Search results for: electronic medical record
Commenced in January 2007
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Edition: International
Paper Count: 5635

Search results for: electronic medical record

2425 Evaluation of Associated Risk Factors and Determinants of near Miss Obstetric Cases at B.P. Koirala Institute of Health Sciences, Dharan

Authors: Madan Khadka, Dhruba Uprety, Rubina Rai

Abstract:

Background and objective: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of the level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near-miss obstetric cases and maternal death. Material and Methods A Prospective Observational Study was done from August 1, 2014, to June 30, 2015, in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by the 5-factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, and a complication of abortion, ruptured uterus, medical/surgical condition and sepsis. Results: A total of 9,727 delivery were attended during the study period from August 2014 to June 2014. There were 6307 (71.5%) vaginal delivery and 2777(28.5%) caesarean section and 181 perinatal death with a total of 9,546 live birth. A total of 162 near miss was identified, and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions (WLTC) of 172, Severe maternal outcome ratio of 18.64 per 1000 live birth, Maternal near-miss mortality ratio (MNM: 1 MD) 10.1:1, Mortality index (MI) of 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9%. 19.75% were prim gravidae, with mean age 25.66 yrs, and cardiovascular and coagulation dysfunction as a major life threatening condition and sepsis (25%) was the major cause of mortality. Conclusion: Hemorrhage and hypertensive disorders are the leading causes of near miss event and sepsis as a leading cause of mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.

Keywords: abortion, eclampsia, hemorrhage, maternal mortility, near miss

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2424 Maturity Level of Knowledge Management in Whole Life Costing in the UK Construction Industry: An Empirical Study

Authors: Ndibarefinia Tobin

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The UK construction industry has been under pressure for many years to produce economical buildings which offer value for money, not only during the construction phase, but more importantly, during the full life of the building. Whole life costing is considered as an economic analysis tool that takes into account the total investment cost in and ownership, operation and subsequent disposal of a product or system to which the whole life costing method is being applied. In spite of its importance, the practice is still crippled by the lack of tangible evidence, ‘know-how’ skills and knowledge of the practice i.e. the lack of professionals with the knowledge and training on the use of the practice in construction project, this situation is compounded by the absence of available data on whole life costing from relevant projects, lack of data collection mechanisms and so on. The aforementioned problems has forced many construction organisations to adopt project enhancement initiatives to boost their performance on the use of whole life costing techniques so as to produce economical buildings which offer value for money during the construction stage also the whole life of the building/asset. The management of knowledge in whole life costing is considered as one of the many project enhancement initiative and it is becoming imperative in the performance and sustainability of an organisation. Procuring building projects using whole life costing technique is heavily reliant on the knowledge, experience, ideas and skills of workers, which comes from many sources including other individuals, electronic media and documents. Due to the diversity of knowledge, capabilities and skills of employees that vary across an organisation, it is significant that they are directed and coordinated efficiently so as to capture, retrieve and share knowledge in order to improve the performance of the organisation. The implementation of knowledge management concept has different levels in each organisation. Measuring the maturity level of knowledge management in whole life costing practice will paint a comprehensible picture of how knowledge is managed in construction organisations. Purpose: The purpose of this study is to identify knowledge management maturity in UK construction organisations adopting whole life costing in construction project. Design/methodology/approach: This study adopted a survey method and conducted by distributing questionnaires to large construction companies that implement knowledge management activities in whole life costing practice in construction project. Four level of knowledge management maturity was proposed on this study. Findings: From the results obtained in the study shows that 34 contractors at the practiced level, 26 contractors at managed level and 12 contractors at continuously improved level.

Keywords: knowledge management, whole life costing, construction industry, knowledge

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2423 Sickle Cell Disease: Review of Managements in Pregnancy and the Outcome in Ampang Hospital, Selangor

Authors: Z. Nurzaireena, K. Azalea, T. Azirawaty, S. Jameela, G. Muralitharan

Abstract:

The aim of this study is the review of the management practices of sickle cell disease patients during pregnancy, as well as the maternal and neonatal outcome at Ampang Hospital, Selangor. The study consisted of a review of pregnant patients with sickle cell disease under follow up at the Hematology Clinic, Ampang Hospital over the last seven years to assess their management and maternal-fetal outcome. The results of the review show that Ampang Hospital is considered the public hematology centre for sickle cell disease and had successfully managed three pregnancies throughout the last seven years. Patients’ presentations, managements and maternal-fetal outcome were compared and reviewed for academic improvements. All three patients were seen very early in their pregnancy and had been given a regime of folic acid, antibiotics and thrombo-prophylactic drugs. Close monitoring of maternal and fetal well being was done by the hematologists and obstetricians. Among the patients, there were multiple admissions during the pregnancy for either a painful sickle cell bone crisis, haemolysis following an infection and anemia requiring phenotype- matched blood and exchange transfusions. Broad spectrum antibiotics coverage during and infection, hydration, pain management and venous-thrombolism prophylaxis were mandatory. The pregnancies managed to reach near term in the third trimester but all required emergency caesarean section for obstetric indications. All pregnancies resulted in live births with good fetal outcome. During post partum all were nursed closely in the high dependency units for further complications and were discharged well. Post partum follow up and contraception counseling was comprehensively given for future pregnancies. Sickle cell disease is uncommonly seen in the East, especially in the South East Asian region, yet more cases are seen in the current decade due to improved medical expertise and advance medical laboratory technologies. Pregnancy itself is a risk factor for sickle cell patients as increased thrombosis event and risk of infections can lead to multiple crisis, haemolysis, anemia and vaso-occlusive complications including eclampsia, cerebrovasular accidents and acute bone pain. Patients mostly require multiple blood product transfusions thus phenotype-matched blood is required to reduce the risk of alloimmunozation. Emphasizing the risks and complications in preconception counseling and establishing an ultimate pregnancy plan would probably reduce the risk of morbidity and mortality to the mother and unborn child. Early management for risk of infection, thromboembolic events and adequate hydration is mandatory. A holistic approach involving multidisciplinary team care between the hematologist, obstetricians, anesthetist, neonatologist and close nursing care for both mother and baby would ensure the best outcome. In conclusion, sickle cell disease by itself is a high risk medical condition and pregnancy would further amplify the risk. Thus, close monitoring with combine multidisciplinary care, counseling and educating the patients are crucial in achieving the safe outcome.

Keywords: anaemia, haemoglobinopathies, pregnancy, sickle cell disease

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2422 Syngas From Polypropylene Gasification in a Fluidized Bed

Authors: Sergio Rapagnà, Alessandro Antonio Papa, Armando Vitale, Andre Di Carlo

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In recent years the world population has enormously increased the use of plastic products for their living needs, in particular for transporting and storing consumer goods such as food and beverage. Plastics are widely used in the automotive industry, in construction of electronic equipment, clothing and home furnishings. Over the last 70 years, the annual production of plastic products has increased from 2 million tons to 460 million tons. About 20% of the last quantity is mismanaged as waste. The consequence of this mismanagement is the release of plastic waste into the terrestrial and marine environments which represents a danger to human health and the ecosystem. Recycling all plastics is difficult because they are often made with mixtures of polymers that are incompatible with each other and contain different additives. The products obtained are always of lower quality and after two/three recycling cycles they must be eliminated either by thermal treatment to produce heat or disposed of in landfill. An alternative to these current solutions is to obtain a mixture of gases rich in H₂, CO and CO₂ suitable for being profitably used for the production of chemicals with consequent savings fossil sources. Obtaining a hydrogen-rich syngas can be achieved by gasification process using the fluidized bed reactor, in presence of steam as the fluidization medium. The fluidized bed reactor allows the gasification process of plastics to be carried out at a constant temperature and allows the use of different plastics with different compositions and different grain sizes. Furthermore, during the gasification process the use of steam increase the gasification of char produced by the first pyrolysis/devolatilization process of the plastic particles. The bed inventory can be made with particles having catalytic properties such as olivine, capable to catalyse the steam reforming reactions of heavy hydrocarbons normally called tars, with a consequent increase in the quantity of gases produced. The plant is composed of a fluidized bed reactor made of AISI 310 steel, having an internal diameter of 0.1 m, containing 3 kg of olivine particles as a bed inventory. The reactor is externally heated by an oven up to 1000 °C. The hot producer gases that exit the reactor, after being cooled, are quantified using a mass flow meter. Gas analyzers are present to measure instantly the volumetric composition of H₂, CO, CO₂, CH₄ and NH₃. At the conference, the results obtained from the continuous gasification of polypropylene (PP) particles in a steam atmosphere at temperatures of 840-860 °C will be presented.

