Search results for: Human health
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2834

Search results for: Human health

164 A Review on the Importance of Nursing Approaches in Nutrition of Children with Cancer

Authors: Ş. Çiftcioğlu, E. Efe

Abstract:

In recent years, cancer has been at the top of diseases that cause death in children. Adequate and balanced nutrition plays an important role in the treatment of cancer. Cancer and cancer treatment is affecting food intake, absorption and metabolism, causing nutritional disorders. Appropriate nutrition is very important for the cancerous child to feel well before, during and after the treatment. There are various difficulties in feeding children with cancer. These are the cancer-related factors. Other factors are environmental and behavioral. As health professionals who spend more time with children in the hospital, nurses should be able to support the children on nutrition and help them to have balanced nutrition. This study aimed to evaluate the importance of nursing approaches in the nutrition of children with cancer. This article is planned as a review article by searching the literature on this field. Anorexia may develop due to psychogenic causes or chemotherapeutic agents or accompanying infections and nutrient uptake may be reduced.  In addition, stomatitis, mucositis, taste and odor changes in the mouth, the feeling of nausea, vomiting and diarrhea can also reduce oral intake and result in significant losses in the energy deficit. In assessing the nutritional status of children with cancer, determining weight loss and good nutrition is essential anamnesis of a child.  Some anthropometric measurements and biochemical tests should be used to evaluate the nutrition of the child. The nutritional status of pediatric cancer patients has been studied for a long time and malnutrition, in particular under nutrition, in this population has long been recognized. Yet, its management remains variable with many malnourished children going unrecognized and consequently untreated. Nutritional support is important to pediatric cancer patients and should be integrated into the overall treatment of these children.

Keywords: Cancer treatment, children, complication, nutrition, nursing approaches.

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163 Quality of Life Assessment across the Cancer Continuum: Understanding the Role of an Exercise Rehabilitation Programme

Authors: Bernat-Carles Serdà Ferrer, Arantza Del Valle Gómez

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The Quality of Life (QoL) paradigm is multidimensional, dynamic and modular and its definition differs across the cancer continuum. The challenge in the interpretation of QoL data in clinical research is that QoL is influenced by psychological phenomena such as adaptation to illness. This research aims to obtain a valid and sensitive assessment of QoL change over the continuum disease, and to evaluate a rehabilitation programme aimed at inverting the observed decrease in QoL when patients return to daily living activities. The sample comprised 66 men. Patients were first assessed to establish a baseline (P1-diagnosis). This was followed by a post-test (P2-discharge) and a then-test measurement (P3-retrospective evaluation) and after returning home patients were randomized in experimental and control groups. The experimental group attended a rehabilitation programme over 24 weeks (P4). Results show that from baseline to post-test, QoL decreased significantly. The recalibration then-test confirmed a low QoL in all periods evaluated. Significant differences between the experimental and control groups prove the positive effect of the Exercise Rehabilitation Programme (ERP) on QoL. Understanding the real dynamic of QoL over time would help to adapt rehabilitation programmes by improving sensitivity and efficacy and provide professionals with a more accurate perception of the impact of treatment and side effects on patients’ QoL. Our results underline the importance of changing the approach adopted by health professionals towards one of watchful waiting on patients’ QoL until their complete recovery in daily life.

Keywords: Prostate cancer, quality of life, rehabilitation programme, response shift.

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162 A Case Study on How Outreach Programmes Form and Develop the Biomedical Engineering Community in Hong Kong

Authors: Sum Lau, Wing Chung Cleo Lau, Wing Yan Chu, Long Ching Ip, Wan Yin Lo, Jo Long Sam Yau, Ka Ho Hui, Sze Yi Mak

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Biomedical engineering (BME) is an interdisciplinary subject where knowledge about biology and medicine is applied to novel applications, solving clinical problems. This subject is crucial for cities such as Hong Kong where the burden on the medical system is rising due to reasons like ageing population. Hong Kong, who is actively boosting technological advancements in recent years, sets BME, or biotechnology as a major category, as reflected in the 2018-19 Budget where biotechnology was one of the four pillars for development. Over the years, while resources in terms of money and space have been provided, there has been a lack of talents, expressed by both the academia and industry. While exogenous factors, such as COVID-19, may have hindered talents from outside Hong Kong to come, endogenous factors should also be considered. In particular, since there are already a few local universities offering BME programmes, their curriculum or style of education requires to be reviewed to intensify the network of the BME community and support post-academic career development. It was observed that while undergraduate (UG) studies focus on knowledge teaching with some technical training and postgraduate (PG) programmes concentrate on upstream research, the programmes are generally confined to the academic sector and lack connections to the industry. In light of that, a “Biomedical Innovation and Outreach Programme 2022” (“B.I.O.2022”) was held to connect students and professors from academia with clinicians and engineers from the industry, serving as a comparative approach to conventional education methods (UG and PG programmes from tertiary institutions). Over 100 participants, including undergraduates, postgraduates, secondary school students, researchers, engineers, and clinicians, took part in various outreach events such as conference and site visits, all held from June to July 2022. As a case study, this programme aimed to tackle the aforementioned problems with the theme of “4Cs” (connection, communication, collaboration, and commercialisation). The effectiveness of the programme is investigated by its ability to serve as adult and continuing education, and the effectiveness of causing social change to tackle current societal challenges, with the focus on tackling the lack of talents engaging in BME. In this study, B.I.O. 2022 is found to be able to complement the traditional educational methods, particularly in terms of knowledge exchange between the academia and the industry. With enhanced communications between participants from different career stages, there were students who followed up to visit or even work with the professionals after the programme. Furthermore, connections between the academia and industry could foster the generation of new knowledge, which ultimately pointed to commercialisation, adding value to the BME industry while filling the gap in terms of human resources. With the continuation of events like B.I.O. 2022, it provides a promising starting point for development and relationship strengthening of a BME community in Hong Kong, and shows potential as an alternative way of adult education or learning with societal benefits.

Keywords: Biomedical engineering, adult education, social change, comparative methods, lifelong learning, innovation, professional community.

