Search results for: neonatal intensive care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4690

Search results for: neonatal intensive care

1090 The Effects of Evidence-Based Nursing Training and Consultation Program on Self-Efficacy and Outcome Expectancy of Evidence-Based Practice among Nurses

Authors: Yea-Pyng Lin

Abstract:

Evidence-based nursing (EBN) can improve quality of patient care and reduce medical expenses. Development of training and consultation program according to nurses’ needs and difficulties is essential to promote their competence and self-efficacy in EBN. However, limited research evaluated the effects of EBN program on EBN self-efficacy among nurses. This study aimed to evaluate the effects of an EBN consultation program on self-efficacy and outcome expectancy of evidence-based practice (EBP) among nurses. A two-group pretest-posttest quasi-experimental design was used. A purposive sample of full-time nurses was recruited from a hospital. Experimental group (n=28) received the EBN consultation program including 18-hour EBN training courses, hand-on practices and group discussion by faculty mentors. Control group (n=33) received regular in-service education with no EBN program. All participants received baseline and post-test assessment using Chinese version of Self-Efficacy in EBP scale (SE-EBP) and Outcome Expectancy for EBP scale (OE-EBP). After receiving EBN consultation program, experimental group’s posttest scores of SE-EBP (t=-4.98, p<0.001) and OE-SEP (t=-3.65, p=0.001) were significantly higher than those of the pretests. By controlling the age and years of nursing work experience, the experimental group‘s SE-EBP(F=10.47, p=0.002) and OE-SEP(F=9.53, p=0.003) scores were significantly improved compared to those of the control group. EBN program focus on hand-on practice and group discussion by faculty mentors in addition to EBN training courses can improve EBP self-efficacy and outcome expectancy among nurses. EBN program focus on English literature reading, database searching, and appraisal practice according to nurses’ needs and difficulties can promote implementation of EBN.

Keywords: evidence-based nursing, evidence-based practice, consultation program, self-efficacy, outcome expectancy

Procedia PDF Downloads 500
1089 A Study on Employer Branding and Its Impacts on Employee’s

Authors: KVNKC Sharma, Soujanya Pasumarthi

Abstract:

Globalization, coupled with increase in competition is compelling organizations to adopt innovative strategies and identify core competencies in order to distinguish themselves from the competition. The capability of an organization is no longer determined by their products or services alone. The intellectual assets and quality of the human resource are fast emerging as key differentiators. Corporations are now positioning themselves as ‘brands’ not solely to market their products and services, but also to lure and to retain the best talent in the business. This paper identifies leadership as the ‘key element’ in developing an organization’s brand, which has a significant influence on the employee’s eventual perception of this external brand as portrayed by the organization. External branding incorporates innovation, consumer concern, trust, quality and sustainability. The paper contends that employees are indeed an organization’s ‘brand ambassadors. Internal branding involves taking care of these ambassadors of corporate brand i.e. human resource. If employees of an organization are not exposed to the organization’s branding (an ongoing process that functionally aligns, motivates and empower employees at all levels to consistently provide a satisfying customer experience), the external brand could be jeopardized. Internal branding, on the other hand, refers to employee’s perception of the organization’s brand. The current business environment can at best, be termed as volatile. Employees with the right technical and behavioral skills remain a scarce resource and the employers need to be ready to capture the attention, interest and commitment of the best and brightest candidates. This paper attempts to review and understand the relationship between employer branding and employee retention. The paper also seeks to identify potential impact of employer branding across all the factors affecting employees.

Keywords: alignment, external branding, internal branding, leadership

Procedia PDF Downloads 303
1088 Optimal Approach for Siewert Type Ⅱ Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Metanalysis

Authors: Maatouk Mohamed, Nouira Mariem

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.

Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review

Procedia PDF Downloads 81
1087 An Experimental Test of the Effects of Acute and Chronic Stress on Maternal Sensitivity

Authors: Mindy A. Brown, Emma E. Reardon, Jennifer Isenhour, Sheila E. Crowell, K. Lee Raby, Elisabeth Conradt

Abstract:

The positive impact of maternal sensitivity on infant social and emotional development is well-known, as is the notion that stress may impair a mother’s ability to provide sensitive care for her infant. However, individual differences in susceptibility to parenting-related stress are less understood. This study explores how chronic prenatal stress moderates the effect of acute stressors on maternal sensitivity. Data were gathered from 110 mothers and their 7-month-old infants. Mothers were exposed to either an acute stress task or a control task, after which they engaged in the still-face paradigm, a face-to-face interaction where maternal sensitivity was measured. Chronic maternal stress was assessed using the UCLA Life Stress Interview during the third trimester of pregnancy. The results revealed that among mothers exposed to the stress condition, those with higher chronic stress levels in the previous six months displayed significantly lower sensitivity during the still-face paradigm compared to those with lower chronic stress. Notably, past stress levels had no effect on maternal sensitivity in the control condition. These findings suggest a moderating effect of chronic stress on maternal caregiving behavior, with higher prenatal stress diminishing a mother’s ability to cope with acute parenting-related stressors in the present. The mechanisms behind this may involve changes in stress reactivity pathways, such as the hypothalamic-pituitary-adrenal (HPA) axis or altered emotion regulation strategies developed in response to chronic stress. Understanding these pathways could guide targeted interventions for mothers who may be more vulnerable to stress, improving caregiving outcomes.

Keywords: acute stress, maternal stress, prenatal stress, still-face paradigm

Procedia PDF Downloads 24
1086 A Theoretical Framework: The Influence of Luxury Companies' Corporate Social Activities on Consumer Purchase Intention

Authors: Kveta Olsanova, Gina Cook, Marija Zlatic

Abstract:

This paper discusses the theoretical framework suggesting the dependencies between luxury brands’ CSR (Corporate Social Responsibility) variables and the purchase intention of luxury shoppers. The framework is based on a literature review and in-depth individual interviews with a sample of luxury users and buyers. The measures of the model are based on existing research and the authors' qualitative research results. The model suggests that purchase intention in the luxury segment is dependent on the luxury values (symbolic, experiential, functional and social), individual sustainable dimension (composed of societal, environmental and economic variables) and awareness of the brand’s CSR, the last two relationships being potentially moderated by certain conditions such as demographics and general attitudes towards CSR and sustainability. The model’s output is in the formulation of several hypotheses, to be tested in an upcoming quantitative study. The qualitative phase indicated that the perceived symbolic, functional and experiential value dimensions of luxury brands were stronger drivers of purchase intention compared to the sustainable dimension. The contribution of the research consists of highlighting CSR’s impact on customer purchase intent as a potential implication for luxury brand management due to two aspects: (i) consumer awareness of the existing CSR activities of luxury brands is low, and this might be challenged by the demands of Gen Z entrants into the lux industry as they are known for their positive approach to CSR; (ii) the UN’s SDGs will bring CSR to the attention of all industries, including currently 'CSR silent' segments represented by luxury. Our research should contribute to incorporation of strategic CSR into the policies and strategies of the luxury segment by providing evidence that luxury customers do care.

