Search results for: clinical benefit

Authors: José Ramón López-Mínguez, Estrella Suárez-Corchuelo, Sergio López-Tejero, Luis Nombela-Franco, Xavier Freixa-Rofastes, Guillermo Bastos-Fernández, Xavier Millán-Álvarez, Raúl Moreno-Gómez, José Antonio Fernández-Díaz, Ignacio Amat-Santos, Tomás Benito-González, Fernando Alfonso-Manterola, Pablo Salinas-Sanguino, Pedro Cepas-Guillén, Dabit Arzamendi, Ignacio Cruz-González, Juan Manuel Nogales-Asensio

Abstract:

Background and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients’ long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

Keywords: stents, atrial fibrillation, anticoagulants, left atrial appendage occlusion

Procedia PDF Downloads 46

Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

Abstract:

Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

Procedia PDF Downloads 186

Authors: Nawras Kurzom, Avi Mendelsohn

Abstract:

The effects of background music on learning and memory are inconsistent, partly due to the intrinsic complexity and variety of music and partly to individual differences in music perception and preference. A prominent musical feature that is known to elicit strong emotional responses is musical tension. Musical tension can be brought about by building anticipation of rhythm, harmony, melody, and dynamics. Delaying the resolution of dominant-to-tonic chord progressions, as well as using dissonant harmonics, can elicit feelings of tension, which can, in turn, affect memory formation of concomitant information. The aim of the presented studies was to explore how forming declarative memory is influenced by musical tension, brought about within continuous music as well as in the form of isolated chords with varying degrees of dissonance/consonance. The effects of musical tension on long-term memory of declarative information were studied in two ways: 1) by evoking tension within continuous music pieces by delaying the release of harmonic progressions from dominant to tonic chords, and 2) by using isolated single complex chords with various degrees of dissonance/roughness. Musical tension was validated through subjective reports of tension, as well as physiological measurements of skin conductance response (SCR) and pupil dilation responses to the chords. In addition, music information retrieval (MIR) was used to quantify musical properties associated with tension and its release. Each experiment included an encoding phase, wherein individuals studied stimuli (words or images) with different musical conditions. Memory for the studied stimuli was tested 24 hours later via recognition tasks. In three separate experiments, we found positive relationships between tension perception and physiological measurements of SCR and pupil dilation. As for memory performance, we found that background music, in general, led to superior memory performance as compared to silence. We detected a trade-off effect between tension perception and memory, such that individuals who perceived musical tension as such displayed reduced memory performance for images encoded during musical tension, whereas tense music benefited memory for those who were less sensitive to the perception of musical tension. Musical tension exerts complex interactions with perception, emotional responses, and cognitive performance on individuals with and without musical training. Delineating the conditions and mechanisms that underlie the interactions between musical tension and memory can benefit our understanding of musical perception at large and the diverse effects that music has on ongoing processing of declarative information.

Keywords: musical tension, declarative memory, learning and memory, musical perception

Procedia PDF Downloads 83

Authors: Usha Barahmand, Maria Stalias, Abdul Haq, Esther Rotlevi, Ying Xiang

Abstract:

Misophonia is a condition in which specific repetitive oral, nasal, or other sounds and movements made by humans trigger impulsive aversive reactions of irritation or disgust that instantly become anger. A few measures exist for the assessment of misophonia, but each has some limitations, and evidence for a formal diagnosis is still lacking. The objective of this study was to develop a reliable and valid measure of misophonia for use in the general population. Adopting a purely descriptive approach, this study focused on developing a self-report measure using all triggers and reactions identified in previous studies on misophonia. A measure with two subscales, one assessing the aversive quality of various triggers and the other assessing reactions of individuals, was developed. Data were gathered from a large sample of both men and women ranging in age from 18 to 65 years. Exploratory factor analysis revealed three main triggers: oral/nasal sounds, hand and leg movements, and environmental sounds. Two clusters of reactions also emerged: nonangry attempts to avoid the impact of the aversive stimuli and angry attempts to stop the aversive stimuli. The examination of the psychometric properties of the scale revealed its internal consistency and test-retest reliability to be excellent. The scale was also found to have very good concurrent and convergent validity. Significant annoyance and disgust in response to the triggers were reported by 12% of the sample, although for some specific triggers, rates as high as 31% were also reported. These findings have implications for the delineation of the criteria for identifying misophonia as a clinical condition.

