Search results for: severe obstetric hemorrhage
Commenced in January 2007
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Paper Count: 1902

Search results for: severe obstetric hemorrhage

432 Hyperthyroidism in a Private Medical Services Center, Addis Ababa: A 5-Year Experience

Authors: Ersumo Tessema, Bogale Girmaye Tamrat, Mohammed Burka

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Background: Hyperthyroidism is a common thyroid disorder especially in women and characterized by increased thyroid hormone synthesis and secretion. The disorder manifests predominantly as Graves’ disease in iodine-sufficient areas and has increasing prevalence in iodine-deficient countries in patients with nodular thyroid disease and following iodine fortification. In Ethiopia, the magnitude of the disorder is unknown and, in Africa, due to scarcity of resources, its management remains suboptimal. Objective: The aim of this study was to analyze the pattern and management of patients with hyperthyroidism at the United Vision Medical Services Center, Addis Ababa between August 30, 2013, and February 1, 2018. Patients and methods: The study was a retrospective analysis of medical records of all patients with hyperthyroidism at the United Vision Private Medical Services Center, Addis Ababa. A questionnaire was filled out; the collected data entered into a computer and statistically analyzed using the SPSS package. The results were tabulated and discussed with literature review. Results: A total of 589 patients were included in this study. The median age was 40 years, and the male to female ratio was 1.0:7.9. Most patients (93%) presented with goiter and the associated features of toxic goiter except weight loss, sweating and tachycardia were uncommon. Majority of patients presented more than two years after the onset of their presenting symptoms. The most common physical finding (91%), as well as diagnosis, was toxic nodular goiter. The most frequent (83%) derangement in the thyroid function tests was a low thyroid-stimulating hormone, and the most commonly (94%) used antithyroid drug was a propylthiouracil. The most common (96%) surgical procedure in 213 patients was a near-total thyroidectomy with a postoperative course without incident in 92% of all the patients. Conclusion: The incidence and prevalence of hyperthyroidism are apparently on the increase in Addis Ababa, which may be related to the existing severe iodine-deficiency and or the salt iodation program (iodine-induced hyperthyroidism). Hyperthyroidism predominantly affects women and, in surgical services, toxic nodular goiter is more common than diffuse goiter, and the treatment of choice in experienced hands is a near-total thyroidectomy.

Keywords: Ethiopia, grave’s disease, hyperthyroidism, toxic nodular goiter

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431 Exploration of Classic Models of Precipitation in Iran: A Case Study of Sistan and Baluchestan Province

Authors: Mohammad Borhani, Ahmad Jamshidzaei, Mehdi Koohsari

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The study of climate has captivated human interest throughout history. In response to this fascination, individuals historically organized their daily activities in alignment with prevailing climatic conditions and seasonal variations. Understanding the elements and specific climatic parameters of each region, such as precipitation, which directly impacts human life, is essential because, in recent years, there has been a significant increase in heavy rainfall in various parts of the world attributed to the effects of climate change. Climate prediction models suggest a future scenario characterized by an increase in severe precipitation events and related floods on a global scale. This is a result of human-induced greenhouse gas emissions causing changes in the natural precipitation patterns. The Intergovernmental Panel on Climate Change reported global warming in 2001. The average global temperature has shown an increasing trend since 1861. In the 20th century, this increase has been between (0/2 ± 0/6) °C. The present study focused on examining the trend of monthly, seasonal, and annual precipitation in Sistan and Baluchestan provinces. The study employed data obtained from 13 precipitation measurement stations managed by the Iran Water Resources Management Company, encompassing daily precipitation records spanning the period from 1997 to 2016. The results indicated that the total monthly precipitation at the studied stations in Sistan and Baluchestan province follows a sinusoidal trend. The highest intense precipitation was observed in January, February, and March, while the lowest occurred in September, October, and then November. The investigation of the trend of seasonal precipitation in this province showed that precipitation follows an upward trend in the autumn season, reaching its peak in winter, and then shows a decreasing trend in spring and summer. Also, the examination of average precipitation indicated that the highest yearly precipitation occurred in 1997 and then in 2004, while the lowest annual precipitation took place between 1999 and 2001. The analysis of the annual precipitation trend demonstrates a decrease in precipitation from 1997 to 2016 in Sistan and Baluchestan province.

Keywords: climate change, extreme precipitation, greenhouse gas, trend analysis

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430 Factors Associated with Commencement of Non-Invasive Ventilation

Authors: Manoj Kumar Reddy Pulim, Lakshmi Muthukrishnan, Geetha Jayapathy, Radhika Raman

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Introduction: In the past two decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure in children. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions, decrease airway injury, and prevent respiratory tract infections. There is a need to determine the clinical profile and parameters which point towards the need for NIV in the pediatric emergency setting. Objectives: i) To study the clinical profile of children who required non invasive ventilation and invasive ventilation, ii) To study the clinical parameters common to children who required non invasive ventilation. Methods: All children between one month to 18 years, who were intubated in the pediatric emergency department and those for whom decision to commence Non Invasive Ventilation was made in Emergency Room were included in the study. Children were transferred to the Paediatric Intensive Care Unit and started on Non Invasive Ventilation as per our hospital policy and followed up in the Paediatric Intensive Care Unit. Clinical profile of all children which included age, gender, diagnosis and indication for intubation were documented. Clinical parameters such as respiratory rate, heart rate, saturation, grunting were documented. Parameters obtained were subject to statistical analysis. Observations: Airway disease (Bronchiolitis 25%, Viral induced wheeze 22%) was a common diagnosis in 32 children who required Non Invasive Ventilation. Neuromuscular disorder was the common diagnosis in 27 children (78%) who were Intubated. 17 children commenced on Non Invasive Ventilation who later needed invasive ventilation had Neuromuscular disease. High frequency nasal cannula was used in 32, and mask ventilation in 17 children. Clinical parameters common to the Non Invasive Ventilation group were age < 1 year (17), tachycardia n = 7 (22%), tachypnea n = 23 (72%) and severe respiratory distress n = 9 (28%), grunt n = 7 (22%), SPO2 (80% to 90%) n = 16. Children in the Non Invasive Ventilation + INTUBATION group were > 3 years (9), had tachycardia 7 (41%), tachypnea 9(53%) with a male predominance n = 9. In statistical comparison among 3 groups,'p' value was significant for pH, saturation, and use of Ionotrope. Conclusion: Invasive ventilation can be avoided in the paediatric Emergency Department in children with airway disease, by commencing Non Invasive Ventilation early. Intubation in the pediatric emergency department has a higher association with neuromuscular disorders.

Keywords: clinical parameters, indications, non invasive ventilation, paediatric emergency room

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429 Application of Shore Protective Structures in Optimum Land Using of Defense Sites Located in Coastal Cities

Authors: Mir Ahmad Lashteh Neshaei, Hamed Afsoos Biria, Ata Ghabraei, Mir Abdolhamid Mehrdad

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Awareness of effective land using issues in coastal area including protection of natural ecosystems and coastal environment due to the increasing of human life along the coast is of great importance. There are numerous valuable structures and heritages which are located in defence sites and waterfront area. Marine structures such as groins, sea walls and detached breakwaters are constructed in coast to improve the coast stability against bed erosion due to changing wave and climate pattern. Marine mechanisms and interaction with the shore protection structures need to be intensively studied. Groins are one of the most prominent structures that are used in shore protection to create a safe environment for coastal area by maintaining the land against progressive coastal erosion. The main structural function of a groin is to control the long shore current and littoral sediment transport. This structure can be submerged and provide the necessary beach protection without negative environmental impact. However, for submerged structures adopted for beach protection, the shoreline response to these structures is not well understood at present. Nowadays, modelling and computer simulation are used to assess beach morphology in the vicinity of marine structures to reduce their environmental impact. The objective of this study is to predict the beach morphology in the vicinity of submerged groins and comparison with non-submerged groins with focus on a part of the coast located in Dahane sar Sefidrood, Guilan province, Iran where serious coast erosion has occurred recently. The simulations were obtained using a one-line model which can be used as a first approximation of shoreline prediction in the vicinity of groins. The results of the proposed model are compared with field measurements to determine the shape of the coast. Finally, the results of the present study show that using submerged groins can have a good efficiency to control the beach erosion without causing severe environmental impact to the coast. The important outcome from this study can be employed in optimum designing of defence sites in the coastal cities to improve their efficiency in terms of re-using the heritage lands.