Keywords: CSR, luxury shoppers, purchase intention, sustainability

Procedia PDF Downloads 148
1085 A Review of the Potential Impact of Employer Branding on Employee

Authors: K. V. N. K. C. Sharma

Abstract:

Globalization, coupled with increase in competition is compelling organizations to adopt innovative strategies and identify core competencies in order to distinguish themselves from the competition. The capability of an organization is no longer determined by their products or services alone. The intellectual assets and quality of the human resource are fast emerging as key differentiators. Corporations are now positioning themselves as ‘brands’ not solely to market their products and services, but also to lure and to retain the best talent in the business. This paper identifies leadership as the ‘key element’ in developing an organization’s brand, which has a significant influence on the employee’s eventual perception of this external brand as portrayed by the organization. External branding incorporates innovation, consumer concern, trust, quality and sustainability. The paper contends that employees are indeed an organization’s ‘brand ambassadors. Internal branding involves taking care of these ambassadors of corporate brand i.e. human resource. If employees of an organization are not exposed to the organization’s branding (an ongoing process that functionally aligns, motivates and empower employees at all levels to consistently provide a satisfying customer experience), the external brand could be jeopardized. Internal branding, on the other hand, refers to employee’s perception of the organization’s brand. The current business environment can at best, be termed as volatile. Employees with the right technical and behavioral skills remain a scarce resource and the employers need to be ready to capture the attention, interest and commitment of the best and brightest candidates. This paper attempts to review and understand the relationship between employer branding and employee retention. The paper also seeks to identify potential impact of employer branding across all the factors affecting employees.

Keywords: external branding, organisation personnel, internal branding, leadership

Procedia PDF Downloads 239
1084 Comparative Policy Analysis on Agropolitan Territorial Development in Rural Area: A Study Case in Bojonegoro Regency, Indonesia

Authors: Fatihin Khoirul, Muhammad Muqorrobin Ist

Abstract:

Bojonegoro Regency is one of the districts that use the concept Agropolitan as the Territorial Development Policy. Three sub-district designated as Area Development District of Agropolitan are Kapas, Dander, and Kalitidu or commonly called KADEKA. Current policy has been shown results, but there was an inequality of results in some areas. One of them occurred in the Ngringinrejo village with the main commodities is Starfruit and Wedi village with the main commodities is Salak fruit. Therefore, a comparative study is used to search for causal factors of inequality result of the policy by using the 5 aspects compared, namely: (1) Management Development Agropolitan; (2) Physical Condition agropolitan Region; (3) Implementing Agency at the Village Level; (4) Village Government Support; and (5) Community support. Based on the discussion of qualitative analysis, it was found that five aspects have their respective roles in creating inequality of outcomes that occur in both villages. But beyond that, there are conditions where the two villages experienced the same condition that is when the initial implementation of the policy. The condition is referred to as 'the phenomenon of price trap.' The condition is caused by lower commodity prices, causing the village government's commitment in implementing policies too low, followed by public awareness in support of the policy is also low, so care for commodities is also low, and the quality is too low lead and eventually back causing low price. However, the difference is that the village Ngringinrejo able to get out of this condition with 'the new culture of administration' at the end of 2013. While the conditions in the village of Wedi compounded by not respected request assistance by the irrigation district.

Keywords: comparative policy analysis, qualitative comparative, inequallity, price trap, new culture of administration

Procedia PDF Downloads 286
1083 Access to Sexual Reproductive Health (SRH) Education and Services to Deaf Adolescents in Wakiso, Uganda - The Ugandan Perspective

Authors: Racheal Ayanga, Nancy Katumba Muwangala, Jane Babirye, Harriet Kivumbi

Abstract:

Background: Deaf adolescents are vulnerable. Deafness limits their access to resources that are accessed by their hearing peers. There is minimal attention placed on the SRH needs of persons with disabilities, especially in developing countries. We sought to assess barriers to access of SRH education and services for deaf adolescents in Uganda. Methods: We performed a cross sectional study using a questionnaire on knowledge of and access to SRH education and services from a selected sample of deaf adolescents aged 13-19 years at Wakiso Secondary school for the deaf. A consecutive sample of eligible participants was asked to join the study after obtaining informed consent until the target sample size was reached. Results: From 01 Jul 2022 to 30 Jan 2023, 70 quantitative interviews were conducted. Participants’ mean age was 17 years, and 66% were female. 89% had heard about several components of SRH. 99% reported a need for education and services but had challenges with access 85% of the time. 54% reported receipt of education and services from government or private facilities, and the rest from friends, parents, siblings, teachers and the internet. Conclusion: Government needs to look into availing tailored, sustainable SRH education/services to deaf adolescents at health facilities and teach health workers sign language. SRH education to parents, teachers and communities of deaf adolescents improves access in hard-to-reach areas. Integration of services into routine health care is key in creating and improving models of access to wider communities of persons with disabilities to improve their mental health.

Keywords: sexual and reproductive health, deaf, adolescents, education, services, disabilities, mental health, hard-to-reach areas

Procedia PDF Downloads 85
1082 Factors Associated with Overweight and Obesity among Recipients of Antiretroviral Therapy at HIV Clinics in Botswana

Authors: Jose G. Tshikuka, Goabaone Rankgoane-Pono, Mgaywa G. M. D. Magafu, Julius C. Mwita, Tiny Masupe, Fortunat M. Kandanda, Shimeles G. Hamda, Roy Tapera, Mooketsi Molefi, John T. Tlhakanelo

Abstract:

Background: Factors associated with overweight and obesity among antiretroviral therapy (ART) recipients have not been sufficiently studied in Botswana. We aimed to study (i) the prevalence and trends in overweight/obesity by duration of exposure to ART among recipients, (ii) changes in body mass index (BMI) categories among recipients before ART initiation (BMI-1) and after ART initiation (BMI-2), (iii) associations between ART and overweight/obesity and (iv) factors associated with BMI changes among ART recipients. Methods: A 12 years retrospective record-based review was conducted. Factors potentially associated with BMI change among patients after at least three years of ART exposure were examined using multiple regression model. Adjusted odds ratios (AOR) and their 95% confidence intervals (CIs) were computed. ART regimens, duration of exposure to ART, and recipients’ demographic and biomedical characteristics including the presence or absence of diabetes mellitus related comorbidities (DRC) were investigated as potential factors associated with overweight/obesity. Results: Twenty-nine percent of recipients were overweight, 16.6% had obesity of whom 2.4% were morbidly-obese at the last clinic visit. Overweight/obesity recipients were more likely to be female, to have DRC and less likely to have nadir CD4 count or CD4 count between 201 – 249 cells/mm³. Neither the first-line nor the second-, third-line ART regimens predicted overweight/obesity more than the other and neither did the duration of exposure to ART. No significant linear trends were observed in the prevalence of overweight/obesity by the duration of exposure to ART. Conclusions: These results indicate that overweight/obesity seen among ART recipients is not directly induced by ART. ART used CD4 and/or DRC pathway to induce overweight/obesity seen among recipients; suggesting that, weight gain documented herein is likely a reflection of improved health status that mirrors trends in the general population or a DRC related effect. Weight management programs may be important components of HIV care.

