Search results for: final outcome

Authors: Mohamed Raouf Benmakrelouf, Joseph Rynkiewicz

Abstract:

Targeted maximum likelihood estimation (TMLE) is well-established method for causal effect estimation with desirable statistical properties. TMLE is a doubly robust maximum likelihood based approach that includes a secondary targeting step that optimizes the target statistical parameter. A causal interpretation of the statistical parameter requires assumptions of the Rubin causal framework. The causal effect of binary variable, E, on outcomes, Y, is defined in terms of comparisons between two potential outcomes as E[YE=1 − YE=0]. Our aim in this paper is to present an adaptation of TMLE methodology to estimate the causal effect of a non-binary categorical variable, providing a large application. We propose coding on the initial data in order to operate a binarization of the interest variable. For each category, we get a transformation of the non-binary interest variable into a binary variable, taking value 1 to indicate the presence of category (or group of categories) for an individual, 0 otherwise. Such a dummy variable makes it possible to have a pair of potential outcomes and oppose a category (or a group of categories) to another category (or a group of categories). Let E be a non-binary interest variable. We propose a complete disjunctive coding of our variable E. We transform the initial variable to obtain a set of binary vectors (dummy variables), E = (Ee : e ∈ {1, ..., |E|}), where each vector (variable), Ee, takes the value of 0 when its category is not present, and the value of 1 when its category is present, which allows to compute a pairwise-TMLE comparing difference in the outcome between one category and all remaining categories. In order to illustrate the application of our strategy, first, we present the implementation of TMLE to estimate the causal effect of non-binary variable on outcome using simulated data. Secondly, we apply our TMLE adaptation to survey data from the French Political Barometer (CEVIPOF), to estimate the causal effect of education level (A five-level variable) on a potential vote in favor of the French extreme right candidate Jean-Marie Le Pen. Counterfactual reasoning requires us to consider some causal questions (additional causal assumptions). Leading to different coding of E, as a set of binary vectors, E = (Ee : e ∈ {2, ..., |E|}), where each vector (variable), Ee, takes the value of 0 when the first category (reference category) is present, and the value of 1 when its category is present, which allows to apply a pairwise-TMLE comparing difference in the outcome between the first level (fixed) and each remaining level. We confirmed that the increase in the level of education decreases the voting rate for the extreme right party.

Keywords: statistical inference, causal inference, super learning, targeted maximum likelihood estimation

Procedia PDF Downloads 98

Authors: Abhay Asthana, Shally Toshkhani, Gyati Shilakari

Abstract:

The objective of the present research work is to develop a topical biodegradable dermal patch based formulation to aid accelerated wound healing. It is always better for patient compliance to be able to reduce the frequency of dressings with improved drug delivery and overall therapeutic efficacy. In present study optimized formulation using biodegradable components was obtained evaluating polymers and excipients (HPMC K4M, Ethylcellulose, Povidone, Polyethylene glycol and Gelatin) to impart significant folding endurance, elasticity, and strength. Molten gelatin was used to get a mixture using ethylene glycol. Chitosan dissolved in acidic medium was mixed with stirring to Gelatin mixture. With continued stirring to the mixture Curcumin was added with the aid of DCM and Methanol in an optimized ratio of 60:40 to get homogenous dispersion. Polymers were dispersed with stirring in the final formulation. The mixture was sonicated casted to get the film form. All steps were carried out under strict aseptic conditions. The final formulation was a thin uniformly smooth textured film with dark brown-yellow color. The film was found to have folding endurance was around 20 to 21 times without a crack in an optimized formulation at RT (23°C). The drug content was in range 96 to 102% and it passed the content uniform test. The final moisture content of the optimized formulation film was NMT 9.0%. The films passed stability study conducted at refrigerated conditions (4±0.2°C) and at room temperature (23 ± 2°C) for 30 days. Further, the drug content and texture remained undisturbed with stability study conducted at RT 23±2°C for 45 and 90 days. Percentage cumulative drug release was found to be 80% in 12h and matched the biodegradation rate as tested in vivo with correlation factor R2>0.9. In in vivo study administration of one dose in equivalent quantity per 2 days was applied topically. The data demonstrated a significant improvement with percentage wound contraction in contrast to control and plain drug respectively in given period. The film based formulation developed shows promising results in terms of stability and in vivo performance.

Keywords: wound healing, biodegradable, polymers, patch

Procedia PDF Downloads 475

Authors: Hamish Love, Navjot Bhullar, Nicola Schutte

Abstract:

Self-control and related psychological constructs have been shown to have a large role in the improvement and maintenance of healthful dietary behaviour. However, self-control for diet, and related constructs such as motivation, level of conflict between tempting desires and dietary goals, and attentional bias for tempting food, have not been studied together to establish their relationships, to the author’s best knowledge. Therefore the aim of this paper was to conduct model testing on these constructs and evaluate how they relate to affect dietary outcomes. 400 Australian adult participants will be recruited via the Qualtrics platform and will be representative across age and gender. They will complete survey and reaction timing surveys to gather data on the five target constructs: Trait Self-control, Attentional Bias for Food, Dietary Goal-Desire Incongruence, Motivation for Dietary Self-control, and Satisfaction with Dietary Behaviour. A model of moderated mediation is predicted, whereby the initial predictor (Dietary Goal-Desire Incongruence) predicts the level of the outcome variable, Satisfaction with Dietary Behaviour. We hypothesise that the relationship between these two variables will be mediated by Trait Self-Control and that the extent that Trait Self-control is allowed to mediate dietary outcome is moderated by both Attentional Bias for Food and Motivation for Dietary Self-control. The analysis will be conducted using the PROCESS module in SPSS 23. The results of model testing in this current study will be valuable to direct future research and inform which constructs could be important targets for intervention to improve dietary outcomes.

Keywords: self-control, diet, model testing, attentional bias, motivation

Procedia PDF Downloads 167

Authors: Eric S. Lee, Connie Bygrave, Jordan Mahar, Naina Garg, Suzanne Cottreau

Abstract:

Marking exams is universally detested by lecturers. Final exams in many higher education courses often last 3.0 hrs. Do exams really need to be so long? Can we justifiably reduce the number of questions on them? Surprisingly few have researched these questions, arguably because of the complexity and difficulty of using traditional methods. To answer these questions empirically, we used a new approach based on three key elements: Use of an unusual variation of a true experimental design, equivalence hypothesis testing, and an expanded set of six psychometric criteria to be met by any shortened exam if it is to replace a current 3.0-hr exam (reliability, validity, justifiability, number of exam questions, correspondence, and equivalence). We compared student performance on each official 3.0-hr exam with that on five shortened exams having proportionately fewer questions (2.5, 2.0, 1.5, 1.0, and 0.5 hours) in a series of four experiments conducted in two classes in each of two finance courses (224 students in total). We found strong evidence that, in these courses, shortening of final exams to 2.0 hrs was warranted on all six psychometric criteria. Shortening these exams by one hour should result in a substantial one-third reduction in lecturer time and effort spent marking, lower student stress, and more time for students to prepare for other exams. Our approach provides a relatively simple, easy-to-use methodology that lecturers can use to examine the effect of shortening their own exams.