Keywords: gasification, fluidized bed, hydrogen, olivine, polypropyle

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2421 Embodied Empowerment: A Design Framework for Augmenting Human Agency in Assistive Technologies

Authors: Melina Kopke, Jelle Van Dijk

Abstract:

Persons with cognitive disabilities, such as Autism Spectrum Disorder (ASD) are often dependent on some form of professional support. Recent transformations in Dutch healthcare have spurred institutions to apply new, empowering methods and tools to enable their clients to cope (more) independently in daily life. Assistive Technologies (ATs) seem promising as empowering tools. While ATs can, functionally speaking, help people to perform certain activities without human assistance, we hold that, from a design-theoretical perspective, such technologies often fail to empower in a deeper sense. Most technologies serve either to prescribe or to monitor users’ actions, which in some sense objectifies them, rather than strengthening their agency. This paper proposes that theories of embodied interaction could help formulating a design vision in which interactive assistive devices augment, rather than replace, human agency and thereby add to a persons’ empowerment in daily life settings. It aims to close the gap between empowerment theory and the opportunities provided by assistive technologies, by showing how embodiment and empowerment theory can be applied in practice in the design of new, interactive assistive devices. Taking a Research-through-Design approach, we conducted a case study of designing to support independently living people with ASD with structuring daily activities. In three iterations we interlaced design action, active involvement and prototype evaluations with future end-users and healthcare professionals, and theoretical reflection. Our co-design sessions revealed the issue of handling daily activities being multidimensional. Not having the ability to self-manage one’s daily life has immense consequences on one’s self-image, and also has major effects on the relationship with professional caregivers. Over the course of the project relevant theoretical principles of both embodiment and empowerment theory together with user-insights, informed our design decisions. This resulted in a system of wireless light units that users can program as a reminder for tasks, but also to record and reflect on their actions. The iterative process helped to gradually refine and reframe our growing understanding of what it concretely means for a technology to empower a person in daily life. Drawing on the case study insights we propose a set of concrete design principles that together form what we call the embodied empowerment design framework. The framework includes four main principles: Enabling ‘reflection-in-action’; making information ‘publicly available’ in order to enable co-reflection and social coupling; enabling the implementation of shared reflections into an ‘endurable-external feedback loop’ embedded in the persons familiar ’lifeworld’; and nudging situated actions with self-created action-affordances. In essence, the framework aims for the self-development of a suitable routine, or ‘situated practice’, by building on a growing shared insight of what works for the person. The framework, we propose, may serve as a starting point for AT designers to create truly empowering interactive products. In a set of follow-up projects involving the participation of persons with ASD, Intellectual Disabilities, Dementia and Acquired Brain Injury, the framework will be applied, evaluated and further refined.

Keywords: assistive technology, design, embodiment, empowerment

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2420 Entropy in a Field of Emergence in an Aspect of Linguo-Culture

Authors: Nurvadi Albekov

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Communicative situation is a basis, which designates potential models of ‘constructed forms’, a motivated basis of a text, for a text can be assumed as a product of the communicative situation. It is within the field of emergence the models of text, that can be potentially prognosticated in a certain communicative situation, are designated. Every text can be assumed as conceptual system structured on the base of certain communicative situation. However in the process of ‘structuring’ of a certain model of ‘conceptual system’ consciousness of a recipient is able act only within the border of the field of emergence for going out of this border indicates misunderstanding of the communicative situation. On the base of communicative situation we can witness the increment of meaning where the synergizing of the informative model of communication, formed by using of the invariant units of a language system, is a result of verbalization of the communicative situation. The potential of the models of a text, prognosticated within the field of emergence, also depends on the communicative situation. The conception ‘the field of emergence’ is interpreted as a unit of the language system, having poly-directed universal structure, implying the presence of the core, the center and the periphery, including different levels of means of a functioning system of language, both in terms of linguistic resources, and in terms of extra linguistic factors interaction of which results increment of a text. The conception ‘field of emergence’ is considered as the most promising in the analysis of texts: oral, written, printed and electronic. As a unit of the language system field of emergence has several properties that predict its use during the study of a text in different levels. This work is an attempt analysis of entropy in a text in the aspect of lingua-cultural code, prognosticated within the model of the field of emergence. The article describes the problem of entropy in the field of emergence, caused by influence of the extra-linguistic factors. The increasing of entropy is caused not only by the fact of intrusion of the language resources but by influence of the alien culture in a whole, and by appearance of non-typical for this very culture symbols in the field of emergence. The borrowing of alien lingua-cultural symbols into the lingua-culture of the author is a reason of increasing the entropy when constructing a text both in meaning and in structuring level. It is nothing but artificial formatting of lexical units that violate stylistic unity of a phrase. It is marked that one of the important characteristics descending the entropy in the field of emergence is a typical similarity of lexical and semantic resources of the different lingua-cultures in aspects of extra linguistic factors.

Keywords: communicative situation, field of emergence, lingua-culture, entropy

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2419 The Effectiveness of Extracorporeal Shockwave Therapy on Pain and Motor Function in Subjects with Knee Osteoarthritis A Systematic Review and Meta-Analysis of Randomized Clinical Trial

Authors: Vu Hoang Thu Huong

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Background and Purpose: The effects of Extracorporeal Shockwave Therapy (ESWT) in the participants with knee osteoarthritis (KOA) were unclear on physical performance although its effects on pain had been investiagted. This study aims to explore the effects of ESWT on pain relief and physical performance on KOA. Methods: The studies with the randomized controlled design to investigate the effects of ESWT on KOA were systematically searched using inclusion and exclusion criteria through seven electronic databases including Pubmed etc. between 1990 and Dec 2022. To summarize those data, visual analog scale (VAS) or pain scores were determined for measure of pain intensity. Range of knee motion, or the scores of physical activities including Lequesne index (LI), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were determined for measure of physical performances. The first evaluate after treatment period was define as the effect of post-treatment period or immediately effect; and the last evaluate was defined as the effect of following period or the end effect in our study. Data analysis was performed using RevMan 5.4.1 software. A significant level was set at p<0.05. Results: Eight studies (number of participant= 499) reporting the ESWT effects on mild-to-moderate severity (Grades I to III Kellgren–Lawrence) of KOA were qualified for meta-analysis. Compared with sham or placebo group, the ESWT group had a significant decrease of VAS rest score (0.90[0.12~1.67] as mean difference [95% confidence interval]) and pain score WOMAC (2.49[1.22~3.76]), and a significant improvement of physical performance with a decrease of the scores of WOMAC activities (8.18[3.97~12.39]), LI (3.47[1.68~5.26]), and KOOS (5.87[1.73~ 10.00]) in the post-treatment period. There were also a significant decrease of WOMAC pain score (2.83[2.12~3.53]) and a significant decrease of the scores of WOMAC activities (9.47[7.65~11.28]) and LI (4.12[2.34 to 5.89]) in the following period. Besides, compared with other treatment groups, ESWT also displayed the improvement in pain and physical performance, but it is not significant. Conclusions: The ESWT was effective and valuable method in pain relief as well as in improving physical activities in the participants with mild-to-moderate KOA. Clinical Relevance: There are the effects of ESWT on pain relief and the improvement of physical performance in the with KOA.

