Search results for: efficient score function
11204 Comparative Evaluation of Pentazocine and Tramadol as Pre-Emptive Analgesics for Ovariohysterectomy in Female Dogs
Authors: Venkatgiri, Ranganath, L. Nagaraja, B. N. Sagar Pandav, S. M. Usturge, D. Dilipkumar, B. V. Shivprakash, B. Bhagwanthappa, D. Jahangir
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A comparative evaluation of Tramadol and Pentazocine as a pre-emptive analgesic in clinical cases of female dogs undergoing ovariohysterectomy was undertaken during this study. During the study, the following parameters were assessed viz., Rectal temperature (ᵒF), Respiratory rate (breaths/min) and Heart rate (beats/min). Hematological and biochemical parameters viz., total erythrocyte count (TEC) (millions/cmm), hemoglobin (g %), otal leucocytes count (TLC) (thousands/cmm), differential leucocytes count (DLC) (%), serum creatinine (mg/dl), plasma protein (mg/dl), blood glucose (mg/dl) was estimated before the surgery and after administration of general anaesthesia and immediate postoperative periods of 0, 12 and 24 hr respectively. Mean Total Pain Score (MTPS) includes measurement of parameters like posture, vocalization, activity level, response to palpation and agitation at different intervals was calculated before surgery and after administration of general anesthesia and post-operative periods of 1, 2, 4, 6, 12hrs and 24 hrs respectively. Mean Total Pain Score (MTPS) was given for each parameter (Posture, Vocalization, Activity Level, Response to Palpation and Agitation) like 0,1,2,3. (maximum score will be given was 4.). Results were revealed in all three groups including control group. There were significant minor alterations in physiological, hematological and biochemical parameters. MTPS (mean total pain score) were revealed and found a significant alteration when compared with control group. In conclusion, Tramadol found to be a better analgesic and had up to 8hrs of analgesic effect and Pentazocine is superior in post-operative pain management when compared to Tramadol because this group of dogs experienced less surgical stress, consumed less anesthetic dose, they recovered early, and they had less MTPS score.Keywords: dog, pentazocine, tramadol, ovariohysterectomy
Procedia PDF Downloads 16711203 Turkish Validation of the Nursing Outcomes for Urinary Incontinence and Their Sensitivities on Nursing Interventions
Authors: Dercan Gencbas, Hatice Bebis, Sue Moorhead
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In the nursing process, many of the nursing classification systems were created to be used in international. From these, NANDA-I, Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). In this direction, the main objective of this study is to establish a model for caregivers in hospitals and communities in Turkey and to ensure that nursing outputs are assessed by NOC-based measures. There are many scales to measure Urinary Incontinence (UI), which is very common in children, in old age, vaginal birth, NOC scales are ideal for use in the nursing process for comprehensive and holistic assessment, with surveys available. For this reason, the purpose of this study is to evaluate the validity of the NOC outputs and indicators used for UI NANDA-I. This research is a methodological study. In addition to the validity of scale indicators in the study, how much they will contribute to recovery after the nursing intervention was assessed by experts. Scope validations have been applied and calculated according to Fehring 1987 work model. According to this, nursing inclusion criteria and scores were determined. For example, if experts have at least four years of clinical experience, their score was 4 points or have at least one year of the nursing classification system, their score was 1 point. The experts were a publication experience about nursing classification, their score was 1 point, or have a doctoral degree in nursing, their score was 2 points. If the expert has a master degree, their score was 1 point. Total of 55 experts rated Fehring as a “senior degree” with a score of 90 according to the expert scoring. The nursing interventions to be applied were asked to what extent these indicators would contribute to recovery. For coverage validity tailored to Fehring's model, each NOC and NOC indicator from specialists was asked to score between 1-5. Score for the significance of indicators was from 1=no precaution to 5=very important. After the expert opinion, these weighted scores obtained for each NOC and NOC indicator were classified as 0.8 critical, 0.8 > 0.5 complements, > 0.5 are excluded. In the NANDA-I / NOC / NIC system (guideline), 5 NOCs proposed for nursing diagnoses for UI were proposed. These outputs are; Urinary Continence, Urinary Elimination, Tissue Integrity, Self CareToileting, Medication Response. After the scales are translated into Turkish, the weighted average of the scores obtained from specialists for the coverage of all 5 NOCs and the contribution of nursing initiatives exceeded 0.8. After the opinions of the experts, 79 of the 82 indicators were calculated as critical, 3 of the indicators were calculated as supplemental. Because of 0.5 > was not obtained, no substance was removed. All NOC outputs were identified as valid and usable scales in Turkey. In this study, five NOC outcomes were verified for the evaluation of the output of individuals who have received nursing knowledge of UI and variant types. Nurses in Turkey can benefit from the outputs of the NOC scale to perform the care of the elderly incontinence.Keywords: nursing outcomes, content validity, nursing diagnosis, urinary incontinence
Procedia PDF Downloads 12511202 Age Estimation from Teeth among North Indian Population: Comparison and Reliability of Qualitative and Quantitative Methods
Authors: Jasbir Arora, Indu Talwar, Daisy Sahni, Vidya Rattan
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Introduction: Age estimation is a crucial step to build the identity of a person, both in case of deceased and alive. In adults, age can be estimated on the basis of six regressive (Attrition, Secondary dentine, Dentine transparency, Root resorption, Cementum apposition and Periodontal Disease) changes in teeth qualitatively using scoring system and quantitatively by micrometric method. The present research was designed to establish the reliability of qualitative (method 1) and quantitative (method 2) of age estimation among North Indians and to compare the efficacy of these two methods. Method: 250 single-rooted extracted teeth (18-75 yrs.) were collected from Department of Oral Health Sciences, PGIMER, Chandigarh. Before extraction, periodontal score of each tooth was noted. Labiolingual sections were prepared and examined under light microscope for regressive changes. Each parameter was scored using Gustafson’s 0-3 point score system (qualitative), and total score was calculated. For quantitative method, each regressive change was measured quantitatively in form of 18 micrometric parameters under microscope with the help of measuring eyepiece. Age was estimated using linear and multiple regression analysis in Gustafson’s method and Kedici’s method respectively. Estimated age was compared with actual age on the basis of absolute mean error. Results: In pooled data, by Gustafson’s method, significant correlation (r= 0.8) was observed between total score and actual age. Total score generated an absolute mean error of ±7.8 years. Whereas, for Kedici’s method, a value of correlation coefficient of r=0.5 (p<0.01) was observed between all the eighteen micrometric parameters and known age. Using multiple regression equation, age was estimated, and an absolute mean error of age was found to be ±12.18 years. Conclusion: Gustafson’s (qualitative) method was found to be a better predictor for age estimation among North Indians.Keywords: forensic odontology, age estimation, North India, teeth