Keywords: exam length, psychometric criteria, synthetic experimental designs, test length

Procedia PDF Downloads 269

Authors: Erwin Geroleo, Higinio Mappala

Abstract:

Introduction Overt Hepatic Encephalopathy (OHE) is the most dreaded outcome of liver cirrhosis. Aside from the triggering factors which are already known to precipitate OHE, there is growing evidence that an altered gut microbiota profile (dysbiosis) can also trigger OHE. MHE is the mildest form of hepatic encephalopathy(HE), affecting about one-third of patients with cirrhosis, and close 80% of patients with cirrhosis and manifests as abnormalities in central nervous system function. Since these symptoms are subclinical most patients are not being treated to prevent OHE. The gut microbiota have been evaluated by several studies as a therapeutic option for MHE, especially in decreasing the levels of ammonia, thus preventing progression to OHE Objectives This study aims to evaluate the efficacy of probiotics in terms of reduction of ammonia levels in patient with minimal hepatic encephalopathies and to determine if Probiotics has role in the prevention of progression to overt hepatic encephalopathy in adult patients with minimal hepatic encephalopathy (MHE) Methods and Analysis The literature search strategy was restricted to human studies in adults subjects from 2004 to 2022. The Jadad Score Calculation was utilized in the assessment of the final studies included in this study. Eight (8) studies were included. Cochrane’s Revman Web, the Fixed Effects model and the Ztest were all used in the overall analysis of the outcomes. A p value of less than 0.0005 was statistically significant. Results. These results show that Probiotics significantly lowers the level of Ammonia in Cirrhotic patients with OHE. It also shows that the use of Probiotics significantly prevents the progression of MHE to OHE. The overall risk of bias graph indicates low risk of publication bias among the studies included in the meta-analysis. Main findings This research found that plasma ammonia concentration was lower among participants treated with probiotics (p<0.00001).) Ammonia level of the probiotics group is lower by 13.96 μmol/ on the average. Overall risk of developing overt hepatic encephalopathy in the probiotics group is shown to be decreased by 15% as compared to the placebo group Conclusion The analysis showed that compared with placebo, probiotics can decrease serum ammonia, may improve MHE and may prevent OHE.

Keywords: minimal hepatic encephalopathy, probiotics, liver cirrhosis, overt hepatic encephalopathy

Procedia PDF Downloads 39

Authors: Tien-Hui Chiang

Abstract:

The code theory, proposed by Basil Bernstein, indicates that framing can be viewed as the core element in constituting the phenomenon of cultural reproduction because it is able to regulate the transmission of pedagogical information. Strong framing increases the social relation boundary between a teacher and pupils, which obstructs information transmission, so that in order to improve underachieving students’ academic performances, teachers need to reduce to strength of framing. Weak framing enables them to transform academic knowledge into commonsense knowledge in daily life language. This study posits that most teachers would deliver strong framing due to their belief mainly confined within the aspect of instrumental rationality that deprives their critical minds. This situation could make them view the normal distribution bell curve of students’ academic performances as a natural outcome. In order to examine the interplay between framing, instrumental rationality and pedagogical action, questionnaires were completed by over 5,000 primary school teachers in Henan province, China, who were stratified sample. The statistical results show that most teachers employed psychological concepts to measure students’ academic performances and, in turn, educational inequity was legitimatized as a natural outcome in the efficiency-led approach. Such efficiency-led minds made them perform as the agent practicing the mechanism of social control and in turn sustaining the phenomenon of cultural reproduction.

Keywords: code, cultural reproduction, framing, instrumental rationality, social relation and interaction

Procedia PDF Downloads 148

Authors: Edoba Bright Omoregie

Abstract:

Nigeria became a federation in 1954 six years before it gained independence away from British colonial rule. The country has remained a federation since then despite the challenging circumstances of military rule and civil strife which have tasked its federal credentials. Since 1961, when it first decided a federalism dispute, cases over vertical and horizontal powers have inundated the country’s Supreme Court. In its current practice of federalism after democratic rule was resumed in 1999, the country has witnessed a spell of intergovernmental disputes over a good number of federalism issues. Such conflicts have eventually found their way to the Supreme Court for resolution, not as a final appellate court (which it is in other non-federal matters) but as a court of first and final instance following the constitutional provision granting the court such power. However, in April 2014 one of such disputes was denied hearing by the court when it declined original jurisdiction to determine the matter. The suit was instituted by one state of the federation against the federal government and the other 35 states challenging the collection of value added tax (a consumption tax)on certain goods and services within the state. The paper appraises the rationale of the court’s decision and reason that its decision to decline jurisdiction is the result of an avoidable misunderstanding of the dual sovereignty instituted by the federal system of Nigeria as well as a misconception of the role which the court is constitutionally assigned to play in resolving intergovernmental schisms in the federal system.

Keywords: dual sovereignty, federalism, intergovernmental conflict, Supreme Court

Procedia PDF Downloads 552

Authors: T. Pradhan, P. Rijal, M. C. Regmi

Abstract:

Background: Eclampsia is a multisystem disorder that involves vital organs and failure of these may lead to deterioration of maternal condition and hypoxia and acidosis of fetus resulting in high maternal and perinatal mortality and morbidity. Thus, evaluation of the contributing factors for this condition and its complications leading to maternal deaths should be the priority. Formulating the plan and protocol to decrease these losses should be our goal. Aims and Objectives: To evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia and to correlate the risk factors associated with maternal and fetal morbidity and mortality. Methods: All patients with eclampsia admitted in Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to patients, and attendants like Antenatal clinic visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate and the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition like maternal Intensive Care Unit admission, neurological impairment and mortality were noted before discharge. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS 11). Mean and percentage were calculated for demographic variables. Pearson’s correlation test and chi-square test were applied to find the relation between the risk factors and the outcomes. P value less than 0.05 was considered significant. Results: There were 10,000 antenatal deliveries during the study period. Fifty-two patients with eclampsia were admitted. All of the patients were unbooked for our institute. Thirty-nine patients were antepartum eclampsia. Thirty-one patients required mechanical ventilator support. Twenty-four patients were delivered by emergency c-section and 21 babies were Low Birth Weight and there were 9 stillbirths. There was one maternal mortality and 45 patients were discharged with improvement but 3 patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate. Conclusion: Early detection and management of hypertensive complicating pregnancy during antenatal clinic check up. Early hospitalization and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes.