Keywords: submerged structures, groin, shore protective structures, coastal cities

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428 MAOD Is Estimated by Sum of Contributions

Authors: David W. Hill, Linda W. Glass, Jakob L. Vingren

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Maximal accumulated oxygen deficit (MAOD), the gold standard measure of anaerobic capacity, is the difference between the oxygen cost of exhaustive severe intensity exercise and the accumulated oxygen consumption (O2; mL·kg–1). In theory, MAOD can be estimated as the sum of independent estimates of the phosphocreatine and glycolysis contributions, which we refer to as PCr+glycolysis. Purpose: The purpose was to test the hypothesis that PCr+glycolysis provides a valid measure of anaerobic capacity in cycling and running. Methods: The participants were 27 women (mean ± SD, age 22 ±1 y, height 165 ± 7 cm, weight 63.4 ± 9.7 kg) and 25 men (age 22 ± 1 y, height 179 ± 6 cm, weight 80.8 ± 14.8 kg). They performed two exhaustive cycling and running tests, at speeds and work rates that were tolerable for ~5 min. The rate of oxygen consumption (VO2; mL·kg–1·min–1) was measured in warmups, in the tests, and during 7 min of recovery. Fingerprick blood samples obtained after exercise were analysed to determine peak blood lactate concentration (PeakLac). The VO2 response in exercise was fitted to a model, with a fast ‘primary’ phase followed by a delayed ‘slow’ component, from which was calculated the accumulated O2 and the excess O2 attributable to the slow component. The VO2 response in recovery was fitted to a model with a fast phase and slow component, sharing a common time delay. Oxygen demand (in mL·kg–1·min–1) was determined by extrapolation from steady-state VO2 in warmups; the total oxygen cost (in mL·kg–1) was determined by multiplying this demand by time to exhaustion and adding the excess O2; then, MAOD was calculated as total oxygen cost minus accumulated O2. The phosphocreatine contribution (area under the fast phase of the post-exercise VO2) and the glycolytic contribution (converted from PeakLac) were summed to give PCr+glycolysis. There was not an interaction effect involving sex, so values for anaerobic capacity were examined using a two-way ANOVA, with repeated measures across method (PCr+glycolysis vs MAOD) and mode (cycling vs running). Results: There was a significant effect only for exercise mode. There was no difference between MAOD and PCr+glycolysis: values were 59 ± 6 mL·kg–1 and 61 ± 8 mL·kg–1 in cycling and 78 ± 7 mL·kg–1 and 75 ± 8 mL·kg–1 in running. Discussion: PCr+glycolysis is a valid measure of anaerobic capacity in cycling and running, and it is as valid for women as for men.

Keywords: alactic, anaerobic, cycling, ergometer, glycolysis, lactic, lactate, oxygen deficit, phosphocreatine, running, treadmill

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427 Developmental Trajectories of Distress and Suicide Risk Following Exposure to Military Sexual Trauma in US Military Service Members

Authors: Rebecca K. Blais, Lindsey Monteith, Hallie Tannahill

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Military sexual trauma (MST) includes sexual harassment or assault that occurred during military service. Studies conducted to date on the association of MST with mental health and suicide outcomes are generally circumscribed to either active duty or veteran samples, precluding a thorough analysis of developmental trajectories of distress following MST within the context of ongoing (vs. discharged from) military service. The Military Social Science Laboratory has collected data on mixed service samples of men and women service members, addressing this important literature gap. The purpose of this study was to examine the association of MST, suicide risk, PTSD, depression, alcohol use, and posttraumatic cognitions using two separate samples, which collectively allow for a comprehensive examination of the development of distress following MST. The first sample consisted of 1389 men and women service members and veterans with varying levels of MST severity, including no MST, harassment-only MST, and assault MST. The second sample consisted of 400 men and women service members, all reporting the highest severity of MST, assault MST. In both samples, roughly half reported being discharged from service. Participants completed self-report measures of MST exposure severity, suicide ideation, suicide risk, PTSD, depression, alcohol misuse, and posttraumatic cognitions, as well as perceptions of how the military responded to their MST. Relative to those still serving in the US military, veterans were more likely to endorse suicidal ideation, higher PTSD symptoms, and higher depression symptoms if they felt the military mishandled their experience of MST (referred to as perceived institutional betrayal). However, among those reporting the most severe MST, veterans reported lower alcohol misuse and more adaptive posttraumatic cognitions. These findings suggest that those separated from the military experience different posttraumatic aftermath following MST relative to those who are currently serving in the military. Such findings suggest critical differences in the developmental trajectory of distress, necessitating different interventions to successfully reduce distress and dysfunction. Additional analyses will explore the impact of gender on these associations and explore full mechanistic models of distress grouped by discharged status.

Keywords: military sexual trauma, PTSD, suicide, developmental trajectories, depression

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426 Design of Built-Spaces and Enhanced Psychological Wellbeing by Limiting Effect of SBS: An Analytical Study across Students in Indian Universities

Authors: Sadaf H. Khan, Jyoti Kumar

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Sick Building Syndrome (SBS) is a situation in which inhabitants of a building develop illness symptoms or get infected with a chronic disease as a result of the building in which they reside or work. Certain symptoms tend to get more severe as an individual spends more time in the building; however, they generally improve with time or even disappear when they leave that space. Though ‘Design of Built-Spaces’ is a crucial factor in regulating these symptoms but it still needs to be identified further as to what specific design features of a ‘Built-Space’ trigger sick building syndrome (SBS). Much of the research work present to date is focused on the physiological or physical sickness caused due to inappropriate built-space design. In this paper, the psychological aspects of sick building syndrome (SBS) will be investigated across the adult population, more specifically graduate students in India trying to settle in back to their previous physical work environments, i.e., campus, classrooms, hostels, after a very long hold which lasted more than a year due to lockdowns during Covid-19 crisis all over the world. The study will follow an analytical approach and the data will be collected through self-reported online surveys. The purpose of this study is to enquire causal agents, diagnosable symptoms and remedial design of built spaces which can enhance the productive level of built environments and better facilitate the inhabitants by improving their psychological wellbeing, which is the most uprising concern. The fact that SBS symptoms can be studied only within the initial few weeks as an occupant starts interacting with a built-environment and leaves as the occupant leaves that space or zone, the post-lockdown incoming of students back to their respective campuses provides an opportunity to clearly draw multiple conclusions of the relationship that exist between the Design of Built-Spaces and Psychological Sickness Syndrome associated with it. The study will be one of a kind approach for understanding and formulating methods to improve psychological wellbeing within a built-setting by better identifying factors associated with these psychological symptoms, including anxiety, mental fatigue, reduced attention span and reduced memory span as refined symptoms of SBS discussed in 1987 by Molhave within his study.

Keywords: built-environment psychology, built-space design, healthcare architecture, psychological wellbeing

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425 Effect of Preoperative Single Dose Dexamethasone and Lignocaine on Post-Operative Quality of Recovery and Pain Relief after Laparoscopic Cholecystectomy

