively). Conclusion: A/H1N1 infection in the obstetric population seems to be associated with a higher proportion of adverse outcomes in relation to COVID-19 infection. The actual impact of maternal influenza A/H1N1 infection on perinatal outcomes is unknown. More COVID-19 studies are needed to understand the impact of maternal infection on perinatal outcomes in this population.

Keywords: A/H1N1, COVID-19, maternal outcomes, perinatal outcomes

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2111 Gastrointestinal Manifestations and Outcomes in Hospitalized COVID-19 Patients: A Retrospective Study

Authors: Jaylo Abalos, Sophia Zamora

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BACKGROUND: Various gastrointestinal (GI) symptoms, including diarrhea, nausea/vomiting and abdominal pain, have been reported in patients with Coronavirus disease 2019 (COVID-19). In this context, the presence of GI symptoms is variably associated with poor clinical outcomes in COVID-19. We aim to determine the outcomes of hospitalized COVID-19 patients with gastrointestinal symptoms. METHODOLOGY: This is a retrospective cohort study that used medical records of admitted COVID-19 patients from March 2020- March 2021 in a tertiary hospital in Pangasinan. Data records were evaluated for the presence of gastrointestinal manifestations, including diarrhea, nausea, vomiting and abdominal pain at the time of admission. Comparison between cases or COVID-19 patients presenting with GI manifestations to controls or COVID-19 patients without GI manifestation was made. RESULTS: Four hundred three patients were included in the study. Of these, 22.3% presented with gastrointestinal symptoms, while 77.7% comprised the study controls. Diarrhea was the most common GI symptom (10.4%). No statistically significant difference was observed in comorbidities and laboratory findings. Mortality was the primary outcome of the study that did not reach statistical significance between cases and controls (13.33% vs. 16.30%, p =0.621). There were also no significant differences observed in the secondary outcomes, mean length of stay, (14 [12-18 days] in cases vs 14 [12- 17.5 days] in controls, p = 0.716) and need for mechanical ventilation (12.22% vs 16.93%, p = 0.329). CONCLUSION: The results of the study revealed no association of the GI symptoms to poor outcomes, including a high rate of mortality, prolonged length of stay and increased need for mechanical ventilation.

Keywords: gastrointestinal symptoms, COVID-19, outcomes, mortality, length of stay

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