Search results for: post hoc explainer
1083 Mild Hypothermia Versus Normothermia in Patients Undergoing Cardiac Surgery: A Propensity Matched Analysis
Authors: Ramanish Ravishankar, Azar Hussain, Mahmoud Loubani, Mubarak Chaudhry
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Background and Aims: Currently, there are no strict guidelines in cardiopulmonary bypass temperature management in cardiac surgery not involving the aortic arch. This study aims to compare patient outcomes undergoing mild hypothermia and normothermia. The aim of this study was to compare patient outcomes between mild hypothermia and normothermia undergoing on-pump cardiac surgery not involving the aortic arch. Methods: This was a retrospective cohort study from January 2015 until May 2023. Patients who underwent cardiac surgery with cardiopulmonary bypass temperatures ≥32oC were included and stratified into mild hypothermia (32oC – 35oC) and normothermia (>35oC) cohorts. Propensity matching was applied through the nearest neighbour method (1:1) using the risk factors detailed in the EuroScore using RStudio. The primary outcome was mortality. Secondary outcomes included post-op stay, intensive care unit readmission, re-admission, stroke, and renal complications. Patients who had major aortic surgery and off-pump operations were excluded. Results: Each cohort had 1675 patients. There was a significant increase in overall mortality with the mild hypothermia cohort (3.59% vs. 2.32%; p=0.04912). There was also a greater stroke incidence (2.09% vs. 1.13%; p=0.0396) and transient ischaemic attack (TIA) risk (3.1% vs. 1.49%; p=0.0027). There was no significant difference in renal complications (9.13% vs. 7.88%; p=0.2155). Conclusions: Patient’s who underwent mild hypothermia during cardiopulmonary bypass have a significantly greater mortality, stroke, and transient ischaemic attack incidence. Mild hypothermia does not appear to provide any benefit over normothermia and does not appear to provide any neuroprotective benefits. This shows different results to that of other major studies; further trials and studies need to be conducted to reach a consensus.Keywords: cardiac surgery, therapeutic hypothermia, neuroprotection, cardiopulmonary bypass
Procedia PDF Downloads 651082 Technical Efficiency in Organic and Conventional Wheat Farms: Evidence from a Primary Survey from Two Districts of Ganga River Basin, India
Authors: S. P. Singh, Priya, Komal Sajwan
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With the increasing spread of organic farming in India, costs, returns, efficiency, and social and environmental sustainability of organic vis-a-vis conventional farming systems have become topics of interest among agriculture scientists, economists, and policy analysts. A study on technical efficiency estimation under these farming systems, particularly in the Ganga River Basin, where the promotion of organic farming is incentivized, can help to understand whether the inputs are utilized to their maximum possible level and what measures can be taken to improve the efficiency. This paper, therefore, analyses the technical efficiency of wheat farms operating under organic and conventional farming systems. The study is based on a primary survey of 600 farms (300 organic ad 300 conventional) conducted in 2021 in two districts located in the Middle Ganga River Basin, India. Technical, managerial, and scale efficiencies of individual farms are estimated by applying the data envelopment analysis (DEA) methodology. The per hectare value of wheat production is taken as an output variable, and values of seeds, human labour, machine cost, plant nutrients, farm yard manure (FYM), plant protection, and irrigation charges are considered input variables for estimating the farm-level efficiencies. The post-DEA analysis is conducted using the Tobit regression model to know the efficiency determining factors. The results show that technical efficiency is significantly higher in conventional than organic farming systems due to a higher gap in scale efficiency than managerial efficiency. Further, 9.8% conventional and only 1.0% organic farms are found operating at the most productive scale size (MPSS), and 99% organic and 81% conventional farms at IRS. Organic farms perform well in managerial efficiency, but their technical efficiency is lower than conventional farms, mainly due to their relatively lower scale size. The paper suggests that technical efficiency in organic wheat can be increased by upscaling the farm size by incentivizing group/collective farming in clusters.Keywords: organic, conventional, technical efficiency, determinants, DEA, Tobit regression
Procedia PDF Downloads 951081 Long-Term Results of Coronary Bifurcation Stenting with Drug Eluting Stents
Authors: Piotr Muzyk, Beata Morawiec, Mariusz Opara, Andrzej Tomasik, Brygida Przywara-Chowaniec, Wojciech Jachec, Ewa Nowalany-Kozielska, Damian Kawecki
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Background: Coronary bifurcation is one of the most complex lesion in patients with coronary ar-tery disease. Provisional T-stenting is currently one of the recommended techniques. The aim was to assess optimal methods of treatment in the era of drug-eluting stents (DES). Methods: The regis-try consisted of data from 1916 patients treated with coronary percutaneous interventions (PCI) using either first- or second-generation DES. Patients with bifurcation lesion entered the analysis. Major adverse cardiac and cardiovascular events (MACCE) were assessed at one year of follow-up and comprised of death, acute myocardial infarction (AMI), repeated PCI (re-PCI) of target ves-sel and stroke. Results: Of 1916 registry patients, 204 patients (11%) were diagnosed with bifurcation lesion >50% and entered the analysis. The most commonly used technique was provi-sional T-stenting (141 patients, 69%). Optimization with kissing-balloons technique was performed in 45 patients (22%). In 59 patients (29%) second-generation DES was implanted, while in 112 pa-tients (55%), first-generation DES was used. In 33 patients (16%) both types of DES were used. The procedure success rate (TIMI 3 flow) was achieved in 98% of patients. In one-year follow-up, there were 39 MACCE (19%) (9 deaths, 17 AMI, 16 re-PCI and 5 strokes). Provisional T-stenting resulted in similar rate of MACCE to other techniques (16% vs. 5%, p=0.27) and similar occurrence of re-PCI (6% vs. 2%, p=0.78). The results of post-PCI kissing-balloon technique gave equal out-comes with 3% vs. 16% of MACCE in patients in whom no optimization technique was used (p=0.39). The type of implanted DES (second- vs. first-generation) had no influence on MACCE (4% vs 14%, respectively, p=0.12) and re-PCI (1.7% vs. 51% patients, respectively, p=0.28). Con-clusions: The treatment of bifurcation lesions with PCI represent high-risk procedures with high rate of MACCE. Stenting technique, optimization of PCI and the generation of implanted stent should be personalized for each case to balance risk of the procedure. In this setting, the operator experience might be the factor of better outcome, which should be further investigated.Keywords: coronary bifurcation, drug eluting stents, long-term follow-up, percutaneous coronary interventions
Procedia PDF Downloads 1981080 Projects and Limits of Memory Engineering: A Case of Lithuanian Partisan War
Authors: Mingaile Jurkute, Vilnius University
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The memory of the Lithuanian partisan war (1944-1953) underwent extremely dramatic transformations. During this war, the image of the resistance and a partisan was one of the key elements of Lithuanian identity. Its importance is evidenced by the extremely large legacy of songs about partisans, no other topic has collected so much folklore in Lithuania. In the Soviet years, this resistance was practically forced to be forgotten. Terror and Soviet laws have forced people to stop talking about the events, even in the family circle. In addition, the Soviets created their own propaganda story, reinterpreting the Lithuanian partisan war, presenting partisans as bandits who brutally tortured and murdered locals. But even in the Soviet years, the memory could neither be completely suppressed, nor completely transformed into wishful shape. The analysis of fiction and cinema shows that the traumatic memory of real events rushed to the surface, thus transforming the very propagandistic narrative. After the restoration of the Republic of Lithuania in 1990, the Lithuanian partisan war was gradually returned to the central place of Lithuanian history. After 2014 the nationalist heroic narrative about Lithuanian partisans became the central narrative of modern Lithuanian history. Nevertheless, interviews I conducted in Lithuanian villages reveal that the memory of local communities and families preserves quite different experiences that do not fit into neither the Soviet narrative nor the heroic one. Such experiences include, for example, partisan violence against local families. This paper is about the efforts of two political ideologies (the Soviet and the Lithuanian patriotic) to use the history of the Lithuanian partisans for their own needs, and the attempts of small communities (mostly families) to resist these efforts. The research reveals that family memory, even when opposed to aggressive state memory policies, can preserve counter-narratives by exploiting unexpected objects beyond the control of the state, such as nature and wildlife. Basically, the paper analyses the limits of the instrumentalization of memory, even by extremely aggressive political regimes.Keywords: collective memory, post-memory, violence, military conflict, family memory
