Search results for: Glasgow outcome score
Commenced in January 2007
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Edition: International
Paper Count: 3730

Search results for: Glasgow outcome score

460 The Incidence of Prostate Cancer in Previous Infected E. Coli Population

Authors: Andreea Molnar, Amalia Ardeljan, Lexi Frankel, Marissa Dallara, Brittany Nagel, Omar Rashid

Abstract:

Background: Escherichia coli is a gram-negative, facultative anaerobic bacteria that belongs to the family Enterobacteriaceae and resides in the intestinal tracts of individuals. E.Coli has numerous strains grouped into serogroups and serotypes based on differences in antigens in their cell walls (somatic, or “O” antigens) and flagella (“H” antigens). More than 700 serotypes of E. coli have been identified. Although most strains of E. coli are harmless, a few strains, such as E. coli O157:H7 which produces Shiga toxin, can cause intestinal infection with symptoms of severe abdominal cramps, bloody diarrhea, and vomiting. Infection with E. Coli can lead to the development of systemic inflammation as the toxin exerts its effects. Chronic inflammation is now known to contribute to cancer development in several organs, including the prostate. The purpose of this study was to evaluate the correlation between E. Coli and the incidence of prostate cancer. Methods: Data collected in this cohort study was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to evaluate patients infected with E.Coli infection and prostate cancer using the International Classification of Disease (ICD-10 and ICD-9 codes). Permission to use the database was granted by Holy Cross Health, Fort Lauderdale for the purpose of academic research. Data analysis was conducted through the use of standard statistical methods. Results: Between January 2010 and December 2019, the query was analyzed and resulted in 81, 037 patients after matching in both infected and control groups, respectively. The two groups were matched by Age Range and CCI score. The incidence of prostate cancer was 2.07% and 1,680 patients in the E. Coli group compared to 5.19% and 4,206 patients in the control group. The difference was statistically significant by a p-value p<2.2x10-16 with an Odds Ratio of 0.53 and a 95% CI. Based on the specific treatment for E.Coli, the infected group vs control group were matched again with a result of 31,696 patients in each group. 827 out of 31,696 (2.60%) patients with a prior E.coli infection and treated with antibiotics were compared to 1634 out of 31,696 (5.15%) patients with no history of E.coli infection (control) and received antibiotic treatment. Both populations subsequently developed prostate carcinoma. Results remained statistically significant (p<2.2x10-16), Odds Ratio=0.55 (95% CI 0.51-0.59). Conclusion: This retrospective study shows a statistically significant correlation between E.Coli infection and a decreased incidence of prostate cancer. Further evaluation is needed in order to identify the impact of E.Coli infection and prostate cancer development.

Keywords: E. Coli, prostate cancer, protective, microbiology

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459 Emergency Surgery in the Elderly, What Particularities

Authors: Mekroud Amel

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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

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458 Usability Evaluation of Four Big e-Commerce Websites in Indonesia

Authors: Harry B. Santoso, Lia Sadita, Firlia Sandyta, Musa Alfatih, Nove Spalo, Nu'man Naufal, Nuryahya P. Utomo, Putu A. Paramatha, Rezka Aufar Leonandya, Tommy Anugrah, Aulia Chairunisa, M. Fadly Uzzaki, Riandy D. Banimahendra

Abstract:

The numbers of Internet active users in Indonesia reach out over 88.1 million, where 48% of them are daily active users. Seeing these numbers, it is the best opportunity for IT companies to grow their business, especially e-Commerce. In fact, the growth of e-Commerce companies in Indonesia is proportional with internet daily active users. This phenomenon shows that competition happening among the e-Commerce companies is raising high. It triggers many e-Commerce companies to improve their services. The authors hypothesized that one of the best ways to improve the services is by improving their usability. So, the authors had done a study to evaluate and find out ways to improve usability of those e-Commerce websites. The authors chose four e-Commerce websites which each of them has different business focus and profiles. Each company is labeled as A, B, C, and D. Company A is a fashion-based e-Commerce services with two-million desktop visits Indonesia. Company B is an international online shopping mall for everyday appliances with 48,3-million desktop visits in Indonesia. Company C is a localized online shopping mall with 3,2-million desktop visits in Indonesia. Company D is an online shopping mall with one-million desktop visits in Indonesia. Writers used popular web traffic analytics platform to gain the numbers. There are some approaches to evaluate the usability of e-Commerce websites. In this study, the authors used usability testing method supported by the User Experience Questionnaire. This method involved the user in interacting directly with the services provided by the e-Commerce company. This study was conducted within two months including preparation, data collection, data analysis, and reporting. We used a pair of computers, a screen-capture video application named Smartboard, and User Experience Questionnaire. A team was built to conduct this study. They consisted of one supervisor, two assistants, four facilitators and four observers. For each e-Commerce, three users aged 17-25 years old were invited to do five task scenarios. Data collected in this study included demographic information of the users, usability testing results, and users’ responses to the questionnaire. Some findings were revealed from the usability testing and the questionnaire. Compared to the other three companies, Company D had the least score for the experiences. One of the most painful issues figured out by the authors from the evaluation was most users claimed feeling confused by user interfaces in these e-Commerce websites. We believe that this study will help e-Commerce companies to improve their services and business in the future.

Keywords: e-commerce, evaluation, usability testing, user experience

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457 A pilot Study of Umbilical Cord Mini-Clamp

Authors: Seng Sing Tan

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Clamping of the umbilical cord after birth is widely practiced as a part of labor management. Further improvements were proposed to produce a smaller, lighter and more comfortable clamp while still maintaining current standards of clamping. A detachable holder was also developed to facilitate the clamping process. This pilot study on the efficacy of the mini-clamp was conducted to evaluate a tightness of the seal and a firm grip of the clamp on the umbilical cord. The study was carried out at National University Hospital, using 5 sets of placental cord. 18 samples of approximate 10 cm each were harvested. The test results showed that the mini-clamp was able to stop the flow through the cord after clamping without rupturing the cord. All slip tests passed with a load of 0.2 kg. In the pressure testing, 30kPa of saline was exerted into the umbilical veins. Although there was no physical sign of fluid leaking through the end secured by the mini-clamp, the results showed the pressure was not able to sustain the pressure set during the tests. 12 out of the 18 test samples have more than 7% of pressure drop in 30 seconds. During the pressure leak test, it was observed on several samples that when pressurized, small droplets of saline were growing on the outer surface of the cord lining membrane. It was thus hypothesized that the pressure drop was likely caused by the perfusion of the injected saline through the Wharton’s jelly and the cord lining membrane. The average pressure in the umbilical vein is roughly 2.67kPa (20 mmHg), less than 10% of 30kPa (~225mmHg), set for the pressure testing. As such, the pressure set could be over-specified, leading to undesirable outcomes. The development of the mini-clamp was an attempt to increase the comfort of newly born babies while maintaining the usability and efficacy of hospital grade umbilical cord clamp. The pressure leak in this study would be unfair to fully attribute it to the design and efficacy of the mini-clamp. Considering the unexpected leakage of saline through the umbilical membrane due to over-specified pressure exerted on the umbilical veins, improvements can definitely be made to the existing experimental setup to obtain a more accurate and conclusive outcome. If proven conclusive and effective, the mini-clamp with a detachable holder could be a smaller and potentially cheaper alternative to existing umbilical cord clamps. In addition, future clinical trials could be conducted to determine the user-friendliness of the mini-clamp and evaluate its practicality in the clinical setting by labor ward clinicians. A further potential improvement could be proposed on the sustainability factor of the mini-clamp. A biodegradable clamp would revolutionise the industry in this increasingly environmentally sustainability world.