Keywords: eclampsia, maternal mortality, perinatal mortality, risk factors

Procedia PDF Downloads 163

Authors: Hend K. Moosa, Eman A. Rashwan, Ezzat M. Hassan, Amany A. Ghazy, Amel G. Sheredy

Abstract:

The stability of microRNA (miR) in the circulation can show a great progress toward the discovery of non-invasive diagnostic and prognostic biomarkers in many diseases. In the present study, circulatory miR-122 and miR-130a were analysed in chronic hepatitis C Egyptian patients in predicting the clinical outcome of interferon treatment. In addition, their expression levels were correlated to viral RNA levels, necro-inflammatory markers (AST, ALT) and to each other. This study was conducted on 51 subjects where 36 were chronic HCV patients in which they were divided into naive and interferon treated HCV patients (responders and non-responders) and 15 matched healthy controls. Serum quantification of miR-122 and miR-130a were performed by quantitative Real-time Polymerase Chain Reaction (qRT-PCR). The results showed a significant upregulation of miR-122 in non-responder patients (P=0.049). By receiver operating characteristic analysis curve, miR-122 revealed 65% sensitivity and 92.3% specificity in predicting non-responsiveness of patients to IFN treatment, while miR-130a showed a sensitivity of 100% and specificity of 53.85%. Remarkably, there was a significant positive correlation between miR-122 and miR-130a in naive HCV patients (r=0.714, p=0.003). However, there was no significant correlation between serum miR-122, miR-130a expression levels and necro-inflammatory markers (AST, ALT). To conclude, miR-122 and miR-130a have a significant association with viral RNA levels and accordingly, they may have a synergistic power in promoting viral replication. Interestingly, miR-122 and miR-130a have a predictive power in predicting clinical outcome of IFN treatment which can be further studied in currently used drugs in order to reduce the socio-economic burden of potentially non-responders.

Keywords: hepatitis C, microRNA, miR-122, miR-130a

Procedia PDF Downloads 165

Authors: Jamunarani Appalasamy, Tha Kyi Kyi, Quek Kia Fatt, Joyce Pauline Joseph, Anuar Zaini M. Zain

Abstract:

Background: The Health Belief Theory had always been associated with chronic disease management. Various health behaviour concepts and perception branching from this Health Belief Theory had involved with medication understanding, use, and self-efficacy which directly link to medication adherence. In a previous quantitative and qualitative study, stroke patients in Malaysia were found to be strongly believing information obtained by various sources such as the internet and social communication. This action leads to lower perception of their stroke preventative medication benefit which in long-term creates non-adherence. Hence, this study intends to pilot an intervention which uses audio-visual concept incorporated with mHealth service to enhance learning and self-reflection among stroke patients to manage their disease. Methods/Design: Twenty patients will be allocated to a proposed intervention whereas another twenty patients are allocated to the usual treatment. The intervention involves a series of developed audio-visual videos sent via mobile phone which later await for responses and feedback from the receiver (patient) via SMS or recorded calls. The primary outcome would be the medication understanding, use and self-efficacy measured over two months pre and post intervention. Secondary outcome is measured from changes of blood parameters and other self-reported questionnaires. Discussion: This study shall also assess uptake/attrition, feasibility, and acceptability of this intervention. Trial Registration: NMRR-15-851-24737 (IIR)

Keywords: health belief, medication understanding, medication use, self-efficacy

Procedia PDF Downloads 216

Authors: Avrokomi Zavitsanou, Spiros Papadopoulos, Theofanis Alexandridis

Abstract:

This paper presents the research project ‘Colour & Travel’, which is co-funded by the European Union and national resources through the Operational Programme “Competitiveness, Entrepreneurship and Innovation” 2014-2020, under the Single RTDI State Aid Action "RESEARCH - CREATE - INNOVATE". The research project proposes the design of an innovative, playful framework for exploring a variety of travel destinations and creating personalised travel narratives, aiming to entertain, educate, and promote culture and tourism. Gamification of the cultural and touristic environment can enhance its experiential, multi-sensory aspects and broaden the perception of the traveler. The latter's involvement in creating and shaping his personal travel narrations and the possibility of sharing it with others can offer him an alternative, more binding way of getting acquainted with a place. In particular, the paper presents the design of an infrastructure: (a) for the development of interactive travel guides for mobile devices, where sites with specific points of interest will be recommended, with which the user can interact in playful ways and then create his personal travel narratives, (b) for the development of innovative games within virtual reality environment, where the interaction will be offered while the user is moving within the virtual environment; and (c) for an online application where the content will be offered through the browser and the modern 3D imaging technologies (WebGL). The technological products that will be developed within the proposed project can strengthen important sectors of economic and social life, such as trade, tourism, exploitation and promotion of the cultural environment, creative industries, etc. The final applications delivered at the end of the project will guarantee an improved level of service for visitors and will be a useful tool for content creators with increased adaptability, expansibility, and applicability in many regions of Greece and abroad. This paper aims to present the research project by referencing the state of the art and the methodological scheme, ending with a brief reflection on the expected outcome in terms of results.

Keywords: gamification, culture, tourism, AR, VR, applications

Procedia PDF Downloads 140

Authors: Diaa Othman, Muhammad Adil Khan, Muhammad Riaz

Abstract:

Without an early intervention to correct the unilateral complete cleft lip and palate deformity, nasal architecture can progress to an exaggerated cleft nose deformity. We present the results of a modified unilateral cleft rhinoplasty procedure ‘the Gujrat technique’ to correct this deformity. Ninety pediatric and adult patients with non-syndromic unilateral cleft lip underwent primary and secondary composite cleft rhinoplasty using the Gujrat technique as a single stage operation over a 10-year period. The technique involved an open rhinoplasty with Tennison lip repair, and employed a combination of three autologous cartilage grafts, seven cartilage-molding sutures and a prolene mesh graft for alar base support. Post-operative evaluation of nasal symmetry was undertaken using the validated computer program ‘SymNose’. Functional outcome and patient satisfaction were assessed using the NOSE scale and ROE (rhinoplasty outcome evaluation) questionnaires. The single group study design used the non-parametric matching pairs Wilcoxon Sign test (p < 0.001), and showed overall good to excellent functional and aesthetic outcomes, including nasal projection and tip definition, and higher scores of the digital SymNose grading system. Objective assessment of the Gujrat cleft rhinoplasty technique demonstrates its aesthetic appeal and functional versatility. Overall it is a simple and reproducible technique, with no significant complications.

