Search results for: diagnosis testing

Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi

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Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.

Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery

Procedia PDF Downloads 154

Authors: Neha Toppo

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Plans and programs for successful secondary education are incomplete without the inclusion of teaching English as an important area. Even after sixteen years of the formation of Jharkhand as a separate state, the students are still struggling to achieve quality education of English. This paper intends to account the present condition of teaching English in Jharkhand board secondary level schools through discussion on various issues of English language teaching, language need and learning challenges of its students. The study is to analyze whether the learning environment, teaching methods and materials, teaching resources, goals of language curriculum are appropriately convincing for the students of the board or require to be reanalyzed and also to provide appropriate suggestions for improvement. Immediate attention must be drawn towards the problem for benefitting those students, who despite their knowledge and talent are lagging behind in numerous fields only due to the lack of proficiency in English. The data and discussion provided are on the basis of a survey, in which semi structured interview with teachers, students and administrators in several schools including both rural and urban area has been taken. Questionnaire, observation and testing were used as important tools. The survey has been conducted in Ranchi district, as it covers large geographical area which includes number of villages and at the same time several towns. The district primarily possesses tribes as well as different class of people including immigrants from all over and outside Jharkhand with their social, economical strata. The observation makes it clear that the English language teaching at the state board is not complementing its context and the whole language teaching system should be re-examined to establish learner oriented environment.

Keywords: material, method, secondary level, teaching resources

Procedia PDF Downloads 559

Authors: Karla D. Vazquez-Valdez, Bradley P. Wynne

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In the last decades manufacturing needs have been changing, leading to the study of manufacturing methods that were underdeveloped, such as incremental forming processes like shear forming. These processes use rotating tools in constant local contact with the workpiece, which is often also rotating, to generate shape. This means much lower loads to forge large parts and no need for expensive special tooling. Potential has already been established by demonstrating manufacture of high-value products, e.g., turbine and satellite parts, with high dimensional accuracy from difficult to manufacture materials. Thus, huge opportunities exist for these processes to replace the current method of manufacture for a range of high value components, e.g., eliminating lengthy machining, reducing material waste and process times; or the manufacture of a complicated shape without the development of expensive tooling. However, little is known about the exact deformation conditions during processing and why certain materials are better than others for shear forming, leading to a lot of trial and error before production. Three alloys were used for this study: Ti-54M, Jethete M154, and IN718. General Microscopy and Electron Backscatter Diffraction (EBSD) were used to measure strains and orientation maps during shear forming. A Design of Experiments (DOE) analysis was also made in order to understand the impact of process parameters in the properties of the final workpieces. Such information was the key to develop a reliable Finite Element Method (FEM) model that closely resembles the deformation paths of this process. Finally, the potential of these three materials to be shear spun was studied using the FEM model and their Forming Limit Diagram (FLD) which led to the development of a rough methodology for testing the shear spinnability of various metals.

Keywords: shear forming, damage, principal strains, forming limit diagram

Procedia PDF Downloads 158

Authors: Benbellil-Tafoughalt Saida, Tababouchet Meriem

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Sexual selection is the most supported explanation for genital extravagance occurring in animals. In promiscuous species, population density, as well as climate conditions, may act on the sperm competition intensity, one of the most important mechanism of post-copulatory sexual selection. The present study is empirical testing of sexual selection's potential role on genitalia variation in the simultanuously hermaphroditic land snail Helixaperta (Pulmonata, Stylommatophora). The purpose was to detect the patterns as well as the origin of the distal genitalia variability and especially to test the potential effect of sexual selection. The study was performed on four populations, H. aperta, different in habitat humidity regimes and presenting variable densities, which were mostly low. The organs of interest were those involved in spermatophore production, reception, and manipulation. We examined whether the evolution of those organs is connected to sperm competition intensity which is traduced by both population density and microclimate humidity. We also tested the hypothesis that those organs evolve in response to shell size. The results revealed remarkable differences in both snails’ size and organs lengths between populations. In most cases, the length of genitalia correlated positively to snails’ body size. Interestingly, snails from the more humid microclimate presented the highest mean weight and shell dimensions comparing to those from the less humid microclimate. However, we failed to establish any relation between snail densities and any of the measured genitalia traits.

Keywords: fertilization pouch, helix aperta, land snails, reproduction, sperm storage, spermatheca

Procedia PDF Downloads 180

Authors: Amritanshu Sandilya, M. V. Shah

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Collapsible soils such as loess are a common geotechnical challenge due to their potential to undergo sudden and severe settlement under certain loading conditions. The need for filling engineering to increase developing land has grown significantly in recent years, which has created several difficulties in managing soil strength and stability during compaction. Numerous engineering problems, such as roadbed subsidence and pavement cracking, have been brought about by insufficient fill strength. Therefore, strict control of compaction parameters is essential to reduce these distresses. Accurately measuring the degree of compaction, which is often represented by compactness is an important component of compaction control. For credible predictions of how collapsible soils will behave under complicated loading situations, the accuracy of laboratory studies is essential. Therefore, this study aims to investigate the energy transfer in collapsible soils during laboratory Proctor compaction tests to provide insights into how energy transfer can be optimized to achieve more accurate and reliable results in compaction testing. The compaction characteristics in terms of energy of loess soil have been studied at moisture content corresponding to dry of optimum, at the optimum and wet side of optimum and at different compaction energy levels. The hammer impact force (E0) and soil bottom force (E) were measured using an impact load cell mounted at the bottom of the compaction mould. The variation in energy consumption ratio (E/ E0) was observed and compared with the compaction curve of the soil. The results indicate that the plot of energy consumption ratio versus moisture content can serve as a reliable indicator of the compaction characteristics of the soil in terms of energy.