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161 Isolation and Screening of Laccase Producing Basidiomycetes via Submerged Fermentations

Authors: Mun Yee Chan, Sin Ming Goh, Lisa Gaik Ai Ong

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Approximately 10,000 different types of dyes and pigments are being used in various industrial applications yearly, which include the textile and printing industries. However, these dyes are difficult to degrade naturally once they enter the aquatic system. Their high persistency in natural environment poses a potential health hazard to all form of life. Hence, there is a need for alternative dye removal strategy in the environment via bioremediation. In this study, fungi laccase is investigated via commercial agar dyes plates and submerged fermentation to explore the application of fungi laccase in textile dye wastewater treatment. Two locally isolated basidiomycetes were screened for laccase activity using media added with commercial dyes such as 2, 2-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid (ABTS), guaiacol and Remazol Brillant Blue R (RBBR). Isolate TBB3 (1.70±0.06) and EL2 (1.78±0.08) gave the highest results for ABTS plates with the appearance of greenish halo on around the isolates. Submerged fermentation performed on Isolate TBB3 with the productivity 3.9067 U/ml/day, whereas the laccase activity for Isolate EL2 was much lower (0.2097 U/ml/day). As isolate TBB3 showed higher laccase production, it was subjected to molecular characterization by DNA isolation, PCR amplification and sequencing of ITS region of nuclear ribosomal DNA. After being compared with other sequences in National Center for Biotechnology Information (NCBI database), isolate TBB3 is probably from species Trametes hirsutei. Further research work can be performed on this isolate by upscale the production of laccase in order to meet the demands of the requirement for higher enzyme titer for the bioremediation of textile dyes.

Keywords: Bioremediation, dyes, fermentation, laccase.

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160 Novel Use of a Quality Assurance Tool for Integrating Technology to HSE

Authors: Ragi Poyyara, Vivek V., Ashish Khaparde

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The product development process (PDP) in the Technology group plays a very important role in the launch of any product. While a manufacturing process encourages the use of certain measures to reduce health, safety and environmental (HSE) risks on the shop floor, the PDP concentrates on the use of Geometric Dimensioning and Tolerancing (GD&T) to develop a flawless design. Furthermore, PDP distributes and coordinates activities between different departments such as marketing, purchasing, and manufacturing. However, it is seldom realized that PDP makes a significant contribution to developing a product that reduces HSE risks by encouraging the Technology group to use effective GD&T. The GD&T is a precise communication tool that uses a set of symbols, rules, and definitions to mathematically define parts to be manufactured. It is a quality assurance method widely used in the oil and gas sector. Traditionally it is used to ensure the interchangeability of a part without affecting its form, fit, and function. Parts that do not meet these requirements are rejected during quality audits. This paper discusses how the Technology group integrates this quality assurance tool into the PDP and how the tool plays a major role in helping the HSE department in its goal towards eliminating HSE incidents. The PDP involves a thorough risk assessment and establishes a method to address those risks during the design stage. An illustration shows how GD&T helped reduce safety risks by ergonomically improving assembling operations. A brief discussion explains how tolerances provided on a part help prevent finger injury. This tool has equipped Technology to produce fixtures, which are used daily in operations as well as manufacturing. By applying GD&T to create good fits, HSE risks are mitigated for operating personnel. Both customers and service providers benefit from reduced safety risks.

Keywords: HSE, PDP, GD&T, risks.

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159 Distinctive Features of Legal Relations in the Area of Subsoil Use, Renewal and Protection in Ukraine

Authors: N. Maksimentseva

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The issue of public administration in subsoil use, renewal and protection is of high importance for Ukraine since it is strongly linked to energy security of the state as well as it shall facilitate the people of Ukraine to efficiently implement its propitiatory rights towards natural resources and redistribution of national wealth. As it is stipulated in the Article 11 of the Subsoil Code of Ukraine (the Code) the authorities that administer the industry are limited to central executive bodies and local governments. In particular, it is stipulated in the Code that the Ukraine’s Cabinet of Ministers carries out public administration in geological exploration, production and protection of subsoil. Other state bodies of public administration include central public authority responsible for state environmental protection policies; central public authority in charge of implementation of state geological exploration and efficient subsoil use policies; central authority in charge of state health and safety control policies. There are also public authorities in the Autonomous Republic of Crimea; local executive bodies and other state authorities and local self-government authorities in compliance with laws of Ukraine. This article is devoted to the analysis of the legal relations in the area of public administration of subsoil use, renewal and protection in Ukraine. The main approaches to study the essence of legal relations in the named area as well as its tasks, functions and methods are analyzed. It is concluded in this article that legal relationship in the field of public administration of subsoil use, renewal and protection is characterized by specifics of its task (development of natural resources).

Keywords: Legal relations, public administration, Subsoil Code of Ukraine, subsoil use, renewal and protection.

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158 Occurrence of Foreign Matter in Food: Applied Identification Method - Association of Official Agricultural Chemists (AOAC) and Food and Drug Administration (FDA)

Authors: E. C. Mattos, V. S. M. G. Daros, R. Dal Col, A. L. Nascimento

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The aim of this study is to present the results of a retrospective survey on the foreign matter found in foods analyzed at the Adolfo Lutz Institute, from July 2001 to July 2015. All the analyses were conducted according to the official methods described on Association of Official Agricultural Chemists (AOAC) for the micro analytical procedures and Food and Drug Administration (FDA) for the macro analytical procedures. The results showed flours, cereals and derivatives such as baking and pasta products were the types of food where foreign matters were found more frequently followed by condiments and teas. Fragments of stored grains insects, its larvae, nets, excrement, dead mites and rodent excrement were the most foreign matter found in food. Besides, foreign matters that can cause a physical risk to the consumer’s health such as metal, stones, glass, wood were found but rarely. Miscellaneous (shell, sand, dirt and seeds) were also reported. There are a lot of extraneous materials that are considered unavoidable since are something inherent to the product itself, such as insect fragments in grains. In contrast, there are avoidable extraneous materials that are less tolerated because it is preventable with the Good Manufacturing Practice. The conclusion of this work is that although most extraneous materials found in food are considered unavoidable it is necessary to keep the Good Manufacturing Practice throughout the food processing as well as maintaining a constant surveillance of the production process in order to avoid accidents that may lead to occurrence of these extraneous materials in food.

Keywords: Food contamination, extraneous materials, foreign matter, surveillance.