Keywords: leak test, mini-clamp, slip test, umbilical cord

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456 Association between Maternal Personality and Postnatal Mother-to-Infant Bonding

Authors: Tessa Sellis, Marike A. Wierda, Elke Tichelman, Mirjam T. Van Lohuizen, Marjolein Berger, François Schellevis, Claudi Bockting, Lilian Peters, Huib Burger

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Introduction: Most women develop a healthy bond with their children, however, adequate mother-to-infant bonding cannot be taken for granted. Mother-to-infant bonding refers to the feelings and emotions experienced by the mother towards her child. It is an ongoing process that starts during pregnancy and develops during the first year postpartum and likely throughout early childhood. The prevalence of inadequate bonding ranges from 7 to 11% in the first weeks postpartum. An impaired mother-to-infant bond can cause long-term complications for both mother and child. Very little research has been conducted on the direct relationship between the personality of the mother and mother-to-infant bonding. This study explores the associations between maternal personality and postnatal mother-to-infant bonding. The main hypothesis is that there is a relationship between neuroticism and mother-to-infant bonding. Methods: Data for this study were used from the Pregnancy Anxiety and Depression Study (2010-2014), which examined symptoms of and risk factors for anxiety or depression during pregnancy and the first year postpartum of 6220 pregnant women who received primary, secondary or tertiary care in the Netherlands. The study was expanded in 2015 to investigate postnatal mother-to-infant bonding. For the current research 3836 participants were included. During the first trimester of gestation, baseline characteristics, as well as personality, were measured through online questionnaires. Personality was measured by the NEO Five Factor Inventory (NEO-FFI), which covers the big five of personality (neuroticism, extraversion, openness, altruism and conscientiousness). Mother-to-infant bonding was measured postpartum by the Postpartum Bonding Questionnaire (PBQ). Univariate linear regression analysis was performed to estimate the associations. Results: 5% of the PBQ-respondents reported impaired bonding. A statistically significant association was found between neuroticism and mother-to-infant bonding (p < .001): mothers scoring higher on neuroticism, reported a lower score on mother-to-infant bonding. In addition, a positive correlation was found between the personality traits extraversion (b: -.081), openness (b: -.014), altruism (b: -.067), conscientiousness (b: -.060) and mother-to-infant bonding. Discussion: This study is one of the first to demonstrate a direct association between the personality of the mother and mother-to-infant bonding. A statistically significant relationship has been found between neuroticism and mother-to-infant bonding, however, the percentage of variance predictable by a personality dimension is very small. This study has examined one part of the multi-factorial topic of mother-to-infant bonding and offers more insight into the rarely investigated and complex matter of mother-to-infant bonding. For midwives, it is important recognize the risks for impaired bonding and subsequently improve policy for women at risk.

Keywords: mother-to-infant bonding, personality, postpartum, pregnancy

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455 Tracing the Developmental Repertoire of the Progressive: Evidence from L2 Construction Learning

Authors: Tianqi Wu, Min Wang

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Research investigating language acquisition from a constructionist perspective has demonstrated that language is learned as constructions at various linguistic levels, which is related to factors of frequency, semantic prototypicality, and form-meaning contingency. However, previous research on construction learning tended to focus on clause-level constructions such as verb argument constructions but few attempts were made to study morpheme-level constructions such as the progressive construction, which is regarded as a source of acquisition problems for English learners from diverse L1 backgrounds, especially for those whose L1 do not have an equivalent construction such as German and Chinese. To trace the developmental trajectory of Chinese EFL learners’ use of the progressive with respect to verb frequency, verb-progressive contingency, and verbal prototypicality and generality, a learner corpus consisting of three sub-corpora representing three different English proficiency levels was extracted from the Chinese Learners of English Corpora (CLEC). As the reference point, a native speakers’ corpus extracted from the Louvain Corpus of Native English Essays was also established. All the texts were annotated with C7 tagset by part-of-speech tagging software. After annotation all valid progressive hits were retrieved with AntConc 3.4.3 followed by a manual check. Frequency-related data showed that from the lowest to the highest proficiency level, (1) the type token ratio increased steadily from 23.5% to 35.6%, getting closer to 36.4% in the native speakers’ corpus, indicating a wider use of verbs in the progressive; (2) the normalized entropy value rose from 0.776 to 0.876, working towards the target score of 0.886 in native speakers’ corpus, revealing that upper-intermediate learners exhibited a more even distribution and more productive use of verbs in the progressive; (3) activity verbs (i.e., verbs with prototypical progressive meanings like running and singing) dropped from 59% to 34% but non-prototypical verbs such as state verbs (e.g., being and living) and achievement verbs (e.g., dying and finishing) were increasingly used in the progressive. Apart from raw frequency analyses, collostructional analyses were conducted to quantify verb-progressive contingency and to determine what verbs were distinctively associated with the progressive construction. Results were in line with raw frequency findings, which showed that contingency between the progressive and non-prototypical verbs represented by light verbs (e.g., going, doing, making, and coming) increased as English proficiency proceeded. These findings altogether suggested that beginning Chinese EFL learners were less productive in using the progressive construction: they were constrained by a small set of verbs which had concrete and typical progressive meanings (e.g., the activity verbs). But with English proficiency increasing, their use of the progressive began to spread to marginal members such as the light verbs.

Keywords: Construction learning, Corpus-based, Progressives, Prototype

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454 Impacts of Climate Change and Natural Gas Operations on the Hydrology of Northeastern BC, Canada: Quantifying the Water Budget for Coles Lake

Authors: Sina Abadzadesahraei, Stephen Déry, John Rex

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Climate research has repeatedly identified strong associations between anthropogenic emissions of ‘greenhouses gases’ and observed increases of global mean surface air temperature over the past century. Studies have also demonstrated that the degree of warming varies regionally. Canada is not exempt from this situation, and evidence is mounting that climate change is beginning to cause diverse impacts in both environmental and socio-economic spheres of interest. For example, northeastern British Columbia (BC), whose climate is controlled by a combination of maritime, continental and arctic influences, is warming at a greater rate than the remainder of the province. There are indications that these changing conditions are already leading to shifting patterns in the region’s hydrological cycle, and thus its available water resources. Coincident with these changes, northeastern BC is undergoing rapid development for oil and gas extraction: This depends largely on subsurface hydraulic fracturing (‘fracking’), which uses enormous amounts of freshwater. While this industrial activity has made substantial contributions to regional and provincial economies, it is important to ensure that sufficient and sustainable water supplies are available for all those dependent on the resource, including ecological systems. In this turn demands a comprehensive understanding of how water in all its forms interacts with landscapes, the atmosphere, and of the potential impacts of changing climatic conditions on these processes. The aim of this study is therefore to characterize and quantify all components of the water budget in the small watershed of Coles Lake (141.8 km², 100 km north of Fort Nelson, BC), through a combination of field observations and numerical modelling. Baseline information will aid the assessment of the sustainability of current and future plans for freshwater extraction by the oil and gas industry, and will help to maintain the precarious balance between economic and environmental well-being. This project is a perfect example of interdisciplinary research, in that it not only examines the hydrology of the region but also investigates how natural gas operations and growth can affect water resources. Therefore, a fruitful collaboration between academia, government and industry has been established to fulfill the objectives of this research in a meaningful manner. This project aims to provide numerous benefits to BC communities. Further, the outcome and detailed information of this research can be a huge asset to researchers examining the effect of climate change on water resources worldwide.

Keywords: northeastern British Columbia, water resources, climate change, oil and gas extraction

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453 Immersive Environment as an Occupant-Centric Tool for Architecture Criticism and Architectural Education

Authors: Golnoush Rostami, Farzam Kharvari

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In recent years, developments in the field of architectural education have resulted in a shift from conventional teaching methods to alternative state-of-the-art approaches in teaching methods and strategies. Criticism in architecture has been a key player both in the profession and education, but it has been mostly offered by renowned individuals. Hence, not only students or other professionals but also critics themselves may not have the option to experience buildings and rely on available 2D materials, such as images and plans, that may not result in a holistic understanding and evaluation of buildings. On the other hand, immersive environments provide students and professionals the opportunity to experience buildings virtually and reflect their evaluation by experiencing rather than judging based on 2D materials. Therefore, the aim of this study is to compare the effect of experiencing buildings in immersive environments and 2D drawings, including images and plans, on architecture criticism and architectural education. As a result, three buildings that have parametric brick facades were studied through 2D materials and in Unreal Engine v. 24 as an immersive environment among 22 architecture students that were selected using convenient sampling and were divided into two equal groups using simple random sampling. This study used mixed methods, including quantitative and qualitative methods; the quantitative section was carried out by a questionnaire, and deep interviews were used for the qualitative section. A questionnaire was developed for measuring three constructs, including privacy regulation based on Altman’s theory, the sufficiency of illuminance levels in the building, and the visual status of the view (visually appealing views based on obstructions that may have been caused by facades). Furthermore, participants had the opportunity to reflect their understanding and evaluation of the buildings in individual interviews. Accordingly, the collected data from the questionnaires were analyzed using independent t-test and descriptive analyses in IBM SPSS Statistics v. 26, and interviews were analyzed using the content analysis method. The results of the interviews showed that the participants who experienced the buildings in the immersive environment were able to have a thorough and more precise evaluation of the buildings in comparison to those who studied them through 2D materials. Moreover, the analyses of the respondents’ questionnaires revealed that there were statistically significant differences between measured constructs among the two groups. The outcome of this study suggests that integrating immersive environments into the profession and architectural education as an effective and efficient tool for architecture criticism is vital since these environments allow users to have a holistic evaluation of buildings for vigorous and sound criticism.