Keywords: soil compaction, proctor compaction test, collapsible soil, energy transfer

Procedia PDF Downloads 81

Authors: Achitphol Chookaew, Paramee Thongsukhsai, Patamarerk Engsontia, Narongwit Nakwan, Pritsana Raugrut

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Lung cancer is one of the most common malignancies and primary cause of death due to cancer worldwide. Non-small cell lung cancer (NSCLC) is the main subtype in which majority of patients present with advanced-stage disease. Herein, we analyzed differentially expressed genes to find potential biomarkers for lung cancer diagnosis as well as prognostic markers. We used transcriptome data from our 2 NSCLC patients and public data (GSE81089) composing of 8 NSCLC and 10 normal lung tissues. Differentially expressed genes (DEGs) between NSCLC and normal tissue and between early-stage and late-stage NSCLC were analyzed by the DESeq2. Pairwise correlation was used to find the DEGs with false discovery rate (FDR) adjusted p-value £ 0.05 and |log2 fold change| ³ 4 for NSCLC versus normal and FDR adjusted p-value £ 0.05 with |log2 fold change| ³ 2 for early versus late-stage NSCLC. Bioinformatic tools were used for functional and pathway analysis. Moreover, the top ten genes in each comparison group were verified the expression and survival analysis via GEPIA. We found 150 up-regulated and 45 down-regulated genes in NSCLC compared to normal tissues. Many immnunoglobulin-related genes e.g., IGHV4-4, IGHV5-10-1, IGHV4-31, IGHV4-61, and IGHV1-69D were significantly up-regulated. 22 genes were up-regulated, and five genes were down-regulated in late-stage compared to early-stage NSCLC. The top five DEGs genes were KRT6B, SPRR1A, KRT13, KRT6A and KRT5. Keratin 6B (KRT6B) was the most significantly increased gene in the late-stage NSCLC. From GEPIA analysis, we concluded that IGHV4-31 and IGKV1-9 might be used as diagnostic biomarkers, while KRT6B and KRT6A might be used as prognostic biomarkers. However, further clinical validation is needed.

Keywords: differentially expressed genes, early and late-stages, gene ontology, non-small cell lung cancer transcriptomics

Procedia PDF Downloads 113

Authors: C. Salis, D. Zedda, M. F. Wilson

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The IDEA project was conceived for teachers who are interested in enhancing their capacity to effectively implement the use of specific technologies in their teaching practice. Participating teachers are coached and supported as they explore technologies applied to the educational context. They access tools such as the technological platform developed by our team. Among the platform functionalities, teachers access an instructional systems design (ISD) tool (learning designer) that was adapted to the needs of our project. The tool is accessible from computers or mobile devices and used in association with other technologies to create new, meaningful learning environments. The objective of an instructional systems design is to guarantee the quality and effectiveness of education and to enhance learning. This goal involves both teachers who want to become more efficient in transferring knowledge or skills and students as the final recipient of their teaching. The use of Blooms’s taxonomy enables teachers to classify the learning objectives into levels of complexity and specificity, thus making it possible to highlight the kind of knowledge teachers would like their students to reach. The fact that the instructional design features can be visualized through the IDEA platform is a guarantee for those who are looking for specific educational materials to be used in their lessons. Despite the benefits offered, a number of teachers are reluctant to use ISD because the preparatory work of having to thoroughly analyze the teaching/learning objectives, the planning of learning material, assessment activities, etc., is long and felt to be time-consuming. This drawback is minimized using a learning designer, as the tool facilitates to reuse of the didactic contents having a clear view of the processes of analysis, planning, and production of educational or testing materials uploaded on our platform. In this paper, we shall present the feedback of the teachers who used our tool in their didactic.

Keywords: educational benefits, educational quality, educational technology, ISD tool

Procedia PDF Downloads 183

Authors: Soukaina Ounss, Hamid Mounir, Abdellatif El Marjani

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Sandwich materials with composite reinforced skins are mostly required in advanced construction applications with a view to ensure resistant structures. Their lightweight, their high flexural stiffness and their optimal thermal insulation make them a suitable solution to obtain efficient structures with performing rigidity and optimal energy safety. In this paper, the mechanical behavior of a sandwich beam with composite skins reinforced by unidirectional carbon fibers is investigated numerically through analyzing the impact of reinforcements specifications on the longitudinal elastic modulus in order to select the adequate sandwich configuration that has an interesting rigidity and an accurate convergence to the analytical approach which is proposed to verify performed numerical simulations. Therefore, concerned study starts by testing flexion performances of skins with various fibers orientations and volume fractions to determine those to use in sandwich beam. For that, the combination of a reinforcement inclination of 30° and a volume ratio of 60% is selected with the one with 60° of fibers orientation and 40% of volume fraction, this last guarantees to chosen skins an important rigidity with an optimal fibers concentration and a great enhance in convergence to analytical results in the sandwich model for the reason of the crucial core role as transverse shear absorber. Thus, a resistant sandwich beam is elaborated from a face-sheet constituted from two layers of previous skins with fibers oriented in 60° and an epoxy core; concerned beam has a longitudinal elastic modulus of 54 Gpa (gigapascal) that equals to the analytical value by a negligible error of 2%.

Keywords: fibers orientation, fibers volume ratio, longitudinal elastic modulus, sandwich beam

Procedia PDF Downloads 163

Authors: Danijela Vranješ, Nataša Vukajlović

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Turning to learner-centered teaching instead of the teacher-centered approach brought a whole new perspective into the process of teaching and learning and set a new goal for improving the educational process itself. However, recently a tremendous decline in students’ performance on various standardized tests can be observed, above all on the PISA-test. The learner-centeredness on its own is not enough anymore: the students’ ability to think is deteriorating. Especially in foreign language learning, one can encounter a lot of learning by heart: whether it is grammar or vocabulary, teachers often seem to judge the students’ success merely on how well they can recall a specific word, phrase, or grammar rule, but they rarely aim to foster their ability to think. Convinced that foreign language teaching can do both, this research aims to discover how two different approaches to teaching foreign language foster the students’ ability to think as well as to what degree they help students get to the state-determined level of foreign language at the end of the semester as defined in the Common European Framework. For this purpose, two different curricula were developed: one is a traditional, learner-centered foreign language curriculum that aims at teaching the four competences as defined in the Common European Framework and serves as a control variable, whereas the second one has been enriched with various thinking routines and aims at teaching the foreign language as a means to communicate ideas and thoughts rather than reducing it to the four competences. Moreover, two types of tests were created for each approach, each based on the content taught during the semester. One aims to test the students’ competences as defined in the CER, and the other aims to test the ability of students to draw on the knowledge gained and come to their own conclusions based on the content taught during the semester. As it is an ongoing study, the results are yet to be interpreted.

