Search results for: median duration
1755 Economic Evaluation Offshore Wind Project under Uncertainly and Risk Circumstances
Authors: Sayed Amir Hamzeh Mirkheshti
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Offshore wind energy as a strategic renewable energy, has been growing rapidly due to availability, abundance and clean nature of it. On the other hand, budget of this project is incredibly higher in comparison with other renewable energies and it takes more duration. Accordingly, precise estimation of time and cost is needed in order to promote awareness in the developers and society and to convince them to develop this kind of energy despite its difficulties. Occurrence risks during on project would cause its duration and cost constantly changed. Therefore, to develop offshore wind power, it is critical to consider all potential risks which impacted project and to simulate their impact. Hence, knowing about these risks could be useful for the selection of most influencing strategies such as avoidance, transition, and act in order to decrease their probability and impact. This paper presents an evaluation of the feasibility of 500 MV offshore wind project in the Persian Gulf and compares its situation with uncertainty resources and risk. The purpose of this study is to evaluate time and cost of offshore wind project under risk circumstances and uncertain resources by using Monte Carlo simulation. We analyzed each risk and activity along with their distribution function and their effect on the project.Keywords: wind energy project, uncertain resources, risks, Monte Carlo simulation
Procedia PDF Downloads 3521754 Nutrient Content and Labelling Status of Pre-Packaged Beverages in Saudi Arabia
Authors: Ruyuf Y. Alnafisah, Nouf S. Alammari, Amani S. Alqahtani
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Background: Beverage choice can have implications for the risk of non-communicable diseases. However, there is a lack of knowledge in assessing the nutritional content of these beverages. This study aims to describe the nutrient content of pre-packaged beverages available in the Saudi market. Design: Data were collected from the Saudi Branded Food Data-base (SBFD). Nutrient content was standardized in terms of units and reference volumes to ensure consistency in analysis. Results: A total of 1490 beverages were analyzed. The highest median levels of the majority of nutrients were found among dairy products; energy (68.4(43-188]kcal/100 ml in a milkshake); protein (8.2(0.5-8.2]g/100 ml in yogurt drinks); total fat (2.1(1.3-3.5]g/100 ml in milk); saturated fat (1.4(0-1.4]g/100 ml in yogurt drinks); cholesterol (30(0-30]mg/100 ml in yogurt drinks); sodium (65(65-65].4mg/100 ml in yogurt drinks); and total sugars (12.9(7.5-27]g/100 ml in milkshake). Carbohydrate level was the highest in nectar (13(11.8-14.2] g/100ml]; fruits drinks (12.9(11.9-13.9] g/100ml), and sparkling juices (12.9(8.8-14] g/100ml). The highest added sugar level was observed among regular soft drinks (12(10.8-14] g/100ml). The average rate of nutrient declaration was 60.95%. Carbo-hydrate had the highest declaration rate among nutrients (99.1%), and yogurt drinks had the highest declaration rate among beverage categories (92.7%). The median content of vitamins A and D in dairy products met the mandatory addition levels. Conclusion: This study provides valuable insights into the nutrient content of pre-packaged beverages in the Saudi market. It serves as a foundation for future research and monitoring. The findings of the study support the idea of taxing sugary beverages and raise concerns about the health effects of high sugar in fruit juices. Despite the inclusion of vitamins D and A in dairy products, the study highlights the need for alternative strategies to address these deficiencies.Keywords: pre-packaged beverages, nutrients content, nutrients declaration, daily percentage value, mandatory addition of vitamins
Procedia PDF Downloads 581753 Predictors of Glycaemic Variability and Its Association with Mortality in Critically Ill Patients with or without Diabetes
Authors: Haoming Ma, Guo Yu, Peiru Zhou
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Background: Previous studies show that dysglycemia, mostly hyperglycemia, hypoglycemia and glycemic variability(GV), are associated with excess mortality in critically ill patients, especially those without diabetes. Glycemic variability is an increasingly important measure of glucose control in the intensive care unit (ICU) due to this association. However, there is limited data pertaining to the relationship between different clinical factors and glycemic variability and clinical outcomes categorized by their DM status. This retrospective study of 958 intensive care unit(ICU) patients was conducted to investigate the relationship between GV and outcome in critically ill patients and further to determine the significant factors that contribute to the glycemic variability. Aim: We hypothesize that the factors contributing to mortality and the glycemic variability are different from critically ill patients with or without diabetes. And the primary aim of this study was to determine which dysglycemia (hyperglycemia\hypoglycemia\glycemic variability) is independently associated with an increase in mortality among critically ill patients in different groups (DM/Non-DM). Secondary objectives were to further investigate any factors affecting the glycemic variability in two groups. Method: A total of 958 diabetic and non-diabetic patients with severe diseases in the ICU were selected for this retrospective analysis. The glycemic variability was defined as the coefficient of variation (CV) of blood glucose. The main outcome was death during hospitalization. The secondary outcome was GV. The logistic regression model was used to identify factors associated with mortality. The relationships between GV and other variables were investigated using linear regression analysis. Results: Information on age, APACHE II score, GV, gender, in-ICU treatment and nutrition was available for 958 subjects. Predictors remaining in the final logistic regression model for mortality were significantly different in DM/Non-DM groups. Glycemic variability was associated with an increase in mortality in both DM(odds ratio 1.05; 95%CI:1.03-1.08,p<0.001) or Non-DM group(odds ratio 1.07; 95%CI:1.03-1.11,p=0.002). For critically ill patients without diabetes, factors associated with glycemic variability included APACHE II score(regression coefficient, 95%CI:0.29,0.22-0.36,p<0.001), Mean BG(0.73,0.46-1.01,p<0.001), total parenteral nutrition(2.87,1.57-4.17,p<0.001), serum albumin(-0.18,-0.271 to -0.082,p<0.001), insulin treatment(2.18,0.81-3.55,p=0.002) and duration of ventilation(0.006,0.002-1.010,p=0.003).However, for diabetes patients, APACHE II score(0.203,0.096-0.310,p<0.001), mean BG(0.503,0.138-0.869,p=0.007) and duration of diabetes(0.167,0.033-0.301,p=0.015) remained as independent risk factors of GV. Conclusion: We found that the relation between dysglycemia and mortality is different in the diabetes and non-diabetes groups. And we confirm that GV was associated with excess mortality in DM or Non-DM patients. Furthermore, APACHE II score, Mean BG, total parenteral nutrition, serum albumin, insulin treatment and duration of ventilation were significantly associated with an increase in GV in Non-DM patients. While APACHE II score, mean BG and duration of diabetes (years) remained as independent risk factors of increased GV in DM patients. These findings provide important context for further prospective trials investigating the effect of different clinical factors in critically ill patients with or without diabetes.Keywords: diabetes, glycemic variability, predictors, severe disease
Procedia PDF Downloads 1891752 Borderline Ovarian Tumor: Management of Recurrence After Conservative Surgical Treatment
Authors: Ghorbeli Eya, Naija Lamia, Khessairi Nayssem, Saadallah Fatma, Slimane Maher, Tarek Ben Dhiab
