Search results for: post mortem interval
4748 American Criminal Justice Responses to Terrorism in the Post 9/11 Era
Authors: Summer Jackson
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September 11, 2001 terrorist attacks exposed weaknesses in federal law enforcement’s ability to proactively counter threats to American homeland security. Following the attacks, legislative reforms and policy changes cleared both bureaucratic and legal obstacles to anti-terrorism efforts. The Federal Bureau of Investigation (FBI) transformed into a domestic intelligence agency responsible for preventing future terrorist attacks. Likewise, the passage of the 2001 USA Patriot Act gave federal agents new discretionary powers to more easily collect intelligence on those suspected of supporting terrorism. Despite these changes, there has been only limited scholarly attention paid to terrorism responses by the federal criminal justice system. This study sought to examine the investigative and prosecutorial changes made in the Post-9/11 era. The methodology employed bivariate and multivariate statistics using data from the American Terrorism Study (ATS). This analysis examined how policy changes are reflected in the nature of terrorism investigations, the handling of terrorist defendants by federal prosecutors, and the outcomes of terrorism cases since 2001. The findings indicate significant investigative and prosecutorial changes in the Post-9/11 era. Specifically, this study found terrorism cases involved younger defendants, fewer indictees per case, less use of human intelligence, less complicated attacks, less serious charges, and more plea bargains. Overall, this study highlights the important shifts in responses to terrorism following the 9/11 attacks.Keywords: terrorism, law enforcement, post-9/11, federal policy
Procedia PDF Downloads 1204747 Actor Training in Social Work Education: A Pilot Study of Theatre Workshops to Enhance Clinical Empathy
Authors: Amanda Coleman, Estefanía Gonzalez
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Empathy is considered an essential skill for engaging with social work clients. Drawing from developments in medical education, researchers will conduct and evaluate a three-part pilot theatre workshop with master level social work students (n ≈ 30) to evaluate the workshop's ability to enhance empathy among participants. Outcomes will be measured using semi-structured post-intervention interviews with a subset of participants (n ≈ 10) as well post-intervention written reflections and pre-and-post intervention quantitative evaluation of empathy using King and Holosko’s 2011 Empathy Scale for Social Workers. The content of the workshop will differ from traditional role plays, which are common in social work education, in that it will draw from role theory and research on creative empathy to emphasize role reversal with clients. Workshops will be held February and March of 2017 with preliminary findings available by April.Keywords: education, empathy, social work, theatre
Procedia PDF Downloads 2754746 A Randomised Controlled Study to Compare Efficacy and Safety of Bupivacaine plus Dexamethasone Versus Bupivacaine plus Fentanyl for Caudal Block in Children
Authors: Ashwini Patil
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Caudal block is one of the most commonly used regional anesthetic techniques in children. Currently, fentanyl is used as an adjuvant to bupivacaine to prolong analgesia but fentanyl is a narcotic. Dexamethasone, a glucocorticoid with strong anti-inflammatory effects provides improvement in post-operative analgesia and post-operative side effects. However, its analgesic efficacy and safety in comparison with fentanyl has not been extensively studied. So the objective of this randomized controlled study is to compare dexamethasone with fentanyl as an adjuvant to bupivacaine for caudal block in children in relation to the duration of caudal analgesia, post-operative analgesic requirement and incidence of post-operative nausea and vomiting. This study included 100 children, aged 1–6 years, undergoing lower abdominal surgeries. Patients were randomized into two groups, 50 each to receive a combination of dexamethasone 0.2 mg/kg along with 1 ml/kg bupivacaine 0.25% (group A) or combination of fentanyl (1 ug/kg) along with 1ml/kg bupivacaine 0.25% (group B). In the post-operative period, pain was assessed using a Modified Objective Pain Scale (MOPS) until 12 hr after surgery and rescue analgesia is administered when MOPS score 4 or more is recorded. Residual motor block, number of analgesic doses required within 24 hr after surgery, sedation scores, intra-operative and post-operative hemodynamic variables, post-operative nausea and vomiting (PONV), and other adverse effects were recorded. Data is analysed using unpaired t test and Significance level of P< 0.05 is considered statistically significant. Group A showed a significantly longer time to first analgesic requirement than group B (p<0.05). The number of rescue analgesic doses required in the first 24 h was significantly less in group A (p<0.05). Group A showed significantly lower MOPS scores than group B(p<0.05). Intra-operative and post-operative hemodynamic variables, Modified Bromage Scale scores, and sedation scores were comparable in both the groups. Group A showed significantly fewer incidences of PONV compared with group B(p<0.05). This study reveals that adding dexamethasone to bupivacaine prolongs the duration of postoperative analgesia and decreases the incidence of PONV as compared to combination of fentanyl to bupivacaine after a caudal block in pediatric patients.Keywords: bupivacaine, caudal analgesia, dexamethasone, pediatric
Procedia PDF Downloads 2084745 Vénus Noire: A (Post)Colonial Gaze
Authors: Hania Pasandi
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Over his first three films, Abdellatif Kechiche established himself as one of the most celebrated directors at work in twenty-first-century French cinema. While his first three movies, La Faute à Voltaire (2000), L’Esquive (2003), and La Graine et le mulet (2007) tell stories about individuals of the Maghrebi origin or descent struggling to find their place in the contemporary French Republic, his 2010’s movie, Vénus noire (2010) recounts the true story of the so-called ‘Hottentot Venus’, Saartjie Baartman, who became famous after her stage appearances in London and Paris in the early eighteenth century. The movie shows the complex ways in which gender and ethnicity can combine in exclusionary discourse. This paper studies gender and racial identities, the irony of science theorisation about ethnicities through the male colonial gaze on a heavily exhibited woman. This paper explores how Vénus Noire engages the spectator’s own corporeal awareness of violence and calls attention to the othering practices of (post)colonial times.Keywords: gender, (post)colonial gaze, other, violence
Procedia PDF Downloads 1404744 Deep Brain Stimulation and Motor Cortex Stimulation for Post-Stroke Pain: A Systematic Review and Meta-Analysis
Authors: Siddarth Kannan