Keywords: immersive environments, architecture criticism, architectural education, occupant-centric evaluation, pre-occupancy evaluation

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452 The Metabolism of Built Environment: Energy Flow and Greenhouse Gas Emissions in Nigeria

Authors: Yusuf U. Datti

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It is becoming increasingly clear that the consumption of resources now enjoyed in the developed nations will be impossible to be sustained worldwide. While developing countries still have the advantage of low consumption and a smaller ecological footprint per person, they cannot simply develop in the same way as other western cities have developed in the past. The severe reality of population and consumption inequalities makes it contentious whether studies done in developed countries can be translated and applied to developing countries. Additional to this disparities, there are few or no metabolism of energy studies in Nigeria. Rather more contentious majority of energy metabolism studies have been done only in developed countries. While researches in Nigeria concentrate on other aspects/principles of sustainability such as water supply, sewage disposal, energy supply, energy efficiency, waste disposal, etc., which will not accurately capture the environmental impact of energy flow in Nigeria, this research will set itself apart by examining the flow of energy in Nigeria and the impact that the flow will have on the environment. The aim of the study is to examine and quantify the metabolic flows of energy in Nigeria and its corresponding environmental impact. The study will quantify the level and pattern of energy inflow and the outflow of greenhouse emissions in Nigeria. This study will describe measures to address the impact of existing energy sources and suggest alternative renewable energy sources in Nigeria that will lower the emission of greenhouse gas emissions. This study will investigate the metabolism of energy in Nigeria through a three-part methodology. The first step involved selecting and defining the study area and some variables that would affect the output of the energy (time of the year, stability of the country, income level, literacy rate and population). The second step involves analyzing, categorizing and quantifying the amount of energy generated by the various energy sources in the country. The third step involves analyzing what effect the variables would have on the environment. To ensure a representative sample of the study area, Africa’s most populous country, with economy that is the second biggest and that is among the top largest oil producing countries in the world is selected. This is due to the understanding that countries with large economy and dense populations are ideal places to examine sustainability strategies; hence, the choice of Nigeria for the study. National data will be utilized unless where such data cannot be found, then local data will be employed which will be aggregated to reflect the national situation. The outcome of the study will help policy-makers better target energy conservation and efficiency programs and enables early identification and mitigation of any negative effects in the environment.

Keywords: built environment, energy metabolism, environmental impact, greenhouse gas emissions and sustainability

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451 Mikrophonie I (1964) by Karlheinz Stockhausen - Between Idea and Auditory Image

Authors: Justyna Humięcka-Jakubowska

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1. Background in music analysis. Traditionally, when we think about a composer’s sketches, the chances are that we are thinking in terms of the working out of detail, rather than the evolution of an overall concept. Since music is a “time art’, it follows that questions of a form cannot be entirely detached from considerations of time. One could say that composers tend to regard time either as a place gradually and partially intuitively filled, or they can look for a specific strategy to occupy it. In my opinion, one thing that sheds light on Stockhausen's compositional thinking is his frequent use of 'form schemas', that is often a single-page representation of the entire structure of a piece. 2. Background in music technology. Sonic Visualiser is a program used to study a musical recording. It is an open source application for viewing, analysing, and annotating music audio files. It contains a number of visualisation tools, which are designed with useful default parameters for musical analysis. Additionally, the Vamp plugin format of SV supports to provide analysis such as for example structural segmentation. 3. Aims. The aim of my paper is to show how SV may be used to obtain a better understanding of the specific musical work, and how the compositional strategy does impact on musical structures and musical surfaces. I want to show that ‘traditional” music analytic methods don’t allow to indicate interrelationships between musical surface (which is perceived) and underlying musical/acoustical structure. 4. Main Contribution. Stockhausen had dealt with the most diverse musical problems by the most varied methods. A characteristic which he had never ceased to be placed at the center of his thought and works, it was the quest for a new balance founded upon an acute connection between speculation and intuition. In the case with Mikrophonie I (1964) for tam-tam and 6 players Stockhausen makes a distinction between the "connection scheme", which indicates the ground rules underlying all versions, and the form scheme, which is associated with a particular version. The preface to the published score includes both the connection scheme, and a single instance of a "form scheme", which is what one can hear on the CD recording. In the current study, the insight into the compositional strategy chosen by Stockhausen was been compared with auditory image, that is, with the perceived musical surface. Stockhausen's musical work is analyzed both in terms of melodic/voice and timbre evolution. 5. Implications The current study shows how musical structures have determined of musical surface. My general assumption is this, that while listening to music we can extract basic kinds of musical information from musical surfaces. It is shown that an interactive strategies of musical structure analysis can offer a very fruitful way of looking directly into certain structural features of music.

Keywords: automated analysis, composer's strategy, mikrophonie I, musical surface, stockhausen

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450 Congenital Diaphragmatic Hernia Outcomes in a Low-Volume Center

Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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449 Instruction Program for Human Factors in Maintenance, Addressed to the People Working in Colombian Air Force Aeronautical Maintenance Area to Strengthen Operational Safety

Authors: Rafael Andres Rincon Barrera

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Safety in global aviation plays a preponderant role in organizations that seek to avoid accidents in an attempt to preserve their most precious assets (the people and the machines). Human factors-based programs have shown to be effective in managing human-generated risks. The importance of training on human factors in maintenance has not been indifferent to the Colombian Air Force (COLAF). This research, which has a mixed quantitative, qualitative and descriptive approach, deals with its absence of structuring an instruction program in Human Factors in Aeronautical Maintenance, which serves as a tool to improve Operational Safety in the military air units of the COLAF. Research shows the trends and evolution of human factors programs in aeronautical maintenance through the analysis of a data matrix with 33 sources taken from different databases that are about the incorporation of these types of programs in the aeronautical industry in the last 20 years; as well as the improvements in the operational safety process that are presented after the implementation of these ones. Likewise, it compiles different normative guides in force from world aeronautical authorities for training in these programs, establishing a matrix of methodologies that may be applicable to develop a training program in human factors in maintenance. Subsequently, it illustrates the design, validation, and development of a human factors knowledge measurement instrument for maintenance at the COLAF that includes topics on Human Factors (HF), Safety Management System (SMS), and aeronautical maintenance regulations at the COLAF. With the information obtained, it performs the statistical analysis showing the aspects of knowledge and strengthening the staff for the preparation of the instruction program. Performing data triangulation based on the applicable methods and the weakest aspects found in the maintenance people shows a variable crossing from color coding, thus indicating the contents according to a training program for human factors in aeronautical maintenance, which are adjusted according to the competencies that are expected to be developed with the staff in a curricular format established by the COLAF. Among the most important findings are the determination that different authors are dealing with human factors in maintenance agrees that there is no standard model for its instruction and implementation, but that it must be adapted to the needs of the organization, that the Safety Culture in the Companies which incorporated programs on human factors in maintenance increased, that from the data obtained with the instrument for knowledge measurement of human factors in maintenance, the level of knowledge is MEDIUM-LOW with a score of 61.79%. And finally that there is an opportunity to improve Operational Safety for the COLAF through the implementation of the training program of human factors in maintenance for the technicians working in this area.