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INTRODUCTION: Borderline ovarian tumors account for 15 to 20% of ovarian tumors. Prognostic factors of recurrence include the stage of the disease, presence of peritoneal implants, micropapillary pattern, microinvasion and intra-epithelial carcinoma. Fertility sparing constitutes a major therapeutic issue in young patients that leads to conservative surgical treatment in specific cases. METHODS: We conducted a retrospective descriptive study including patients treated at the Salah Azaiez Institute for Borderline Ovarian Tumor who underwent conservative surgical treatment from 2003 to 2018. RESULTS: Nine patients were included in our study. The median age was 33 years. Three patients were nulliparous. Given the age, conservative treatment was indicated in all these patients. Cystectomy without ovariectomy was indicated in 5 of the 9 women, which was within the margin of tumor resection on definitive anatomopathic examination in 3 of the 5 women. In contrast, given the impossibility of ovarian conservation, total annexectomy was carried out in 4 of all these women. All of the patients were followed regularly postoperatively; three had a carcinomatous transformation as an ovarian adenocarcinoma at an average interval of 18 months. Among these three patients, a single one presented intra-peritoneal metastases, requiring radical surgical treatment and adjuvant chemotherapy with 6 cures of Carbo-Taxol, with a good tolerance and a complete response. Moreover, one patient had a recurrence on the contralateral ovary as a Borderline mucinous ovarian tumor. For the remaining four women, after a median follow-up of 35 months, one patient fell spontaneously pregnant during follow-up, and three patients were in complete remission at 16 months. CONCLUSION: Borderline tumors of the ovary usually occur in young patients, which makes conservative treatment advisable if possible, but this always comes with a risk of recurrence and/or carcinomatous transformation, especially if the conservative surgical procedure was a cystectomy instead of a total annexectomy, and even more so if the resection margins were tumoral.Keywords: ovarian tumor, conservative treatment, surgical management, borderline ovarian tumor, recurrence management
Procedia PDF Downloads 281751 Pathogenicity of Entomopathogenic Fungi, Beauveria bassiana Against Red Palm Weevil, (Rhynchophorus ferrugineus)
Authors: Muhammad Mamoon-Ur-Rashid, Gul Rehman
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Entomopathogenic fungi are considered effective bio-control agents for the management of a range of insect pests including red palm weevil. The research studies were conducted under laboratory and field conditions against 5th and 6th instars larvae and adults of [Rhynchophorus ferrugineus (Olivier)] at the faculty of Agriculture, Gomal University Dera Ismail Khan (KPK) Pakistan. The 5th instar larvae were used under field conditions whereas, the 6th instar larvae and newly emerged adults were used under lab conditions. Conidial suspensions were used at five different concentrations of 1×10⁴, 1×10⁵, 1×10⁶, 1×10⁷ and 1×10⁸, conidia per ml. The data were recorded on the mortality, total larval duration, weight of larvae, pre-pupal and pupal durations, percent pupal formation, pupal weight, percent adult emergence, and adult longevity (♂ and ♀) of red palm weevil. The B. bassiana had varying degrees of pathogenicity against different developmental stages of red palm weevil. The maximum larval duration (113.40 days) was noted when 5th instar larvae were treated with the maximum concentration (1 × 10⁸) of B. bassiana, whereas; the minimum total larval duration of 87.20 days was recorded on the lowest concentration (1 × 10⁴) of B. bassiana. The maximum pre-pual and pupal durations were noted at the maximum concentration. The maximum life span of adult male and females were noted at the lowest concentration, whereas; the minimum values were noted at the maximum concentration. The earliest mortality of red palm weevil was observed 1-day after treatment at higher concentrations of 1 × 10⁷ and 1 × 10⁸, whereas; it was recorded 3 and 4 days after treatment at lower concentrations of 1 × 10⁵ and 1 × 10⁴. At 10 days after treatment, the entomopathogenic fungus caused > 80% cumulative mortality of 5th and 6th instar larvae and adult weevils at the maximum concentrations which were more than double than those recorded at the lowest concentration. Overall, the 5th instar larvae of red palm weevils were most susceptible to the fungus compared to the 6th instar larvae and adult weevils. Based on current findings, it is suggested that entomopathogenic fungi could be used for the safer management of red palm weevil.Keywords: entomopathogenic nematodes, mortality, red palm weevil, sub-lethal effects
Procedia PDF Downloads 921750 Breast Cancer in Very Young (Less Than 25 Yeras) Women: An Institutional Analysis from Developing Country
Authors: Ajay Gogia, Svs Deo, Dn Sharma, Atul Batra, Ashutash Mishra
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Background and Aims: Breast cancer in women aged less than 25 years (defined as very young breast cancer, VYBC) is rare and accounts for 0.25% of all breast cancer in the West. There is no data available on VYBC from developing countries. The aim of this study was to analyze the clinical, pathological, and prognostic factors and outcomes in VYBC. Methods: This retrospective analysis was performed on 80 patients aged 25 years or less (screened 8000 files of female BC) who were registered at All India Institute of Medical Sciences (AIIMS), New Delhi, India, over a 15-year period between 2011 and 2023. Results: The median age was 21.5 years (range 16-25). A positive family history (siblings and parents) was elicited in 30% of cases, and breast cancer gene (BRCA1/2) mutation was found in 33% of cases patients. Ten patients (12.5%) patients have pregnancy-associated breast cancer (BC detected during pregnancy or 1 year after postpartum period). The TNM stage distribution was Stage I was 0, stage II -30%, stage III –60% and Stage IV -10 %patients. Seventy percent of tumors were high grade, and 90% had pathological node-positive disease. Estrogen, Progesterone, and human epidermal growth factor receptor 2 (HER2)/neu positivity were 25%,25% and 35%, respectively. Triple-negative breast cancer constituted 40% of patients. With a median follow-up of 42 months, 3 years, relapse-free survival (nonmetastatic disease), progression-free survival (metastatic disease) and overall survival were 30%, 15% and 50%, respectively. Conclusions: Very young women constituted 1% of all breast cancer cases. Advanced disease at presentation and high-risk pathological features result in poor outcomes. One-third of VYBCs are associated with BRCA mutation, which requires genetic counseling and risk reduction surgery if required. Due to the aggressive behavior of BC in this age group, need early diagnosis and prompt treatmentKeywords: very young, breast cancer, outcome, developing country, India
Procedia PDF Downloads 281749 Regionalization of IDF Curves with L-Moments for Storm Events
Authors: Noratiqah Mohd Ariff, Abdul Aziz Jemain, Mohd Aftar Abu Bakar
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The construction of Intensity-Duration-Frequency (IDF) curves is one of the most common and useful tools in order to design hydraulic structures and to provide a mathematical relationship between rainfall characteristics. IDF curves, especially those in Peninsular Malaysia, are often built using moving windows of rainfalls. However, these windows do not represent the actual rainfall events since the duration of rainfalls is usually prefixed. Hence, instead of using moving windows, this study aims to find regionalized distributions for IDF curves of extreme rainfalls based on storm events. Homogeneity test is performed on annual maximum of storm intensities to identify homogeneous regions of storms in Peninsular Malaysia. The L-moment method is then used to regionalized Generalized Extreme Value (GEV) distribution of these annual maximums and subsequently. IDF curves are constructed using the regional distributions. The differences between the IDF curves obtained and IDF curves found using at-site GEV distributions are observed through the computation of the coefficient of variation of root mean square error, mean percentage difference and the coefficient of determination. The small differences implied that the construction of IDF curves could be simplified by finding a general probability distribution of each region. This will also help in constructing IDF curves for sites with no rainfall station.Keywords: IDF curves, L-moments, regionalization, storm events