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Objectives: Deep Brain Stimulation (DBS) and Motor Cortex stimulation (MCS) are innovative interventions in order to treat various neuropathic pain disorders such as post-stroke pain. While each treatment has a varying degree of success in managing pain, comparative analysis has not yet been performed, and the success rates of these techniques using validated, objective pain scores have not been synthesised. The aim of this study was to compare the effect of pain relief offered by MCS and DBS on patients with post-stroke pain and to assess if either of these procedures offered better results. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines (PROSPEROID CRD42021277542). Three databases were searched, and articles published from 2000 to June 2023 were included (last search date 25 June 2023). Meta-analysis was performed using random effects models. We evaluated the performance of DBS or MCS by assessing studies that reported pain relief using the Visual Analogue Scale (VAS). Data analysis of descriptive statistics was performed using SPSS (Version 27; IBM; Armonk; NY; USA). R statistics (Rstudio Version 4.0.1) was used to perform meta-analysis. Results: Of the 478 articles identified, 27 were included in the analysis (232 patients- 117 DBS & 115 MCS). The pooled number of patients who improved after DBS was 0.68 (95% CI, 0.57-0.77, I2=36%). The pooled number of patients who improved after MCS was 0.72 (95% CI, 0.62-0.80, I2=59%). Further sensitivity analysis was done to include only studies with a minimum of 5 patients in order to assess if there was any impact on the overall results. Nine studies each for DBS and MCS met these criteria. There seemed to be no significant difference in results. Conclusions: The use of surgical interventions such as DBS and MCS is an upcoming field for the treatment of post-stroke pain, with limited studies exploring and comparing these two techniques. While our study shows that MCS might be a slightly better treatment option, further research would need to be done in order to determine the appropriate surgical intervention for post-stroke pain.Keywords: post-stroke pain, deep brain stimulation, motor cortex stimulation, pain relief
Procedia PDF Downloads 1394743 Research Methodology and Mixed Methods (Qualitative and Quantitative) for Ph.D. Construction Management – Post-Disaster Reconstruction
Authors: Samuel Quashie
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Ph.D. Construction Management methodology and mixed methods are organized to guide the researcher to assemble and assess data in the research activities. Construction management research is close to business management and social science research. It also contributes to researching the phenomenon and answering the research question, generating an integrated management system for post-disaster reconstruction in construction and related industries. Research methodology and methods drive the research to achieve the goal or goals, contribute to knowledge, or increase knowledge. This statement means the research methodology, mixed methods, aim, objectives, and processes address the research question, facilitate its achievement and foundation to conduct the study. Mixed methods use project-based case studies, interviews, observations, literature and archival document reviews, research questionnaires, and surveys, and evaluation of integrated systems used in the construction industry and related industries to address the research work. The research mixed methods (qualitative, quantitative) define the research topic and establish a more in-depth study. The research methodology is action research, which involves the collaboration of participants and service users to collect and evaluate data, studying the phenomenon, research question(s) to improve the situation in post-disaster reconstruction phase management.Keywords: methodology, Ph.D. research, post-disaster reconstruction, mixed-methods qualitative and quantitative
Procedia PDF Downloads 2314742 Effects of Evening vs. Morning Training on Motor Skill Consolidation in Morning-Oriented Elderly
Authors: Maria Korman, Carmit Gal, Ella Gabitov, Avi Karni
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The main question addressed in this study was whether the time-of-day wherein training is afforded is a significant factor for motor skill ('how-to', procedural knowledge) acquisition and consolidation into long term memory in the healthy elderly population. Twenty-nine older adults (60-75 years) practiced an explicitly instructed 5-element key-press sequence by repeatedly generating the sequence ‘as fast and accurately as possible’. Contribution of three parameters to acquisition, 24h post-training consolidation, and 1-week retention gains in motor sequence speed was assessed: (a) time of training (morning vs. evening group) (b) sleep quality (actigraphy) and (c) chronotype. All study participants were moderately morning type, according to the Morningness-Eveningness Questionnaire score. All participants had sleep patterns typical of age, with average sleep efficiency of ~ 82%, and approximately 6 hours of sleep. Speed of motor sequence performance in both groups improved to a similar extent during training session. Nevertheless, evening group expressed small but significant overnight consolidation phase gains, while morning group showed only maintenance of performance level attained at the end of training. By 1-week retention test, both groups showed similar performance levels with no significant gains or losses with respect to 24h test. Changes in the tapping patterns at 24h and 1-week post-training were assessed based on normalized Pearson correlation coefficients using the Fisher’s z-transformation in reference to the tapping pattern attained at the end of the training. Significant differences between the groups were found: the evening group showed larger changes in tapping patterns across the consolidation and retention windows. Our results show that morning-oriented older adults effectively acquired, consolidated, and maintained a new sequence of finger movements, following both morning and evening practice sessions. However, time-of-training affected the time-course of skill evolution in terms of performance speed, as well as the re-organization of tapping patterns during the consolidation period. These results are in line with the notion that motor training preceding a sleep interval may be beneficial for the long-term memory in the elderly. Evening training should be considered an appropriate time window for motor skill learning in older adults, even in individuals with morning chronotype.Keywords: time-of-day, elderly, motor learning, memory consolidation, chronotype
Procedia PDF Downloads 1364741 Sunflower Oil as a Nutritional Strategy to Reduce the Impacts of Heat Stress on Meat Quality and Dirtiness Pigs Score
Authors: Angela Cristina Da F. De Oliveira, Salma E. Asmar, Norbert P. Battlori, Yaz Vera, Uriel R. Valencia, Tâmara D. Borges, Antoni D. Bueno, Leandro B. Costa