Keywords: overweight/obesity, recipients of antiretroviral therapy, HIV/AIDS, Botswana

Procedia PDF Downloads 159
1081 Patient Engagement in Healthcare and Health Literacy in China: A Survey in China

Authors: Qing Wu, Xuchun Ye, Qiuchen Wang, Kirsten Corazzini

Abstract:

Objective: It’s increasing acknowledged that patient engagement in healthcare and health literacy both have positive impact on patient outcome. Health literacy emphasizes the ability of individuals to understand and apply health information and manage health. Patients' health literacy affected their willingness to participate in decision-making, but its impact on the behavior and willingness of patient engagement in healthcare is not clear, especially in China. Therefore, this study aimed to explore the correlation between the behavior and willingness of patient engagement and health literacy. Methods: A cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale (AAHLS). A convenient sample of 443 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province and Zhejiang Province, from September 2016 to January 2017. Results: The mean score for the willingness was (4.41±0.45), and the mean score for the patient engagement behavior was (4.17±0.49); the mean score for the patient's health literacy was (2.36±0.29),the average score of its three dimensions- the functional literacy, the Communicative/interactive literacy and the Critical literacy, was (2.26±0.38), (2.28±0.42), and (2.61±0.43), respectively. Patients' health literacy was positively correlated with their willingness of engagement (r = 0.367, P < 0.01), and positively correlated with patient engagement behavior (r = 0.357, P < 0.01). All dimensions of health literacy were positively correlated with the behavior and willingness of patient engagement in healthcare; the dimension of Communicative/interactive literacy (r = 0.312, P < 0.01; r = 0.357, P < 0.01) and the Critical literacy (r = 0.357, P < 0.01; r = 0.357, P < 0.01) are more relevant to the behavior and willingness than the dimension of basic/functional literacy (r=0.150, P < 0.01; r = 0.150, P < 0.01). Conclusions: The behavior and willingness of patient engagement in healthcare are positively correlated with health literacy and its dimensions. In clinical work, medical staff should pay attention to patients’ health literacy, especially the situation that low literacy leads to low participation and provide health information to patients through health education or communication to improve their health literacy as well as guide them to actively and rationally participate in their own health care.

Keywords: patient engagement, health literacy, healthcare, correlation

Procedia PDF Downloads 166
1080 Window Analysis and Malmquist Index for Assessing Efficiency and Productivity Growth in a Pharmaceutical Industry

Authors: Abbas Al-Refaie, Ruba Najdawi, Nour Bata, Mohammad D. AL-Tahat

Abstract:

The pharmaceutical industry is an important component of health care systems throughout the world. Measurement of a production unit-performance is crucial in determining whether it has achieved its objectives or not. This paper applies data envelopment (DEA) window analysis to assess the efficiencies of two packaging lines; Allfill (new) and DP6, in the Penicillin plant in a Jordanian Medical Company in 2010. The CCR and BCC models are used to estimate the technical efficiency, pure technical efficiency, and scale efficiency. Further, the Malmquist productivity index is computed to measure then employed to assess productivity growth relative to a reference technology. Two primary issues are addressed in computation of Malmquist indices of productivity growth. The first issue is the measurement of productivity change over the period, while the second is to decompose changes in productivity into what are generally referred to as a ‘catching-up’ effect (efficiency change) and a ‘frontier shift’ effect (technological change). Results showed that DP6 line outperforms the Allfill in technical and pure technical efficiency. However, the Allfill line outperforms DP6 line in scale efficiency. The obtained efficiency values can guide production managers in taking effective decisions related to operation, management, and plant size. Moreover, both machines exhibit a clear fluctuations in technological change, which is the main reason for the positive total factor productivity change. That is, installing a new Allfill production line can be of great benefit to increasing productivity. In conclusions, the DEA window analysis combined with the Malmquist index are supportive measures in assessing efficiency and productivity in pharmaceutical industry.

Keywords: window analysis, malmquist index, efficiency, productivity

Procedia PDF Downloads 609
1079 Assessment of the Road Safety Performance in National Scale

Authors: Abeer K. Jameel, Harry Evdorides

Abstract:

The Assessment of the road safety performance is a challengeable issue. This is not only because of the ineffective and unreliability of road and traffic crash data system but also because of its systematic character. Recent strategic plans and interventions implemented in some of the developed countries where a significant decline in the rate of traffic and road crashes considers that the road safety is a system. This system consists of four main elements which are: road user, road infrastructure, vehicles and speed in addition to other supporting elements such as the institutional framework and post-crash care system. To assess the performance of a system, it is required to assess all its elements. To present an understandable results of the assessment, it is required to present a unique term representing the performance of the overall system. This paper aims to develop an overall performance indicator which may be used to assess the road safety system. The variables of this indicators are the main elements of the road safety system. The data regarding these variables will be collected from the World Health Organization report. Multi-criteria analysis method is used to aggregate the four sub-indicators for the four variables. Two weighting methods will be assumed, equal weights and different weights. For the different weights method, the factor analysis method is used. The weights then will be converting to scores. The total score will be the overall indicator for the road safety performance in a national scale. This indicator will be used to compare and rank countries according to their road safety performance indicator. The country with the higher score is the country which provides most sustainable and effective interventions for successful road safety system. These indicator will be tested by comparing them with the aggregate real crash rate for each country.

Keywords: factor analysis, Multi-criteria analysis, road safety assessment, safe system indicator

Procedia PDF Downloads 270
1078 Factors Associated with Non-Adherence to Antiretroviral Treatment among HIV Infected Patients in Ukraine

Authors: Larissa Burruano, Sergey Grabovyj, Irina Nguen

Abstract:

The study aimed to assess the level of adherence to anti retroviral therapy (ART) and to examine the relationship between adherence and risk behavior factor (drug use) among patients infected with HIV. The patients with newly diagnosed or established HIV infection under follow-up at the Sumskij Regional Centre for AIDS Prevention in Ukraine were eligible for this study. Medical records were used to measure the patient’s adherence to medication. Measurements were obtained at month 6 and at month 12 to calculate the number of medication omission during the past 30 days: (on a 2-point scale – once until three in a month – were considered adherent, three and more in a month – were considered non-adherent). Of the 50 study participants, 27 (54.0%) were men and 23 (46.0%) women. The mean age is 35.2 years (SD= 5.1). A majority of the patients (82.0%) is in the age group of 25-30 years. The main level of adherence was 74.0% and 66.0% at 6 and 12 months, respectively. The main routes of HIV transmission were drug injection among men 12 (44.4%) and sexual contact among women 11 (47.8%). Univariate analyses indicated that patients who had lower level of education were more likely to have been non-adherent at month 6- (X2 =5.1, n=50, p < .05) and at month 12 (X2 = 4.34, n=50, p < .05). Multivariate tests showed that only age (OR= 1.163 [95% CI 0.98–1.370]) was significant independent predictor of treatment adherence, while gender, education, employment status were not predictive for the risk of developing non-compliance. There was not a significant interaction between non-adherence and intravenous drug use. Consistent with these findings, younger people were more likely to have missed a dose of their medication because they had a greater sense of invulnerability than older patients. The study indicates that the socio demographic characteristic should be taken into an account in the future research regarding adherence in the case of HIV infection. If the patient anti retroviral adherence can be improved by qualitatively better medical care in all regions of the Ukraine, behavioral changes in the population can to be expected in the long term.