Procedia PDF Downloads 24211201 Usability Testing on Information Design through Single-Lens Wearable Device
Authors: Jae-Hyun Choi, Sung-Soo Bae, Sangyoung Yoon, Hong-Ku Yun, Jiyoung Kwahk
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This study was conducted to investigate the effect of ocular dominance on recognition performance using a single-lens smart display designed for cycling. A total of 36 bicycle riders who have been cycling consistently were recruited and participated in the experiment. The participants were asked to perform tasks riding a bicycle on a stationary stand for safety reasons. Independent variables of interest include ocular dominance, bike usage, age group, and information layout. Recognition time (i.e., the time required to identify specific information measured with an eye-tracker), error rate (i.e. false answer or failure to identify the information in 5 seconds), and user preference scores were measured and statistical tests were conducted to identify significant results. Recognition time and error ratio showed significant difference by ocular dominance factor, while the preference score did not. Recognition time was faster when the single-lens see-through display on the dominant eye (average 1.12sec) than on the non-dominant eye (average 1.38sec). Error ratio of the information recognition task was significantly lower when the see-through display was worn on the dominant eye (average 4.86%) than on the non-dominant eye (average 14.04%). The interaction effect of ocular dominance and age group was significant with respect to recognition time and error ratio. The recognition time of the users in their 40s was significantly longer than the other age groups when the display was placed on the non-dominant eye, while no difference was observed on the dominant eye. Error ratio also showed the same pattern. Although no difference was observed for the main effect of ocular dominance and bike usage, the interaction effect between the two variables was significant with respect to preference score. Preference score of daily bike users was higher when the display was placed on the dominant eye, whereas participants who use bikes for leisure purposes showed the opposite preference patterns. It was found more effective and efficient to wear a see-through display on the dominant eye than on the non-dominant eye, although user preference was not affected by ocular dominance. It is recommended to wear a see-through display on the dominant eye since it is safer by helping the user recognize the presented information faster and more accurately, even if the user may not notice the difference.Keywords: eye tracking, information recognition, ocular dominance, smart headware, wearable device
Procedia PDF Downloads 27311200 Robust Variogram Fitting Using Non-Linear Rank-Based Estimators
Authors: Hazem M. Al-Mofleh, John E. Daniels, Joseph W. McKean
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In this paper numerous robust fitting procedures are considered in estimating spatial variograms. In spatial statistics, the conventional variogram fitting procedure (non-linear weighted least squares) suffers from the same outlier problem that has plagued this method from its inception. Even a 3-parameter model, like the variogram, can be adversely affected by a single outlier. This paper uses the Hogg-Type adaptive procedures to select an optimal score function for a rank-based estimator for these non-linear models. Numeric examples and simulation studies will demonstrate the robustness, utility, efficiency, and validity of these estimates.Keywords: asymptotic relative efficiency, non-linear rank-based, rank estimates, variogram
Procedia PDF Downloads 43211199 Slip Suppression Sliding Mode Control with Various Chattering Functions
Authors: Shun Horikoshi, Tohru Kawabe
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This study presents performance analysis results of SMC (Sliding mode control) with changing the chattering functions applied to slip suppression problem of electric vehicles (EVs). In SMC, chattering phenomenon always occurs through high frequency switching of the control inputs. It is undesirable phenomenon and degrade the control performance, since it causes the oscillations of the control inputs. Several studies have been conducted on this problem by introducing some general saturation function. However, study about whether saturation function was really best and the performance analysis when using the other functions, weren’t being done so much. Therefore, in this paper, several candidate functions for SMC are selected and control performance of candidate functions is analyzed. In the analysis, evaluation function based on the trade-off between slip suppression performance and chattering reduction performance is proposed. The analyses are conducted in several numerical simulations of slip suppression problem of EVs. Then, we can see that there is no difference of employed candidate functions in chattering reduction performance. On the other hand, in slip suppression performance, the saturation function is excellent overall. So, we conclude the saturation function is most suitable for slip suppression sliding mode control.Keywords: sliding mode control, chattering function, electric vehicle, slip suppression, performance analysis
Procedia PDF Downloads 32611198 Comparison of Existing Predictor and Development of Computational Method for S- Palmitoylation Site Identification in Arabidopsis Thaliana
Authors: Ayesha Sanjana Kawser Parsha
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S-acylation is an irreversible bond in which cysteine residues are linked to fatty acids palmitate (74%) or stearate (22%), either at the COOH or NH2 terminal, via a thioester linkage. There are several experimental methods that can be used to identify the S-palmitoylation site; however, since they require a lot of time, computational methods are becoming increasingly necessary. There aren't many predictors, however, that can locate S- palmitoylation sites in Arabidopsis Thaliana with sufficient accuracy. This research is based on the importance of building a better prediction tool. To identify the type of machine learning algorithm that predicts this site more accurately for the experimental dataset, several prediction tools were examined in this research, including the GPS PALM 6.0, pCysMod, GPS LIPID 1.0, CSS PALM 4.0, and NBA PALM. These analyses were conducted by constructing the receiver operating characteristics plot and the area under the curve score. An AI-driven deep learning-based prediction tool has been developed utilizing the analysis and three sequence-based input data, such as the amino acid composition, binary encoding profile, and autocorrelation features. The model was developed using five layers, two activation functions, associated parameters, and hyperparameters. The model was built using various combinations of features, and after training and validation, it performed better when all the features were present while using the experimental dataset for 8 and 10-fold cross-validations. While testing the model with unseen and new data, such as the GPS PALM 6.0 plant and pCysMod mouse, the model performed better, and the area under the curve score was near 1. It can be demonstrated that this model outperforms the prior tools in predicting the S- palmitoylation site in the experimental data set by comparing the area under curve score of 10-fold cross-validation of the new model with the established tools' area under curve score with their respective training sets. The objective of this study is to develop a prediction tool for Arabidopsis Thaliana that is more accurate than current tools, as measured by the area under the curve score. Plant food production and immunological treatment targets can both be managed by utilizing this method to forecast S- palmitoylation sites.Keywords: S- palmitoylation, ROC PLOT, area under the curve, cross- validation score