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The present study aimed to evaluate the replacement of 5% of starch per 5% of sunflower oil (SO) on meat quality and animal welfare of growing and finishing pigs (Iberic x Duroc), exposed to a heat stress environment. The experiment lasted 90 days, and it was carried out in a randomized block design, in a 2 x 2 factorial, composed of two diets (starch or sunflower oil (with or without) and two feed intake management (ad libitum and restriction). Seventy-two crossbred males (51± 6,29 kg body weight - BW) were housed in climate-controlled rooms, in collective pens and exposed to heat stress environment (32°C; 35% to 50% humidity). The treatments studies were: 1) control diet (5% starch x 0% SO) with ad libitum intake (n = 18); 2) SO diet (replacement of 5% of starch per 5% of SO) with ad libitum intake (n = 18); 3) control diet with restriction feed intake (n = 18); or 4) SO diet with restriction feed intake (n = 18). Feed were provided in two phases, 50-100 Kg BW for growing and 100-140 Kg BW for finishing, respectively. Within welfare evaluations, dirtiness score was evaluated all morning during ninety days of the experiment. The presence of manure was individually measured based on one side of the pig´s body and scored according to: 0 (less than 20% of the body surface); 1 (more than 20% but less than 50% of the body surface); 2 (over 50% of the body surface). After the experimental period, when animals reach 130-140 kg BW, they were slaughtered using carbon dioxide (CO2) stunning. Carcass weight, leanness and fat content, measured at the last rib, were recorded within 20 min post-mortem (PM). At 24h PM, pH, electrical conductivity and color measures (L, a*, b*) were recorded in the Longissimus thoracis and Semimembranosus muscles. Data shown no interaction between diet (control x SO) and management feed intake (ad libitum x restriction) on the meat quality parameters. Animals in ad libitum management presented an increase (p < 0.05) on BW, carcass weight (CW), back fat thickness (BT), and intramuscular fat content (IM) when compared with animals in restriction management. In contrast, animals in restriction management showing a higher (p < 0.05) carcass yield, percentage of lean and loin thickness. To welfare evaluations, the interaction between diet and management feed intake did not influence the degree of dirtiness. Although, the animals that received SO diet, independently of the management, were cleaner than animals in control group (p < 0,05), which, for pigs, demonstrate an important strategy to reduce body temperature. Based in our results, the diet and management feed intake had a significant influence on meat quality and animal welfare being considered efficient nutritional strategies to reduce heat stress and improved meat quality.Keywords: dirtiness, environment, meat, pig
Procedia PDF Downloads 2634740 Portrayal of Pak-US Relations in Perspective of Bin Laden Killing by the Leading American and British Newspapers: A Content Analysis of the Guardian, the Telegraph, Washington Post and the New York Times
Authors: Shahzad Ali
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This article expounds the coverage of Pak-US relations in the context of Osama Bin Laden killing in four selected leading newspapers of UK and the US viz The Telegraph, The Guardian, The New York Times and The Washington Post during the specific time period of three months, i.e., April-June, 2011. The study is scrutinized on the basis of Operation Neptune Spear. The research study is theoretically linked with the propaganda model of Herman and Chomsky and the Shoemaker and Reeve‘s theory of content effect, specifically the impact of foreign policy as a driving instrument influencing the nature and treatment of the coverage of Pak-US relations. The relations between Pakistan and USA are of great importance in the context of Bin Laden. The Pak-US relations were less aggravated and hostile in pre OBL period but post OBL period worsened these relations. It is also interesting to mention that the policies of these newspapers were dependent on the foreign policy of their countries. It was explored that the news coverage was found favorable as and when the relations Pakistan and the US or UK were cordial and smooth. And it turned into negative and unfavorable when the relations were in strain and deteriorating and endorsed various studies that the Western mainstream media tried to be more nationalistic in projecting official stance while covering foreign coverage instead of adhering to universal cannon of journalism, i.e., objectivity, fairness, and neutrality, etc. Overall 219 news items of these four selected newspapers regarding Pak-US relations in the context of pre and post OBL’s killing operation were undertaken for analysis. The ratio of negative slants was found higher as compared to the positive and neutral slants. Besides, the ratio of news items with unfavorable frames was found higher in post OBL operation in comparison of pre-era of the coverage related to Pak-US relations in the leading British and American newspapers.Keywords: Osama Bin Laden, Pakistan, USA, UK, relations, Guardian, Washington Post, Telegraph, New York Times, Operation Neptune Spear
Procedia PDF Downloads 1734739 Expand Rabies Post-Exposure Prophylaxis to Where It Is Needed the Most
Authors: Henry Wilde, Thiravat Hemachudha
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Human rabies deaths are underreported worldwide at 55,000 annual cases; more than of dengue and Japanese encephalitis. Almost half are children. A recent study from the Philippines of nearly 2,000 rabies deaths revealed that none of had received incomplete or no post exposure prophylaxis. Coming from a canine rabies endemic country, this is not unique. There are two major barriers to reducing human rabies deaths: 1) the large number of unvaccinated dogs and 2) post-exposure prophylaxis (PEP) that is not available, incomplete, not affordable, or not within reach for bite victims travel means. Only the first barrier, inadequate vaccination of dogs, is now being seriously addressed. It is also often not done effectively or sustainably. Rabies PEP has evolved as a complex, prolonged process, usually delegated to centers in larger cities. It is virtually unavailable in villages or small communities where most dog bites occur, victims are poor and usually unable to travel a long distance multiple times to receive PEP. Reseacrh that led to better understanding of the pathophysiology of rabies and immune responses to potent vaccines and immunoglobulin have allowed shortening and making PEP more evidence based. This knowledge needs to be adopted and applied so that PEP can be rendered safely and affordably where needed the most: by village health care workers who have long performed more complex services after appropriate training. Recent research makes this an important and long neglected goal that is now within our means to implement.Keywords: rabies, post-exposure prophylaxis, availability, immunoglobulin
Procedia PDF Downloads 2644738 A Pilot Study to Investigate the Use of Machine Translation Post-Editing Training for Foreign Language Learning
Authors: Hong Zhang
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The main purpose of this study is to show that machine translation (MT) post-editing (PE) training can help our Chinese students learn Spanish as a second language. Our hypothesis is that they might make better use of it by learning PE skills specific for foreign language learning. We have developed PE training materials based on the data collected in a previous study. Training material included the special error types of the output of MT and the error types that our Chinese students studying Spanish could not detect in the experiment last year. This year we performed a pilot study in order to evaluate the PE training materials effectiveness and to what extent PE training helps Chinese students who study the Spanish language. We used screen recording to record these moments and made note of every action done by the students. Participants were speakers of Chinese with intermediate knowledge of Spanish. They were divided into two groups: Group A performed PE training and Group B did not. We prepared a Chinese text for both groups, and participants translated it by themselves (human translation), and then used Google Translate to translate the text and asked them to post-edit the raw MT output. Comparing the results of PE test, Group A could identify and correct the errors faster than Group B students, Group A did especially better in omission, word order, part of speech, terminology, mistranslation, official names, and formal register. From the results of this study, we can see that PE training can help Chinese students learn Spanish as a second language. In the future, we could focus on the students’ struggles during their Spanish studies and complete the PE training materials to teach Chinese students learning Spanish with machine translation.Keywords: machine translation, post-editing, post-editing training, Chinese, Spanish, foreign language learning
