Search results for: major adverse cardiac events

Authors: Patompong Satapornpong, Therdpong Tempark, Pawinee Rerknimitr, Jettanong Klaewsongkram, Chonlaphat Sukasem

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Dapsone (4, 4’-diaminodiphenyl sulfone, DDS) is broadly used for the treatment of inflammatory diseases and infections such as; leprosy, Pneumocystis jiroveci pneumonia in patients with HIV infection, neutrophilic dermatoses, dermatitis herpetiformis and autoimmune bullous disease. The severe cutaneous adverse drug reactions (SCARs) including, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) are rare but severe life-threatening adverse drug reactions. Dapsone is one of many culprit drugs induced SJS, TEN and DRESS. Notwithstanding, to our knowledge, there are no studies of the association of HLA class I alleles and dapsone-induced SCARs in non-leprosy Thai patients. This investigation was a prospective cohort study, which performed in a total of 45 non-leprosy patients. Fifteen patients of dapsone-induced SCARs were classified as following the RegiSCAR criteria, and 30 dapsone-tolerant controls were exposed to dapsone more than 6 months without any evidence of cutaneous reactions. The genotyping of HLA-A, -B and –C were performed using sequence-specific oligonucleotides (PCR-SSOs). The Ethics Committee of Ramathibodi hospital, Mahidol University, approved this study. Among all HLA class I alleles, HLA-A*24:07, HLA-B*13:01, HLA-B*15:02, HLA-C*03:04 and HLA-C*03:09 were significantly associated with dapsone-induced SCARs (OR = 10.55, 95% CI = 1.06 – 105.04, p = 0.0360; OR = 56.00, 95% CI = 8.27 – 379.22, p = 0.0001; OR = 7.00, 95% CI = 1.17 – 42.00, p = 0.0322; OR = 6.00, 95% CI = 1.24 – 29.07, p = 0.0425 and OR = 17.08, 95% CI = 0.82 – 355.45, p = 0.0321, respectively). Furthermore, HLA-B*13:01 allele had strong association with dapsone-induced SJS-TEN and DRESS when compared with dapsone-tolerant controls (OR = 42.00, 95% CI = 2.88 – 612.31, p = 0.0064 and OR = 63.00, 95% CI = 7.72 – 513.94 and p = 0.0001, respectively). Consequently, HLA-B*13:01 might serve as a pharmacogenetic marker for screening before initiating the therapy with dapsone for prevention of dapsone-induced SCARs.

Keywords: dapsone-induced SCARs, HLA-B*13:01, HLA class I alleles, severe cutaneous adverse reactions, Thai

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Authors: Jasmin H. Kwon , Thomas M. Brinthaupt

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There is a general lack of consumer behavior research on seasonal shopping events. Studying these kinds of events is interesting and important for several reasons. First, global shopping opportunities have implications for cross-cultural shopping events and effects on seasonal events in other countries. Second, seasonal shopping events are subject to economic conditions and may wane in popularity, especially with e-commerce options. Third, retailers can expand the success of their seasonal shopping events by taking advantage of cross-cultural opportunities. Fourth, it is interesting to consider how consumers from other countries might take advantage of different countries’ seasonal shopping events. Many countries have seasonal shopping events such as Black Friday. Research on these kinds of events can lead to the identification of cross-cultural similarities and differences in consumer behavior. We compared shopping motivations of college students who did (n=36) and did not (n=81) shop on Cyber Monday. The results showed that the groups did not differ significantly on any of the shopping motivation subscales. The Cyber Monday shoppers reported being significantly more likely to agree than disagree that their online shopping experience was enjoyable and exciting. They were more likely to disagree than agree that their experience was overwhelming. In addition, they agreed that they shopped only for deals, purchased the exact items they wanted, and thought that their efforts were worth it. Finally, they intended to shop again at next year’s Cyber Monday. It appears that there are many positive aspects to online seasonal shopping, independent of one’s typical shopping motivations. Different countries have seasonal events similar to the Black Friday and Cyber Monday shopping holiday (e.g., Boxing Day, Fukubukuro, China’s Singles Day). In Korea, there is increasing interest in taking advantage of U.S. Black Friday and Cyber Monday opportunities. Government officials are interested in adapting the U.S. holiday to Korean retailers, essentially recreating the Black Friday/Cyber Monday holiday there. Similarly, the Japanese Fukubukuro ('Lucky Bag') holiday is being adapted by other countries such as Korea and the U.S. International shipping support companies are also emerging that help customers to identify and receive products from other countries. U.S. department stores also provide free shipping on international orders for certain items. As these structural changes are occurring and new options for global shopping emerge, the need to understand the role of shoppers’ motivations becomes even more important. For example, the Cyber Monday results are particularly relevant to the new landscape with e-commerce and cross-cultural opportunities, since many of these events involve e-commerce. Within today’s global market, physical location of a retail store is no longer a limitation to growing one’s market share. From a consumer perspective, it is important to investigate how shopping motivations are related to e-commerce seasonal events. From a retail perspective, understanding the shopping motivations of international customers would help retailers to expand and better tailor their seasonal shopping events beyond the boundaries of their own countries. From a collaborative perspective, research on this topic can include interdisciplinary researchers, including those from fashion merchandising, marketing, retailing, and psychology.

Keywords: Black Friday, cross-cultural research, Cyber Monday, seasonal shopping behavior

Procedia PDF Downloads 377

Authors: Luciane Lauffer

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Over the past decade, the expansion of women’s football as a competitive sport has gained more attention from the media and researchers. However, the practice of the sport is not new, and in Asia and Oceania, women’s football has emerged as a common physical activity in many countries since the 1970s. This study recovers the major occurrences that made women’s football possible in an international context, also resulting from the main achievements of the feminist movement in most Westernized countries. Using archival research, the author reviews documents that compose the history of the women’s game, marked by many imposed barriers imposed by social and gender norms. This materials present how women managed their sport in their respective countries and regions, mostly prompted by a spirit of cooperation and partnerships that allowed the staging of major international events. The findings point out that, despite the layers of gendered boundaries that attempted to contain the expansion of the sport, women from Asia and Oceania made the sport flourish and eventually achieving recognition at the international level.