Procedia PDF Downloads 5281748 Lethal and Sublethal Effect of Azadirachtin on the Development of an Insect Model: Drosophila melanogaster (Diptera)
Authors: Bendjazia Radia, Samira Kilani-Morakchi, Nadia Aribi
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Azadirachtin is a biorational insecticide commonly reported as selective to a range of beneficial insects. It is one of the most biologically active natural inhibitors of insect growth and development and it is known to be an antagonist of the juvenile hormone and 20-hydroxyecdysone (20E). However, its mechanism of action remains still unknown. In the present study, the toxicity of a commercial formulation of Azadirachtin (Neem Azal, 1% azadirachtine) was evaluated by topical application at various doses (0.1, 0.25, 0.5, 1 and 2 µg/insect) on the third instars larvae of D. melanogaster. Lethal doses (LD25: 0.28µg and LD50: 0.67µg), were evaluated by cumulated mortality at the immature stages. The effects of azadirachtin (LD25 and LD50) were then evaluated on the development (duration of the larval and pupal instars, the weight of larvae, pupa and adults) of Drosophila melanogaster. Results showed that the insecticide increased significantly the larval and pupal instar duration. A reduction of larval and pupal weight is noted under azadirachtin treatment as compared to controls. In addition, the weight of surviving adults at the two tested dose was also reduced. In conclusion, azadirachtin seemed to interfere with the functions of the endocrine system resulting in development defects.Keywords: azadirachtin, d.melanogaster, toxicity, development
Procedia PDF Downloads 4601747 English Theticity and Focus Expression in Spanish Heritage Speakers
Authors: Sebastian Leal-Arenas
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English uses in-situ Nuclear Stress (NS) to express the meanings of theticity and focus. The NS is phonetically represented by an increase in duration, intensity, and pitch range. On the other hand, Spanish conveys the same meanings by aligning the constituent that carries the NS to the end of the sentence via word-order movement. However, little is known about heritage speakers’ production of theticity and focus in English or Spanish. The present study investigates heritage speakers’ production of thetic and subject focus statements. Participants (n = 11) were heritage speakers of Spanish with varying proficiency enrolled in a writing course at a university in the United States. In the production task, participants observed contextualized images and uttered a sentence to answer a provided question. Duration, intensity, and F0 peak were the correlates to stress considered in this investigation. Results indicated that participants tended to present an intonation closer to what is expected in English monolinguals in subject-focus statements than in thetic sentences. However, participants with lower Spanish proficiency used in-situ NS placement in thetic statements more often than those with higher proficiency. Results are discussed in terms of the production patterns observed in heritage speakers with emphasis on the role of language dominance.Keywords: focus, heritage speakers, prosody, theticity
Procedia PDF Downloads 711746 A Retrospective Analysis of the Impact of the Choosing Wisely Canada Campaign on Emergency Department Imaging Utilization for Head Injuries
Authors: Sameer Masood, Lucas Chartier
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Head injuries are a commonly encountered presentation in emergency departments (ED) and the Choosing Wisely Canada (CWC) campaign was released in June 2015 in an attempt to decrease imaging utilization for patients with minor head injuries. The impact of the CWC campaign on imaging utilization for head injuries has not been explored in the ED setting. In our study, we describe the characteristics of patients with head injuries presenting to a tertiary care academic ED and the impact of the CWC campaign on CT head utilization. This retrospective cohort study used linked databases from the province of Ontario, Canada to assess emergency department visits with a primary diagnosis of head injury made between June 1, 2014 and Aug 31, 2016 at the University Health Network in Toronto, Canada. We examined the number of visits during the study period, the proportion of patients that had a CT head performed before and after the release of the CWC campaign, as well as mode of arrival, and disposition. There were 4,322 qualifying visits at our site during the study period. The median presenting age was 44.12 years (IQR 27.83,67.45), the median GCS was 15 (IQR 15,15) and the majority of patients presenting had intermediate acuity (CTAS 3). Overall, 43.17% of patients arrived via ambulance, 49.24 % of patients received a CT head and 10.46% of patients were admitted. Compared to patients presenting before the CWC campaign release, there was no significant difference in the rate of CT heads after the CWC (50.41% vs 47.68%, P = 0.07). There were also no significant differences between the two groups in mode of arrival (ambulance vs ambulatory) (42.94% vs 43.48%, P = 0.72) or admission rates (9.85% vs 11.26%, P = 0.15). However, more patients belonged to the high acuity groups (CTAS 1 or 2) in the post CWC campaign release group (12.98% vs 8.11% P <0.001). Visits for head injuries make up a significant proportion of total ED visits and approximately half of these patients receive CT imaging in the ED. The CWC campaign did not seem to impact imaging utilization for head injuries in the 14 months following its launch. Further efforts, including local quality improvement initiatives, are likely needed to increase adherence to its recommendation and reduce imaging utilization for head injuries.Keywords: choosing wisely, emergency department, head injury, quality improvement
Procedia PDF Downloads 2251745 Cross-Cultural Competence Development through 'Learning by Reflection': A Case Study of Chinese International Students Learning through Taking Part-Time Jobs in the UK
Authors: Xin Zhao
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The project aims to expand the notion of narrative learning and address the importance of learning by reflection in our learning and teaching context at a British university. Drawing on the key concepts such as development ZPD, transition and reflection-in and –on-action, this project analyses the learning experiences of a small sample of Chinese postgraduate students in a British University, who use part-time job experience to develop cross-cultural communication skills. The project adopts a mixed methods approach. Questionnaires and focus group interviews are used to examine the way in which students adapt (or not adapt) to the culture of learning in a British university and develop a renewed sense of self in transitions from one culture to the other. The project also looks at how the students appropriate opportunities for learning not just from classrooms but outside classrooms from everyday encounters. The project aims to address the implication of learning by reflection as development in transition. Time in and for learning, or duration, is taken for granted in theorising narrative learning. The project shall explore this very issue of time in relation to learning by reflection in considering time in/of/for learning as duration.Keywords: cross-cultural competence, learning by refection, international student transition, part-time work experience
Procedia PDF Downloads 1831744 Translation Directionality: An Eye Tracking Study
Authors: Elahe Kamari