Procedia PDF Downloads 1444737 COVID-19 Pandemic and Disruptions in Nigeria’s Domestic Economic Activities: A Pre-post Empirical Investigation
Authors: Amaefule, Leonard Ifeanyi
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The study evaluated the disruptions in Nigeria’s domestic economic activities occasioned by the COVID-19 pandemic: a pre and post-pandemic investigation approach. Domestic economic activities were measured with composite manufacturing purchasing managers index (PMI) and composite non-manufacturing PMI. Production and employment levels indices were proxies for composite manufacturing PMI, while business activities and employment level indices were proxies for non-manufacturing PMI. Data for these indices were sourced from monthly and quarterly publications of the Central Bank of Nigeria for periods covering fifteen (15) months before and 15 months after the outbreak of the virus in Nigeria. Test of equality of means was employed in establishing the significance of the difference of means between the pre and post-pandemic domestic economic activities. Results from the analysis indicated that a significant negative difference exists in each of the measures of domestic economic activities between the pre and post-pandemic periods. These findings, therefore, offer empirical evidence that the COVID-19 pandemic has disrupted domestic economic activities in Nigeria; thus, it exerts a negative influence on the measures of the nation’s domestic economic activities. The study thus recommended (among other things) that the Nigerian government should focus on policies that would enhance domestic production, employment and enhance business activities.Keywords: COVID-19, domestic economic activities, composite manufacturing indices, composite non-manufacturing indices
Procedia PDF Downloads 1794736 Estimation of a Finite Population Mean under Random Non Response Using Improved Nadaraya and Watson Kernel Weights
Authors: Nelson Bii, Christopher Ouma, John Odhiambo
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Non-response is a potential source of errors in sample surveys. It introduces bias and large variance in the estimation of finite population parameters. Regression models have been recognized as one of the techniques of reducing bias and variance due to random non-response using auxiliary data. In this study, it is assumed that random non-response occurs in the survey variable in the second stage of cluster sampling, assuming full auxiliary information is available throughout. Auxiliary information is used at the estimation stage via a regression model to address the problem of random non-response. In particular, the auxiliary information is used via an improved Nadaraya-Watson kernel regression technique to compensate for random non-response. The asymptotic bias and mean squared error of the estimator proposed are derived. Besides, a simulation study conducted indicates that the proposed estimator has smaller values of the bias and smaller mean squared error values compared to existing estimators of finite population mean. The proposed estimator is also shown to have tighter confidence interval lengths at a 95% coverage rate. The results obtained in this study are useful, for instance, in choosing efficient estimators of the finite population mean in demographic sample surveys.Keywords: mean squared error, random non-response, two-stage cluster sampling, confidence interval lengths
Procedia PDF Downloads 1414735 Effectiveness of Mobile Health Augmented Cardiac Rehabilitation (MCard) on Health-Related Quality of Life among Post-Acute Coronary Syndrome Patients: A Randomized Controlled Trial
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
Procedia PDF Downloads 1684734 Control of Biofilm Formation and Inorganic Particle Accumulation on Reverse Osmosis Membrane by Hypochlorite Washing
Authors: Masaki Ohno, Cervinia Manalo, Tetsuji Okuda, Satoshi Nakai, Wataru Nishijima
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Reverse osmosis (RO) membranes have been widely used for desalination to purify water for drinking and other purposes. Although at present most RO membranes have no resistance to chlorine, chlorine-resistant membranes are being developed. Therefore, direct chlorine treatment or chlorine washing will be an option in preventing biofouling on chlorine-resistant membranes. Furthermore, if particle accumulation control is possible by using chlorine washing, expensive pretreatment for particle removal can be removed or simplified. The objective of this study was to determine the effective hypochlorite washing condition required for controlling biofilm formation and inorganic particle accumulation on RO membrane in a continuous flow channel with RO membrane and spacer. In this study, direct chlorine washing was done by soaking fouled RO membranes in hypochlorite solution and fluorescence intensity was used to quantify biofilm on the membrane surface. After 48 h of soaking the membranes in high fouling potential waters, the fluorescence intensity decreased to 0 from 470 using the following washing conditions: 10 mg/L chlorine concentration, 2 times/d washing interval, and 30 min washing time. The chlorine concentration required to control biofilm formation decreased as the chlorine concentration (0.5–10 mg/L), the washing interval (1–4 times/d), or the washing time (1–30 min) increased. For the sample solutions used in the study, 10 mg/L chlorine concentration with 2 times/d interval, and 5 min washing time was required for biofilm control. The optimum chlorine washing conditions obtained from soaking experiments proved to be applicable also in controlling biofilm formation in continuous flow experiments. Moreover, chlorine washing employed in controlling biofilm with suspended particles resulted in lower amounts of organic (0.03 mg/cm2) and inorganic (0.14 mg/cm2) deposits on the membrane than that for sample water without chlorine washing (0.14 mg/cm2 and 0.33 mg/cm2, respectively). The amount of biofilm formed was 79% controlled by continuous washing with 10 mg/L of free chlorine concentration, and the inorganic accumulation amount decreased by 58% to levels similar to that of pure water with kaolin (0.17 mg/cm2) as feed water. These results confirmed the acceleration of particle accumulation due to biofilm formation, and that the inhibition of biofilm growth can almost completely reduce further particle accumulation. In addition, effective hypochlorite washing condition which can control both biofilm formation and particle accumulation could be achieved.Keywords: reverse osmosis, washing condition optimization, hypochlorous acid, biofouling control
Procedia PDF Downloads 3524733 The Relationship between EFL Learners' Self-Regulation and Willingness to Communicate
Authors: Mania Nosratinia, Zahra Deris