Keywords: common european framework of reference, foreign language learning, foreign language teaching, testing and assignment

Procedia PDF Downloads 99

Authors: O. S. Ebrahim, K. O. Shawky, M. O. S. Ebrahim, P. K. Jain

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Induction Motor (IM) driving pump is the main consumer of electricity in a typical fluid transportation system (FTS). It was illustrated that changing the connection of the stator windings from delta to star at no load could achieve noticeable active and reactive energy savings. This paper proposes a supervisory hysteresis liquid-level control with three-state energy saving mode (ESM) for IM in FTS including storage tank. The IM pump drive comprises modified star/delta switch and hydromantic coupler. Three-state ESM is defined, along with the normal running, and named analog to computer ESMs as follows: Sleeping mode in which the motor runs at no load with delta stator connection, hibernate mode in which the motor runs at no load with a star connection, and motor shutdown is the third energy saver mode. A logic flow-chart is synthesized to select the motor state at no-load for best energetic cost reduction, considering the motor thermal capacity used. An artificial neural network (ANN) state estimator, based on the recurrent architecture, is constructed and learned in order to provide fault-tolerant capability for the supervisory controller. Sequential test of Wald is used for sensor fault detection. Theoretical analysis, preliminary experimental testing and, computer simulations are performed to show the effectiveness of the proposed control in terms of reliability, power quality and energy/coenergy cost reduction with the suggestion of power factor correction.

Keywords: ANN, ESM, IM, star/delta switch, supervisory control, FT, reliability, power quality

Procedia PDF Downloads 183

Authors: Rasheed Amao Busari, Ahmed Ibrahim

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The engineering properties of giant palms are crucial for the reasonable design of the processing and handling systems. The research was conducted to investigate some engineering properties of giant palm seeds in relation to their oil potential. The ripe giant palm fruit was sourced from some parts of Zaria in Kaduna State and Ado Ekiti in Ekiti State, Nigeria. The mesocarps of the fruits collected were removed to obtain the nuts, while the collected nuts were dried under ambient conditions for several days. The actual moisture content of the nuts at the time of the experiment was determined using KT100S Moisture Meter, with moisture content ranged 17.9% to 19.15%. The physical properties determined are axial dimension, geometric mean diameter, arithmetic mean diameter, sphericity, true and bulk densities, porosity, angles of repose, and coefficients of friction. The nuts were measured using a vernier caliper for physical assessment of their sizes. The axial dimensions of 100 nuts were taken and the result shows that the size ranges from 7.30 to 9.32cm for major diameter, 7.2 to 8.9 cm for intermediate diameter, and 4.2 to 6.33 for minor diameter. The mechanical properties determined were compressive force, compressive stress, and deformation both at peak and break using Instron hydraulic universal tensile testing machine. The work also revealed that giant palm seed can be classified as an oil-bearing seed. The seed gave 18% using the solvent extraction method. The results obtained from the study will help in solving the problem of equipment design, handling, and further processing of the seeds.

Keywords: giant palm seeds, engineering properties, oil potential, moisture content, and giant palm fruit

Procedia PDF Downloads 73

Authors: Xiaoyuan Suo

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3D object reconstruction is a broad research area within the computer vision field involving many stages and still open problems. One of the existing challenges in this field lies with micromotion, such as the facial expressions on the appearance of the human or animal face. Similar literatures in this field focuses on 3D reconstruction in stable conditions such as an existing image or photos taken in a rather static environment, while the purpose of this work is to discuss a flexible scan system using multiple cameras that can correctly reconstruct 3D stable and moving objects -- human face with expression in particular. Further, a mathematical model is proposed at the end of this literature to automate the 3D object reconstruction process. The reconstruction process takes several stages. Firstly, a set of simple 2D lines would be projected onto the object and hence a set of uneven curvy lines can be obtained, which represents the 3D numerical data of the surface. The lines and their shapes will help to identify object’s 3D construction in pixels. With the two-recorded angles and their distance from the camera, a simple mathematical calculation would give the resulting coordinate of each projected line in an absolute 3D space. This proposed research will benefit many practical areas, including but not limited to biometric identification, authentications, cybersecurity, preservation of cultural heritage, drama acting especially those with rapid and complex facial gestures, and many others. Specifically, this will (I) provide a brief survey of comparable techniques existing in this field. (II) discuss a set of specialized methodologies or algorithms for effective reconstruction of 3D objects. (III)implement, and testing the developed methodologies. (IV) verify findings with data collected from experiments. (V) conclude with lessons learned and final thoughts.

Keywords: 3D photogrammetry, 3D object reconstruction, facial expression recognition, facial recognition

Procedia PDF Downloads 147

Authors: O. D. Adegbehingbe, S. D. Eyono Obono

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The education sector is constantly faced with rapid changes in technologies in terms of ensuring that the curriculum is up to date and in terms of making sure that students are aware of these technological changes. This challenge can be seen as the motivation for this study, which is to examine the factors affecting computing students’ awareness of the latest Information Technologies (ICTs). The aim of this study is divided into two sub-objectives which are: the selection of relevant theories and the design of a conceptual model to support it as well as the empirical testing of the designed model. The first objective is achieved by a review of existing literature on technology adoption theories and models. The second objective is achieved using a survey of computing students in the four universities of the KwaZulu-Natal province of South Africa. Data collected from this survey is analyzed using Statistical package for the Social Science (SPSS) using descriptive statistics, ANOVA and Pearson correlations. The main hypothesis of this study is that there is a relationship between the demographics and the prior conditions of the computing students and their awareness of general ICT trends and of Digital Switch Over (DSO) a new technology which involves the change from analog to digital television broadcasting in order to achieve improved spectrum efficiency. The prior conditions of the computing students that were considered in this study are students’ perceived exposure to career guidance and students’ perceived curriculum currency. The results of this study confirm that gender, ethnicity, and high school computing course affect students’ perceived curriculum currency while high school location affects students’ awareness of DSO. The results of this study also confirm that there is a relationship between students prior conditions and their awareness of general ICT trends and DSO in particular.