Keywords: women’s football, gender norms, game development, Asia-pacific

Procedia PDF Downloads 94

Authors: Milica Lazic, Jovana Jestrovic

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The aim of this research is to examine moderating role of positive and negative affect, defined as traits, in relationship between a number of stressful life events to which an individual is exposed and life satisfaction. The tendency to experience positive and negative emotions is considered as relatively independent, and life satisfaction depends on presence and intensity of emotions of different valence. However, the role of positive and negative affect can be much more complex. It can change the direction and/or intensity of correlation between a number of stressful life events and life satisfaction. Thus, this question is important for two reasons, (I) better comprehension of inconsistent result of correlation intensity between stressful events and life satisfaction (II) verification on what conditions positive and negative affect have a protective role, and on what conditions the positive and/or negative affect is vulnerability factor. Longitudinal data were collected in two waves from 660 adolescents. Firstly, participants completed the Positive and Negative Affect Schedule. A year later, Life events questionnaire, which measures the number of stressful events in the past six months and Satisfaction with Life Scale were administered. The data were analyzed using hierarchical regression analyses: three-way interaction. The results show that number of life events, positive and negative effect contribute to the level of life satisfaction. The check of moderation role shows the significant three-way interaction of number of life event, and both, positive and negative affect. Individuals who report high level of positive affect, estimate to be moderate to highly satisfied with their lives, regardless of number of stressors to which they are exposed and also how often they experience negative emotions. Individuals, who often experience negative emotions and rarely positive, report the lowest level of life satisfaction. It doesn't change despite the number of stressors they were exposed to. Individuals who report that rarely experience not only positive than also negative emotions estimate different level of life satisfaction depending on number of stressors they were exposed to. Under the influence of numerous stressors, their level of life satisfaction is low, and it's equal to life satisfaction level of individuals who often experience negative and rarely positive emotions. The result of this research shows that tendency to often experience positive emotions is the protective factor in situation when individuals are exposed to high number of stressors. On the other hand, tendency to rarely experience positive emotions present vulnerability factor. Conclusions and practical implications are further discussed.

Keywords: life events, life satisfaction, subjective well-being, positive and negative affect

Procedia PDF Downloads 278

Authors: Kearney Dover, Viviene Temple, Lynneth Stuart-Hill

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Heart Rate Variability (HRV) is the beat-to-beat variation in adjacent heartbeats. HRV is a non-invasive measure of the autonomic nervous system (ANS) and provides information about the sympathetic (SNS) and parasympathetic (PNS) nervous systems. The HRV of a well-conditioned heart is generally high at rest, whereas low HRV has been associated with adverse outcomes/conditions, including congestive heart failure, diabetic neuropathy, depression, and hospital admissions. HRV has received very little research attention among individuals with intellectual disabilities in general or Special Olympic athletes. Purpose: 1) Having a longer post-exercise rest and recovery time to establish how long it takes for the athletes’ HRV components to return to pre-exercise levels, 2) To determine if greater familiarization with the testing processes influences HRV. Participants: Two separate samples of 10 adult Special Olympics athletes will be recruited for 2 separate studies. Athletes will be between 18 and 50 years of age and will be members of Special Olympics BC. Anticipated Findings: To answer why the Special Olympics athletes display poor cardiac responsiveness to changes in autonomic modulation during exercise. By testing the cortisol levels in the athletes, we can determine their stress levels which will then explain their measured HRV.

Keywords: 6MWT, autonomic modulation, cortisol levels, intellectual disability

Procedia PDF Downloads 289

Authors: Alex Eldo Simon, Abhishek Yadav

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This study aimed to evaluate the utility of postmortem computed tomography (CT) and heart weight measurements in the assessment of cardiomegaly in cases of sudden death due to cardiac origin by comparing the results of these two diagnostic methods. The study retrospectively analyzed postmortem computed tomography (PMCT) data from 54 cases of sudden natural death and compared the findings with those of the autopsy. The study involved measuring the cardiothoracic ratio (CTR) from coronal computed tomography (CT) images and determining the actual cardiac weight by weighing the heart during the autopsy. The inclusion criteria for the study were cases of sudden death suspected to be caused by cardiac pathology, while exclusion criteria included death due to unnatural causes such as trauma or poisoning, diagnosed natural causes of death related to organs other than the heart, and cases of decomposition. Sensitivity, specificity, and diagnostic accuracy were calculated, and to evaluate the accuracy of using the cardiothoracic ratio (CTR) to detect an enlarged heart, the study generated receiver operating characteristic (ROC) curves. The cardiothoracic ratio (CTR) is a radiological tool used to assess cardiomegaly by measuring the maximum cardiac diameter in relation to the maximum transverse diameter of the chest wall. The clinically used criteria for CTR have been modified from 0.50 to 0.57 for use in postmortem settings, where abnormalities can be detected by comparing CTR values to this threshold. A CTR value of 0.57 or higher is suggestive of hypertrophy but not conclusive. Similarly, heart weight is measured during the traditional autopsy, and a cardiac weight greater than 450 grams is defined as hypertrophy. Of the 54 cases evaluated, 22 (40.7%) had a cardiothoracic ratio (CTR) ranging from > 0.50 to equal 0.57, and 12 cases (22.2%) had a CTR greater than 0.57, which was defined as hypertrophy. The mean CTR was calculated as 0.52 ± 0.06. Among the 54 cases evaluated, the weight of the heart was measured, and the mean was calculated as 369.4 ± 99.9 grams. Out of the 54 cases evaluated, 12 were found to have hypertrophy as defined by PMCT, while only 9 cases were identified with hypertrophy in traditional autopsy. The sensitivity and specificity of the test were calculated as 55.56% and 84.44%, respectively. The sensitivity of the hypertrophy test was found to be 55.56% (95% CI: 26.66, 81.12¹), the specificity was 84.44% (95% CI: 71.22, 92.25¹), and the diagnostic accuracy was 79.63% (95% CI: 67.1, 88.23¹). The limitation of the study was a low sample size of only 54 cases, which may limit the generalizability of the findings. The comparison of the cardiothoracic ratio with heart weight in this study suggests that PMCT may serve as a screening tool for medico-legal autopsies when performed by forensic pathologists. However, it should be noted that the low sensitivity of the test (55.5%) may limit its diagnostic accuracy, and therefore, further studies with larger sample sizes and more diverse populations are needed to validate these findings.