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The purpose of the present study was to investigate the relationship between EFL learners' self-regulation (SR) and willingness to communicate (WTC). To this end, 520 male and female EFL learners, ranging between 19 and 34 years old (Mage = 26), majoring in English Translation, English Language Teaching and English Literature at Islamic Azad University, Fars Province, were randomly selected. They were given two questionnaires: Self-Regulation Questionnaire devised by Brown, Miller, and Lawendowski (1999) and Willingness to Communicate Scale devised by McCroskey and Baer (1985). Preliminarily, pertinent analyses were performed on the data to check the assumptions of normality, linearity, and homoscedasticity. Since the assumption of normality was violated, Spearman's rank-order correlation was employed to probe the relationships between SR and WTC. The results indicated a significant and positive correlation between the two variables, ρ = .56, n = 520, p < .05, which signified a large effect size supplemented by a very small confidence interval (0.503 – 0.619). The results of the Kruskal-Wallis tests indicated that there is a statistically significant difference in WTC score between the different levels of SR, χ2(2) = 157.843, p = 0.000 with a mean rank SR score of 128.13 for low-SR level, 286.64 for mid-SR level, and 341.12 for high-SR level. Also, a post-hoc comparison through running a Dwass-Steel-Critchlow-Fligner indicated significant differences among the SR level groups on WTC scores. Given the findings of the study, the obtained results may help EFL teachers, teacher trainers, and material developers to possess a broader perspective towards the TEFL practice and to take practical steps towards the attainments of the desired objectives and effective instruction.Keywords: EFL learner, self-regulation, willingness to communicate, relationship
Procedia PDF Downloads 3324732 Impact of an Exercise Program on Physical Fitness of a Candidate to Naval Academy: A Case Study
Authors: Ricardo Chaves, Carlos Vasconcelos
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Candidates to join the Naval Academy have to take a set of physical tests, which is crucial for a high level of physical fitness. Thus, the planning of physical exercises for candidates to the Naval School must take into account the improvement of their physical fitness. The aim of this study was to investigate the impact of a 6-month exercise program to improve the physical fitness of an individual who will apply for the Naval Academy. This was a non-experimental pre-post-evaluation study. The patient was male, had 18 years old, and a body mass index of 21.1 kg.m². The patient participated in a 6-month aerobic and strength exercise program (3 sessions per week, 75 minutes duration each session). Physical fitness tests were performed according to the physical fitness requirements for entry into the Naval academy (muscle strength [maximum number of lifts and maximum number of sit-ups for 1 minute]; aerobic fitness [2.4 km run and 200 m swimming test]) before (baseline) and after the exercise intervention (6 months). Regarding muscle strength, in the abdominal test, the improvements between the pre-test (39 abdominals.) and post-test (61 abdominals) were 56.4%. For elevations, there was an increase in its number by 150% between the pre-test (4 elevations) and post-test (10 elevations). With regard to aerobic fitness, in the 2.4 km race, there was an evolution of 32.0% between the pre-test (16.46 min.) and the post-test (12.42 min.). For the 200-meter swimming test, there was a negative variation of 2% between the pre-test (2.25 min.) and post-test (2.28 min). A 6-month aerobic and strength exercise program leads to a positive evolution in the muscular strength of the patient. Regarding aerobic fitness, opposite results were found, with a positive evolution in the 2.4 km running test and a negative evolution in the swimming test. In future exercise programs for the improvement of the physical fitness of candidates for the Naval Academy, more emphasis has to be done on specific swimming training.Keywords: case study, exercise program, Naval Academy, physical fitness
Procedia PDF Downloads 924731 Predictors and 3-Year Outcomes of Compromised Left Circumflex Coronary Artery After Left Main Crossover Stenting
Authors: Hameed Ullah, Karim Elakabawi, Han KE, Najeeb Ullah, Habib Ullah, Sardar Ali Shah, Hamad Haider Khan, Muhammad Asad Khan, Ning Guo, Zuyi Yuan
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Background: Predictors of decreased fractional flow reserve at left circumflex coronary artery after left main (LM) crossover stenting are still lacking. The objectives of the present study were to provide the predictors for low Fractional flow reserve (FFR) at coronary artery (LCx) and the possible treatment strategies for the compromised LCx-together with their long term outcomes. Methods: A total of 563 included patients out of 1974 patients admitted to our hospital from February 2015 to November 2020 with significant distal LM-bifurcation lesions. The enrolled patients underwent single-stent cross-over PCI under IVUS guidance with further LCx intervention as indicated by measured FFR. Results: The included patients showed angiographic significant LCx ostial affection after LM-stenting, but only 116 (20.6%) patients had FFR <0.8. The 3-year composite MACE rates were comparable between the high and low FFR groups (16.8% vs. 15.5%, respectively; P=0.744). In a multivariable analysis, a low FFR in the LCx was associated with post-stenting MLA of the LCx (OR: 0.032, P <0.001), post-stenting LCx-plaque burden (OR: 1.166, P <0.001), post-stenting LM-MLA (OR: 0.821, P =0.038) and pre-stenting LCx-MLA (OR: 0.371, P =0.044). In patients with low FFR, management of compromised LCx with DEB had the lowest 3-year MACE rate (8.1%) as compared to either KBI (17.5%) or stenting group (20.5%), P =0.299. Conclusion: FFR-guided LCx intervention can avoid unnecessary LCx intervention. The post-stenting predictors of low FFR include post-stenting MLA and plaque burden of the LCx and MV stent length. The 3-year MACE rates were comparable between high FFR patients and patients who had low FFR and were adequately managed.Keywords: fractional flow reserve, left main stem, percutaneous coronary interventions, intravascular ultrasound
Procedia PDF Downloads 434730 Students’ Post COVID-19 Experiences with E-Learning Platforms among Undergraduate Students of Public Universities in the Ashanti Region, Ghana
Authors: Michael Oppong, Stephanie Owusu Ansah, Daniel Ofori
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The study investigated students’ post-covid-19 experiences with e-learning platforms among undergraduate students of public universities in the Ashanti region of Ghana. The study respectively drew 289 respondents from two public universities, i.e., Kwame Nkrumah University of Science and Technology (KNUST) Business School and the Kumasi Technical University (KsTU) Business School in Ghana. Given that the population from the two public universities was fairly high, sampling had to be done. The overall population of the study was 480 students randomly sampled from the two public universities using the sampling ratio given by Alreck and Settle (2004). The population constituted 360 students from the Kwame Nkrumah University of Science and Technology (KNUST) Business School and 120 from the Kumasi Technical University Business School (KsTU). The study employed questionnaires as a data collection tool. The data gathered were 289 responses out of 480 questionnaires administered, representing 60.2%. The data was analyzed using pie charts, bar charts, percentages, and line graphs. Findings revealed that the e-learning platforms were still useful. However, the students used it on a weekly basis post-COVID-19, unlike in the COVID-19 era, where it was used daily. All other academic activities, with the exception of examinations, are still undertaken on the e-learning platforms; however, it is underutilized in the post-COVID-19 experience. The study recommends that universities should invest in infrastructure development to enable all academic activities, most especially examinations, to be undertaken using the e-learning platforms to curtail future challenges.Keywords: e-learning platform, undergraduate students, post-COVID-19 experience, public universities
