Search results for: length of follow up

Authors: K. Nikilsha, Lakshmi Manohar, Debayan Chatterjee

Abstract:

Landscape is a setting that informs the way of life of a set of people, and the repository of intangible values and human meanings that nurture our very existence. Along with the linkage that it forms with our lives, it can be argued that landscape and memory cannot be separated, as landscape is the nucleus of our memories. In this context, this paper studies landscape evolution of a region with unique geographic setting, where the dependency of the inhabitants on its resources, led to the formation of certain peculiar beliefs and taboos that formed the basis of a set of unwritten rules and guidelines which they still follow as a part of their lifestyle. One such example is Kuttanad, a low lying region in Kerala which is a complex mosaic of fragmented agricultural landscape incorporating coastal backwaters, rivers, marshes, paddy fields and water channels. The more the physical involvement with the resources, the more was the inhabitants attachment towards it. This attachment of the inhabitants to the place is very strong because the creation of this land was the result of the toil of the low caste labourers who strived day and night to create Kuttanad, which was reclaimed from water with the help of the finance supplied by their landlords. However, the greatest challenge faced by them is posed by the forces of water in the form of floods. As this land is fed by five rivers, even the slight variation in rainfall in its watershed area can cause a large imbalance in the water level causing the reclaimed land to be inundated. The effects of climate change including increase in rainfall, rise in sea level and change of seasons can act as a catalyst to this damage. Hasty urbanization has led to the conversion of paddy fields to housing plots and coconut/plantain fields giving no regard to the traditional systems which had once respected nature and combated floods and draughts through the various cultural practices and taboos practiced by the people. Thus it is essential to look back at the landscape evolution of Kuttanad and to recognise methods used traditionally in the region to establish a cultural landscape, and to understand how climate change and urbanisation shall pose a challenge to the existing landscape and lifestyle. This research also explores the possibilities of alternative and sustainable approaches for resilient urban development learned from Kuttanad as a case study.

Keywords: ecological conservation, landscape and ecological engineering, landscape evolution, man-made landscapes

Procedia PDF Downloads 261

Authors: Ashleigh Hillier, Jody Goldstein, Lauren Tornatore, Emily Byrne

Abstract:

As individuals with disabilities attend higher education in greater numbers, universities are seeking ways to support the retention and success of these students, beyond the academically based accommodations. Although mentoring programs for this population are being implemented more frequently, there is a lack of empirically validated outcomes which could promote program replication. The research objective of this exploratory study was to examine outcomes for students with disabilities participating in a peer-to-peer mentoring program. Mentees (students with disabilities) met with their mentor (trained upperclassman) once a week for an hour for one semester (14-weeks). Mentors followed a curriculum structured by monthly and weekly goals to guide the sessions. Curriculum topics included socializing on campus, peer pressure, time management, communicating with peers and professors, classroom etiquette, study skills, and seeking help and campus resources. Data was collected over a period of seven semesters resulting in seven separate cohorts (n=46). The impact of the program was measured using quantitative self-report measures as well as qualitative content analysis of focus groups. Academic outcomes (retention, credits earned, and GPA) were compared between those in the mentoring program and a matched group of students registered with Disability Services who did not receive mentoring. In addition, a one-year follow up was conducted to examine the longer term impact of participation. Findings indicated that mentoring had the most impact in knowing how things work at the university, knowing how and where to find opportunities to meet people on campus, and knowing how to access supports. Mentors also provided a supportive relationship to the mentees and helped with social skills. There were no significant differences in academic outcomes between those who were mentored and those in the comparison group. Most mentees reported continuing to benefit from the program one year on, providing support for the retention of knowledge gained and maintenance of positive outcomes over time. In conclusion, while a range of positive outcomes were evidenced, the model was limited in its impact more broadly, particularly with regards to academic success and impacting more complex challenges.

Keywords: mentor, outcomes, students with disabilities, university

Procedia PDF Downloads 140

Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

Abstract:

Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

Procedia PDF Downloads 76

Authors: Cruz Queen Allysa Rose, Bautista Joymeeh Anne, Lantoria Kaye, Barretto Katya Louise

Abstract:

The study presents the preferences of passengers on the quality of service provided by the two airline check-in methods currently present in airports-traditional counter check-in and common-use self-service kiosks. Since a study has shown that airlines perceive self-service kiosks alone are sufficient enough to ensure adequate services and customer satisfaction, and in contrast, agents and passengers stated that it alone is not enough and that human interaction is essential. In reference with former studies that established opposing ideas about the choice of the more favorable airline check-in method to employ, it is the purpose of this study to present a recommendation that shall somehow fill-in the gap between the conflicting ideas by means of comparing the perceived quality of service through the RATER model. Furthermore, this study discusses the major competencies present in each method which are supported by the theories–FIRO Theory of Needs upholding the importance of inclusion, control and affection, and the Queueing Theory which points out the discipline of passengers and the length of the queue line as important factors affecting quality service. The findings of the study were based on the data gathered by the researchers from selected Thomasian third year and fourth year college students currently enrolled in the first semester of the academic year 2014-2015, who have already experienced both airline check-in methods through the implication of a stratified probability sampling. The statistical treatments applied in order to interpret the data were mean, frequency, standard deviation, t-test, logistic regression and chi-square test. The final point of the study revealed that there is a greater effect in passenger preference concerning the satisfaction experienced in common-use self-service kiosks in comparison with the application of the traditional counter check-in.

Keywords: traditional counter check-in, common-use self-service Kiosks, airline check-in methods

Procedia PDF Downloads 403

Authors: Dawit Thomas

Abstract:

Feeding and weaning practices vary from culture to culture and depend on different child-rearing values. The socio-cultural dimensions that influence the acceptable infant feeding practices are varied and complex. Understanding cultural differences in beliefs and practices relating to infant feeding is important to enhance designing programs for delivering successful psychological, social, physiological and economic well-being of mothers and infants. The main purpose of this study was exploring mothers infant feeding practices in the context of Hadiyya culture. After purposively selecting Harche Huyaya Uyaya Kebele eight infant feeding mothers were selected using snowball sampling technique. The study employed interviews and focus group discussion. The study found out early initiation and prolonged breastfeeding and early complementary feeding in some instances immediately after birth. In addition, infants were not forced to wean unless the mothers encounter pressing issues like pregnancy and health related problems. Furthermore, the main weaning techniques were putting unpleasant materials on the tip of nipples and sending infants to grandparents home. The study also found out gender difference in weaning, i.e., early initiation of weaning for girls. This can be indicative of gender-based bias on weaning practice. Finally, health extension workers, office of women and children affairs and Hadiyya Zone Tourism office should organize awareness raising programs to preserve vital infant feeding practices like prolonged breastfeeding and length of weaning. In addition, the offices should raise awareness among communities on negative side effects of sending infant to grandparents home that may weaken infant-mothers attachment and create favorable ground for the development of phobia.