Keywords: PMCT, virtopsy, CTR, cardiothoracic ratio

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Authors: Kashif Hassan, M.A. Ahanger

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Floods have become more frequent and severe due to effects of global climate change and human alterations of the natural environment. Flood prediction/ forecasting and control is one of the greatest challenges facing the world today. The forecast of floods is achieved by the use of hydraulic models such as HEC-RAS, which are designed to simulate flow processes of the surface water. Extreme flood events in river Jhelum , lasting from a day to few are a major disaster in the State of Jammu and Kashmir, India. In the present study HEC-RAS model was applied to two different reaches of river Jhelum in order to estimate the flood levels corresponding to 25, 50 and 100 year return period flood events at important locations and to deduce flood vulnerability of important areas and structures. The flow rates for the two reaches were derived from flood-frequency analysis of 50 years of historic peak flow data. Manning's roughness coefficient n was selected using detailed analysis. Rating Curves were also generated to serve as base for determining the boundary conditions. Calibration and Validation procedures were applied in order to ensure the reliability of the model. Sensitivity analysis was also performed in order to ensure the accuracy of Manning's n in generating water surface profiles.

Keywords: flood plain, HEC-RAS, Jhelum, return period

Procedia PDF Downloads 409

Authors: Olukayode Bamgbose, Feyisola Agboola, Adewale M. Taiwo, Olanrewaju Olujimi Oluwole Terebo, Azeez Soyingbe, Akeem Bamgbade

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The present study evaluated the contents and health risk assessment of metals determined in milk and milk product samples collected from the Abeokuta market. Forty-five milk and milk product (yoghurt) samples were digested and analysed for selected metals using Atomic Absorption Spectrophotometric method. Health risk assessment was evaluated for hazard quotient (HQ), hazard index (HI), and cancer risk (CR). Data were subjected to descriptive and inferential statistics. The concentrations of Zn, which ranged from 3.24±0.59 to 4.35±0.59 mg/kg, were the highest in the samples. Cr and Cd were measured below the detection limit of the analytical instrument, while the Pb level was higher than the Codex Alimentarius Commission value of 0.02 mg/kg, indicating unsafe for consumption. However, the HQ of Pb and other metals in milk and milk product samples was less than 1.0, thereby establishing no adverse health effects for Pb and other metals. The distribution pattern of metals in milk and milk product samples followed the decreasing order of Zn > Fe > Ni > Co > Cu > Mn > Pb > Cd/Cr. The CR levels of meals were also less than the permissible limit of 1.0 x 10-4, establishing no possible development of cancer. Keywords: adverse effects, cancer, metals, milk, milk product, the permissible limit.

Keywords: adverse effects, cancer, metals, milk, milk product, permissible limit

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Authors: Nisa Mohan

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Adverse drug event (ADE) related hospital admissions are common among older people. The first step in prevention is accurately estimating the prevalence of ADE admissions. Clinical coding is an efficient method to estimate the prevalence of ADE admissions. The objective of the study is to estimate the rate of under-coding of ADE admissions in older people in New Zealand and to explore how clinical coders decide whether or not to code an admission as an ADE. There has not been any research in New Zealand to explore these areas. This study is done using a mixed-methods approach. Two common and serious ADEs in older people, namely bleeding and hypoglycaemia were selected for the study. In study 1, eight hundred medical records of people aged 65 years and above who are admitted to hospital due to bleeding and hypoglycemia during the years 2015 – 2016 were selected for quantitative retrospective medical records review. This selection was made to estimate the proportion of ADE-related bleeding and hypoglycemia admissions that are not coded as ADEs. These files were reviewed and recorded as to whether the admission was caused by an ADE. The hospital discharge data were reviewed to check whether all the ADE admissions identified in the records review were coded as ADEs, and the proportion of under-coding of ADE admissions was estimated. In study 2, thirteen clinical coders were selected to conduct qualitative semi-structured interviews using a general inductive approach. Participants were selected purposively based on their experience in clinical coding. Interview questions were designed in a way to investigate the reasons for the under-coding of ADE admissions. The records review study showed that 35% (Cl 28% - 44%) of the ADE-related bleeding admissions and 22% of the ADE-related hypoglycemia admissions were not coded as ADEs. Although the quality of clinical coding is high across New Zealand, a substantial proportion of ADE admissions were under-coded. This shows that clinical coding might under-estimate the actual prevalence of ADE related hospital admissions in New Zealand. The interviews with the clinical coders added that lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing might be the potential reasons for the under-coding of the ADE admissions. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. These results highlight that further work is needed on interventions to improve the clinical coding of ADE admissions, such as providing education to coders about the importance of ADEs, education to clinicians about the importance of clear and confirmed medical records entries, availing pharmacist service to improve the detection and clear documentation of ADE admissions and including a mandatory field in the discharge summary about external causes of diseases.