Keywords: knee osteoarthritis, extracorporeal shockwave therapy, pain relief, physical performance, shockwave

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2418 A Randomised Simulation Study to Assess the Impact of a Focussed Crew Resource Management Course on UK Medical Students

Authors: S. MacDougall-Davis, S. Wysling, R. Willmore

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Background: The application of good non-technical skills, also known as crew resource management (CRM), is central to the delivery of safe, effective healthcare. The authors have been running remote trauma courses for over 10 years, primarily focussing on developing participants’ CRM in time-critical, high-stress clinical situations. The course has undergone an iterative process over the past 10 years. We employ a number of experiential learning techniques for improving CRM, including small group workshops, military command tasks, high fidelity simulations with reflective debriefs, and a ‘flipped classroom’, where participants are asked to create their own simulations and assess and debrief their colleagues’ CRM. We created a randomised simulation study to assess the impact of our course on UK medical students’ CRM, both at an individual and a teams level. Methods: Sixteen students took part. Four clinical scenarios were devised, designed to be of similar urgency and complexity. Professional moulage effects and experienced clinical actors were used to increase fidelity and to further simulate high-stress environments. Participants were block randomised into teams of 4; each team was randomly assigned to one pre-course simulation. They then underwent our 5 day remote trauma CRM course. Post-course, students were re-randomised into four new teams; each was randomly assigned to a post-course simulation. All simulations were videoed. The footage was reviewed by two independent CRM-trained assessors, who were blinded to the before/after the status of the simulations. Assessors used the internationally validated team emergency assessment measure (TEAM) to evaluate key areas of team performance, as well as a global outcome rating. Prior to the study, assessors had scored two unrelated scenarios using the same assessment tool, demonstrating 89% concordance. Participants also completed pre- and post-course questionnaires. Likert scales were used to rate individuals’ perceived NTS ability and their confidence to work in a team in time-critical, high-stress situations. Results: Following participation in the course, a significant improvement in CRM was observed in all areas of team performance. Furthermore, the global outcome rating for team performance was markedly improved (40-70%; mean 55%), thus demonstrating an impact at Level 4 of Kirkpatrick’s hierarchy. At an individual level, participants’ self-perceived CRM improved markedly after the course (35-70% absolute improvement; mean 55%), as did their confidence to work in a team in high-stress situations. Conclusion: Our study demonstrates that with a short, cost-effective course, using easily reproducible teaching sessions, it is possible to significantly improve participants’ CRM skills, both at an individual and, perhaps more importantly, at a teams level. The successful functioning of multi-disciplinary teams is vital in a healthcare setting, particularly in high-stress, time-critical situations. Good CRM is of paramount importance in these scenarios. The authors believe that these concepts should be introduced from the earliest stages of medical education, thus promoting a culture of effective CRM and embedding an early appreciation of the importance of these skills in enabling safe and effective healthcare.

Keywords: crew resource management, non-technical skills, training, simulation

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2417 Evaluation of the Trauma System in a District Hospital Setting in Ireland

Authors: Ahmeda Ali, Mary Codd, Susan Brundage

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Importance: This research focuses on devising and improving Health Service Executive (HSE) policy and legislation and therefore improving patient trauma care and outcomes in Ireland. Objectives: The study measures components of the Trauma System in the district hospital setting of the Cavan/Monaghan Hospital Group (CMHG), HSE, Ireland, and uses the collected data to identify the strengths and weaknesses of the CMHG Trauma System organisation, to include governance, injury data, prevention and quality improvement, scene care and facility-based care, and rehabilitation. The information will be made available to local policy makers to provide objective situational analysis to assist in future trauma service planning and service provision. Design, setting and participants: From 28 April to May 28, 2016 a cross-sectional survey using World Health Organisation (WHO) Trauma System Assessment Tool (TSAT) was conducted among healthcare professionals directly involved in the level III trauma system of CMHG. Main outcomes: Identification of the strengths and weaknesses of the Trauma System of CMHG. Results: The participants who reported inadequate funding for pre hospital (62.3%) and facility based trauma care at CMHG (52.5%) were high. Thirty four (55.7%) respondents reported that a national trauma registry (TARN) exists but electronic health records are still not used in trauma care. Twenty one respondents (34.4%) reported that there are system wide protocols for determining patient destination and adequate, comprehensive legislation governing the use of ambulances was enforced, however, there is a lack of a reliable advisory service. Over 40% of the respondents reported uncertainty of the injury prevention programmes available in Ireland; as well as the allocated government funding for injury and violence prevention. Conclusions: The results of this study contributed to a comprehensive assessment of the trauma system organisation. The major findings of the study identified three fundamental areas: the inadequate funding at CMHG, the QI techniques and corrective strategies used, and the unfamiliarity of existing prevention strategies. The findings direct the need for further research to guide future development of the trauma system at CMHG (and in Ireland as a whole) in order to maximise best practice and to improve functional and life outcomes.

Keywords: trauma, education, management, system

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2416 Mediterranean Diet, Duration of Admission and Mortality in Elderly, Hospitalized Patients: A Cross-Sectional Study

Authors: Christos Lampropoulos, Maria Konsta, Ifigenia Apostolou, Vicky Dradaki, Tamta Sirbilatze, Irini Dri, Christina Kordali, Vaggelis Lambas, Kostas Argyros, Georgios Mavras

Abstract:

Objectives: Mediterranean diet has been associated with lower incidence of cardiovascular disease and cancer. The purpose of our study was to examine the hypothesis that Mediterranean diet may protect against mortality and reduce admission duration in elderly, hospitalized patients. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). The following data were taken into account in analysis: anthropometric and laboratory data, dietary habits (MedDiet score), patients’ nutritional status [Mini Nutritional Assessment (MNA) score], physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and admission duration difference respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 30% per each unit increase of MedDiet score (OR=0.7, 95% CI:0.6-0.8, p < 0.0001). Patients with cancer-related admission were 37.7 times more likely to die, compared to those with infection (OR=37.7, 95% CI:4.4-325, p=0.001). According to multivariate linear regression analysis, admission duration was inversely related to Mediterranean diet, since it is decreased 0.18 days on average for each unit increase of MedDiet score (b:-0.18, 95% CI:-0.33 - -0.035, p=0.02). Additionally, the duration of current admission increased on average 0.83 days for each previous hospital admission (b:0.83, 95% CI:0.5-1.16, p<0.0001). The admission duration of patients with cancer was on average 4.5 days higher than the patients who admitted due to infection (b:4.5, 95% CI:0.9-8, p=0.015). Conclusion: Mediterranean diet adequately protects elderly, hospitalized patients against mortality and reduces the duration of hospitalization.