Keywords: feeding, infant, practices, weaning

Procedia PDF Downloads 316

Authors: Houman Tamaddon, Mehrdad Behnia, Masud Behnia

Abstract:

An accurate study of blood flow is associated with an accurate vascular pattern and geometrical properties of the organ of interest. Due to the complexity of vascular networks and poor accessibility in vivo, it is challenging to reconstruct the entire vasculature of any organ experimentally. The objective of this study is to introduce an innovative approach for the reconstruction of a full vascular tree from available morphometric data. Our method consists of implementing morphometric data on those parts of the vascular tree that are smaller than the resolution of medical imaging methods. This technique reconstructs the entire arterial tree down to the capillaries. Vessels greater than 2 mm are obtained from direct volume and surface analysis using contrast enhanced computed tomography (CT). Vessels smaller than 2mm are reconstructed from available morphometric and distensibility data and rearranged by applying Murray’s Laws. Implementation of morphometric data to reconstruct the branching pattern and applying Murray’s Laws to every vessel bifurcation simultaneously, lead to an accurate vascular tree reconstruction. The reconstruction algorithm generates full arterial tree topography down to the first capillary bifurcation. Geometry of each order of the vascular tree is generated separately to minimize the construction and simulation time. The node-to-node connectivity along with the diameter and length of every vessel segment is established and order numbers, according to the diameter-defined Strahler system, are assigned. During the simulation, we used the averaged flow rate for each order to predict the pressure drop and once the pressure drop is predicted, the flow rate is corrected to match the computed pressure drop for each vessel. The final results for 3 cardiac cycles is presented and compared to the clinical data.

Keywords: blood flow, morphometric data, vascular tree, Strahler ordering system

Procedia PDF Downloads 268

Authors: Chia-Chih Wei, Yun-Qi Li, Ssu-Ying Chen, Hsuan-Jung Chen, Hsi-Wen Yang, Chih-Yuan Chen, Chien-Chon Chen

Abstract:

In this paper we used high quality anodization technique to make colored wind chime with a nano-tube structure anodic film, which controls the length to diameter ratio of an aluminum rod and controls the oxide film structure on the surface of the aluminum rod by anodizing method. The research experiment used hard anodization to grow a controllable thickness of anodic film on aluminum alloy surface. The hard anodization film has high hardness, high insulation, high temperature resistance, good corrosion resistance, colors, and mass production properties can be further applied to transportation, electronic products, biomedical fields, or energy industry applications. This study also in-depth research and detailed discussion in the related process of aluminum alloy surface hard anodizing including pre-anodization, anodization, and post-anodization. The experiment parameters of anodization including using a mixed acid solution of sulfuric acid and oxalic acid as an anodization electrolyte, and control the temperature, time, current density, and final voltage to obtain the anodic film. In the experiments results, the properties of anodic film including thickness, hardness, insulation, and corrosion characteristics, microstructure of the anode film were measured and the hard anodization efficiency was calculated. Thereby obtaining different transmission speeds of sound in the aluminum rod and different audio sounds can be presented on the aluminum rod. Another feature of the present invention is the use of anodizing method dyeing method, laser engraving patterning and electrophoresis method to make colored aluminum wind chimes.

Keywords: anodization, colored, high quality, wind chime, nano-tube

Procedia PDF Downloads 240

Authors: S. S. Singh, A. Bhattacharya, S. Bhattacharya

Abstract:

The eukaryotic exosome complex plays a pivotal role in RNA biogenesis, maturation, surveillance and differential expression of various RNAs in response to varying environmental signals. The exosome is composed of evolutionary conserved nine core subunits and the associated exonucleases Rrp6 and Rrp44. Rrp6p is crucial for the processing of rRNAs, other non-coding RNAs, regulation of polyA tail length and termination of transcription. Rrp6p, a 3’-5’ exonuclease is required for degradation of 5’-external transcribed spacer (ETS) released from the rRNA precursors during the early steps of pre-rRNA processing. In the parasitic protist Entamoeba histolytica in response to growth stress, there occurs the accumulation of unprocessed pre-rRNA and 5’ ETS sub fragment. To understand the processes leading to this accumulation, we looked for Rrp6 and the exosome subunits in E. histolytica, by in silico approaches. Of the nine core exosomal subunits, seven had high percentage of sequence similarity with the yeast and human. The EhRrp6 homolog contained exoribonuclease and HRDC domains like yeast but its N- terminus lacked the PMC2NT domain. EhRrp6 complemented the temperature sensitive phenotype of yeast rrp6Δ cells suggesting conservation of biological activity. We showed 3’-5’ exoribonuclease activity of EhRrp6p with in vitro-synthesized appropriate RNAs substrates. Like the yeast enzyme, EhRrp6p degraded unstructured RNA, but could degrade the stem-loops slowly. Furthermore, immunolocalization revealed that EhRrp6 was nuclear-localized in normal cells but was diminished from nucleus during serum starvation, which could explain the accumulation of 5’ETS during stress. Our study shows functional conservation of EhRrp6p in E.histolytica, an early-branching eukaryote, and will help to understand the evolution of exosomal components and their regulatory function.

Keywords: entamoeba histolytica, exosome complex, rRNA processing, Rrp6

Procedia PDF Downloads 197

Authors: Srishti Bhatt, Vaibhav Bhavsar, Adil Hussain, Aashay Mhaske, S. C. Bali, T. S. Srikanth

Abstract:

Shape Memory Alloys (SMA) are widely known for their unique shape recovery properties. SMA based actuation systems have high-force to weight ratio, light weight and also bio-compatible material. Which is why they are being used in different fields of aerospace, robotics, automotive and biomedical industries. However, in the automotive industry plenty of patents are available but commercially viable products are very few in market. This could be due to SMA material limitations like small stroke, direct dependability of lifecycle on stroke, pull load of the wire and high cycle time. In automotive sector, SMA being considered as an actuator which is required to have high stroke and constraint arises to accommodate a long length of wire (to compensate maximum 4 % strain as per better fatigue life cycle) not only increases complexity but also adds on the cost. More than 200 different types of actuators are used in an automobile, few of them whose efficiency can highly increase by replacing them with SMA based actuators which include latch lock mechanism, glove box, Head lamp leveling, side mirror and rear mirror leveling, tailgate opener and fuel lid cap actuator. To overcome the limitation of available space for required stroke of an actuator which leads to study the effect of different loading positions on SMA wires, different orientations of SMA wire by using pulleys and lever based systems to achieve maximum stroke. This investigation summarizes the loading under the V shape orientation the required stroke and carrying load capacity in more compact in comparison with straight orientation of wire. Similarly, the U shape orientation its showing higher load carrying capacity but reduced stroke which is aligned with concept of bundled wire method. Life-cycle of these orientations were also evaluated.