Authors: Gurjeet Khurana, Surender Singh, Poonam Arora, Praveendra K. Sachan

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Introduction: Post-operative quality of recovery is the key outcome in the perspective of anesthesiologist. It is directly related to patient satisfaction. This is unsurprising, considering most aspects of a poor quality recovery after surgery will impair satisfaction with care. This study was thus undertaken to evaluate effects of Dexamethasone and Lignocaine on Quality of Recovery using QoR- 40 questionnaire and compare their effects. Material and methods: After obtaining the ethical committee approval and written informed consent, 67 patients of 18-60 years, ASA grade I and II scheduled for elective laparoscopic cholecystectomy were randomly allocated into two groups. Group I of 34 patients received 2mg/kg lignocaine diluted to 10ml with normal saline. Group 2 of 33 patients received 0.1 mg/kg I/V Dexamethasone diluted to 10ml with normal saline. QoR-40 was assessed on pre-operative day, and again QoR-40 was assessed at 24 hr post-operative day-1. Postoperative pain scores, nausea and vomiting and shoulder pain were secondary outcomes. Results: The Global QoR-40 was more than 180 at 24 hr in both the groups. The Dexamethasone group had higher Global QoR-40 than lignocaine group 187.94 v/s 182.85. Amongst dimensions of QoR-40 Dexamethasone had statistically better physical comfort, physical independence, and pain relief as compared to Lignocaine. Positive items had excellent responses in Dexamethasone group. Headache, backache and sore throat were also less severe in Dexamethasone group as compared to Lignocaine group. Dexamethasone group had lower VAS compared to lignocaine group. Similarly, there was less fentanyl consumption in dexamethasone group (364.08 ± 127.31) in postoperative period when compared to the lignocaine group (412.31 ± 147.8). Group receiving dexamethasone had 36% increase in appetite compared to lignocaine group (17.6%), which facilitated early oral feeding. Frequency of PONV was less in group-2 at different time interval as compared to group 1. Total episode of PONV were 18 in group 1 and 7 in group 2. Statistically significant difference was seen among two groups (p value= 0.007). Use of antiemetic was more in group 1 as compared to group 2 at all the times, though it was not statistically significant at different time intervals. Antiemetics were administered to 18 patients in group 1 as compared to 5 patients in group 2 postoperatively. Statistically significant difference (p value= 0.011) was seen in total antiemetic consumption. Conclusion: Our study demonstrated that pre-operative administration of a single dose of dexamethasone enhanced the quality of recovery after laparoscopic cholecystectomy as compared to Lignocaine bolus dose.

Keywords: dexamethasone, lignocaine, QoR-40 questionnaire, quality of recovery

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424 Ethics and Military Defections in Nonviolent Resistance Campaigns

Authors: Adi Levy

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Military and security personnel defections during nonviolent resistance (NVR) campaigns are recognized as an effective way of undermining the regime’s power, but they also may generate moral dilemmas that contradict the moral standing of NVR tactics. NVR campaigns have been primarily praised for their adherence to moral and legal norms, yet some of NVR tactics raise serious ethical concerns. This paper focuses on NVR tactics that seek to promote defections and disobedience within military and security personnel to sustain their campaign. Academic literature regarding NVR tactics indicates that compared to violent forms of resistance, defections are more likely to occur when security forces confront nonviolent activists. Indeed, defections play a strategically fundamental role in nonviolent campaigns, particularly against authoritarian regimes, as it enables activists to undermine the regime’s central pillars of support. This study examines the events of the Arab Spring and discusses the ethical problems that arise in nonviolent activists’ promotion of defections and disobedience. The cases of Syria and Egypt suggest that the strategic promotion of defections and disobedience was significantly effective in sustaining the campaign. Yet, while such defections enhance nonviolent activists’ resilience, how they are promoted can be morally contentious and the consequences can be dire. Defections are encouraged by social, moral and emotional appeals that use the power disparities between unarmed civilians and powerful regimes to affect soldiers and security personnel’s process of decision-making. In what is commonly referred to as dilemma action, nonviolent activists deliberately entangle security forces in a moral dilemma that compels them to follow a moral code to protect unarmed civilians. In this way, activists sustain their struggle and even gain protection. Nonviolent activists are likely to be completely defeated when confronted with armed forces. Therefore they rely on the military and security personnel’s moral conscious of convincing them to refrain from using force against them. While this is effective, it also leaves soldiers and security forces exposed to the implications and punishments that might follow their disobedience or defection. As long as they remain nonviolent, activists enjoy civilian immunity despite using morally contentious tactics. But the severe implications brought upon defectors. As a result, demand a deep examination of this tactic’s moral permissibility and a discussion that assesses culpability for the moral implications of its application.

Keywords: culpability, defections, nonviolence, permissibility

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423 The First Transcriptome Assembly of Marama Bean: An African Orphan Crop

Authors: Ethel E. Phiri, Lionel Hartzenberg, Percy Chimwamuromba, Emmanuel Nepolo, Jens Kossmann, James R. Lloyd

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Orphan crops are underresearched and underutilized food plant species that have not been categorized as major food crops, but have the potential to be economically and agronomically significant. They have been documented to have the ability to tolerate extreme environmental conditions. However, limited research has been conducted to uncover their potential as food crop species. The New Partnership for Africa’s Development (NEPAD) has classified Marama bean, Tylosema esculentum, as an orphan crop. The plant is one of the 101 African orphan crops that must have their genomes sequenced, assembled, and annotated in the foreseeable future. Marama bean is a perennial leguminous plant that primarily grows in poor, arid soils in southern Africa. The plants produce large tubers that can weigh as much as 200kg. While the foliage provides fodder, the tuber is carbohydrate rich and is a staple food source for rural communities in Namibia. Also, the edible seeds are protein- and oil-rich. Marama Bean plants respond rapidly to increased temperatures and severe water scarcity without extreme consequences. Advances in molecular biology and biotechnology have made it possible to effectively transfer technologies between model- and major crops to orphan crops. In this research, the aim was to assemble the first transcriptomic analysis of Marama Bean RNA-sequence data. Many model plant species have had their genomes sequenced and their transcriptomes assembled. Therefore the availability of transcriptome data for a non-model crop plant species will allow for gene identification and comparisons between various species. The data has been sequenced using the Ilumina Hiseq 2500 sequencing platform. Data analysis is underway. In essence, this research will eventually evaluate the potential use of Marama Bean as a crop species to improve its value in agronomy. data for a non-model crop plant species will allow for gene identification and comparisons between various species. The data has been sequenced using the Ilumina Hiseq 2500 sequencing platform. Data analysis is underway. In essence, this researc will eventually evaluate the potential use of Marama bean as a crop species to improve its value in agronomy.

Keywords: 101 African orphan crops, RNA-Seq, Tylosema esculentum, underutilised crop plants

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422 The Pharmacogenetics of Type 1 Cannabinoid Receptor (CB1) Gene Associated with Adverse Drug Reactions in Thai Patients

Authors: Kittitara Chunlakittiphan, Patompong Satapornpong

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Introduction: The variation of genetics affects how our body responds to pharmaceuticals elucidates the correlation between long-term use of medical cannabis and adverse drug reactions (ADRs). Medical cannabis is regarded as the treatment for chronic pain, cancer pain, acute pain, psychological disorders, multiple sclerosis and migraine management. However, previous studies have shown that delta-9-Tetrahydrocannabinol (THC), an ingredient found in cannabis, was the cause of ADRs in CB1 receptors found in humans. Previous research suggests that distributions of the cannabinoid type 1 (CB1) receptor gene and pharmacogenetic markers, which vary amongst different populations, might affect incidences of ADRs. Although there is an evident need to investigate the level of the CB1 receptor gene (rs806365), studies on the distribution of CB1-pharmacogenetics markers in Thai patients are limited. Objective: Therefore, the aim of this study is to investigate the distribution of the rs806365 polymorphism in Thai patients who have been treated with medical cannabis. Materials and Methods: We enrolled 31 Thai patients with THC-induced ADRs and 34 THC-tolerant controls to take part in this study. All patients with THC-induced ADRs were accessed through a review of medical records by physicians. EDTA blood of 3ml was collected to obtain the CNR1 gene (rs806365) and genotyping of this gene was conducted using the real-time PCR ViiA7 (ABI, Foster City, CA, USA) following the manufacturer’s instruction. Results: The sample consisted of 65 patients (40/61.54%) were females and (25/38.46%) were males, with an age range of 19-87 years, who have been treated with medical cannabis. In this study, the most common THC-induced ADRs were dry mouth and/or dry throat, tachycardia, nausea, and arrhythmia. Across the whole sample, we found that 52.31% of Thai patients carried a heterozygous variant (rs806365, CT allele). Moreover, the number of rs806365 (CC, homozygous variant) carriers totaled seventeen people (26.15%) amongst the subjects of Thai patients treated with medical cannabis. Furthermore, 17 out of 22 patients (77.27%) who experienced severe ADRs: Tachycardia and/or arrhythmia, carried an abnormal rs806365 gene (CT and CC alleles). Conclusions: The results propose that the rs806365 gene is widely distributed amongst the Thai population and there is a link between this gene and vulnerability to developing THC-induced ADRs after being treated with medical cannabis. Therefore, it is necessary to screen for the rs806365 gene before using medical cannabis to treat a patient.