Procedia PDF Downloads 7911197 Compare the Effectiveness of Web Based and Blended Learning on Paediatric Basic Life Support
Authors: Maria Janet, Anita David, P. Vijayasamundeeswarimaria
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Introduction: The main purpose of this study is to compare the effectiveness of web-based and blended learning on Paediatric Basic Life Support on competency among undergraduate nursing students in selected nursing colleges in Chennai. Materials and methods: A descriptive pre-test and post-test study design were used for this study. Samples of 100 Fourth year B.Sc., nursing students at Sri Ramachandra Faculty of Nursing SRIHER, Chennai, 100 Fourth year B.Sc., nursing students at Apollo College of Nursing, Chennai, were selected by purposive sampling technique. The instrument used for data collection was Knowledge Questionnaire on Paediatric Basic Life Support (PBLS). It consists of 29 questions on the general expansion of Basic Life Support and Cardiopulmonary Resuscitation, Prerequisites of Basic Life Support, and Knowledge on Paediatric Basic Life Support in which each question has four multiple choices answers, each right answer carrying one mark and no negative scoring. This questionnaire was formed with reference to AHA 2020 (American Heart Association) revised guidelines. Results: After the post-test, in the web-based learning group, 58.8% of the students had an inadequate level of objective performance score, while 41.1% of them had an adequate level of objective performance score. In the blended learning group, 26.5% of the students had an inadequate level of an objective performance score, and 73.4% of the students had an adequate level of an objective performance score. There was an association between the post-test level of knowledge and the demographic variables of undergraduate nursing students undergoing blended learning. The age was significant at a p-value of 0.01, and the performance of BLS before was significant at a p-value of 0.05. The results show that there was a significant positive correlation between knowledge and objective performance score of undergraduate nursing students undergoing web-based learning on paediatric basic life support.Keywords: basic life support, paediatric basic life support, web-based learning, blended learning
Procedia PDF Downloads 6911196 A Study of Student Satisfaction of the University TV Station
Authors: Prapoj Na Bangchang
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This research aimed to study the satisfaction of university students on the Suan Sunandha Rajabhat University television station. The sample were 250 undergraduate students from Year 1 to Year 4. The tool used to collect data was a questionnaire. Statistics used in data analysis were percentage, mean and standard deviation. The results showed that student satisfaction on the University's television station location received high score, followed by the number of devices, and the content presented received the lowest score. Most students want the content of the programs to be improved especially entertainment content, followed by sports content.Keywords: student satisfaction, university TV channel, media, broadcasting
Procedia PDF Downloads 38611195 Assessment of Association Between Microalbuminuria and Lung Function Test Among the Community of Jimma Town
Authors: Diriba Dereje
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Background: Cardiac and renal disease are the most prevalent chronic non-communicable diseases (CNCD) affecting the community in a significant manner. The best and recommended method in halting CNCD is by working on prevention as early as possible. This is only possible if early surrogate markers are identified. As part of the stated solution, this study will identify an association between microalbuminuria (an early surrogate marker of renal and cardiac disease) and lung function test among adult in the community. Objective: The main aim of this study was to assess an association between microalbuminuria (an early surrogate marker of renal and cardiac disease) and lung function test among adult in the community. Methodology: Community based cross sectional study was conducted among 384 adult in Jimma town. A systematic sampling technique was used in selecting participants to the study. In searching for the possible association, binary and multivariate logistic regression and t-test was conducted. Finally, the association between microalbuminuria and lung function test was well stated in the form of figures and written description. Result and Conclusion: A significant association was found between microalbuminuria and different lung function test parameters.Keywords: microalbuminuria, lung function, association, test
Procedia PDF Downloads 19411194 The Importance of Functioning and Disability Status Follow-Up in People with Multiple Sclerosis
Authors: Sanela Slavkovic, Congor Nad, Spela Golubovic
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Background: The diagnosis of multiple sclerosis (MS) is a major life challenge and has repercussions on all aspects of the daily functioning of those attained by it – personal activities, social participation, and quality of life. Regular follow-up of only the neurological status is not informative enough so that it could provide data on the sort of support and rehabilitation that is required. Objective: The aim of this study was to establish the current level of functioning of persons attained by MS and the factors that influence it. Methods: The study was conducted in Serbia, on a sample of 108 persons with relapse-remitting form of MS, aged 20 to 53 (mean 39.86 years; SD 8.20 years). All participants were fully ambulatory. Methods applied in the study include Expanded Disability Status Scale-EDSS and World Health Organization Disability Assessment Schedule, WHODAS 2.0 (36-item version, self-administered). Results: Participants were found to experience the most problems in the domains of Participation, Mobility, Life activities and Cognition. The least difficulties were found in the domain of Self-care. Symptom duration was the only control variable with a significant partial contribution to the prediction of the WHODAS scale score (β=0.30, p < 0.05). The total EDSS score correlated with the total WHODAS 2.0 score (r=0.34, p=0.00). Statistically significant differences in the domain of EDSS 0-5.5 were found within categories (0-1.5; 2-3.5; 4-5.5). The more pronounced a participant’s EDSS score was, although not indicative of large changes in the neurological status, the more apparent the changes in the functional domain, i.e. in all areas covered by WHODAS 2.0. Pyramidal (β=0.34, p < 0.05) and Bowel and bladder (β=0.24, p < 0.05) functional systems were found to have a significant partial contribution to the prediction of the WHODAS score. Conclusion: Measuring functioning and disability is important in the follow-up of persons suffering from MS in order to plan rehabilitation and define areas in which additional support is needed.Keywords: disability, functionality, multiple sclerosis, rehabilitation