Keywords: actuators, automotive, nitinol, shape memory alloy, SMA wire orientations

Procedia PDF Downloads 82

Authors: Omar Youssef, Aija Knuuttila, Paivi Piirilä, Virinder Sarhadi, Sakari Knuutila

Abstract:

Exhaled breath condensate (EBC) is a unique sample that allows studying different genetic changes in lung carcinoma through a non-invasive way. With the aid of next generation sequencing (NGS) technology, analysis of genetic mutations has been more efficient with increased sensitivity for detection of genetic variants. In order to investigate the possibility of applying this method for cancer diagnostics, mutations in EBC DNA from lung cancer patients and healthy individuals were studied by using NGS. The key aim is to assess the feasibility of using this approach to detect clinically important mutations in EBC. EBC was collected from 20 healthy individuals and 9 lung cancer patients (four lung adenocarcinomas, four 8 squamous cell carcinoma, and one case of mesothelioma). Mutations in hotpot regions of 22 genes were studied by using Ampliseq Colon and Lung cancer panel and sequenced on Ion PGM. Results demonstrated that all nine patients showed a total of 19 cosmic mutations in APC, BRAF, EGFR, ERBB4, FBXW7, FGFR1, KRAS, MAP2K1, NRAS, PIK3CA, PTEN, RET, SMAD4, and TP53. In controls, 15 individuals showed 35 cosmic mutations in BRAF, CTNNB1, DDR2, EGFR, ERBB2, FBXW7, FGFR3, KRAS, MET, NOTCH1, NRAS, PIK3CA, PTEN, SMAD4, and TP53. Additionally, 45 novel mutations not reported previously were also seen in patients’ samples, and 106 novel mutations were seen in controls’ specimens. KRAS exon 2 mutations G12D was identified in one control specimen with mutant allele fraction of 6.8%, while KRAS G13D mutation seen in one patient sample showed mutant allele fraction of 17%. These findings illustrate that hotspot mutations are present in DNA from EBC of both cancer patients and healthy controls. As some of the cosmic mutations were seen in controls too, no firm conclusion can be drawn on the clinical importance of cosmic mutations in patients. Mutations reported in controls could represent early neoplastic changes or normal homeostatic process of apoptosis occurring in lung tissue to get rid of mutant cells. At the same time, mutations detected in patients might represent a non-invasive easily accessible way for early cancer detection. Follow up of individuals with important cancer mutations is necessary to clarify the significance of these mutations in both healthy individuals and cancer patients.

Keywords: exhaled breath condensate, lung cancer, mutations, next generation sequencing

Procedia PDF Downloads 174

Authors: Nazihe Sedighi, Mohsen Nokhbatolphoghaei

Abstract:

Bisphenol A (BPA) is a monomer used in the manufacture of polycarbonate plastics. Due to having properties such as transparency, heat and impact resistance, it is used widely in medicine, sorts, electronic components, and food containers. It is also used in the production of resins which is applied for lining cans. BPA releases from resins and polycarbonate when it is heated or continuously used the containers from which BPA can enter the body. There are several reports indicating the presence of BPA in the placenta, amniotic fluid, and the embryo itself. While researchers investigated the teratogenic effect of BPA on embryos, very limited work has been done on the effects of BPA when applied from early stages of development. In this study, The teratogenic effect of BPA was investigated at earliest preimplantation (day zero) through day 15.5 of the development of Balb/C mouse embryos. After ensuring the pregnancy via observing vaginal plug, Pregnant mice were divided into five groups. For the three experimental groups, the amount of 500, 750, and 1000 mg/kg/d Bisphenol A was given orally according to body weight. The sham group that was treated with sesame oil, which was used as vehicle and control group remained intact. On day 18.5 of gestation, embryos were removed from the uterus. Randomly half of the embryo were fixed in Bouin for tissue analysis. The other half were prepared for skeletal system staining using Alizarin Red and alcian blue dies. The results showed that the embryonic weight and the crown-rump length of embryos decreased significantly (P < 0.05) in all experimental groups compared to the control group and the sham. In this study, skeletal abnormalities such as delay in ossification of skull and limbs as well as the deviation in the backbone were seen. This research suggests that pregnant mothers need to be aware of possible teratogenic effects of BPA at any stage of pregnancy especially from early to mid stages. In this case, pregnant mothers may need to stop using any manufacture of polycarbonate plastics, as a container for food or drinking.

Keywords: bisphenol A, development, polycarbonate plastic, skeletal system, teratogenicity

Procedia PDF Downloads 290

Authors: Hana Hanaee-Ahvaz, Monika Cserjan-Puschmann, Christopher Tauer, Gerald Striedner

Abstract:

Incorporation of noncanonical amino acids (ncAA) into proteins has become an interesting topic as proteins featured with ncAAs offer a wide range of different applications. Nowadays, technologies and systems exist that allow for the site-specific introduction of ncAAs in vivo, but the efficient production of proteins modified this way is still a big challenge. This is especially true for 'hard-to-express' proteins where low yields are encountered even with the native sequence. In this study, site-specific incorporation of azido-ethoxy-carbonyl-Lysin (azk) into an anti-tumor-necrosis-factor-α-Fab (FTN2) was investigated. According to well-established parameters, possible site positions for ncAA incorporation were determined, and corresponding FTN2 genes were constructed. Each of the modified FTN2 variants has one amber codon for azk incorporated either in its heavy or light chain. The expression level for all variants produced was determined by ELISA, and all azk variants could be produced with a satisfactory yield in the range of 50-70% of the original FTN2 variant. In terms of expression yield, neither the azk incorporation position nor the subunit modified (heavy or light chain) had a significant effect. We confirmed correct protein processing and azk incorporation by mass spectrometry analysis, and antigen-antibody interaction was determined by surface plasmon resonance analysis. The next step is to characterize the effect of azk incorporation on protein stability and aggregation tendency via differential scanning calorimetry and light scattering, respectively. In summary, the incorporation of ncAA into our Fab candidate FTN2 worked better than expected. The quantities produced allowed a detailed characterization of the variants in terms of their properties, and we can now turn our attention to potential applications. By using click chemistry, we can equip the Fabs with additional functionalities and make them suitable for a wide range of applications. We will now use this option in a first approach and develop an assay that will allow us to follow the degradation of the recombinant target protein in vivo. Special focus will be laid on the proteolytic activity in the periplasm and how it is influenced by cultivation/induction conditions.

Keywords: degradation, FTN2, hard-to-express protein, non-canonical amino acids

Procedia PDF Downloads 228

Authors: Giselle Tran, Ralitza Parina, Phuong T. Nguyen

Abstract:

Background/Aims: Pancreatic cysts (PC) have recently become an increasingly common entity, often diagnosed as incidental findings on cross-sectional imaging. Clinically, management of the lesions is difficult because of uncertainties in their potential for malignant degeneration. Prior series have reported that carcinoembryonic antigen (CEA), a biomarker collected from cyst fluid aspiration, has a high diagnostic accuracy for discriminating between mucinous and non-mucinous lesions, at the patient’s initial presentation. To the author’s best knowledge, no prior studies have reported PC CEA levels obtained from endoscopic ultrasound fine-needle aspiration (EUS-FNA) over years of serial EUS surveillance imaging. Methods: We report a consecutive retrospective series of 624 patients who underwent EUS evaluation for a PC between 11/20/2009 and 11/13/2018. Of these patients, 401 patients had CEA values obtained at the point of entry. Of these, 157 patients had two or more CEA values obtained over the course of their EUS surveillance. Of the 157 patients (96 F, 61 M; mean age 68 [range, 62-76]), the mean interval of EUS follow-up was 29.7 months [3.5-128]. The mean number of EUS procedures was 3 [2-7]. To assess CEA value fluctuations, we defined an appreciable increase in CEA as "spikes" – two-times increase in CEA on a subsequent EUS-FNA of the same cyst, with the second CEA value being greater than 1000 ng/mL. Using this definition, cysts with a spike in CEA were compared to those without a spike in a bivariate analysis to determine if a CEA spike is associated with poorer outcomes and the presence of high-risk features. Results: Of the 157 patients analyzed, 29 had a spike in CEA. Of these 29 patients, 5 had a cyst with size increase >0.5cm (p=0.93); 2 had a large cyst, >3cm (p=0.77); 1 had a cyst that developed a new solid component (p=0.03); 7 had a cyst with a solid component at any time during surveillance (p=0.08); 21 had a complex cyst (p=0.34); 4 had a cyst categorized as "Statistically Higher Risk" based on molecular analysis (p=0.11); and 0 underwent surgical resection (p=0.28). Conclusion: With serial EUS imaging in the surveillance of PC, an increase in CEA level defined as a spike did not predict poorer outcomes. Most notably, a spike in CEA did not correlate with the number of patients sent to surgery or patients with an appreciable increase in cyst size. A spike in CEA did not correlate with the development of a solid nodule within the PC nor progression on molecular analysis. Future studies should focus on the selected use of CEA analysis when patients undergo EUS surveillance evaluation for PCs.