Keywords: education, information technologies, IDT, awareness

Procedia PDF Downloads 355

Authors: Marcela Karmazínová, Jindrich Melcher, Lubomír Vítek, Petr Cikrle

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The paper deals with the diagnostics of steel roof structure of the winter sports stadiums built in 1970 year. The necessity of the diagnostics has been given by the requirement to the evaluation design of this structure, which has been caused by the new situation in the field of the loadings given by the validity of the European Standards in the Czech Republic from 2010 year. Due to these changes in the normative rules, in practice, existing structures are gradually subjected to the evaluation design and depending on its results to the strengthening or reconstruction, respectively. The steel roof is composed of plane truss main girders, purlins and bracings and the roof structure is supported by two arch main girders with the span of L=84 m. The in situ diagnostics of the roof structure was oriented to the following parts: (i) determination and evaluation of the actual material properties of used steel and (ii) verification of the actual dimensions of the structural members. For the solution, the non-destructive methods have been used for in situ measurement. For the indicative determination of steel strengths the modified method based on the determination of Rockwell’s hardness has been used. For the verification of the member’s dimensions (thickness of hollow sections) the ultrasound method has been used. This paper presents the results obtained using these testing methods and their evaluation, from the viewpoint of the usage for the subsequent static assessment and design evaluation of the existing structure. For the comparison, the examples of the similar evaluations realized for steel structures of the stadiums in Olomouc and Jihlava cities are briefly illustrated, too.

Keywords: actual dimensions, destructive methods, diagnostics, existing steel structure, indirect non-destructive methods, Rockwel’s hardness, sport hall, steel strength, ultrasound method.

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Authors: T. Nakpun, T. Kanjanarach, T. Kittisopee

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Turnover of community pharmacist can affect continuity of patient care and most importantly the quality of care and also the costs of a pharmacy. It was hypothesized that organizational resources, job characteristics, and social supports had direct effect on pharmacist turnover intention, and indirect effect on pharmacist turnover intention via pharmacist engagement. This research aimed to study influencing factors on pharmacist engagement and pharmacist turnover intention by testing the proposed structural hypothesized model to explain the relationship among organizational resources, job characteristics, and social supports that effect on pharmacist turnover intention and pharmacist engagement in Thai community pharmacists. A cross sectional study design with self-administered questionnaire was conducted in 209 Thai community pharmacists. Data were analyzed using Structural Equation Modeling technique with analysis of a moment structures AMOS program. The final model showed that only organizational resources had significant negative direct effect on pharmacist turnover intention (β =-0.45). Job characteristics and social supports had significant positive relationship with pharmacist engagement (β = 0.44, and 0.55 respectively). Pharmacist engagement had significant negative relationship with pharmacist turnover intention (β = - 0.24). Thus, job characteristics and social supports had significant negative indirect effect on turnover intention via pharmacist engagement (β =-0.11 and -0.13, respectively). The model fit the data well (χ2/ degree of freedom (DF) = 2.12, the goodness of fit index (GFI)=0.89, comparative fit index (CFI) = 0.94 and root mean square error of approximation (RMSEA) = 0.07). This study can be concluded that organizational resources were the most important factor because it had direct effect on pharmacist turnover intention. Job characteristics and social supports were also help decrease pharmacist turnover intention via pharmacist engagement.

Keywords: community pharmacist, influencing factor, turnover intention, work engagement

Procedia PDF Downloads 199

Authors: Jonah Kenei, Elisha Opiyo

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Electronic health records, as a repository of patient information, is nowadays the most commonly used technology to record, store and review patient clinical records and perform other clinical tasks. However, the accurate identification and retrieval of relevant information from clinical records is a difficult task due to the unstructured nature of clinical documents, characterized in particular by a lack of clear structure. Therefore, medical practice is facing a challenge thanks to the rapid growth of health information in electronic health records (EHRs), mostly in narrative text form. As a result, it's becoming important to effectively manage the growing amount of data for a single patient. As a result, there is currently a requirement to visualize electronic health records (EHRs) in a way that aids physicians in clinical tasks and medical decision-making. Leveraging text visualization techniques to unstructured clinical narrative texts is a new area of research that aims to provide better information extraction and retrieval to support clinical decision support in scenarios where data generated continues to grow. Clinical datasets in electronic health records (EHR) offer a lot of potential for training accurate statistical models to classify facets of information which can then be used to improve patient care and outcomes. However, in many clinical note datasets, the unstructured nature of clinical texts is a common problem. This paper examines the very issue of getting raw clinical texts and mapping them into meaningful structures that can support healthcare professionals utilizing narrative texts. Our work is the result of a collaborative design process that was aided by empirical data collected through formal usability testing.

Keywords: classification, electronic health records, narrative texts, visualization

Procedia PDF Downloads 115

Authors: Dmitriy Syssoyev, Aslan Seitkamzin, Natalya Lim, Kamilla Mussina, Abduzhappar Gaipov, Dimitri Poddighe, Dinara Galiyeva