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Research on translation process has been conducted for more than 20 years, investigating various issues and using different research methodologies. Most recently, researchers have started to use eye tracking to study translation processes. They believed that the observable, measurable data that can be gained from eye tracking are indicators of unobservable cognitive processes happening in the translators’ mind during translation tasks. The aim of this study was to investigate directionality in translation processes through using eye tracking. The following hypotheses were tested: 1) processing the target text requires more cognitive effort than processing the source text, in both directions of translation; 2) L2 translation tasks on the whole require more cognitive effort than L1 tasks; 3) cognitive resources allocated to the processing of the source text is higher in L1 translation than in L2 translation; 4) cognitive resources allocated to the processing of the target text is higher in L2 translation than in L1 translation; and 5) in both directions non-professional translators invest more cognitive effort in translation tasks than do professional translators. The performance of a group of 30 male professional translators was compared with that of a group of 30 male non-professional translators. All the participants translated two comparable texts one into their L1 (Persian) and the other into their L2 (English). The eye tracker measured gaze time, average fixation duration, total task length and pupil dilation. These variables are assumed to measure the cognitive effort allocated to the translation task. The data derived from eye tracking only confirmed the first hypothesis. This hypothesis was confirmed by all the relevant indicators: gaze time, average fixation duration and pupil dilation. The second hypothesis that L2 translation tasks requires allocation of more cognitive resources than L1 translation tasks has not been confirmed by all four indicators. The third hypothesis that source text processing requires more cognitive resources in L1 translation than in L2 translation and the fourth hypothesis that target text processing requires more cognitive effort in L2 translation than L1 translation were not confirmed. It seems that source text processing in L2 translation can be just as demanding as in L1 translation. The final hypothesis that non-professional translators allocate more cognitive resources for the same translation tasks than do the professionals was partially confirmed. One of the indicators, average fixation duration, indicated higher cognitive effort-related values for professionals.Keywords: translation processes, eye tracking, cognitive resources, directionality
Procedia PDF Downloads 4631743 Optimum Er: YAG Laser Parameters for Orthodontic Composite Debonding: An in vitro Study
Authors: Mohammad Zamzam, Wesam Bachir, Imad Asaad
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Several studies have produced estimates of Er:YAG laser parameters and specifications but there is still insufficient data for reliable selection of laser parameters. As a consequence, there is a heightened need for ideal specifications of Er:YAG laser to reduce the amount of enamel ablation. The objective of this paper is to investigate the influence of Er:YAG laser parameters, energy level and pulse duration, on orthodontic composite removal after bracket debonding. The sample consisted of 45 cuboids of orthodontic composite made by plastic moulds. The samples were divided into three groups, each was irradiated with Er:YAG laser set at different energy levels and three values for pulse durations (50 µs, 100 µs, and 300 µs). Geometrical parameters (depth and area) of cavities formed by laser irradiation were determined. ANCOVA test showed statistically significant difference (p < 0.0.5) between the groups indicating a potential effect of laser pulse duration on the geometrical parameters after controlling laser energy level. A post-hoc Bonferroni test ranked the 50µ Er:YAG laser pulse as the most influential factor for all geometrical parameters in removing remnant composite from enamel surface. Also, 300 mJ laser pulses caused the largest removal of the composite. The results of the present study demonstrated the efficacy of 50 µs and 300 mJ Er:YAG laser pulse for removal of remnant orthodontic composite.Keywords: enamel, Er:YAG, geometrical parameters, orthodontic composite, remnant composite
Procedia PDF Downloads 5531742 The Effectiveness of Scalp Cooling Therapy on Reducing Chemotherapy Induced Alopecia: A Critical Literature Review
Authors: M. Krishna
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The study was intended to identify if scalp cooling therapy is effective on preventing chemotherapy-induced hair loss among cancer patients. Critical literature of non-randomized controlled trials was used to investigate whether scalp cooling therapy is effective on preventing chemotherapy-induced alopecia. The review identified that scalp cooling therapy is effective on preventing chemotherapy-induced alopecia. Most of the patients receiving chemotherapy experience alopecia. It is also perceived as the worst effect of chemotherapy. This may be severe and lead the patients to withdraw the chemo treatment. The image disturbance caused by alopecia will make the patient depressed and will lead to declined immunity. With the knowledge on effectiveness of scalp cooling therapy on preventing chemotherapy-induced alopecia, patient undergoing chemotherapy will not be hesitant to undergo the treatment. Patients are recommended to go through scalp cooling therapy every chemo cycle and the proper therapy duration is 30 minutes before, during chemo. The suggested duration of the scalp cooling therapy is 45-90 minutes for an effective and positive outcome. This finding is excluding other factors of alopecia such as menopause, therapeutic drugs, poor hair density, liver function problems, and drug regimes.Keywords: alopecia, cancer, chemotherapy, scalp cooling therapy
Procedia PDF Downloads 2081741 To Evaluate the Function of Cardiac Viability After Administration of I131
Authors: Baburao Ganpat Apte, Gajodhar
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Introduction: diopathic Parkinson’s disease (PD) is the most common neurodegenerative disorder. Early PD may present a diagnostic challenge with broad differential diagnoses that are not associated with striatal dopamine deficiency. This test was performed by using special type of radioactive precursor which was made available through our logistics. 131I-TOPA L-6-[131I] Iodo-3,4-Trihydroxyphenylalnine (131I -TOPA) is a positron emission tomography (PET) agent that measures the uptake of dopamine precursors for assessment of presynaptic dopaminergic integrity and has been shown to accurately reflect the sign of nervous mind going in patients suffers from monoaminergic disturbances in PD. Both qualitative and quantitative analyses of the scans were performed. Therefore, the early clinical diagnosis alone may be accurate and this reinforces the importance of functional imaging targeting the patholigically of the disease process. The patient’s medical records were then assessed for length of follow-up, response to levotopa, clinical course of sickness, and usually though of symptoms at time of 131I -TOPA PET. A respective analysis was carried out for all patients that gone through 131I -TOPA PET brain scan for motor symptoms suspicious for PD between 2000 - 2006. The eventual diagnosis by the referring neurologist, movement therapist, physiotherapist, was used as the accurate measurements in standard for further analysis. In this study, our goal to illustrate our local experience to determine the accuracy of 131I -TOPA PET for diagnosis of PD. We studied a total of 48 patients. Of the 25 scans, it found that one was a false negative, 40 were true positives, and 7 were true negatives. The resultant values are Sensitivity 90.4% (95% CI: 100%-71.3%), Specificity 100% (92% CI: 100%-58.0%), PPV 100% (91% CI 100%-75.7%), and NPV 80.5% (95% CI: 92.5%-48.5%). Result: Twenty-three patients were found in the initial query, and 1 were excluded (2 uncertain diagnosis, 2 inadequate follow-up). Twenty-eight patients (28 scans) remained with 15 males (62%) and 8 females (30%). All the patients had a clinical follow-up of at least 3 years, however the median length of follow-up was 5.5 years (range: 2-8 years). The median age at scan time was 51.2 years (range: 35-75)Keywords: 18F-TOPA, petct, parkinson’s disease, cardiac