Procedia PDF Downloads 12211193 Acoustic and Thermal Compliance from the Execution Theory
Authors: Saou Mohamed Amine
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The construction industry has been identified as a user of substantial amount of materials and energy resources that has an enormous impact on environment. The energy efficient in refurbishment project is being considered as one of the approaches to achieve sustainability in construction industry. The increasing concern for environment has made building owners and designers to incorporate the energy efficiency features into their building projects. However, an overwhelming issue of existing non-energy efficient buildings which exceeds the number of new building could be ineffective if the buildings are not refurbished through the energy efficient measures. Thus, energy efficient in refurbishment project is being considered as one of the approaches to achieve sustainability that offers significant opportunities for reducing global energy consumption and greenhouse gas emissions. However, the quality of design team attributes and the characteristics of the refurbishment building projects have been argued to be the main factors that determine the energy efficiency performance of the building.Keywords: construction industry, design team attributes, energy efficient performance, refurbishment projects characteristics
Procedia PDF Downloads 36811192 Lamb Fleece Quality as an Indicator of Endoparasitism
Authors: Maria Christine Rizzon Cintra, Tâmara Duarte Borges, Cristina Santos Sotomaior
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Lamb’s fleece quality can be influenced by many factors, including welfare, stress, nutritional imbalance and presence of ectoparasites. The association of fleece quality and endoparasitism, until now, was not well solved. The present study was undertaken to evaluate if a fleece visual score could predict lamb parasitosis with the focus on gastrointestinal parasites. Fleece quality was scored based on a combination of cleanliness and wool cover, using a three-point scale (1-3). Score 1: fleece shows no sign of dirt or contamination, and had sufficient fleece for the breed and time of year with whole body coverage; Score 2: fleece was little damp or wet, with coat contaminated by small patches of mud or dung and some areas of fleece loose, but no shed or bald patches of no more than 10cm in diameter; Score 3: fleece filthy, very wet with coated in mud or dug, and loose fleece with shed areas of pulls with bald patches greater than 10cm, some areas may be trailing. All fleece quality scores (FQS) were assessed with lamb restrained to ensure close inspection and were done along lamb back and considered just one side of the body. To confirm the gastrointestinal parasites and animal’s anemia, faecal egg counts (FEC) and hematocrit were done for each animal. Lambs were also weighed. All these measurements were done every 15-days, beginning at 60-days until 150-days of life, using 48 animals crossed Texel x Ile de France. For statistics analysis, it was used Stratigraphic Program (4.1. version), and all significant differences between FQS, weight gain, age, hematocrit, and FEC were assessed using analysis of variance following by Duncan test, and the correlation was done by Pearson test at P<0.05. Results showed that animals scored as ‘3’ in FQS had a lower hematocrit and a higher FEC (p<0.05) than animals scored as ‘1’ (hematocrit: 26, 24, 23 and FEC 2107, 2962, 4626 respectively for 1, 2 and 3 FQS). There were correlations between FQS and FEC (r = 0.16), FQS and hematocrit (r = -0.33) an FQS and weight gain (r = -0.20) indicating that worst FQS animals (score 3) had greater gastrointestinal parasites’ infection, were more anemic and had lower weight gain than animals scored as ‘1’ or ‘2’ for FQS. Concerning the lamb´s age, animals that received score ‘3’ in FQS, maintained gastrointestinal parasites’ infection over the time (P<0.05). It was concluded that FQS could be an important indicator to be included in the selective treatment for control verminosis in lambs.Keywords: fleece, gastrointestinal parasites, sheep, welfare
Procedia PDF Downloads 24211191 Generalization of Tsallis Entropy from a Q-Deformed Arithmetic
Authors: J. Juan Peña, J. Morales, J. García-Ravelo, J. García-Martínez
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It is known that by introducing alternative forms of exponential and logarithmic functions, the Tsallis entropy Sᵩ is itself a generalization of Shannon entropy S. In this work, from a deformation through a scaling function applied to the differential operator, it is possible to generate a q-deformed calculus as well as a q-deformed arithmetic, which not only allows generalizing the exponential and logarithmic functions but also any other standard function. The updated q-deformed differential operator leads to an updated integral operator under which the functions are integrated together with a weight function. For each differentiable function, it is possible to identify its q-deformed partner, which is useful to generalize other algebraic relations proper of the original functions. As an application of this proposal, in this work, a generalization of exponential and logarithmic functions is studied in such a way that their relationship with the thermodynamic functions, particularly the entropy, allows us to have a q-deformed expression of these. As a result, from a particular scaling function applied to the differential operator, a q-deformed arithmetic is obtained, leading to the generalization of the Tsallis entropy.Keywords: q-calculus, q-deformed arithmetic, entropy, exponential functions, thermodynamic functions
Procedia PDF Downloads 7811190 A Game-Based Methodology to Discriminate Executive Function – a Pilot Study With Institutionalized Elderly People
Authors: Marlene Rosa, Susana Lopes
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There are few studies that explore the potential of board games as a performance measure, despite it can be an interesting strategy in the context of frailty populations. In fact, board games are immersive strategies than can inhibit the pressure of being evaluated. This study aimed to test the ability of gamed-base strategies to assess executive function in elderly population. Sixteen old participants were included: 10 with affected executive functions (G1 – 85.30±6.00 yrs old; 10 male); 6 with executive functions with non-clinical important modifications (G2 - 76.30±5.19 yrs old; 6 male). Executive tests were assessed using the Frontal Assessment Battery (FAB), which is a quick-applicable cognitive screening test (score<12 means impairment). The board game used in this study was the TATI Hand Game, specifically for training rhythmic coordination of the upper limbs with multiple cognitive stimuli. This game features 1 table grid, 1 set of Single Game cards (to play with one hand); Double Game cards (to play simultaneously with two hands); 1 dice to plan Single Game mode; cards to plan the Double Game mode; 1 bell; 2 cups. Each participant played 3 single game cards, and the following data were collected: (i) variability in time during board game challenges (SD); (ii) number of errors; (iii) execution speed (sec). G1 demonstrated: high variability in execution time during board game challenges (G1 – 13.0s vs G2- 0.5s); a higher number of errors (1.40 vs 0.67); higher execution velocity (607.80s vs 281.83s). These results demonstrated the potential of implementing board games as a functional assessment strategy in geriatric care. Future studies might include larger samples and statistical methodologies to find cut-off values for impairment in executive functions during performance in TATI game.Keywords: board game, aging, executive function, evaluation