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157 Long Term Follow-Up, Clinical Outcomes and Quality of Life after Total Arterial Revascularisation versus Conventional Coronary Surgery: A Retrospective Study

Authors: Jitendra Jain, Cassandra Hidajat, Hansraj Riteesh Bookun

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Graft patency underpins long-term prognosis after coronary artery bypass grafting surgery (CABG). The benefits of the combined use of only the left internal mammary artery and radial artery, referred to as total arterial revascularisation (TAR), on long-term clinical outcomes and quality of life are relatively unknown. The aim of this study was to identify whether there were differences in long term clinical outcomes between recipients of TAR compared to a cohort of mostly arterial revascularization involving the left internal mammary, at least one radial artery and at least one saphenous vein graft. A retrospective analysis was performed on all patients who underwent TAR or were re-vascularized with supplementary saphenous vein graft from February 1996 to December 2004. Telephone surveys were conducted to obtain clinical outcome parameters including major adverse cardiac and cerebrovascular events (MACCE) and Short Form (SF-36v2) Health Survey responses. A total of 176 patients were successfully contacted to obtain postop follow up results. The mean follow-up length from time of surgery in our study was TAR 12.4±1.8 years and conventional 12.6±2.1. PCS score was TAR 45.9±8.8 vs LIMA/Rad/ SVG 44.9±9.2 (p=0.468) and MCS score was TAR 52.0±8.9 vs LIMA/Rad/SVG 52.5±9.3 (p=0.723). There were no significant differences between groups for NYHA class 3+ TAR 9.4% vs. LIMA/Rad/SVG 6.6%; or CCS 3+ TAR 2.35% vs. LIMA/Rad/SVG 0%.

Keywords: CABG, MACCEs, quality of life, total arterial revascularization.

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156 Evaluation of Phenolic Profiles and Antioxidant Activities of Turkish Medicinal Plants: Tiliaargentea, Crataegi Folium Leaves and Polygonum bistorta Roots

Authors: S. Demiray, M. E. Pintado, P. M. L. Castro

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There is a growing interest in the food industry and in preventive health care for the development and evaluation of natural antioxidants from medicinal plant materials. In the present work, extracts of three medicinal plants (Tilia argentea, Crataegi folium leaves and Polygonum bistorta roots) used in Turkish phytotheraphy were screened for their phenolic profiles and antioxidant properties. Crude extracts were obtained from different parts of plants, by solidliquid extraction with pure water, 70% acetone and 70% methanol aqueous solvents. The antioxidant activity of the extracts was determined by ABTS.+ radical cation scavenging activity. The Folin Ciocalteu procedure was used to assess the total phenolic concentrations of the extracts as gallic acid equivalents. A modified liquid chromatography-electro spray ionization-mass spectrometry (LC-ESI-MS) was used to obtain chromatographic profiles of the phenolic compounds in the medicinal plants. The predominant phenolic compounds detected in different extracts of the plants were catechin, protocatechuic and chlorogenic acids. The highest phenolic contents were obtained by using 70% acetone as aqueous solvent, whereas the lowest phenolic contents were obtained by water extraction due to Folin Ciocalteu results. The results indicate that acetone extracts of Tilia argentea had the highest antioxidant capacity as free ABTS radical scavengers. The lowest phenolic contents and antioxidant capacities were obtained from Polygonum bistorta root extracts.

Keywords: Medicinal plants, antioxidant activity, totalphenolics, LC-ESI-MS.

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155 (Anti)Depressant Effects of Non-Steroidal Antiinflammatory Drugs in Mice

Authors: Horia Păunescu

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Purpose: The study aimed to assess the depressant or antidepressant effects of several Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) in mice: the selective cyclooxygenase-2 (COX-2) inhibitor meloxicam, and the non-selective COX-1 and COX-2 inhibitors lornoxicam, sodium metamizole, and ketorolac. The current literature data regarding such effects of these agents are scarce. Materials and methods: The study was carried out on NMRI mice weighing 20-35 g, kept in a standard laboratory environment. The study was approved by the Ethics Committee of the University of Medicine and Pharmacy „Carol Davila”, Bucharest. The study agents were injected intraperitoneally, 10 mL/kg body weight (bw) 1 hour before the assessment of the locomotor activity by cage testing (n=10 mice/ group) and 2 hours before the forced swimming tests (n=15). The study agents were dissolved in normal saline (meloxicam, sodium metamizole), ethanol 11.8% v/v in normal saline (ketorolac), or water (lornoxicam), respectively. Negative and positive control agents were also given (amitryptilline in the forced swimming test). The cage floor used in the locomotor activity assessment was divided into 20 equal 10 cm squares. The forced swimming test involved partial immersion of the mice in cylinders (15/9cm height/diameter) filled with water (10 cm depth at 28C), where they were left for 6 minutes. The cage endpoint used in the locomotor activity assessment was the number of treaded squares. Four endpoints were used in the forced swimming test (immobility latency for the entire 6 minutes, and immobility, swimming, and climbing scores for the final 4 minutes of the swimming session), recorded by an observer that was „blinded” to the experimental design. The statistical analysis used the Levene test for variance homogeneity, ANOVA and post-hoc analysis as appropriate, Tukey or Tamhane tests. Results: No statistically significant increase or decrease in the number of treaded squares was seen in the locomotor activity assessment of any mice group. In the forced swimming test, amitryptilline showed an antidepressant effect in each experiment, at the 10 mg/kg bw dosage. Sodium metamizole was depressant at 100 mg/kg bw (increased the immobility score, p=0.049, Tamhane test), but not in lower dosages as well (25 and 50 mg/kg bw). Ketorolac showed an antidepressant effect at the intermediate dosage of 5 mg/kg bw, but not so in the dosages of 2.5 and 10 mg/kg bw, respectively (increased the swimming score, p=0.012, Tamhane test). Meloxicam and lornoxicam did not alter the forced swimming endpoints at any dosage level. Discussion: 1) Certain NSAIDs caused changes in the forced swimming patterns without interfering with locomotion. 2) Sodium metamizole showed a depressant effect, whereas ketorolac proved antidepressant. Conclusion: NSAID-induced mood changes are not class effects of these agents and apparently are independent of the type of inhibited cyclooxygenase (COX-1 or COX-2). Disclosure: This paper was co-financed from the European Social Fund, through the Sectorial Operational Programme Human Resources Development 2007-2013, project number POSDRU /159 /1.5 /S /138907 "Excellence in scientific interdisciplinary research, doctoral and postdoctoral, in the economic, social and medical fields -EXCELIS", coordinator The Bucharest University of Economic Studies.

Keywords: Antidepressant, depressant, forced swim, NSAIDs.