Keywords: Colombian air force, human factors, safety culture, safety management system, triangulation

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448 Dose Profiler: A Tracking Device for Online Range Monitoring in Particle Therapy

Authors: G. Battistoni, F. Collamati, E. De Lucia, R. Faccini, C. Mancini-Terracciano, M. Marafini, I. Mattei, S. Muraro, V. Patera, A. Sarti, A. Sciubba, E. Solfaroli Camillocci, M. Toppi, G. Traini, S. M. Valle, C. Voena

Abstract:

Accelerated charged particles, mainly protons and carbon ions, are presently used in Particle Therapy (PT) to treat solid tumors. The precision of PT exploiting the charged particle high localized dose deposition in tissues and biological effectiveness in killing cancer cells demands for an online dose monitoring technique, crucial to improve the quality assurance of treatments: possible patient mis-positionings and biological changes with respect to the CT scan could negatively affect the therapy outcome. In PT the beam range confined in the irradiated target can be monitored thanks to the secondary radiation produced by the interaction of the projectiles with the patient tissue. The Dose Profiler (DP) is a novel device designed to track charged secondary particles and reconstruct their longitudinal emission distribution, correlated to the Bragg peak position. The feasibility of this approach has been demonstrated by dedicated experimental measurements. The DP has been developed in the framework of the INSIDE project, MIUR, INFN and Centro Fermi, Museo Storico della Fisica e Centro Studi e Ricerche 'E. Fermi', Roma, Italy and will be tested at the Proton Therapy center of Trento (Italy) within the end of 2017. The DP combines a tracker, made of six layers of two-view scintillating fibers with square cross section (0.5 x 0.5 mm2) with two layers of two-view scintillating bars (section 12.0 x 0.6 mm2). The electronic readout is performed by silicon photomultipliers. The sensitive area of the tracking planes is 20 x 20 cm2. To optimize the detector layout, a Monte Carlo (MC) simulation based on the FLUKA code has been developed. The complete DP geometry and the track reconstruction code have been fully implemented in the MC. In this contribution, the DP hardware will be described. The expected detector performance computed using a dedicated simulation of a 220 MeV/u carbon ion beam impinging on a PMMA target will be presented, and the result will be discussed in the standard clinical application framework. A possible procedure for real-time beam range monitoring is proposed, following the expectations in actual clinical operation.

Keywords: online range monitoring, particle therapy, quality assurance, tracking detector

Procedia PDF Downloads 226
447 Understanding Strategic Engagement on the Conversation Table: Countering Terrorism in Nigeria

Authors: Anisah Ari

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Effects of organized crime permeate all facets of life, including public health, socio-economic endeavors, and human security. If any element of this is affected, it impacts large-scale national and global interest. Seeking to address terrorist networks through technical thinking is like trying to kill a weed by just cutting off its branches. It will re-develop and expand in proportions beyond one’s imagination, even in horrific ways that threaten human security. The continent of Africa has been bedeviled by this menace, with little or no solution to the problem. Nigeria is dealing with a protracted insurgency that is perpetrated by a sect against any form of westernization. Reimagining approaches to dealing with pressing issues like terrorism may require engaging the right set of people in the conversation for any sustainable change. These are people who have lived through the daily effects of the violence that ensues from the activities of terrorist activities. Effective leadership is required for an inclusive process, where spaces are created for diverse voices to be heard, and multiple perspectives are listened to, and not just heard, that supports a determination of the realistic outcome. Addressing insurgency in Nigeria has experienced a lot of disinformation and uncertainty. This may be in part due to poor leadership or an iteration of technical solutions to adaptive challenge peacemaking efforts in Nigeria has focused on behaviors, attitudes and practices that contribute to violence. However, it is important to consider the underlying issues that build-up, ignite and fan the flames of violence—looking at conflict as a complex system, issues like climate change, low employment rates, corruption and the impunity of discrimination due to ethnicity and religion. This article will be looking at an option of the more relational way of addressing insurgency through adaptive approaches that embody engagement and solutions with the people rather than for the people. The construction of a local turn in peacebuilding is informed by the need to create a locally driven and sustained peace process that embodies the culture and practices of the people in enacting an everyday peace beyond just a perennial and universalist outlook. A critical analysis that explores the socially identified individuals and situations will be made, considering the more adaptive approach to a complex existential challenge rather than a universalist frame. Case Study and Ethnographic research approach to understand what other scholars have documented on the matter and also a first-hand understanding of the experiences and viewpoints of the participants.

Keywords: terrorism, adaptive, peace, culture

Procedia PDF Downloads 81
446 Baseline Study of Water Quality in Indonesia Using Dynamic Methods and Technologies

Authors: R. L. P. de Lima, F. C. B. Boogaard, D. Setyo Rini, P. Arisandi, R. E. de Graaf-Van Dinther

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Water quality in many Asian countries is very poor due to inefficient solid waste management, high population growth and the lack of sewage and purification systems for households and industry. A consortium of Indonesian and Dutch organizations has begun a large-scale international research project to evaluate and propose solutions to face the surface water pollution challenges in Brantas Basin, Indonesia (East Java: Malang / Surabaya). The first phase of the project consisted in a baseline study to assess the current status of surface water bodies and to determine the ambitions and strategies among local stakeholders. This study was conducted with high participatory / collaborative and knowledge sharing objectives. Several methods such as using mobile sensors (attached to boats or underwater drones), test strips and mobile apps, bio-monitoring (sediments), ecology scans using underwater cameras, or continuous / static measurements, were applied in different locations in the regions of the basin, at multiple locations within the water systems (e.g. spring, upstream / downstream of industry and urban areas, mouth of the Surabaya River, groundwater). Results gave an indication of (reference) values of basic water quality parameters such as turbidity, electrical conductivity, dissolved oxygen or nutrients (ammonium / nitrate). An important outcome was that collecting random samples may not be representative of a body of water, given that water quality parameters can vary widely in space (x, y, and depth) and time (day / night and seasonal). Innovative / dynamic monitoring methods (e.g. underwater drones, sensors on boats) can contribute to better understand the quality of the living environment (water, ecology, sediment) and factors that affect it. The field work activities, in particular, underwater drones, revealed potential as awareness actions as they attracted interest from locals and local press. This baseline study involved the cooperation with local managing organizations with Dutch partners, and their willingness to work together is important to ensure participatory actions and social awareness regarding the process of adaptation and strengthening of regulations, or for the construction of facilities such as sewage.

Keywords: water quality monitoring, pollution, underwater drones, social awareness

Procedia PDF Downloads 172
445 The Negative Implications of Childhood Obesity and Malnutrition on Cognitive Development

Authors: Stephanie Remedios, Linda Veronica Rios

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Background. Pediatric obesity is a serious health problem linked to multiple physical diseases and ailments, including diabetes, heart disease, and joint issues. While research has shown pediatric obesity can bring about an array of physical illnesses, it is less known how such a condition can affect children’s cognitive development. With childhood overweight and obesity prevalence rates on the rise, it is essential to understand the scope of their cognitive consequences. The present review of the literature tested the hypothesis that poor physical health, such as childhood obesity or malnutrition, negatively impacts a child’s cognitive development. Methodology. A systematic review was conducted to determine the relationship between poor physical health and lower cognitive functioning in children ages 4-16. Electronic databases were searched for studies dating back to ten years. The following databases were used: Science Direct, FIU Libraries, and Google Scholar. Inclusion criteria consisted of peer-reviewed academic articles written in English from 2012 to 2022 that analyzed the relationship between childhood malnutrition and obesity on cognitive development. A total of 17,000 articles were obtained, of which 16,987 were excluded for not addressing the cognitive implications exclusively. Of the acquired articles, 13 were retained. Results. Research suggested a significant connection between diet and cognitive development. Both diet and physical activity are strongly correlated with higher cognitive functioning. Cognitive domains explored in this work included learning, memory, attention, inhibition, and impulsivity. IQ scores were also considered objective representations of overall cognitive performance. Studies showed physical activity benefits cognitive development, primarily for executive functioning and language development. Additionally, children suffering from pediatric obesity or malnutrition were found to score 3-10 points lower in IQ scores when compared to healthy, same-aged children. Conclusion. This review provides evidence that the presence of physical activity and overall physical health, including appropriate diet and nutritional intake, has beneficial effects on cognitive outcomes. The primary conclusion from this research is that childhood obesity and malnutrition show detrimental effects on cognitive development in children, primarily with learning outcomes. Assuming childhood obesity and malnutrition rates continue their current trade, it is essential to understand the complete physical and psychological implications of obesity and malnutrition in pediatric populations. Given the limitations encountered through our research, further studies are needed to evaluate the areas of cognition affected during childhood.