Keywords: Mediterranean diet, malnutrition, nutritional status, prognostic factors for mortality

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2415 Pregnancy and Birth Outcomes of Single versus Multiple Embryo Transfer in Gestational Surrogacy Arrangements: A Systematic Review

Authors: Jutharat Attawet, Alex Y. Wang, Cindy M. Farquhar, Elizabeth A. Sullivan

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Background: Adverse maternal and perinatal outcomes of multiple pregnancies resulting from multiple embryo transfers (ET) has become significant concerns. This is particularly relevant for gestational carriers since they usually do not have infertility issues. Single embryo transfer (SET) therefore has been encouraged to assist reproductive technology (ART) practice in order to reduce multiple pregnancies. Objectives: This systematic review aims to investigate the pregnancy and birth outcomes of SET and multiple ET in surrogacy arrangements. Search methods: This study is a systematic review. Electronic databases were searched from CINAHL, Medline, Embase, Scopus and ProQuest for studies from 1980 to 2017. Cross-references and national ART reports were also manual searchings. Articles without restriction of English language and study types were accessed. Carrier cycles involving in SET and multiple ET were identified in database searching. The main outcome measures including clinical pregnancy, live delivery and multiple deliveries per gestational carrier cycle were compared between SET and multiple ET. Mantel-Haenzel risk ratios (RRs) with 95% confidence intervals (CIs), using the numbers of outcome events in SET and multiple ET of each study were calculated suing RevMan5.3. Outcomes: The search returned 97 articles of which 5 met the inclusion criteria. Approximately 50% of carrier cycles were transferred a single embryo and 50% were transferred more than one embryo. The clinical pregnancy rate (CPR) was 39% for SET and 53% for multiple ET, which was not significantly different with RR = 0.83 (95% CI: 0.67-1.03). The live delivery rate was 33% for SET and 57% for multiple ET which was not significantly different with RR = 0.78 (95% CI: 0.61-1.00). The multiple delivery rate per carrier was greater risks in the multiple ET carrier cycles (RR =0.4, 95% CI: 0.01-0.26). There were 104 sets of twins (including one set of twins selectively reduced from triplets to twins) and 1 set of triples in the multiple ET carrier cycle. In the SET carrier cycles, there were 2 sets of twins. Significance of the study: SET should be advocated among surrogate carriers to prevent multiple pregnancies and subsequent adverse outcomes for both carrier and baby. Surrogacy practice should be reviewed and surrogate carriers should be fully informed of the risk of adverse maternal and birth outcome of multiple pregnancies due to multiple embryo transfers.

Keywords: assisted reproduction, birth outcomes, carrier, gestational surrogacy, multiple embryo transfer, multiple pregnancy, pregnancy outcomes, single embryo transfer, surrogate mother, systematic review

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2414 Socio-Spatial Transformations in Obsolete Port Regions: A Case for Istanbul-Karaköy District

Authors: Umut Tuğlu Karslı

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While, port function had a major role during the antiquity and medieval times, it has started to lose its significance in 19th century. In many port cities, while heavy industrial functions and ports have been moved out of the former port districts, the resulting derelict spaces have been transformed to new waterfront quarters to accommodate commercial, tourism, cultural, residential and public uses. Primary aim of these operations is to revitalize abandoned spaces of historical potential and re-establish a relationship between the city and the coast. Karakoy Port, field of this study, located in the Bosphorus, was surrounded by the city centre in time due to the transformation of urban functions, and as a result it has lost its former significance. While Karakoy has 24 hours lively residential and commercial uses in old times; in early 1980s, became a district of mechanical, plumbing and electronic parts suppliers during the day and a place for homeless at night. Today, activities for revitalization of this region continue in two forms and scales. First of these activities is the "planned transformation projects," which also includes the most important one “Galataport project”, and the second one is "spontaneous transformation," which consists of individual interventions. Galataport project that based on the idea of arranging the area specifically for tourists was prepared in 2005 and became a topic of tremendous public debate. On the other hand, the "spontaneous transformation" that is observed in the Karakoy District starts in 2004 with the foundation of “Istanbul Modern Museum”. Istanbul Modern, the first contemporary arts museum of the city, allowed the cultural integration of old naval warehouses of the port to the daily life. Following this adaptive reuse intervention, the district started to accommodate numerous art galleries, studios, café-workshops and design stores. In this context, this paper briefly examines revitalization studies in obsolete port regions, analyzes the planned and ongoing socio-spatial transformations in the specific case of Karakoy under the subjects of "planned transformation projects" and "spontaneous transformation", and realizes a critical review of the sustainability of the proposals on how to reinstate the district in the active life of Istanbul.

Keywords: port cities, socio-spatial transformation, urban regeneration, urban revitalization

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2413 Case Study of Obstructive Sleep Apnea and Methods of Treatment for a Professional Driver

Authors: R. Pääkkönen, L. Korpinen, T. Kava, I. Salmi

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This study evaluates obstructive sleep apnea treatment through a case study involving a 67-year-old male driver who had a successful continuous positive airway pressure (CPAP) treatment at home but experienced difficulties with traveling and dental care. There are many cheap sleep apnea and snoring devices available, but there is little professional advice on what kind of devices can help. Professional drivers receive yearly specialized medical care follow-up.

Keywords: sleep, apnea patient, CPAP, professional driver

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2412 Development of a Journal over 20 Years: Citation Analysis

Authors: Byung Lee, Charles Perschau

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This study analyzes the development of a communication journal, the Journal of Advertising Education (JAE) over the past 20 years by examining citations of all research articles there. The purpose of a journal is to offer a stable and transparent forum for the presentation, scrutiny, and discussion of research in a targeted domain. This study asks whether JAE has fulfilled this purpose. The authors and readers who are involved in a journal need to have common research topics of their interest. In the case of the discipline of communication, scholars have a variety of backgrounds beyond communication itself since the social scientific study of communication is a relatively recent development, one that emerged after World War II, and the discipline has been heavily indebted to other social sciences, such as psychology, sociology, social psychology, and political science. When authors impart their findings and knowledge to others, their work is not done in isolation. They have to stand on previous studies, which are listed as sources in the bibliography. Since communication has heavily piggybacked on other disciplines, cited sources should be as diverse as the resources it taps into. This paper analyzes 4,244 articles that were cited by JAE articles in the past 36 issues. Since journal article authors reveal their intellectual linkage by using bibliographic citations, the analysis of citations in journal articles will reveal various networks of relationships among authors, journal types, and fields in an objective and quantitative manner. The study found that an easier access to information sources because of the development of electronic databases and the growing competition among scholars for publication seemed to influence authors to increase the number of articles cited even though some variations existed during the examined period. The types of articles cited have also changed. Authors have more often cited journal articles, periodicals (most of them available online), and web site sources, while decreased their dependence on books, conference papers, and reports. To provide a forum for discussion, a journal needs a common topic or theme. This can be realized when an author writes an article about a topic, and that article is cited and discussed in another article. Thus, the citation of articles in the same journal is vital for a journal to form a forum for discussion. JAE has gradually increased the citations of in-house articles with a few fluctuations over the years. The study also examines not only specific articles that are often cited, but also specific authors often cited. The analysis of citations in journal articles shows how JAE has developed into a full academic journal while offering a communal forum even though the speed of its formation is not as fast as desired probably because of its interdisciplinary nature.

Keywords: citation, co-citation, the Journal of Advertising Education, development of a journal

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2411 Policy Implications of Cashless Banking on Nigeria’s Economy

Authors: Oluwabiyi Adeola Ayodele

Abstract:

This study analysed the Policy and general issues that have arisen over time in Nigeria’ Cashless banking environment as a result of the lack of a Legal framework on Electronic banking in Nigeria. It undertook an in-depth study of the cashless banking system. It discussed the evolution, growth and development of cashless banking in Nigeria; It revealed the expected benefits of the cashless banking system; It appraised regulatory issues and other prevalent problems on cashless banking in Nigeria; and made appropriate recommendations where necessary. The study relied on primary and secondary sources of information. The primary sources included the Constitution of the Federal Republic of Nigeria, Statutes, Conventions and Judicial decisions, while the secondary sources included Books, Journals Articles, Newspapers and Internet Materials. The study revealed that cashless banking has been adopted in Nigeria but still at the developing stage. It revealed that there is no law for the regulation of cashless banking in Nigeria, what Nigeria relies on for regulation is the Central Bank of Nigeria’s Cashless Policy, 2014. The Banks and Other Financial Institutions Act Chapter B3, LFN, 2004 of Nigeria lack provision to accommodate issues on Internet banking. However, under the general principles of legality in criminal law, and by the provisions of the Nigerian Constitution, a person can only be punished for conducts that have been defined to be criminal by written laws with the penalties specifically stated in the law. Although Nigeria has potent laws for the regulation of paper banking, these laws cannot be substituted for paperless transactions. This is because the issues involved in both transactions vary. The study also revealed that the absence of law in the cashless banking environment in Nigeria will subject consumers to endless risks. This study revealed that the creation of banking markets via the Internet relies on both available technologies and appropriate laws and regulations. It revealed however that Law of some of the countries considered on cashless banking has taken care of most of the legal issues and other problems prevalent in the cashless banking environment. The study also revealed some other problems prevalent in the Nigerian cashless banking environment. The study concluded that for Nigeria to find solutions to the legal issues raised in its cashless banking environment and other problems of cashless banking, it should have a viable legal Frame work for internet banking. The study concluded that the Central Bank of Nigeria’s Policy on Cashless banking is not potent enough to tackle the challenges posed to cashless banking in Nigeria because policies only have a persuasive effect and not a binding effect. There is, therefore, a need for appropriate Laws for the regulation of cashless Banking in Nigeria. The study also concluded that there is a need to create more awareness of the system among Nigerians and solve infrastructural problems like prevalent power outage which often have been creating internet network problem.