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154 Perception of Neighbourhood-Level Built Environment in Relation to Youth Physical Activity in Malaysia

Authors: A. Abdullah, N. Faghih Mirzaei, S. Hany Haron

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Neighbourhood environment walkability on reported physical activity (PA) levels of students of Universiti Sains Malaysia (USM) in Malaysia. Compared with previous generations, today’s young people spend less time playing outdoors and have lower participation rates in PA. Research suggests that negative perceptions of neighbourhood walkability may be a potential barrier to adolescents’ PA. The sample consisted of 200 USM students (to 24 years old) who live outside of the main campus and engage in PA in sport halls and sport fields of USM. The data were analysed using the t-test, binary logistic regression, and discriminant analysis techniques. The present study found that youth PA was affected by neighbourhood environment walkability factors, including neighbourhood infrastructures, neighbourhood safety (crime), and recreation facilities, as well as street characteristics and neighbourhood design variables such as facades of sidewalks, roadside trees, green spaces, and aesthetics. The finding also illustrated that active students were influenced by street connectivity, neighbourhood infrastructures, recreation facilities, facades of sidewalks, and aesthetics, whereas students in the less active group were affected by access to destinations, neighbourhood safety (crime), and roadside trees and green spaces for their PAs. These results report which factors of built environments have more effect on youth PA and they message to the public to create more awareness about the benefits of PA on youth health.

Keywords: Fear of crime, neighbourhood built environment, physical activities, street characteristics design.

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153 Cirrhosis Mortality Prediction as Classification Using Frequent Subgraph Mining

Authors: Abdolghani Ebrahimi, Diego Klabjan, Chenxi Ge, Daniela Ladner, Parker Stride

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In this work, we use machine learning and data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. Our work applies modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Keywords: machine learning, liver cirrhosis, subgraph mining, supervised learning

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152 The Effects of Pilates and McKenzie Exercises on Quality of Life and Lumbar Spine Position Sense in Patients with Low Back Pain: A Comparative Study with a 4-Week Follow-Up

Authors: Vahid Mazloum, Mansour Sahebozamani, Amirhossein Barati, Nouzar Nakhaee, Pouya Rabiei

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Non-specific chronic low back pain (NSCLBP) is a common condition with no exact diagnosis and mechanism for its occurrence. Recently, different therapeutic exercises have taken into account to manage NSCLBP. So, the aim of this study has mainly been placed on comparing the effects of Pilates and Mackenzie exercises on quality of life (QOL) lumbar spine position sense (LSPS) in patients with NSCLBP. In this randomized clinical trial, 47 patients with NSCLBP were voluntarily divided into three groups of Pilates (n=16) (with mean age 37.1 ± 9.5 years, height 168.9 ± 7.4 cm, body mass 76.1 ± 5.9 k), McKenzie (n=15) (with mean age 42.7 ± 8.1 years, height 165.7 ± 6.8, body mass 74.1 ± 4.8 kg) and control (n=16) (with mean age 39.3 ± 9.8 years, height 168.1 ± 8.1 cm, body mass 74.2 ± 5.8 kg). Primary outcome included QOL and secondary was LSPS. Both variables were assessed by the WHOQOL-BREF questionnaires and electrogoniameter, respectively. The measurements were performed at baseline, following a 6-week intervention, and after a 4-week follow-up. The ANCOVA test at P < 0.05 was administrated to analyze the collected data using SPSS software. There was a statistically significant difference between experimental groups and the control group to improve QOL. But, no difference was seen regarding the effects of two exercises on LSPS (p < 0.05). Both Pilates and Mackenzie exercises demonstrated improvement in QOL after 6-week intervention and a 4-week follow-up while none of them considerably affected LSPS. Further studies are required to establish a supporting evidence for the effectiveness of two exercises on NSCLBP.

Keywords: Pilates, Mackenzie, proprioception, low back pain, physical health.

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151 Early Depression Detection for Young Adults with a Psychiatric and AI Interdisciplinary Multimodal Framework

Authors: Raymond Xu, Ashley Hua, Andrew Wang, Yuru Lin

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During COVID-19, the depression rate has increased dramatically. Young adults are most vulnerable to the mental health effects of the pandemic. Lower-income families have a higher ratio to be diagnosed with depression than the general population, but less access to clinics. This research aims to achieve early depression detection at low cost, large scale, and high accuracy with an interdisciplinary approach by incorporating clinical practices defined by American Psychiatric Association (APA) as well as multimodal AI framework. The proposed approach detected the nine depression symptoms with Natural Language Processing sentiment analysis and a symptom-based Lexicon uniquely designed for young adults. The experiments were conducted on the multimedia survey results from adolescents and young adults and unbiased Twitter communications. The result was further aggregated with the facial emotional cues analyzed by the Convolutional Neural Network on the multimedia survey videos. Five experiments each conducted on 10k data entries reached consistent results with an average accuracy of 88.31%, higher than the existing natural language analysis models. This approach can reach 300+ million daily active Twitter users and is highly accessible by low-income populations to promote early depression detection to raise awareness in adolescents and young adults and reveal complementary cues to assist clinical depression diagnosis.

Keywords: Artificial intelligence, depression detection, facial emotion recognition, natural language processing, mental disorder.

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150 Impact of Standardized Therapeutic Hypothermia Protocol on Neurological Performance after Resuscitation from Cardiac Arrest

Authors: Tahsien Mohamed Okasha, Warda Youssef Mohamed Morsy, Hanan Elsayed Zaghla

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We hypothesized that post cardiac arrest patients with Glasgow Coma Scale (GCS) score of less than 8 and who will be exposed to therapeutic hypothermia protocol will exhibit improvement in their neurological performance. 17 subjects were enrolled in this study all over one year. The study was carried out using Quasi-experimental research design. Four tools were used for data collection of this study: Demographic and medical data sheet, Post cardiac arrest health assessment sheet, Bedside Shivering Assessment Scale (BSAS), and Glasgow Pittsburgh cerebral performance category scale (CPC). The mean age was X̅ ± SD = 53 ± 8.122 years, 47.1% were arrested because of cardiac etiology. 35.3% subjects were initially arrested in form of ventricular tachycardia (VT), 23.5% initially arrested in form of ventricular fibrillation (VF), and 29.4% in form of A-Systole. Favorable neurological outcome was seen among 70.6%. There was significant statistical difference in WBC, Platelets, blood gases value, random blood sugar. Also, initial arrest rhythm, etiology of cardiac arrest, and shivering status were significantly correlated with cerebral performance categories score. Therapeutic hypothermia has positive effects on neurological performance among post cardiac arrest patients with GCS score of less than 8. Replication of the study on larger probability sample, with randomized control trial design is recommended with further study for suggesting nursing protocol for patients undergoing therapeutic hypothermia is recommended.