Keywords: adverse drug events, bleeding, clinical coders, clinical coding, hypoglycemia

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Authors: Therese Scali

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Couple separations and divorces seem to be commonplace events. However, their frequency does not reduce their impact. Indeed, the adverse effects of parental divorce on children have been well documented. Thus, supporting the children from divorced families is a key concern. Several preventive interventions have been developed for children of divorced parents, such as Children’s Support Group. The present paper aims at presenting the program that has been created in Liege (Belgium). The setting and the tools will be presented. This Children’s Support Group is based on psychoeducational and systemic principles, art-therapy, and aims at acquiring coping skills and seeking social support. Also, the effectiveness of the program will be discussed. Results show that after parental divorce, a group intervention for children can be efficacious in promoting children’s well-being and parent-child communication. This paper contributes to enrich the understanding of children’s needs and to highlight the existence and efficacy of a program that helps them overcome the difficulties of divorce.

Keywords: art-therapy, children’s support group, divorce, efficacy, separation

Procedia PDF Downloads 135

Authors: Habib Abida, Noura Dahri

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Flash floods are among the most serious natural hazards that have disastrous environmental and human impacts. They are associated with exceptional rain events, characterized by short durations, very high intensities, rapid flows and small spatial extent. Flash floods happen very suddenly and are difficult to forecast. They generally cause damage to agricultural crops and property, infrastructures, and may even result in the loss of human lives. The city of Gabes (South-eastern Tunisia) has been exposed to numerous damaging floods because of its mild topography, clay soil, high urbanization rate and erratic rainfall distribution. The risks associated with this situation are expected to increase further in the future because of climate change, deemed responsible for the increase of the frequency and the severity of this natural hazard. Recently, exceptional events hit Gabes City causing death and major property losses. A major flooding event hit the region on June 2nd, 2014, causing human deaths and major material losses. It resulted in the stagnation of storm water in the numerous low zones of the study area, endangering thereby human health and causing disastrous environmental impacts. The characterization of flood risk in Gabes Watershed (South-eastern Tunisia) is considered an important step for flood management. Analytical Hierarchy Process (AHP) method coupled with Monte Carlo simulation and geographic information system were applied to delineate and characterize flood areas. A spatial database was developed based on geological map, digital elevation model, land use, and rainfall data in order to evaluate the different factors susceptible to affect flood analysis. Results obtained were validated by remote sensing data for the zones that showed very high flood hazard during the extreme rainfall event of June 2014 that hit the study basin. Moreover, a survey was conducted from different areas of the city in order to understand and explore the different causes of this disaster, its extent and its consequences.

Keywords: analytical hierarchy process, flash floods, Gabes, remote sensing, Tunisia

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Authors: Hacer Y. Teke, Sultan Pehlivan, Mustafa Karapırlı, Asude Gökmen, Sait Özsoy

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The case is here presented of a patient with DMD with electrocardiograph findings within normal limits who underwent spinal surgery then developed the rarely seen complication of cardiac tamponade which resulted in death. A 17-year old male with DMD was admitted to hospital for spinal surgery. Due to a postoperative drop in hemoglobin, blood transfusion was administered to the patient, no complication developed and he was discharged on the third day. Four days after discharge, the patient worsened at home and an ambulance was called. Before the nearest hospital was reached, the patient died in the ambulance. An autopsy was performed. A fatal but rarely seen complication of Acute Myocardial Infarction (AMI) is myocardial rupture. 85% of ruptures occur in the first week of AMI but just as they can be seen on the day of the infarct, they can also be seen 2 weeks later. The case presented here had infarction findings related to different times and in different areas.

Keywords: duchenne muscular dystrophy, myocardial infarction, myocardial rupture, anesthesia

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Authors: Sk Ajim Ali

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The present study is an attempt to overview on the major environmental and health impacts due to hazardous waste generation and poor management. In present scenario, not only hazardous waste, but as a common term ‘Waste’ is one of the acceptable and thinkable environmental issues. With excessive increasing population, industrialization and standardization of human’s life style heap in extra waste generation which is directly or indirectly related with hazardous waste generation. Urbanization and population growth are solely responsible for establishing industrial sector and generating various Hazardous Waste (HW) and concomitantly poor management practice arising adverse effect on environment and human health. As compare to other Indian state, West Bengal is not too much former in HW generation. West Bengal makes a rank of 7th in HW generation followed by Maharashtra, Gujarat, Tamil Nadu, U.P, Punjab and Andhra Pradesh. During the last 30 years, the industrial sectors in W.B have quadrupled in size, during 1995 there were only 440 HW generating Units in West Bengal which produced 129826 MTA hazardous waste but in 2011, it rose up into 609 units and it produced about 259777 MTA hazardous waste. So, the notable thing is that during a 15 year interval there increased 169 waste generating units but it produced about 129951 MTA of hazardous waste. Major chemical industries are the main sources of HW and causes of adverse effect on the environment and human health. HW from industrial sectors contains heavy metals, cyanides, pesticides, complex aromatic compounds (i.e. PCB) and other chemical which are toxic, flammable, reactive, and corrosive and have explosive properties which highly affect the surrounding environment and human health in and around he disposal sites. The main objective of present study is to highlight on the sources and components of hazardous waste in West Bengal and impacts of improper HW management on health and environment. This study is carried out based on a secondary source of data and qualitative method of research. The secondary data has been collected annual report of WBPCB, WHO’s report, research paper, article, books and so on. It has been found that excessive HW generation from various sources and communities has serious health hazards that lead to the spreading of infectious disease and environmental change.