Procedia PDF Downloads 271740 Wearable System for Prolonged Cooling and Dehumidifying of PPE in Hot Environments
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While personal protective equipment (PPE) prevents the healthcare personnel from exposing to harmful surroundings, it creates a barrier to the dissipation of body heat and perspiration, leading to severe heat stress during prolonged exposure, especially in hot environments. It has been found that most of the existed personal cooling strategies have limitations in achieving effective cooling performance with long duration and lightweight. This work aimed to develop a lightweight (<1.0 kg) and less expensive wearable air cooling and dehumidifying system (WCDS) that can be applied underneath the protective clothing and provide 50W mean cooling power for more than 5 hours at 35°C environmental temperature without compromising the protection of PPE. For the WCDS, blowers will be used to activate an internal air circulation inside the clothing microclimate, which doesn't interfere with the protection of PPE. An air cooling and dehumidifying chamber (ACMR) with a specific design will be developed to reduce the air temperature and humidity inside the protective clothing. Then the cooled and dried air will be supplied to upper chest and back areas through a branching tubing system for personal cooling. A detachable ice cooling unit will be applied from the outside of the PPE to extract heat from the clothing microclimate. This combination allows for convenient replacement of the cooling unit to refresh the cooling effect, which can realize a continuous cooling function without taking off the PPE or adding too much weight. A preliminary thermal manikin test showed that the WCDS was able to reduce the microclimate temperature inside the PPE averagely by about 8°C for 60 minutes when the environmental temperature was 28.0 °C and 33.5 °C, respectively. Replacing the ice cooling unit every hour can maintain this cooling effect, while the longest operation duration is determined by the battery of the blowers, which can last for about 6 hours. This unique design is especially helpful for the PPE users, such as health care workers in infectious and hot environments when continuous cooling and dehumidifying are needed, but the change of protective clothing may increase the risk of infection. The new WCDS will not only improve the thermal comfort of PPE users but can also extend their safe working duration.Keywords: personal thermal management, heat stress, ppe, health care workers, wearable device
Procedia PDF Downloads 791739 Causes and Impacts of Marine Heatwaves in the Bay of Bengal Region in the Recent Period
Authors: Sudhanshu Kumar, Raghvendra Chandrakar, Arun Chakraborty
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In the ocean, the temperature extremes have the potential to devastate marine habitats, ecosystems together with ensuing socioeconomic consequences. In recent years, these extreme events are more frequent and intense globally and their increasing trend is expected to continue in the upcoming decades. It recently attracted public interest, as well as scientific researchers, which motivates us to analyze the current marine heatwave (MHW) events in the Bay of Bengal region. we have isolated 107 MHW events (above 90th percentile threshold) in this region of the Indian Ocean and investigated the variation in duration, intensity, and frequency of MHW events during our test period (1982-2021). Our study reveals that in the study region the average of three MHW events per year with an increasing linear trend of 1.11 MHW events per decade. In the analysis, we found the longest MHW event which lasted about 99 days, which is far greater than an average MHW event duration. The maximum intensity was 5.29°C (above the climatology-mean), while the mean intensity was 2.03°C. In addition, we observed net heat flux accompanied by anticyclonic eddies to be the primary cause of these events. Moreover, we concluded that these events affect sea surface height and oceanic productivity, highlighting the adverse impact of MHWs on marine ecosystems.Keywords: marine heatwaves, global warming, climate change, sea surface temperature, marine ecosystem
Procedia PDF Downloads 1231738 Palliative Orthovoltage Radiotherapy and Subcutaneous Infusion of Carboplatin for Treatment of Appendicular Osteosarcoma in Dogs
Authors: Kathryn L. Duncan, Charles A. Kuntz, Alessandra C. Santamaria, James O. Simcock
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Access to megavoltage radiation therapy for small animals is limited in many locations around the world. This can preclude the use of palliative radiation therapy for the treatment of appendicular osteosarcoma in dogs. The objective of this study was to retrospectively assess the adverse effects and survival times of dogs with appendicular osteosarcoma that were treated with hypofractionated orthovoltage radiation therapy and adjunctive carboplatin chemotherapy administered via a single subcutaneous infusion. Medical records were reviewed retrospectively to identify client-owned dogs with spontaneously occurring appendicular osteosarcoma that was treated with palliative orthovoltage radiation therapy and a single subcutaneous infusion of carboplatin. Data recorded included signalment, tumour location, results of diagnostic imaging, haematologic and serum biochemical analyses, adverse effects of radiation therapy and chemotherapy, and survival times. Kaplan-Meier survival analysis was performed, and log-rank analysis was used to determine the impact of specific patient variables on survival time. Twenty-three dogs were identified that met the inclusion criteria. Median survival time for dogs was 182 days. Eleven dogs had adverse haematologic effects, 3 had adverse gastrointestinal effects, 6 had adverse effects at the radiation site and 7 developed infections at the carboplatin infusion site. No statistically significant differences were identified in survival times based on sex, tumour location, development of infection, or pretreatment serum alkaline phosphatase. Median survival time and incidence of adverse effects were comparable to those previously reported in dogs undergoing palliative radiation therapy with megavoltage or cobalt radiation sources and conventional intravenous carboplatin chemotherapy. The use of orthovoltage palliative radiation therapy may be a reasonable alternative to megavoltage radiation in locations where access is limited.Keywords: radiotherapy, veterinary oncology, chemotherapy, osteosarcoma
Procedia PDF Downloads 731737 Estimation of Fragility Curves Using Proposed Ground Motion Selection and Scaling Procedure
Authors: Esra Zengin, Sinan Akkar