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Background: Data on the epidemiology of congenital heart defects (CHD) in Kazakhstan is scarce. Therefore, the aim of this study was to describe the incidence, prevalence and all-cause mortality of patients with CHD in Kazakhstan, using national large-scale registry data from the Unified National Electronic Healthcare System (UNEHS) for the period of 2014-2020. Methods: In this retrospective cohort study, the included data pertained to all patients diagnosed with CHD in Kazakhstan and registered in UNEHS between January 2014 and December 2020. CHD was defined based on International Classification of Diseases 10th Revision (ICD-10) codes Q20-Q26. Incidence, prevalence, and all-cause mortality rates were calculated per 100,000 population. Survival analysis was performed using Cox proportional hazards regression modeling and the Kaplan-Meier method. Results: In total, 66,512 patients were identified. Among them, 59,534 (89.5%) were diagnosed with a single CHD, while 6,978 (10.5%) had more than two CHDs. The median age at diagnosis was 0.08 years (interquartile range (IQR) 0.01 – 0.66) for people with multiple CHD types and 0.39 years (IQR 0.04 – 8.38) for those with a single CHD type. The most common CHD types were atrial septal defect (ASD) and ventricular septal defect (VSD), accounting for 25.8% and 21.2% of single CHD cases, respectively. The most common multiple types of CHD were ASD with VSD (23.4%), ASD with patent ductus arteriosus (PDA) (19.5%), and VSD with PDA (17.7%). The incidence rate of CHD decreased from 64.6 to 47.1 cases per 100,000 population among men and from 68.7 to 42.4 among women. The prevalence rose from 66.1 to 334.1 cases per 100,000 population among men and from 70.8 to 328.7 among women. Mortality rates showed a slight increase from 3.5 to 4.7 deaths per 100,000 in men and from 2.9 to 3.7 in women. Median follow-up was 5.21 years (IQR 2.47 – 11.69). Male sex (HR 1.60, 95% CI 1.45 - 1.77), having multiple CHDs (HR 2.45, 95% CI 2.01 - 2.97), and living in a rural area (HR 1.32, 95% CI 1.19 - 1.47) were associated with a higher risk of all-cause mortality. Conclusion: The incidence of CHD in Kazakhstan has shown a moderate decrease between 2014 and 2020, while prevalence and mortality have increased. Male sex, multiple CHD types, and rural residence were significantly associated with a higher risk of all-cause mortality.

Keywords: congenital heart defects (CHD), epidemiology, incidence, Kazakhstan, mortality, prevalence

Procedia PDF Downloads 91

Authors: Naim Izet Kajtazi

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Context: The third ventricle colloid cyst (CC) is a benign growth usually located in the third ventricle and can cause various neurological symptoms, including sudden death. Modern surgical interventions may still result in a wide range of complications and cerebral venous thrombosis (CVT) is among them. Process: A 38-year-old female with an existing diagnosis of diabetes mellitus (DM) and hypothyroidism and a six-month history of headaches, blurred vision, and vomiting presented to our clinic three days after the headaches became excessively severe. Neurological examination on admission revealed bilateral papilledema without any associated focal neurological deficits. Brain computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the presence of a third ventricle colloid cyst and associated non-communicating hydrocephalus involving the lateral ventricles. As a result, the patient underwent emergency bilateral external ventricular drainage (EVD) insertion followed by a third ventricular CC excision under neuronavigation through a right frontal craniotomy. Twelve days post-operatively, the patient developed further headaches, followed by a generalized tonic-clonic seizure that led to no postictal neurological deficits. Nonetheless, computed tomography venography of the brain revealed extensive thrombosis of the superior sagittal sinus, inferior sagittal sinus, right sigmoid sinus, and right internal jugular vein. A newly diagnosed CVT was treated with intravenous heparin. The patient was discharged with warfarin, which was discontinued after 12 months. Ten years after her illness, she remained stable and free from any neurological deficits but still suffered from mild chronic headaches. Outcome: Ten years after her illness, she remained stable and free from any neurological deficits but still suffered from mild chronic headaches. Relevance: A preoperative venous study should be performed in all cases to gain a better understanding of the venous anatomy. We advocate meticulous microsurgical techniques to protect the venous system surrounding the foramen of Monro and reduce the amount of retraction during surgery.

Keywords: CVT, seizures, third ventricle colloid cyst, MRI of brain

Procedia PDF Downloads 62

Authors: Faizan Asghar, Mohammad Jamal Khattak

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Aging, in general, refers to changes in rheological characteristics of asphalt mixture due to changes in chemical composition over the course of construction and service life of the pavement. The main goal of this study was to investigate the impact of oxidation on fatigue characteristics of a novel HMA composite fabricated with a combination of crumb rubber (CRM) and polyvinyl alcohol (PVA) fiber subject to aging of 7 and 14 days. A flexural beam fatigue test was performed to evaluate several characteristics of control, CRM modified, PVA reinforced, and novel rubber-fiber HMA composite. Experimental results revealed that aging had a significant impact on the fatigue performance of novel HMA composite. It was found that a suitable proportion of CRM and PVA radically affected the performance of novel rubber-fiber HMA in resistance to fracture and fatigue cracking when subjected to long-term aging. The developed novel HMA composite containing 2% CRM and 0.2% PVA presented around 29 times higher resistance to fatigue cracking for a period of 7 days of aging. To develop a cumulative plastic deformation level of 250 micros, such a mixture required over 50 times higher cycles than control HMA. Moreover, the crack propagation rate was reduced by over 90%, with over 12 times higher energy required to propagate a unit crack length in such a mixture compared to conventional HMA. Further, digital imaging correlation analyses revealed a more twisted and convoluted fracture path and higher strain distribution in rubber-fiber HMA composite. The fatigue performance after long-term aging of such novel HMA composite explicitly validates the ability to withstand load repetition that could lead to an extension in the service life of pavement infrastructure and reduce taxpayers’ dollars spent.

Keywords: crumb rubber, PVA fibers, dry process, aging, performance testing, fatigue life

Procedia PDF Downloads 63

Authors: R. W. A. V. A. Wijenayake, P. M. R. N. Fernando, S. Nilesh, M. D. G. M. S. Diddeniya, M. Weligodapola, P. Shamila

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The study is designed to examine the impact of a lifelong learning mindset on the career success of accounting and finance professionals in the western province of Sri Lanka. The learning mindset impacts the career success of accounting and finance professionals. The main objective of this study is to identify how the lifelong-learning mindset impacts on the career success of accounting and finance professionals. The lifelong learning mindset is the desire to learn new things and curiosity, resilience, and strategic thinking are the selected constructs to measure the lifelong learning mindset. Career success refers to certain objectives and emotional measures of improvement in one’s work life. The related variables of career success are measured through the number of promotions that have been granted in his/her work life. Positivism is the research paradigm, and the deductive approach is involved as this study relies on testing an existing theory. To conduct the study, the accounting and finance professionals in the western province in Sri Lanka were selected because most reputed international and local companies and specifically, headquarters of most of the companies are in western province. The responses cannot be collected from the whole population. Therefore, this study used a simple random sampling method, and the sample size was 120. Therefore, to identify the impact, 5-point Likert scale is used to perform this quantitative data. Required data gathered through an online questionnaire and the final outputs of the study will offer certain important recommendations to several parties such as universities, undergraduates, companies, and the policymakers to improve, help mentally and financially and motivate the students and the employees to continue their studies without ceasing after completion of their degree.