Keywords: rs806365, THC-induced adverse drug reactions, CB1 receptor, Thai population

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421 Sociocultural Context of Pain Management in Oncology and Palliative Nursing Care

Authors: Andrea Zielke-Nadkarni

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Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: pain management, migrants, sociocultural context, palliative care

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420 Optimal Data Selection in Non-Ergodic Systems: A Tradeoff between Estimator Convergence and Representativeness Errors

Authors: Jakob Krause

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Past Financial Crisis has shown that contemporary risk management models provide an unjustified sense of security and fail miserably in situations in which they are needed the most. In this paper, we start from the assumption that risk is a notion that changes over time and therefore past data points only have limited explanatory power for the current situation. Our objective is to derive the optimal amount of representative information by optimizing between the two adverse forces of estimator convergence, incentivizing us to use as much data as possible, and the aforementioned non-representativeness doing the opposite. In this endeavor, the cornerstone assumption of having access to identically distributed random variables is weakened and substituted by the assumption that the law of the data generating process changes over time. Hence, in this paper, we give a quantitative theory on how to perform statistical analysis in non-ergodic systems. As an application, we discuss the impact of a paragraph in the last iteration of proposals by the Basel Committee on Banking Regulation. We start from the premise that the severity of assumptions should correspond to the robustness of the system they describe. Hence, in the formal description of physical systems, the level of assumptions can be much higher. It follows that every concept that is carried over from the natural sciences to economics must be checked for its plausibility in the new surroundings. Most of the probability theory has been developed for the analysis of physical systems and is based on the independent and identically distributed (i.i.d.) assumption. In Economics both parts of the i.i.d. assumption are inappropriate. However, only dependence has, so far, been weakened to a sufficient degree. In this paper, an appropriate class of non-stationary processes is used, and their law is tied to a formal object measuring representativeness. Subsequently, that data set is identified that on average minimizes the estimation error stemming from both, insufficient and non-representative, data. Applications are far reaching in a variety of fields. In the paper itself, we apply the results in order to analyze a paragraph in the Basel 3 framework on banking regulation with severe implications on financial stability. Beyond the realm of finance, other potential applications include the reproducibility crisis in the social sciences (but not in the natural sciences) and modeling limited understanding and learning behavior in economics.

Keywords: banking regulation, non-ergodicity, risk management, semimartingale modeling

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419 Analysis of Sickle Cell Disease and Maternal Mortality in United Kingdom

Authors: Basma Hassabo, Sarah Ahmed, Aisha Hameed

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Aims and Objectives: To determine the incidence of maternal mortality amongst pregnant women with sickle cell disease (SCD) in the United Kingdom and to determine exact cause of death in these women. Background: SCD is caused by the ‘sickle’ gene and is characterized by episodes of severe bone pain and other complications like acute chest syndrome, chronic pulmonary hypertension, stroke, retinopathy, chronic renal failure, hepato-splenic crises, avascular bone necrosis, sepsis and leg ulcers. SCD is a continual cause of maternal mortality and fetal complications, and it comprises 1.5% of all Direct and Indirect deaths in the UK. Sepsis following premature rupture of membranes with ascending infection, post-partum infection and pre-labour overwhelming septic shock is one of its leading causes of death. Over the last fifty years of maternal mortality reports in UK, between 1 to 4 pregnant women died in each triennium. Material and Method: This is a retrospective study that involves pregnant women who died from SCD complications in the UK between 1952-2012. Data were collected from the UK Confidential Enquiries into Maternal Death and its causes between 1952–2012. Prior to 1985, exact cause of death in this cohort was not recorded. Results: 33 deaths reported between 1964 and 1984. 17 deaths were reported due to sickle cell disease between 1985 and 2012. Five women in this group died of sickle cell crisis, one woman had liver sequestration crisis, two women died of venous thromboembolism, two had myocardial fibrosis and three died of sepsis. Remaining women died of amniotic fluid embolism, SUDEP, myocardial ischemia and intracranial haemorrhage. Conclusion: The leading causes of death in sickle cell sick pregnant women are sickle cell crises, sepsis, venous thrombosis and thromboembolism. Prenatal care for women with SCD should be managed by a multidisciplinary team that includes an obstetrician, nutritionist, primary care physician, and haematologist. In every sick Sickle Cell woman Sickle Cell crises should be on the top of the list of differential diagnosis. Aggressive treatment of complications with low threshold to commence broad-spectrum antibiotics and LMWH contribute to better outcomes.

Keywords: incidence, maternal mortality, sickle cell disease (SCD), uk

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418 Psychosocial Strategies Used by Individuals with Schizophrenia: An Analysis of Internet Forum Posts

Authors: Charisse H. Tay

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Background: Schizophrenia is a severe chronic mental disorder that can result in hallucinations, delusions, reduced social engagement, and lack of motivation. While antipsychotic medications often provide the basis for treatment, psychosocial strategies complement the benefit of medications and can result in meaningful improvements in symptoms and functioning. The aim of the study was to investigate psychosocial strategies used by internet self-help forum participants to effectively manage symptoms caused by schizophrenia. Internet self-help forums are a resource for medical and psychological problems and are commonly used to share information about experiences with symptom management. Method: Three international self-help internet forums on schizophrenia were identified using a search engine. 1,181 threads regarding non-pharmacological, psychosocial self-management of schizophrenia symptoms underwent screening, resulting in the final identification and coding of 91 threads and 191 posts from 134 unique forum users that contained details on psychosocial strategies endorsed personally by users that allowed them to effectively manage symptoms of schizophrenia, including positive symptoms (e.g., auditory/visual/tactile hallucinations, delusions, paranoia), negative symptoms (e.g.., avolition, apathy, anhedonia), symptoms of distress, and cognitive symptoms (e.g., memory loss). Results: Effective symptom management strategies personally endorsed by online forum users were psychological skills (e.g., re-focusing, mindfulness/meditation, reality checking; n = 94), engaging in activities (e.g., exercise, working/volunteering, hobbies; n = 84), social/familial support (n = 48), psychotherapy (n = 33), diet (n = 18), and religion/spirituality (n = 14). 44.4% of users reported using more than one strategy to manage their symptoms. The most common symptoms targeted and effectively managed, as specified by users, were positive symptoms (n = 113), negative symptoms (n = 17), distress (n = 8), and memory loss (n = 6). 10.5% of users reported more than one symptom effectively targeted. 70.2% of users with positive symptoms reported that psychological skills were effective for symptom relief. 88% of users with negative symptoms and 75% with distress symptoms reported that engaging in activities was effective. Discussion: Individuals with schizophrenia rely on a variety of different psychosocial methods to manage their symptoms. Different symptomology appears to be more effectively targeted by different types of psychosocial strategies. This may help to inform treatment strategy and tailored for individuals with schizophrenia.

Keywords: psychosocial treatment, qualitative methods, schizophrenia, symptom management

Procedia PDF Downloads 93
417 Seroepidemiological Study of Toxoplasma gondii Infection in Women of Child-Bearing Age in Communities in Osun State, Nigeria

Authors: Olarinde Olaniran, Oluyomi A. Sowemimo

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Toxoplasmosis is frequently misdiagnosed or underdiagnosed, and it is the third most common cause of hospitalization due to food-borne infection. Intra-uterine infection with Toxoplasma gondii due to active parasitaemia during pregnancy can cause severe and often fatal cerebral damage, abortion, and stillbirth of a fetus. The aim of the study was to investigate the prevalence of T. gondii infection in women of childbearing age in selected communities of Osun State with a view to determining the risk factors which predispose to the T. gondii infection. Five (5) ml of blood was collected by venopuncture into a plain blood collection tube by a medical laboratory scientist. Serum samples were separated by centrifuging the blood samples at 3000 rpm for 5 mins. The sera were collected with Eppendorf tubes and stored at -20°C analysis for the presence of IgG and IgM antibodies against T. gondii by commercially available enzyme-linked immunosorbent assay (ELISA) kit (Demeditec Diagnostics GmbH, Germany) conducted according to the manufacturer’s instructions. The optical densities of wells were measured by a photometer at a wavelength of 450 nm. Data collected were analysed using appropriate computer software. The overall seroprevalence of T. gondii among the women of child-bearing age in selected seven communities in Osun state was 76.3%. Out of 76.3% positive for Toxoplasma gondii infection, 70.0% were positive for anti- T. gondii IgG, and 32.3% were positive for IgM, and 26.7% for both IgG and IgM. The prevalence of T. gondii was lowest (58.9%) among women from Ile Ife, a peri-urban community, and highest (100%) in women residing in Alajue, a rural community. The prevalence of infection was significantly higher (P= 0.000) among Islamic women (87.5%) than in Christian women (70.8%). The highest prevalence (86.3%) was recorded in women with primary education, while the lowest (61.2%) was recorded in women with tertiary education (p =0.016). The highest prevalence (79.7%) was recorded in women that reside in rural areas, and the lowest (70.1%) was recorded in women that reside in peri-urban area (p=0.025). The prevalence of T. gondii infection was highest (81.4%) in women with one miscarriage, while the prevalence was lowest in women with no miscarriages (75.9%). The age of the women (p=0.042), Islamic religion (p=0.001), the residence of the women (p=0.001), and water source were all positively associated with T. gondii infection. The study concluded that there was a high seroprevalence of T. gondii recorded among women of child-bearing age in the study area. Hence, there is a need for health education and create awareness of the disease and its transmission to women of reproductive age group in general and pregnant women in particular to reduce the risk of T. gondii in pregnant women.