Keywords: carcinoembryonic antigen (CEA), endoscopic ultrasound (EUS), fine-needle aspiration (FNA), pancreatic cyst, spike

Procedia PDF Downloads 139

Authors: Bouhouf Atef, Beloulou Mohamed Lamine

Abstract:

Introduction: Outpatient surgery is continually developing compared to conventional inpatient surgery; its rate is constantly increasing every year due to global socio-economic pressure. Most hospitals continue to perform proctologic surgery in conventional hospitalization. Purpose: As part of a monocentric prospective descriptive study, we examined the feasibility of proctologic surgery under saddle block on an outpatient basis with the same safety conditions as in traditional hospitalization. Material and methods: This is a monocentric prospective descriptive study spread over a period of 24 months, from December 2018 to December 2020 including 150 patients meeting the medico-surgical and socio-environmental criteria of eligibility for outpatient surgery, operated for proctological pathologies under saddle block in outpatient mode, in the surgery department of the regional military hospital of Constantine Algeria. The data were collected and analyzed by the biomedical statistics software Epi-info and Microsoft Excel, then compared with other related studies. Results: This study involved over a period of two years, 150 male patients with an average age of 32 years (20-64). Most patients (95,33%) were ASA I class, and 4,67% ASA II class. All patients received saddle blocks. The average length of stay of patients was six hours. The quality indicators in outpatient surgery in our study were: zero (0)% of deprogrammings, three (3)% of conversions to full hospitalization, 0,7% of readmissions, an average waiting time before access to the operating room of 83 minutes without delay of discharge, a satisfaction rate of 90,8% and a reduction in the cost compared to conventional inpatient surgery in proportions ranging from – 32,6% and – 48,75%. Conclusions: The outpatient management of proctological surgery under saddle block is very beneficial in terms of safety, efficiency, simplicity, and economy. Our results are in line with those of the literature and our work deserves to be continued to include many patients.

Keywords: outpatient surgery, proctological surgery, saddle block, satisfaction, cost

Procedia PDF Downloads 7

Authors: Dimitra Riza

Abstract:

This paper examines different ways of exploring a city by using smart phones' applications while walking, and the way this new attitude will change our perception of the urban environment. By referring to various examples of such applications we will consider options and possibilities that open up with new technologies, their advantages and disadvantages, as well as ways of experiencing and interpreting the urban environment. The widespread use of smart phones gave access to information, maps, knowledge, etc. at all times and places. The city tourism marketing takes advantage of this event and promotes the city's attractions through technology. Mobile mediated walking tours, provide new possibilities and modify the way we used to explore cities, for instance by giving directions proper to find easily destinations, by displaying our exact location on the map, by creating our own tours through picking points of interest and interconnecting them to create a route. These apps act as interactive ones, as they filter the user's interests, movements, etc. Discovering a city on foot and visiting interesting sites and landmarks, became very easy, and has been revolutionized through the help of navigational and other applications. In contrast to the re-invention of the city as suggested by the Baudelaire's Flâneur in the 19th century, or to the construction of situations by the Situationists in 60s, the new technological means do not allow people to "get lost", as these follow and record our moves. In the case of strolling or drifting around the city, the option of "getting lost" is desired, as the goal is not the "wayfinding" or the destination, but it is the experience of walking itself. Getting lost is not always about dislocation, but it is about getting a feeling, free of the urban environment while experiencing it. So, on the one hand, walking is considered to be a physical and embodied experience, as the observer becomes an actor and participates with all his senses in the city activities. On the other hand, the use of a screen turns out to become a disembodied experience of the urban environment, as we perceive it in a fragmented and distanced way. Relations with the city are similar to Alberti’s isolated viewer, detached from any urban stage. The smartphone, even if we are present, acts as a mediator: we interact directly with it and indirectly with the environment. Contrary to the Flaneur and to the Situationists, who discovered the city with their own bodies, today the body itself is being detached from that experience. While contemporary cities turn out to become more walkable, the new technological applications tend to open out all possibilities in order to explore them by suggesting multiple routes. Exploration becomes easier, but Perception changes.

Keywords: body, experience, mobile apps, walking

Procedia PDF Downloads 409

Authors: Maria Manzoor, Iram Gul, Muhammad Arshad

Abstract:

Bacterial strains were isolated from contaminated soil collected from Rawalpindi and Islamabad. The strains were investigated for lead resistance and their effect on Pb solubility and PGPR activity. Incubation experiments were carried for inoculated and unoculated soil containing different levels of Pb. Results revealed that few stains (BTM-4, BTM-11, BTM-14) were able to tolerate Pb up to 600 mg L-1, whereas five strains (BTM-3, BTM-6, BTM-10, BTM-21 and BTM-24) showed significant increase in solubility of Pb when compared to all other strains and control. The CaCl2 extractable Pb was increased by 13.6, 6.8, 4.4 and 2.4 folds compared to un-inoculated control soil at increased soil Pb concentration (500, 1000, 1500 and 200 mg kg-1, respectively). The selected bacterial strains (11) were further investigated for plant growth promotion activity through PGPR assays including. Germination and root elongation assays were also conducted under elevated metal concentration in controlled conditions to elucidate the effects of microbial strains upon plant growth and development. The results showed that all the strains tested in this study, produced significantly varying concentrations of IAA, siderophores and gibberellic acid along with ability to phosphorus solubilization index (PSI). The results of germination and root elongation assay further confirmed the beneficial role of the microbial strains in elevating metal stress through PGPR activity. Among all tested strains, BTM-10 significantly improved plant growth. 1.3 and 2.7 folds increase in root and shoot length was observed when compared to control. Which may be attributed to presence of important plant growth promoting enzymes (IAA 74.6 μg/ml; GA 19.23 μg/ml; Sidrophore units 49% and PSI 1.3 cm). The outcome of this study indicates that these Pb tolerant and solubilizing strains may have the potential for plant growth promotion under metal stress and can be used as mediator when coupled with heavy metal hyperaccumulator plants for phytoremediation of Pb contaminated soil.