Keywords: adults, factor analysis, misophonia, psychometric properties, scale

Procedia PDF Downloads 180

Authors: Samantha Meyr, Eman Mirdamadi, Martha Wang, Tao Lowe, Ryan Smith, Quinn Burke

Abstract:

Critical-sized bone defects (CSD) treatment options remain a major clinical orthopedic challenge. They are uniquely contoured diseased or damaged bones and can be defined as those that will not heal spontaneously and require surgical intervention. Autografts are the current gold standard CSD treatment, which are histocompatible and provoke a minimal immunogenic response; however, they can cause donor site morbidity and will not suffice for the size required for replacement. As an alternative to traditional surgical methods, bone tissue engineering will be implemented via 3D printing methods. A freeze-dried bone matrix (FDBM) is a type of graft material available but will only function as desired when in the presence of bone growth factors. Polycaprolactone (PCL) is a known biodegradable material with good biocompatibility that has been proven manageable in 3D printing as a medical device. A 3D-extrusion printing strategy is introduced to print these materials into scaffolds for bone grafting purposes, which could be more accessible and rapid than the current standard. Mechanical, thermal, cytotoxic, and physical properties were investigated throughout a degradation period of 6 months using fibroblasts and dental pulp stem cells. PCL-FDBM scaffolds were successfully printed with high print fidelity in their respective pore sizes and allograft content. Additionally, we have created a method for evaluating PCL using differential scanning calorimetry (DSC) and have evaluated PCL degradation over roughly 6 months.

Keywords: 3D printing, bone tissue engineering, cytotoxicity, degradation, scaffolds

Procedia PDF Downloads 86

Authors: Nadeen Eltoukhy, Sahar S. Sheta, Walaa Elnaggar, Karim Bakr

Abstract:

Purpose: The aim of this study is to compare the clinical efficacy and side effects of oral versus intralesional propranolol treatment of infantile capillary hemangiomas in infants. Methods: The study enrolled 40 infants diagnosed with infantile capillary hemangiomas. Patients were divided into 2 groups: Group A (Non-invasive group) included 20 infants who received oral propranolol hydrochloride starting at a dose of 1 mg/kg/day BID, then increased to a max of 2 mg/kg/day BID gradually over 2 weeks for 3 months. Group B (Invasive group) included 20 infants who received intralesional propranolol injection at a dose of 1 mg/mL; the volume of the injected drug depended on the size of the lesion (0.2 mL injected per cm of lesion diameter), with a maximum volume of 1 mL for a lesion of 5 cm diameter under complete aseptic conditions in the operating theater. Results: At three months after initiating treatment, the circumferential size of the hemangioma showed a statistically significant decrease in both groups; in Group A from 3.66±2.89 cm to 1.56±1.26 cm with p-value <0.05 and in Group B from 2.99±2.73 cm to 1.32±1.18 cm with p-value <0.05. There is no statistically significant comparative difference between the two groups (p-value = 0.538 = insignificant). Regarding the complications of oral propranolol, one patient (5%) had bradycardia, and one patient (5%) had diarrhea. In the injection group, 20 patients (100%) had local edema, and one patient (5%) had a local infection. Conclusions: Both oral non-invasive and intralesional invasive propranolol are safely used to successfully treat and decrease the size of infantile hemangioma while showing no statistically comparative difference between both treatment techniques.