Procedia PDF Downloads 891079 Development of an Experiment for Impedance Measurement of Structured Sandwich Sheet Metals by Using a Full Factorial Multi-Stage Approach
Authors: Florian Vincent Haase, Adrian Dierl, Anna Henke, Ralf Woll, Ennes Sarradj
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Structured sheet metals and structured sandwich sheet metals are three-dimensional, lightweight structures with increased stiffness which are used in the automotive industry. The impedance, a figure of resistance of a structure to vibrations, will be determined regarding plain sheets, structured sheets, and structured sandwich sheets. The aim of this paper is generating an experimental design in order to minimize costs and duration of experiments. The design of experiments will be used to reduce the large number of single tests required for the determination of correlation between the impedance and its influencing factors. Full and fractional factorials are applied in order to systematize and plan the experiments. Their major advantages are high quality results given the relatively small number of trials and their ability to determine the most important influencing factors including their specific interactions. The developed full factorial experimental design for the study of plain sheets includes three factor levels. In contrast to the study of plain sheets, the respective impedance analysis used on structured sheets and structured sandwich sheets should be split into three phases. The first phase consists of preliminary tests which identify relevant factor levels. These factor levels are subsequently employed in main tests, which have the objective of identifying complex relationships between the parameters and the reference variable. Possible post-tests can follow up in case additional study of factor levels or other factors are necessary. By using full and fractional factorial experimental designs, the required number of tests is reduced by half. In the context of this paper, the benefits from the application of design for experiments are presented. Furthermore, a multistage approach is shown to take into account unrealizable factor combinations and minimize experiments.Keywords: structured sheet metals, structured sandwich sheet metals, impedance measurement, design of experiment
Procedia PDF Downloads 3701078 Development of Power System Stability by Reactive Power Planning in Wind Power Plant With Doubley Fed Induction Generators Generator
Authors: Mohammad Hossein Mohammadi Sanjani, Ashknaz Oraee, Oriol Gomis Bellmunt, Vinicius Albernaz Lacerda Freitas
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The use of distributed and renewable sources in power systems has grown significantly, recently. One the most popular sources are wind farms which have grown massively. However, ¬wind farms are connected to the grid, this can cause problems such as reduced voltage stability, frequency fluctuations and reduced dynamic stability. Variable speed generators (asynchronous) are used due to the uncontrollability of wind speed specially Doubley Fed Induction Generators (DFIG). The most important disadvantage of DFIGs is its sensitivity to voltage drop. In the case of faults, a large volume of reactive power is induced therefore, use of FACTS devices such as SVC and STATCOM are suitable for improving system output performance. They increase the capacity of lines and also passes network fault conditions. In this paper, in addition to modeling the reactive power control system in a DFIG with converter, FACTS devices have been used in a DFIG wind turbine to improve the stability of the power system containing two synchronous sources. In the following paper, recent optimal control systems have been designed to minimize fluctuations caused by system disturbances, for FACTS devices employed. For this purpose, a suitable method for the selection of nine parameters for MPSH-phase-post-phase compensators of reactive power compensators is proposed. The design algorithm is formulated ¬¬as an optimization problem searching for optimal parameters in the controller. Simulation results show that the proposed controller Improves the stability of the network and the fluctuations are at desired speed.Keywords: renewable energy sources, optimization wind power plant, stability, reactive power compensator, double-feed induction generator, optimal control, genetic algorithm
Procedia PDF Downloads 821077 Effects of Aerobic Dance Circuit Training Programme on Blood Pressure Variables of Obese Female College Students in Oyo State, Nigeria
Authors: Isiaka Oladele Oladipo, Olusegun Adewale Ajayi
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The blood pressure fitness of female college students has been implicated in sedentary lifestyles. This study was designed to determine the effects of the Aerobic Dance Circuit Training Programme (ADCT) on blood pressure variables (Diastolic Blood Pressure (DBP) and Systolic Blood Pressure (SBP). Participants’ Pretest-Posttest control group quasi-experimental design using a 2x2x4 factorial matrix was adopted, while one (1) research question and two (2) research hypotheses were formulated. Seventy (70) untrained obese students-volunteers age 21.10±2.46 years were purposively selected from Oyo town, Nigeria; Emmanuel Alayande College of Education (experimental group and Federal College of Education (special) control group. The participants’ BMI, weight (kg), height (m), systolic bp(mmHg), and diastolic bp (mmHg) were measured before and completion of ADCT. Data collected were analysed using a pie chart, graph, percentage, mean, frequency, and standard deviation, while a t-test was used to analyse the stated hypotheses set at the critical level of 0.05. There were significant mean differences in baseline and post-treatment values of blood pressure variables in terms of SBP among the experimental group 136.49mmHg and 131.66mmHg; control group 130.82mmHg and 130.56mmHg (crit-t=2.00, cal.t=3.02, df=69, p<.0, the hypothesis was rejected; while DBP experimental group 88.65mmHg and 82.21mmHg; control group 69.91mmHg and 72.66mmHg (crit-t=2.00, cal.t=1.437, df=69, p>.05) in which the hypothesis was accepted). It was revealed from the findings that participants’ SBP decrease from week 4 to week 12 of ADCT indicated an effective reduction in blood pressure variables of obese female students. Therefore, the study confirmed that the use of ADCT is safe and effective in the management of blood pressure for the healthy benefit of obesity.Keywords: aerobic dance circuit training, fitness lifestyles, obese college female students, systolic blood pressure, diastolic blood pressure
Procedia PDF Downloads 671076 Pupil Size: A Measure of Identification Memory in Target Present Lineups
Authors: Camilla Elphick, Graham Hole, Samuel Hutton, Graham Pike