Keywords: Pb resistant bacteria, Pb mobilizing bacteria, Phytoextraction of Pb, PGPR activity of bacteria

Procedia PDF Downloads 215

Authors: Meredith Jones, Susan Catapano, Carol McNulty

Abstract:

Study abroad experiences create unique learning opportunities for preservice teachers to strengthen their reflective thinking practices through applied learning experiences. Not only do study abroad experiences provide opportunities for students to expand their cultural sensitivity, but incorporating applied learning experiences in study abroad trips creates unique opportunities for preservice teachers to engage in critical reflection on their teaching skills. Applied learning experiences are designed to nurture learning and growth through a reflective, experiential process outside the traditional classroom setting. As students participate in applied learning experiences, they engage in critical reflection independently, with their peers, and with university faculty. Critical reflection within applied learning contexts generates, deepens, and documents learning but must be intentionally designed to be effective. Grounded in Dewey’s model of reflection, this qualitative study examines longitudinal data from various study abroad cohorts from a particular university. Reflective data was collected during the study abroad trip, and follow up data on critical reflection of teaching practices were collected six months and a year after the trip. Dewey’s model of reflection requires preservice teachers to make sense of their experiences by reflecting on theoretical knowledge, experiences, and pedagogical knowledge. Guided reflection provides preservice teachers with a framework to respond to questions and ideas critical to the applied learning outcomes. Prompts are used to engage preservice teachers in reflecting on situations they have experienced and how they can be transferred to their teaching. Findings from this study noted that students with previous field experiences, or work in the field, engaged in more critical reflection on pedagogical knowledge throughout their applied learning experience. Preservice teachers with limited experiences in the field benefited from engaging in critical reflection prompted by university faculty during the applied learning experience. However, they were able to independently engage in critical reflection once they began work in the field through university field placements, internships, or student teaching. Finally, students who participated in study abroad applied learning experiences reported their critical reflection on their teaching practices, and cultural sensitivity enhanced their teaching and relationships with children once they formally entered the teaching profession.

Keywords: applied learning experiences, critical reflection, cultural sensitivity, preservice teachers, teacher education

Procedia PDF Downloads 134

Authors: Thanooja Naushad, Meena Natarajan, Tushar Vasant Kulkarni

Abstract:

Background: The Lacey Assessment of Preterm Infants (LAPI) is used in clinical practice to identify premature babies at risk of neuromotor impairments, especially cerebral palsy. This study attempted to find the validity of the Lacey assessment of preterm infants to predict neuromotor outcomes of premature babies at 12 months corrected age and to compare its predictive ability with the brain ultrasound. Methods: This prospective cohort study included 89 preterm infants (45 females and 44 males) born below 35 weeks gestation who were admitted to the neonatal intensive care unit of a government hospital in Dubai. Initial assessment was done using the Lacey assessment after the babies reached 33 weeks postmenstrual age. Follow up assessment on neuromotor outcomes was done at 12 months (± 1 week) corrected age using two standardized outcome measures, i.e., infant neurological international battery and Alberta infant motor scale. Brain ultrasound data were collected retrospectively. Data were statistically analyzed, and the diagnostic accuracy of the Lacey assessment of preterm infants (LAPI) was calculated -when used alone and in combination with the brain ultrasound. Results: On comparison with brain ultrasound, the Lacey assessment showed superior specificity (96% vs. 77%), higher positive predictive value (57% vs. 22%), and higher positive likelihood ratio (18 vs. 3) to predict neuromotor outcomes at one year of age. The sensitivity of Lacey assessment was lower than brain ultrasound (66% vs. 83%), whereas specificity was similar (97% vs. 98%). A combination of Lacey assessment and brain ultrasound results showed higher sensitivity (80%), positive (66%), and negative (98%) predictive values, positive likelihood ratio (24), and test accuracy (95%) than Lacey assessment alone in predicting neurological outcomes. The negative predictive value of the Lacey assessment was similar to that of its combination with brain ultrasound (96%). Conclusion: Results of this study suggest that the Lacey assessment of preterm infants can be used as a supplementary assessment tool for premature babies in the neonatal intensive care unit. Due to its high specificity, Lacey assessment can be used to identify those babies at low risk of abnormal neuromotor outcomes at a later age. When used along with the findings of the brain ultrasound, Lacey assessment has better sensitivity to identify preterm babies at particular risk. These findings have applications in identifying premature babies who may benefit from early intervention services.

Keywords: brain ultrasound, lacey assessment of preterm infants, neuromotor outcomes, preterm

Procedia PDF Downloads 136

Authors: Sule Pallavi, Shah Priyank, Thavkar Amit, Mehta Suyog, Rohira Poonam

Abstract:

Minoxidil is used topically to help hair growth in the treatment of male androgenetic alopecia. The objective of this study is to compare irritation potential of three conventional formulation of minoxidil 5% topical solution of in human patch test. The study was a single centre, double blind, non-randomized controlled study in 56 healthy adult Indian subjects. Occlusive patch test for 24 hours was performed with three formulation of minoxidil 5% topical solution. Products tested included aqueous based minoxidil 5% (AnasureTM 5%, Sun Pharma, India – Brand A), alcohol based minoxidil 5% (Brand B) and aqueous based minoxidil 5% (Brand C). Isotonic saline 0.9% and 1% w/w sodium lauryl sulphate were included as negative control and positive control respectively. Patches were applied and removed after 24hours. The skin reaction was assessed and clinically scored 24 hours after the removal of the patches under constant artificial daylight source using Draize scale (0-4 points scale for erythema/wrinkles/dryness and for oedema). A combined mean score up to 2.0/8.0 indicates a product is “non-irritant” and score between 2.0/8.0 and 4.0/8.0 indicates “mildly irritant” and score above 4.0/8.0 indicates “irritant”. Follow-up was scheduled after one week to confirm recovery for any reaction. The procedure of the patch test followed the principles outlined by Bureau of Indian standards (BIS) (IS 4011:2018; Methods of Test for safety evaluation of Cosmetics-3rd revision). Fifty six subjects with mean age 30.9 years (27 males and 29 females) participated in the study. The combined mean score (± standard deviation) were: 0.13 ± 0.33 (Brand A), 0.39 ± 0.49 (Brand B), 0.22 ± 0.41 (Brand C), 2.91 ± 0.79 (Positive control) and 0.02 ± 0.13 (Negative control). The mean score of Brand A (Sun Pharma product) was significantly lower than Brand B (p=0.001) and was comparable with Brand C (p=0.21). The combined mean erythema score (± standard deviation) were: 0.09 ± 0.29 (Brand A), 0.27 ± 0.5 (Brand B), 0.18 ± 0.39 (Brand C), 2.02 ± 0.49 (Positive control) and 0.0 ± 0.0 (Negative control). The mean erythema score of Brand A was significantly lower than Brand B (p=0.01) and was comparable with Brand C (p=0.16). Any reaction observed at 24hours after patch removal subsided in a week. All the three topical formulation of minoxidil 5% were non-irritant. Brand A of 5% minoxidil (Sun Pharma) was found to be least irritant than Brand B and Brand C based on the combined mean score and mean erythema score in the human patch test as per the BIS, IS 4011;2018.