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Reliable and accurate prediction of nonlinear structural response requires specification of appropriate earthquake ground motions to be used in nonlinear time history analysis. The current research has mainly focused on selection and manipulation of real earthquake records that can be seen as the most critical step in the performance based seismic design and assessment of the structures. Utilizing amplitude scaled ground motions that matches with the target spectra is commonly used technique for the estimation of nonlinear structural response. Representative ground motion ensembles are selected to match target spectrum such as scenario-based spectrum derived from ground motion prediction equations, Uniform Hazard Spectrum (UHS), Conditional Mean Spectrum (CMS) or Conditional Spectrum (CS). Different sets of criteria exist among those developed methodologies to select and scale ground motions with the objective of obtaining robust estimation of the structural performance. This study presents ground motion selection and scaling procedure that considers the spectral variability at target demand with the level of ground motion dispersion. The proposed methodology provides a set of ground motions whose response spectra match target median and corresponding variance within a specified period interval. The efficient and simple algorithm is used to assemble the ground motion sets. The scaling stage is based on the minimization of the error between scaled median and the target spectra where the dispersion of the earthquake shaking is preserved along the period interval. The impact of the spectral variability on nonlinear response distribution is investigated at the level of inelastic single degree of freedom systems. In order to see the effect of different selection and scaling methodologies on fragility curve estimations, results are compared with those obtained by CMS-based scaling methodology. The variability in fragility curves due to the consideration of dispersion in ground motion selection process is also examined.Keywords: ground motion selection, scaling, uncertainty, fragility curve
Procedia PDF Downloads 5831736 Study of Performance Based Parameters on Sprint Interval Training and Steady State Run: Trained Young Female
Authors: Abdul Latif Shaikh, Osama Kattos
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Purpose: The study compared the effects of intra and inter group short duration intensity training and long duration steady state-run training on the cardiovascular performance on female athletes. Method: Twenty trained young female athletes age between 17 to 20 years were randomly selected to participate in the test. The sprint interval training (n-10) program consisted of 5 min sprints and steady state run (n-10) conducted for 30 min. Both groups completed eight sessions of training within four weeks. Result: In intragroup distribution of mean % change in all the variables from week 4 to week 1 did not differ significantly (p-value > 0.05). The inter-group means value of post resting heart rate, max oxygen consumption (VO2max), and calorie expenditure in sprint interval training was higher with compared with steady state run. Conclusion: The comparative mean value of the intergroups program concludes that the SIT program is superior to SSR in performance-based variables in trained young females. The SIT program can be applied as a time-efficient program for improving performance.Keywords: calorie expenditure, maximum rate of oxygen consumption, post recovery HR (1-4-7 min), time domain
Procedia PDF Downloads 1721735 A Comparative Study of Mechanisms across Different Online Social Learning Types
Authors: Xinyu Wang
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In the context of the rapid development of Internet technology and the increasing prevalence of online social media, this study investigates the impact of digital communication on social learning. Through three behavioral experiments, we explore both affective and cognitive social learning in online environments. Experiment 1 manipulates the content of experimental materials and two forms of feedback, emotional valence, sociability, and repetition, to verify whether individuals can achieve online emotional social learning through reinforcement using two social learning strategies. Results reveal that both social learning strategies can assist individuals in affective, social learning through reinforcement, with feedback-based learning strategies outperforming frequency-dependent strategies. Experiment 2 similarly manipulates the content of experimental materials and two forms of feedback to verify whether individuals can achieve online knowledge social learning through reinforcement using two social learning strategies. Results show that similar to online affective social learning, individuals adopt both social learning strategies to achieve cognitive social learning through reinforcement, with feedback-based learning strategies outperforming frequency-dependent strategies. Experiment 3 simultaneously observes online affective and cognitive social learning by manipulating the content of experimental materials and feedback at different levels of social pressure. Results indicate that online affective social learning exhibits different learning effects under different levels of social pressure, whereas online cognitive social learning remains unaffected by social pressure, demonstrating more stable learning effects. Additionally, to explore the sustained effects of online social learning and differences in duration among different types of online social learning, all three experiments incorporate two test time points. Results reveal significant differences in pre-post-test scores for online social learning in Experiments 2 and 3, whereas differences are less apparent in Experiment 1. To accurately measure the sustained effects of online social learning, the researchers conducted a mini-meta-analysis of all effect sizes of online social learning duration. Results indicate that although the overall effect size is small, the effect of online social learning weakens over time.Keywords: online social learning, affective social learning, cognitive social learning, social learning strategies, social reinforcement, social pressure, duration
Procedia PDF Downloads 461734 Using the Bootstrap for Problems Statistics
Authors: Brahim Boukabcha, Amar Rebbouh
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The bootstrap method based on the idea of exploiting all the information provided by the initial sample, allows us to study the properties of estimators. In this article we will present a theoretical study on the different methods of bootstrapping and using the technique of re-sampling in statistics inference to calculate the standard error of means of an estimator and determining a confidence interval for an estimated parameter. We apply these methods tested in the regression models and Pareto model, giving the best approximations.Keywords: bootstrap, error standard, bias, jackknife, mean, median, variance, confidence interval, regression models
Procedia PDF Downloads 3801733 Study and Modeling of Flood Watershed in Arid and Semi Arid Regions of Algeria
Authors: Belagoune Fares, Boutoutaou Djamel
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The study on floods in Algeria established by the National Agency of Water Resources (ANRH) shows that the country is confronted with the phenomenon of very destructive floods and floods especially in arid and semiarid regions. Flooding of rivers in these areas is less known. They are characterized by their sudden duration (rain showers, thunderstorm).The duration of the flood is of the order of minutes to hours. The human and material damage caused by these floods were still high. The study area encompasses three watersheds in semi-arid and arid south and Algeria. THERE are pools of Chott-Melghir (68,751 km2), highland Constantine-07 (9578 km2) and El Hodna-05 basin (25,843 km2). The total area of this zone is about 104,500km2.Studies of protection against floods and design studies of hydraulic structures (spillway, storm basin, etc.) require the raw data which is often unknown in several places particularly at ungauged wadis of these areas. This makes it very difficult to schedules and managers working in the field of hydraulic studies. The objective of this study and propose a methodology for determining flows in the absence of observations in the semi-arid and arid south eastern Algeria. The objective of the study is to propose a methodology for these areas of flood calculation for ungauged rivers.Keywords: flood, watershed, specific flow, coefficient of variation, arid
Procedia PDF Downloads 5061732 The Impact of the Urban Planning and Environmental Problems over the Quality of Life Case Study: Median Zone of Bucharest's Sector 1, Romania
Authors: Cristian Cazacu, Bela Kobulniczky