Keywords: hemangioma, oral beta blocker, intralesional beta blocker, infants

Procedia PDF Downloads 36

Authors: Mannan Mridha, Mohammad S. Islam

Abstract:

Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

Procedia PDF Downloads 133

Authors: Ni Putu Evi Wijayanti, Made Darmiati, Ni Ketut Wiwiek Agustina, Putu Gde Arie Yudhistira, Marcel Hardono

Abstract:

This research study discusses the tourists’ perception to white water rafting service quality in Bali (Case Study: Ayung River). The aim is to determine the tourists’ perception to: firstly, the services quality of white water rafting trip in Bali, secondly, is to determine which dimensions of the service quality that need to take main handling priority in accordance with the level of important service of white water rafting company’s working performance toward the service quality of rafting in Bali especially on Ayung Riveri, lastly, is to know the efforts are needed to improve the service quality of white water rafting trip for tourist in Bali, specifically on Ayung River. This research uses the concept of the service quality with five principal dimensions, namely: Tangibles, Reliability, Responsiveness, Assurance, Empathy. Location of the research is tourist destination area of the Ayung River, that lies between the boundary of Badung Regency at Western part and Gianyar Regency eastern side. There are three rafting companies located on the Ayung River. This research took 100 respondents who were selected as a sample by using purposive sampling method. Data were collected through questionnaires distributed to domestic tourists then tabulated using the weighting scale (Likert scale) and analyzed using analysis of the benefit performance (important performance analysis) in the form of Cartesian diagram. The results of the research are translated into three points. Firstly, there are 23 indicators assessed by the service aspect of domestic tourists where the highest value is the aspect of familiarity between the tourist and employees with points (0.29) and the lowest score is the aspect of the clarity of the Ayung River water discharge value (-0.35). This shows that the indicator has not been fully able to meet the expectations of service aspects of the rating. Secondly, the dimensions of service quality that requires serious attention is the dimension of tangibles. The third point is the efforts that needs to be done adapted to the results of the Cartesian diagram breaks down into four quadrants. Based on the results of the research suggested to the manager of the white water rafting tour in order to continuously improve the service quality to tourists, performing new innovations in terms of product variations, provide insight and training to its employees to increase their competence, especially in the field of excellent service so that the satisfaction rating can be achieved.

Keywords: perception, rafting, service quality, tourist satisfaction

Procedia PDF Downloads 227

Authors: Mohammad Didar Hossain

Abstract:

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

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

Procedia PDF Downloads 146

Authors: Mona Hejazi, Ali Motie Nasrabadi

Abstract:

Epilepsy is a persistent neurological disorder that affects more than 50 million people worldwide. Hence, there is a necessity to introduce an efficient prediction model for making a correct diagnosis of the epileptic seizure and accurate prediction of its type. In this study we consider how the Effective Connectivity (EC) patterns obtained from intracranial Electroencephalographic (EEG) recordings reveal information about the dynamics of the epileptic brain and can be used to predict imminent seizures, as this will enable the patients (and caregivers) to take appropriate precautions. We use this definition because we believe that effective connectivity near seizures begin to change, so we can predict seizures according to this feature. Results are reported on the standard Freiburg EEG dataset which contains data from 21 patients suffering from medically intractable focal epilepsy. Six channels of EEG from each patients are considered and effective connectivity using Directed Transfer Function (DTF) and Granger Causality (GC) methods is estimated. We concentrate on effective connectivity standard deviation over time and feature changes in five brain frequency sub-bands (Alpha, Beta, Theta, Delta, and Gamma) are compared. The performance obtained for the proposed scheme in predicting seizures is: average prediction time is 50 minutes before seizure onset, the maximum sensitivity is approximate ~80% and the false positive rate is 0.33 FP/h. DTF method is more acceptable to predict epileptic seizures and generally we can observe that the greater results are in gamma and beta sub-bands. The research of this paper is significantly helpful for clinical applications, especially for the exploitation of online portable devices.

Keywords: effective connectivity, Granger causality, directed transfer function, epilepsy seizure prediction, EEG

Procedia PDF Downloads 447

Authors: Rabia Ashfaq, Saeed Iqbal, Atiq ur Rehman, Irfanullah Khan

Abstract:

An extensive series of radiopharmaceuticals have been explored in order to discover a better brain tumour diagnostic agent. Tc99m labelling with cysteine and its derivatives in liposomes shows effective tagging of about 70% to 80 %. Due to microscopic size it successfully crossed the brain barrier in 2 minutes which gradually decreases in 5 to 15 minutes. HMPAO labelled with Tc99m is another important radiopharmaceutical used to study brain perfusion but it comes with a flaw that it’s only functional during epilepsy. 1, 1 ECD is purely used in Tc99m ECD formulation; because it not only tends to cross the blood brain barrier but it can be metabolized which can be easily entrapped in human brain. Radio labelling of Cysteine with Tc99m at room temperature was performed which yielded no good results. Hence cysteine derivatives with salicylaldehyde were prepared that produced about 75 % yield for ligand. In order to perform it’s radio labelling a suitable solvent DMSO was selected and physical parameters were performed. Elemental analyser produced remarkably similar results for ligand as reported in literature. IR spectra of Ligand in DMSO concluded in the absence of SH stretch and presence of N-H vibration. Thermal analysis of the ligand further suggested its decomposition pattern with no distinct curve for a melting point. Radio labelling of ligand was performed which produced excellent results giving up to 88% labelling at pH 5.0. Clinical trials using Rabbit were performed after validating the products reproducibility. The radiopharmaceutical prepared was injected into the rabbit. Dynamic as well as static study was performed under the SPECT. It showed considerable uptake in the kidneys and liver considering it suitable for the Hypatobilliary study.

Keywords: marcapto compounds, 99mTc - radiolabeling, salicylaldicysteine, thiozolidine

Procedia PDF Downloads 327

Authors: James Rate, Apostolos Pesiridis

Abstract:

In this paper, the propulsion requirements required to achieve sustained hypersonic flight for commercial air transportation are evaluated. In addition, a design methodology is developed and used to determine the propulsive capabilities of both ramjet and scramjet engines. Twelve configurations are proposed for hypersonic flight using varying combinations of turbojet, turbofan, ramjet and scramjet engines. The optimal configuration was determined based on how well each of the configurations met the projected requirements for hypersonic commercial transport. The configurations were separated into four sub-configurations each comprising of three unique derivations. The first sub-configuration comprised four afterburning turbojets and either one or two ramjets idealised for Mach 5 cruise. The number of ramjets required was dependent on the thrust required to accelerate the vehicle from a speed where the turbojets cut out to Mach 5 cruise. The second comprised four afterburning turbojets and either one or two scramjets, similar to the first configuration. The third used four turbojets, one scramjet and one ramjet to aid acceleration from Mach 3 to Mach 5. The fourth configuration was the same as the third, but instead of turbojets, it implemented turbofan engines for the preliminary acceleration of the vehicle. From calculations which determined the fuel consumption at incremental Mach numbers this paper found that the ideal solution would require four turbojet engines and two Scramjet engines. The ideal mission profile was determined as being an 8000km sortie based on an averaging of popular long haul flights with strong business ties, which included Los Angeles to Tokyo, London to New York and Dubai to Beijing. This paper deemed that these routes would benefit from hypersonic transport links based on the previously mentioned factors. This paper has found that this configuration would be sufficient for the 8000km flight to be completed in approximately two and a half hours and would consume less fuel than Concord in doing so. However, this propulsion configuration still result in a greater fuel cost than a conventional passenger. In this regard, this investigation contributes towards the specification of the engine requirements throughout a mission profile for a hypersonic passenger vehicle. A number of assumptions have had to be made for this theoretical approach but the authors believe that this investigation lays the groundwork for appropriate framing of the propulsion requirements for sustained hypersonic flight for commercial air transportation. Despite this, it does serve as a crucial step in the development of the propulsion systems required for hypersonic commercial air transportation. This paper provides a methodology and a focus for the development of the propulsion systems that would be required for sustained hypersonic flight for commercial air transportation.