Keywords: environmental impacts, existing HW generation and management practice, hazardous waste (HW), health impacts, recommendation and planning

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Authors: Van Trieu, Shouhuai Xu, Yusheng Feng

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Tracking attack trajectories can be difficult, with limited information about the nature of the attack. Even more difficult as attack information is collected by Intrusion Detection Systems (IDSs) due to the current IDSs having some limitations in identifying malicious and anomalous traffic. Moreover, IDSs only point out the suspicious events but do not show how the events relate to each other or which event possibly cause the other event to happen. Because of this, it is important to investigate new methods capable of performing the tracking of attack trajectories task quickly with less attack information and dependency on IDSs, in order to prioritize actions during incident responses. This paper proposes a two-level graph causality framework for tracking attack trajectories in internet networks by leveraging observable malicious behaviors to detect what is the most probable attack events that can cause another event to occur in the system. Technically, given the time series of malicious events, the framework extracts events with useful features, such as attack time and port number, to apply to the conditional independent tests to detect the relationship between attack events. Using the academic datasets collected by IDSs, experimental results show that the framework can quickly detect the causal pairs that offer meaningful insights into the nature of the internet network, given only reasonable restrictions on network size and structure. Without the framework’s guidance, these insights would not be able to discover by the existing tools, such as IDSs. It would cost expert human analysts a significant time if possible. The computational results from the proposed two-level graph network model reveal the obvious pattern and trends. In fact, more than 85% of causal pairs have the average time difference between the causal and effect events in both computed and observed data within 5 minutes. This result can be used as a preventive measure against future attacks. Although the forecast may be short, from 0.24 seconds to 5 minutes, it is long enough to be used to design a prevention protocol to block those attacks.

Keywords: causality, multilevel graph, cyber-attacks, prediction

Procedia PDF Downloads 143

Authors: In Kyong Yi, Yun Jeong Chae, Jihoon Hwang, Sook-Young Lee, Jong-Yeop Kim

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Background: Pentax airway scope (AWS) is a recently developed video laryngoscope for use in both normal and difficult airways, providing a good laryngeal view. The purpose of this randomized noninferior study was to evaluate the efficacy of the Pentax-AWS regarding intubation time, laryngeal view and ease of intubation in pediatric patients with normal airway, compared to Macintosh laryngoscope. Method: A total of 136 pediatric patients aged 1 to 10 with American Society of Anesthesiologists physical status I or II undergoing general anesthesia required orotracheal intubation were randomly allocated into two groups: Macintosh laryngoscope (n =68) and Pentax AWS (n=68). Anesthesia was induced with propofol, rocuronium, and sevoflurane. The primary outcome was intubation time. Cormack-Lehane laryngeal view grade, application of optimal laryngeal external manipulation (OELM), intubation difficulty scale (IDS), intubation failure rate and adverse events were also measured. Result: No significant difference was observed between the two groups regarding intubation time (Macintosh; 23[22-26] sec vs. Pentax; 23.5[22-27.75] sec, p=0.713). As for the laryngeal view grade, the Pentax group showed less number of grade 2a or higher grade cases compared to the Macintosh group (1/2a/2b/3; 52.9%/41.2%/4.4%/1.5% vs. 98.5%/1.5%/0%/0%, p=0.000). No optimal laryngeal external manipulation application was required in the Pentax group (38.2% vs. 0%, p=0.000). Intubation difficulty scale resulted in lower values for Pentax group (0 [0-2] vs. 0 [0-0.55], p=0.001). Failure rate was not different between the two groups (1.5% vs. 4.4%, p=0.619). Adverse event-wise, slightly higher incidence of bleeding (1.5% vs. 5.9%, p=0.172) and teeth injury (0% vs. 5.9%, p=0.042) occurred in the Pentax group. Conclusion: In conclusion, Pentax-AWS provided better laryngeal view, similar intubation time and similar success rate compared with Macintosh laryngoscope in children with normal airway. However, the risk of teeth injury might increase and warrant special attention.

Keywords: Pentax-AWS, pediatric, video laryngoscope, intubation

Procedia PDF Downloads 183

Authors: S. B. Rathna Kumar, Sale Kranthi, Sandya K. Varudhini

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The precise perception of spoken language is influenced by several variables, including the listeners’ native language, distance between speaker and listener, reverberation and background noise. When noise is present in an acoustic environment, it masks the speech signal resulting in reduction in the redundancy of the acoustic and linguistic cues of speech. There is strong evidence that bilinguals face difficulty in speech perception for their second language compared with monolingual speakers under adverse listening conditions such as presence of background noise. This difficulty persists even for speakers who are highly proficient in their second language and is greater in those who have learned the second language later in life. The present study aimed to assess the performance of monolingual (Telugu speaking) and bilingual (Tamil as first language and Telugu as second language) speakers on Telugu speech perception task under quiet and noisy environments. The results indicated that both the groups performed similar in both quiet and noisy environments. The findings of the present study are not in accordance with the findings of previous studies which strongly report poorer speech perception in adverse listening conditions such as noise with bilingual speakers for their second language compared with monolinguals.

Keywords: monolingual, bilingual, second language, speech perception, quiet, noise

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Authors: Elham Sharifineyestani, Mohammad Farshchin

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Tropical cyclones are one of the most expensive and deadliest natural disasters. They cause heavy rainfall and serious flash flooding that result in billions of dollars of damage and considerable mortality each year in the United States. Prediction of the frequency of tropical cyclone-induced rainfall events can be helpful in emergency planning and flood risk management. In this study, we have developed a machine-learning model to predict the exceedance frequencies of tropical cyclone-induced rainfall events in the United States. Model results show a satisfactory agreement with available observations. To examine the effectiveness of our approach, we also have compared the result of our predictions with the exceedance frequencies predicted using a physics-based rainfall model by Feldmann.

Keywords: flash flooding, tropical cyclones, frequencies, machine learning, risk management

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Authors: Marie E. Docken

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At some point in the lifecycle of a country, patterns of political and social unrest of varying degrees are observed. Events involving public disorder or civil disobedience may produce effects that range a wide spectrum of varying outcomes, depending on the level of unrest. Many previous studies, primarily theoretical in nature, have attempted to measure public disorder in answering why or how it occurs in society by examining causal factors or underlying issues in the social or political position of a population. The main objective in doing so is to understand how these activities evolve or seek some predictive capability for the events. In contrast, this research involves the fusion of analytics and social studies to provide more knowledge of the public disorder and civil disobedience intensity in populations. With a greater understanding of the magnitude of these events, it is believed that we may learn how they relate to extreme actions such as mass migration or violence. Upon establishing a model for measuring civil unrest based upon empirical data, a case study on various Latin American countries is performed. Interpretations of historical events are combined with analytical results to provide insights regarding the magnitude and effect of social and political activism.