Procedia PDF Downloads 1034729 The Impact of Nutrition Education Intervention in Improving the Nutritional Status of Sickle Cell Patients
Authors: Lindy Adoma Dampare, Marina Aferiba Tandoh
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Sickle cell disease (SCD) is an inherited blood disorder that mostly affects individuals in sub-Saharan Africa. Nutritional deficiencies have been well established in SCD patients. In Ghana, studies have revealed the prevalence of malnutrition, especially amongst children with SCD and hence the need to develop an evidence-based comprehensive nutritional therapy for SCD to improve their nutritional status. The aim of the study was to develop and assess the effect of a nutrition education material on the nutritional status of SCD patients in Ghana. This was a pre-post interventional study. Patients between the ages of 2 to 60 years were recruited from the Tema General Hospital. Following a baseline nutrition knowledge (NK), beliefs, sanitary practice and dietary consumption pattern assessment, a twice-monthly nutrition education was carried out for 3 months, followed by a post-intervention assessment. Nutritional status of SCD patients was assessed using a 3-days dietary recall and anthropometric measurements. Nutrition education (NE) was given to SCD adults and caregivers of SCD children. Majority of the caregivers (69%) and SCD adult (82%) at baseline had low NK. The level of NK improved significantly in SCD adults (4.18±1.83 vs. 10.00±1.00, p<0.001) and caregivers (5.58 ± 2.25 vs.10.44± 0.846, p<0.001) after NE. Increase in NK improved dietary intake and dietary consumption pattern of SCD patients. Significant increase in weight (23.2±11.6 vs. 25.9±12.1, p=0.036) and height (118.5±21.9 vs. 123.5±22.2, p=0.011) was observed in SCD children at post intervention. Stunting (10.5% vs. 8.6%, p=0.62) and wasting (22.1% vs. 14.4%, p=0.30) reduced in SCD children after NE although not statistically significant. Reduction (18.2% vs. 9.1%) in underweight and an increase (18.2% vs. 27.3%) in overweight SCD adults was recorded at post intervention. Fat mass remained the same while high muscle mass increased (18.2% vs. 27.3%) at post intervention in SCD adult. Anaemic status of SCD patients improved at post intervention and the improvement was statistically significant amongst SCD children. Nutrition education improved the NK of SCD caregivers and adults hence, improving the dietary consumption pattern and nutrient intake of SCD patients. Overall, NE improved the nutritional status of SCD patients. This study shows the potential of nutrition education in improving the nutritional knowledge, dietary consumption pattern, dietary intake and nutritional status of SCD patients, and should be further explored.Keywords: sickle cell disease, nutrition education, dietary intake, nutritional status
Procedia PDF Downloads 1044728 Comparing the Efficacy of Quantitative Electroencephalogram-Based Neurofeedback Therapy Program versus Organizational Skills Training Program to Reduce the Core Symptoms among Children Group of ADHD
Authors: Radwa R. El-Saadany , Medhat Abu Zeid, Tarek Omar, Marwa S. Maqsoud
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Attention deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders characterized by attention deficit, hyperactivity, and impulsivity. Neurofeedback (NF) is one of the neurotherapy treatments that cause brain wave changes. Method: The current pseudo-experimental study with a pre–post-test design was conducted on a population of children with attention deficit hyperactivity disorder (ADHD).The sample size comprised of (30) children selected by random sampling method and assigned to two therapeutic groups: First therapeutic group received a neurofeedback program. Based on QEEG, it reached (10) children. The second therapeutic group received an organization skills training program, it reached (10) and the control group that did not receive programs, it reached (10) children. Results: There are significant differences between pre- and post-assessments among therapeutic groups in reducing the three core symptoms of ADHD in favor of post measurement. There are no significant differences between post-assessment and follow up measurement of the therapeutic groups.Keywords: QEEG-based neurofeedback therapy program, organizational skills training program, attention deficit hyperactivity disorder
Procedia PDF Downloads 774727 Cephalometric Changes of Patient with Class II Division 1 [Malocclusion] Post Orthodontic Treatment with Growth Stimulation: A Case Report
Authors: Pricillia Priska Sianita
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An aesthetic facial profile is one of the goals in Orthodontics treatment. However, this is not easily achieved, especially in patients with Class II Division 1 malocclusion who have the clinical characteristics of convex profile and significant skeletal discrepancy due to mandibular growth deficiency. Malocclusion with skeletal problems require proper treatment timing for growth stimulation, and it must be done in early age and in need of good cooperation from the patient. If this is not done and the patient has passed the growth period, the ideal treatment is orthognathic surgery which is more complicated and more painful. The growth stimulation of skeletal malocclusion requires a careful cephalometric evaluation ranging from diagnosis to determine the parts that require stimulation to post-treatment evaluation to see the success achieved through changes in the measurement of the skeletal parameters shown in the cephalometric analysis. This case report aims to describe skeletal changes cephalometrically that were achieved through orthodontic treatment in growing period. Material and method: Lateral Cephalograms, pre-treatment, and post-treatment of cases of Class II Division 1 malocclusion is selected from a collection of cephalometric radiographic in a private clinic. The Cephalogram is then traced and measured for the skeletal parameters. The result is noted as skeletal condition data of pre-treatment and post-treatment. Furthermore, superimposition is done to see the changes achieved. The results show that growth stimulation through orthodontic treatment can solve the skeletal problem of Class II Division 1 malocclusion and the skeletal changes that occur can be verified through cephalometric analysis. The skeletal changes have an impact on the improvement of patient's facial profile. To sum up, the treatment timing on a skeletal malocclusion is very important to obtain satisfactory results for the improvement of the aesthetic facial profile, and skeletal changes can be verified through cephalometric evaluation of pre- and post-treatment.Keywords: cephalometric evaluation, class II division 1 malocclusion, growth stimulation, skeletal changes, skeletal problems
Procedia PDF Downloads 2504726 A Comparative Study of the Effectiveness of Narrative Therapy in Individual and Group Counseling on Promoting Hope in With Breast Cancer’s Women
Authors: Sajadian Akram, Tavasoli F.