Keywords: seroepidemiology, Toxoplasma gondii, women, child-bearing, age, communities, Ile -Ife, Nigeria

Procedia PDF Downloads 147
416 Sustainable Geographic Information System-Based Map for Suitable Landfill Sites in Aley and Chouf, Lebanon

Authors: Allaw Kamel, Bazzi Hasan

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Municipal solid waste (MSW) generation is among the most significant sources which threaten the global environmental health. Solid Waste Management has been an important environmental problem in developing countries because of the difficulties in finding sustainable solutions for solid wastes. Therefore, more efforts are needed to be implemented to overcome this problem. Lebanon has suffered a severe solid waste management problem in 2015, and a new landfill site was proposed to solve the existing problem. The study aims to identify and locate the most suitable area to construct a landfill taking into consideration the sustainable development to overcome the present situation and protect the future demands. Throughout the article, a landfill site selection methodology was discussed using Geographic Information System (GIS) and Multi Criteria Decision Analysis (MCDA). Several environmental, economic and social factors were taken as criterion for selection of a landfill. Soil, geology, and LUC (Land Use and Land Cover) indices with the Sustainable Development Index were main inputs to create the final map of Environmentally Sensitive Area (ESA) for landfill site. Different factors were determined to define each index. Input data of each factor was managed, visualized and analyzed using GIS. GIS was used as an important tool to identify suitable areas for landfill. Spatial Analysis (SA), Analysis and Management GIS tools were implemented to produce input maps capable of identifying suitable areas related to each index. Weight has been assigned to each factor in the same index, and the main weights were assigned to each index used. The combination of the different indices map generates the final output map of ESA. The output map was reclassified into three suitability classes of low, moderate, and high suitability. Results showed different locations suitable for the construction of a landfill. Results also reflected the importance of GIS and MCDA in helping decision makers finding a solution of solid wastes by a sanitary landfill.

Keywords: sustainable development, landfill, municipal solid waste (MSW), geographic information system (GIS), multi criteria decision analysis (MCDA), environmentally sensitive area (ESA)

Procedia PDF Downloads 120
415 Advanced Compound Coating for Delaying Corrosion of Fast-Dissolving Alloy in High Temperature and Corrosive Environment

Authors: Lei Zhao, Yi Song, Tim Dunne, Jiaxiang (Jason) Ren, Wenhan Yue, Lei Yang, Li Wen, Yu Liu

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Fasting dissolving magnesium (DM) alloy technology has contributed significantly to the “Shale Revolution” in oil and gas industry. This application requires DM downhole tools dissolving initially at a slow rate, rapidly accelerating to a high rate after certain period of operation time (typically 8 h to 2 days), a contradicting requirement that can hardly be addressed by traditional Mg alloying or processing itself. Premature disintegration has been broadly reported in downhole DM tool from field trials. To address this issue, “temporary” thin polymers of various formulations are currently coated onto DM surface to delay its initial dissolving. Due to conveying parts, harsh downhole condition, and high dissolving rate of the base material, the current delay coatings relying on pure polymers are found to perform well only at low temperature (typical < 100 ℃) and parts without sharp edges or corners, as severe geometries prevent high quality thin film coatings from forming effectively. In this study, a coating technology combining Plasma Electrolytic Oxide (PEO) coatings with advanced thin film deposition has been developed, which can delay DM complex parts (with sharp corners) in corrosive fluid at 150 ℃ for over 2 days. Synergistic effects between porous hard PEO coating and chemical inert elastic-polymer sealing leads to its delaying dissolution improvement, and strong chemical/physical bonding between these two layers has been found to play essential role. Microstructure of this advanced coating and compatibility between PEO and various polymer selections has been thoroughly investigated and a model is also proposed to explain its delaying performance. This study could not only benefit oil and gas industry to unplug their High Temperature High Pressure (HTHP) unconventional resources inaccessible before, but also potentially provides a technical route for other industries (e.g., bio-medical, automobile, aerospace) where primer anti-corrosive protection on light Mg alloy is highly demanded.

Keywords: dissolvable magnesium, coating, plasma electrolytic oxide, sealer

Procedia PDF Downloads 82
414 Influential Factors Impacting the Utilization of Pain Assessment Tools among Hospitalized Elderly Patients in Taiwan

Authors: Huei Jiun Chen, Hui Mei Huan

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Introduction: Pain is an unpleasant experience for hospitalized patients that impacts both their physical and mental well-being. It is important to select appropriate pain assessment tools to ensure effective pain management. Therefore, it is suggested to use Verbal Rating Scale (VRS) instead for better assessment. The Wong-Baker FACES Pain Rating Scale(WBS) is a widely used pain assessment tool in Taiwan to help individuals communicate the intensity of their pain. However, in clinical practice, even when using various assessment tools to evaluate pain, Numeric Rating Scale-11 (NRS-11) is still commonly utilized to quantify the intensity of pain. The correlation between NRS and other pain assessment tools has not been extensively explored in Taiwan. Additionally, the influence of gender and education level on pain assessment among elderly individuals has not been extensively studied in Taiwan. The aim of this study is to investigate the correlation between pain assessment scales (NRS-11, VRS, WBS) in assessing pain intensity among elderly inpatients. The secondary objective of this study is to examine how gender and education level influence pain assessment among individuals, as well as to explore their preferences regarding pain assessment tools. Method: In this study, a questionnaire survey and purposive sampling were employed to recruit participants from a medical center located in central Taiwan. Participants were requested to assess their pain intensity in the past 24 hours using NRS-11, VRS, and WBS. Additionally, the study investigated their preferences for pain assessment tools. Result: A total of 252 participants were included in this study, with a mean age of 71.1 years (SD=6.2). Of these participants, 135 were male (53.6%), and 44.4% had a primary level or below education. Participants were asked to use NRS-11, VRS, and WBS to assess their current, maximum, and minimum pain intensity experienced in the past 24 hours. The findings indicated a significant correlation (p< .01) among all three pain assessment tools. No significant differences were observed in gender across the three pain assessment scales. For severe pain, there were significant differences in self-rated pain scales among the elderly participants with different education levels (F=3.08, p< .01; X²=17.25, X²=17.21, p< .01), but there were no significant differences observed for mild pain. Regarding preferences for pain assessment tools, 158 participants (62.7%) favored VRS, followed by WBS; gender and education level had no influence on their preferences. Conclusion: Most elderly participants prefer using VRS (Verbal Rating Scale) to self-reported their pain. The reason for this preference may be attributed to the verbal nature of VRS, as it is simple and easy to understand. Furthermore, it could be associated with the level of education among the elderly participants. The pain assessment using VRS demonstrated a significant correlation with NRS-11 and WBS, and gender was not found to have any influence on these assessment. Further research is needed to explore the effect of different education levels on self-reported pain intensity among elderly people in Taiwan.