Keywords: HIV, antiretroviral therapy, adherence, Ukraine, Eastern Europe

Procedia PDF Downloads 289
1077 The Role of Leadership in Enhancing Health Information Systems to Improve Patient Outcomes in China

Authors: Nisar Ahmad, Xuyi, Ali Akbar

Abstract:

As healthcare systems worldwide strive for improvement, the integration of advanced health information systems (HIS) has emerged as a pivotal strategy. This study aims to investigate the critical role of leadership in the implementation and enhancement of HIS in Chinese hospitals and how such leadership can drive improvements in patient outcomes and overall healthcare satisfaction. We propose a comprehensive study to be conducted across various hospitals in China, targeting healthcare professionals as the primary population. The research will leverage established theories of transformational leadership and technology acceptance to underpin the analysis. In our approach, data will be meticulously gathered through surveys and interviews, focusing on the experiences and perceptions of healthcare professionals regarding HIS implementation and its impact on patient care. The study will utilize SPSS and SmartPLS software for robust data analysis, ensuring precise and comprehensive insights into the correlation between leadership effectiveness and HIS success. We hypothesize that strong, visionary leadership is essential for the successful adoption and optimization of HIS, leading to enhanced patient outcomes and increased satisfaction with healthcare services. By applying advanced statistical methods, we aim to identify key leadership traits and practices that significantly contribute to these improvements. Our research will provide actionable insights for policymakers and healthcare administrators in China, offering evidence-based recommendations to foster leadership that champions HIS and drives continuous improvement in healthcare delivery. This study will contribute to the global discourse on health information systems, emphasizing the future role of leadership in transforming healthcare environments and outcomes.

Keywords: health information systems, leadership, patient outcomes, healthcare satisfaction

Procedia PDF Downloads 36
1076 Annual Audit for the Year 2021 for Patients with Hyperparathyroidism: Not as Rare an Entity as We Believe

Authors: Antarip Bhattacharya, Dhritiman Maitra

Abstract:

Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia due to autonomous production of parathormone (PTH) and the third most common endocrine disorder. Upto 2% of postmenopausal women could have this condition. Primary hyperparathyroidism is characterized by hypercalcemia with a high or insufficiently suppressed level of parathyroid hormone and is caused by a solitary parathyroid adenoma in 85-90% of patients. PHPT may also be caused by parathyroid hyperplasia (involving multiple glands) or parathyroid carcinoma. Associated morbidities and sequelae include decreased bone mineral density, fractures, kidney stones, hypertension, cardiac comorbidities and psychiatric disorder which entail huge costs for treatment. In the year 2021, by virtue of running a Breast and Endocrine Surgery clinic in a Tier 1 city at a tertiary care hospital, the opportunity to be associated with patients of hyperparathyroidism came our way. Here, we shall describe the spectrum of clinical presentations and customisation of treatment for parathyroid diseases with reference to the above patients. A retrospective analysis of the data of all patients presenting with symptoms of parathyroid diseases was made and classified according to the cause. 13 patients had presented with symptoms of hyperparathyroidism and each case presented with unique symptoms and necessitated detailed evaluation. The treatment or surgery offered to each patient was tailored to his/her individual disease and led to favourable outcomes. Diseases affecting parathyroid are not as rare as we believe. Each case merits detailed clinical evaluation, investigations and tailoring of suitable treatment with regard to medical management and extent of surgery. Intra-operative frozen section/iOPTH monitoring are really useful adjuncts for intra-operative decision making.

Keywords: hyperparathyroidism, parathyroid adenoma, parathyroid surgery, PTH

Procedia PDF Downloads 125
1075 Patterns of Self-Medication with Over-the-Counter Pain Relievers (Acetaminophen, Ibuprofen, and Aspirin) among the Kuwaiti Population

Authors: Nabil Ahmed Kamal Badawy, Ali Falah Alhajraf, Mawaheb Falah Alsamdan

Abstract:

Objectives: To estimate the prevalence of self-medication with over-the-counter pain relievers (acetaminophen, ibuprofen, and aspirin) among Kuwaiti citizens above the age of 16 years old and describe their patterns of use, perceived awareness of, and concerns about the drugs’ potential side effects. Design: A descriptive cross-sectional questionnaire-based survey. Setting: Samples were selected from the six Kuwaiti governorates. Subjects: The data were collected over a four-month period in 2012, from 850 subjects who identified as Kuwaiti citizens. These subjects were recruited using stratified random sampling. Results: Overall, a 67% response rate was obtained. In total, 68% (573) of the respondents reported the use of over-the-counter pain relievers. Women, middle-aged or single individuals, and those who had completed higher education used these drugs more than any other subgroup (p<0.05). We found evidence of inappropriate use of these drugs, with 15% (88) of the consumers using them almost daily. Further, 19% (111) of the consumers exceeded the recommended dosage at least once. Not only were 81% of the consumers unaware of the potential side effects, but also more than 61% were not concerned about them. Women were more knowledgeable than men regarding the maximum dose (p=0.036, OR 1.49, CI 1.03–2.17). Consumers with higher levels of education did not show distinct knowledge regarding the maximum allowed dose of the drugs (p=0.252, OR 1.71, CI 0.68-4.25). Conclusion: The results showed a high prevalence of self-medication with over-the-counter pain relievers among Kuwaiti citizens. The subjects showed marked unawareness and a lack of concern regarding the potential complications resulting from the inappropriate use of these analgesics. This demonstrates the need for educational interventions directed toward both patients and health care workers.