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Pupil size has been found to change irrespective of luminosity, suggesting that it can be used to make inferences about cognitive processes, such as cognitive load. To see whether identifying a target requires a different cognitive load to rejecting distractors, the effect of viewing a target (compared with viewing distractors) on pupil size was investigated using a sequential video lineup procedure with two lineup sessions. Forty one participants were chosen randomly via the university. Pupil sizes were recorded when viewing pre target distractors and post target distractors and compared to pupil size when viewing the target. Overall, pupil size was significantly larger when viewing the target compared with viewing distractors. In the first session, pupil size changes were significantly different between participants who identified the target (Hits) and those who did not. Specifically, the pupil size of Hits reduced significantly after viewing the target (by 26%), suggesting that cognitive load reduced following identification. The pupil sizes of Misses (who made no identification) and False Alarms (who misidentified a distractor) did not reduce, suggesting that the cognitive load remained high in participants who failed to make the correct identification. In the second session, pupil sizes were smaller overall, suggesting that cognitive load was smaller in this session, and there was no significant difference between Hits, Misses and False Alarms. Furthermore, while the frequency of Hits increased, so did False Alarms. These two findings suggest that the benefits of including a second session remain uncertain, as the second session neither provided greater accuracy nor a reliable way to measure it. It is concluded that pupil size is a measure of face recognition strength in the first session of a target present lineup procedure. However, it is still not known whether cognitive load is an adequate explanation for this, or whether cognitive engagement might describe the effect more appropriately. If cognitive load and cognitive engagement can be teased apart with further investigation, this would have positive implications for understanding eyewitness identification. Nevertheless, this research has the potential to provide a tool for improving the reliability of lineup procedures.Keywords: cognitive load, eyewitness identification, face recognition, pupillometry
Procedia PDF Downloads 4001075 Nutritional Impact in Patients Who Underwent Sleeve-Type Bariatric Surgery
Authors: Melissa Mattos, Camila Lima, Ibraim Castro, Augusto Carioca, Saulo Magalhães, Paula Freitas, Keciany Oliveira
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Obesity is a chronic, multifactorial, relapsing disease that has increased dramatically over the years. Its control is considered a public health issue, and more and more treatments and interventions are being studied to reduce its prevalence. When interventions in lifestyle and the use of drugs do not generate lasting results, bariatric procedures emerge as a resource for obesity control. The main guidelines for the treatment of obesity emphasize the need for pre-procedure and post-procedure nutritional monitoring to avoid nutritional deficiencies that may occur. The individual who undergoes bariatric surgery needs to understand the changes that will be necessary for life in view of the intense anatomical and metabolic changes that result from surgical techniques. To assess the nutritional profile of patients who undergo bariatric surgery, we analyzed data from the medical records of all people who underwent sleeve-type bariatric surgery from January to June 2022 at a clinic in the City of Fortaleza. 38 patients were analyzed, 32 women and 6 men in the pre-surgical period, 6 and 12 months after surgery. The data showed an average weight loss of 24.45% at 6 months and 30.85% at 12 months, with a reduction of 21.32% and 30.41%, respectively, in the fat percentage, also indicating that 13.15% used drugs for weight loss during this period, leading to reflection on the isolated long-term efficacy of bariatric surgery, requiring multidisciplinary follow-up for a change in lifestyle. Only 12 individuals, corresponding to 31.57%, reached eutrophic BMI 12 months after surgery, 20 individuals remained overweight, corresponding to 52.63% of the sample, and 6 individuals (15.78%) remained in the BMI obese class I. As for body composition, there was a 52.39% reduction in fat mass and a 12.82% reduction in muscle mass, and 21% of individuals underwent cholecystectomy. Sleeve-type bariatric surgery promoted significant weight loss after 1 year of the procedure, with a reduction in body fat percentage and fat mass. Most patients were still overweight and had a significant reduction in muscle mass.Keywords: bariatric surgery, sleeve gastrectomy, obesity, sleeve
Procedia PDF Downloads 621074 Chemical Composition and Antifungal Activity of Selected Essential Oils against Toxigenic Fungi Associated with Maize (Zea mays L.)
Authors: Birhane Atnafu, Chemeda Abedeta Garbaba, Fikre Lemessa, Abdi Mohammed, Alemayehu Chala
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Essential oil is a bio-pesticide plant product used as an alternative to pesticides in managing plant pests, including fungal pathogens. Thus, the current study aims to investigate the chemical composition and antifungal activities of essential oils (EO) extracted from three aromatic plants i.e., Thymus vulgaris, Coriandrum sativum, and Cymbopogon martini. The leaf parts of those selected plants were collected from the Jimma area and their essential oil was extracted by hydro-distillation method in a Clevenger apparatus. The chemical composition of selected plant essential oil was analyzed by using Gas chromatography-mass spectrometry (GC/MS) and their inhibitory effects were tested in vitro on toxigenic fungi isolated from maize kernel. Chemical analysis results revealed the presence of 32 compounds in C. sativum with Hexanedioic acid, bis (2-ethylhexyl) ester (46. 9%), 2-Decenal, (E)- (12.6), and linalool (8.3%) being the dominant ones. T. vulgaris essential oils constituted 25 compounds, of which thymol (34.4%), o-cymene (17.5%), and Gamma-Terpinene (16.8%) were the major components. Twenty-five compounds were detected in C. martinii of which geraniol (51.4%), Geranyl acetate (14.5%), and Trans – ß-Ocimene (11.7%) were dominant. The EOs of the tested plants had very high antifungal activity (up to 100% efficacy) against Aspergillus flavus, Aspergillus niger, Fusarium graminearum and Fusarium verticillioides in vitro and on maize grains. The antifungal activities of these essential oils were dependent on the major components such as thymol, hexanedioic acid, bis (2-ethylhexyl) ester, and geraniol. The study affirmed the potential of these essential oils controlling as bio-fungicides to manage the effects of potentially toxigenic fungi associated with maize under post-harvest stages. This can reduce the consequences of the health impacts of the mold and toxigenic compounds produced in maize.Keywords: bio-activity, bio-pesticides, maize, mycotoxin
Procedia PDF Downloads 631073 Tomato Endophytes Trichoderma asperellum AAUTLF and Stenotrophomonas maltophilia D1B Exhibits Plant Growth-Promotion and Fusarium Wilt Suppression
Authors: Bandana Saikia, Ashok Bhattacharyya
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Endophytic microbes and their metabolites positively impact overall plant health, which may have a potential implication in agriculture. In the present study, 177 bacterial endophytes and 57 fungal endophytes were isolated, with the highest recovery rate from tomato roots. A maximum of 112 endophytes were isolated during monsoon, followed by 64 isolates and 58 isolates isolated during pre-monsoon and post-monsoon periods, respectively, indicating the rich diversity in bacterial and fungal endophytes of tomato crops from different locations of Assam, India. Further, the endophytes were evaluated for their antagonistic potential against Fusarium oxysporum f. sp. lycopersici. Fungal endophytic isolate AAUTLF (Endophytic Fungi of Tomato Leaf from Assam Agricultural University, Assam, India area) and bacterial endophyte D1B (Endophytic bacteria of tomato from Dhemiji, India district) showed the highest antifungal activity against the pathogen both in vitro and in vivo. Based on 5.8 rDNA sequence analysis of fungal and 16S rDNA sequence of bacteria endophytes, the most effective fungal and bacterial isolates against FOL were identified as Trichoderma asperellum AAUTLF and Stenotrophomonas maltophilia D1B, respectively. The isolates showed an antagonistic effect against Fusarium oxysporum f.sp. lycopersici in-vitro and reduced the disease index of Fusarium wilt in tomatoes by 64.4% under pot conditions. Trichoderma asperellum AAUTLF produced an antifungal compound viz., 6-pentyl-2H-pyran-2-one, which also possesses growth-promoting characteristics. The bacteria Stenotrophomonas maltophilia D1B produced antifungal compounds, including benzothiazole, oleic acid, phenylacetic acid, and 3-(Hydroxy-phenyl-methyl)-2,3-dimethyl-octan-4-one. This would be of high importance for the source of antagonistic strains and biocontrol of tomato Fusarium wilt, as well as other plant fungal diseases.Keywords: root endophytes, Stemotrophomonas, Trichoderma, benzothiazole, 6-pentyl-2H-pyran-2-one
Procedia PDF Downloads 651072 Predictor Factors in Predictive Model of Soccer Talent Identification among Male Players Aged 14 to 17 Years
Authors: Muhamad Hafiz Ismail, Ahmad H., Nelfianty M. R.