Procedia PDF Downloads 14211189 Postoperative Pain Management: Efficacy of Caudal Tramadol in Pediatric Lower Abdominal Surgery: A Randomized Clinical Study
Authors: Reza Farahmand Rad, Farnad Imani, Azadeh Emami, Reza Salehi, Ali Reza Ghavamy, Ali Nima Shariat
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Background: One of the methods of pain control after pediatric surgical procedures is regional techniques, including caudal block, despite their limitations. Objectives: In this study, the pain score and complications of caudal tramadol were evaluated in pediatrics following lower abdom- inal surgery. Methods: In this study, 46 children aged 3 to 10 years were allocated into two equal groups (R and TR) for performing caudal anal- gesia after lower abdominal surgery. The injectate contained 0.2% ropivacaine 1 mL/kg in the R group (control group) and tramadol (2 mg/kg) and ropivacaine in the TR group. The pain score, duration of pain relief, amount of paracetamol consumption, hemody- namic alterations, and possible complications at specific times (1, 2, and 6 hours) were evaluated in both groups. Results: No considerable difference was observed in the pain score between the groups in the first and second hours (P > 0.05). However, in the sixth hour, the TR group had a significantly lower pain score than the R group (P < 0.05). Compared to the R group, the TR group had a longer period of analgesia and lower consumption of analgesic drugs (P < 0.05). Heart rate and blood pressure differences were not significant between the two groups (P > 0.05). Similarly, the duration of operation and recovery time were not remarkably different between the two groups (P > 0.05). Complications had no apparent differences between these two groups, as well (P > 0.05). Conclusions: In this study, the addition of tramadol to caudal ropivacaine in pediatric lower abdominal surgery promoted pain relief without complications.Keywords: tramadol, ropivacaine, caudal block, pediatric, lower abdominal surgery, postoperative pain
Procedia PDF Downloads 1511188 Ranking All of the Efficient DMUs in DEA
Authors: Elahe Sarfi, Esmat Noroozi, Farhad Hosseinzadeh Lotfi
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One of the important issues in Data Envelopment Analysis is the ranking of Decision Making Units. In this paper, a method for ranking DMUs is presented through which the weights related to efficient units should be chosen in a way that the other units preserve a certain percentage of their efficiency with the mentioned weights. To this end, a model is presented for ranking DMUs on the base of their superefficiency by considering the mentioned restrictions related to weights. This percentage can be determined by decision Maker. If the specific percentage is unsuitable, we can find a suitable and feasible one for ranking DMUs accordingly. Furthermore, the presented model is capable of ranking all of the efficient units including nonextreme efficient ones. Finally, the presented models are utilized for two sets of data and related results are reported.Keywords: data envelopment analysis, efficiency, ranking, weight
Procedia PDF Downloads 45711187 Tele-Rehabilitation for Multiple Sclerosis: A Case Study
Authors: Sharon Harel, Rachel Kizony, Yoram Feldman, Gabi Zeilig, Mordechai Shani
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Multiple Sclerosis (MS) is a neurological disease that may cause restriction in participation in daily activities of young adults. Main symptoms include fatigue, weakness and cognitive decline. The appearance of symptoms, their severity and deterioration rate, change between patients. The challenge of health services is to provide long-term rehabilitation services to people with MS. The objective of this presentation is to describe a course of tele-rehabilitation service of a woman with MS. Methods; R is a 48 years-old woman, diagnosed with MS when she was 22. She started to suffer from weakness of her non-dominant left upper extremity about ten years after the diagnosis. She was referred to the tele-rehabilitation service by her rehabilitation team, 16 years after diagnosis. Her goals were to improve ability to use her affected upper extremity in daily activities. On admission her score in the Mini-Mental State Exam was 30/30. Her Fugl-Meyer Assessment (FMA) score of the left upper extremity was 48/60, indicating mild weakness and she had a limitation of her shoulder abduction (90 degrees). In addition, she reported little use of her arm in daily activities as shown in her responses to the Motor Activity Log (MAL) that were equal to 1.25/5 in amount and 1.37 in quality of use. R. received two 30 minutes on-line sessions per week in the tele-rehabilitation service, with the CogniMotion system. These were complemented by self-practice with the system. The CogniMotion system provides a hybrid (synchronous-asynchronous), the home-based tele-rehabilitation program to improve the motor, cognitive and functional status of people with neurological deficits. The system consists of a computer, large monitor, and the Microsoft’s Kinect 3D sensor. This equipment is located in the client’s home and connected to a clinician’s computer setup in a remote clinic via WiFi. The client sits in front of the monitor and uses his body movements to interact with games and tasks presented on the monitor. The system provides feedback in the form of ‘knowledge of results’ (e.g., the success of a game) and ‘knowledge of performance’ (e.g., alerts for compensatory movements) to enhance motor learning. The games and tasks were adapted for R. motor abilities and level of difficulty was gradually increased according to her abilities. The results of her second assessment (after 35 on-line sessions) showed improvement in her FMA score to 52 and shoulder abduction to 140 degrees. Moreover, her responses to the MAL indicated an increased amount (2.4) and quality (2.2) of use of her left upper extremity in daily activities. She reported high level of enjoyment from the treatments (5/5), specifically the combination of cognitive challenges while moving her body. In addition, she found the system easy to use as reflected by her responses to the System Usability Scale (85/100). To-date, R. continues to receive treatments in the tele-rehabilitation service. To conclude, this case report shows the potential of using tele-rehabilitation for people with MS to provide strategies to enhance the use of the upper extremity in daily activities as well as for maintaining motor function.Keywords: motor function, multiple-sclerosis, tele-rehabilitation, daily activities
Procedia PDF Downloads 18211186 Predicting Mortality among Acute Burn Patients Using BOBI Score vs. FLAMES Score
Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah
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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.Keywords: BOBI, burns, FLAMES, scoring systems, outcome
Procedia PDF Downloads 33611185 Strategic Role of Fintechs in Evolving Financial Functions and Enhancing Corporate Resilience amid Economic Crises
Authors: Ghizlane Barzi, Zineb Bamousse
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In an increasingly volatile global economic context characterized by recurring crises, the financial function of companies is called upon to play a strategic role not only in resource management but also in organizational resilience. The emergence of financial technologies (fintech) offers innovative tools capable of transforming this function by enhancing the efficiency of financial processes and increasing companies' ability to adapt and overcome economic shocks. However, despite the rapid rise of fintechs and their growing adoption by companies, there remain uncertainties regarding the real impact of these innovations on the financial resilience of organizations. Indeed, how do fintech-driven innovations transform the financial function, and to what extent does this transformation contribute to strengthening the financial resilience of companies in the face of contemporary crises? This research aims to explore these questions by examining the interrelationships between the financial function, fintech innovations, and corporate resilience, in order to identify optimization levers that could be adopted for better financial risk management.Keywords: finance, financial function, fintech, resilience, innovation
Procedia PDF Downloads 3111184 The Effect of Education on Nurses' Knowledge Level for Ventrogluteal Site Injection: Pilot Study
Authors: Emel Bayraktar, Gulengun Turk
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Introduction and Objective: Safe administration of medicines is one of the main responsibilities of nurses. Intramuscular drug administration is among the most common methods used by nurses among all drug applications. This study was carried out in order to determine determine the effect of education given on injection in ventrogluteal area on the level of knowledge of nurses on this subject. Methods: The sample of the study consisted of 20 nurses who agreed to participate in the study between 01 October and 31 December 2019. The research is a pretest-posttest comparative, quasi-experimental type pilot study. The nurses were given a 4-hour training prepared on injection into the ventrogluteal area. The training consisted of two hours of theoretical and two hours of laboratory practice. Before the training and 4 weeks after the training, a questionnaire form containing questions about their knowledge and practices regarding the injection of the ventrogluteal region was applied to the nurses. Results: The average age of the nurses is 26.55 ± 7.60, 35% (n = 7) of them are undergraduate and 30% (n = 6) of them work in intensive care units. Before the training, 35% (n = 7) of the nurses stated that the most frequently used intramuscular injection site was the ventrogluteal area, and 75% (n = 15) stated that the safest area was the rectus femoris muscle. After the training, 55% (n = 11) of the nurses stated that they most frequently used the ventrogluteal area and 100% (n = 20) of them stated that the ventrogluteal area was the safest area. The average score the nurses got from the premises before the training is 14.15 ± 6.63 (min = 0, max = 20), the total score is 184. The average score obtained after the training was determined as 18.69 ± 2.35 (min = 12, max = 20), and the total score was 243. Conclusion: As a result of the research, it was determined that the training given on the injection of ventrogluteal area increased the knowledge level of the nurses. It is recommended to organize in-service trainings for all nurses on the injection of ventrogluteal area.Keywords: safe injection, knowledge level, nurse, intramuscular injection, ventrogluteal area
Procedia PDF Downloads 21211183 Attitude towards Doping of High-Performance Athletes in a Sports Institute of the City of Medellin, Colombia
Authors: Yuban Sebastian Cuartas-Agudelo, Sandra Marcela López-Hincapié, Vivianna Alexandra Garrido-Altamar, María de los Ángeles Rodríguez-Gázquez, Camilo Ruiz-Mejía, Lina María Martínez-Sánchez, Gloria Inés Martínez-Domínguez, Luis Eduardo Contreras, Felipe Eduardo Marino-Isaza
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Introduction: Doping is a prohibited practice in competitive sports with potential adverse effects; therefore, it is crucial to describe the attitudes of athletes towards this behavior and to determine which o these increase the susceptibility to carry out this practice. Objective: To determine the attitude of high-performance athletes towards doping in a sports institute in the city of Medellin, Colombia. Methods: We performed a cross-sectional study during 2016, with a sample taken to convenience consisting of athletes over 18 years old enrolled in a sports institute of the city of Medellin (Colombia). The athletes filled by themselves the Petroczi and Aidman questionnaire: Performance Enhancement Attitude Scale (PEAS) adapted to the Spanish language by Morente-Sánchez et al. This scale has 17 items with likert answer options, with a score ranging from 1 to 6, with a higher score indicating a stronger tendency towards doping practices. Results: 112 athletes were included with an average age of 21.6 years old, a 60% of them were male and the most frequent sports were karate 17%, judo 12.5% and athletics 9.8%. The average score of the questionnaire was 35.5 points of a 102 possible points. The lowest score was obtained in the following items: Is Doping necessary 1,4 and Doping isn’t cheating, everyone does it 1,5. Conclusion: In our population, there is a low tendency towards doping practices.Keywords: sports, doping in sports, athletic performance, attitude
Procedia PDF Downloads 23211182 Assessing the Efficiency of Pre-Hospital Scoring System with Conventional Coagulation Tests Based Definition of Acute Traumatic Coagulopathy
Authors: Venencia Albert, Arulselvi Subramanian, Hara Prasad Pati, Asok K. Mukhophadhyay
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Acute traumatic coagulopathy in an endogenous dysregulation of the intrinsic coagulation system in response to the injury, associated with three-fold risk of poor outcome, and is more amenable to corrective interventions, subsequent to early identification and management. Multiple definitions for stratification of the patients' risk for early acute coagulopathy have been proposed, with considerable variations in the defining criteria, including several trauma-scoring systems based on prehospital data. We aimed to develop a clinically relevant definition for acute coagulopathy of trauma based on conventional coagulation assays and to assess its efficacy in comparison to recently established prehospital prediction models. Methodology: Retrospective data of all trauma patients (n = 490) presented to our level I trauma center, in 2014, was extracted. Receiver operating characteristic curve analysis was done to establish cut-offs for conventional coagulation assays for identification of patients with acute traumatic coagulopathy was done. Prospectively data of (n = 100) adult trauma patients was collected and cohort was stratified by the established definition and classified as "coagulopathic" or "non-coagulopathic" and correlated with the Prediction of acute coagulopathy of trauma score and Trauma-Induced Coagulopathy Clinical Score for identifying trauma coagulopathy and subsequent risk for mortality. Results: Data of 490 trauma patients (average age 31.85±9.04; 86.7% males) was extracted. 