Keywords: public disorder, civil disobedience, Latin America, metrics, data analysis

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Authors: Alexander Heckman, Rohan Goswami, Zachi Attia, Paul Friedman, Peter Noseworthy, Demilade Adedinsewo, Pablo Moreno-Franco, Rickey Carter, Tathagat Narula

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Background: Postoperative atrial fibrillation (POAF) is associated with adverse health consequences, higher costs, and longer hospital stays. Utilizing existing predictive models that rely on clinical variables and circulating biomarkers, multiple societies have published recommendations on the treatment and prevention of POAF. Although reasonably practical, there is room for improvement and automation to help individualize treatment strategies and reduce associated complications. Methods and Results: In this retrospective cohort study of solid organ transplant recipients, we evaluated the diagnostic utility of a previously developed AI-based ECG prediction for silent AF on the development of POAF within 30 days of transplant. A total of 2261 non-cardiac transplant patients without a preexisting diagnosis of AF were found to have a 5.8% (133/2261) incidence of POAF. While there were no apparent sex differences in POAF incidence (5.8% males vs. 6.0% females, p=.80), there were differences by race and ethnicity (p<0.001 and 0.035, respectively). The incidence in white transplanted patients was 7.2% (117/1628), whereas the incidence in black patients was 1.4% (6/430). Lung transplant recipients had the highest incidence of postoperative AF (17.4%, 37/213), followed by liver (5.6%, 56/1002) and kidney (3.6%, 32/895) recipients. The AUROC in the sample was 0.62 (95% CI: 0.58-0.67). The relatively low discrimination may result from undiagnosed AF in the sample. In particular, 1,177 patients had at least 1 AI-ECG screen for AF pre-transplant above .10, a value slightly higher than the published threshold of 0.08. The incidence of POAF in the 1104 patients without an elevated prediction pre-transplant was lower (3.7% vs. 8.0%; p<0.001). While this supported the hypothesis that potentially undiagnosed AF may have contributed to the diagnosis of POAF, the utility of the existing AI-ECG screening algorithm remained modest. When the prediction for POAF was made using the first postoperative ECG in the sample without an elevated screen pre-transplant (n=1084 on account of n=20 missing postoperative ECG), the AUROC was 0.66 (95% CI: 0.57-0.75). While this discrimination is relatively low, at a threshold of 0.08, the AI-ECG algorithm had a 98% (95% CI: 97 – 99%) negative predictive value at a sensitivity of 66% (95% CI: 49-80%). Conclusions: This study's principal finding is that the incidence of POAF is rare, and a considerable fraction of the POAF cases may be latent and undiagnosed. The high negative predictive value of AI-ECG screening suggests utility for prioritizing monitoring and evaluation on transplant patients with a positive AI-ECG screening. Further development and refinement of a post-transplant-specific algorithm may be warranted further to enhance the diagnostic yield of the ECG-based screening.

Keywords: artificial intelligence, atrial fibrillation, cardiology, transplant, medicine, ECG, machine learning

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Authors: I. M. Sujaul, M. A. Sobahan, A. A. Edriyana, F. M. Yahaya, R. M. Yunus

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This study was carried out to investigate the adverse effect of industrial waste water on surface water quality in Gebeng industrial estate, Pahang, Malaysia. Surface water was collected from 6 sampling stations. Physico-chemical parameters were characterized based on in-situ and ex-situ analysis according to standard methods by American Public Health Association (APHA). Selected heavy metals were determined by using Inductively Coupled Plasma Mass Spectrometry (ICP MS). The result reveled that the concentration of heavy metals such as Pb, Cu, Cd, Cr and Hg were high in samples. The result showed that the value of Pb and Hg were higher in the wet season in comparison to dry season. According to Malaysia National Water Quality Standard (NWQS) and Water Quality Index (WQI) all the sampling station were categorized as class IV (highly polluted). The present study reveled that the adverse effects of careless disposal of wastes and directly discharge of effluents affected on surface water quality. Therefore, the authorities should implement the laws to ensure the proper practices of waste water management for environmental sustainability around the study area.

Keywords: water, heavy metals, water quality index, Gebeng

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Authors: Jitendra Pratap, Daphne Prybyszcuk, Luke Elliott, Arnold Ng

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Introduction: Coronary CT angiography is a non-invasive imaging technique for the assessment of coronary artery disease and has high sensitivity and negative predictive value. However, the correlation between the degree of CT coronary stenosis and the significance of hemodynamic obstruction is poor. The assessment of myocardial perfusion has mostly been undertaken by Nuclear Medicine (SPECT), but it is now possible to perform stress myocardial CT perfusion (CTP) scans quickly and effectively using CT scanners with high temporal resolution. Myocardial CTP is in many ways similar to neuro perfusion imaging technique, where radiopaque iodinated contrast is injected intravenously, transits the pulmonary and cardiac structures, and then perfuses through the coronary arteries into the myocardium. On the Siemens Force CT scanner, a myocardial perfusion scan is performed using a dynamic axial acquisition, where the scanner shuffles in and out every 1-3 seconds (heart rate dependent) to be able to cover the heart in the z plane. This is usually performed over 38 seconds. Report: A CT myocardial perfusion scan can be utilised to complement the findings of a CT Coronary Angiogram. Implementing a CT Myocardial Perfusion study as part of a routine CT Coronary Angiogram procedure provides a ‘One Stop Shop’ for diagnosis of coronary artery disease. This case study demonstrates that although the CT Coronary Angiogram was within normal limits, the perfusion scan provided additional, clinically significant information in regards to the haemodynamics within the myocardium of a patient with Hypertrophic Obstructive Cardio Myopathy (HOCM). This negated the need for further diagnostics studies such as cardiac ECHO or Nuclear Medicine Stress tests. Conclusion: CT coronary angiography with adenosine stress myocardial CTP was utilised in this case to specifically exclude coronary artery disease in conjunction with accessing perfusion within the hypertrophic myocardium. Adenosine stress myocardial CTP demonstrated the reduced myocardial blood flow within the hypertrophic myocardium, but the coronary arteries did not show any obstructive disease. A CT coronary angiogram scan protocol that incorporates myocardial perfusion can provide diagnostic information on the haemodynamic significance of any coronary artery stenosis and has the potential to be a “One Stop Shop” for cardiac imaging.