Keywords: cashless-banking, Nigeria, policies, laws

Procedia PDF Downloads 493
2410 Comparative Study between the Absorbed Dose of 67ga-Ecc and 68ga-Ecc

Authors: H. Yousefnia, S. Zolghadri, S. Shanesazzadeh, A.Lahooti, A. R. Jalilian

Abstract:

In this study, 68Ga-ECC and 67Ga-ECC were both prepared with the radiochemical purity of higher than 97% in less than 30 min. The biodistribution data for 68Ga-ECC showed the extraction of the most of the activity from the urinary tract. The absorbed dose was estimated based on biodistribution data in mice by the medical internal radiation dose (MIRD) method. Comparison between human absorbed dose estimation for these two agents indicated the values of approximately ten-fold higher after injection of 67Ga-ECC than 68Ga-ECC in the most organs. The results showed that 68Ga-ECC can be considered as a more potential agent for renal imaging compared to 67Ga-ECC.

Keywords: effective absorbed dose, ethylenecysteamine cysteine, Ga-67, Ga-68

Procedia PDF Downloads 471
2409 Switching of Series-Parallel Connected Modules in an Array for Partially Shaded Conditions in a Pollution Intensive Area Using High Powered MOSFETs

Authors: Osamede Asowata, Christo Pienaar, Johan Bekker

Abstract:

Photovoltaic (PV) modules may become a trend for future PV systems because of their greater flexibility in distributed system expansion, easier installation due to their nature, and higher system-level energy harnessing capabilities under shaded or PV manufacturing mismatch conditions. This is as compared to the single or multi-string inverters. Novel residential scale PV arrays are commonly connected to the grid by a single DC–AC inverter connected to a series, parallel or series-parallel string of PV panels, or many small DC–AC inverters which connect one or two panels directly to the AC grid. With an increasing worldwide interest in sustainable energy production and use, there is renewed focus on the power electronic converter interface for DC energy sources. Three specific examples of such DC energy sources that will have a role in distributed generation and sustainable energy systems are the photovoltaic (PV) panel, the fuel cell stack, and batteries of various chemistries. A high-efficiency inverter using Metal Oxide Semiconductor Field-Effect Transistors (MOSFETs) for all active switches is presented for a non-isolated photovoltaic and AC-module applications. The proposed configuration features a high efficiency over a wide load range, low ground leakage current and low-output AC-current distortion with no need for split capacitors. The detailed power stage operating principles, pulse width modulation scheme, multilevel bootstrap power supply, and integrated gate drivers for the proposed inverter is described. Experimental results of a hardware prototype, show that not only are MOSFET efficient in the system, it also shows that the ground leakage current issues are alleviated in the proposed inverter and also a 98 % maximum associated driver circuit is achieved. This, in turn, provides the need for a possible photovoltaic panel switching technique. This will help to reduce the effect of cloud movements as well as improve the overall efficiency of the system.

Keywords: grid connected photovoltaic (PV), Matlab efficiency simulation, maximum power point tracking (MPPT), module integrated converters (MICs), multilevel converter, series connected converter

Procedia PDF Downloads 129
2408 Neural Rendering Applied to Confocal Microscopy Images

Authors: Daniel Li

Abstract:

We present a novel application of neural rendering methods to confocal microscopy. Neural rendering and implicit neural representations have developed at a remarkable pace, and are prevalent in modern 3D computer vision literature. However, they have not yet been applied to optical microscopy, an important imaging field where 3D volume information may be heavily sought after. In this paper, we employ neural rendering on confocal microscopy focus stack data and share the results. We highlight the benefits and potential of adding neural rendering to the toolkit of microscopy image processing techniques.

Keywords: neural rendering, implicit neural representations, confocal microscopy, medical image processing

Procedia PDF Downloads 666
2407 A Mixed Method Systematic Review of the Experience of Communication in the Care of Children with Palliative Care Needs

Authors: Maha Atout, Pippa Hemingway, Jane Seymour

Abstract:

Background: A mixed method systematic review was undertaken in order to explore issues related to the experiences of health care providers and parents in the care of children with palliative care needs. The aims of this systematic review were to identify existing evidence about the experiences of communication in the care of children with palliative care needs, to appraise the research conducted in this area and to identify gaps in the literature in order to recommend for future related studies. Method: A mixed method systematic review of research on the experience of communication in the care of children with palliative care needs, conducted with parents and health professionals was undertaken. The electronic databases of CINAHL, Cochrane, PubMed, OVID, Social Care Online, Web of Science, Scopus, and ProQuest were searched for the period of 2000-2016. Inclusion was limited to studies of communication experience in the care of children with palliative care needs. Result: Thirty-eight studies were found. The studies were conducted in a variety of countries: Uganda, Jordan, USA, UK, Taiwan, Turkey, Ireland, Poland, Brazil, Australia, Switzerland, Sweden, Netherland, Lebanon, Spain, Greece, and China. The current review shows that parents tend to protect their children when they are discussing their illnesses with them, particularly where they have a life-threatening or life-limiting condition. The approach of parents towards the discussion of sensitive issues concerning death with their children is significantly affected by the cultural background of the families. Conservative cultures encourage collusion behaviours which tend to keep children unaware of the incurable nature of the disease. The major communication challenges reported by health professionals are facing difficulties in judging how much information should be given to parents, responding to difficult questions, conflicts with families and inadequate skills to support grieving families. Conclusion: It is probably significant for the future studies to consider the change of parent-child communication experience over time in order to understand how the parents could change their interaction styles with their children according to the different stages of their children’s disease. Moreover, further studies are required to investigate the experience of communication of parents of children with non-malignant life-threatening and life-limiting illnesses.

Keywords: children with life-threatening or life- limiting illnesses, end of life, experience of communication, healthcare care providers, paediatric palliative care

Procedia PDF Downloads 300
2406 Children’s Perception of Conversational Agents and Their Attention When Learning from Dialogic TV

Authors: Katherine Karayianis

Abstract:

Children with Attention Deficit Hyperactivity Disorder (ADHD) have trouble learning in traditional classrooms. These children miss out on important developmental opportunities in school, which leads to challenges starting in early childhood, and these problems persist throughout their adult lives. Despite receiving supplemental support in school, children with ADHD still perform below their non-ADHD peers. Thus, there is a great need to find better ways of facilitating learning in children with ADHD. Evidence has shown that children with ADHD learn best through interactive engagement, but this is not always possible in schools, given classroom restraints and the large student-to-teacher ratio. Redesigning classrooms may not be feasible, so informal learning opportunities provide a possible alternative. One popular informal learning opportunity is educational TV shows like Sesame Street. These types of educational shows can teach children foundational skills taught in pre-K and early elementary school. One downside to these shows is the lack of interactive dialogue between the TV characters and the child viewers. Pseudo-interaction is often deployed, but the benefits are limited if the characters can neither understand nor contingently respond to the child. AI technology has become extremely advanced and is now popular in many electronic devices that both children and adults have access to. AI has been successfully used to create interactive dialogue in children’s educational TV shows, and results show that this enhances children’s learning and engagement, especially when children perceive the character as a reliable teacher. It is likely that children with ADHD, whose minds may otherwise wander, may especially benefit from this type of interactive technology, possibly to a greater extent depending on their perception of the animated dialogic agent. To investigate this issue, I have begun examining the moderating role of inattention among children’s learning from an educational TV show with different types of dialogic interactions. Preliminary results have shown that when character interactions are neither immediate nor accurate, children who are more easily distracted will have greater difficulty learning from the show, but contingent interactions with a TV character seem to buffer these negative effects of distractibility by keeping the child engaged. To extend this line of work, the moderating role of the child’s perception of the dialogic agent as a reliable teacher will be examined in the association between children’s attention and the type of dialogic interaction in the TV show. As such, the current study will investigate this moderated moderation.