53.3% had head injury, 26.6% had fractures, 7.5% had chest and abdominal injury. Acute traumatic coagulopathy was defined as international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s. Of the 100 adult trauma patients (average age 36.5±14.2; 94% males), 63% had early coagulopathy based on our conventional coagulation assay definition. Overall prediction of acute coagulopathy of trauma score was 118.7±58.5 and trauma-induced coagulopathy clinical score was 3(0-8). Both the scores were higher in coagulopathic than non-coagulopathic patients (prediction of acute coagulopathy of trauma score 123.2±8.3 vs. 110.9±6.8, p-value = 0.31; trauma-induced coagulopathy clinical score 4(3-8) vs. 3(0-8), p-value = 0.89), but not statistically significant. Overall mortality was 41%. Mortality rate was significantly higher in coagulopathic than non-coagulopathic patients (75.5% vs. 54.2%, p-value = 0.04). High prediction of acute coagulopathy of trauma score also significantly associated with mortality (134.2±9.95 vs. 107.8±6.82, p-value = 0.02), whereas trauma-induced coagulopathy clinical score did not vary be survivors and non-survivors. Conclusion: Early coagulopathy was seen in 63% of trauma patients, which was significantly associated with mortality. Acute traumatic coagulopathy defined by conventional coagulation assays (international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s) demonstrated good ability to identify coagulopathy and subsequent mortality, in comparison to the prehospital parameter-based scoring systems. Prediction of acute coagulopathy of trauma score may be more suited for predicting mortality rather than early coagulopathy. In emergency trauma situations, where immediate corrective measures need to be taken, complex multivariable scoring algorithms may cause delay, whereas coagulation parameters and conventional coagulation tests will give highly specific results.Keywords: trauma, coagulopathy, prediction, model
Procedia PDF Downloads 17611181 Scoring System for the Prognosis of Sepsis Patients in Intensive Care Units
Authors: Javier E. García-Gallo, Nelson J. Fonseca-Ruiz, John F. Duitama-Munoz
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Sepsis is a syndrome that occurs with physiological and biochemical abnormalities induced by severe infection and carries a high mortality and morbidity, therefore the severity of its condition must be interpreted quickly. After patient admission in an intensive care unit (ICU), it is necessary to synthesize the large volume of information that is collected from patients in a value that represents the severity of their condition. Traditional severity of illness scores seeks to be applicable to all patient populations, and usually assess in-hospital mortality. However, the use of machine learning techniques and the data of a population that shares a common characteristic could lead to the development of customized mortality prediction scores with better performance. This study presents the development of a score for the one-year mortality prediction of the patients that are admitted to an ICU with a sepsis diagnosis. 5650 ICU admissions extracted from the MIMICIII database were evaluated, divided into two groups: 70% to develop the score and 30% to validate it. Comorbidities, demographics and clinical information of the first 24 hours after the ICU admission were used to develop a mortality prediction score. LASSO (least absolute shrinkage and selection operator) and SGB (Stochastic Gradient Boosting) variable importance methodologies were used to select the set of variables that make up the developed score; each of this variables was dichotomized and a cut-off point that divides the population into two groups with different mean mortalities was found; if the patient is in the group that presents a higher mortality a one is assigned to the particular variable, otherwise a zero is assigned. These binary variables are used in a logistic regression (LR) model, and its coefficients were rounded to the nearest integer. The resulting integers are the point values that make up the score when multiplied with each binary variables and summed. The one-year mortality probability was estimated using the score as the only variable in a LR model. Predictive power of the score, was evaluated using the 1695 admissions of the validation subset obtaining an area under the receiver operating characteristic curve of 0.7528, which outperforms the results obtained with Sequential Organ Failure Assessment (SOFA), Oxford Acute Severity of Illness Score (OASIS) and Simplified Acute Physiology Score II (SAPSII) scores on the same validation subset. Observed and predicted mortality rates within estimated probabilities deciles were compared graphically and found to be similar, indicating that the risk estimate obtained with the score is close to the observed mortality, it is also observed that the number of events (deaths) is indeed increasing as the outcome go from the decile with the lowest probabilities to the decile with the highest probabilities. Sepsis is a syndrome that carries a high mortality, 43.3% for the patients included in this study; therefore, tools that help clinicians to quickly and accurately predict a worse prognosis are needed. This work demonstrates the importance of customization of mortality prediction scores since the developed score provides better performance than traditional scoring systems.Keywords: intensive care, logistic regression model, mortality prediction, sepsis, severity of illness, stochastic gradient boosting
Procedia PDF Downloads 22311180 Education Function of Botanical Gardens
Authors: Ruhugül Özge Ocak, Banu Öztürk Kurtaslan
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Botanical gardens are very significant organizations which protect the environment against the increasing environmental problems, provide environmental education for people, offer recreation possibilities, etc. This article describes botanical gardens and their functions. The most important function of a botanical garden is to provide environmental education for people and improve environmental awareness. Considering this function, some botanical gardens were examined and opinions were suggested about the subject.Keywords: botanical garden, environment, environmental education, recreation
Procedia PDF Downloads 53011179 Anyword: A Digital Marketing Tool to Increase Productivity in Newly Launching Businesses
Authors: Jana Atteah, Wid Jan, Yara AlHibshi, Rahaf AlRougi