Keywords: awareness of side effects, concern, patterns of use, prevalence

Procedia PDF Downloads 500
1074 Development of Patient Satisfaction Questionnaire for Diabetes Management in Thailand and Lao People Democratic Republic

Authors: Phoutsathaphone Sibounheuang, Phayom Sookaneknun Olson, Chanuttha Ploylearmsang, Santiparp Sookaneknun, Chanthanom Manithip

Abstract:

Patient satisfaction is an outcome that can be measured and used to improve diabetes care and management. There are limited instruments for assessing patient satisfaction covering the whole process of diabetes management. In this study, the questionnaire was developed with items pooled from a systematic review of qualitative studies of patients’ and healthcare providers’ perspectives in diabetes management. The questionnaire consists of 11 domains with 45 items. The Thai version was translated to Lao and then checked by back-translating it into Thai. We tested the questionnaire on 150 diabetes patients in Thailand and 150 in Lao People Democratic Republic (PDR). Validity was performed by factor analysis and Pearson correlation. Internal consistency reliability was estimated by calculating Cronbach’s alpha. The study was approved by the Mahasarakham University Ethics Committee, and the National Ethics Committee for Health Research, Lao PDR. The Thai and Lao versions showed the construct validity by principal component analysis. This consisted of 11 domains which account for 71.23% of the variance (Thai version) and 71.66% of the variance (Lao version) in the total patient satisfaction scores. The Kaiser-Meyer-Olkin (KMO) measures were 0.85 for the Thai version and 0.75 for the Lao version. The Bartlett tests of sphericity of both versions were significant (p < 0.001). The factor loadings of all items in both versions were > 0.40. The convergent validity of the Thai and Lao versions was 93.63% and 79.54% respectively. The discriminant validity for the Thai and Lao versions was 92.68% and 88.68% respectively. Cronbach’s alpha was 0.95 in both versions. The Patient Satisfaction Questionnaire (PSQ) in both versions had acceptable properties. This study has yielded evidence supporting the validity and reliability of both versions.

Keywords: construct validity, diabetes management, patient satisfaction, questionnaire development, reliability

Procedia PDF Downloads 140
1073 Risk Tolerance in Youth With Emerging Mood Disorders

Authors: Ange Weinrabe, James Tran, Ian B. Hickie

Abstract:

Risk-taking behaviour is common during youth. In the time between adolescence and early adulthood, young people (aged 15-25 years) are more vulnerable to mood disorders, such as anxiety and depression. What impact does an emerging mood disorder have on decision-making in youth at critical decision points in their lives? In this article, we explore the impact of risk and ambiguity on youth decision-making in a clinical setting using a well-known economic experiment. At two time points, separated by six to eight weeks, we measured risky and ambiguous choices concurrently with findings from three psychological questionnaires, the 10-item Kessler Psychological Distress Scale (K10), the 17-item Quick Inventory of Depressive Symptomatology Adolescent Version (QIDS-A17), and the 12-item Somatic and Psychological Health Report (SPHERE-12), for young help seekers aged 16-25 (n=30, mean age 19.22 years, 19 males). When first arriving for care, we found that 50% (n=15) of participants experienced severe anxiety (K10 ≥ 30) and were severely depressed (QIDS-A17 ≥ 16). In Session 2, taking attrition rates into account (n=5), we found that 44% (n=11) remained severe across the full battery of questionnaires. When applying multiple regression analyses of the pooled sample of observations (N=55), across both sessions, we found that participants who rated severely anxious avoided making risky decisions. We suggest there is some statistically significant (although weak) (p=0.09) relation between risk and severe anxiety scores as measured by K10. Our findings may support working with novel tools with which to evaluate youth experiencing an emerging mood disorder and their cognitive capacities influencing decision-making.

Keywords: anxiety, decision-making, risk, adolescence

Procedia PDF Downloads 116
1072 Correlation between Peripheral Arterial Disease and Coronary Artery Disease in Bangladeshi Population: A Five Years Retrospective Study

Authors: Syed Dawood M. Taimur

Abstract:

Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown. Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between the presence of PAD and severity of CAD. Material & Methods: This five years retrospective study was conducted at an invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, coronary artery and peripheral artery profile. Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension was detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 79.2% and 58.4% had a positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients, 52 had both coronary and peripheral arterial disease which was statistically significant (p < .014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. The peripheral angiogram revealed 54.5% had superficial femoral artery disease, 26% had anterior tibial artery disease, 27.3% had posterior tibial artery disease, 20.8% had common iliac artery disease, 15.6% had common femoral artery disease and 2.6% had renal artery disease. Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.

Keywords: coronary artery disease (CAD), peripheral artery disease(PVD), risk, factors, correlation, cathetarization

Procedia PDF Downloads 426
1071 Optimizing Stormwater Sampling Design for Estimation of Pollutant Loads

Authors: Raja Umer Sajjad, Chang Hee Lee

Abstract:

Stormwater runoff is the leading contributor to pollution of receiving waters. In response, an efficient stormwater monitoring program is required to quantify and eventually reduce stormwater pollution. The overall goals of stormwater monitoring programs primarily include the identification of high-risk dischargers and the development of total maximum daily loads (TMDLs). The challenge in developing better monitoring program is to reduce the variability in flux estimates due to sampling errors; however, the success of monitoring program mainly depends on the accuracy of the estimates. Apart from sampling errors, manpower and budgetary constraints also influence the quality of the estimates. This study attempted to develop optimum stormwater monitoring design considering both cost and the quality of the estimated pollutants flux. Three years stormwater monitoring data (2012 – 2014) from a mix land use located within Geumhak watershed South Korea was evaluated. The regional climate is humid and precipitation is usually well distributed through the year. The investigation of a large number of water quality parameters is time-consuming and resource intensive. In order to identify a suite of easy-to-measure parameters to act as a surrogate, Principal Component Analysis (PCA) was applied. Means, standard deviations, coefficient of variation (CV) and other simple statistics were performed using multivariate statistical analysis software SPSS 22.0. The implication of sampling time on monitoring results, number of samples required during the storm event and impact of seasonal first flush were also identified. Based on the observations derived from the PCA biplot and the correlation matrix, total suspended solids (TSS) was identified as a potential surrogate for turbidity, total phosphorus and for heavy metals like lead, chromium, and copper whereas, Chemical Oxygen Demand (COD) was identified as surrogate for organic matter. The CV among different monitored water quality parameters were found higher (ranged from 3.8 to 15.5). It suggests that use of grab sampling design to estimate the mass emission rates in the study area can lead to errors due to large variability. TSS discharge load calculation error was found only 2 % with two different sample size approaches; i.e. 17 samples per storm event and equally distributed 6 samples per storm event. Both seasonal first flush and event first flush phenomena for most water quality parameters were observed in the study area. Samples taken at the initial stage of storm event generally overestimate the mass emissions; however, it was found that collecting a grab sample after initial hour of storm event more closely approximates the mean concentration of the event. It was concluded that site and regional climate specific interventions can be made to optimize the stormwater monitoring program in order to make it more effective and economical.