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The longitudinal study is conducted to identify predictive factors of soccer talent among male players aged 14 to 17 years. Convenience sampling involving elite respondents (n=20) and sub-elite respondents (n=20) male soccer players. Descriptive statistics were reported as frequencies and percentages. The inferential statistical analysis is used to report the status of reliability, independent samples t-test, paired samples t-test, and multiple regression analysis. Generally, there are differences in mean of height, muscular strength, muscular endurance, cardiovascular endurance, task orientation, cognitive anxiety, self-confidence, juggling skills, short pass skills, long pass skills, dribbling skills, and shooting skills for 20 elite players and sub-elite players. Accordingly, there was a significant difference between pre and post-test for thirteen variables of height, weight, fat percentage, muscle strength, muscle endurance, cardiovascular endurance, flexibility, BMI, task orientation, juggling skills, short pass skills, a long pass skills, and dribbling skills. Based on the first predictive factors (physical), second predictive factors (fitness), third predictive factors (psychological), and fourth predictive factors (skills in playing football) pledged to the soccer talent; four multiple regression models were produced. The first predictive factor (physical) contributed 53.5 percent, supported by height and percentage of fat in soccer talents. The second predictive factor (fitness) contributed 63.2 percent and the third predictive factors (psychology) contributed 66.4 percent of soccer talent. The fourth predictive factors (skills) contributed 59.0 percent of soccer talent. The four multiple regression models could be used as a guide for talent scouting for soccer players of the future.Keywords: soccer talent identification, fitness and physical test, soccer skills test, psychological test
Procedia PDF Downloads 1501071 Improving Quality of Family Planning Services in Pakistan
Authors: Mohammad Zakir, Saamia Shams
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Background: Provision of quality family planning services remarkably contribute towards increased uptake of modern contraceptive methods and have important implications on reducing fertility rates. The quality of care in family planning has beneficial impact on reproductive health of women, yet little empirical evidence is present to show the relationship between the impact of adequate training of Community Mid Wives (CMW) and quality family planning services. Aim: This study aimed to enhance the knowledge and counseling skills of CMWs in improving the access to quality client-centered family planning services in Pakistan. Methodology: A quasi-experimental longitudinal study using Initial Quality Assurance Scores-Training-Post Training Quality Assurance Scores design with a non- equivalent control group was adopted to compare a set of experimental CMWs that received four days training package including Family Planning Methods, Counselling, Communication skills and Practical training on IUCD insertion with a set of comparison CMWs that did not receive any intervention. A sample size of 100 CMW from Suraj Social Franchise (SSF) private providers was recruited from both urban and rural Pakistan. Results: Significant improvement in the family planning knowledge and counseling skills (p< 0.001) of the CMWs was evident in the experimental group as compared to comparison group with p > 0.05. Non- significant association between pre-test level family planning knowledge and counseling skills was observed in both the groups (p>0.05). Conclusion: The findings demonstrate that adequate training is an important determinant of quality of family planning services received by clients. Provider level training increases the likelihood of contraceptives uptake and decreases the likelihood of both unintended and unwanted pregnancies. Enhancing quality of family planning services may significantly help reduce the fertility and improve the reproductive health indicators of women in Pakistan.Keywords: community mid wives, family planning services, quality of care, training
Procedia PDF Downloads 3341070 Effect of Smartphone Applications on Patients' Knowledge of Surgery-Related Adverse Events during Hospitalization
Authors: Eunjoo Lee
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Background: As the number of surgeries increases, the incidence of adverse events is likely to become more prevalent. Patients who are somewhat knowledgeable about surgery-related adverse events are more likely to engage in safety initiatives to prevent them. Objectives: To evaluate the impact of a smartphone application developed during the study to enhance patients’ knowledge of surgery-related adverse events during hospitalization. Design: Non-randomized, one group, measured pre- and post-intervention. Participants: Thirty-six hospitalized patients admitted to the orthopedics unit of a general hospital in South Korea. Methods. First, a smartphone application to enhance patients’ knowledge of surgery-related adverse events was developed through an iterative process, which included a literature review, expert consultation, and pilot testing. The application was installed on participants’ smartphones, and research assistants taught the participants to use it. Twenty-five true/false questions were used to assess patients’ knowledge of preoperative precautions (eight items), surgical site infection (five items), Foley catheter management (four items), drainage management (four items), and anesthesia-related complications (four items). Results: Overall, the percentage of correct answers increased significantly, from 57.02% to 73.82%, although answers related to a few specific topics did not increase that much. Although the patients’ understanding of drainage management and the Foley catheter did increase substantially after they used the smartphone application, it was still relatively low. Conclusions: The smartphone application developed during this study enhanced the patients’ knowledge of surgery-related adverse events during hospitalization. However, nurses must make an additional effort to help patients to understand certain topics, including drainage and Foley catheter management. Relevance to clinical practice: Insufficient patient knowledge increases the risk of adverse events during hospitalization. Nurses should take active steps to enhance patients’ knowledge of a range of safety issues during hospitalization, in order to decrease the number of surgery-related adverse events.Keywords: patient education, patient participation, patient safety, smartphone application, surgical errors
Procedia PDF Downloads 2411069 Levels of CTX1 in Premenopausal Osteoporotic Women Study Conducted in Khyberpuktoonkhwa Province, Pakistan
Authors: Mehwish Durrani, Rubina Nazli, Muhammad Abubakr, Muhammad Shafiq
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Objectives: To evaluate the high socio-economic status, urbanization, and decrease ambulation can lead to early osteoporosis in women reporting from Peshawar region. Study Design: Descriptive cross-sectional study was done. Sample size was 100 subjects, using 30% proportion of osteoporosis, 95% confidence level, and 9% margin of error under WHO software for sample size determination. Place and Duration of study: This study was carried out in the tertiary referral health care facilities of Peshawar viz PGMI Hayatabad Medical Complex, Peshawar, Khyber Pakhtunkhwa Province, Pakistan. Ethical approval for the study was taken from the Institutional Ethical Research board (IERD) at Post Graduate Medical Institute, Hayatabad Medical Complex, and Peshawar.The study was done in six months time period. Patients and Methods: Levels of CTX1 as a marker of bone degradation in radiographically assessed perimenopausal women was determined. These females were randomly selected and screened for osteoporosis. Hemoglobin in gm/dl, ESR by Westergren method as millimeter in 1 hour, Serum Ca mg/dl, Serum alkaline Phosphatase international units per liter radiographic grade of osteoporosis according to Singh index as 1-6 and CTX 1 level in pg/ml. Results: High levels of CTX1 was observed in perimenopausal osteoporotic women which were radiographically diagnosed as osteoporotic patients. The High socio-economic class also predispose to osteoporosis. Decrease ambulation another risk factor showed significant association with the increased levels of CTX1. Conclusion: The results of this study propose that minimum ambulation and high socioeconomic class both had significance association with the increase levels of serum CTX1, which in turn will lead to osteoporosis and to its complications.Keywords: osteoporosis, CTX1, perimenopausal women, Hayatabad Medical Complex, Khyberpuktoonkhwa
Procedia PDF Downloads 3281068 Real-World Economic Burden of Musculoskeletal Disorders in Nigeria
Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole
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Musculoskeletal disorders (MSDs) such as low back pain (LBP), cervical spondylosis (CSPD), sprain, osteoarthritis (OA), and post immobilization stiffness (PIS) have a major impact on individuals, health systems and society in terms of morbidity, long-term disability, and economics. This study estimated the direct and indirect costs of common MSDs in Osun State, Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out. The occupational class of the patients was determined using the International Labour Classification (ILO). The direct and indirect costs were estimated using a cost-of-illness approach. Physiotherapy related health resource use, and costs of the common MSDs, including consultation fee, total fee charge per session, costs of consumables were estimated. Data were summarised using descriptive statistics mean and standard deviation (SD). Overall, 1582 (Male = 47.5%, Female = 52.5%) patients with MSDs population with a mean age of 47.8 ± 25.7 years participated in this study. The mean (SD) direct costs estimate for LBP, CSPD, PIS, sprain, OA, and other conditions were $18.35 ($17.33), $34.76 ($17.33), $32.13 ($28.37), $35.14 ($44.16), $37.19 ($41.68), and $15.74 ($13.96), respectively. The mean (SD) indirect costs estimate of LBP, CSPD, PIS, sprain, OA, and other MSD conditions were $73.42 ($43.54), $140.57 ($69.31), $128.52 ($113.46), sprain $140.57 ($69.31), $148.77 ($166.71), and $62.98 ($55.84), respectively. Musculoskeletal disorders contribute a substantial economic burden to individuals with the condition and society. The unacceptable economic loss of MSDs should be reduced using appropriate strategies. Further research is required to determine the clinical and cost effectiveness of strategies to improve health outcomes of patients with MSDs. The findings of the present study may assist health policy and decision makers to understand the economic burden of MSDs and facilitate efficient allocation of healthcare resources to alleviate the burden associated with these conditions in Nigeria.Keywords: economic burden, low back pain, musculoskeletal disorders, real-world
Procedia PDF Downloads 2141067 Implementation of Enhanced Recovery after Surgery (ERAS) Protocols in Laparoscopic Sleeve Gastrectomy (LSG); A Systematic Review and Meta-analysis
Authors: Misbah Nizamani, Saira Malik
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Introduction: Bariatric surgery is the most effective treatment for patients suffering from morbid obesity. Laparoscopic sleeve gastrectomy (LSG) accounts for over 50% of total bariatric procedures. The aim of our meta-analysis is to investigate the effectiveness and safety of Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing laparoscopic sleeve gastrectomy. Method: To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials and cohort studies involving adult patients (≥18 years) undergoing bariatric surgeries, i.e., Laparoscopic sleeve gastrectomy. Outcome measures included LOS, postoperative narcotic usage, postoperative pain score, postoperative nausea and vomiting, postoperative complications and mortality, emergency department visits and readmission rates. RevMan version 5.4 was used to analyze outcomes. Results: Three RCTs and three cohorts with 1522 patients were included in this study. ERAS group and control group were compared for eight outcomes. LOS was reduced significantly in the intervention group (p=0.00001), readmission rates had borderline differences (p=0.35) and higher postoperative complications in the control group, but the result was non-significant (p=0.68), whereas postoperative pain score was significantly reduced (p=0.005). Total MME requirements became significant after performing sensitivity analysis (p= 0.0004). Postoperative mortality could not be analyzed on account of invalid data showing 0% mortality in two cohort studies. Conclusion: This systemic review indicated the effectiveness of the application of ERAS protocols in LSG in reducing the length of stay, post-operative pain and total MME requirements postoperatively, indicating the feasibility and assurance of its application.Keywords: eras protocol, sleeve gastrectomy, bariatric surgery, enhanced recovery after surgery
Procedia PDF Downloads 341066 Promotion of a Healthy City by Medical Plants
Authors: Ana M. G. Sperandio, Adriana A. C. Rosa, Jussara C. Guarnieri
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This study consists of a research of the Post Occupancy Assessment (POA) of Medicinal Gardens' project of Urban Social Center’s square, in the city of 'Santa Barbara d'Oeste', located in the interior of Sao Paulo, Brazil. In view of the fact that community gardens, as well as medicinal gardens, are based on innumerable functions. The addition to the pedagogical function rescues people from their origins through (re)contact with the land, as a vehicle for social integration. Bearing in mind the project has the potential to fight hunger among the low-income population, to treat some diseases, also works as a strategy of environmental recovery especially of idle land. Such as very often only accumulate weeds and garbage, and therefore, must be considered in the Municipal Master Plan for the activity to be regulated. Objective: Identify on implantation the medicinal plants' value and principles for the promotion of a healthy city. Methodology: Application of the walkthrough, where it is possible to affirm that this instrument has three routes: one officer applied within the urban social center and two complementary ones, one being about 3 miles and the other being almost 5,5 miles. Results: Through a dialogical course, one can observe the benefits that the community medicinal gardens bring to the local population. In addition, it is consistent with the proposal for the community to be enabled to access collective care with home orientations that rescue the local and regional culture making the physical environment. This project aims at promoting more pleasant and inclusive through the actions of the caregiver, local leadership and the co-participation of local government. Although with the aim of increasing the supply value and improving the living conditions of social groups and interrelationship. Conclusion: This type of urban intervention, which articulates social participation, rescue of medicinal cultures and local knowledge, intersectoriality, social inclusion, among other premises connected with health promotion, and the city presents a potential for reverberation of practices in social networks with the objective of meeting the healthy city strategies.Keywords: healthy city, healthy urban planning, medicinal gardens, social participation
Procedia PDF Downloads 1371065 The Post-Crisis Expansion of European Central Bank Powers: Understanding the Legitimate Boundaries of the ECB's Supervisory Independence and Accountability
Authors: Jakub Gren
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The recent transfer of banking supervision to the ECB has expanded its influence as of a non-majoritarian and technocratic policy-shaper in EU supervisory policies. To fulfil the main policy objectives of the Single Supervisory Mechanism, the ECB has been tasked with building a single supervisory approach to supervised banks across the euro area and is now exclusively responsible for direct supervision of the largest ‘significant’ euro area banks and the oversight of the remaining ‘less significant’ banks. This enhanced supranational position of the ECB significantly alters the EU institutional order and creates powerful incentives to actively pursue integrationist agenda by the ECB. However, this drastic shift has a little impact upon adapting the ECB’s new supervisory mandate to the requirements of democratic legitimacy. Whereas the ECB’s strong pre-crisis independence and limited accountability could be reconciled with democratic principles through a clearly articulated price stability mandate, independence and limited accountability in the context of a more complex supervisory mandate is problematic. Hence, in order to ensure the democratic legitimacy of the ECB/SSM’s supervisory policies, the ECB’s supervisory mandate requires both a lower scope of independence and higher accountability requirements. To address this situation, organizational separation (“Chinese Wall”) between the ECB monetary and supervisory arms was introduced. This separation includes different reporting lines and the relocation of the ECB’s monetary function to a new building complex while leaving its supervisory function at the Euro-tower (“Two Towers”). This paper argues that these measures are not sufficient to establish proper checks and balances on the ECB’s powers to pursue euro zone’s wide supervisory policies. As a remedy, this contribution suggests that the ECB’s Treaties-embedded independence, as set out by art. 130 TFEU, designed to carry out its monetary function shall not be fully applicable to its supervisory function. Indeed functional and conditional reading of this provision to ECB supervisory function could enhance the legitimacy of future ECB’s supervisory action.Keywords: accountability and transparency, democratic governance, financial management, rule of law