Keywords: erythema, irritation, minoxidil, patch test

Procedia PDF Downloads 93

Authors: Lucia Ceccherini Nelli, Alessandra Donato

Abstract:

The ABITA Master course of the University of Florence offered by the Department of Architecture covers nearly all the energy-relevant issues that can arise in public and private companies and sectors. The main purpose of the Master course, active since 2003, is to analyse the energy consumption of building technologies, components, and structures at the conceptual design stage, so it could be very helpful, for designers, when making decisions related to the selection of the most suitable design alternatives and for the materials choice that will be used in an energy-efficient building. The training course provides a solid basis for increasing the knowledge and skills of energy managers and is developed with an emphasis on practical experiences related to the knowledge through case studies, measurements, and verification of energy-efficient solutions in buildings, in the industry and in the cities. The main objectives are: i)To raise the professional standards of those engaged in energy auditing, ii) To improve the practice of energy auditors by encouraging energy auditing professionals in a continuing education program of professional development, iii) Implement in the use of instrumentations for the typical measurements, iv) To propose an integrated methodology that links energy analysis tools with green building certification systems. This methodology will be applied at the early design stage of a project’s life. The final output of the practical training is to achieve an elevated professionalism in the study of environmental design and Energy management in buildings. The results are the redaction of line guides instruction for the energy refurbishment of Public schools in Florence. The school heritage of the Municipality of Florence requires interventions for the control of energy performance, as old construction buildings are often made without taking into account the necessary envelope performance. For this reason, every year, the Master's course aims to study groups of public schools to enable the Municipality to carry out energy redevelopment interventions on the existing building heritage. The future challenges of the education and training program are related to follow-up activities, the development of interactive tools and the curriculum's customization to meet the constantly growing needs of energy experts from industry.

Keywords: expert in energy, energy auditing, public buildings, thermal analysis

Procedia PDF Downloads 186

Authors: Ahsan Khan, Nazish Shah, Muhammad Salman

Abstract:

The present study deals with the toxicological effects of copper, lead and chromium on brain and liver tissues of grass carp (Ctenopharyngodon idella). The average length of experimental fish was 8.5 ± 5.5 cm and weighed 9.5 ± 6.5 g. Grass carp was exposed to lethal concentration (LC₁₅) of copper, lead and chromium for 24, 48, 72 and 96 hours respectively. (LC₁₅) for copper was 1.5, 1.4, 1.2 and 1mgL⁻¹. Similarly, LC₁₅ of lead was 250, 235, 225 and 216mgL⁻¹ while (LC₁₅) for chromium was 25.5, 22.5, 20 and 18mgL⁻¹ respectively. During the time of exposure against various doses of heavy metals the grass carp showed some behavioral changes. In the initial stages of experiment, the rapid movements and gulping of air were observed. Several times the fish tried to jump to scat from the toxic median. In addition, the accumulation of heavy metals in different tissues of grass carp particularly in liver and brain tissues were observed. Lead was highly accumulated in brain tissue after the exposure of fish for 24 and 48 hours, while highly accumulated in liver tissues after the exposure of fish for 72 and 96 hours. Chromium was highly accumulated in the liver tissues after the exposure of fish for 24 hours while its accumulation was found highly in the brain tissues after the exposure of fish for 48, 72 and 96 hours. Similarly, accumulation of copper concentration was found highly in brain tissues after the exposure of 48 and 96 hours while its accumulation was high in liver tissues after the exposure of 24 and 72 hours. Comparatively maximum accumulation of lead was found in brain and liver tissues of grass carp followed by chromium and copper. Furthermore, accumulation of these metals caused many abnormalities like gliosis, destruction of cell, change in cell shape and shrinkage of cells in brain tissue while in liver tissues aggregation in hepatocytes, widen space between cells and also destruction of cell was observed. These experiments and observations can be useful to monitor the aquatic pollution and quality of aquatic environment system.

Keywords: brain, grass carp, liver, lethal concentration, toxicity

Procedia PDF Downloads 154

Authors: E. Tchandao Mangamana, V. Cariou, E. Vigneau, R. Glele Kakai, E. M. Qannari

Abstract:

A new definition of a latent variable associated with a dataset makes it possible to propose variants of the PLS2 regression and the multi-block PLS (MB-PLS). We shall refer to these variants as Rd-PLS regression and Rd-MB-PLS respectively because they are inspired by both Redundancy analysis and PLS regression. Usually, a latent variable t associated with a dataset Z is defined as a linear combination of the variables of Z with the constraint that the length of the loading weights vector equals 1. Formally, t=Zw with ‖w‖=1. Denoting by Z' the transpose of Z, we define herein, a latent variable by t=ZZ’q with the constraint that the auxiliary variable q has a norm equal to 1. This new definition of a latent variable entails that, as previously, t is a linear combination of the variables in Z and, in addition, the loading vector w=Z’q is constrained to be a linear combination of the rows of Z. More importantly, t could be interpreted as a kind of projection of the auxiliary variable q onto the space generated by the variables in Z, since it is collinear to the first PLS1 component of q onto Z. Consider the situation in which we aim to predict a dataset Y from another dataset X. These two datasets relate to the same individuals and are assumed to be centered. Let us consider a latent variable u=YY’q to which we associate the variable t= XX’YY’q. Rd-PLS consists in seeking q (and therefore u and t) so that the covariance between t and u is maximum. The solution to this problem is straightforward and consists in setting q to the eigenvector of YY’XX’YY’ associated with the largest eigenvalue. For the determination of higher order components, we deflate X and Y with respect to the latent variable t. Extending Rd-PLS to the context of multi-block data is relatively easy. Starting from a latent variable u=YY’q, we consider its ‘projection’ on the space generated by the variables of each block Xk (k=1, ..., K) namely, tk= XkXk'YY’q. Thereafter, Rd-MB-PLS seeks q in order to maximize the average of the covariances of u with tk (k=1, ..., K). The solution to this problem is given by q, eigenvector of YY’XX’YY’, where X is the dataset obtained by horizontally merging datasets Xk (k=1, ..., K). For the determination of latent variables of order higher than 1, we use a deflation of Y and Xk with respect to the variable t= XX’YY’q. In the same vein, extending Rd-MB-PLS to the path modeling setting is straightforward. Methods are illustrated on the basis of case studies and performance of Rd-PLS and Rd-MB-PLS in terms of prediction is compared to that of PLS2 and MB-PLS.

Keywords: multiblock data analysis, partial least squares regression, path modeling, redundancy analysis

Procedia PDF Downloads 146

Authors: Mazoun Nasser Rashid Al Kharusi, Nada Al Siyabi

Abstract:

Objectives: The main aim of this study is to Find the rate of susceptibility of ESBL E. coli causing UTI to oral antibiotics. Secondary objectives: Prevalence of ESBL E. coli from community urine samples, identify the best empirical oral antibiotics with the least resistance rate for UTI and identify alternative oral antibiotics for testing and utilization. Methods: This study is a retrospective descriptive study of the last three years in five major hospitals in Oman (Khowla Hospital, AN’Nahdha Hospital, Rustaq Hospital, Nizwa Hospital, and Ibri Hospital) equipped with a microbiologist. Inclusion criteria include all eligible outpatient urine culture isolates, excluding isolates from admitted patients with hospital-acquired urinary tract infections. Data was collected through the MOH database. The MOH hospitals are using different types of testing, automated methods like Vitek2 and manual methods. Vitek2 machine uses the principle of the fluorogenic method for organism identification and a turbidimetric method for susceptibility testing. The manual method is done by double disc diffusion for identifying ESBL and the disc diffusion method is for antibiotic susceptibility. All laboratories follow the clinical laboratory science institute (CLSI) guidelines. Analysis was done by SPSS statistical package. Results: Total urine cultures were (23048). E. coli grew in (11637) 49.6% of the urine, whereas (2199) 18.8% of those were confirmed as ESBL. As expected, the resistance rate to amoxicillin and cefuroxime is 100%. Moreover, the susceptibility of those ESBL-producing E. coli to nitrofurantoin, trimethoprim+sulfamethoxazole, ciprofloxacin and amoxicillin-clavulanate is progressing over the years; however, still low. ESBL E. coli was predominating in the female gender and those aged 66-74 years old throughout all the years. Other oral antibiotic options need to be explored and tested so that we add to the pool of oral antibiotics for ESBL E. coli causing UTI in the community. Conclusion: High rate of ESBL E. coli in urine from the community. The high resistance rates to oral antibiotics highlight the need for alternative treatment options for UTIs caused by these bacteria. Further research is needed to identify new and effective treatments for UTIs caused by ESBL-E. Coli.