Keywords: first flush, pollutant load, stormwater monitoring, surrogate parameters

Procedia PDF Downloads 240
1070 The Use of Online Multimedia Platforms to Deliver a Regional Medical Schools Finals Revision Course During the COVID-19 Pandemic

Authors: Matthew Edmunds, Andrew Hunter, Clare Littlewood, Wisha Gul, Gabriel Heppenstall-Harris, Thomas Humphries

Abstract:

Background: Revision courses for medical students undertaking their final examinations are commonplace throughout the UK. Traditionally these take the form of a series of lectures over multiple weeks or a single day of intensive lectures. The COVID-19 pandemic, however, has required medical educators to create new teaching formats to ensure they adhere to social distancing requirements. It has provided an unexpected opportunity to accelerate the development of students proficiency in the use of ‘technology-enabled communication platforms’, as mandated in the 2018 GMC Outcomes of Graduates. Recent advances in technology have made distance learning possible, whilst also providing novel and more engaging learning opportunities for students. Foundation Year 2 doctors at Aintree University Hospital developed an online series of videos to help prepare medical students in the North West and byond for their final medical school examinations. Method: Eight hour-long videos covering the key topics in medicine and surgery were posted on the Peer Learning Liverpool Youtube channel. These videos were created using new technology such as the screen and audio recording platform, Loom. Each video compromised at least 20 single best answer (SBA) questions, in keeping with the format in most medical school finals. Explanations of the answers were provided, and additional important material was covered. Students were able to ask questions by commenting on the videos, with the authors replying as soon as possible. Feedback was collated using an online Google form. Results: An average of 327 people viewed each video, with 113 students filling in the feedback form. 65.5% of respondents were within one month of their final medical school examinations. The average rating for how well prepared the students felt for their finals was 6.21/10 prior to the course and 8.01/10 after the course. A paired t-test demonstrated a mean increase of 1.80 (95% CI 1.66-1.93). Overall, 98.2% said the online format worked well or very well, and 99.1% would recommend the course to a peer. Conclusions: Based on the feedback received, the online revision course was successful both in terms of preparing students for their final examinations, and with regards to how well the online format worked. Free-text qualitative feedback highlighted advantages such as; students could learn at their own pace, revisit key concepts important to them, and practice exam style questions via the case-based format. Limitations identified included inconsistent audiovisual quality, and requests for a live online Q&A session following the conclusion of the course. This course will be relaunched later in the year with increased opportunities for students to access live feedback. The success of this online course has shown the roll that technology can play in medical education. As well as providing novel teaching modes, online learning allows students to access resources that otherwise would not be available locally, and ensure that they do not miss out on teaching that was previously provided face to face, in the current climate of social distancing.

Keywords: COVID-19 pandemic, Medical School, Online learning, Revision course

Procedia PDF Downloads 153
1069 Factors Affecting the Caregiving Experience of Children with Parental Mental Illnesses: A Systematic Review

Authors: N. Anjana

Abstract:

Worldwide, the prevalence of mental illnesses is increasing. The issues of persons with mental illness and their caregivers have been well documented in the literature. However, data regarding the factors affecting the caregiving experience of children with parental mental illnesses is sparse. This systematic review aimed to examine the existing literature of the factors affecting the caregiving experience of children of parents with mental illnesses. A comprehensive search of databases such as PubMed, EBSCO, JSTOR, ProQuest Central, Taylor and Francis Online, and Google Scholar were performed to identify peer-reviewed papers examining the factors associated with caregiving experiences of children with parental mental illnesses such as schizophrenia and major depression, for the 10-year period ending November 2019. Two researchers screened studies for eligibility. One researcher extracted data from eligible studies while a second performed verification of results for accuracy and completeness. Quality appraisal was conducted by both reviewers. Data describing major factors associated with caregiving experiences of children with parental mental illnesses were synthesized and reported in narrative form. Five studies were considered eligible and included in this review. Findings are organized under major themes such as the impact of parental mental illness on children’s daily life, how children provide care to their mentally ill parents as primary carers, social and relationship factors associated with their caregiving, positive and negative experiences in caregiving and how children cope with their experiences with parental mental illnesses. Literature relating to the caregiving experiences of children with parental mental illnesses is sparse. More research is required to better understand the children’s caregiving experiences related to parental mental illnesses so as to better inform management for enhancing their mental health, wellbeing, and caregiving practice.

Keywords: caregiving experience, children, parental mental illnesses, wellbeing

Procedia PDF Downloads 141
1068 Application of Federated Learning in the Health Care Sector for Malware Detection and Mitigation Using Software-Defined Networking Approach

Authors: A. Dinelka Panagoda, Bathiya Bandara, Chamod Wijetunga, Chathura Malinda, Lakmal Rupasinghe, Chethana Liyanapathirana

Abstract:

This research takes us forward with the concepts of Federated Learning and Software-Defined Networking (SDN) to introduce an efficient malware detection technique and provide a mitigation mechanism to give birth to a resilient and automated healthcare sector network system by also adding the feature of extended privacy preservation. Due to the daily transformation of new malware attacks on hospital Integrated Clinical Environment (ICEs), the healthcare industry is at an undefinable peak of never knowing its continuity direction. The state of blindness by the array of indispensable opportunities that new medical device inventions and their connected coordination offer daily, a factor that should be focused driven is not yet entirely understood by most healthcare operators and patients. This solution has the involvement of four clients in the form of hospital networks to build up the federated learning experimentation architectural structure with different geographical participation to reach the most reasonable accuracy rate with privacy preservation. While the logistic regression with cross-entropy conveys the detection, SDN comes in handy in the second half of the research to stack up the initial development phases of the system with malware mitigation based on policy implementation. The overall evaluation sums up with a system that proves the accuracy with the added privacy. It is no longer needed to continue with traditional centralized systems that offer almost everything but not privacy.

Keywords: software-defined network, federated learning, privacy, integrated clinical environment, decentralized learning, malware detection, malware mitigation

Procedia PDF Downloads 187
1067 Research on the Spatial Evolution of Tourism-Oriented Rural Settlements: Take the Xiaochanfangyu Village, Dongshuichang Village, Maojiayu Village in Jixian County, Tianjin City as Examples

Authors: Yu Zhang, Jie Wu, Li Dong

Abstract:

Rural tourism is the service industry which regards the agricultural production, rural life, rural nature and cultural landscape as the tourist attraction. It aims to meet the needs of the city tourists such as country sightseeing, vacation, and leisure. According to the difference of the tourist resources, the rural settlements can be divided into different types: The type of tourism resources, scenic spot, and peri-urban. In the past ten years, the rural tourism has promoted the industrial transformation and economic growth in rural areas of China. And it is conducive to the coordinated development of urban and rural areas and has greatly improved the ecological environment and the standard of living for farmers in rural areas. At the same time, a large number of buildings and sites are built in the countryside in order to enhance the tourist attraction and the ability of tourist reception and also to increase the travel comfort and convenience, which has significant influence on the spatial evolution of the village settlement. This article takes the XiangYing Subdistrict, which is in JinPu District of Dalian in China as the exemplification and uses the technology of Remote Sensing (RS), Geographic Information System (GIS) and the technology of Landscape Spatial Analysis to study the influence of the rural tourism development in the rural settlement spaces in four steps. First, acquiring the remote sensing image data at different times of 8 administrative villages in the XiangYing Subdistrict, by using the remote sensing application EDRAS8.6; second, vectoring basic maps of XiangYing Subdistrict including its land-use map with the application of ArcGIS 9.3, associating with social and economic attribute data of rural settlements and analyzing on the rural evolution visually; third, quantifying the comparison of these patches in rural settlements by using the landscape spatial calculation application Fragstats 3.3 and analyzing on the evolution of the spatial structure of settlement in macro and medium scale; finally, summarizing the evolution characteristics and internal reasons of tourism-oriented rural settlements. The main findings of this article include: first of all, there is difference in the evolution of the spatial structure between the developing rural settlements and undeveloped rural settlements among the eight administrative villages; secondly, the villages relying on the surrounding tourist attractions, the villages developing agricultural ecological garden and the villages with natural or historical and cultural resources have different laws of development; then, the rural settlements whose tourism development in germination period, development period and mature period have different characteristics of spatial evolution; finally, the different evolution modes of the tourism-oriented rural settlement space have different influences on the protection and inheritance of the village scene. The development of tourism has a significant impact on the spatial evolution of rural settlement. The intensive use of rural land and natural resources is the fundamental principle to protect the rural cultural landscape and ecological environment as well as the critical way to improve the attraction of rural tourism and promote the sustainable development of countryside.