Keywords: hypersonic, ramjet, propulsion, Scramjet, Turbojet, turbofan

Procedia PDF Downloads 303

Authors: Garry Gorman, Nigel McKelvey, James Connolly

Abstract:

This study will evaluate a growth mindset intervention with Junior Cycle Coding and Senior Cycle Computer Science students in Ireland, where gamification will be used to incentivise growth mindset behaviour. An artificial intelligence (AI) driven personalised learning system will be developed to present computer programming learning tasks in a manner that is best suited to the individuals’ own learning preferences while incentivising and rewarding growth mindset behaviour of persistence, mastery response to challenge, and challenge seeking. This research endeavours to measure mindset with before and after surveys (conducted nationally) and by recording growth mindset behaviour whilst playing a digital game. This study will harness the capabilities of AI and aims to determine how a personalised learning (PL) experience can impact the mindset of a broad range of students. The focus of this study will be to determine how personalising the learning experience influences female and disadvantaged students' sense of belonging in the computer science classroom when tasks are presented in a manner that is best suited to the individual. Whole Brain Learning will underpin this research and will be used as a framework to guide the research in identifying key areas such as thinking and learning styles, cognitive potential, motivators and fears, and emotional intelligence. This research will be conducted in multiple school types over one academic year. Digital games will be played multiple times over this period, and the data gathered will be used to inform the AI algorithm. The three data sets are described as follows: (i) Before and after survey data to determine the grit scores and mindsets of the participants, (ii) The Growth Mind-Set data from the game, which will measure multiple growth mindset behaviours, such as persistence, response to challenge and use of strategy, (iii) The AI data to guide PL. This study will highlight the effectiveness of an AI-driven personalised learning experience. The data will position AI within the Irish educational landscape, with a specific focus on the teaching of CS. These findings will benefit coding and computer science teachers by providing a clear pedagogy for the effective delivery of personalised learning strategies for computer science education. This pedagogy will help prevent students from developing a fixed mindset while helping pupils to exhibit persistence of effort, use of strategy, and a mastery response to challenges.

Keywords: computer science education, artificial intelligence, growth mindset, pedagogy

Procedia PDF Downloads 75

Authors: Sumeeta Khurana, Kirti Megha, Amit Gupta, Rakesh Sehgal

Abstract:

Background: Amoebic keratitis is a painful vision threatening infection caused by a free living pathogenic amoeba Acanthamoeba. It can be misdiagnosed and very difficult to treat if not suspected early. The epidemiology of Acanthamoeba genotypes causing infection in our geographical area is not yet known to the best of our knowledge. Objective: To characterize Acanthamoeba isolates from amoebic keratitis patients. Methods: A total of 19 isolates obtained from patients with amoebic keratitis presenting to the Advanced Eye Centre at Postgraduate Institute of Medical Education and Research, a tertiary care centre of North India over a period of last 10 years were included. Their corneal scrapings, lens solution and lens case (in case of lens wearer) were collected for microscopic examination, culture and molecular diagnosis. All the isolates were maintained in the Non Nutrient agar culture medium overlaid with E.coli and 13 strains were axenised and maintained in modified Peptone Yeast Dextrose Agar. Identification of Acanthamoeba genotypes was based on amplification of diagnostic fragment 3 (DF3) region of the 18srRNA gene followed by sequencing. Nucleotide similarity search was performed by BLAST search of sequenced amplicons in GenBank database (http//www.ncbi.nlm.nih.gov/blast). Multiple Sequence alignments were determined by using CLUSTAL X. Results: Nine out of 19 Acanthamoeba isolates were found to belong to Genotype T4 followed by 6 isolates of genotype T11, 3 T5 and 1 T3 genotype. Conclusion: T4 is the predominant Acanthamoeba genotype in our geographical area. Further studies should focus on differences in pathogenicity of these genotypes and their clinical significance.

Keywords: Acanthamoeba, free living amoeba, keratitis, genotype, ocular

Procedia PDF Downloads 226

Authors: Gaya Bin Noon, Thoko Hanjahanja-Phiri, Laura Xavier Fadrique, Plinio Pelegrini Morita, Hélène Vaillancourt, Jennifer Teague, Tania Donovska

Abstract:

Active Assisted Living (AAL) refers to systems designed to improve the quality of life, aid in independence, and create healthier lifestyles for care recipients. As the population ages, there is a pressing need for non-intrusive, continuous, adaptable, and reliable health monitoring tools to support aging in place. AAL has great potential to support these efforts with the wide variety of solutions currently available, but insufficient efforts have been made to address concerns arising from the integration of AAL into care. The purpose of this research was to (1) explore the integration of AAL technologies and data into the clinical pathway, and (2) map data access and governance for AAL technology in order to develop standards for use by policy-makers, technology manufacturers, and developers of smart communities for seniors. This was done through four successive research phases: (1) literature search to explore existing work in this area and identify lessons learned; (2) modeling of the continuum of care; (3) adapting a framework for data governance into the AAL context; and (4) interviews with stakeholders to explore the applicability of previous work. Opportunities for standards found in these research phases included a need for greater consistency in language and technology requirements, better role definition regarding who can access and who is responsible for taking action based on the gathered data, and understanding of the privacy-utility tradeoff inherent in using AAL technologies in care settings.

Keywords: active assisted living, aging in place, internet of things, standards

Procedia PDF Downloads 119

Authors: Kara Terki Ibtissem, Hassaine Hafida, Bellifa Samia

Abstract:

Introduction: Staphylococcus aureus is one of the species that are most frequently isolated from urinary catheters. The ability to produce a biofilm is an important step in the pathogenesis of these staphylococci; biofilm formation is strongly dependent on the environmental conditions it also depends on the different parameters these biofilms are subjected to. Antiseptics, including ethanol and betadine, are used in clinical practice for disinfection and infection prevention. Recent studies, however, demonstrate that disinfectants may enhance biofilm production in Staphylococci. Methods: In this study, 48 staphylococcus aureus isolated from urinary catheters at the University Hospital Center of Sidi Bel Abbes (in Northwestern Algeria) were analyzed to detect the formation of biofilm by culture on Red Congo Agar (RCA), the Tube Method (TM) and tissue Culture Plate (TCP) techniques, this last was also used to investigate the effect of ethanol and Betadine on the preformed biofilm In a second time to know which environment is most favorable to the formation of the biofilm we perform a statistical test based on the student test by the software R. Results: It has been found that 23 strains produced a bacterial slime on the Congo red medium, 5 strains produced a biofilm by the tube method, 2 of which are highly productive. In addition, 7 strains produced a biofilm on polystyrene micro-plates; this number was higher in the presence of ethanol 70% and ethanol 90% with 19 and 11 biofilm-producing strains, respectively. On the other hand, no biofilm was formed in the presence of Betadine. Conclusion: It is important to examine the response of biofilms following an imposed external constraint, such as disinfectants, in order to develop new strategies to combat bacterial biofilms but also to better control their formation.

Keywords: staphylococcus aureus, biofilm, urinary catheter, ethanol

Procedia PDF Downloads 37

Authors: Shivani Yadav

Abstract:

The Study of terrorism lends itself to the constructivist framework as constructivism focuses on the importance of ideas and norms in shaping interests and identities. Constructivism is pertinent to understand the phenomenon of a terrorist organization like the Islamic State (IS), which opportunistically utilizes radical ideas and norms to shape its ‘politics of identity’. This ‘identity’, which is at the helm of preferences and interests of actors, in turn, shapes actions. The paper argues that an effective counter-terrorism policy must recognize the importance of ideas in order to counter the threat arising from acts of radicalism and terrorism. Traditional theories of international relations, with an emphasis on state-centric security problematic, exhibit several limitations and problems in interpreting the phenomena of terrorism. With the changing global order, these theories have failed to adapt to the changing dimensions of terrorism, especially ‘newer’ actors like the Islamic State (IS). The paper observes that IS distinguishes itself from other terrorist organizations in the way that it recruits and spreads its propaganda. Not only are its methods different, but also its tools (like social media) are new. Traditionally, too, force alone has rarely been sufficient to counter terrorism, but it seems especially impossible to completely root out an organization like IS. Time is ripe to change the discourse around terrorism and counter-terrorism strategies. The counter-terrorism measures adopted by states, which primarily focus on mitigating threats to the national security of the state, are preoccupied with statist objectives of the continuance of state institutions and maintenance of order. This limitation prevents these theories from addressing the questions of justice and the ‘human’ aspects of ideas and identity. These counter-terrorism strategies adopt a problem-solving approach that attempts to treat the symptoms without diagnosing the disease. Hence, these restrictive strategies fail to look beyond calculated retaliation against violent actions in order to address the underlying causes of discontent pertaining to ‘why’ actors turn violent in the first place. What traditional theories also overlook is that overt acts of violence may have several causal factors behind them, some of which are rooted in the structural state system. Exploring these root causes through the constructivist framework helps to decipher the process of ‘construction of terror’ and to move beyond the ‘what’ in theorization in order to describe ‘why’, ‘how’ and ‘when’ terrorism occurs. Study of terrorism would much benefit from a constructivist analysis in order to explore non-military options while countering the ideology propagated by the IS.