Keywords: UTI, ESBL, oral antibiotics, E. coli, susceptibility

Procedia PDF Downloads 88

Authors: R. Furutani, K. Ishii

Abstract:

Laser interferometers are now widely used for length and displacement measurement. In conventional methods, the optical path difference between two mirrors, one of which is a reference mirror and the other is a target mirror, is measured, as in Michelson interferometry, or two target mirrors are set up and the optical path difference between the two targets is measured, as in differential interferometry. In these interferometers, the two laser beams pass through different optical elements so that the measurement result is affected by the vibration and other effects in the optical paths. In addition, it is difficult to measure the roll angle around the optical axis. The proposed interferometer simultaneously measures both the translational motion along the optical axis and the roll motion around it by combining the retroreflective principle of the ball lens (BL) and the polarization. This interferometer detects the interferogram by the two beams traveling along the identical optical path from the beam source to BL. This principle is expected to reduce external influences by using the interferogram between the two lasers in an identical optical path. The proposed interferometer uses a BL so that the reflected light from the lens travels on the identical optical path as the incident light. After reaching the aperture of the He-Ne laser oscillator, the reflected light is reflected by a mirror with a very high reflectivity installed in the aperture and is irradiated back toward the BL. Both the first laser beam that enters the BL and the second laser beam that enters the BL after the round trip interferes with each other, enabling the measurement of displacement along the optical axis. In addition, for the measurement of the roll motion, a quarter-wave plate is installed on the optical path to change the polarization state of the laser. The polarization states of the first laser beam and second laser beam are different by the roll angle of the target. As a result, this system can measure the displacement and the roll angle of BL simultaneously. It was verified by the simulation and the experiment that the proposed optical system could measure the displacement and the roll angle simultaneously.

Keywords: common path interferometer, displacement measurement, laser interferometer, simultaneous measurement, roll angle measurement

Procedia PDF Downloads 87

Authors: Shlomit Hon-Snir, Sharon Teitler-Regev, Anabel Lifszyc Friedlander

Abstract:

Tourism, one of the world's largest and fastest growing industries, exerts a major economic influence. The number of international tourists is growing every year, and the relative portion of independent (FIT) tourists is growing as well. The characteristics of independent tourists differ from those of tourists who travel in organized trips. The purpose of the research is to identify the factors that affect the individual tourist's expenses in Israel: total expenses, expenses per day, expenses per tourist, expenses per day per tourist, accommodation expenses, dining expenses and transportation expenses. Most of the research analyzed the total expenses using OLS regression. The determinants influencing expenses were divided into four groups: budget constraints, socio-demographic data, psychological characteristics and travel-related characteristics. Since the effect of each variable may change over different levels of total expenses the quantile regression (QR) theory will be applied. The current research will use data collected by the Israeli Ministry of Tourism in 2015 from individual independent tourists at the end of their visit to Israel. Preliminary results show that: At lower levels of expense, only income has a (positive) effect on total expenses, while at higher levels of expense, both income and length of stay have (positive) effects. -The effect of income on total expenses is higher for higher levels of expenses than for lower level of expenses. -The number of sites visited during the trip has a (negative) effect on tourist accommodation expenses only for tourists with a high level of total expenses. Due to the increasing share of independent tourism in Israel and around the world and due to the importance of tourism to Israel, it is very important to understand the factors that influence the expenses and behavior of independent tourists. Understanding the factors that affect independent tourists' expenses in Israel can help Israeli policymakers in their promotional efforts to attract tourism to Israel.

Keywords: independent tourist, quantile regression theory, tourism expenses, tourism

Procedia PDF Downloads 271

Authors: C. M. Choi, H. C. Tsang, W. K. Fong, Y. K. Cheng, T. K. Chui, L. Y. Chan, K. W. Lee, C. K. Yuen, P. W. Lau, Y. L. To, K. C. Chow

Abstract:

Six-minute walk test (6MWT) is a sub-maximal exercise test to assess aerobic capacity and exercise tolerance of patients with chronic respiratory disease and heart failure. This has been proven to be a reliable and valid tool and commonly used in clinical situations. Traditional 6MWT is labour-intensive and time-consuming especially for patients who require assistance in ambulation and oxygen use. When performing the test with these patients, one staff will assist the patient in walking (with or without aids) while another staff will need to manually record patient’s oxygen saturation, heart rate and walking distance at every minute and/or carry oxygen cylinder at the same time. Physiotherapist will then have to document the test results in bed notes in details. With the use of electronic 6MWT (E-6MWT), patients wear a wireless oximeter that transfers data to a tablet PC via Bluetooth. Real-time recording of oxygen saturation, heart rate, and distance are displayed. No manual work on recording is needed. The tablet will generate a comprehensive report which can be directly attached to the patient’s bed notes for documentation. Data can also be saved for later patient follow up. This study was carried out in North District Hospital. Patients who followed commands and required 6MWT assessment were included. Patients were assigned to study or control groups. In the study group, patients adopted the E-6MWT while those in control group adopted the traditional 6MWT. Manpower and time consumed were recorded. Physiotherapists also completed a questionnaire about the use of E-6MWT. Total 12 subjects (Study=6; Control=6) were recruited during 11-12/2017. An average number of staff required and time consumed in traditional 6MWT were 1.67 and 949.33 seconds respectively; while in E-6MWT, the figures were 1.00 and 630.00 seconds respectively. Compared to traditional 6MWT, E-6MWT required 67.00% less manpower and 50.10% less in time spent. Physiotherapists (n=7) found E-6MWT is convenient to use (mean=5.14; satisfied to very satisfied), requires less manpower and time to complete the test (mean=4.71; rather satisfied to satisfied), has better data management (mean=5.86; satisfied to very satisfied) and is recommended to be used clinically (mean=5.29; satisfied to very satisfied). It is proven that E-6MWT requires less manpower input with higher efficiency and better data management. It is welcomed by the clinical frontline staff.