Keywords: landscape pattern, rural settlement, spatial evolution, tourism-oriented, Xiangying Subdistrict

Procedia PDF Downloads 291
1066 Development of Medical Intelligent Process Model Using Ontology Based Technique

Authors: Emmanuel Chibuogu Asogwa, Tochukwu Sunday Belonwu

Abstract:

An urgent demand for creative solutions has been created by the rapid expansion of medical knowledge, the complexity of patient care, and the requirement for more precise decision-making. As a solution to this problem, the creation of a Medical Intelligent Process Model (MIPM) utilizing ontology-based appears as a promising way to overcome this obstacle and unleash the full potential of healthcare systems. The development of a Medical Intelligent Process Model (MIPM) using ontology-based techniques is motivated by a lack of quick access to relevant medical information and advanced tools for treatment planning and clinical decision-making, which ontology-based techniques can provide. The aim of this work is to develop a structured and knowledge-driven framework that leverages ontology, a formal representation of domain knowledge, to enhance various aspects of healthcare. Object-Oriented Analysis and Design Methodology (OOADM) were adopted in the design of the system as we desired to build a usable and evolvable application. For effective implementation of this work, we used the following materials/methods/tools: the medical dataset for the test of our model in this work was obtained from Kaggle. The ontology-based technique was used with Confusion Matrix, MySQL, Python, Hypertext Markup Language (HTML), Hypertext Preprocessor (PHP), Cascaded Style Sheet (CSS), JavaScript, Dreamweaver, and Fireworks. According to test results on the new system using Confusion Matrix, both the accuracy and overall effectiveness of the medical intelligent process significantly improved by 20% compared to the previous system. Therefore, using the model is recommended for healthcare professionals.

Keywords: ontology-based, model, database, OOADM, healthcare

Procedia PDF Downloads 78
1065 Predictability of Pupil Mydriasis as a Biomarker for Diabetes

Authors: Naveen Kumar Challa, Pavan Verıkıcherla, Madhubalan, Ashısh Sharma

Abstract:

Aim: Aim of the study was to find whether any difference exists in pupil mydriasis measured with Orbscan in non-diabetic and type 2 diabetic patients at various intervals after installation of Tropicamide 0.8% and Phenylephrine 5%. Methods: the Observational study conducted at a tertiary care eye hospital during September 2014 to March 2015. 240 eyes from 120 patients (40 non-diabetic, 80 diabetic) were dilated with Tropicamide 0.8% and Phenylephrine 5%. One drop of a drug was installed twice. The second drop is installed at 20 minutes after installation of the first drop. In two groups’ pupil diameter was measured before installation of drops and also at 15, 30, 45 and 60 minutes after installation of the first drop using both Orbscan. Result: Mean age of the non-diabetic group is 48.67 ± 7.93 years; Diabetic group is 59.97 ± 8.77 years. Mean duration of Diabetes was 7.01 ± 5.05 years. Mean pupil diameter measured with Orbscan before installation of the drops and also at 15, 30, 45 and 60 minutes after installation of first drop in non-diabetic group was 4.18 ± 0.64mm, 6.15 ± 0.41mm, 7.76 ±0.34, 9.59 ± 0.30, and 9.97 ± 0.10 mm respectively and for the diabetic group it was 4.00 ± 0.56 mm, 5.53 ± 0.52 mm, 7.018 ± 0.58mm, 8.25±0.51mm and 9.18 ± 0.46mm respectively. The mean difference between the mean pupil diameters of the non-diabetic and diabetic group shows a significant difference (P< 0.01) at all intervals except before dilatation. There is a significant negative correlation (r = 0.78 – 0.92) between the duration of diabetes and pupil dilatation at all intervals after installation of the drops. There is also significant difference (P< 0.005) in the mean values of pupil diameter between non retinopathy diabetic subjects and diabetic retinopathy subjects at all intervals after installation of drops. Conclusion: People attending eye clinic, whose pupil mydriasis values falls below the normal may be referred for diabetic evaluation. If normative data is established for the pupil size in Indian population using Orbscan then the values fall under normative data could be a predictor for diabetes. This would in turn help ophthalmologist to detect the diabetes at an early stage and prevent the complications resulting from the diabetes.

Keywords: diabetes mellitus, pupil diameter, orbscan, tropicamide

Procedia PDF Downloads 526
1064 Hemodialysis Technique in a Diabetic Population

Authors: Daniel Thompson, Sophie Cerutti, Muhammad Peerbux, Hansraj Bookun

Abstract:

Introduction: Diabetic nephropathy is the leading cause end stage renal failure in Australia, responsible for 36% of cases. Patients who require dialysis may be suitable for haemodialysis through an arteriovenous fistula (AVF), and preoperatively careful planning is required to select suitable vessels for a long-lasting fistula that provides suitable dialysis access. Due to high levels of vascular disease in diabetic patients, we sought to investigate whether there is a difference in the types of autologous AVFs created for diabetic patients in renal failure compared to their non-diabetic counterparts. Method: Data was collected from the Australasian Vascular Audit, for all vascular surgery completed at St. Vincent’s Hospital Melbourne between 2011-2020. Patients were selected by operative type, creation of AVF, and compared in two groups, diabetic patients and patients without diabetes. Chi-squared test was utilised to determine significance. Results: Data analysis is ongoing and will be complete with updated abstract in time for the conference. Discussion: Diabetic nephropathy is the cause for roughly a third of end stage renal failure in Australia. Diabetic patients present with a unique set of challenges when it comes to dialysis access due to increased risk of peripheral vascular disease and arterial calcification. Care must be taken in the creation of fistulas to minimise complications and increase the chance of long-lasting access. Our study investigates the difference in autologous AVFs between diabetics and non-diabetics, and results may be used to influence location of fistula creation. Further research may be used to investigate patency rates of fistulas in diabetics vs non-diabetics which would further influence treatment decisions.