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Even though nowadays the median area of the Bucharest’s Sector 1 owns one of the best reputations in terms of quality of life level, the problems in urban planning from the last twenty years, as well as those related to the urban environment, became more and more obvious and shrill. And all this happened as long as non-compliance with urban and spatial planning laws, corroborated with uncontrolled territorial expansion on certain areas and faulty management of public and private spaces were more acute. The action of all these factors has been felt more and more strongly in the territory in the last twenty years, generating the degradation of the quality of the urban environment and affecting in parallel the general level of the inhabitants¬’ quality of life. Our methodology is based on analyzing a wide range of environmental parameters and it is also based on using advanced resources and skills for mapping planning and environmental dysfunctions as well as the possibility of integrating information into GIS programs, all data sets corroborated with problems related to spatial planning management and inaccuracies of the urbanistic sector. In the end, we managed to obtain a calculated and realistic image of the dysfunctions and a quantitative view of their magnitude in the territory. We also succeeded to create a full general map of the degree of degradation of the urban environment by typologies of urban tissues. Moreover, the methods applied by us can also be used globally to calculate and create realistic images and intelligent maps over the quality of the environment in areas larger than this one. Our study shows that environmental degradation occurred differently in the urban tissues from our study area, depending on several factors, reviewing the faulty way in which the processes of recovery / urban regeneration of the gap in recent years have led to the creation of new territorial dysfunctions. The general, centralized results show that the analyzed space has a much wider range of problems than initially thought, although notoriety and social etiquette place them far above other spaces from the same city of study.Keywords: environment, GIS, planning, urban tissues
Procedia PDF Downloads 1471731 Identifying and Quantifying Factors Affecting Traffic Crash Severity under Heterogeneous Traffic Flow
Authors: Praveen Vayalamkuzhi, Veeraragavan Amirthalingam
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Studies on safety on highways are becoming the need of the hour as over 400 lives are lost every day in India due to road crashes. In order to evaluate the factors that lead to different levels of crash severity, it is necessary to investigate the level of safety of highways and their relation to crashes. In the present study, an attempt is made to identify the factors that contribute to road crashes and to quantify their effect on the severity of road crashes. The study was carried out on a four-lane divided rural highway in India. The variables considered in the analysis includes components of horizontal alignment of highway, viz., straight or curve section; time of day, driveway density, presence of median; median opening; gradient; operating speed; and annual average daily traffic. These variables were considered after a preliminary analysis. The major complexities in the study are the heterogeneous traffic and the speed variation between different classes of vehicles along the highway. To quantify the impact of each of these factors, statistical analyses were carried out using Logit model and also negative binomial regression. The output from the statistical models proved that the variables viz., horizontal components of the highway alignment; driveway density; time of day; operating speed as well as annual average daily traffic show significant relation with the severity of crashes viz., fatal as well as injury crashes. Further, the annual average daily traffic has significant effect on the severity compared to other variables. The contribution of highway horizontal components on crash severity is also significant. Logit models can predict crashes better than the negative binomial regression models. The results of the study will help the transport planners to look into these aspects at the planning stage itself in the case of highways operated under heterogeneous traffic flow condition.Keywords: geometric design, heterogeneous traffic, road crash, statistical analysis, level of safety
Procedia PDF Downloads 3021730 Aboriginal Head and Neck Cancer Patients Have Different Patterns of Metastatic Involvement, and Have More Advanced Disease at Diagnosis
Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern
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Introduction: The mortality gap in Aboriginal Head and Neck Cancer is well known, but the reasons for poorer survival are not well established. Aim: We aimed to evaluate the locoregional and metastatic involvement, and stage at diagnosis, in Aboriginal compared with non-Aboriginal patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, regions involved, stage at diagnosis, treatment history, and survival and relapse patterns, including sites of metastatic and locoregional involvement. Results: Aboriginal patients had a significantly higher incidence of lung metastases (26.3% versus 13.7%, p=0.009). Aboriginal patients also had a numerically but non-statistically significant higher incidence of thoracic nodal involvement (10% vs 5.8%) and malignant pleural effusions (3.8% vs 2.5%). Aboriginal patients also had a numerically but not statistically significantly higher incidence of adrenal and bony involvement. Interestingly, non-Aboriginal patients had an increased rate of cutaneous (2.1% vs 0%) and liver metastases (4.6% vs 2.5%) compared with Aboriginal patients. In terms of locoregional involvement, Aboriginal patients were more than twice as likely to have contralateral neck involvement (58.8% vs 24.2%, p<0.00001), and 30% more likely to have ipsilateral neck lymph node involvement (78.8% vs 60%, p=0.002) than non-Aboriginal patients. Aboriginal patients had significantly more advanced disease at diagnosis (p=0.008). Aboriginal compared with non-Aboriginal patients were less likely to present with stage I (7.5% vs 22.5%), stage II (11.3% vs 13.8%), or stage III disease (13.8% vs 17.1%), and more likely to present with more advanced stage IVA (42.5% vs 34.6%), stage IVB (15% vs 7.1%), or stage IVC (10% vs 5%) disease (p=0.008). Number of regions of disease involvement was higher in Aboriginal patients (median 3, mean 3.64, range 1-10) compared with non-Aboriginal patients (median 2, mean 2.80, range 1-12). Conclusion: Aboriginal patients had a significantly higher incidence of lung metastases, and significantly more frequent involvement of ipsilateral and contralateral neck lymph nodes. Aboriginal patients also had significantly more advanced disease at presentation with a higher stage at diagnosis. We are performing further analyses to investigate explanations for these findings.Keywords: head and neck cancer, Aboriginal, metastases, locoregional, pattern of relapse, sites of disease
Procedia PDF Downloads 691729 Divergent Preferences for Rice Variety Attributes among Farmers and Breeders in Nepal
Authors: Bibek Sapkota, Michael Burton, Krishna Prasad Timsina
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This paper presents a discrete choice experiment (DCE)-based analysis of farmers' preferences for rice variety attributes involving 540 farmers from the Terai region of Nepal clustered into East, Mid, and Western Terai regions. Findings reveal that farmers prioritize grain yield, finer grain types, drought tolerance, and shorter crop duration when selecting rice varieties, with subtle gender-based differences observed. However, breeding programs have predominantly emphasized grain yield and crop duration, possibly neglecting other vital traits. Furthermore, the research reveals a concerning decline in the yield trends of both released and registered rice varieties. Notably, the limited availability of recommended rainfed varieties, despite strong farmer preferences for drought tolerance, underscores the imperative of bridging this gap to ensure food security. This study provides insights into the multifaceted nature of farmer preferences and calls for a more holistic approach to varietal development that aligns with farmers' needs and the evolving challenges of rice farming in the Terai region of Nepal.Keywords: breeders’ preferences, discrete choice experiment, farmers’ preferences, rice variety attributes