Keywords: CT, cardiac, myocardium, perfusion

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Authors: Eric Muñoz de la Torre, Julián González Trinidad, Efrén González Ramírez

Abstract:

Rain varies greatly in its duration, intensity, and spatial coverage, it is important to have sub-daily rainfall data for various applications, including risk prevention. However, the ground measurements are limited by the low and irregular density of rain gauges. An alternative to this problem are the Satellite Precipitation Products (SPPs) that use passive microwave and infrared sensors to estimate rainfall, as IMERG, however, these SPPs have to be validated before their application. The aim of this study is to evaluate the performance of the IMERG: Integrated Multi-satellitE Retrievals for Global Precipitation Measurament final run V06B SPP in a semi-arid region of Mexico, using 4 automatic rain gauges (pluviographs) sub-daily data of October 2019 and June to September 2021, using the Minimum inter-event Time (MIT) criterion to separate unique rain events with a dry period of 10 hrs. for the purpose of evaluating the rainfall properties (depth, duration and intensity). Point to pixel analysis, continuous, categorical, and volumetric statistical metrics were used. Results show that IMERG is capable to estimate the rainfall depth with a slight overestimation but is unable to identify the real duration and intensity of the rain events, showing large overestimations and underestimations, respectively. The study zone presented 80 to 85 % of convective rain events, the rest were stratiform rain events, classified by the depth magnitude variation of IMERG pixels and pluviographs. IMERG showed poorer performance at detecting the first ones but had a good performance at estimating stratiform rain events that are originated by Cold Fronts.

Keywords: IMERG, rainfall, rain gauge, remote sensing, statistical evaluation

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Authors: Ethan Shafer, Timothy Graziano

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This research seeks to answer whether first-year courses at institutions of higher learning can impact STEM major selection. Unlike many universities, an entry-level technology course (often referred to as CS0) is required for all United States Military Academy (USMA) students–regardless of major–in their first year of attendance. Students at the academy choose their major at the end of their first year of studies. Through student responses to a multi-semester survey, this paper identifies a number of factors that potentially influence STEM major selection. Student demographic data, pre-existing exposure and access to technology, perceptions of STEM subjects, and initial desire for a STEM major are captured before and after taking a CS0 course. An analysis of factors that contribute to student perception of STEM and major selection are presented. This work provides recommendations and suggestions for institutions currently providing or looking to provide CS0-like courses to their students.

Keywords: education, STEM, pedagogy, digital literacy

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Authors: Aniket Alam, Sravya Gurram

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This paper proposes a categorization of sport that is based on the system of rules that a sport must adhere to. We focus on these systems of rules to examine how a winner is produced in different sports. The rules of a sport dictate the game play and the direction it takes. We propose to break down the game play into events. At this junction, we observe two kinds of events that constitute the game play of a sport –ones that follow sequential logic and ones that do not. Our focus is pertained to sports that are comprised of sequential events. To examine these events further, to understand how a winner emerges, we take the help of finite-state automaton from the theory of computation (Automata theory). We showcase how sequential sports are eligible to be represented as finite state machines. We depict these finite state machines as state diagrams. We examine these state diagrams to observe how a team/player reaches the final states of the sport, with a special focus on one final state –the final state which determines the winner. This exercise has been carried out for the following sports: Hurdles, Track, Shot Put, Long Jump, Bowling, Badminton, Pacman and Weightlifting (Snatch). Based on our observations of how this final state of winning is achieved, we propose a categorization of sports.

Keywords: sport classification, sport modelling, ontology, automata theory

Procedia PDF Downloads 100

Authors: Mohd Asharf Ganie, Aafia Rashid, Mohd Afzal Zargar, Showkat Ali Zargar, Syed Mudasar, Tabasum Parvaiz, Zafar Amin Shah

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Accumulating evidence suggests that Vitamin D deficiency (VDD) might at least contribute to the metabolic co-morbidities in PCOS. Hence, we aimed to study the effect of vitamin D supplementation in co-prescription with insulin sensitizers like metformin and pioglitazone on clinical, hormonal and metabolic parameters in women with PCOS. In this open label randomized, controlled trial a total of 120 women with PCOS diagnosis (AE-PCOS 2009 Criteria) were assigned to four treatment groups (n= 30 in each): group I (metformin 1 gm/day in combination with cholecalciferol 4000 IU/day), group II (pioglitazone 30 mg/day in combination with cholecalciferol 4000 IU/day), group III (metformin 1 gm /day) and group IV (pioglitazone 30 mg/day). Vitamin D supplementation was given as 60,000 units every two weeks for 24 weeks. All the subjects were routinely evaluated for clinical, biochemical, hormonal and insulin sensitivity parameters in addition to various safety parameters especially serum calcium levels at baseline and after 24 weeks of the treatment. Our results indicate that 95.5% of PCOS women were vitamin D deficient at baseline. Serum 25 (OH) D levels increased significantly (p < 0.001) in groups I and II without any adverse effects after 24 weeks of oral administration of 4000 IU cholecalciferol daily. However, serum 25 (OH) D levels remained unchanged in group III and IV. By six months, number of menstrual cycles per year increased whereas Ferriman-Gallwey score, serum total testosterone and HOMA-IR decreased significantly (P < 0.001) in the treatment groups supplemented with cholecalciferol as compared to those treated either drug alone. No significant beneficial changes were observed on weight, BMI, blood pressure, glucose tolerance and serum lipids in any of the groups supplemented with cholecalciferol. We conclude that daily dose of 4000 IU cholecalciferol might be a useful adjunct in complex treatment of PCOS with fewer adverse events. Furthermore, pioglitazone and cholecalciferol combination seems to be marginally better although there was no statistical significance.