Keywords: cleft lip and palate, congenital rhinoplasty, nasal deformity, secondary rhinoplasty

Procedia PDF Downloads 198

Authors: N. Gopal, K. Jaasminerjiit, L. Z. Xiang

Abstract:

Quinazoline-4(3H)-one ring system has been consistently regarded as promising privileged structural icon owing to its pharmacodynamic versatility in many of its synthetic derivatives as well as in several naturally occurring alkaloids. The literature reveals that 2nd & 3rd positions of the quinazolin-4(3H)-one pharmacophore are the target for substitution with other moieties. On the other hand, sulphanilamide derivatives and isatin moiety also displayed valuable biological activities. Hence, it was thought worthwhile to study the effects of three pharmacophoric moieties like quinazolinone, sulphanilamide and isatin in a single molecule for the better analgesic activity with lower toxicity. Series of novel 2,3-disubstituted quinazolin-4(3H)-one derivatives have been synthesised from the intermediate Schiff base of 2-(4’-substitutedphenyl)-3-[(N-2-oxoindolin-3-ylidene)-4”-sulphonamidophenyl]-quinazolin-4(3H)-one derivatives, which was prepared from reacting 2-(substituted phenyl)-4H-benzo[d][1,3]-oxazin-4-one with sulphanilamide. The required benzoxazinone derivatives were prepared by reacting anthranilic acid with benzoyl chloride. All the compounds structure was characterised by using H1 NMR, IR and Mass spectroscopy. The intermediate Schiff base and final Mannich base compounds were evaluated for their analgesic activity by acetic acid-induced writhing method at the dose of 25mg/kg, 50 mg/kg, and 100 mg/kg (bw) and Diclofenac (25mg/kg of body weight) will be used as the reference drugs. From the results of the study, it has been observed that final Mannich base showed a better analgesic activity when compared to the parent Schiff bases, it was found that compound substituted with N-methyl piperazine at 1st position of the indole nucleus of the final quinazolinone derivatives (GA4B1) i.e. 2-(4’-methoxy phenyl)-3-[4-(N-(1-N-methyl piperazine amine) methyl-2-oxo indoilin-3-ylidene] benzenesulfonyl quinazolin-4(3H)-one increases the analgesic activity and among the synthesised compounds, GA4B1 exhibited quite superior analgesic activity. The remaining Schiff bases and Mannich base derivatives exhibited moderate analgesic activity. All the compounds showed a dose dependent activity. None of the synthesised compound showed ulcer index whereas the standard drug, diclofenac [25 mg/kg (bw)] showed significantly higher gross ulcer index values.

Keywords: analgesic activity, isatin, mannich base, quinazolin-4(3H)-one

Procedia PDF Downloads 339

Authors: Hassan Wajid, Syed T. Ahmed, Syed G. Haider Jr., Razia Latif, Ahsan Ali, Maira Anam

Abstract:

The phenomenon of Metamorphosis can be associated with any object, organism, or structure gradually and progressively going through the change of systemic or morphological form. This phenomenon can be integrated while teaching drawing to architecture students. In architectural drawings, metamorphosis’s main focus and purpose are not to completely imitate any object. In the process of drawing, the changes in systemic or morphological form happen until the complete process, and the visuals of the complete process change the drawing, opening up possibilities for the imagination of the perceivers. Metamorphosis in architectural drawings begins with an initial form and, through various noticeable stages, ends up final form or manifestation. How much of the initial form is manifested in the final form and progressively among various intermediate stages becomes an indication of the nature of metamorphosis as a phenomenon. It is important at this stage to clarify that the term metamorphosis is presently being coopted from its original domain, usually in life sciences. In this current exercise, the architectural drawings are to act as an operative analog process transforming one image of art and/or architecture in its broadest sense. That composition is claimed to have come from one source (individual work, a cultural artifact, civilizational remain). It dialectically meets, opposes, or confronts some carefully chosen alien opposites from a different domain. As an example, the layers of a detailed drawing of a Turkish prayer rug of 5 x 7 ratio over a detailed architectural plan of a religious, historical complex can be observed such that the two drawings, though at markedly different scales could dialectically converse with one another and through their mutual congruencies. In the final stage, the idea concludes contradictions across the scales to initiate the analogous roles of metamorphosed third reality, which suggests the previous un-acknowledged architectural or artistic identity. The proposed paper explores the trajectory of reproduction by analyzing drawings through detailed drawing stages and analyzes challenges as well as opportunities in the discovered realm of imagination. This description further aims at identifying factors influencing creativity and innovation in producing architectural drawings through the process of observing drawings from inception to the concluding stage.

Keywords: architectural drawings, metamorphosis, perceptions, discovery

Procedia PDF Downloads 100

Authors: Soofia Malik

Abstract:

The purpose of this study is to develop an instrument to measure undergraduate students’ attitudes toward mathematics (MAT) and to assess the data collected from the instrument for validity and reliability. The instrument is developed using five subscales: anxiety, enjoyment, self-confidence, value, and technology. The technology dimension is added as the fifth subscale of attitude toward mathematics because of the recent trend of incorporating online homework in mathematics courses as well as due to heavy reliance of higher education on using online learning management systems, such as Blackboard and Moodle. The sample consists of 163 (M = 82, F = 81) undergraduates enrolled in College Algebra course in the summer 2017 semester at a university in the USA. The data is analyzed to answer the research question: if and how do undergraduate students’ attitudes toward mathematics load using Principal Components Analysis (PCA)? As a result of PCA, three subscales emerged namely: anxiety/self-confidence scale, enjoyment, and value scale. After deleting the last five items or the last two subscales from the initial MAT scale, the Cronbach’s alpha was recalculated using the scores from 20 items and was found to be α = .95. It is important to note that the reliability of the initial MAT form was α = .93. This means that employing the final MAT survey form would yield consistent results in repeated uses. The final MAT form is, therefore, more reliable as compared to the initial MAT form.