Keywords: career success, curiosity, lifelong learning mindset, resilience, strategic thinking

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Authors: Aneta Binkowska, Grzegorz Michalak, Slawomir Pilip, Lukasz Bondaruk, Daniel Celinski, Robert Slotwinski

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Post-traumatic mortality rates are still very high and show an increasing tendency. Early identification of patients at high risk of severe complications has a significant impact on treatment outcomes. The aim of the study was to better understand the early pathological inflammatory response to injury and infection and to determine the usefulness of the assessment of TNF-α and sTNFR1 concentrations in the peripheral blood as early indicators of severe post-traumatic complications. The study was carried out in a group of 51 patients after trauma treated in the ED, including 32 patients that met inclusion criteria for immunological analysis. Patients were divided into two groups using the ISS scale (group A with ISS ≥20, group B with ISS <20). Serum levels of TNF-α and sTNFR1 were determined after admission to the ED and after 3, 6, 12 and 24 hours. The highest TNF-α and sTNFR1 concentrations in both groups were recorded at admission and were significantly higher in group A compared to group B (A vs B TNF-α 2.46 pg/ml vs 1.78 pg/ml; sTNFR1 1667.5 pg/ml vs 875.2 p<0.005). The concentration of sTNFR1 in patients with severe complications was significantly higher compared to patients without complications and preceded clinical symptoms of complications ( C+ vs C- 1561.5 pg/ml vs 930.6 pg/ml). Spearman's correlation showed a statistically significant positive correlation between the baseline concentrations of IL-6 (r=0.38, p<0.043) and sTNFR1 (r=0.59, p=0.001) and the ISS scores. The high diagnostic sensitivity calculated from the ROC (receiver operating characteristic) curves was found for the concentrations of both cytokines: TNF α (AUC=0.91, p=0.004) and sTNFR1 (AUC=0.86, p=0.011). Elevated levels of sTNFR1, determined in the peripheral blood shortly after injury, is significantly associated with the occurrence of later complications, which in some patients lead to death. In contrast, high levels of TNF-α shortly after injury are associated with high mortality.

Keywords: cytokine, SIRS, MODS, trauma

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Authors: Hazaila Binti Hassan, Abu Yazid Bin Abu Bakar, Salleh Amat

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This study is to get the validity and reliability of the questionnaire for behaviour change on low-performing officers. This study aimed to develop and evaluate the behaviour of low performing officers. There are 75 items in this questionnaire which involves 5 subscales, which are the 5 dimensions intended to be studied: 1st emotional stability, 2nd psycho-spiritual enhancement, 3rd social skills development, 4th cognitive and rationality improvement and 5th behavioural alignment and adjustment. There are 2 processes in this research whereby to check the validity and reliability. Both use quantitative methods. Validity content testing has been conducted to validate the behavioural change questionnaire of the low performing officers. For the face validity, 4 people are involved, two are psychologists who carried out the program and the other two are officers of the same rank, i.e. supporting officers. They are involved in correction of sentences, languages, and grammar as well as the sentence structures so that it tallies with the purpose of studies. The questionnaire underwent content validity by the experts. Five experts are appointed to attend this session, 3 are directly involved in the construction of this questionnaire and 2 others are experts from the university with a background in questionnaire development. The result shows that the content validity obtained a high coefficient of 0.745 with a minimum and maximum value of more than 0.60 which satisfies the characteristic of Content Value Ratio. The Cronbach’s alpha result is 0.867. The highest scores are the behavioural alignment and adjustment sub-scale recorded the highest value, followed by social skills development sub-scale, cognitive and rational improvements sub-scale, psycho-spiritual enhancement sub-scale, and lastly emotional stability. Therefore, both of validity and reliability result were accepted that this questionnaire is valid and reliable can be used in the study of behaviour changes of low performing officers in the civil service.

Keywords: content validity, reliability, five dimension, low-performing officers, questionnaire

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Authors: Julio Jesus Salazar, Max Jesus De Lama

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The challenges of water management are aggravated by global change, which implies high complexity and associated uncertainty; water management is difficult because water networks cross domains (natural, societal, and political), scales (space, time, jurisdictional, institutional, knowledge, etc.) and levels (area: patches to global; knowledge: a specific case to generalized principles). In this context, we need to apply natural and non-natural measures to manage water and soil. The Basin Management Methodology considers multifunctional measures of natural water retention and erosion control and soil formation to protect water resources and address the challenges related to the recovery or conservation of the ecosystem, as well as natural characteristics of water bodies, to improve the quantitative status of water bodies and reduce vulnerability to floods and droughts. This method of water management focuses on the positive impacts of the chemical and ecological status of water bodies, restoration of the functioning of the ecosystem and its natural services; thus, contributing to both adaptation and mitigation of climate change. This methodology was applied in 7 interventions in the sub-basin of the Shullcas River in Huancayo-Junín-Peru, obtaining great benefits in the framework of the participation of alliances of actors and integrated planning scenarios. To implement the methodology in the sub-basin of the Shullcas River, a process called Climate Smart Territories (CST) was used; with which the variables were characterized in a highly complex space. The diagnosis was then worked using risk management and adaptation to climate change. Finally, it was concluded with the selection of alternatives and projects of this type. Therefore, the CST approach and process face the challenges of climate change through integrated, systematic, interdisciplinary and collective responses at different scales that fit the needs of ecosystems and their services that are vital to human well-being. This methodology is now replicated at the level of the Mantaro river basin, improving with other initiatives that lead to the model of a resilient basin.