Keywords: attention, dialogic TV, informal learning, educational TV, perception of teacher

Procedia PDF Downloads 89
2405 Analyzing Electromagnetic and Geometric Characterization of Building Insulation Materials Using the Transient Radar Method (TRM)

Authors: Ali Pourkazemi

Abstract:

The transient radar method (TRM) is one of the non-destructive methods that was introduced by authors a few years ago. The transient radar method can be classified as a wave-based non destructive testing (NDT) method that can be used in a wide frequency range. Nevertheless, it requires a narrow band, ranging from a few GHz to a few THz, depending on the application. As a time-of-flight and real-time method, TRM can measure the electromagnetic properties of the sample under test not only quickly and accurately, but also blindly. This means that it requires no prior knowledge of the sample under test. For multi-layer structures, TRM is not only able to detect changes related to any parameter within the multi-layer structure but can also measure the electromagnetic properties of each layer and its thickness individually. Although the temperature, humidity, and general environmental conditions may affect the sample under test, they do not affect the accuracy of the Blind TRM algorithm. In this paper, the electromagnetic properties as well as the thickness of the individual building insulation materials - as a single-layer structure - are measured experimentally. Finally, the correlation between the reflection coefficients and some other technical parameters such as sound insulation, thermal resistance, thermal conductivity, compressive strength, and density is investigated. The sample to be studied is 30 cm x 50 cm and the thickness of the samples varies from a few millimeters to 6 centimeters. This experiment is performed with both biostatic and differential hardware at 10 GHz. Since it is a narrow-band system, high-speed computation for analysis, free-space application, and real-time sensor, it has a wide range of potential applications, e.g., in the construction industry, rubber industry, piping industry, wind energy industry, automotive industry, biotechnology, food industry, pharmaceuticals, etc. Detection of metallic, plastic pipes wires, etc. through or behind the walls are specific applications for the construction industry.

Keywords: transient radar method, blind electromagnetic geometrical parameter extraction technique, ultrafast nondestructive multilayer dielectric structure characterization, electronic measurement systems, illumination, data acquisition performance, submillimeter depth resolution, time-dependent reflected electromagnetic signal blind analysis method, EM signal blind analysis method, time domain reflectometer, microwave, milimeter wave frequencies

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2404 The Incidence of Maxillary Canine Ankylosis: A Single-Centre Analysis of 206 Canines Following Surgical Exposure and Orthodontic Alignment

Authors: Sidra Suleman, Maliha Suleman, Jinesh Shah

Abstract:

Maxillary canines play a crucial role in occlusion and aesthetics. Successful management of impacted canines requires early identification and intervention to prevent complications such as resorption of adjacent teeth and cystic changes. Although removal of the deciduous canine can encourage normal eruption of its successor, this is not always successful. Some patients may require surgical exposure and bonding of a gold chain to mobilise and align the canine, which can take up to 3 years. As this procedure has various risks, patients need to be appropriately consented to. Failure of such treatment commonly occurs due to inadequate anchorage or failure of the gold chain attachment, but in some cases, this is due to ankylosis. Aim: The aim of this study was to determine the incidence of ankylosis of unerupted maxillary ectopic canines following surgical exposure and orthodontic alignment at the Maxillofacial and Orthodontic Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: Patients treated from January 1, 2017, to December 31, 2019, were retrospectively studied. Electronic records with post-treatment follow-up at 3-6 months and 12-15 months were extracted and analysed. Patients were excluded based on three criteria, non-compliance with orthodontic treatment post-surgery, presence of canine transposition, and external orthodontic treatment. Sample: Overall, 159 suitable patients were selected from the 171 patients identified. Surgical exposure and gold chain bonding was carried out for a total of 206 maxillary canines, with the pattern of impaction being 159 (77.2 %) palatal, 46 (22.3%) buccal, and 1 (0.49%) in line of the arch. The sample consisted of 57 (35.8%) males and 102 (64.2%) females between the age range of 10 to 32 years, with the mean age being 15 years. The procedures were carried out under general anaesthesia for all but three patients, with two cases being repeats. Closed exposure was carried out for 189 (91.7%) canines. Results: The incidence of ankylosis from this study was 0.97%. In total, two patients had upper left canine ankylosis, which was identified at their 12-15 months orthodontic follow-up. Both patients were males, one having closed exposure at age 15 and the other having open exposure at age 19. Conclusions: Although this data shows that there is a low risk of ankylosis (0.97%), it highlights the difficulty in predicting which patients may be affected, and thus, a thorough pre-treatment assessment and careful observation during treatment is necessary. Future studies involving larger cohorts are warranted to further analyse factors affecting outcomes.

Keywords: ankylosis, ectopic, maxillary canines, orthodontics

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2403 Foot Self-Monitoring Knowledge, Attitude, Practice, and Related Factors among Diabetic Patients: A Descriptive and Correlational Study in a Taiwan Teaching Hospital

Authors: Li-Ching Lin, Yu-Tzu Dai

Abstract:

Recurrent foot ulcers or foot amputation have a major impact on patients with diabetes mellitus (DM), medical professionals, and society. A critical procedure for foot care is foot self-monitoring. Medical professionals’ understanding of patients’ foot self-monitoring knowledge, attitude, and practice is beneficial for raising patients’ disease awareness. This study investigated these and related factors among patients with DM through a descriptive study of the correlations. A scale for measuring the foot self-monitoring knowledge, attitude, and practice of patients with DM was used. Purposive sampling was adopted, and 100 samples were collected from the respondents’ self-reports or from interviews. The statistical methods employed were an independent-sample t-test, one-way analysis of variance, Pearson correlation coefficient, and multivariate regression analysis. The findings were as follows: the respondents scored an average of 12.97 on foot self-monitoring knowledge, and the correct answer rate was 68.26%. The respondents performed relatively lower in foot health screenings and recording, and awareness of neuropathy in the foot. The respondents held a positive attitude toward self-monitoring their feet and a negative attitude toward having others check the soles of their feet. The respondents scored an average of 12.64 on foot self-monitoring practice. Their scores were lower in their frequency of self-monitoring their feet, recording their self-monitoring results, checking their pedal pulse, and examining if their soles were red immediately after taking off their shoes. Significant positive correlations were observed among foot self-monitoring knowledge, attitude, and practice. The correlation coefficient between self-monitoring knowledge and self-monitoring practice was 0.20, and that between self-monitoring attitude and self-monitoring practice was 0.44. Stepwise regression analysis revealed that the main predictive factors of the foot self-monitoring practice in patients with DM were foot self-monitoring attitude, prior experience in foot care, and an educational attainment of college or higher. These factors predicted 33% of the variance. This study concludes that patients with DM lacked foot self-monitoring practice and advises that the patients’ self-monitoring abilities be evaluated first, including whether patients have poor eyesight, difficulties in bending forward due to obesity, and people who can assist them in self-monitoring. In addition, patient education should emphasize self-monitoring knowledge and practice, such as perceptions regarding the symptoms of foot neurovascular lesions, pulse monitoring methods, and new foot self-monitoring equipment. By doing so, new or recurring ulcers may be discovered in their early stages.