Keywords: dialysis, diabetes, renal access, fistula

Procedia PDF Downloads 139
1063 Comparison of Machine Learning-Based Models for Predicting Streptococcus pyogenes Virulence Factors and Antimicrobial Resistance

Authors: Fernanda Bravo Cornejo, Camilo Cerda Sarabia, Belén Díaz Díaz, Diego Santibañez Oyarce, Esteban Gómez Terán, Hugo Osses Prado, Raúl Caulier-Cisterna, Jorge Vergara-Quezada, Ana Moya-Beltrán

Abstract:

Streptococcus pyogenes is a gram-positive bacteria involved in a wide range of diseases and is a major-human-specific bacterial pathogen. In Chile, this year the 'Ministerio de Salud' declared an alert due to the increase in strains throughout the year. This increase can be attributed to the multitude of factors including antimicrobial resistance (AMR) and Virulence Factors (VF). Understanding these VF and AMR is crucial for developing effective strategies and improving public health responses. Moreover, experimental identification and characterization of these pathogenic mechanisms are labor-intensive and time-consuming. Therefore, new computational methods are required to provide robust techniques for accelerating this identification. Advances in Machine Learning (ML) algorithms represent the opportunity to refine and accelerate the discovery of VF associated with Streptococcus pyogenes. In this work, we evaluate the accuracy of various machine learning models in predicting the virulence factors and antimicrobial resistance of Streptococcus pyogenes, with the objective of providing new methods for identifying the pathogenic mechanisms of this organism.Our comprehensive approach involved the download of 32,798 genbank files of S. pyogenes from NCBI dataset, coupled with the incorporation of data from Virulence Factor Database (VFDB) and Antibiotic Resistance Database (CARD) which contains sequences of AMR gene sequence and resistance profiles. These datasets provided labeled examples of both virulent and non-virulent genes, enabling a robust foundation for feature extraction and model training. We employed preprocessing, characterization and feature extraction techniques on primary nucleotide/amino acid sequences and selected the optimal more for model training. The feature set was constructed using sequence-based descriptors (e.g., k-mers and One-hot encoding), and functional annotations based on database prediction. The ML models compared are logistic regression, decision trees, support vector machines, neural networks among others. The results of this work show some differences in accuracy between the algorithms, these differences allow us to identify different aspects that represent unique opportunities for a more precise and efficient characterization and identification of VF and AMR. This comparative analysis underscores the value of integrating machine learning techniques in predicting S. pyogenes virulence and AMR, offering potential pathways for more effective diagnostic and therapeutic strategies. Future work will focus on incorporating additional omics data, such as transcriptomics, and exploring advanced deep learning models to further enhance predictive capabilities.

Keywords: antibiotic resistance, streptococcus pyogenes, virulence factors., machine learning

Procedia PDF Downloads 31
1062 Vehicle Timing Motion Detection Based on Multi-Dimensional Dynamic Detection Network

Authors: Jia Li, Xing Wei, Yuchen Hong, Yang Lu

Abstract:

Detecting vehicle behavior has always been the focus of intelligent transportation, but with the explosive growth of the number of vehicles and the complexity of the road environment, the vehicle behavior videos captured by traditional surveillance have been unable to satisfy the study of vehicle behavior. The traditional method of manually labeling vehicle behavior is too time-consuming and labor-intensive, but the existing object detection and tracking algorithms have poor practicability and low behavioral location detection rate. This paper proposes a vehicle behavior detection algorithm based on the dual-stream convolution network and the multi-dimensional video dynamic detection network. In the videos, the straight-line behavior of the vehicle will default to the background behavior. The Changing lanes, turning and turning around are set as target behaviors. The purpose of this model is to automatically mark the target behavior of the vehicle from the untrimmed videos. First, the target behavior proposals in the long video are extracted through the dual-stream convolution network. The model uses a dual-stream convolutional network to generate a one-dimensional action score waveform, and then extract segments with scores above a given threshold M into preliminary vehicle behavior proposals. Second, the preliminary proposals are pruned and identified using the multi-dimensional video dynamic detection network. Referring to the hierarchical reinforcement learning, the multi-dimensional network includes a Timer module and a Spacer module, where the Timer module mines time information in the video stream and the Spacer module extracts spatial information in the video frame. The Timer and Spacer module are implemented by Long Short-Term Memory (LSTM) and start from an all-zero hidden state. The Timer module uses the Transformer mechanism to extract timing information from the video stream and extract features by linear mapping and other methods. Finally, the model fuses time information and spatial information and obtains the location and category of the behavior through the softmax layer. This paper uses recall and precision to measure the performance of the model. Extensive experiments show that based on the dataset of this paper, the proposed model has obvious advantages compared with the existing state-of-the-art behavior detection algorithms. When the Time Intersection over Union (TIoU) threshold is 0.5, the Average-Precision (MP) reaches 36.3% (the MP of baselines is 21.5%). In summary, this paper proposes a vehicle behavior detection model based on multi-dimensional dynamic detection network. This paper introduces spatial information and temporal information to extract vehicle behaviors in long videos. Experiments show that the proposed algorithm is advanced and accurate in-vehicle timing behavior detection. In the future, the focus will be on simultaneously detecting the timing behavior of multiple vehicles in complex traffic scenes (such as a busy street) while ensuring accuracy.

Keywords: vehicle behavior detection, convolutional neural network, long short-term memory, deep learning

Procedia PDF Downloads 130
1061 Role of Imaging in Predicting the Receptor Positivity Status in Lung Adenocarcinoma: A Chapter in Radiogenomics

Authors: Sonal Sethi, Mukesh Yadav, Abhimanyu Gupta

Abstract:

The upcoming field of radiogenomics has the potential to upgrade the role of imaging in lung cancer management by noninvasive characterization of tumor histology and genetic microenvironment. Receptor positivity like epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) genotyping are critical in lung adenocarcinoma for treatment. As conventional identification of receptor positivity is an invasive procedure, we analyzed the features on non-invasive computed tomography (CT), which predicts the receptor positivity in lung adenocarcinoma. Retrospectively, we did a comprehensive study from 77 proven lung adenocarcinoma patients with CT images, EGFR and ALK receptor genotyping, and clinical information. Total 22/77 patients were receptor-positive (15 had only EGFR mutation, 6 had ALK mutation, and 1 had both EGFR and ALK mutation). Various morphological characteristics and metastatic distribution on CT were analyzed along with the clinical information. Univariate and multivariable logistic regression analyses were used. On multivariable logistic regression analysis, we found spiculated margin, lymphangitic spread, air bronchogram, pleural effusion, and distant metastasis had a significant predictive value for receptor mutation status. On univariate analysis, air bronchogram and pleural effusion had significant individual predictive value. Conclusions: Receptor positive lung cancer has characteristic imaging features compared with nonreceptor positive lung adenocarcinoma. Since CT is routinely used in lung cancer diagnosis, we can predict the receptor positivity by a noninvasive technique and would follow a more aggressive algorithm for evaluation of distant metastases as well as for the treatment.

Keywords: lung cancer, multidisciplinary cancer care, oncologic imaging, radiobiology

Procedia PDF Downloads 136