Keywords: college algebra, Cronbach's alpha reliability coefficient, Principal Components Analysis, PCA, technology in mathematics

Procedia PDF Downloads 120

Authors: Mohammad Didar Hossain

Abstract:

Background/Purpose: The purpose of this study was to examine the associations between productive engagements and the psychological well-being of older adults in the U.S by analyzing cross-sectional data from a secondary dataset. Specifically, this paper analyzed the associations of 4 different types of productive engagements, including current work status, caregiving to the family members, volunteering and religious strengths with the psychological well-being as an outcome variable. Methods: Data and sample: The study used the data from the Health and Retirement Study (HRS). The HRS is a nationally representative prospective longitudinal cohort study that has been conducting biennial surveys since 1992 to community-dwelling individuals 50 years of age or older on diverse issues. This analysis was based on the 2016 wave (cross-sectional) of the HRS dataset and the data collection period was April 2016 through August 2017. The samples were recruited from a multistage, national area-clustered probability sampling frame. Measures: Four different variables were considered as the predicting variables in this analysis. Firstly, current working status was a binary variable that measured by 0=Yes and 1= No. The second and third variables were respectively caregiving and volunteering, and both of them were measured by; 0=Regularly, 1= Irregularly. Finally, find in strength was measured by 0= Agree and 1= Disagree. Outcome (Wellbeing) variable was measured by 0= High level of well-being, 1= Low level of well-being. Control variables including age were measured in years, education in the categories of 0=Low level of education, 1= Higher level of education and sex r in the categories 0=male, 1= female. Analysis and Results: Besides the descriptive statistics, binary logistic regression analyses were applied to examine the association between independent and dependent variables. The results showed that among the four independent variables, three of them including working status (OR: .392, p<.001), volunteering (OR: .471, p<.003) and strengths in religion (OR .588, p<.003), were significantly associated with psychological well-being while controlling for age, gender and education factors. Also, no significant association was found between the caregiving engagement of older adults and their psychological well-being outcome. Conclusions and Implications: The findings of this study are mostly consistent with the previous studies except for the caregiving engagements and their impact on older adults’ well-being outcomes. Therefore, the findings support the proactive initiatives from different micro to macro levels to facilitate opportunities for productive engagements for the older adults, and all of these may ultimately benefit their psychological well-being and life satisfaction in later life.

Keywords: productive engagements, older adults, psychological wellbeing, productive aging

Procedia PDF Downloads 153

Authors: Nuralam Sam, Irawan Yusuf, Irfan Idris, Endi Adnan

Abstract:

The most case in the shoulder in the the adult is the frozen shoulder. It make an uncomfortable sensation which disturbance daily activity. The studies of frozen shoulder are still limited. This study used a true experimental pre and post test design with a group design. The participant underwent dextrose prolotherapy injection in the rotator cuff, intraarticular glenohumeral joint, long head tendon biceps, and acromioclavicular joint injections with 15% dextrose, respectively, at week 2, week 4, and week 6. Participants were followed for 12 weeks. The specific biomarker MMP and TIMP, ROM, DASH score were measured at baseline, at week 6, and week 12. The data were analyzed by multivariate analysis (repeated measurement ANOVA, Paired T-Test, and Wilcoxon) to determine the effect of the intervention. The result showed a significant decrease in The Disability of the Arm, Shoulder, and Hand (DASH) score in prolo injection patients in each measurement week (p < 0.05). While the measurement of Range of Motion (ROM), each direction of shoulder motion showed a significant difference in average each week, from week 0 to week 6 (p <0.05).Dextrose prolotherapy injection results give a significant improvement in functional outcome of the shoulder joint, and ROMand did not show significant results in assessing the specific biomarker, MMP-1, and TIMP-1 in tissue repair. This study suggestion an alternative to the use of injection prolotherapy in Frozen shoulder patients, which has fewer side effects and better effectiveness than the use of corticosteroid injections.

Keywords: frozen shoulder, ROM, DASH score, prolotherapy, MMP-1, TIMP-1

Procedia PDF Downloads 106

Authors: R. A. C. K. Gunathilaka, P. T. D. Peiris, O. S. M. Jayawardane, S. M. A. I. Kulathunga

Abstract:

Waste management is one of the predominant aspects of resource utilization and sustainability. The absence of a proper waste management system may lead to adverse troubles and catastrophic tragedies ultimately. Sri Lanka has faced different predicaments for a long time due to the unavailability of a systematic manner in the waste management process. The main objective of this research is to design an efficient waste management system for an urban area in Sri Lanka. The research was dispersed into three categories as biodegradable, non-biodegradable, and hazardous waste. Different waste materials were researched for each category by probing the entire process from the beginning to final disposal for perceiving the prevailing problems in the waste management system. The distinctive segment of this research is comparing efficient foreign waste management strategies with efficacious approaches on increasing public commitment to uncovering cognizable ways of implementing such a system in the Sri Lankan context. Waste management systems in Singapore, Japan, Malaysia, USA, Maldives, and China incorporated their exemplary plan of action on tackling the waste problem in diverse sectors were studied. Ultimately, three coherent models were proposed for each category pertaining to the concepts of circular economy and lean manufacturing from the inception to the final disposal of the waste. This research also includes concealed financial opportunities regarding waste management.

Keywords: circular economy, efficient waste management system, lean manufacturing, sustainability, urban area

Procedia PDF Downloads 168

Authors: Ali A. Alshahrani

Abstract:

This study aims to identify Saudi English as a Foreign Language (EFL) students' perspectives towards using the English language in their studies. The study explores students' self-confident and its association with students' actual performance in English courses in their different academic programs. A multimodal methodology was used to fulfill the research purpose and answer the research questions. A 25-item survey questionnaire and final examination grades were used to collect data. Two hundred forty-one students agreed to participate in the study. They completed the questionnaire and agreed to release their final grades to be a part of the collected data. The data were coded and analyzed by SPSS software. The findings indicated a significant difference in students' performance in English courses between participants' academic programs on the one hand. Students' self-confidence in their English language skills, on the other hand, was not significantly different between participants' academic programs. Data analysis also revealed no correlational relationship between students' self-confidence level and their language skills and their performance. The study raises more questions about other vital factors such as course instructors' views of the materials, faculty members of the target department, family belief in the usefulness of the program, potential employers. These views and beliefs shape the student's preparation process and, therefore, should be explored further.

Keywords: English language intensive program, language proficiency, performance, self-confidence

Procedia PDF Downloads 132

Authors: M. G. Talasbayen, N. N. Dyussenbayev, Y. D. Kali, R. A. Zholbarysov, Y. N. Duissenbayev, I. Z. Mammadinova, S. M. Nuradilov

Abstract:

Background. Hemorrhagic stroke is an acute cerebrovascular accident resulting from rupture of a cerebral vessel or increased permeability of the wall and imbibition of blood into the brain parenchyma. Arterial hypertension is a common cause of hemorrhagic stroke. Male gender and age over 55 years is a risk factor for intracerebral hemorrhage. Treatment of intracerebral hemorrhage is aimed at the primary pathophysiological link: the relief of coagulopathy and the control of arterial hypertension. Early surgical treatment can limit cerebral compression; prevent toxic effects of blood to the brain parenchyma. Despite progress in the development of neuroimaging data, the use of minimally invasive techniques, and navigation system, mortality from intracerebral hemorrhage remains high. Materials and methods. The study included 78 patients (62.82% male and 37.18% female) with a verified diagnosis of hemorrhagic stroke in the period from 2019 to 2021. The age of patients ranged from 25 to 80 years, the average age was 54.66±11.9 years. Demographic, brain CT data (localization, volume of hematomas), methods of treatment, and disease outcome were analyzed. Results. The retrospective analyze demonstrate that 78.2% of all patients underwent surgical treatment: decompressive craniectomy in 37.7%, craniotomy with hematoma evacuation in 29.5%, and hematoma draining in 24.59% cases. The study of the proportion of deaths, depending on the volume of intracerebral hemorrhage, shows that the number of deaths was higher in the group with a hematoma volume of more than 60 ml. Evaluation of the relationship between the time before surgery and mortality demonstrates that the most favorable outcome is observed during surgical treatment in the interval from 3 to 24 hours. Mortality depending on age did not reveal a significant difference between age groups. An analysis of the impact of the surgery type on mortality reveals that decompressive craniectomy with or without hematoma evacuation led to an unfavorable outcome in 73.9% of cases, while craniotomy with hematoma evacuation and drainage led to mortality only in 28.82% cases. Conclusion. Even though the multimodal approaches, the development of surgical techniques and equipment, and the selection of optimal conservative therapy, the question of determining the tactics of managing and treating hemorrhagic strokes is still controversial. Nevertheless, our experience shows that surgical intervention within 24 hours from the moment of admission and craniotomy with hematoma evacuation improves the prognosis of treatment outcomes.

Keywords: hemorragic stroke, Intracerebral hemorrhage, surgical treatment, stroke mortality

Procedia PDF Downloads 102

Authors: Awole Seid, Yosef Zenebe, Hadgu Gerensea, Kebede Haile Misgina

Abstract:

Background: Clinical competence is one of the ultimate goals of nursing education. Clinical skills are more than successfully performing tasks; it incorporates client assessment, identification of deficits and the ability to critically think to provide solutions. Assessment of clinical competence, particularly identifying gaps that need improvement and determining the educational needs of nursing students have great importance in nursing education. Thus this study aims determining clinical self-efficacy of final year school of nursing students in three universities of Tigray Region. Methods: A cross-sectional study was conducted on 224 final year school of nursing students from department of nursing, psychiatric nursing, and midwifery on three universities of Tigray region. Anonymous self-administered questionnaire was administered to generate data collected on June, 2017. The data were analyzed using SPSS version 20. The result is described using tables and charts as required. Logistic regression was employed to test associations. Result: The mean age of students was 22.94 + 1.44. Generally, 21% of students have been graduated in the department in which they are not interested. The study demonstrated 28.6% had poor and 71.4% had good perceived clinical self-efficacy. Beside this, 43.8% of psychiatric nursing and 32.6% of comprehensive nursing students have poor clinical self-efficacy. Among the four domains, 39.3% and 37.9% have poor clinical self- efficacy with regard to ‘Professional development’ and ‘Management of care’. Place of the institution [AOR=3.480 (1.333 - 9.088), p=0.011], interest during department selection [AOR=2.202 (1.045 - 4.642), p=.038], and theory-practice gap [AOR=0.224 (0.110 - 0.457), p=0.000] were significantly associated with perceived clinical self-efficacy. Conclusion: The magnitude of students with poor clinically self efficacy was high. Place of institution, theory-practice gap, students interest to the discipline were the significant predictors of clinical self-efficacy. Students from youngest universities have good clinical self-efficacy. During department selection, student’s interest should be respected. The universities and other stakeholders should improve the capacity of surrounding affiliate teaching hospitals to set and improve care standards in order to narrow the theory-practice gap. School faculties should provide trainings to hospital staffs and monitor standards of clinical procedures.

Keywords: clinical self-efficacy, nursing students, Tigray, northern Ethiopia

Procedia PDF Downloads 165

Authors: Kwei Huan Liw, Sashi B. Darshan

Abstract:

Background: Double eyelid surgery has become one of the most sought-after aesthetic procedures among Asians. Many surgeons perform surgical blepharoplasty and various other methods of non-incisional blepharoplasty. Face-Q is a validated method of measuring patient satisfaction for facial aesthetic procedures. Here we have analyzed the overall eye satisfaction score, the upper eyelid appraisal score and the adverse effect on eyes score Methods: 274 patients (548 eyes), aged between 18 to 40 years old, were recruited from 2015-2018. Each patient underwent a non-incisional double-eyelid blepharoplasty using a single-knotted continuous buried suture. 3 – 5 stab incisions were made depending on the upper eyelid size. A needle loaded with 7-0 nylon is passed from the lateral most wound through the dermis and the conjunctiva in an alternate fashion into the remaining stab wounds. The suture is then tunneled back laterally in the deeper dermis and knotted securely with the suture end. The knot is then buried within the orbicularis oculi muscle. Each patient was required to fill the Face-Q questionnaire before the procedure and 2 weeks post procedure. The results are described based on the percentage of the maximum achievable score. Patients were reviewed after 12 to 18 months to assess the long-term outcome. Results: The overall eye satisfaction score demonstrated a high level of post-operative satisfaction (97.85%), compared to 27.32% pre-operatively. The appraisal of upper eyelid scores showed drastic improvement in perception post-operatively (95.31%) compared to 21.44% pre-operatively. Adverse effect on eyes score showed a very low post-operative complication rate (0.4%) The long-term follow-up showed 6 cases that had developed asymmetrical folds. Only 1 patient agreed for revision surgery. The other 5 patients were still satisfied with the outcome and were not keen for revision surgery. None of the cases had loosening of knots. Conclusion: Modified single-knot continuous buried suture technique is a simple and non-invasive method to create aesthetically pleasing non-surgical double-eyelids, which has long-term effects. Proper patient selection is crucial and good surgical technique is required to achieve a desirable outcome.