Keywords: childhood malnutrition, childhood obesity, cognitive development, cognitive functioning

Procedia PDF Downloads 100
444 Evidence of Social Media Addiction and Problematic Internet Use Among High School and University Students in Cyprus

Authors: Costas Christodoulides

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Excessive use of social networking sites (SNS) and the Internet by high school pupils and university students, can cause consequences similar to those observed in substance or gambling related addictions, negatively influence individual well-being notwithstanding self-assessments that people make about their life and experiences. The present study examined, for the first time in Cyprus, the levels of problematic use of the Social Media and the Internet among Cypriot pupils and students aiming at contributing to the discussion about the need for a more conclusive policy framework in the island. The Bergen Social Media Addiction Scale (BSMAS) and the Generalized Problematic Internet Use Scale 2 (GPIUS-2) were adapted to a Cypriot version and along with a sociodemographic questionnaire were introduced to a sample of 1059 young persons in order to respectively assess the addiction risk for Social Media Use and the risk of Problematic Internet Use. The sample consisted of 59% females, aged 15 to 35 (M=18.9 years, SD=3.20), 465 of them were high school students and 594 university students. Of 1059 respondents from 4 high-schools and 5 Universities (HEI) in Cyprus, 8.3% of the sample had BSMAS scores suggestive of addiction. Approximately a quarter of the sample (24%), demonstrated GPIUS-2 scores suggestive of high risk for problematic internet use. It is notable that differences seem to exist across gender with the score of the female population (11.1%) reaching levels of addiction to social media more than twice the level of addiction of the male population (4.3%). Also, the female population of high school students seems to be at the most vulnerable position for problematic internet use (28%). The 26% of the sample often or very often used some SNSs to forget of personal problems. The results of this study show that half of those surveyed used the Internet to feel better when they were upset or to escape the isolation they felt. Among the sample population, the study reports that 60% of the pupils and female university students are in agreement with the relevant statements. Conclusively, this study suggests that SNSs addiction levels among pupils and students in Cyprus ought to be an important public health concern. The same if not more alarming is the identified by the study prevalence of problematic Internet use among the same population. These results confirm international trends reported by scholarly research while also suggest that particular categories such as high school pupils and young females may be more exposed to problem SNSs and Internet use. Preventive strategies need first to acknowledge the problem in order to then formulate an effective strategy for prevention and intervention. For relevant authorities it is of primary importance to “exploit” the fact that high schools and universities can be seen as small communities and units potentially available for forging alliances for healthy Social Media and Internet use.

Keywords: problematic internet use, social media addiction, social networking sites, well-being

Procedia PDF Downloads 155
443 Developing Gifted Students’ STEM Career Interest

Authors: Wing Mui Winnie So, Tian Luo, Zeyu Han

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To fully explore and develop the potentials of gifted students systematically and strategically by providing them with opportunities to receive education at appropriate levels, schools in Hong Kong are encouraged to adopt the "Three-Tier Implementation Model" to plan and implement the school-based gifted education, with Level Three refers to the provision of learning opportunities for the exceptionally gifted students in the form of specialist training outside the school setting by post-secondary institutions, non-government organisations, professional bodies and technology enterprises. Due to the growing concern worldwide about low interest among students in pursuing STEM (Science, Technology, Engineering, and Mathematics) careers, cultivating and boosting STEM career interest has been an emerging research focus worldwide. Although numerous studies have explored its critical contributors, little research has examined the effectiveness of comprehensive interventions such as “Studying with STEM professional”. This study aims to examine the effect on gifted students’ career interest during their participation in an off-school support programme designed and supervised by a team of STEM educators and STEM professionals from a university. Gifted students were provided opportunities and tasks to experience STEM career topics that are not included in the school syllabus, and to experience how to think and work like a STEM professional in their learning. Participants involved 40 primary school students joining the intervention programme outside the normal school setting. Research methods included adopting the STEM career interest survey and drawing tasks supplemented with writing before and after the programme, as well as interviews before the end of the programme. The semi-structured interviews focused on students’ views regarding STEM professionals; what’s it like to learn with a STEM professional; what’s it like to work and think like a STEM professional; and students’ STEM identity and career interest. The changes in gifted students’ STEM career interest and its well-recognised significant contributors, for example, STEM stereotypes, self-efficacy for STEM activities, and STEM outcome expectation, were collectively examined from the pre- and post-survey using T-test. Thematic analysis was conducted for the interview records to explore how studying with STEM professional intervention can help students understand STEM careers; build STEM identity; as well as how to think and work like a STEM professional. Results indicated a significant difference in STEM career interest before and after the intervention. The influencing mechanism was also identified from the measurement of the related contributors and the analysis of drawings and interviews. The potential of off-school support programme supervised by STEM educators and professionals to develop gifted students’ STEM career interest is argued to be further unleashed in future research and practice.

Keywords: gifted students, STEM career, STEM education, STEM professionals

Procedia PDF Downloads 55
442 Measuring the Visibility of the European Open Access Journals with Bibliometric Indicators

Authors: Maja Jokić, Andrea Mervar, Stjepan Mateljan

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Peer review journals, as the main communication channel among researchers, fully achieve their objective if they are available to the global research community, which is accomplished through open access. In the EU countries, the idea of open access has spread over the years through various projects, initiatives, and strategic documents. Consequently, in this paper we want to analyze, using various bibliometric indicators, visibility, and significance of open access peer review journals compared to the conventional (non-open access) ones. We examine the sample of open access (OA) journals in 28 EU countries in addition to open access journals in three EU candidate countries (Bosnia and Herzegovina, FYR Macedonia and Serbia), all indexed by Scopus (N=1,522). These journals comprise 42% of the total number of OA journals indexed by Scopus. The distribution of OA journals in our sample according to the subject fields indicates that the largest share has OA journals in Health Sciences, 29% followed by Social Sciences and Physical Sciences with 25%, and 21% in Life Sciences. At the same time, the distribution according to countries (N=31) shows the dominance of EU15 countries with the share of 68.3% (N=1041) while post-socialist European countries (EU11 plus three candidate EU countries) have the share of 31.6% (N=481). Bibliometric indicators are derived from the SCImago Journal Ranking database. The analysis of OA journals according to their quartile scores (that reflect the relation between number of articles and their citations) shows that the largest number of OA journals from our sample was in the third quartile in 2015. For comparison, the majority of all academic journals indexed in Scopus from the countries in our sample were in the same year in the first quartile. The median of SJR indicator (SCImago Journal Rankings) for 2015 that measures the journal's prestige, amounted 0.297 for OA journals from the sample, while it was modestly lower for all OA journals, 0.284. The value of the same indicator for all journals indexed by Scopus (N=11,086) from our group of countries was 0.358, which is significantly different from the one for OA journals. Apart from the number of OA journals we also confirm significant differences between EU15 and post-socialist countries in bibliometric status of OA journals. The median SJR indicator for 2015 for EU15 countries was 0.394, while for post-socialist countries it amounted to 0.226. The changes in bibliometric indicators: quartile score, SJR (SCImago Journal Rankings), SNIP (Sources Normalised Impact by Paper) and IPP (Impact per Publication) of OA journals during 2012-2015 period, as well as H-index for the main four subject fields (Life Sciences, Physical Sciences, Social Sciences and Health Sciences) in the whole sample as well as in two main groups of European countries, show increasing trend of acceptance and visibility of OA journals within the academic community. More comprehensive insights into the visibility of OA journals could be reached by using additional qualitative research methods such as for example, interviews with researchers.