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Breast cancer is the second most common cancer in the world and certainly the most frequent cancer mostly among women. This study was aimed to compare the effectiveness of individual counseling and group narrative therapy on female patients' life expectancy afflicted by breast cancer. The present study is a pre-test-post-test clinical trial. Fifty-five patients with breast cancer were randomly selected in the follow-up period and after their active medical treatment completion. Then, they were randomly divided into two groups: individual counseling and group counseling. Herth hope index (HHI) was used to measure the patients' hope level. Data were analyzed using t-test and SPSS software. hope rate was statistically significant in both groups receiving individual and group narrative therapy in the post-test compared to the pre-test (P <00000). Moreover, the comparative evaluation of hope in both groups (individual & group counseling) in the post-test showed that group narrative counseling is more effective than individual narrative counseling (P <00000). Conclusion: Narrative therapy promotes hope in breast cancer patients effectively. Due to the nature of breast cancer and its psychological effects in the post-treatment period, providing narrative group therapy can improve life quality. Patients' life quality changes in tandem with changes in hope.Keywords: hope, narrative therapy, counseling, breast cancer
Procedia PDF Downloads 1254725 Effects of Hypolipidemic Agents in Aminoglycoside-Induced Experimental Nephrotoxicity in Rats: Biochemical and Histopathological Evidence
Authors: Balakumar Pitchai, Xiang Llan Ang, Sunil Prajapati, Varatharajan Rajavel, Sundram Karupiah, Mohd Baidi Bahari
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The study examined the pretreatment and post-treatment effects of low-doses of fenofibrate and rosuvastatin in gentamicin-induced acute nephrotoxicity in rats. Gentamicin (100 mg/kg/day, i.p.) was administered to rats for 8 days. In the pretreatment protocol, low-dose fenofibrate (30 mg/kg/day, p.o.) or low-dose rosuvastatin (2 mg/kg/day, p.o.) treatments were started a day before the administration of gentamicin and continued for 8 days. In the post-treatment protocol, rats administered gentamicin were treated with low-dose fenofibrate (30 mg/kg/day, p.o.) or low-dose rosuvastatin (2 mg/kg/day, p.o.) for 6 days after the completion of 8 days protocol of gentamicin administration. Gentamicin-associated acute nephrotoxicity in rats was assessed in terms of biochemical analysis and renal histopathological studies. Gentamicin-administered rats showed marked renal functional changes as assessed in terms of a significant increase in serum creatinine and urea levels as compared to normal rats. The renal dysfunction noted in gentamicin administered rats was accompanied with elevated serum uric acid level as compared to normal rats while there was no significant change in lipid profile. Low-dose fenofibrate pretreatment in gentamicin-administered rats afforded a significant renal functional improvements and renoprotection while its post-treatment showed no significant renoprotection. On the other hand, pretreatment with low-dose rosuvastatin partially reduced gentamicin-induced increase in serum creatinine level, but its post-treatment did not afford renal functional improvements in gentamicin-administered rats. However, all pre and post-treatments with low-doses of fenofibrate or rosuvastatin significantly reduced the elevated serum uric acid concentration in gentamicin-administered rats. Renal histopathological analysis showed a discernible incidence of acute tubular necrosis in gentamicin-administered rats which were markedly reduced by low-dose fenofibrate or low-dose rosuvastatin pretreatments; but, not by their post-treatments. In conclusion, low-dose fenofibrate pretreatment considerably prevented gentamicin-induced acute tubular necrosis and renal functional abnormalities in rats while its post-treatment resulted in no significant renoprotective action. In spite of effective prevention of gentamicin-induced acute tubular necrosis, the pretreatment with low-dose rosuvastatin had only a partial and fractional protection on renal functional abnormalities. The post-treatment with low-dose rosuvastatin was ineffective in affording a renoprotection in gentamicin-administered rats.Keywords: gentamicin-nephrotoxicity, low-dose fenofibrate, low-dose rosuvastatin, renoprotection
Procedia PDF Downloads 2044724 A Review of Paleo-Depositional Environment and Thermal Alteration Index of Carboniferous, Permian, and Triassic of A1-9 Well, NW Libya
Authors: M. A. Alrabib, Y. Sherif, A. K. Mohamed, E. A. Elfandi, E. I. Fandi
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This paper introduces a paleo-environmental and hydrocarbon show in this well was identified in the interval of Dembaba formation to the Hassaona Formation was poor to very poor oil show. And from palaeo-environmental analysis there is neither particularly good reservoir nor source rock have been developed in the area. Recent palaeo-environment work undertakes that the sedimentary succession in this area comprises the Upper Paleozoic rock of the Carboniferous and Permian and the Mesozoic (Triassic) sedimentary sequences. No early Paleozoic rocks have been found in this area, these rocks were eroding during the Late Carboniferous and Early Permian time. During Latest Permian and earliest Triassic time evidence for major marine transgression has occurred. From depths 5930-5940 feet, to 10800-10810 feet, the TAI of the Al Guidr, the Bir Al Jaja Al Uotia, Hebilia and the top varies between 3+ to 4-(mature-dry gas). This interval corporate the rest part of the Dembaba Formation. From depth 10800- 10810 feet, until total sediment depth (11944 feet Log) which corporate the rest of the Dembaba and underlying equivalents of the Assedjefar and M Rar Formations and the underlying Indeterminate unit (Hassouna Formation) the TAI varies between 4 and 5 (dry gas-black and deformed).Keywords: paleoenvironmental, thermal alteration index, north western Libya, hydrocarbon
Procedia PDF Downloads 4704723 Knowledge and Capabilities of Primary Caregivers in Providing Quality Care for Elderly Patients with Post- Operative Hip Fracture, Songklanagarind Hospital
Authors: Manee Hasap, Mongkolchai Hasap, Tasanee Nasae
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The purpose of this study was to evaluate the primary caregivers’ knowledge and capabilities for providing quality care to be hospitalized post-hip fracture surgery elderly patients. The theoretical framework of the study was derived from the concepts of dependent care agency in Orem’s Self-Care theory, and family care provision for the elderly and chronically ill patients. 59 subjects were purposively selected. The subjects were primary caregivers of post-operated hip fracture elderly patients who had been admitted to the Orthopaedic Ward of Songklanagarind Hospital. Demographic data of the caregivers and patients were collected by non-participant observation using the evaluation and recording forms. The reliability of caregivers’ knowledge measurement (0.86) was obtained by KR-20 and that of caregivers’ capabilities for post-operative care evaluation form (0.97) obtained from 2 observers by interrater reliability. The data were analyzed using descriptive statistic, which were frequency, percentage, mean, and standard deviation. The result of this study indicated that elderly patients with post-hip fracture surgery had many pre-discharge self care limitations. Approximately, 75% of the caregivers had knowledge to respond to patient’s essential needs at a high level, while the rest (25%) had this knowledge a moderate level. For observation, 57.63% of the subjects had capabilities in care practice at a moderate level; 28.81% had capabilities in care practice at a high level, while 13.56% had at a low level. The result of this study can be used as basic information for patients and caregivers capabilities developing plan especially, providing patients’ activities, accident surveillance and complications prevention for a good life quality of elderly patients after hip surgery both hospitalization and rehabilitation at home.Keywords: care givers’ knowledge, care givers’ capabilities, elderly hip fracture patients, patients