Keywords: electronic, physiotherapy, six-minute walk test, 6MWT

Procedia PDF Downloads 150

Authors: Alisha M. Ebrahim, Bijoy K. Menon, Eddy Lang, Shelagh B. Coutts, Katie Lin

Abstract:

Introduction: Frontline emergency physicians require clear and evidence-based approaches to guide neuroimaging investigations for patients presenting with suspected acute stroke or transient ischemic attack (TIA). Various forms of computed tomography (CT) are currently available for initial investigation, including non-contrast CT (NCCT), CT angiography head and neck (CTA), and CT perfusion (CTP). However, there is uncertainty around optimal imaging choice for cost-effectiveness, particularly for minor or resolved neurological symptoms. In addition to the cost of CTA and CTP testing, there is also a concern for increased incidental findings, which may contribute to the burden of overdiagnosis. Methods: In this cross-sectional observational study, analysis was conducted on 586 anonymized triage and diagnostic imaging (DI) reports for neuroimaging orders completed on patients presenting to adult emergency departments (EDs) with a suspected stroke or TIA from January-December 2019. The primary outcome of interest is the diagnostic yield of NCCT+CTA compared to NCCT alone for patients presenting to urban academic EDs with Canadian Emergency Department Information System (CEDIS) complaints of “symptoms of stroke” (specifically acute stroke and TIA indications). DI reports were coded into 4 pre-specified categories (endorsed by a panel of stroke experts): no abnormalities, clinically significant findings (requiring immediate or follow-up clinical action), incidental findings (not meeting prespecified criteria for clinical significance), and both significant and incidental findings. Standard descriptive statistics were performed. A two-sided p-value <0.05 was considered significant. Results: 75% of patients received NCCT+CTA imaging, 21% received NCCT alone, and 4% received NCCT+CTA+CTP. The diagnostic yield of NCCT+CTA imaging for prespecified clinically significant findings was 24%, compared to only 9% in those who received NCCT alone. The proportion of incidental findings was 30% in the NCCT only group and 32% in the NCCT+CTA group. CTP did not significantly increase the yield of significant or incidental findings. Conclusion: In this cohort of patients presenting with suspected stroke or TIA, an NCCT+CTA neuroimaging strategy had a higher diagnostic yield for clinically significant findings than NCCT alone without significantly increasing the number of incidental findings identified.

Keywords: stroke, diagnostic yield, neuroimaging, emergency department, CT

Procedia PDF Downloads 96

Authors: Morteza Khashehchi, Kamel Hooman

Abstract:

Thermal effects on the dynamics and stability of the flow past a circular cylinder operating in the mixed convection regime is studied experimentally for Reynolds number (ReD) between 1000 and 4000, and different cylinder wall temperatures (Tw) between 25 and 75°C by means of Particle Image Velocimetry (PIV). The experiments were conducted in a horizontal wind tunnel with the heated cylinder placed horizontally. With such assumptions, the direction of the thermally induced buoyancy force acting on the fluid surrounding the heated cylinder would be perpendicular to the flow direction. In each experiment, to acquire 3000 PIV image pairs, the temperature and Reynolds number of the approach flow were held constant. By adjusting different temperatures in different Reynolds numbers, the corresponding Richardson number (RiD = Gr/Re^2) was varied between 0:0 (unheated) and 10, resulting in a change in the heat transfer process from forced convection to mixed convection. With increasing temperature of the wall cylinder, significant modifications of the wake flow pattern and wake vortex shedding process were clearly revealed. For cylinder at low wall temperature, the size of the wake and the vortex shedding process are found to be quite similar to those of an unheated cylinder. With high wall temperature, however, the high temperature gradient in the wake shear layer creates a type of vorticity with opposite sign to that of the shear layer vorticity. This temperature gradient vorticity weakens the strength of the shear layer vorticity, causing delay in reaching the recreation point. In addition to the wake characteristics, the shedding frequency for the heated cylinder is determined for all aforementioned cases. It is found that, as the cylinder wall is heated, the organization of the vortex shedding is altered and the relative position of the first detached vortices with respect to the second one is changed. This movement of the first detached vortex toward the second one increases the frequency of the shedding process. It is also found that the wake closure length decreases with increasing the Richardson number.

Keywords: heated cylinder, PIV, wake, Reynolds number

Procedia PDF Downloads 388

Authors: Danny Mwangi, Collins Oduor Ondiek

Abstract:

Mass mobility is one of the most important characteristics of every industrialized civilization. Man must travel about in order to fulfill his commitment to putting food on his table. As a result, movement is an important part of human life. Man must travel from one place to another. This is a natural trait of humans, according to elementary science. Variables in human mobility have arisen as a result of technological advancements over time. Public transit is one of these modes of transportation. When it comes to reducing safety-related risks in the public transport system, awareness is crucial. So much so even when it comes to public transportation in Kenya. Having a system that can be able to keep users updated with real-time traffic updates on the route, they are on and also have the ability to rate drivers after a trip could go a long way in improving safety on Kenyan roads. What this proposed system is intended to accomplish is to reduce occurrences of reckless driving and give matatu drivers the feeling that they are accountable to someone and more so have the incentive to be better drivers who are motivated to follow the law and have passenger safety as a priority. The research was conducted, and the findings show that 95.2% of respondents were not satisfied with the current safety measures in the Kenyan public transport sector. This means that the chances for this system to be accepted in the market are high because it addresses a key issue. 98.8% of the respondents were of the opinion that the implementation of the proposed system would significantly increase safety measures in the public transport sector. During the research, it was clear that the main challenge 77.1% of the respondents face when using public transport is that there is no way to monitor driver safety performance, and 68.7% of the respondent believed the widespread use of unroadworthy public transit vehicles contributed to the lack of safety when using public transport. However, 77.1% of the respondents expect the benefit of creating a sense of accountability for the drivers, and 74.7% of the respondents expect the benefit of increased passenger safety. 63.9% believe that with the implementation of the system, there will be the benefit of monitoring driver performance. This shows that with the implementation of the proposed system, it will be possible to make a lot of progress in terms of making Kenyan roads safer when using public transit. According to the findings, it is recommended that this proposed public transportation safety awareness system be implemented as it will be able to address matatu passengers' safety concerns while also encouraging matatu drivers to drive more carefully. As a result, it's a project with a chance of becoming viable, marketable, and feasible.

Keywords: public safety, public transportation, accountable driving, safe transportation

Procedia PDF Downloads 97

Authors: Ahmed Elbeltagy, Francesca Bertolini, Damarius Fleming, Angelica Van Goor, Chris Ashwell, Carl Schmidt, Donald Kugonza, Susan Lamont, Max Rothschild

Abstract:

The major factor in shaping genomic variation of the African indigenous rural chicken is likely natural selection drives the development genetic footprints in the chicken genomes. To investigate such a hypothesis of a selection footprint, a total of 292 birds were randomly sampled from three indigenous ecotypes from East Africa (Uganda, Rwanda) and North Africa (Egypt) and two registered Egyptian breeds (Fayoumi and Dandarawi), and from the synthetic Kuroiler breed. Samples were genotyped using the Affymetrix 600K Axiom® Array. A total of 526,652 SNPs were utilized in the downstream analysis after quality control measures. The intra-population runs of homozygosity (ROH) that were consensuses in > 50% of individuals of an ecotype or > 75% of a breed were studied. To identify inter-population differentiation due to genetic structure, FST was calculated for North- vs. East- African populations in addition to population-pairwise combinations for overlapping windows (500Kb with an overlap of 250Kb). A total of 28,563 ROH were determined and were classified into three length categories. ROH and Fst detected sweeps were identified on several autosomes. Several genes in these regions are likely to be related to adaptation to local environmental stresses that include high altitude, diseases resistance, poor nutrition, oxidative and heat stresses and were linked to gene ontology terms (GO) related to immune response, oxygen consumption and heme binding, carbohydrate metabolism, oxidation-reduction, and behavior. Results indicated a possible effect of natural selection forces on shaping genomic structure for adaptation to local environmental stresses.

Keywords: African Chicken, runs of homozygosity, FST, selection footprints

Procedia PDF Downloads 311