Keywords: bibliometric analysis, European countries, journal evaluation, open access journals

Procedia PDF Downloads 202
441 Medial Temporal Tau Predicts Memory Decline in Cognitively Unimpaired Elderly

Authors: Angela T. H. Kwan, Saman Arfaie, Joseph Therriault, Zahra Azizi, Firoza Z. Lussier, Cecile Tissot, Mira Chamoun, Gleb Bezgin, Stijn Servaes, Jenna Stevenon, Nesrine Rahmouni, Vanessa Pallen, Serge Gauthier, Pedro Rosa-Neto

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Alzheimer’s disease (AD) can be detected in living people using in vivo biomarkers of amyloid-β (Aβ) and tau, even in the absence of cognitive impairment during the preclinical phase. [¹⁸F]-MK-6420 is a high affinity positron emission tomography (PET) tracer that quantifies tau neurofibrillary tangles, but its ability to predict cognitive changes associated with early AD symptoms, such as memory decline, is unclear. Here, we assess the prognostic accuracy of baseline [18F]-MK-6420 tau PET for predicting longitudinal memory decline in asymptomatic elderly individuals. In a longitudinal observational study, we evaluated a cohort of cognitively normal elderly participants (n = 111) from the Translational Biomarkers in Aging and Dementia (TRIAD) study (data collected between October 2017 and July 2020, with a follow-up period of 12 months). All participants underwent tau PET with [¹⁸F]-MK-6420 and Aβ PET with [¹⁸F]-AZD-4694. The exclusion criteria included the presence of head trauma, stroke, or other neurological disorders. There were 111 eligible participants who were chosen based on the availability of Aβ PET, tau PET, magnetic resonance imaging (MRI), and APOEε4 genotyping. Among these participants, the mean (SD) age was 70.1 (8.6) years; 20 (18%) were tau PET positive, and 71 of 111 (63.9%) were women. A significant association between baseline Braak I-II [¹⁸F]-MK-6240 SUVR positivity and change in composite memory score was observed at the 12-month follow-up, after correcting for age, sex, and years of education (Logical Memory and RAVLT, standardized beta = -0.52 (-0.82-0.21), p < 0.001, for dichotomized tau PET and -1.22 (-1.84-(-0.61)), p < 0.0001, for continuous tau PET). Moderate cognitive decline was observed for A+T+ over the follow-up period, whereas no significant change was observed for A-T+, A+T-, and A-T-, though it should be noted that the A-T+ group was small.Our results indicate that baseline tau neurofibrillary tangle pathology is associated with longitudinal changes in memory function, supporting the use of [¹⁸F]-MK-6420 PET to predict the likelihood of asymptomatic elderly individuals experiencing future memory decline. Overall, [¹⁸F]-MK-6420 PET is a promising tool for predicting memory decline in older adults without cognitive impairment at baseline. This is of critical relevance as the field is shifting towards a biological model of AD defined by the aggregation of pathologic tau. Therefore, early detection of tau pathology using [¹⁸F]-MK-6420 PET provides us with the hope that living patients with AD may be diagnosed during the preclinical phase before it is too late.

Keywords: alzheimer’s disease, braak I-II, in vivo biomarkers, memory, PET, tau

Procedia PDF Downloads 59
440 Rohingya Problem and the Impending Crisis: Outcome of Deliberate Denial of Citizenship Status and Prejudiced Refugee Laws in South East Asia

Authors: Priyal Sepaha

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A refugee crisis is manifested by challenges, both for the refugees and the asylum giving state. The situation turns into a mega-crisis when the situation is prejudicially handled by the home state, inappropriate refugee laws, exploding refugee population, and above all, no hope of any foreseeable solution or remedy. This paper studies the impact on the capability of stateless Rohingyas to migrate and seek refuge due to the enforcement of rigid criteria of movement imposed both by Myanmar as well as the adjoining countries in the name of national security. This theoretical study identifies the issues and the key factors and players which have precipitated the crisis. It further discusses the possible ramifications in the home, asylum giving, and the adjoining countries for not discharging their roles aptly. Additionally, an attempt has been made to understand the scarce response given to the impending crisis by the regional organizations like SAARC, ASEAN and CHOGAM as well as international organizations like United Nations Human Rights Council, Security Council, Office of High Commissioner for Refugees and so on, in the name of inadequacy of monetary funds and physical resources. Based on the refugee laws and practices pertaining to the case of Rohingyas, this paper analyses that the Rohingya Crisis is in dire need of an effective action plan to curb and resolve the biggest humanitarian crisis situation of the century. This mounting human tragedy can be mitigated permanently, by strengthening existing and creating new interdependencies among all stakeholders, as further ignorance can drive the countries of the Indian Sub-continent, in particular, and South East Asia, by and large into a violent civil war for seizing long-awaited civil rights by the marginalized Rohingyas. To curb this mass crisis, it will require the application of coercive pressure and diplomatic pursuance on the home country to acknowledge the rights of its fleeing citizens. This further necessitates mustering adequate monetary funds and physical resources for the asylum providing state. Additional challenges such as devising mechanisms for the refugee’s safe return, comprehensive planning for their holistic economic development and rehabilitation plan are needed. These, however, can only come into effect with a conscious strive by the regional and international community to fulfil their assigned role.

Keywords: asylum, citizenship, crisis, humanitarian, human rights, refugee, rohingya

Procedia PDF Downloads 114
439 Posttraumatic Stress Disorder and Associated Factors among Patients with Prostate Cancer

Authors: Meral Huri, Sedef Şahin

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Post-traumatic stress disorder (PTSD) is characterized by psychiatric symptoms and triggered by a terrifying experience which may immediately effect cognitive, affective, behavioral and social skills of the individual. One of the most common noncutaneous cancer among men is prostate cancer. The incidence of psychological stress is quite common in men with prostate cancer. The aim of the study was to explore the PTSD frequency among prostate cancer and define the relationship between occupational participation, coping skills and level of perceived social support among patients with prostate cancer. Forty patients diagnosed with prostate cancer were included in the study. After dividing the patients into two groups ( study/ control) according to type of tumor, we recorded their characteristics and evaluations differences. We evaluated the demographic information form, Structured Clinical Interview for DSM-IV (SCID- I)- Clinical Version for PTSD, Multidimensional Scale of Perceived Social Support, Styles of Coping Inventory and Canadian Occupational Performance Measure (COPM) before and after 1 month from surgery. The mean age of the study group (n:18) was 65.85.6 years (range: 61-79 years). The mean age of the control group (n: 22) was a little bit higher than the study group with mean age 71.3±6.9 years (range: 60-85 years). There was no statistically significant difference between the groups for age and the other characteristics. According to the results of the study, statistically significant difference was found between the level of PTSD of study and the control group. 22% of study group showed PTSD while 13% of the control group showed PTSD (r: 0.02, p<0.001). The scores of study group and control group showed statistically significant difference in five sub-categories of Styles of Coping Inventory. Patients with prostate cancer showed decreased scores in optimistic, seeking social supports and self-confident approach, while increased scores in helpless and submissive sub-categories than the control group (p<0.001). The scores of Multidimensional Scale of Perceived Social Supports of study group and control group showed statistically significant difference. The total perceived social supports score of the study group was 71.34 ± 0.75 while it was 75.34 ± 0.64 for the control group. Total and the sub-category scores of study group were statistically significant lower than the control group. According to COPM, mean scores of occupational participation of study group for occupational performance were 4.32±2.24 and 7.01±1.52 for the control group, respectively). Mean Satisfaction scores were 3,22±2.31 and 7.45±1.74 for the study and control group, respectively. The patients with prostate cancer and benign prostate hyperplasia (BPH) did not show any statistically difference in activity performance (r:0.87) while patients with prostate cancer showed statistically lower scores than the patients with BPH in activity satisfaction (r:0.02, p<0.001).Psycho-social occupational therapy interventions might help to decrease the prevalence of PTSD by increasing associated factors such as the social support perception, using coping skills and activity participation of patients with prostate cancer.