Keywords: diabetic foot, foot self-monitoring attitude, foot self-monitoring knowledge, foot self-monitoring practice

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2402 Impact of Interdisciplinary Therapy Allied to Online Health Education on Cardiometabolic Parameters and Inflammation Factor Rating in Obese Adolescents

Authors: Yasmin A. M. Ferreira, Ana C. K. Pelissari, Sofia De C. F. Vicente, Raquel M. Da S. Campos, Deborah C. L. Masquio, Lian Tock, Lila M. Oyama, Flavia C. Corgosinho, Valter T. Boldarine, Ana R. Dâmaso

Abstract:

The prevalence of overweight and obesity is growing around the world and currently considered a global epidemic. Food and nutrition are essential requirements for promoting health and protecting non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate the inflammation and oxidative stress in obese individuals. Few studies have investigated the dietary Inflammation Factor Rating (IFR) in obese adolescents. The IFR was developed to characterize an individual´s diet on anti- to pro-inflammatory score. This evaluation contributes to investigate the effects of inflammatory diet in metabolic profile in several individual conditions. Objectives: The present study aims to investigate the effects of a multidisciplinary weight loss therapy on inflammation factor rating and cardiometabolic risk in obese adolescents. Methods: A total of 26 volunteers (14-19 y.o) were recruited and submitted to 20 weeks interdisciplinary therapy allied to health education website- Ciclo do Emagrecimento®, including clinical, nutritional, psychological counseling and exercise training. The body weight was monitored weekly by self-report and photo. The adolescents answered a test to evaluate the knowledge of the topics covered in the videos. A 24h dietary record was applied at the baseline and after 20 weeks to assess the food intake and to calculate IFR. A negative IFR suggests that diet may have inflammatory effects and a positive IFR indicates an anti-inflammatory effect. Statistical analysis was performed using the program STATISTICA version 12.5 for Windows. The adopted significant value was α ≤ 5 %. Data normality was verified with the Kolmogorov Smirnov test. Data were expressed as mean±SD values. To analyze the effects of intervention it was applied test t. Pearson´s correlations test was performed. Results: After 20 weeks of treatment, body mass index (BMI), body weight, body fat (kg and %), abdominal and waist circumferences decreased significantly. The mean of high-density lipoprotein cholesterol (HDL-c) increased after the therapy. Moreover, it was found an improvement of inflammation factor rating from -427,27±322,47 to -297,15±240,01, suggesting beneficial effects of nutritional counselling. Considering the correlations analysis, it was found that pro-inflammatory diet is associated with increase in the BMI, very low-density lipoprotein cholesterol (VLDL), triglycerides, insulin and insulin resistance index (HOMA-IR); while an anti-inflammatory diet is associated with improvement of HDL-c and insulin sensitivity Check index (QUICKI). Conclusion: The 20-week blended multidisciplinary therapy was effective to reduce body weight, anthropometric circumferences and improve inflammatory markers in obese adolescents. In addition, our results showed that an increase in inflammatory profile diet is associated with cardiometabolic parameters, suggesting the relevance to stimulate anti-inflammatory diet habits as an effective strategy to treat and control of obesity and related comorbidities. Financial Support: FAPESP (2017/07372-1) and CNPq (409943/2016-9)

Keywords: cardiometabolic risk, inflammatory diet, multidisciplinary therapy, obesity

Procedia PDF Downloads 196
2401 Public Health Emergency Management (PHEM) to COVID-19 Pandemic in North-Eastern Part of Thailand

Authors: Orathai Srithongtham, Ploypailin Mekathepakorn, Tossaphong Buraman, Pontida Moonpradap, Rungrueng Kitpati, Chulapon Kratet, Worayuth Nak-ai, Suwaree Charoenmukkayanan, Peeranuch Keawkanya

Abstract:

The COVID-19 pandemic was effect to the health security of the Thai people. The PHEM principle was essential to the surveillance, prevention, and control of COVID-19. This study aimed to present the process of prevention and control of COVID-19 from February 29, 2021- April 30, 2022, and the factors and conditions influent the successful outcome. The study areas were three provinces. The target group was 37 people, composed of public health personnel. The data was collected in-depth, and group interviews followed the non-structure interview guide and were analyzed by content analysis. The components of COVID-19 prevention and control were found in the process of PHEM as follows; 1) Emergency Operation Center (EOC) with an incidence command system (ICS) from the district to provincial level and to propose the provincial measure, 2) Provincial Communicable Disease Committee (PCDC) to decide the provincial measure 3) The measure for surveillance, prevention, control, and treatment of COVID-19, and 4) outcomes and best practices for surveillance and control of COVID-19. The success factors of 4S and EC were as follows; Space: prepare the quarantine (HQ, LQ), Cohort Ward (CW), field hospital, and community isolation and home isolation to face with the patient and risky group, Staff network from various organization and group cover the community leader and Health Volunteer (HV), Stuff the management and sharing of the medical and non-medical equipment, System of Covid-19 respond were EOC, ICS, Joint Investigation Team (JIT) and Communicable Disease Control Unit (CDCU) for monitoring the real-time of surveillance and control of COVID-19 output, Environment management in hospital and the community with Infections Control (IC) principle, and Culture in term of social capital on “the relationship of Isan people” supported the patient provide the good care and support. The structure of PHEM, Isan’s Culture, and good preparation was a significant factor in the three provinces.

Keywords: public health, emergency management, covid-19, pandemic

Procedia PDF Downloads 85
2400 The Evaporation Study of 1-ethyl-3-methylimidazolium chloride

Authors: Kirill D. Semavin, Norbert S. Chilingarov, Eugene.V. Skokan

Abstract:

The ionic liquids (ILs) based on imidazolium cation are well known nowadays. The changing anions and substituents in imidazolium ring may lead to different physical and chemical properties of ILs. It is important that such ILs with halogen as anion are characterized by a low thermal stability. The data about thermal stability of 1-ethyl-3-methylimidazolium chloride are ambiguous. In the works of last years, thermal stability of this IL was investigated by thermogravimetric analysis and obtained results are contradictory. Moreover, in the last study, it was shown that the observed temperature of the beginning of decomposition significantly depends on the experimental conditions, for example, the heating rate of the sample. The vapor pressure of this IL is not presented at the literature. In this study, the vapor pressure of 1-ethyl-3-methylimidazolium chloride was obtained by Knudsen effusion mass-spectrometry (KEMS). The samples of [ЕMIm]Cl (purity > 98%) were supplied by Sigma–Aldrich and were additionally dried at dynamic vacuum (T = 60 0C). Preliminary procedures with Il were derived into glove box. The evaporation studies of [ЕMIm]Cl were carried out by KEMS with using original research equipment based on commercial MI1201 magnetic mass spectrometer. The stainless steel effusion cell had an effective evaporation/effusion area ratio of more than 6000. The cell temperature, measured by a Pt/Pt−Rh (10%) thermocouple, was controlled by a Termodat 128K5 device with an accuracy of ±1 K. In first step of this study, the optimal temperature of experiment and heating rate of samples were customized: 449 K and 5 K/min, respectively. In these conditions the sample is decomposed, but the experimental measurements of the vapor pressures are possible. The thermodynamic activity of [ЕMIm]Cl is close to 1 and products of decomposition don’t affect it at firstly 50 hours of experiment. Therefore, it lets to determine the saturated vapor pressure of IL. The electronic ionization mass-spectra shows that the decomposition of [ЕMIm]Cl proceeds with two ways. Nonetheless, the MALDI mass spectra of the starting sample and residue in the cell were similar. It means that the main decomposition products are gaseous under experimental conditions. This result allows us to obtain information about the kinetics of [ЕMIm]Cl decomposition. Thus, the original KEMS-based procedure made it possible to determine the IL vapor pressure under decomposition conditions. Also, the loss of sample mass due to the evaporation was obtained.