Keywords: pain assessment, elderly, gender, education

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413 Hidro-IA: An Artificial Intelligent Tool Applied to Optimize the Operation Planning of Hydrothermal Systems with Historical Streamflow

Authors: Thiago Ribeiro de Alencar, Jacyro Gramulia Junior, Patricia Teixeira Leite

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The area of the electricity sector that deals with energy needs by the hydroelectric in a coordinated manner is called Operation Planning of Hydrothermal Power Systems (OPHPS). The purpose of this is to find a political operative to provide electrical power to the system in a given period, with reliability and minimal cost. Therefore, it is necessary to determine an optimal schedule of generation for each hydroelectric, each range, so that the system meets the demand reliably, avoiding rationing in years of severe drought, and that minimizes the expected cost of operation during the planning, defining an appropriate strategy for thermal complementation. Several optimization algorithms specifically applied to this problem have been developed and are used. Although providing solutions to various problems encountered, these algorithms have some weaknesses, difficulties in convergence, simplification of the original formulation of the problem, or owing to the complexity of the objective function. An alternative to these challenges is the development of techniques for simulation optimization and more sophisticated and reliable, it can assist the planning of the operation. Thus, this paper presents the development of a computational tool, namely Hydro-IA for solving optimization problem identified and to provide the User an easy handling. Adopted as intelligent optimization technique is Genetic Algorithm (GA) and programming language is Java. First made the modeling of the chromosomes, then implemented the function assessment of the problem and the operators involved, and finally the drafting of the graphical interfaces for access to the User. The results with the Genetic Algorithms were compared with the optimization technique nonlinear programming (NLP). Tests were conducted with seven hydroelectric plants interconnected hydraulically with historical stream flow from 1953 to 1955. The results of comparison between the GA and NLP techniques shows that the cost of operating the GA becomes increasingly smaller than the NLP when the number of hydroelectric plants interconnected increases. The program has managed to relate a coherent performance in problem resolution without the need for simplification of the calculations together with the ease of manipulating the parameters of simulation and visualization of output results.

Keywords: energy, optimization, hydrothermal power systems, artificial intelligence and genetic algorithms

Procedia PDF Downloads 386
412 The Non-Motor Symptoms of Filipino Patients with Parkinson’s Disease

Authors: Cherrie Mae S. Sia, Noel J. Belonguel, Jarungchai Anton S. Vatanagul

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Background: Parkinson’s disease (PD) is a chronic progressive, neurodegenerative disorder known for its motor symptoms such as bradykinesia, resting tremor, muscle rigidity, and postural instability. Patients with PD also experience non-motor symptoms (NMS) such as depression, fatigue, and sleep disturbances that are most of the time unrecognized by clinicians. This may be due to the lack of spontaneous reports from the patients or partly because of the lack of systematic questioning from the healthcare professional. There is limited data with regards to these NMS especially that of Filipino patients with PD. Objectives: This study aims to determine the non-motor symptoms of Filipino patients with Parkinson’s disease. Materials and Methods: This is a prospective, cohort study involving thirty-four patients of Filipino-descent diagnosed with PD in three out-patient clinics in Cebu City from April to September 2014. Each patient was interviewed using the Non-Motor Symptom Scale (NMSS). A Cebuano version of the NMSS was also provided for the non-English speaking patients. Interview time was approximately ten to fifteen minutes for each respondent. Results: Of the thirty-four patients with Parkinson’s disease, majority was noted to be males (N=19) and the disease was noted to be more prevalent in patients with a mean age of 62 (SD±9) years old. Hypertension (59%) and diabetes mellitus (29%) were the common co-morbidities in the study population. All patients presented more than one NMS, with insomnia (41.2%), poor memory (23.5%) and depression (14.7%) being the first non-motor symptoms to occur. Symptoms involving mood/cognition (mean=2.21), and attention/memory (mean=2.05) were noted to be the most frequent and of moderate severity. Based on the NMSS, the symptoms that were noted to be mild and often to occur were those that involved the mood/cognition (score=3.84), attention/memory (score=3.50), and sleep/fatigue (score=3.00) domains. Levodopa-Carbidopa, Ropinirole, and Pramipexole were the most frequently used medications in the study population. Conclusion: Non-motor symptoms (NMS) are common in patients with Parkinson’s disease (PD). They appear at the time of diagnosis of PD or even before the motor symptoms manifest. The earliest non-motor symptoms to occur are insomnia, poor memory, and depression. Those pertaining to mood/cognition and attention/memory are the most frequent NMS and they are of moderate severity. Identifying these NMS by doing a questionnaire-guided interview such as the Non-Motor Symptom Scale (NMSS) before they can become more severe and affect the patient’s quality of life is a must for every clinician caring for a PD patient. Early treatment and control of these NMS can then be given, hence, improving the patient’s outcome and prognosis.

Keywords: non motor symptoms, Parkinson's Disease, insomnia, depression

Procedia PDF Downloads 414
411 Identification and Management of Septic Arthritis of the Untouched Glenohumeral Joint

Authors: Sumit Kanwar, Manisha Chand, Gregory Gilot

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Background: Septic arthritis of the shoulder has infrequently been discussed. Focus on infection of the untouched shoulder has not heretofore been described. We present four patients with glenohumeral septic arthritis. Methods: Case 1: A 59 year old male with left shoulder pain in the anterior, posterior and superior aspects. Case 2: A 60 year old male with fever, chills, and generalized muscle aches. Case 3: A 70 year old male with right shoulder pain about the anterior and posterior aspects. Case 4: A 55 year old male with global right shoulder pain, swelling, and limited ROM. Results: In case 1, the left shoulder was affected. Physical examination, swelling was notable, there was global tenderness with a painful range of motion (ROM). The lab values indicated an erythrocyte sedimentation rate (ESR) of 96, and a C-reactive protein (CRP) of 304.30. Imaging studies were performed and MRI indicated a high suspicion for an abscess with osteomyelitis of the humeral head. Our second case’s left arm was affected. He had swelling, global tenderness and painful ROM. His ESR was 38, CRP was 14.9. X-ray showed severe arthritis. Case 3 differed with the right arm being affected. Again, global tenderness and painful ROM was observed. His ESR was 94, and CRP was 10.6. X-ray displayed an eroded glenoid space. Our fourth case’s right shoulder was affected. He had global tenderness and painful, limited ROM. ESR was 108 and CRP was 2.4. X-ray was non-significant. Discussion: Monoarticular septic arthritis of the virgin glenohumeral joint is seldom diagnosed in clinical practice. Common denominators include elevated ESR, painful, limited ROM, and involvement of the dominant arm. The male population is more frequently affected with an average age of 57. Septic arthritis is managed with incision and drainage or needle aspiration of synovial fluid supplemented with 3-6 weeks of intravenous antibiotics. Due to better irrigation and joint visualization, arthroscopy is preferred. Open surgical drainage may be indicated if the above methods fail. Conclusion: If a middle-aged male presents with vague anterior or posterior shoulder pain, elevated inflammatory markers and a low grade fever, an x-ray should be performed. If this displays degenerative joint disease, the complete further workup with advanced imaging, such as an MRI, CT scan, or an ultrasound. If these imaging modalities display anterior space joint effusion with soft tissue involvement, we can suspect septic arthritis of the untouched glenohumeral joint and surgery is indicated.

Keywords: glenohumeral joint, identification, infection, septic arthritis, shoulder

Procedia PDF Downloads 393
410 Posterior Cortical Atrophy Phenotype of Alzheimer’s Dementia: A Case Report

Authors: Joana Beyer

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Background: Alzheimer’s disease (AD) is the predominant cause of dementia, characterized by progressive cognitive decline. Posterior cortical atrophy (PCA) is a less common variant of AD, primarily affecting younger individuals and presenting with visual, visuospatial, and visuoperceptual deficits, often leading to delayed diagnosis due to its atypical presentation. Case Presentation: We report the case of a 58-year-old woman referred to psychiatric services with a two-year history of progressive visuospatial decline, mild memory difficulties, and language impairments, notably anomia. Despite undergoing cataract and squint surgeries, her visual symptoms persisted, impacting her professional life as a music educator. The neuropsychological evaluation revealed profound visuoperceptual and visuospatial disturbances, with neuroimaging supporting a diagnosis of PCA. Treatment with Donepezil showed symptom improvement, highlighting the challenges and importance of early intervention and managing this atypical form of AD. Methods: The diagnostic process involved comprehensive physical, neuropsychological assessments, and neuroimaging, including MRI and F18 FDG PET CT, which demonstrated severe bilateral posterior cortical involvement. The case underscores the utility of these modalities in diagnosing PCA. Results: The initiation of Donepezil, an acetylcholinesterase inhibitor, resulted in symptom improvement, emphasizing the potential for AD treatments to benefit PCA patients. However, challenges in management, including treatment side effects and the necessity of multidisciplinary care, are discussed. Conclusion: This case highlights PCA's diagnostic challenges due to its atypical presentation and the broader implications for managing younger patients with early-onset dementia. It underscores the necessity for early recognition, comprehensive assessment, and tailored management strategies, including both pharmacological and non-pharmacological interventions, to improve patients' quality of life. Additionally, the case illustrates the need for expanding community memory services to accommodate younger patients with atypical forms of dementia, advocating for a more inclusive approach to dementia care.