Keywords: Therapeutic hypothermia, neurological performance, after resuscitation from cardiac arrest, initial arrest rhythm.

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149 Conservation Agriculture Practice in Bangladesh: Farmers’ Socioeconomic Status and Soil Environment Perspective

Authors: Mohammad T. Uddin, Aurup R. Dhar

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The study was conducted to assess the impact of conservation agriculture practice on farmers’ socioeconomic condition and soil environmental quality in Bangladesh. A total of 450 (i.e., 50 focal, 150 proximal and 250 control) farmers from five districts were selected for this study. Descriptive statistics like sum, averages, percentages, etc. were calculated to evaluate the socioeconomic data. Using Enyedi’s crop productivity index, it was found that the crop productivity of focal, proximal and control farmers was increased by 0.9, 1.2 and 1.3 percent, respectively. The result of DID (Difference-in-difference) analysis indicated that the impact of conservation agriculture practice on farmers’ average annual income was significant. Multidimensional poverty index (MPI) indicates that poverty in terms of deprivation of health, education and living standards was decreased; and a remarkable improvement in farmers’ socioeconomic status was found after adopting conservation agriculture practice. Most of the focal and proximal farmers stated about increased soil environmental condition where majority of control farmers stated about constant environmental condition in this regard. The Probit model reveals that minimum tillage operation, permanent organic soil cover, and application of compost and vermicompost were found significant factors affecting soil environmental quality under conservation agriculture. Input support, motivation, training programmes and extension services are recommended to implement in order to raise the awareness and enrich the knowledge of the farmers on conservation agriculture practice.

Keywords: Conservation agriculture, crop productivity, socioeconomic status, soil environment quality.

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148 Evaluation of Urban Development Proposals An ANP Approach

Authors: T. Gómez-Navarro, M. García-Melón, D. Díaz-Martín, S. Acuna-Dutra,

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In this paper a new approach to prioritize urban planning projects in an efficient and reliable way is presented. It is based on environmental pressure indices and multicriteria decision methods. The paper introduces a rigorous method with acceptable complexity of rank ordering urban development proposals according to their environmental pressure. The technique combines the use of Environmental Pressure Indicators, the aggregation of indicators in an Environmental Pressure Index by means of the Analytic Network Process method and interpreting the information obtained from the experts during the decision-making process. The ANP method allows the aggregation of the experts- judgments on each of the indicators into one Environmental Pressure Index. In addition, ANP is based on utility ratio functions which are the most appropriate for the analysis of uncertain data, like experts- estimations. Finally, unlike the other multicriteria techniques, ANP allows the decision problem to be modelled using the relationships among dependent criteria. The method has been applied to the proposal for urban development of La Carlota airport in Caracas (Venezuela). The Venezuelan Government would like to see a recreational project develop on the abandoned area and mean a significant improvement for the capital. There are currently three options on their table which are currently under evaluation. They include a Health Club, a Residential area and a Theme Park. The participating experts coincided in the appreciation that the method proposed in this paper is useful and an improvement from traditional techniques such as environmental impact studies, lifecycle analysis, etc. They find the results obtained coherent, the process seems sufficiently rigorous and precise, and the use of resources is significantly less than in other methods.

Keywords: Environmental pressure indicators, multicriteria decision analysis, analytic network process.

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147 Wind Power Mapping and NPV of Embedded Generation Systems in Nigeria

Authors: Oluseyi O. Ajayi, Ohiose D. Ohijeagbon, Mercy Ogbonnaya, Ameh Attabo

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The study assessed the potential and economic viability of stand-alone wind systems for embedded generation, taking into account its benefits to small off-grid rural communities at 40 meteorological sites in Nigeria. A specific electric load profile was developed to accommodate communities consisting of 200 homes, a school and a community health centre. This load profile was incorporated within the distributed generation analysis producing energy in the MW range, while optimally meeting daily load demand for the rural communities. Twenty-four years (1987 to 2010) of wind speed data at a height of 10m utilized for the study were sourced from the Nigeria Meteorological Department, Oshodi. The HOMER® software optimizing tool was engaged for the feasibility study and design. Each site was suited to 3MW wind turbines in sets of five, thus 15MW was designed for each site. This design configuration was adopted in order to easily compare the distributed generation system amongst the sites to determine their relative economic viability in terms of life cycle cost, as well as levelised cost of producing energy. A net present value was estimated in terms of life cycle cost for 25 of the 40 meteorological sites. On the other hand, the remaining sites yielded a net present cost; meaning the installations at these locations were not economically viable when utilizing the present tariff regime for embedded generation in Nigeria.

Keywords: Wind speed, wind power, distributed generation, cost per kilowatt-hour, clean energy, Nigeria.

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146 Groundwater Potential Zone Identification in Unconsolidated Aquifer Using Geophysical Techniques around Tarbela Ghazi, District Haripur, Pakistan

Authors: Syed Muzyan Shahzad, Liu Jianxin, Asim Shahzad, Muhammad Sharjeel Raza, Sun Ya, Fanidi Meryem

Abstract:

Electrical resistivity investigation was conducted in vicinity of Tarbela Ghazi, in order to study the subsurface layer with a view of determining the depth to the aquifer and thickness of groundwater potential zones. Vertical Electrical Sounding (VES) using Schlumberger array was carried out at 16 VES stations. Well logging data at four tube wells have been used to mark the super saturated zones with great discharge rate. The present paper shows a geoelectrical identification of the lithology and an estimate of the relationship between the resistivity and Dar Zarrouk parameters (transverse unit resistance and longitudinal unit conductance). The VES results revealed both homogeneous and heterogeneous nature of the subsurface strata. Aquifer is unconfined to confine in nature, and at few locations though perched aquifer has been identified, groundwater potential zones are developed in unconsolidated deposits layers and more than seven geo-electric layers are observed at some VES locations. Saturated zones thickness ranges from 5 m to 150 m, whereas at few area aquifer is beyond 150 m thick. The average anisotropy, transvers resistance and longitudinal conductance values are 0.86 %, 35750.9821 Ω.m2, 0.729 Siemens, respectively. The transverse unit resistance values fluctuate all over the aquifer system, whereas below at particular depth high values are observed, that significantly associated with the high transmissivity zones. The groundwater quality in all analyzed samples is below permissible limit according to World Health Standard (WHO).