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Anyword is an AI copywriting tool that helps marketers create effective campaigns for specific audiences. It offers a wide range of templates for various platforms, brand voice guidelines, and valuable analytics insights. Anyword is used by top global companies and has been recognized as one of the "Fastest Growing Products" in the 2023 software awards. A recent study examined the utilization and impact of AI-powered writing tools, specifically focusing on the adoption of AI in writing pursuits and the use of the Anyword platform. The results indicate that a majority of respondents (52.17%) had not previously used Anyword, but those who had were generally satisfied with the platform. Notable productivity improvements were observed among 13% of the participants, while an additional 34.8% reported a slight increase in productivity. A majority (47.8%) maintained a neutral stance, suggesting that their productivity remained unaffected. Only a minimal percentage (4.3%) claimed that their productivity did not improve with the usage of Anyword AI. In terms of the quality of written content generated, the participants responded positively. Approximately 91% of participants gave Anyword AI a score of 5 or higher, with roughly 17% giving it a perfect score. A small percentage (approximately 9%) gave a low score between 0-2. The mode result was a score of 7, indicating a generally positive perception of the quality of content generated using Anyword AI. These findings suggest that AI can contribute to increased productivity and positively influence the quality of written content. Further research and exploration of AI tools in writing pursuits are warranted to fully understand their potential and limitations.Keywords: artificial intelligence, marketing platforms, productivity, user interface
Procedia PDF Downloads 6411178 Relation between Roots and Tangent Lines of Function in Fractional Dimensions: A Method for Optimization Problems
Authors: Ali Dorostkar
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In this paper, a basic schematic of fractional dimensional optimization problem is presented. As will be shown, a method is performed based on a relation between roots and tangent lines of function in fractional dimensions for an arbitrary initial point. It is shown that for each polynomial function with order N at least N tangent lines must be existed in fractional dimensions of 0 < α < N+1 which pass exactly through the all roots of the proposed function. Geometrical analysis of tangent lines in fractional dimensions is also presented to clarify more intuitively the proposed method. Results show that with an appropriate selection of fractional dimensions, we can directly find the roots. Method is presented for giving a different direction of optimization problems by the use of fractional dimensions.Keywords: tangent line, fractional dimension, root, optimization problem
Procedia PDF Downloads 19211177 Prediction Fluid Properties of Iranian Oil Field with Using of Radial Based Neural Network
Authors: Abdolreza Memari
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In this article in order to estimate the viscosity of crude oil,a numerical method has been used. We use this method to measure the crude oil's viscosity for 3 states: Saturated oil's viscosity, viscosity above the bubble point and viscosity under the saturation pressure. Then the crude oil's viscosity is estimated by using KHAN model and roller ball method. After that using these data that include efficient conditions in measuring viscosity, the estimated viscosity by the presented method, a radial based neural method, is taught. This network is a kind of two layered artificial neural network that its stimulation function of hidden layer is Gaussian function and teaching algorithms are used to teach them. After teaching radial based neural network, results of experimental method and artificial intelligence are compared all together. Teaching this network, we are able to estimate crude oil's viscosity without using KHAN model and experimental conditions and under any other condition with acceptable accuracy. Results show that radial neural network has high capability of estimating crude oil saving in time and cost is another advantage of this investigation.Keywords: viscosity, Iranian crude oil, radial based, neural network, roller ball method, KHAN model
Procedia PDF Downloads 50211176 Impact of ICT on Efficient Services Providing to Users by LIPs in NCR India
Authors: Mani Gupta
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This study deals with question: i) Whether ICT plays a positive role in improvement of efficiency of LIPs in terms of providing efficient services to the Users in LICs? and ii) Role of finance in terms of required technological logistics and infrastructure for usage of ICT based services to comfort in accessing databases by Users in LICs. This is based on primary data which are collected from various libraries and Information Centers of NCR Delhi. The survey conducted during December 15 and 31, 2010 on 496 respondents across 96 libraries and information centers in NCR Delhi through electronic data collection method. There is positive and emphatic relationship between ICT and its effect on improving the level of efficient services providing by LIPs in LICs in NCR Delhi. This is divided into 6 sub-headings and finally the outcomes.Keywords: modern globalization, linear correlation, efficient service, internet revolution, logistics
Procedia PDF Downloads 35811175 The Use of Coronary Calcium Scanning for Cholesterol Assessment and Management
Authors: Eva Kirzner
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Based on outcome studies published over the past two decades, in 2018, the ACC/AHA published new guidelines for the management of hypercholesterolemia that incorporate the use of coronary artery calcium (CAC) scanning as a decision tool for ascertaining which patients may benefit from statin therapy. This use is based on the recognition that the absence of calcium on CAC scanning (i.e., a CAC score of zero) usually signifies the absence of significant atherosclerotic deposits in the coronary arteries. Specifically, in patients with a high risk for atherosclerotic cardiovascular disease (ASCVD), initiation of statin therapy is generally recommended to decrease ASCVD risk. However, among patients with intermediate ASCVD risk, the need for statin therapy is less certain. However, there is a need for new outcome studies that provide evidence that the management of hypercholesterolemia based on these new ACC/AHA recommendations is safe for patients. Based on a Pub-Med and Google Scholar literature search, four relevant population-based or patient-based cohort studies that studied the relationship between CAC scanning, risk assessment or mortality, and statin therapy that were published between 2017 and 2021 were identified (see references). In each of these studies, patients were assessed for their baseline risk for atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohorts Equation (PCE), an ACC/AHA calculator for determining patient risk based on assessment of patient age, gender, ethnicity, and coronary artery disease risk factors. The combined findings of these four studies provided concordant evidence that a zero CAC score defines patients who remain at low clinical risk despite the non-use of statin therapy. Thus, these new studies confirm the use of CAC scanning as a safe tool for reducing the potential overuse of statin therapy among patients with zero CAC scores. Incorporating these new data suggest the following best practice: (1) ascertain ASCVD risk according to the PCE in all patients; (2) following an initial attempt trial to lower ASCVD risk with optimal diet among patients with elevated ASCVD risk, initiate statin therapy for patients who have a high ASCVD risk score; (3) if the ASCVD score is intermediate, refer patients for CAC scanning; and (4) and if the CAC score is zero among the intermediate risk ASCVD patients, statin therapy can be safely withheld despite the presence of an elevated serum cholesterol level.Keywords: cholesterol, cardiovascular disease, statin therapy, coronary calcium
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