Keywords: ionic liquids, Knudsen effusion mass spectrometry, thermal stability, vapor pressure

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2399 The Quality of Life, Situations and Emerging Concerns of Parents of Children with Neurodevelopmental Disorders in Philippine Children's Medical Center during the Covid-19 Pandemic

Authors: Annelyn Fatima Lopez, Ermenilda Avendano, Aileen Marie Vargas, Lara Baylon, Rorilee Angeles

Abstract:

BACKGROUND: The COVID-19 resulted in a public health emergency and quarantine measures which may negatively impact psychosocial and environmental aspects of vulnerable populations. OBJECTIVES: This study intended to determine the quality of life, situations and emerging concerns of parents of children with neurodevelopmental disorders during the ongoing coronavirus pandemic. METHODOLOGY: Parents of patients seen in the PCMC Neurodevelopmental Pediatrics OPD clinic were recruited to fill out questionnaires on parent and child characteristics, survey on situations and emerging concerns during the coronavirus pandemic and WHOQOL-BREF (Filipino version) for parental quality of life. RESULTS: Data from 115 respondents showed a lower score in the environmental domain. The child characteristics that are statistically comparable with the QoL scores include sex, severity of ID and ADHD while the parent characteristics that are statistically comparable with the QoL scores include educational attainment, monthly family income, father’s employment status and family structure (P-value <0.05). Most respondents reported physical distancing (82.61%) and curfew (80.87%) as measures implemented due to the pandemic. Inability to access essential services (43.48-74.48%) were further compounded by limited financial resources (51.30%) and public transport (60%). Government responses received include quarantine pass (90.43%), food allowance or relief package (86.09%), disinfection (60.87%), DSWD-SAP (42.61%) and cash distribution (41.74%). Concerns encountered include socio-environmental issues (i.e. no available transportation, effect on the ability to earn, inadequate food/medicine rations, disruptions in basic social services) and patient concerns (i.e. access to education, medical, developmental and behavioral services, nutrition and sleep). RECOMMENDATIONS: Programs and policies should be planned accordingly to provide improvement of quality of life for both parents and the child with a neurodevelopmental disorder.

Keywords: covid-19, neurodevelopmental disorder, parental quality of life, whoqol-bref

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2398 Somatic Delusional Disorder Subsequent to Phantogeusia: A Case Report

Authors: Pedro Felgueiras, Ana Miguel, Nélson Almeida, Raquel Silva

Abstract:

Objective: Through the study of a clinical case of delusional somatic disorder secondary to phantogeusia, we aim to highlight the importance of considering psychosomatic conditions in differential diagnosis, as well as to emphasize the complexity of its comprehension, treatment, and respective impact on patients’ functioning. Methods: Bearing this in mind, we conducted a critical analysis of a case series based on patient observations, clinical data, and complementary diagnostic methods, as well as a non-systematic review of the literature on the subject. Results: A 61-year-old female patient with no history of psychiatric conditions. Family psychiatric history of mood disorder (depression), with psychotic features found in her mother. Medical history of many comorbidities affecting different organ systems (endocrine, gastrointestinal, genitourinary, ophthalmological). Documented neuroticism traits of personality. The patient’s family described a persistent concern about several physical symptoms across her life, with a continuous effort to obtain explanations about any sensation out of her normal perception. Since being subjected to endoscopy in 2018, she started complaints of persistent phantogeusia (acid taste) and developed excessive thoughts, feelings, and behaviors associated with this somatic symptom. The patient was evaluated by several medical specialties, and an extensive panel of medical exams was carried out, excluding any disease. Besides all the investigation and with no evidence of disease signs, acute anxiety, time, and energy dispended to this symptom culminated in severe psychosocial impairment. The patient was admitted to a psychiatric ward for investigation and treatment of this clinical picture, leading to the diagnosis of the delusional somatic disorder. In order to exclude the acute organic etiology of this psychotic disorder, an analytic panel was carried out with no abnormal results. In the context of a psychotic clinical picture, a CT scan was performed, which revealed a right cortical vascular lesion. Neuropsychological evaluation was made, with the description of cognitive functioning being globally normative. During treatment with an antipsychotic (pimozide), a complete remission of the somatic delusion was associated with the disappearance of gustative perception disturbance. In follow-up, a relapse of gustative sensation was documented, and her thoughts and speech were dominated by concerns about multiple somatic symptoms. Conclusion: In terms of abnormal bodily sensations, the oral cavity is one of the frequent sites of delusional disorder. Patients with these gustatory perception distortions complain about unusual sensations without corresponding abnormal findings in the oral area. Its pathophysiology has not been fully elucidated yet. In terms of its comprehensive psychopathology, this case was hypothesized as a paranoid development of a delusional somatic disorder triggered by a post-invasive procedure phantogeusia (which is described as a possible side effect of an endoscopy) in a patient with an anankastic personality. This case presents interesting psychopathology, reinforcing the complexity of psychosomatic disorders in terms of their etiopathogenesis, clinical treatment, and long-term prognosis.

Keywords: psychosomatics, delusional somatic disorder, phantogeusia, paranoid development

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2397 Riesz Mixture Model for Brain Tumor Detection

Authors: Mouna Zitouni, Mariem Tounsi

Abstract:

This research introduces an application of the Riesz mixture model for medical image segmentation for accurate diagnosis and treatment of brain tumors. We propose a pixel classification technique based on the Riesz distribution, derived from an extended Bartlett decomposition. To our knowledge, this is the first study addressing this approach. The Expectation-Maximization algorithm is implemented for parameter estimation. A comparative analysis, using both synthetic and real brain images, demonstrates the superiority of the Riesz model over a recent method based on the Wishart distribution.

Keywords: EM algorithm, segmentation, Riesz probability distribution, Wishart probability distribution

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2396 Perovskite Nanocrystals and Quantum Dots: Advancements in Light-Harvesting Capabilities for Photovoltaic Technologies

Authors: Mehrnaz Mostafavi

Abstract:

Perovskite nanocrystals and quantum dots have emerged as leaders in the field of photovoltaic technologies, demonstrating exceptional light-harvesting abilities and stability. This study investigates the substantial progress and potential of these nano-sized materials in transforming solar energy conversion. The research delves into the foundational characteristics and production methods of perovskite nanocrystals and quantum dots, elucidating their distinct optical and electronic properties that render them well-suited for photovoltaic applications. Specifically, it examines their outstanding light absorption capabilities, enabling more effective utilization of a wider solar spectrum compared to traditional silicon-based solar cells. Furthermore, this paper explores the improved durability achieved in perovskite nanocrystals and quantum dots, overcoming previous challenges related to degradation and inconsistent performance. Recent advancements in material engineering and techniques for surface passivation have significantly contributed to enhancing the long-term stability of these nanomaterials, making them more commercially feasible for solar cell usage. The study also delves into the advancements in device designs that incorporate perovskite nanocrystals and quantum dots. Innovative strategies, such as tandem solar cells and hybrid structures integrating these nanomaterials with conventional photovoltaic technologies, are discussed. These approaches highlight synergistic effects that boost efficiency and performance. Additionally, this paper addresses ongoing challenges and research endeavors aimed at further improving the efficiency, stability, and scalability of perovskite nanocrystals and quantum dots in photovoltaics. Efforts to mitigate concerns related to material degradation, toxicity, and large-scale production are actively pursued, paving the way for broader commercial application. In conclusion, this paper emphasizes the significant role played by perovskite nanocrystals and quantum dots in advancing photovoltaic technologies. Their exceptional light-harvesting capabilities, combined with increased stability, promise a bright future for next-generation solar cells, ushering in an era of highly efficient and cost-effective solar energy conversion systems.

Keywords: perovskite nanocrystals, quantum dots, photovoltaic technologies, light-harvesting, solar energy conversion, stability, device designs

Procedia PDF Downloads 104