Procedia PDF Downloads 1991064 Transorbital Craniectomy for Treatment of Frontal Lobe and Olfactory Bulb Neoplasia in Two Canids
Authors: Kathryn L. Duncan, Charles A. Kuntz, James O. Simcock
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A surgical approach to the cranium for treatment of frontal lobe and olfactory bulb neoplasia in dogs is described in this report, which provided excellent access for visualisation and removal of gross neoplastic tissue. An 8-year-old spayed female Shih Tzu crossbreed dog (dog 1) and a 13-year-old neutered male Miniature Fox Terrier (dog 2) were evaluated for removal of neoplasms involving both the frontal lobe and olfactory bulb. Both dogs presented with abnormal neurological clinical signs, decreased menace responses, and behavioural changes. Additionally, dog 2 presented with compulsive circling and generalized tonic-clonic seizure activity. Computed tomography was performed in both dogs, and MRI was also performed in dog 1. Imaging was consistent with frontal lobe and olfactory bulb neoplasia. A transorbital frontal bone craniectomy, with orbital ligament desmotomy and ventrolateral retraction of the globe, was performed in both cases without complication. Dog 1 had a focal area of lysis in the frontal bone adjacent to the neoplasm in the frontal lobe. The presence of the bone defect provided part of the impetus for this approach, as it would permit resection of the lytic bone. In addition, the neoplasms would be surgically accessible without encountering interposed brain parenchyma, reducing the risk of iatrogenic injury. Both dogs were discharged from the hospital within 72 hours post-operatively, both with normal mentation. Case 1 had a histopathologic diagnosis of malignant anaplastic neoplasm. The tumour recurred 101d postoperatively, and the patient was euthanized. Case 2 was diagnosed with a meningioma and was neurologically normal at 294d postoperatively. This transorbital surgical approach allowed successful removal of the intracranial frontal lobe and olfactory bulb neoplasms in 2 dogs. This approach should be considered for dogs with lateralized frontal lobe and olfactory bulb neoplasms that are closely associated with the suborbital region of the frontal bone.Keywords: neurosurgery, small animal surgery, surgical oncology, veterinary neurology
Procedia PDF Downloads 1461063 Assessing the Correlation between Environmental Awareness and Variability of Employees’ Positions in Aviation and Aerospace Industries
Authors: Eva Maleviti, Evan Stamoulis
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This paper is part of a wider research project, on environmental management in aviation and aerospace industries. The core elements of this research are the level of knowledge, awareness, applicability of environmental management systems, according to employees’ perspectives. This paper focuses at employees’ level of environmental awareness. The main scope of this research is to evaluate the level of environmental awareness and the adoption of environmental management practices. The primary scope of the research is to define a method to quantify the key indicators that would improve the implementation of environmental management. The opinion of people employed in aviation industry is considered, based on the versatility of their working positions. Up to this stage, 330 respondents have participated globally in the current research. This study uses a questionnaire survey to gain an understanding of the views and attitudes of aerospace staff toward environmental management. The results are analyzed through a quantitative approach using SPSS. The statistical significance shows that the data could follow the same distribution as the distribution of the total population that the sample belongs. As of the above, the number of respondents constitutes a representative sample of the total population. A descriptive analysis is presented. According to the responses given in the survey, the data are analyzed according to the working positions and the characteristics of each position that all the respondents hold. The results demonstrate that the level of environmental awareness is immediately linked with the employees’ positions. Managerial/post holder positions, as expected have, a higher level of environmental awareness. However, the level of applicability of environmental practices by the same group is considered low. The other working groups show variability in environmental awareness, which also depends on their operating task and the applicability or not of environmental practices. Flight operations and engineering/maintenance employees, that their tasks involve higher safety considerations, there are more reluctant in applying environmental practices in their positions. In the current paper an analysis of the data collection is presented, correlating them with the working positions and responsibilities of respondents.Keywords: environmental awareness, environmental management, sustainability, sustainable aviation
Procedia PDF Downloads 4501062 Performance Management in Higher Education: Lessons from Germany's New Public Management System
Authors: Patrick Oehler, Nicholas Folger
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Following a new public management approach, Germany has widely reformed its higher education system around the turn of the millennium. Aimed at preparing the country’s publicly funded universities and applied science colleges for a century of glory, the reforms led to the introduction of rigid performance measurement and management practices, which disrupted the inert system on all levels. Yet, many of the new policies met significant resistance, and some of them had to be reversed over time. Ever since Germany has struggled to find a balance between its pre- and its post-millennial approach to performance measurement and management. This contribution combines insights of a joint research project, which was created and funded by the German Federal Ministry of Education and Research with the aim to better understand the effects of its performance measurement and management policies, including those the ministry had implemented over the previous decades. The research project combines researchers from 17 German research institutions who employed a wide range of theories from various disciplines and very diverse research methods to explain performance measurement and management and their consequences on the behavior of various stakeholders in higher education systems. In these projects, performance measurement and management have been researched from three angles—education, research, and third mission. The collaborative project differentiated functional and dysfunctional elements of common performance measurement and management practices, and identified key problems with these practices, such as (1) oversimplification of performance indicators, (2) ‘overmeasurement’ of performance in general, (3) excessive use of quantitative indicators, and (4), a myopic focus on research-focused indicators and a negligence of measures targeting education and third mission. To address these issues, the collaborative project developed alternative approaches to performance measurement and management, including suggestions for qualitative performance measures, improved supervision, review, and evaluations methods, and recommendations how to better balance education, research, and third mission. The authors would like to share the rich findings of the joint research project with an international audience and discuss their implications for alternative higher education systems.Keywords: performance measurement, performance management, new public management, performance evaluation
Procedia PDF Downloads 2641061 The Moderating Role of Perceived University Environment in the Formation of Entrepreneurial Intention among Creative Industries Students
Authors: Patrick Ebong Ebewo
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The trend of high unemployment levels globally is a growing concern, which suggests that university students especially those studying the creative industries are most likely to face unemployment upon completion of their studies. Therefore the effort of university in fostering entrepreneurial knowledge is equally important to the development of student’s soft skill. The purpose of this paper is to assess the significance of perceived university environment and perceived educational support that influencing University students’ intention in starting their own business in the future. Thus, attempting to answer the question 'How does perceived university environment affect students’ attitude towards entrepreneurship as a career option, perceived entrepreneurial abilities, subjective norm and entrepreneurial intentions?' The study is based on the Theory of Planned Behaviour model adapted from previous studies and empirically tested on graduates at the Tshwane University of Technology. A sample of 150 graduates from the Arts and Design graduates took part in the study and data collected were analysed using structural equation modelling (SEM). Our findings seem to suggest the indirect impact of perceived university environment on entrepreneurial intention through perceived environment support and perceived entrepreneurial abilities. Thus, any increase in perceived university environment might influence students to become entrepreneurs. Based on these results, it is recommended that: (a) Tshwane University of Technology and other universities of technology should establish an ‘Entrepreneurship Internship Programme’ as a tool for stimulated work integrated learning. Post-graduation intervention could be implemented by the development of a ‘Graduate Entrepreneurship Program’ which should be embedded in the Bachelor of Technology (B-Tech now Advance Diploma) and Postgraduate courses; (b) Policymakers should consider the development of a coherent national policy framework that addresses entrepreneurship for the Arts/creative industries sector. This would create the enabling environment for the evolution of Higher Education Institutions from merely Teaching, Learning & Research to becoming drivers for creative entrepreneurship.Keywords: business venture, entrepreneurship education, entrepreneurial intent, university environment