Keywords: blepharoplasty, double-eyelid, face-Q, non-incisional

Procedia PDF Downloads 117

Authors: Johnson Adafin, James O. B. Rotimi, Suzanne Wilkinson, Abimbola O. Windapo

Abstract:

An aspect of client expenditure management that requires attention is the level of accuracy achievable in design-stage elemental cost planning. This has been a major concern for construction clients and practitioners in New Zealand (NZ). Pre-tender estimating inaccuracies are significantly influenced by the level of risk information available to estimators. Proper cost planning activities should ensure the production of a project’s likely construction costs (initial and final), and subsequent cost control activities should prevent unpleasant consequences of cost overruns, disputes and project abandonment. If risks were properly identified and priced at the design stage, observed variance between design-stage elemental cost plans (ECPs) and final tender sums (FTS) (initial contract sums) could be reduced. This study investigates the variations between design-stage ECPs and FTS of construction projects, with a view to identifying risk factors that are responsible for the observed variance. Data were sourced through interviews, and risk factors were identified by using thematic analysis. Access was obtained to project files from the records of study participants (consultant quantity surveyors), and document analysis was employed in complementing the responses from the interviews. Study findings revealed the discrepancies between ECPs and FTS in the region of -14% and +16%. It is opined in this study that the identified risk factors were responsible for the variability observed. The values obtained from the analysis would enable greater accuracy in the forecast of FTS by Quantity Surveyors. Further, whilst inherent risks in construction project developments are observed globally, these findings have important ramifications for construction projects by expanding existing knowledge on what is needed for reasonable budgetary performance and successful delivery of construction projects. The findings contribute significantly to the study by providing quantitative confirmation to justify the theoretical conclusions generated in the literature from around the world. This therefore adds to and consolidates existing knowledge.

Keywords: accuracy, design-stage, elemental cost plan, final tender sum

Procedia PDF Downloads 265

Authors: Ayda Youssef, Mohammed Ali Khalaf, Tarek Rafaat

Abstract:

Background: Langerhans cell histiocytosis (LCH) is a rare multi-systemic disease that shows an abnormal proliferation of these kinds of cells associated with a granular infiltration that affects different structures of the human body, including the lung, liver, spleen, lymph nodes, brain, mucocutaneous, soft tissue (head and neck), and salivary glands. Evaluation of the extent of disease is one of the major predictors of patient outcome. Objectives: To recognize the pathogenesis of Langerhans cell histiocytosis (LCH), describe the radiologic criteria that are suggestive of LCH in different organs rather than the bones and to illustrate the appropriate differential diagnoses for LCH in each of the common extra-osseous sites. Material and methods: A retrospective study was done on 150 biopsy-proven LCH patients from 2007 to 2012. All patients underwent imaging studies, mostly US, CT, and MRI. These patients were reviewed to assess the extra-skeletal manifestations of LCH. Results: In 150 patients with biopsy-proven LCH, There were 33 patients with liver affection, 5 patients with splenic lesions, 55 patients with enlarged lymph nodes, 9 patient with CNS disease and 11 patients with lung involvement. Conclusions: Because of the frequent LCH children and evaluation of the extent of disease is one of the major predictors of patient outcome. Radiologist need to be familiar with its presentation in different organs and regions of body outside the commonest site of affection (bones). A high-index suspicion should be raised a biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality.

Keywords: langerhans cell histiocytosis, extra-skeletal, pediatrics, radiology

Procedia PDF Downloads 433

Authors: Ewa Rudnik

Abstract:

Poster shows a comparison of hydrometallurgical routes of copper recovery from low-grade e-waste. Electronic scrap was smelted to produce Cu–Zn–Ag alloy. The alloy was then treated in the following ways: (a) anodic dissolution with simultaneous metal electrodeposition using ammoniacal and sulfuric acid solutions. This resulted in the separation of metals, where lead, silver and tin accumulated mainly in the slimes, while copper was transferred to the electrolyte and then recovered on the cathode. The best conditions of the alloy treatment were obtained in the sulfuric acid, where the final product was metal of high purity (99% Cu) at the current efficiency of 90%. (b) leaching in ammoniacal solutions of various compositions and then copper electrowinning. Alloy was leached in chloride, carbonate, sulfate and thiosulfate baths. This resulted in the separation of the metals, wherein copper and zinc were transferred to the electrolyte, while metallic tin and silver as well as lead salts remained in the slimes. Copper was selectively recovered from the ammoniacal solutions by the electrolysis, leaving zinc ions in the electrolyte. The best conditions of the alloy treatment were obtained in the ammonia-carbonate system, where the final product was copper of high purity (99.9%) at the current efficiency of 60%. Thiosulfate solution was not applicable for the leaching of the copper alloy due to secondary reactions of the formation of copper (I) thiosulfate complexes and precipitation of copper (I) sulfide.

Keywords: alloy, electrolysis, e-waste, leaching

Procedia PDF Downloads 366

Authors: Adedoyin Opeyemi Osokoya

Abstract:

The study assesses the influence of social media on perceived learning outcome of agricultural science students in tertiary institutions in Oyo state, Nigeria. The four-stage sampling procedure was used to select participants. All students in the seven tertiary institutions that offer agriculture science as a course of study in Oyo State was the population. A university, a college of agriculture and a college of education were sampled, and a department from each was randomly selected. Twenty percent of the students’ population in the respective selected department gave a sample size of 165. Questionnaire was used to collect information on respondents’ personal characteristics and information related to access to social media. Data were analysed using descriptive statistics, chi-square, correlation, and multiple regression at the 0.05 confidence level. Age and household size were 21.13 ± 2.64 years and 6 ± 2.1 persons respectively. All respondents had access to social media, majority (86.1%) owned Android phone, 57.6% and 52.7% use social media for course work and entertainment respectively, while the commonly visited sites were WhatsApp, Facebook, Google, Opera mini. Over half (53.9%) had an unfavourable attitude towards the use of social media for learning; benefits of the use of social media for learning was high (56.4%). Removal of information barrier created by distance (x̄=1.58) was the most derived benefit, while inadequate power supply (x̄=2.36), was the most severe constraints. Age (β=0.23), sex (β=0.37), ownership of Android phone (β=-1.29), attitude (β=0.37), constraints (β =-0.26) and use of social media (β=0.23) were significant predictors of influence on perceived learning outcomes.

Keywords: use of social media, agricultural science students, undergraduates of tertiary institutions, Oyo State of Nigeria

Procedia PDF Downloads 132

Authors: Dmitriy V. Chulkov

Abstract:

Escalation of commitment is defined as continuation of a project after receiving negative information about it. While literature in management and psychology identified various factors contributing to escalation behavior, this phenomenon has received little analysis in economics, potentially due to the apparent irrationality of escalation. In this study, we present an economic model of escalation with asymmetric information in a principal-agent setup where the agents are responsible for a project selection decision and discover the outcome of the project before the principal. Our theoretical model complements the existing literature on several accounts. First, we link the incentive to escalate commitment to a project with the turnover decision by the manager. When a manager learns the outcome of the project and stops it that reveals that a mistake was made. There is an incentive to continue failing projects and avoid admitting the mistake. This incentive is enhanced when the agent may voluntarily resign from the firm before the outcome of the failing project is revealed, and thus not bear the full extent of reputation damage due to project failure. As long as some successful managers leave the firm for extraneous reasons, outside firms find it difficult to link failing projects with certainty to managers that left a firm. Second, we demonstrate that non-CEO managers have reputation concerns separate from those of the CEO, and thus may escalate commitment to projects they oversee, when such escalation can attenuate damage to reputation from impending project failure. Such incentive for escalation will be present for non-CEO managers if the CEO delegates responsibility for a project to a non-CEO executive. If reputation matters for promotion to the CEO, the incentive for a rising executive to escalate in order to protect reputation is distinct from that of a CEO. Third, our theoretical model is supported by empirical analysis of changes in the firm’s operations measured by the presence of discontinued operations at the time of turnover among the top four members of the top management team. Discontinued operations are indicative of termination of failing projects at a firm. The empirical results demonstrate that in a large dataset of over three thousand publicly traded U.S. firms for a period from 1993 to 2014 turnover by top executives significantly increases the likelihood that the firm discontinues operations. Furthermore, the type of turnover matters as this effect is strongest when at least one non-CEO member of the top management team leaves the firm and when the CEO departure is due to a voluntary resignation and not to a retirement or illness. Empirical results are consistent with the predictions of the theoretical model and suggest that escalation of commitment is primarily observed in decisions by non-CEO members of the top management team.

Keywords: discontinued operations, escalation of commitment, executive turnover, top management teams

Procedia PDF Downloads 363

Authors: Jesús M. Martín, Francisco Corona, Dolores Hidalgo

Abstract:

Landfills present long-term threats to soil, air, groundwater and surface water due to the formation of greenhouse gases (methane gas and carbon dioxide) and leachate from decomposing garbage. The composition of leachate differs from site to site and also within the landfill. The leachates alter with time (from weeks to years) since the landfilled waste is biologically highly active and their composition varies. Mainly, the composition of the leachate depends on factors such as characteristics of the waste, the moisture content, climatic conditions, degree of compaction and the age of the landfill. Therefore, the leachate composition cannot be generalized and the traditional treatment models should be adapted in each case. Although leachate composition is highly variable, what different leachates have in common is hazardous constituents and their potential eco-toxicological effects on human health and on terrestrial ecosystems. Since leachate has distinct compositions, each landfill or dumping site would represent a different type of risk on its environment. Nevertheless, leachates consist always of high organic concentration, conductivity, heavy metals and ammonia nitrogen. Leachate could affect the current and future quality of water bodies due to uncontrolled infiltrations. Therefore, control and treatment of leachate is one of the biggest issues in urban solid waste treatment plants and landfills design and management. This work presents a treatment model that will be carried out "in-situ" using a cost-effective novel technology that combines solar evaporation/condensation plus forward osmosis. The plant is powered by renewable energies (solar energy, biomass and residual heat), which will minimize the carbon footprint of the process. The final effluent quality is very high, allowing reuse (preferred) or discharge into watercourses. In the particular case of this work, the final effluents will be reused for cleaning and gardening purposes. A minority semi-solid residual stream is also generated in the process. Due to its special composition (rich in metals and inorganic elements), this stream will be valorized in ceramic industries to improve the final products characteristics.

Keywords: forward osmosis, landfills, leachate valorization, solar evaporation

Procedia PDF Downloads 200

Authors: Jorge Rodriguez-Guerra, Carlos Calleja, Aron Pujana, Ana Maria Macarulla

Abstract:

Hydraulic-press commissioning consumes a great amount of man-hours, due to the fact that it takes place several miles away from where it has been designed. This factor became exacerbated due to control designers’ lack of knowledge about which will be the final controller gains before they start working with it. Virtual commissioning has been postulated as an optimal solution to deal with this lack of knowledge. Here, a case study is presented in which a controller is set up against a real-time model based on a hydraulic-press. The press model is designed following manufacturer specifications and it is embedded in a real-time simulator. This methodology ensures that the model achieves similar responses as the real machine that would be placed on the industry. A deterministic communication protocol is in charge of the bidirectional information transmission between the real-time model and the controller. This platform allows the engineer to test and verify the final control responses with exactly the same hardware that is going to be installed in the hydraulic-press, in other words, realize a virtual commissioning of the electro-hydraulic actuator. The Hardware in the Loop (HiL) platform validates in laboratory conditions and harmless for the machine the control algorithms designed, which allows embedding them afterwards in the industrial environment without further modifications.

Keywords: deterministic communication protocol, electro-hydraulic actuator, hardware in the loop, real-time, virtual commissioning

Procedia PDF Downloads 136

Authors: Inkyong Yi

Abstract:

Acute kidney injury (AKI) in trauma patients is known to be associated with multiple factors, especially shock and consequent inadequate renal perfusion, yet its clinical presentation is little known in severe trauma patients. Our aim was to investigate the clinical presentation of acute kidney injury and its outcome in severe trauma patients at a level I trauma center. A total of 93 consecutive adult trauma patients with an injury severity score (ISS) of more than 15 were analyzed retrospectively from our Level I trauma center data base. Patients with direct renal injury were excluded. Patients were dichotomized into two groups, according to the presence of AKI. Various clinical parameters were compared between two groups, with Student’s T test and Mann-Whitney’s U test. The AKI group was further dichotomized into patients who recovered within seven days, and those who required more than 7days for recovery or those who did not recover at all. Various clinical parameters associated with outcome were further analyzed. Patients with AKI (n=33, 35%) presented with significantly higher age (61.4±17.3 vs. 45.4±17.3, p < 0.0001), incidence of comorbidities (hypertension; 51.5% vs. 13.3%, OR 6.906 95%CI 2.515-18.967, diabetes; 27.3% vs. 6.7%, OR 5.250, 95%CI 1.472-18.722), odds of head and neck trauma (69.7% vs. 41.7%, OR 3.220, 95%CI 1.306-7.942) and presence of shock during emergency room care (66.7% vs 21.7% OR 7.231, 95%CI, 2.798-18.687). Among AKI patients, patients who recovered within 1 week showed lower peak lactate (4.7mmol/L, 95%CI 2.9-6.5 vs 7.3mmol/L, 95%CI 5.0-9.6, p < 0.0287), lesser units of transfusion during first 24 hours (pRBC; 20.4unit, 95%CI 12.5-28.3 vs. 58.9unit, 95%CI 39.4-78.5, p=0.0003, FFP; 16.6unit, 95%CI 6.8-26.4 vs. 56.1unit, 95%CI 26.9-85.2, p=0.0027). In severe trauma patients, patients with AKI showed different clinical presentations and worse outcomes. Initial presence of shock and higher DIC profiles may be important risk factors for AKI in severe trauma patients. In patients with AKI, peak lactate level and amounts of transfusion are related to recovery.

Keywords: acute kidney injury, lactate, transfusion, trauma

Procedia PDF Downloads 197