Keywords: Alzheimer’s disease, posterior cortical atrophy, dementia, diagnosis, management, donepezil, early-onset dementia

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409 Long Time Oxidation Behavior of Machined 316 Austenitic Stainless Steel in Primary Water Reactor

Authors: Siyang Wang, Yujin Hu, Xuelin Wang, Wenqian Zhang

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Austenitic stainless steels are widely used in nuclear industry to manufacture critical components owing to their excellent corrosion resistance at high temperatures. Almost all the components used in nuclear power plants are produced by surface finishing (surface cold work) such as milling, grinding and so on. The change of surface states induced by machining has great influence on the corrosion behavior. In the present study, long time oxidation behavior of machined 316 austenitic stainless steel exposed to simulated pressure water reactor environment was investigated considering different surface states. Four surface finishes were produced by electro-polishing (P), grinding (G), and two milling (M and M1) processes respectively. Before oxidation, the surface Vickers micro-hardness, surface roughness of each type of sample was measured. Corrosion behavior of four types of sample was studied by using oxidation weight gain method for six oxidation periods. The oxidation time of each period was 120h, 216h, 336h, 504h, 672h and 1344h, respectively. SEM was used to observe the surface morphology of oxide film in several period. The results showed that oxide film on austenitic stainless steel has a duplex-layer structure. The inner oxide film is continuous and compact, while the outer layer is composed of oxide particles. The oxide particle consisted of large particles (nearly micron size) and small particles (dozens of nanometers to a few hundred nanometers). The formation of oxide particle could be significantly affected by the machined surface states. The large particle on cold worked samples (grinding and milling) appeared earlier than electro-polished one, and the milled sample has the largest particle size followed by ground one and electro-polished one. For machined samples, the large particles were almost distributed along the direction of machining marks. Severe exfoliation was observed on one milled surface (M) which had the most heavily cold worked layer, while rare local exfoliation occurred on the ground sample (G) and the other milled sample (M1). The electro-polished sample (P) entirely did not exfoliate.

Keywords: austenitic stainless steel, oxidation, machining, SEM

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408 Development and Evaluation of a Calcium Rich Plant-Based Supplement on Bone Turnover of Peri and Post Menopausal Women

Authors: Gayathri.G, Hemamalini.A.J, Chandrasekaran.A

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Problem statement: Nutritional deficiency, especially calcium, may lead to poor bone formation and mineralization. Although there are plenty of synthetic supplements available, it is essential to make a calcium rich food supplement accessible to combat calcium deficiency that could be readily prepared at the household level. Thus the current study aimed to formulate and standardize an indigenous low-cost calcium-rich food supplement and to study the impact of supplementation on the bone resorption and formation markers. Methods: A Randomized controlled trial was conducted with 60 subjects distributed equally in control and experimental groups, including perimenopausal and postmenopausal women. A plant-based calcium-rich product was developed and supplemented in form of balls as a midmorning and evening snack by addition of optimized proportions of leaves of Sesbania Grandiflora, seeds of Sesamum indicum, Eleusine coracana, Glycine max, Vigna mungo for a period of 6 months. Postmenopausal and perimenopausal women received 1200mg and 800mg of calcium per day from the supplemented, respectively. Outcome measures like serum calcium; betacrosslaps (bone resorption marker) and total P1NP (bone absorption marker) were assessed after 3 months and after 6 months. Results: There were no significant changes seen in the serum calcium and total P1NP levels (bone formation marker) among the subjects during the supplementation period. The bone resorption marker (betacrosslaps) reduced in all the groups and the reduction (0.32 ± 0.130 ng/ml to 0.25 ± 0.130 ng/ml) was found to be statistically highly significant (p < 0.01) in experimental group of perimenopausal subjects and significant (p < 0.05) in experimental group of postmenopausal subjects (1.11 ± 0.290 ng/ml to 0.42 ± 0.263 ng/ml). Conclusion: With the current severe calcium deficiency in the Indian population, integrating low-cost, calcium-rich native foods that could be readily prepared at household level would be useful in raising the nutritional consumption of calcium, which would, in turn, decrease bone turnover.

Keywords: calcium, sesbania grandiflora, sesamum indicum, eleusine coracana, glycine max, vigna mungo, postmenopause, perimenopause, bone resorption, bone absorption, betacrosslaps, total P1NP

Procedia PDF Downloads 99
407 Non-Invasive Viscosity Determination of Liquid Organic Hydrogen Carriers by Alteration of Temperature and Flow Velocity Using Cavity Based Permittivity Measurement

Authors: I. Wiemann, N. Weiß, E. Schlücker, M. Wensing, A. Kölpin

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Chemical storage of hydrogen by liquid organic hydrogen carriers (LOHC) is a very promising alternative to compression or cryogenics. These carriers have high energy density and allow at the same time efficient and safe storage of hydrogen under ambient conditions and without leakage losses. Another benefit of LOHC is the possibility to transport it using already available infrastructure for transport of fossil fuels. Efficient use of LOHC is related to a precise process control, which requires a number of sensors in order to measure all relevant process parameters, for example, to measure the level of hydrogen loading of the carrier. The degree of loading is relevant for the energy content of the storage carrier and represents simultaneously the modification in chemical structure of the carrier molecules. This variation can be detected in different physical properties like viscosity, permittivity or density. Thereby, each degree of loading corresponds to different viscosity values. Conventional measurements currently use invasive viscosity measurements or near-line measurements to obtain quantitative information. Avoiding invasive measurements has several severe advantages. Efforts are currently taken to provide a precise, non-invasive measurement method with equal or higher precision of the obtained results. This study investigates a method for determination of the viscosity of LOHC. Since the viscosity can retroactively derived from the degree of loading, permittivity is a target parameter as it is a suitable for determining the hydrogenation degree. This research analyses the influence of common physical properties on permittivity. The permittivity measurement system is based on a cavity resonator, an electromagnetic resonant structure, whose resonation frequency depends on its dimensions as well as the permittivity of the medium inside. For known resonator dimensions, the resonation frequency directly characterizes the permittivity. In order to determine the dependency of the permittivity on temperature and flow velocity, an experimental setup with heating device and flow test bench was designed. By varying temperature in the range of 293,15 K -393,15 K and flow velocity up to 140 mm/s, corresponding changes in the resonation frequency were measured in the hundredths of the GHz range.

Keywords: liquid organic hydrogen carriers, measurement, permittivity, viscosity., temperature, flow process

Procedia PDF Downloads 56
406 Influence of Farnesol on Growth and Development of Dysdercus koenigii

Authors: Shailendra Kumar, Kamal Kumar Gupta

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Dysdercus koenigii is an economically important pest of cotton worldwide. The pest damages the crop by sucking sap, staining lint, reducing the oil content of the seeds and deteriorating the quality of cotton. Plant possesses a plethora of secondary metabolites which are used as defense mechanism against herbivores. One of the important categories of such chemicals is insect growth regulators and the intermediates in their biosynthesis. Farnesol belongs to sesquiterpenoid. It is an intermediate in Juvenile hormone biosynthetic pathway in insects has been widely reported in the variety of plants. This chemical can disrupt the normal metabolic function and therefore, affects various life processes of the insects. Present study tested the efficacy of farnesol against Dysdercus koenigii. 2μl of 5% (100µg) and 10% (200µg) of the farnesol was applied topically on the dorsum of thoracic region of the newly emerged fifth instar nymphs of Dysdercus. The treated insects were observed daily for their survival, weight gain, and developmental anomalies for a period of ten days. The results indicated that treatment with 200µg farnesol decreased survival of the insects to 70% after 24h of exposure. At lower doses, no significant decrease in the survival was observed. However, the surviving nymphs showed alteration in growth, development, and metamorphosis. The weight gain in the treated nymphs showed deviation from control. The treated nymphs showed an increase in mortality during subsequent days and increase in the nymphal duration. The number of nymphs undergoing metamorphosis decreased to 46% and 88% in the treatments with the dose of 200µg and 100µg respectively. Severe developmental anomalies were also observed in the treated nymphs. The treated nymphs moulted into supernumerary nymphs, adultoids, adults with exuviae attached and adults with wing deformities. On treatment with 200µg; 26% adultoid, 4% adults with exuviae attached and 12% adults with wing deformed were produced. Treatment with 100µg resulted in production of 34% adultoid, 26% adults with deformed wing and 4% adults with exuviae attached. Many of the treated nymphs did not metamorphose into adults, remained in nymphal stage and died. Our results indicated potential application plant-derived secondary metabolites like farnesol in the management of Dysdercus population.