Procedia PDF Downloads 3281060 The Effectiveness of a School-Based Addiction Prevention Program: Pilot Evaluation of Rajasthan Addiction Prevention Project
Authors: Sadhana Sharma, Neha Sharma, Hardik Khandelwal, Arti Sharma
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Background: It is widely acknowledged globally that parents must advocate for their children's drug and substance abuse prevention. However, many parents find it difficult to advocate due to systemic and logistical barriers. Alternatives to introducing advocacy, awareness, and support for the prevention of drug and substance abuse to children could occur in schools. However, little research has been conducted on the development of advocates for substance abuse in school settings. Objective: to evaluate the effectiveness of a school-based addiction prevention and control created as part of the Rajasthan Addiction Prevention Project (a partnership between state-community initiative). Methods: We conducted an evaluation in this study to determine the impact of a RAPP on a primary outcome (substance abuse knowledge) and other outcomes (family–school partnership, empowerment, and support). Specifically, between September-December 2022, two schools participated in the intervention group (advocacy training), and two schools participated in the control group (waiting list). The RAPP designed specialised 2-hrs training to equip teachers-parents with the knowledge and skills necessary to advocate for their own children and those of other families. All participants were required to complete a pre- and post-survey. Results: The intervention group established school advocates in schools where trained parents volunteered to lead support groups for high-risk children. Compared to the participants in the wait list control group, those in the intervention group demonstrated greater education knowledge, P = 0.002, and self-mastery, P = 0.04, and decreased family–school partnership quality, P = 0.002.Conclusions: The experimental evaluation of school-based advocacy programme revealed positive effects on substance abuse that persist over time. The approach wa s deemed feasible and acceptable by both parents and the school.Keywords: prevention, school based, addiction, advocacy
Procedia PDF Downloads 871059 The Impacts of an Adapted Literature Circle Model on Reading Comprehension, Engagement, and Cooperation in an EFL Reading Course
Authors: Tiantian Feng
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There is a dearth of research on the literary circle as a teaching strategy in English as a Foreign Language (EFL) classes in Chinese colleges and universities and even fewer empirical studies on its impacts. In this one-quarter, design-based project, the researcher aims to increase students’ engagement, cooperation, and, on top of that, reading comprehension performance by utilizing a researcher-developed, adapted reading circle model in an EFL reading course at a Chinese college. The model also integrated team-based learning and portfolio assessment, with an emphasis on the specialization of individual responsibilities, contributions, and outcomes in reading projects, with the goal of addressing current issues in EFL classes at Chinese colleges, such as passive learning, test orientation, ineffective and uncooperative teamwork, and lack of dynamics. In this quasi-experimental research, two groups of students enrolled in the course were invited to participate in four in-class team projects, with the intervention class following the adapted literature circle model and team members rotating as Leader, Coordinator, Brain trust, and Reporter. The researcher/instructor used a sequential explanatory mixed-methods approach to quantitatively analyze the final grades for the pre-and post-tests, as well as individual scores for team projects and will code students' artifacts in the next step, with the results to be reported in a subsequent paper(s). Initial analysis showed that both groups saw an increase in final grades, but the intervention group enjoyed a more significant boost, suggesting that the adapted reading circle model is effective in improving students’ reading comprehension performance. This research not only closes the empirical research gap of literature circles in college EFL classes in China but also adds to the pool of effective ways to optimize reading comprehension performance and class performance in college EFL classes.Keywords: literature circle, EFL teaching, college english reading, reading comprehension
Procedia PDF Downloads 961058 Price Compensation Mechanism with Unmet Demand for Public-Private Partnership Projects
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Public-private partnership (PPP), as an innovative way to provide infrastructures by the private sector, is being widely used throughout the world. Compared with the traditional mode, PPP emerges largely for merits of relieving public budget constraint and improving infrastructure supply efficiency by involving private funds. However, PPP projects are characterized by large scale, high investment, long payback period, and long concession period. These characteristics make PPP projects full of risks. One of the most important risks faced by the private sector is demand risk because many factors affect the real demand. If the real demand is far lower than the forecasting demand, the private sector will be got into big trouble because operating revenue is the main means for the private sector to recoup the investment and obtain profit. Therefore, it is important to study how the government compensates the private sector when the demand risk occurs in order to achieve Pareto-improvement. This research focuses on price compensation mechanism, an ex-post compensation mechanism, and analyzes, by mathematical modeling, the impact of price compensation mechanism on payoff of the private sector and consumer surplus for PPP toll road projects. This research first investigates whether or not price compensation mechanisms can obtain Pareto-improvement and, if so, then explores boundary conditions for this mechanism. The research results show that price compensation mechanism can realize Pareto-improvement under certain conditions. Especially, to make the price compensation mechanism accomplish Pareto-improvement, renegotiation costs of the government and the private sector should be lower than a certain threshold which is determined by marginal operating cost and distortionary cost of the tax. In addition, the compensation percentage should match with the price cut of the private investor when demand drops. This research aims to provide theoretical support for the government when determining compensation scope under the price compensation mechanism. Moreover, some policy implications can also be drawn from the analysis for better risk-sharing and sustainability of PPP projects.Keywords: infrastructure, price compensation mechanism, public-private partnership, renegotiation
Procedia PDF Downloads 1731057 Establishment and Evaluation of a Nutrition Therapy Guide and 7-Day Menu for Educating Hemodialysis Patients: A Case Study of Douala General Hospital, Cameroon
Authors: Ngwa Lodence Njwe