Keywords: Geoelectric layers, Dar Zarrouk parameters, Aquifer, Electro-stratigraphic.

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145 Traumatic Ankle Pain: Adequacy of Clinical Information in X-Ray Request with Reference to the Ottawa Ankle Rule

Authors: Rania Mustafa

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This audit was conducted at Manchester University NHS Foundation Trust, Wythenshawe Hospital Radiology and Accident and Emergency [A&E] Department to assess the appropriateness of clinical information in X-ray requests, specifically in cases of acute ankle injuries. As per the Ottawa Ankle Rules and the recommendations of National Institute for Health and Care Excellence [NICE] and the Royal College of Radiology, we aimed to evaluate the appropriateness of referrals and the thoroughness of clinical information provided by Emergency Department [ED] clinicians for ankle radiography. Our goal was to achieve 100% compliance with these guidelines. The audit involved a comprehensive analysis spanning the period from August 2022 to January 2023, encompassing patient records, radiographic orders, and clinical assessments. Data collection included patient demographics, presenting complaints, clinical assessments, adherence to Ottawa Ankle Rules criteria, and subsequent radiography orders. Here we conducted two audit cycles, involving 38 patients in the first cycle and 86 patients in the second cycle. The data were furtherly filtered to include all patients who were referred from the ED for an ankle Xray with a history of acute trauma and age of more than 18 years. The key finding was that in August 2022, 60% of cases met the Ottawa Ankle Rules criteria accurately, indicating a need for improvement in adherence. However, by January 2023, there was a notable improvement, with 95% of cases accurately meeting the criteria. This significant change reflects an increased alignment with best practices for ankle radiography referrals.

Keywords: Ankle, injuries, Ottawa Ankle Rule, X-rays.

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144 Body Composition Response to Lower Body Positive Pressure Training in Obese Children

Authors: Basant H. El-Refay, Nabeel T. Faiad

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Background: The high prevalence of obesity in Egypt has a great impact on the health care system, economic and social situation. Evidence suggests that even a moderate amount of weight loss can be useful. Aim of the study: To analyze the effects of lower body positive pressure supported treadmill training, conducted with hypocaloric diet, on body composition of obese children. Methods: Thirty children aged between 8 and 14 years, were randomly assigned into two groups: intervention group (15 children) and control group (15 children). All of them were evaluated using body composition analysis through bioelectric impedance. The following parameters were measured before and after the intervention: body mass, body fat mass, muscle mass, body mass index (BMI), percentage of body fat and basal metabolic rate (BMR). The study group exercised with antigravity treadmill three times a week during 2 months, and participated in a hypocaloric diet program. The control group participated in a hypocaloric diet program only. Results: Both groups showed significant reduction in body mass, body fat mass and BMI. Only study group showed significant reduction in percentage of body fat (p = 0.0.043). Changes in muscle mass and BMR didn't reach statistical significance in both groups. No significant differences were observed between groups except for muscle mass (p = 0.049) and BMR (p = 0.042) favoring study group. Conclusion: Both programs proved effective in the reduction of obesity indicators, but lower body positive pressure supported treadmill training was more effective in improving muscle mass and BMR.

Keywords: Children, Hypocaloric diet, Lower body positive pressure supported treadmill, obesity.

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143 Dietary Habit and Anthropometric Status in Hypertensive Patients Compared to Normotensive Participants in the North of Iran

Authors: Marjan Mahdavi-Roshan, Arsalan Salari, Mahbobeh Gholipour

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Hypertension is one of the important reasons of morbidity and mortality in countries, including Iran. It has been shown that hypertension is a consequence of the interaction of genetics and environment. Nutrients have important roles in the controlling of blood pressure. We assessed dietary habit and anthropometric status in patients with hypertension in the north of Iran, and that have special dietary habit and according to their culture. This study was conducted on 127 patients with newly recognized hypertension and the 120 normotensive participants. Anthropometric status was measured and demographic characteristics, and medical condition were collected by valid questionnaires and dietary habit assessment was assessed with 3-day food recall (two weekdays and one weekend). The mean age of participants was 58 ± 6.7 years. The mean level of energy intake, saturated fat, vitamin D, potassium, zinc, dietary fiber, vitamin C, calcium, phosphorus, copper and magnesium was significantly lower in the hypertensive group compared to the control (p < 0.05). After adjusting for energy intake, positive association was observe between hypertension and some dietary nutrients including; Cholesterol [OR: 1.1, P: 0.001, B: 0.06], fiber [OR: 1.6, P: 0.001, B: 1.8], vitamin D [OR: 2.6, P: 0.006, B: 0.9] and zinc [OR: 1.4, P: 0.006, B: 0.3] intake. Logistic regression analysis showed that there was not significant association between hypertension, weight and waist circumference. In our study, the mean intake of some nutrients was lower in the hypertensive individuals compared to the normotensive individual. Health training about suitable dietary habits and easier access to vitamin D supplementation in patients with hypertension are cost-effective tools to improve outcomes in Iran.

Keywords: Hypertension, dietary intake, weight, waist circumference, North of Iran.

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142 “FGM is with us Everyday“ Women and Girls Speak out about Female Genital Mutilation in the UK

Authors: Susana Oguntoye, Naana Otoo-Oyortey, Joanne Hemmings, Kate Norman, Eiman Hussein

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There is inadequate information on the practice of female genital mutilation (FGM) in the UK, and there are often myths and perceptions within communities that influence the effectiveness of prevention programmes. This means it is difficult to address the trends and changes in the practice in the UK. To this end, FORWARD undertook novel and innovative research using the Participatory Ethnographic and Evaluative Research (PEER) method to explore the views of women from Eritrea, Sudan, Somalia and Ethiopia that live in London and Bristol (two UK cities). Women-s views, taken from PEER interviews, reflected reasons for continued practice of FGM: marriageability, the harnessing and control of female sexuality, and upholding traditions from their countries of origin. It was also clear that the main supporters of the practice were believed to be older women within families and communities. Women described the impact FGM was having on their lives as isolating. And although it was clearly considered a private and personal matter, they developed a real sense of connection with their peers within the research process. The women were overwhelmingly positive about combating the practice, although they believed it would probably take a while before it ends completely. They also made concrete recommendations on how to improve support services for women affected by FGM: Training for professionals (particularly in healthcare), increased engagement with, and outreach to, communities, culturally appropriate materials and information made available and accessible to communities, and more consequent implementation of legislation. Finally, the women asked for more empathy and understanding, particularly from health professionals. Rather than presenting FGM as a completely alien and inconceivable practice, it may help for those looking into these women-s lives and working with them to understand the social and economic context in which the practice takes place.