Keywords: climate-smart territories, climate change, ecosystem services, natural measures, Climate Smart Territories (CST) approach

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Authors: Thummalapalli CSM Gupta, Banti Sidhiwala

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Mineral oils of naphthenic and paraffinic type have been traditionally been used as insulating liquids in the transformer applications to protect the solid insulation from moisture and ensures effective heat transfer/cooling. The performance of these type of oils have been proven in the field over many decades and the condition monitoring and diagnosis of transformer performance have been successfully monitored through oil properties and dissolved gas analysis methods successfully. Different type of gases representing various types of faults due to components or operating conditions effectively. While large amount of data base has been generated in the industry on dissolved gas analysis for mineral oil based transformer oils and various models for predicting the fault and analysis, oil specifications and standards have also been modified to include stray gassing limits which cover the low temperature faults and becomes an effective preventative maintenance tool that can benefit greatly to know the reasons for the breakdown of electrical insulating materials and related components. Natural esters have seen a rise in popularity in recent years due to their "green" credentials. Some of its benefits include biodegradability, a higher fire point, improvement in load capability of transformer and improved solid insulation life than mineral oils. However, the Stray gases evolution like hydrogen and hydrocarbons like methane (CH4) and ethane (C2H6) show very high values which are much higher than the limits of mineral oil standards. Though the standards for these type esters are yet to be evolved, the higher values of hydrocarbon gases that are available in the market is of concern which might be interpreted as a fault in transformer operation. The current paper focuses on developing a natural ester based transformer oil which shows very levels of stray gassing by standard test methods show much lower values compared to the products available currently and experimental results on various test conditions and the underlying mechanism explained.

Keywords: biodegadability, fire point, dissolved gassing analysis, stray gassing

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Authors: Rolivhuwa Bishop Ramagoma1*, Lynn Cairncross1, , Saartjie Roux1

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According to the world health organisation, colon cancer is among the most common cancers diagnosed in both men and women. Specifically, it is the second leading cause of cancer related deaths accounting for over 860 000 deaths worldwide in 2018. Currently, chemotherapy has become an essential component of most cancer treatments. Despite progress in cancer drug development over the previous years, traditional chemotherapeutic drugs still have low selectivity for targeting tumour tissues and are frequently constrained by dose-limiting toxicity. The creation of nanoscale delivery vehicles capable of directly directing treatment into cancer cells has recently caught the interest of researchers. Herein, the development of peptide-functionalized polyethylene glycol gold nanoparticles (Peptide-PEG-AuNPs) as a cellular probe and delivery agent is described, with the higher aim to develop a specific diagnostic prototype and assess their specificity not only against cell lines but primary human cells as well. Gold nanoparticles (AuNPs) were synthesized and stabilized through chemical conjugation. The synthesized AuNPs were characterized, stability in physiological solutions was assessed, their cytotoxicity against colon carcinoma and non-carcinoma skin fibroblasts was also studied. Furthermore, genetic effect through real-time polymerase chain reaction (RT-PCR), localization and uptake, peptide specificity were also determined. In this study, different peptide-AuNPs were found to have preferential toxicity at higher concentrations, as revealed by cell viability assays, however, all AuNPs presented immaculate stability for over 3 months following the method of synthesis. The final obtained peptide-PEG-AuNP conjugates showed good biocompatibility in the presence of high ionic solutions and biological media and good cellular uptake. Formulation of colon cancer specific targeting peptide was successful, additionally, the genes/pathways affected by the treatments were determined through RT-PCR. Primary cells study is still on going with promising results thus far.

Keywords: nanotechnology, cancer, diagnosis, therapeutics, gold nanoparticles.

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Authors: Caroline S. Dutra, Tatiana C. Squeff

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It is well known that the history between South Korea and Japan influences their international relations; thus, also encompassing their economic relations. In this sense, it is impossible to analyze the latter without understanding the development of the former, which is known for episodes of hostility, like on Japanese colonization, but also had moments of cultural and trade interexchange. Indeed, since 1965, with the establishment of diplomatic relations between both countries, their trade relations have improved, especially after both nations have signed the General Agreement on Tariffs and Trade (GATT). Thereafter, with the establishment of the World Trade Organization (WTO) in 1995, another chapter of their diplomatic and economic relations have been inaugurated. Hence, bearing in mind this history between both nations, this research intends to examine their relations through the analysis of the WTO panels they have engaged in between each other, which are, in chronological order, “DS323: Japan – Import Quotas on Dried Laver and Seasoned Laver”, “DS336: Japan - Countervailing Duties on Dynamic Random Access Memories from Korea”, “DS495: Korea - Import Band, and Testing and Certification Requirements for Radionuclides”, “DS553: Korea - Sunset Review of Anti-Dumping Duties on Stainless Steel Bars” and “DS571: Korea - Measures Affecting Trade in Commercial Vessels”. The objective of this case analysis is to point out what are the areas that are more conflictual between Japan and South Korea in regard to their economic relations so that it is possible to assert on their future (economic) relations and other possible outcomes. And in order to do so, bibliographic and documental research will be made, particularly those involving the WTO and the nations under consideration. Regarding the methods used, it is important to highlight that this is applied research in the field of international economic relations and international law, which follows a hypothetic-deductive model.

Keywords: international economic relations, Japan, South Korea, World Trade Organization

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Authors: Tholokuhle T. Ntshakala, Seraphin D. Eyono Obono

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Nations are still finding it quite difficult to win mega sport competitions despite the major contribution of sport to society in terms of social and economic development, personal health, and in education. Even though the world of sports has been transformed into a huge global economy, it is important to note that the first step of sport is usually its introduction to children at school through physical education or PE. In other words, nations who do not win mega sport competitions also suffer from a weak and neglected PE system. This problem of the neglect of PE systems is the main motivation of this research aimed at examining the factors affecting the perceived awareness of physical education teachers on the ICT's that are adoptable for the teaching and learning of physical education. Two types of research objectives will materialize this aim: relevant theories will be identified in relation to the analysis of the perceived ICT awareness of PE teachers and subsequent models will be compiled and designed from existing literature; the empirical testing of such theories and models will also be achieved through the survey of PE teachers from the Camperdown magisterial district of the KwaZulu-Natal province of South Africa. The main hypothesis at the heart of this study is the relationship between the demographics of PE teachers, their behavior both as individuals and as social entities, and their perceived awareness of the ICTs that are adoptable for PE, as postulated by existing literature; except that this study categorizes human behavior under performance expectancy, computer attitude, and social influence. This hypothesis was partially confirmed by the survey conducted by this research in the sense that performance expectancy and teachers’ age, gender, computer usage, and class size were found to be the only factors affecting their awareness of ICT's for physical education.