Keywords: activity performance, occupational therapy, posttraumatic stress disorder, prostate cancer

Procedia PDF Downloads 123
438 CertifHy: Developing a European Framework for the Generation of Guarantees of Origin for Green Hydrogen

Authors: Frederic Barth, Wouter Vanhoudt, Marc Londo, Jaap C. Jansen, Karine Veum, Javier Castro, Klaus Nürnberger, Matthias Altmann

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Hydrogen is expected to play a key role in the transition towards a low-carbon economy, especially within the transport sector, the energy sector and the (petro)chemical industry sector. However, the production and use of hydrogen only make sense if the production and transportation are carried out with minimal impact on natural resources, and if greenhouse gas emissions are reduced in comparison to conventional hydrogen or conventional fuels. The CertifHy project, supported by a wide range of key European industry leaders (gas companies, chemical industry, energy utilities, green hydrogen technology developers and automobile manufacturers, as well as other leading industrial players) therefore aims to: 1. Define a widely acceptable definition of green hydrogen. 2. Determine how a robust Guarantee of Origin (GoO) scheme for green hydrogen should be designed and implemented throughout the EU. It is divided into the following work packages (WPs). 1. Generic market outlook for green hydrogen: Evidence of existing industrial markets and the potential development of new energy related markets for green hydrogen in the EU, overview of the segments and their future trends, drivers and market outlook (WP1). 2. Definition of “green” hydrogen: step-by-step consultation approach leading to a consensus on the definition of green hydrogen within the EU (WP2). 3. Review of existing platforms and interactions between existing GoO and green hydrogen: Lessons learnt and mapping of interactions (WP3). 4. Definition of a framework of guarantees of origin for “green” hydrogen: Technical specifications, rules and obligations for the GoO, impact analysis (WP4). 5. Roadmap for the implementation of an EU-wide GoO scheme for green hydrogen: the project implementation plan will be presented to the FCH JU and the European Commission as the key outcome of the project and shared with stakeholders before finalisation (WP5 and 6). Definition of Green Hydrogen: CertifHy Green hydrogen is hydrogen from renewable sources that is also CertifHy Low-GHG-emissions hydrogen. Hydrogen from renewable sources is hydrogen belonging to the share of production equal to the share of renewable energy sources (as defined in the EU RES directive) in energy consumption for hydrogen production, excluding ancillary functions. CertifHy Low-GHG hydrogen is hydrogen with emissions lower than the defined CertifHy Low-GHG-emissions threshold, i.e. 36.4 gCO2eq/MJ, produced in a plant where the average emissions intensity of the non-CertifHy Low-GHG hydrogen production (based on an LCA approach), since sign-up or in the past 12 months, does not exceed the emissions intensity of the benchmark process (SMR of natural gas), i.e. 91.0 gCO2eq/MJ.

Keywords: green hydrogen, cross-cutting, guarantee of origin, certificate, DG energy, bankability

Procedia PDF Downloads 470
437 Correlation Between Cytokine Levels and Lung Injury in the Syrian Hamster (Mesocricetus Auratus) Covid-19 Model

Authors: Gleb Fomin, Kairat Tabynov, Nurkeldy Turebekov, Dinara Turegeldiyeva, Rinat Islamov

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The level of major cytokines in the blood of patients with COVID-19 varies greatly depending on age, gender, duration and severity of infection, and comorbidity. There are two clinically significant cytokines, IL-6 and TNF-α, which increase in levels in patients with severe COVID-19. However, in a model of COVID-19 in hamsters, TNF-α levels are unchanged or reduced, while the expression of other cytokines reflects the profile of cytokines found in patients’ plasma. The aim of our study was to evaluate the relationship between the level of cytokines in the blood, lungs, and lung damage in the model of the Syrian hamster (Mesocricetus auratus) infected with the SARS-CoV-2 strain. The study used outbred female and male Syrian hamsters (n=36, 4 groups) weighing 80-110 g and 5 months old (protocol IACUC, #4, 09/22/2020). Animals were infected intranasally with the hCoV-19/Kazakhstan/KazNAU-NSCEDI-481/2020 strain and euthanized at 3 d.p.i. The level of cytokines IL-6, TNF-α, IFN-α, and IFN-γ was determined by ELISA MyBioSourse (USA) for hamsters. Lung samples were subjected to histological processing. The presence of pathological changes in histological preparations was assessed on a 3-point scale. The work was carried out in the ABSL-3 laboratory. The data were analyzed in GraphPad Prism 6.00 (GraphPad Software, La Jolla, California, USA). The work was supported by the MES RK grant (AP09259865). In the blood, the level of TNF-α increased in males (p=0.0012) and IFN-γ in males and females (p=0.0001). On the contrary, IFN-α production decreased (p=0.0006). Only TNF-α level increased in lung tissues (p=0.0011). Correlation analysis showed a negative relationship between the level of IL-6 in the blood and lung damage in males (r -0.71, p=0.0001) and females (r-0.57, p=0.025). On the contrary, in males, the level of IL-6 in the lungs and score is positively correlated (r 0.80, p=0.01). The level of IFN-γ in the blood (r -0.64, p=0.035) and lungs (r-0.72, p=0.017) in males has a negative correlation with lung damage. No links were found for TNF-α and IFN-α. The study showed a positive association between lung injury and tissue levels of IL-6 in male hamsters. It is known that in humans, high concentrations of IL-6 in the lungs are associated with suppression of cellular immunity and, as a result, with an increase in the severity of COVID-19. TNF-α and IFN-γ play a key role in the pathogenesis of COVID-19 in hamsters. However, the mechanisms of their activity require more detailed study. IFN-α plays a lesser role in direct lung injury in a Syrian hamster model. We have shown the significance of tissue IL-6 and IFN-γ as predictors of the severity of lung damage in COVID-19 in the Syrian hamster model. Changes in the level of cytokines in the blood may not always reflect pathological processes in the lungs with COVID-19.

Keywords: syrian hamster, COVID-19, cytokines, biological model

Procedia PDF Downloads 63
436 Plantar Neuro-Receptor Activation in Total Knee Arthroplasty Patients: Impact on Clinical Function, Pain, and Stiffness - A Randomized Controlled Trial

Authors: Woolfrey K., Woolfrey M., Bolton C. L., Warchuk D.

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Objectives: Osteoarthritis is the most common joint disease of adults worldwide. Despite total knee arthroplasty (TKA) demonstrating high levels of success, 20% of patients report dissatisfaction with their result. VOXX Wellness Stasis Socks are embedded with a proprietary pattern of neuro-receptor activation points that have been proven to activate a precise neuro-response, according to the pattern theory of haptic perception, which stimulates improvements in pain and function. The use of this technology in TKA patients may prove beneficial as an adjunct to recovery as many patients suffer from deficits to their proprioceptive system caused by ligamentous damage and alterations to mechanoreceptors during the procedure. We hypothesized that VOXX Wellness Stasis Socks are a safe, cost-effective, and easily scalable strategy to support TKA patients through their recovery. Design: Double-blinded, placebo-controlled randomized trial. Participants: Patients scheduled to receive TKA were considered eligible for inclusion in the trial. Interventions: Intervention group (I): VOXX Wellness Stasis socks containing receptor point-activation technology. Control group (C): VOXX Wellness Stasis socks without receptor point-activation technology. Sock use during the waking hours x 6 weeks. Main Outcome Measures: Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) questionnaire completed at baseline, 2 weeks, and 6 weeks to assess pain, stiffness, and physical function. Results: Data analysis using SPSS software. P-values, effect sizes, and confidence intervals are reported to assess clinical relevance of the finding. Physical status classifications were compared using t-test. Within-subject and between-subject differences in the mean WOMAC were analyzed by ANOVA. Effect size was analyzed using Cramer’s V. Consistent improvement in WOMAC scores for pain and stiffness at 2 weeks post op in the I over the C group. The womac scores assessing physical function showed a consistent improvement at both 2 and 6 weeks post op in the I group compared to C group. Conclusions: VOXX proved to be a low cost, safe intervention in TKA to help patients improve with regard to pain, stiffness, and physical function. Disclosures: None

Keywords: osteoarthritis, RCT, pain management, total knee arthroplasty

Procedia PDF Downloads 511
435 An Appraisal of Mining Sector Corporate Social Responsibility Processes in Mhondoro-Ngezi, Zimbabwe