Keywords: Female Genital Mutilation, FemaleCircumcision/Cutting, Participatory Research, PEER method.

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141 An Initial Assessment of the Potential Contribution of ‘Community Empowerment’ to Mitigating the Drivers of Deforestation and Forest Degradation, in Giam Siak Kecil-Bukit Batu Biosphere Reserve

Authors: A. Sunkar, Y. Santosa, S. B. Rushayati

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Indonesia has experienced annual forest fires that have rapidly destroyed and degraded its forests. Fires in the peat swamp forests of Riau Province, have set the stage for problems to worsen, this being the ecosystem most prone to fires (which are also the most difficult, to extinguish). Despite various efforts to curb deforestation, and forest degradation processes, severe forest fires are still occurring. To find an effective solution, the basic causes of the problems must be identified. It is therefore critical to have an indepth understanding of the underlying causal factors that have contributed to deforestation and forest degradation as a whole, in order to attain reductions in their rates. An assessment of the drivers of deforestation and forest degradation was carried out, in order to design and implement measures that could slow these destructive processes. Research was conducted in Giam Siak Kecil–Bukit Batu Biosphere Reserve (GSKBB BR), in the Riau Province of Sumatera, Indonesia. A biosphere reserve was selected as the study site because such reserves aim to reconcile conservation with sustainable development. A biosphere reserve should promote a range of local human activities, together with development values that are in line spatially and economically with the area conservation values, through use of a zoning system. Moreover, GSKBB BR is an area with vast peatlands, and is experiencing forest fires annually. Various factors were analysed to assess the drivers of deforestation and forest degradation in GSKBB BR; data were collected from focus group discussions with stakeholders, key informant interviews with key stakeholders, field observation and a literature review. Landsat satellite imagery was used to map forest-cover changes for various periods. Analysis of landsat images, taken during the period 2010-2014, revealed that within the non-protected area of core zone, there was a trend towards decreasing peat swamp forest areas, increasing land clearance, and increasing areas of community oilpalm and rubber plantations. Fire was used for land clearing and most of the forest fires occurred in the most populous area (the transition area). The study found a relationship between the deforested/ degraded areas, and certain distance variables, i.e. distance from roads, villages and the borders between the core area and the buffer zone. The further the distance from the core area of the reserve, the higher was the degree of deforestation and forest degradation. Research findings suggested that agricultural expansion may be the direct cause of deforestation and forest degradation in the reserve, whereas socio-economic factors were the underlying driver of forest cover changes; such factors consisting of a combination of sociocultural, infrastructural, technological, institutional (policy and governance), demographic (population pressure) and economic (market demand) considerations. These findings indicated that local factors/problems were the critical causes of deforestation and degradation in GSKBB BR. This research therefore concluded that reductions in deforestation and forest degradation in GSKBB BR could be achieved through ‘local actor’-tailored approaches such as community empowerment.

Keywords: Actor-led solution, community empowerment, drivers of deforestation and forest degradation, Giam Siak Kecil– Bukit Batu Biosphere Reserve.

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140 Fabrication of Nanoengineered Radiation Shielding Multifunctional Polymeric Sandwich Composites

Authors: Nasim Abuali Galehdari, Venkat Mani, Ajit D. Kelkar

Abstract:

Space Radiation has become one of the major factors in successful long duration space exploration. Exposure to space radiation not only can affect the health of astronauts but also can disrupt or damage materials and electronics. Hazards to materials include degradation of properties, such as, modulus, strength, or glass transition temperature. Electronics may experience single event effects, gate rupture, burnout of field effect transistors and noise. Presently aluminum is the major component in most of the space structures due to its lightweight and good structural properties. However, aluminum is ineffective at blocking space radiation. Therefore, most of the past research involved studying at polymers which contain large amounts of hydrogen. Again, these materials are not structural materials and would require large amounts of material to achieve the structural properties needed. One of the materials to alleviate this problem is polymeric composite materials, which has good structural properties and use polymers that contained large amounts of hydrogen. This paper presents steps involved in fabrication of multi-functional hybrid sandwich panels that can provide beneficial radiation shielding as well as structural strength. Multifunctional hybrid sandwich panels were manufactured using vacuum assisted resin transfer molding process and were subjected to radiation treatment. Study indicates that various nanoparticles including Boron Nano powder, Boron Carbide and Gadolinium nanoparticles can be successfully used to block the space radiation without sacrificing the structural integrity.

Keywords: Multi-functional, polymer composites, radiation shielding, sandwich composites.

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139 Mobile App versus Website: A Comparative Eye-Tracking Case Study of Topshop

Authors: Zofija Tupikovskaja-Omovie, David Tyler, Sam Dhanapala, Steve Hayes

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The UK is leading in online retail and mobile adoption. However, there is a dearth of information relating to mobile apparel retail, and developing an understanding about consumer browsing and purchase behaviour in m-retail channel would provide apparel marketers, mobile website and app developers with the necessary understanding of consumers’ needs. Despite the rapid growth of mobile retail businesses, no published study has examined shopping behaviour on fashion mobile apps and websites. A mixed method approach helped to understand why fashion consumers prefer websites on smartphones, when diverse mobile apps are also available. The following research methods were employed: survey, eye-tracking experiments, observation, and interview with retrospective think aloud. The mobile gaze tracking device by SensoMotoric Instruments was used to understand frustrations in navigation and other issues facing consumers in mobile channel. This method helped to validate and compliment other traditional user-testing approaches in order to optimize user experience and enhance the development of mobile retail channel. The study involved eight participants - females aged 18 to 35 years old, who are existing mobile shoppers. The participants used the Topshop mobile app and website on a smart phone to complete a task according to a specified scenario leading to a purchase. The comparative study was based on: duration and time spent at different stages of the shopping journey, number of steps involved and product pages visited, search approaches used, layout and visual clues, as well as consumer perceptions and expectations. The results from the data analysis show significant differences in consumer behaviour when using a mobile app or website on a smart phone. Moreover, two types of problems were identified, namely technical issues and human errors. Having a mobile app does not guarantee success in satisfying mobile fashion consumers. The differences in the layout and visual clues seem to influence the overall shopping experience on a smart phone. The layout of search results on the website was different from the mobile app. Therefore, participants, in most cases, behaved differently on different platforms. The number of product pages visited on the mobile app was triple the number visited on the website due to a limited visibility of products in the search results. Although, the data on traffic trends held by retailers to date, including retail sector breakdowns for visits and views, data on device splits and duration, might seem a valuable source of information, it cannot explain why consumers visit many product pages, stay longer on the website or mobile app, or abandon the basket. A comprehensive list of pros and cons was developed by highlighting issues for website and mobile app, and recommendations provided. The findings suggest that fashion retailers need to be aware of actual consumers’ behaviour on the mobile channel and their expectations in order to offer a seamless shopping experience. Added to which is the challenge of retaining existing and acquiring new customers. There seem to be differences in the way fashion consumers search and shop on mobile, which need to be explored in further studies.