Keywords: human behavior, ICT Awareness, physical education, teachers

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Authors: C. Malça, P. Gonçalves, N. Alves, A. Mateus

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Regardless of the manufacturing process used, subtractive or additive, material, purpose and application, produced components are conventionally solid mass with more or less complex shape depending on the production technology selected. Aspects such as reducing the weight of components, associated with the low volume of material required and the almost non-existent material waste, speed and flexibility of production and, primarily, a high mechanical strength combined with high structural performance, are competitive advantages in any industrial sector, from automotive, molds, aviation, aerospace, construction, pharmaceuticals, medicine and more recently in human tissue engineering. Such features, properties and functionalities are attained in metal components produced using the additive technique of Rapid Prototyping from metal powders commonly known as Selective Laser Melting (SLM), with optimized internal topologies and varying densities. In order to produce components with high strength and high structural and functional performance, regardless of the type of application, three different internal topologies were developed and analyzed using numerical computational tools. The developed topologies were numerically submitted to mechanical compression and four point bending testing. Finite Element Analysis results demonstrate how different internal topologies can contribute to improve mechanical properties, even with a high degree of porosity relatively to fully dense components. Results are very promising not only from the point of view of mechanical resistance, but especially through the achievement of considerable variation in density without loss of structural and functional high performance.

Keywords: additive manufacturing, internal topologies, porosity, rapid prototyping, selective laser melting

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Authors: Ammar Asma, Bouafia Nabiha, Ghammam Rim, Ezzi Olfa, Ben Cheikh Asma, Mahjoub Mohamed, Helali Radhia, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

Abstract:

Background: Central venous catheter associated infections (CVC-AI) are among the serious hospital-acquired infections. The aims of this study are to determine the incidence of CVC-AI, and their risk factors among patients followed in a Tunisian medical intensive care unit (ICU). Materials / Methods: A prospective cohort study conducted between September 15th, 2015 and November 15th, 2016 in an 8-bed medical ICU including all patients admitted for more than 48h. CVC-AI were defined according to CDC of ATLANTA criteria. The enrollment was based on clinical and laboratory diagnosis of CVC-AI. For all subjects, age, sex, underlying diseases, SAPS II score, ICU length of stay, exposure to CVC (number of CVC placed, site of insertion and duration catheterization) were recorded. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: Among 192 eligible patients, 144 patients (75%) had a central venous catheter. Twenty-eight patients (19.4%) had developed CVC-AI with density rate incidence 20.02/1000 CVC-days. Among these infections, 60.7% (n=17) were systemic CVC-AI (with negative blood culture), and 35.7% (n=10) were bloodstream CVC-AI. The mean SAPS II of patients with CVC-AI was 32.76 14.48; their mean Charlson index was 1.77 1.55, their mean duration of catheterization was 15.46 10.81 days and the mean duration of one central line was 5.8+/-3.72 days. Gram-negative bacteria was determined in 53.5 % of CVC-AI (n= 15) dominated by multi-drug resistant Acinetobacter baumani (n=7). Staphylococci were isolated in 3 CVC-AI. Fourteen (50%) patients with CVC-AI died. Univariate analysis identified men (p=0.034), the referral from another hospital department (p=0.03), tobacco (p=0.006), duration of sedation (p=0.003) and the duration of catheterization (p=0), as possible risk factors of CVC-AI. Multivariate analysis showed that independent factors of CVC-AI were, male sex; OR= 5.73, IC 95% [2; 16.46], p=0.001, Ramsay score; OR= 1.57, IC 95% [1.036; 2.38], p=0.033, and duration of catheterization; OR=1.093, IC 95% [1.035; 1.15], p=0.001. Conclusion: In a monocenter cohort, CVC-AI had a high density and is associated with poor outcome. Identifying the risk factors is necessary to find solutions for this major health problem.

Keywords: central venous catheter associated infection, intensive care unit, prospective cohort studies, risk factors

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Authors: Abubakar Mukhtar Yakasai, Muhammad Tahir Jan

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Purpose: This paper is aimed at exploring factors influencing online shopping intention among the young consumers in Nigeria. Design/Methodology/approach: The paper adopted and extended Technology Acceptance Model (TAM) as the basis for literature review. Additionally, the paper proposed a framework with the inclusion of culture as a moderating factor of consumer online shopping intention among consumers in Nigeria. Findings: Despite high rate of internet penetration in Nigerian, as well as the rapid advancement of online shopping in the world, little attention was paid to this important revolution specifically among Nigeria’s consumers. Based on the review of extant literature, the TAM extended to include perceived risk and enjoyment (PR and PE) was discovered to be a better alternative framework for predicting Nigeria’s young consumers’ online shopping intention. The moderating effect of culture in the proposed model is shown to help immensely in ascertaining differences, if any, between various cultural groups among online shoppers in Nigeria. Originality/ value: The critical analysis of different factors will assist practitioners (like online retailers, e-marketing managers, website developers, etc.) by signifying which combinations of factors can best predict consumer online shopping behaviour in particular instances, thereby resulting in effective value delivery. Online shopping is a newly adopted technology in Nigeria, hence the paper will give a clear focus for effective e-marketing strategy. In addition, the proposed framework in this paper will guide future researchers by providing a tool for systematic evaluation and testing of real empirical situation of online shopping in Nigeria.

Keywords: online shopping, perceived ease of use, perceived usefulness, perceived enjoyment, technology acceptance model, Nigeria

Procedia PDF Downloads 274