Keywords: PCOS, vitamin D supplementation, insulin resistance, spironolactone, metformin, pioglitazone

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Authors: Imene Skhakhfa, Lahbaci Ouerdachi

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To ensure the overall coherence of simulated results, it is necessary to develop a robust validation process. In many applications, it is no longer content to calibrate and validate the model only in relation to the hydro graph measured at the outlet, but we try to better simulate the functioning of the watershed in space. Therefore the timing also performs compared to other variables such as water level measurements in intermediate stations or groundwater levels. As part of this work, we limit ourselves to modeling flood of short duration for which the process of evapotranspiration is negligible. The main parameters to identify the models are related to the method of unit hydro graph (HU). Three different models were tested: SNYDER, CLARK and SCS. These models differ in their mathematical structure and parameters to be calibrated while hydrological data are the same, the initial water content and precipitation. The models are compared on the basis of their performance in terms six objective criteria, three global criteria and three criteria representing volume, peak flow, and the mean square error. The first type of criteria gives more weight to strong events whereas the second considers all events to be of equal weight. The results show that the calibrated parameter values are dependent and also highlight the problems associated with the simulation of low flow events and intermittent precipitation.

Keywords: model calibration, intensity, runoff, hydrograph

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Authors: Aliya Hisam, Zia Ul Haq, Sohail Aziz, Patrick Doherty, Jill Pell

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Objective: To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome(post-ACS) patients. Methodology: In a randomized controlled trial, post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counseling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three-time points (baseline, 12 weeks and 24 weeks). Result: At baseline, 160 patients (80 in each group; mean age 52.66+8.46 years; 126 males, 78.75%) were recruited, of which 121(75.62%) continued and were analyzed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs. control 43.87, p<.001) and 24 weeks (53.52 vs. 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs. control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group. Conclusion: MCard is feasible and effective at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.

Keywords: acute coronary syndrome, mobile health augmented cardiac rehabilitation (MCard), cardiovascular diseases, cardiac rehabilitation, health-related quality of life, short form 12, MacNew QLMI

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Authors: F. Kovács, K. Kádár, G. Hosszú, Á. T. Balogh, T. Zsedrovits, N. Kersner, A. Nagy, Gy. Jeney

Abstract:

The paper presents a novel screening method to indicate congenital heart diseases (CHD), which otherwise could remain undetected because of their low level. Therefore, not belonging to the high-risk population, the pregnancies are not subject to the regular fetal monitoring with ultrasound echocardiography. Based on the fact that CHD is a morphological defect of the heart causing turbulent blood flow, the turbulence appears as a murmur, which can be detected by fetal phonocardiography (fPCG). The proposed method applies measurements on the maternal abdomen and from the recorded sound signal a sophisticated processing determines the fetal heart murmur. The paper describes the problems and the additional advantages of the fPCG method including the possibility of measurements at home and its combination with the prescribed regular cardiotocographic (CTG) monitoring. The proposed screening process implemented on a telemedicine system provides an enhanced safety against hidden cardiac diseases.

Keywords: cardiac murmurs, fetal phonocardiography, screening of CHDs, telemedicine system

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Authors: Seyed Fakhroddin Hejazi, Mohammad Saleh Sadeghi, Leili Iranirad

Abstract:

Silent myocardial infarction is defined as the appearance of pathological Q waves in the electrocardiogram, without objective signs of myocardial infarction and any minimal or atypical symptoms. Although this condition has been known for a long time, but little is known about its phenomenon and the mechanisms of it remain unclear. Its coincidence with stroke is also still controversial. This case report introduces a middle-aged man with silent myocardial infarction presented with homonymous hemianopia, which except stage 1 hypertension, had no other major cardiovascular risk factors including diabetes mellitus, hypercholesterolemia, family history of cardiac diseases and smoking. In conclusion, this case report indicated that existence of only one cardiovascular risk factor would lead to the development of MI or stroke.

Keywords: silent myocardial infarction, homonymous hemianopia, stroke, hypertension

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Authors: Naci Büyükkaracığan, Hasan Uzun

Abstract:

Flood is the event which damage to the surrounding lands, residential places, infrastructure and vibrant, because of the streams overflow events from its bed for several reasons. Flood is a natural formation which develops due to its region's climatic conditions, technical and topographical characteristics. However, factors causing floods with global warming caused by human activity are events such as uncontrolled urbanization. Floods in Turkey are natural disasters which cause huge economic losses after the earthquake. At the same time, the flood disaster is one of the most observed hydrometeorological disasters, compared to 30%, in Turkey. Every year, there are around 200 flood-flood disasters and the disaster as a result of financial losses of $ 100 million per year are reported to occur in public institutions. The amount allocated for carrying out investment-project activities for reducing and controlling of flood damage control are around US $ 30 million per year. The existence of a linear increase in the number of flood disasters is noteworthy due to various reasons in the last 50 years of observation. In this study, first of all, big events of the flood in Turkey and their reasons were examined. And then, the information about the work to be done in order to prevent flooding by government was given with examples. Meteorological early warning systems, flood risk maps and regulation of urban development studies are described for this purpose. As a result, recommendations regarding in the event of the occurrence of floods disaster management were issues raised.

Keywords: flood, disaster, disaster management, Türkiye

Procedia PDF Downloads 303