Keywords: Consumer behaviour, eye-tracking technology, fashion retail, mobile app, m-retail, smart phones, Topshop, user experience, website.

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138 Obesity and Bone Mineral Density in Patients with Large Joint Osteoarthritis

Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Zaverukha, Roksolana Povoroznyuk

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Along with the global aging of population, the number of people with somatic diseases is increasing, including such interrelated pathologies as obesity, osteoarthritis (OA) and osteoporosis (OP). The objective of the study is to examine the connection between body mass index (BMI), OA and bone mineral density (BMD) of lumbar spine, femoral neck and trabecular bone score (TBS) in postmenopausal women with OA. We have observed 359 postmenopausal women (50-89 years old) and divided them into four groups by age: 50-59 yrs, 60-69 yrs, 70-79 yrs and over 80 years old. In addition, according to the American College of Rheumatology (ACR) Clinical classification criteria for knee and hip OA, we divided them into 2 groups: group I – 117 females with symptomatic OA (including 89 patients with knee OA, 28 patients with hip OA) and group II –242 women with a normal functional activity of large joints. Analysis of data was performed taking into account their BMI, classified by World Health Organization (WHO). Diagnosis of obesity was established when BMI was above 30 kg/m2. In woman with obesity, a symptomatic OA was detected in 44 postmenopausal women (41.1%), a normal functional activity of large joints - in 63 women (58.9%). However, in women with normal BMI – 73 women, who account for 29.0% of cases, a symptomatic OA was detected. According to a chi-squared (χ2) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ2 = 5.05, p = 0.02). Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of large joints. No significant differences of BMD of femoral necks or TBS were detected in either the group with OA or with a normal functional activity of large joints.

Keywords: Bone mineral density, BMD, body mass index, BMI, obesity, overweight, postmenopausal women, osteoarthritis.

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137 Improving Health Care and Patient Safety at the ICU by Using Innovative Medical Devices and ICT Tools: Examples from Bangladesh

Authors: Mannan Mridha, Mohammad S. Islam

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Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: Accidents reporting system, patient car and safety, safe medical devices.

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136 The Role of Mobile Technology in Surveillance of Adverse Events Following Immunization during New Vaccines Introduction in Cameroon: A Cross-Sectional Study

Authors: A. A. Njoh, S. T. Ndoula, A. Adidja, G. N. Menan, A. Mengue, E. Mboke, H. B. Bachir, S. C. Nchinjoh, L. Adisso, Y. Saidu, L. Cleenewerck de Kiev

Abstract:

Vaccines serve a great deal in protecting the population globally. Vaccine products are subject to rigorous quality control and approval before use to ensure safety. Even if all actors take the required precautions, some people could still have adverse events following immunization (AEFI) caused by the vaccine composition or an error in its administration. AEFI underreporting is pronounced in low-income settings like Cameroon. The Country introduced electronic platforms to strengthen surveillance. With the introduction of many novel vaccines, like COVID-19 and the novel Oral Polio Vaccine (nOPV) 2, there was a need to monitor AEFI in Cameroon. A cross-sectional study was conducted from July to December 2022. Data on AEFI per region of Cameroon were reviewed for the previous five years. Data were analyzed with MS Excel, and the results were presented in proportions. AEFI reporting was uncommon in Cameroon. With the introduction of novel vaccines in 2021, the health authorities engaged in new tools and training to capture cases. AEFI detected almost doubled using the open data kit (ODK) compared to previous platforms, especially following the introduction of the nOPV2 and COVID-19 vaccines. The AEFI rate was 1.9 and 160 per administered 100,000 doses of nOPV2 and COVID-19 vaccines, respectively. This mobile tool captured individual information for people with AEFI from all regions. The platform helped to identify common AEFI following the use of these new vaccines. The ODK mobile technology was vital in improving AEFI reporting and providing data to monitor the use of new vaccines in Cameroon.

Keywords: Adverse events following immunization, AEFI, Cameroon, COVID-19 vaccines, novel oral polio vaccine 2, open data kit.

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135 Performance Analysis of Search Medical Imaging Service on Cloud Storage Using Decision Trees

Authors: González A. Julio, Ramírez L. Leonardo, Puerta A. Gabriel

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Telemedicine services use a large amount of data, most of which are diagnostic images in Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7) formats. Metadata is generated from each related image to support their identification. This study presents the use of decision trees for the optimization of information search processes for diagnostic images, hosted on the cloud server. To analyze the performance in the server, the following quality of service (QoS) metrics are evaluated: delay, bandwidth, jitter, latency and throughput in five test scenarios for a total of 26 experiments during the loading and downloading of DICOM images, hosted by the telemedicine group server of the Universidad Militar Nueva Granada, Bogotá, Colombia. By applying decision trees as a data mining technique and comparing it with the sequential search, it was possible to evaluate the search times of diagnostic images in the server. The results show that by using the metadata in decision trees, the search times are substantially improved, the computational resources are optimized and the request management of the telemedicine image service is improved. Based on the experiments carried out, search efficiency increased by 45% in relation to the sequential search, given that, when downloading a diagnostic image, false positives are avoided in management and acquisition processes of said information. It is concluded that, for the diagnostic images services in telemedicine, the technique of decision trees guarantees the accessibility and robustness in the acquisition and manipulation of medical images, in improvement of the diagnoses and medical procedures in patients.

Keywords: Cloud storage, decision trees, diagnostic image, search, telemedicine.

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