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This study investigated the response of hemodialysis patients to an established nutrition therapy guide accompanied by a 7-day menu plan administered for a month. End stage renal disease (ESRD), also known as end stage kidney disease (ESKD), is a non-communicable disease primarily caused by hypertension and diabetes, posing significant challenges in both developed and developing nations. Hemodialysis is a key treatment for these patients. In this experimental study, 100 hemodialysis patients from Douala General Hospital in Cameroon participated. A questionnaire was used to collect data on sociodemographic and anthropometric characteristics, health status, and dietary intake, while medical records provided biomedical data. The most prevalent age group was 40-49 years, with males constituting 70% and females 30% of respondents. Among these patients, 80% were hypertensive, 3% had both hypertension and diabetes, 9% were hypertensive, diabetic, and obese, and 1% suffered from hypertension and heart failure. Analysis of anthropometric parameters revealed a high prevalence of underweight, overweight, and obesity, highlighting the urgent need for targeted nutrition interventions to modify cooking methods, enhance food choices, and increase dietary variety for improved quality of life. Before the nutrition therapy guide was implemented, average calcium levels were 73.05 mg/L for males and 89.44 mg/L for females; post-implementation, these values increased to 77.55 mg/L and 91.44 mg/L, respectively. Conversely, average phosphorus levels decreased from 42.05 mg/L for males and 43.55 mg/L for females to 41.05 mg/L and 39.3 mg/L, respectively, after the intervention. Additionally, average hemoglobin levels increased from 8.35 g/dL for males and 8.5 g/dL for females to 9.2 g/dL and 8.95 g/dL, respectively. The findings confirm that the nutrition therapy guide and the 7-day menu significantly impacted the biomedical parameters of hemodialysis patients, underscoring the need for ongoing nutrition education and counseling for this population.Keywords: end stage kidney disease, nutrition therapy guide, nutritional status, anthropometric parameters, food frequency and biomedical data
Procedia PDF Downloads 01056 Modelling and Simulation of Natural Gas-Fired Power Plant Integrated to a CO2 Capture Plant
Authors: Ebuwa Osagie, Chet Biliyok, Yeung Hoi
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Regeneration energy requirement and ways to reduce it is the main aim of most CO2 capture researches currently being performed and thus, post-combustion carbon capture (PCC) option is identified to be the most suitable for the natural gas-fired power plants. From current research and development (R&D) activities worldwide, two main areas are being examined in order to reduce the regeneration energy requirement of amine-based PCC, namely: (a) development of new solvents with better overall performance than 30wt% monoethanolamine (MEA) aqueous solution, which is considered as the base-line solvent for solvent-based PCC, (b) Integration of the PCC Plant to the power plant. In scaling-up a PCC pilot plant to the size required for a commercial-scale natural gas-fired power plant, process modelling and simulation is very essential. In this work, an integrated process made up of a 482MWe natural gas-fired power plant, an MEA-based PCC plant which is developed and validated has been modelled and simulated. The PCC plant has four absorber columns and a single stripper column, the modelling and simulation was performed with Aspen Plus® V8.4. The gas turbine, the heat recovery steam generator and the steam cycle were modelled based on a 2010 US DOE report, while the MEA-based PCC plant was modelled as a rate-based process. The scaling of the amine plant was performed using a rate based calculation in preference to the equilibrium based approach for 90% CO2 capture. The power plant was integrated to the PCC plant in three ways: (i) flue gas stream from the power plant which is divided equally into four stream and each stream is fed into one of the four absorbers in the PCC plant. (ii) Steam draw-off from the IP/LP cross-over pipe in the steam cycle of the power plant used to regenerate solvent in the reboiler. (iii) Condensate returns from the reboiler to the power plant. The integration of a PCC plant to the NGCC plant resulted in a reduction of the power plant output by 73.56 MWe and the net efficiency of the integrated system is reduced by 7.3 % point efficiency. A secondary aim of this study is the parametric studies which have been performed to assess the impacts of natural gas on the overall performance of the integrated process and this is achieved through investigation of the capture efficiencies.Keywords: natural gas-fired, power plant, MEA, CO2 capture, modelling, simulation
Procedia PDF Downloads 4401055 Stereological Evaluation of Liver of Rabbit Fetuses After Transplantation of Human Wharton’s Jelly-Derived Mesenchymal Stromal/Stem Cells
Authors: Zahra Khodabandeh, Leila Rezaeian, Mohammad Amin Edalatmanesh, Asghar Mogheiseh, Nader Tanideh, Mehdi Dianatpour, Shahrokh Zare, Hossein Bordbar, Neda Baghban, Amin Tamadon
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Background: In-utero xenotransplantation of stem cells in abnormal fetuses effectively treats several genetic illnesses. Objective: The current research aimed to evaluate structural and morphological alterations in the liver of rabbit fetuses following xenotransplantation of human Wharton’s jelly-derived mesenchymal stromal cells (hWJ-MSCs) using a stereological technique. Methods: hWJ-MSCs were isolated from the human umbilical cord, and their authenticity was established by flow cytometry and differentiation. At gestational day 14, the rabbits were anesthetized, and hWJ-MSCs were injected into the uteri of 24 fetuses. Twenty-two fetuses were born successfully. Ten rabbit liver specimens were prepared from injected fetuses, including eight rabbits on day three following birth and two rabbits on the 21st post-natal day. The non-injected fetuses were considered positive controls. The livers of the control and hWJ-MSCs-treated rabbits were fixed, processed, stained, and examined through stereological approaches. Results: In the hWJ-MSCs-treated group, the mean liver weight and volume increased by 42% and 78% compared to the control group. The total volume of the hepatocytes increased by 63% and that of sinusoids by threefold in the treated rabbits. The total volume of the central veins increased by 70%. The total number corresponding to hepatocytes in the experimental group increased by 112% compared to the rabbits in the control. The total volume of the hepatocyte nuclei in the experimental group increased by 117% compared to the rabbits in the control. Conclusion: After xenotransplantation of human MSCs, host tissue microenvironments (here, the rabbit liver) were altered, and these included quantitative factors corresponding to the liver tissue and hepatocyte morphometric indices.Keywords: xenotransplantation, mesenchymal stromal, stem cell, Wharton ‘s jelly, liver
Procedia PDF Downloads 881054 Influence of IL-1β on Hamster Blastocyst Hatching via Regulation of Hatching Associated Proteases
Authors: Madhulika Pathak, Polani Seshagiri, Vani Venkatappa
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Blastocyst hatching is an indispensable process for successful implantation. One of the major reasons for implantation failure in IVF clinic is poor quality of embryo, which are not development/hatching-competent. Therefore, attempts are required to develop or enhance the culture system with a molecule recapitulating the autocrine/paracrine factors containing the environment of in-vivo endometrial milieu. We have tried to explore the functional molecules involved in the hamster hatching phenomenon. Blastocyst hatching is governed by several molecules that are entwined and regulate this process, among which cytokines are known to be expressed and are still least explored. Two of such cytokines we have used for our study are IL-1β and its natural antagonist IL-1ra to understand the functional dynamics of cytokines involved in the hatching process. Using hamster, an intriguing experimental model for hatching behavior, we have shown the mRNA (qPCR) and protein (ICC) expression of IL-1β, IL-1ra and IL-1 receptor type 1 throughout all the stages of morula, blastocyst and hatched blastocyst. Post-asserting the expression, the functional role is shown by supplementation studies, where IL-1β supplementation showed enhancement in hatching level (IL-1β treated: 84.1 ± 4.2% vs control: 63.7 ± 3.1 %, N=11), further confirmed by the diminishing effect of IL-1ra on hatching rate (IL-1ra treated: 27.5 ± 11.1% vs control: 67.9 ± 3.1%). The exogenous supplementation of IL-1ra decreased the survival rate of embryos and affected the viability in dose-dependent manner, establishing the importance of IL-1β in blastocyst cell survival. Previously, the cathepsin L and B were established as the proteases that were involved in the hamster hatching process. The inducing effect of IL-1β was correlated with enhanced mRNA level, as analyzed by qPCR, for both CAT L (by 1.9 ± 0.5 fold) and CAT B (by 3.5 ± 0.1) fold which was diminished in presence of IL-1ra (Cat L by 88 percent and Cat B by 94 percent. Moreover, using a specific fluorescent substrate-based assay kit, the enzymatic activity of these proteases was found to be increased in presence of IL-1β (Cat L by 2.1 ± 0.1 fold and CAT B by 2.3 ± 0.7 fold) and was curtailed in presence of IL-1ra. These observations provide functional insights with respect to the involvement of cytokines in the hatching process. This has implications in understanding the hatching biology and improving the embryo development quality in IVF clinics.Keywords: Blastocyst, Cytokines, Hatching, Interleukin
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