Procedia PDF Downloads 1371728 Use of Telephone Counselling in Employee Assistance Program
Authors: Andy S.K. Cheng, Samuel Leung, Cindy Kwok, Hector Tsang
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Background: Telephone counselling is one of the essential interventions that can be found in most of the Employee Assistance Programs (EAP). The purposes of this study were to (1) explore the trend of the telephone counselling from 2003-2016 in Hong Kong; (2) explore which EAP issue requires more follow-up; and 3) examine the relationship between the EAP issues and demographic data such as gender and job ranking. Method: Date of EAP services usage was collected from EAP providers in Hong Kong during 2003-2016. EAP issues were categorized into two domains, namely workplace issues and personal issues. Each domain has 12 sub-categories. Two hypotheses were formulated in this study (1) there was a gender difference in EAP issues and the follow-up hours; and (2) there was a significant difference between job ranking, EAP issues and follow-up hours. Results: A total of eight hundred and ninety-three valid cases were identified for analysis. Of them, three hundred and forty-three cases sought for follow-up. The duration of follow-up by hours was calculated for each of the follow-up cases. The results of the study shows that the top three workplace issues that required the longest duration of follow-up were (1) workload, (2) supervisor-subordinate relationship; and (3) team member’s relationship. On the other hand, the top three personal issues that required the longest duration of follow-up were (1) parenting/parent-child relationship, (2) family care, and (3) marital relationship. Two-way ANOVA was performed to compare the total follow-up hours (excluding first intake) between gender and EAP issues. There was no statistical significance for gender (p =.891), but a statistically significant main effect for EAP issues (p <.001) was found. Post-hoc analysis (Tukey’s test) showed that total follow-up hour in personal issues was statistically significant higher than that in handling workplace issues (p <.001). However, there was no statistically significant interaction effect between gender and EAP issues (p=.879) and between job ranking and EAP issues (p=.843). Conclusion: Telephone counselling is a very common intervention in addressing EAP issues arising from workplace and personal level in Hong Kong. It was frequently used to handle interpersonal relationships and the service usage was independent of gender and job ranking.Keywords: employee assistance program, follow-up time, interpersonal relationships, telephone counselling
Procedia PDF Downloads 2161727 The Effects of Billboard Content and Visible Distance on Driver Behavior
Authors: Arsalan Hassan Pour, Mansoureh Jeihani, Samira Ahangari
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Distracted driving has been one of the most integral concerns surrounding our daily use of vehicles since the invention of the automobile. While much attention has been recently given to cell phones related distraction, commercial billboards along roads are also candidates for drivers' visual and cognitive distractions, as they may take drivers’ eyes from the road and their minds off the driving task to see, perceive and think about the billboard’s content. Using a driving simulator and a head-mounted eye-tracking system, speed change, acceleration, deceleration, throttle response, collision, lane changing, and offset from the center of the lane data along with gaze fixation duration and frequency data were collected in this study. Some 92 participants from a fairly diverse sociodemographic background drove on a simulated freeway in Baltimore, Maryland area and were exposed to three different billboards to investigate the effects of billboards on drivers’ behavior. Participants glanced at the billboards several times with different frequencies, the maximum of which occurred on the billboard with the highest cognitive load. About 74% of the participants didn’t look at billboards for more than two seconds at each glance except for the billboard with a short visible area. Analysis of variance (ANOVA) was performed to find the variations in driving behavior when they are invisible, readable, and post billboards area. The results show a slight difference in speed, throttle, brake, steering velocity, and lane changing, among different areas. Brake force and deviation from the center of the lane increased in the readable area in comparison with the visible area, and speed increased right after each billboard. The results indicated that billboards have a significant effect on driving performance and visual attention based on their content and visibility status. Generalized linear model (GLM) analysis showed no connection between participants’ age and driving experience with gaze duration. However, the visible distance of the billboard, gender, and billboard content had a significant effect on gaze duration.Keywords: ANOVA, billboards, distracted driving, drivers' behavior, driving simulator, eye-Tracking system, GLM
Procedia PDF Downloads 1281726 Comparing Trastuzumab-Related Cardiotoxicity between Elderly and Younger Patients with Breast Cancer: A Prospective Cohort Study
Authors: Afrah Aladwani, Alexander Mullen, Mohammad AlRashidi, Omamah Alfarisi, Faisal Alterkit, Abdulwahab Aladwani, Asit Kumar, Emad Eldosouky
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Introduction: Trastuzumab is a HER-2 targeted humanized monoclonal antibody that significantly improves the therapeutic outcomes of metastatic and non-metastatic breast cancer. However, it is associated with increased risk of cardiotoxicity that ranges from mild decline in the cardiac ejection fraction to permanent cardiomyopathy. Concerns have been raised in treating eligible older patients. This study compares trastuzumab outcomes between two age cohorts in the Kuwait Cancer Control Centre (KCCC). Methods: In a prospective comparative observational study, 93 HER-2 positive breast cancer patients undergoing different chemotherapy protocols + trastuzumab were included and divided into two cohorts based on their age (˂60 and ≥60 years old). The baseline left ventricular ejection fraction (LVEF) was assessed and monitored every three months during trastuzumab treatment. Event of cardiotoxicity was defined as ≥10% decline in the LVEF from the baseline. The lower accepted normal limit of the LVEF was 50%. Results: The median baseline LVEF was 65% in both age cohorts (IQR 8% and 9% for older and younger patients respectively). Whereas, the median LVEF post-trastuzumab treatment was 51% and 55% in older and younger patients respectively (IQR 8%; p-value = 0.22), despite the fact that older patients had significantly lower exposure to anthracyclines compared to younger patients (60% and 84.1% respectively; p-value ˂0.001). 86.7% and 55.6% of older and younger patients, respectively, developed ≥10% decline in their LVEF from the baseline. Among those, only 29% of older and 27% of younger patients reached a LVEF value below 50% (p-value = 0.88). Statistically, age was the only factor that significantly correlated with trastuzumab induced cardiotoxicity (OR 4; p-value ˂0.012), but it did not increase the requirement for permanent discontinuation of treatment. A baseline LVEF value below 60% contributed to developing a post-treatment value below normal ranges (50%). Conclusion: Breast cancer patients aged 60 years and above in Kuwait were at 4-fold higher risk of developing ≥10% decline in their LVEF from the baseline than younger patients during trastuzumab treatment. Surprisingly, previous exposure to anthracyclines and multiple comorbidities were not associated with significant increased risk of cardiotoxicity.Keywords: breast cancer, elderly, Trastuzumab, cardiotoxicity
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