Authors: A. T. Muruviwa

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To-date, the discourse on corporate social responsibility (CSR) has primarily centred on the actions and inactions of corporations; hence, the dominant focus on CSR has been on impacts and outcomes. The obscuring effect of this approach has, arguably, resulted in the emergence of what may be termed a ‘Northern’ agenda on CSR theory and practice, in contrast to an emergency ‘Southern’ discourse, which appears to highlight the crucial issues of poverty reduction, infrastructure development and the broader questions of social provisioning and community empowerment. Some scholars have explicitly called for a CSR research agenda that focuses on the 'reciprocal duties' of the stakeholders in the CSR process rather than fixate on the actions and inactions of business. It is against the backdrop of these contestations that this study assesses the reciprocal relationships amongst CSR stakeholders in a Zimbabwean platinum mining town, with a view to demonstrating how such relationships – and the expectations and obligations embedded in them – impact on the success or failure of CSR initiatives. The existence of mutual relations between the corporation and its stakeholders signifies the successes of CSR processes and hence the outcomes. The company is Zimplats Mining Company; the community is Mhondoro-Ngezi, and the stakeholders are clearly identified in the study. The study utilised a triangulated design, with data collected using a mini survey, focus groups, in-depth interview and observation. The key findings are that the CSR process in the study community is dominated by the mining company. Despite the existence of a CSR framework that recognises government, local leaders and community members as legitimate stakeholders, there is little evidence of concrete contributions made by these stakeholders towards the realisation of CSR objectives. As a result, the community development process – in so far as CSR is concerned – fails to address the developmental concerns of the various stakeholders. On the basis of these findings, the study concludes that there is a crisis of reciprocity in the CSR process in Mhondoro-Ngezi, and that a situation where the conceptualisation of local development needs and the deployment of specific development tools seems to be driven by one stakeholder almost to the exclusion of all others, can only present contradictory development outcomes. The significance of this study is that it allows for the development of a more nuanced and robust CSR discourse. Rather than focusing on the corporate and stakeholder perspectives and outcomes of CSR initiatives, this study examines the CSR- development nexus by interrogating the idea of reciprocal responsibility as a sin qua non to CSR success. This analytical strategy and focus allow the researcher to gain a clear understanding of how stakeholder relationships and duties influence CSR processes and also the overall outcome. At a more practical level, the findings of the study should help to shape the policy on corporate community relationships with a view to enhancing the role of mining in development.

Keywords: community development, processes, reciprocity, stakeholders

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434 Implementing a Screening Tool to Assist with Palliative Care Consultation in Adult Non-ICU Patients

Authors: Cassey Younghans

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Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

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433 A Development of English Pronunciation Using Principles of Phonetics for English Major Students at Loei Rajabhat University

Authors: Pongthep Bunrueng

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This action research accentuates the outcome of a development in English pronunciation, using principles of phonetics for English major students at Loei Rajabhat University. The research is split into 5 separate modules: 1) Organs of Speech and How to Produce Sounds, 2) Monopthongs, 3) Diphthongs, 4) Consonant sounds, and 5) Suprasegmental Features. Each module followed a 4 step action research process, 1) Planning, 2) Acting, 3) Observing, and 4) Reflecting. The research targeted 2nd year students who were majoring in English Education at Loei Rajabhat University during the academic year of 2011. A mixed methodology employing both quantitative and qualitative research was used, which put theory into action, taking segmental features up to suprasegmental features. Multiple tools were employed which included the following documents: pre-test and post-test papers, evaluation and assessment papers, group work assessment forms, a presentation grading form, an observation of participants form and a participant self-reflection form. All 5 modules for the target group showed that results from the post-tests were higher than those of the pre-tests, with 0.01 statistical significance. All target groups attained results ranging from low to moderate and from moderate to high performance. The participants who attained low to moderate results had to re-sit the second round. During the first development stage, participants attended classes with group participation, in which they addressed planning through mutual co-operation and sharing of responsibility. Analytic induction of strong points for this operation illustrated that learner cognition, comprehension, application, and group practices were all present whereas the participants with weak results could be attributed to biological differences, differences in life and learning, or individual differences in responsiveness and self-discipline. Participants who were required to be re-treated in Spiral 2 received the same treatment again. Results of tests from the 5 modules after the 2nd treatment were that the participants attained higher scores than those attained in the pre-test. Their assessment and development stages also showed improved results. They showed greater confidence at participating in activities, produced higher quality work, and correctly followed instructions for each activity. Analytic induction of strong and weak points for this operation remains the same as for Spiral 1, though there were improvements to problems which existed prior to undertaking the second treatment.

Keywords: action research, English pronunciation, phonetics, segmental features, suprasegmental features

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432 Radar on Bike: Coarse Classification based on Multi-Level Clustering for Cyclist Safety Enhancement

Authors: Asma Omri, Noureddine Benothman, Sofiane Sayahi, Fethi Tlili, Hichem Besbes

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Cycling, a popular mode of transportation, can also be perilous due to cyclists' vulnerability to collisions with vehicles and obstacles. This paper presents an innovative cyclist safety system based on radar technology designed to offer real-time collision risk warnings to cyclists. The system incorporates a low-power radar sensor affixed to the bicycle and connected to a microcontroller. It leverages radar point cloud detections, a clustering algorithm, and a supervised classifier. These algorithms are optimized for efficiency to run on the TI’s AWR 1843 BOOST radar, utilizing a coarse classification approach distinguishing between cars, trucks, two-wheeled vehicles, and other objects. To enhance the performance of clustering techniques, we propose a 2-Level clustering approach. This approach builds on the state-of-the-art Density-based spatial clustering of applications with noise (DBSCAN). The objective is to first cluster objects based on their velocity, then refine the analysis by clustering based on position. The initial level identifies groups of objects with similar velocities and movement patterns. The subsequent level refines the analysis by considering the spatial distribution of these objects. The clusters obtained from the first level serve as input for the second level of clustering. Our proposed technique surpasses the classical DBSCAN algorithm in terms of geometrical metrics, including homogeneity, completeness, and V-score. Relevant cluster features are extracted and utilized to classify objects using an SVM classifier. Potential obstacles are identified based on their velocity and proximity to the cyclist. To optimize the system, we used the View of Delft dataset for hyperparameter selection and SVM classifier training. The system's performance was assessed using our collected dataset of radar point clouds synchronized with a camera on an Nvidia Jetson Nano board. The radar-based cyclist safety system is a practical solution that can be easily installed on any bicycle and connected to smartphones or other devices, offering real-time feedback and navigation assistance to cyclists. We conducted experiments to validate the system's feasibility, achieving an impressive 85% accuracy in the classification task. This system has the potential to significantly reduce the number of accidents involving cyclists and enhance their safety on the road.

Keywords: 2-level clustering, coarse classification, cyclist safety, warning system based on radar technology

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431 Data Refinement Enhances The Accuracy of Short-Term Traffic Latency Prediction

Authors: Man Fung Ho, Lap So, Jiaqi Zhang, Yuheng Zhao, Huiyang Lu, Tat Shing Choi, K. Y. Michael Wong

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Nowadays, a tremendous amount of data is available in the transportation system, enabling the development of various machine learning approaches to make short-term latency predictions. A natural question is then the choice of relevant information to enable accurate predictions. Using traffic data collected from the Taiwan Freeway System, we consider the prediction of short-term latency of a freeway segment with a length of 17 km covering 5 measurement points, each collecting vehicle-by-vehicle data through the electronic toll collection system. The processed data include the past latencies of the freeway segment with different time lags, the traffic conditions of the individual segments (the accumulations, the traffic fluxes, the entrance and exit rates), the total accumulations, and the weekday latency profiles obtained by Gaussian process regression of past data. We arrive at several important conclusions about how data should be refined to obtain accurate predictions, which have implications for future system-wide latency predictions. (1) We find that the prediction of median latency is much more accurate and meaningful than the prediction of average latency, as the latter is plagued by outliers. This is verified by machine-learning prediction using XGBoost that yields a 35% improvement in the mean square error of the 5-minute averaged latencies. (2) We find that the median latency of the segment 15 minutes ago is a very good baseline for performance comparison, and we have evidence that further improvement is achieved by machine learning approaches such as XGBoost and Long Short-Term Memory (LSTM). (3) By analyzing the feature importance score in XGBoost and calculating the mutual information between the inputs and the latencies to be predicted, we identify a sequence of inputs ranked in importance. It confirms that the past latencies are most informative of the predicted latencies, followed by the total accumulation, whereas inputs such as the entrance and exit rates are uninformative. It also confirms that the inputs are much less informative of the average latencies than the median latencies. (4) For predicting the latencies of segments composed of two or three sub-segments, summing up the predicted latencies of each sub-segment is more accurate than the one-step prediction of the whole segment, especially with the latency prediction of the downstream sub-segments trained to anticipate latencies several minutes ahead. The duration of the anticipation time is an increasing function of the traveling time of the upstream segment. The above findings have important implications to predicting the full set of latencies among the various locations in the freeway system.

Keywords: data refinement, machine learning, mutual information, short-term latency prediction

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