Keywords: development, Dysdercus koenigii, farnesol, survival

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405 Constructed Wetlands with Subsurface Flow for Nitrogen and Metazachlor Removal from Tile Drainage: First Year Results

Authors: P. Fucik, J. Vymazal, M. Seres

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Pollution from agricultural drainage is a severe issue for water quality, and it is a major reason for the failure in accomplishment of 'good chemical status' according to Water Framework Directive, especially due to high nitrogen and pesticide burden of receiving waters. Constructed wetlands were proposed as a suitable measure for removal of nitrogen from agricultural drainage in the early 1990s. Until now, the vast majority of constructed wetlands designed to treat tile drainage were free-surface constructed wetlands. In 2018, three small experimental constructed wetlands with horizontal subsurface flow were built in Czech Highlands to treat tile drainage from 15.73 ha watershed. The wetlands have a surface area of 79, 90 and 98 m² and were planted with Phalaris arundinacea and Glyceria maxima in parallel bands. The substrate in the first two wetlands is gravel (4-8 mm) mixed with birch woodchips (10:1 volume ratio). In one of those wetlands, the water level is kept 10 cm above the surface; in the second one, the water is kept below the surface. The third wetland has 20 cm layer of birch woodchips on top of gravel. The drainage outlet, as well as wetland outlets, are equipped with automatic discharge-gauging devices, temperature probes, as well as automatic water samplers (Teledyne ISCO). During the monitored period (2018-2019), the flows were unexpectedly low due to a drop of the shallow ground water level, being the main source of water for the monitored drainage system, as experienced at many areas of the Czech Republic. The mean water residence time was analyzed in the wetlands (KBr), which was 16, 9 and 27 days, respectively. The mean total nitrogen concentration eliminations during one-year period were 61.2%, 62.6%, and 70.9% for wetlands 1, 2, and 3, respectively. The average load removals amounted to 0.516, 0.323, and 0.399 g N m-2 d-1 or 1885, 1180 and 1457 kg ha-1 yr-1 in wetlands 1, 2 and 3, respectively. The plant uptake and nitrogen sequestration in aboveground biomass contributed only marginally to the overall nitrogen removal. Among the three variants, the one with shallow water on the surface was revealed to be the most effective for removal of nitrogen from drainage water. In August 2019, herbicide Metazachlor was experimentally poured in time of 2 hours at drainage outlet in a concentration of 250 ug/l to find out the removal rates of the aforementioned wetlands. Water samples were taken the first day every six hours, and for the next nine days, every day one water sample was taken. The removal rates were as follows 94, 69 and 99%; when the most effective wetland was the one with the longest water residence time and the birch woodchip-layer on top of gravel.

Keywords: constructed wetlands, metazachlor, nitrogen, tile drainage

Procedia PDF Downloads 107
404 LWD Acquisition of Caliper and Drilling Mechanics in a Geothermal Well, A Case Study in Sorik Marapi Field – Indonesia

Authors: Vinda B. Manurung, Laila Warkhaida, David Hutabarat, Sentanu Wisnuwardhana, Christovik Simatupang, Dhani Sanjaya, Ashadi, Redha B. Putra, Kiki Yustendi

Abstract:

The geothermal drilling environment presents many obstacles that have limited the use of directional drilling and logging-while-drilling (LWD) technologies, such as borehole washout, mud losses, severe vibration, and high temperature. The case study presented in this paper demonstrates a practice to enhance data logging in geothermal drilling by deploying advanced telemetry and LWD technologies. This operation is aiming continuous improvement in geothermal drilling operations. The case study covers a 12.25-in. hole section of well XX-05 in Pad XX of the Sorik Marapi Geothermal Field. LWD string consists of electromagnetic (EM) telemetry, pressure while drilling (PWD), vibration (DDSr), and acoustic calliper (ACAL). Through this tool configuration, the operator acquired drilling mechanics and caliper logs in real-time and recorded mode, enabling effective monitoring of wellbore stability. Throughout the real-time acquisition, EM-PPM telemetry had provided a three times faster data rate to the surface unit. With the integration of Caliper data and Drilling mechanics data (vibration and ECD -equivalent circulating density), the borehole conditions were more visible to the directional driller, allowing for better control of drilling parameters to minimize vibration and achieve optimum hole cleaning in washed-out or tight formation sequences. After reaching well TD, the recorded data from the caliper sensor indicated an average of 8.6% washout for the entire 12.25-in. interval. Washout intervals were compared with loss occurrence, showing potential for the caliper to be used as an indirect indicator of fractured intervals and validating fault trend prognosis. This LWD case study has given added value in geothermal borehole characterization for both drilling operation and subsurface. Identified challenges while running LWD in this geothermal environment need to be addressed for future improvements, such as the effect of tool eccentricity and the impact of vibration. A perusal of both real-time and recorded drilling mechanics and caliper data has opened various possibilities for maximizing sensor usage in future wells.

Keywords: geothermal drilling, geothermal formation, geothermal technologies, logging-while-drilling, vibration, caliper, case study

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403 Nondecoupling Signatures of Supersymmetry and an Lμ-Lτ Gauge Boson at Belle-II

Authors: Heerak Banerjee, Sourov Roy

Abstract:

Supersymmetry, one of the most celebrated fields of study for explaining experimental observations where the standard model (SM) falls short, is reeling from the lack of experimental vindication. At the same time, the idea of additional gauge symmetry, in particular, the gauged Lμ-Lτ symmetric models have also generated significant interest. They have been extensively proposed in order to explain the tantalizing discrepancy in the predicted and measured value of the muon anomalous magnetic moment alongside several other issues plaguing the SM. While very little parameter space within these models remain unconstrained, this work finds that the γ + Missing Energy (ME) signal at the Belle-II detector will be a smoking gun for supersymmetry (SUSY) in the presence of a gauged U(1)Lμ-Lτ symmetry. A remarkable consequence of breaking the enhanced symmetry appearing in the limit of degenerate (s)leptons is the nondecoupling of the radiative contribution of heavy charged sleptons to the γ-Z΄ kinetic mixing. The signal process, e⁺e⁻ →γZ΄→γ+ME, is an outcome of this ubiquitous feature. Taking the severe constraints on gauged Lμ-Lτ models by several low energy observables into account, it is shown that any significant excess in all but the highest photon energy bin would be an undeniable signature of such heavy scalar fields in SUSY coupling to the additional gauge boson Z΄. The number of signal events depends crucially on the logarithm of the ratio of stau to smuon mass in the presence of SUSY. In addition, the number is also inversely proportional to the e⁺e⁻ collision energy, making a low-energy, high-luminosity collider like Belle-II an ideal testing ground for this channel. This process can probe large swathes of the hitherto free slepton mass ratio vs. additional gauge coupling (gₓ) parameter space. More importantly, it can explore the narrow slice of Z΄ mass (MZ΄) vs. gₓ parameter space still allowed in gauged U(1)Lμ-Lτ models for superheavy sparticles. The spectacular finding that the signal significance is independent of individual slepton masses is an exciting prospect indeed. Further, the prospect that signatures of even superheavy SUSY particles that may have escaped detection at the LHC may show up at the Belle-II detector is an invigorating revelation.

Keywords: additional gauge symmetry, electron-positron collider, kinetic mixing, nondecoupling radiative effect, supersymmetry

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