Procedia PDF Downloads 5634722 Aquatic Therapy Improving Balance Function of Individuals with Stroke: A Systematic Review with Meta-Analysis
Authors: Wei-Po Wu, Wen-Yu Liu, Wei−Ting Lin, Hen-Yu Lien
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Introduction: Improving balance function for individuals after stroke is a crucial target in physiotherapy. Aquatic therapy which challenges individual’s postural control in an unstable fluid environment may be beneficial in enhancing balance functions. The purposes of the systematic review with meta-analyses were to validate the effects of aquatic therapy in improving balance functions for individuals with strokes in contrast to conventional physiotherapy. Method: Available studies were explored from three electronic databases: PubMed, Scopus, and Web of Science. During literature search, the published date of studies was not limited. The study design of the included studies should be randomized controlled trials (RCTs) and the studies should contain at least one outcome measurement of balance function. The PEDro scale was adopted to assess the quality of included studies, while the 'Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence' was used to evaluate the level of evidence. After the data extraction, studies with same outcome measures were pooled together for meta-analysis. Result: Ten studies with 282 participants were included in analyses. The research qualities of the studies were ranged from fair to good (4 to 8 points). Levels of evidence of the included studies were graded as level 2 and 3. Finally, scores of Berg Balance Scale (BBS), Eye closed force plate center of pressure velocity (anterior-posterior, medial-lateral axis) and Timed up and Go test were pooled and analyzed separately. The pooled results shown improvement in balance function (BBS mean difference (MD): 1.39 points; 95% confidence interval (CI): 0.05-2.29; p=0.002) (Eye closed force plate center of pressure velocity (anterior-posterior axis) MD: 1.39 mm/s; 95% confidence interval (CI): 0.93-1.86; p<0.001) (Eye closed force plate center of pressure velocity (medial-lateral) MD: 1.48 mm/s; 95% confidence interval (CI): 0.15-2.82; p=0.03) and mobility (MD: 0.9 seconds; 95% CI: 0.07-1.73; p=0.03) of stroke individuals after aquatic therapy compared to conventional therapy. Although there were significant differences between two treatment groups, the differences in improvement were relatively small. Conclusion: The aquatic therapy improved general balance function and mobility in the individuals with stroke better than conventional physiotherapy.Keywords: aquatic therapy, balance function, meta-analysis, stroke, systematic review
Procedia PDF Downloads 2024721 Application of Artificial Neural Network for Prediction of High Tensile Steel Strands in Post-Tensioned Slabs
Authors: Gaurav Sancheti
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This study presents an impacting approach of Artificial Neural Networks (ANNs) in determining the quantity of High Tensile Steel (HTS) strands required in post-tensioned (PT) slabs. Various PT slab configurations were generated by varying the span and depth of the slab. For each of these slab configurations, quantity of required HTS strands were recorded. ANNs with backpropagation algorithm and varying architectures were developed and their performance was evaluated in terms of Mean Square Error (MSE). The recorded data for the quantity of HTS strands was used as a feeder database for training the developed ANNs. The networks were validated using various validation techniques. The results show that the proposed ANNs have a great potential with good prediction and generalization capability.Keywords: artificial neural networks, back propagation, conceptual design, high tensile steel strands, post tensioned slabs, validation techniques
Procedia PDF Downloads 2224720 A Comparative Study of Sampling-Based Uncertainty Propagation with First Order Error Analysis and Percentile-Based Optimization
Authors: M. Gulam Kibria, Shourav Ahmed, Kais Zaman
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In system analysis, the information on the uncertain input variables cause uncertainty in the system responses. Different probabilistic approaches for uncertainty representation and propagation in such cases exist in the literature. Different uncertainty representation approaches result in different outputs. Some of the approaches might result in a better estimation of system response than the other approaches. The NASA Langley Multidisciplinary Uncertainty Quantification Challenge (MUQC) has posed challenges about uncertainty quantification. Subproblem A, the uncertainty characterization subproblem, of the challenge posed is addressed in this study. In this subproblem, the challenge is to gather knowledge about unknown model inputs which have inherent aleatory and epistemic uncertainties in them with responses (output) of the given computational model. We use two different methodologies to approach the problem. In the first methodology we use sampling-based uncertainty propagation with first order error analysis. In the other approach we place emphasis on the use of Percentile-Based Optimization (PBO). The NASA Langley MUQC’s subproblem A is developed in such a way that both aleatory and epistemic uncertainties need to be managed. The challenge problem classifies each uncertain parameter as belonging to one the following three types: (i) An aleatory uncertainty modeled as a random variable. It has a fixed functional form and known coefficients. This uncertainty cannot be reduced. (ii) An epistemic uncertainty modeled as a fixed but poorly known physical quantity that lies within a given interval. This uncertainty is reducible. (iii) A parameter might be aleatory but sufficient data might not be available to adequately model it as a single random variable. For example, the parameters of a normal variable, e.g., the mean and standard deviation, might not be precisely known but could be assumed to lie within some intervals. It results in a distributional p-box having the physical parameter with an aleatory uncertainty, but the parameters prescribing its mathematical model are subjected to epistemic uncertainties. Each of the parameters of the random variable is an unknown element of a known interval. This uncertainty is reducible. From the study, it is observed that due to practical limitations or computational expense, the sampling is not exhaustive in sampling-based methodology. That is why the sampling-based methodology has high probability of underestimating the output bounds. Therefore, an optimization-based strategy to convert uncertainty described by interval data into a probabilistic framework is necessary. This is achieved in this study by using PBO.Keywords: aleatory uncertainty, epistemic uncertainty, first order error analysis, uncertainty quantification, percentile-based optimization
Procedia PDF Downloads 2414719 Clinical Impact of Delirium and Antipsychotic Therapy: 10-Year Experience from a Referral Coronary Care Unit
Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham
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Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine
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