Keywords: constructivism, counter terrorism, Islamic State, politics of identity

Procedia PDF Downloads 168

Authors: Minna-Maari Harmaala, Hanna Harilainen

Abstract:

Estimates of the economic value of transitioning to circular economy models vary but it has been estimated to represent $1 trillion worth of new business into the global economy. In Europe alone, estimates claim that adopting circular-economy principles could not only have environmental and social benefits but also generate a net economic benefit of €1.8 trillion by 2030. Proponents of a circular economy argue that it offers a major opportunity to increase resource productivity, decrease resource dependence and waste, and increase employment and growth. A circular system could improve competitiveness and unleash innovation. Yet, most companies are not capturing these opportunities and thus the even abundant circular opportunities remain uncaptured even though they would seem inherently profitable. Service design in broad terms relates to developing an existing or a new service or service concept with emphasis and focus on the customer experience from the onset of the development process. Service design may even mean starting from scratch and co-creating the service concept entirely with the help of customer involvement. Service design methodologies provide a structured way of incorporating customer understanding and involvement in the process of designing better services with better resonance to customer needs. A business model is a depiction of how the company creates, delivers, and captures value; i.e. how it organizes its business. The process of business model development and adjustment or modification is also called business model innovation. Innovating business models has become a part of business strategy. Our hypothesis is that in addition to linear models still being easier to adopt and often with lower threshold costs, companies lack an understanding of how circular models can be adopted into their business and how customers will be willing and ready to adopt the new circular business models. In our research, we use robust service design methodology to develop circular economy solutions with two case study companies. The aim of the process is to not only develop the service concepts and portfolio, but to demonstrate the willingness to adopt circular solutions exists in the customer base. In addition to service design, we employ business model innovation methods to develop, test, and validate the new circular business models further. The results clearly indicate that amongst the customer groups there are specific customer personas that are willing to adopt and in fact are expecting the companies to take a leading role in the transition towards a circular economy. At the same time, there is a group of indifferents, to whom the idea of circularity provides no added value. In addition, the case studies clearly show what changes adoption of circular economy principles brings to the existing business model and how they can be integrated.

Keywords: business model innovation, circular economy, circular economy business models, service design

Procedia PDF Downloads 116

Authors: Arjumand Warsy

Abstract:

Among the Muslims, the Holy Quran is taught from early childhood and generally by the age of 7-8 years the reading of the entire Quran is completed by most of the children in Muslim families. During this period excellent reciter’s are selected to teach and emphasis is laid on correct reading, pronunciation and memorization. Following these years, the parents lay emphasis on the recitation of the Quran on daily basis. During the month of Ramadan the entire Quran is read one or more times and there are considerable number of Muslims who complete the entire Quran once or more each calendar month. Many Muslims do not know Arabic and for them message in the Quran is what others tell them and often they have no idea about this Guidance sent to them. This deficiency is reflected in many ways, both among people living in Muslim or non-Muslim countries. Due to the deficiency in knowledge about Islamic teachings, the foundations of Islam are being eroded by a variety of forces. In an attempt to guard against the non-Islamic influences, every Muslim must have a clear understanding of the Islamic teachings and requirements. The best guidance can be provided by the understanding of the Holy Quran. However, we are faced with the problem that often the Quran is taught in a way that fails to develop an interest and understanding of the message from Allah. Looking at the teaching of other subjects both scientific and non-scientific, at school, college or University levels, it is obvious that the advances in teaching methodologies using electronic technology have had a major impact, where both the understanding and the interest of the students are significantly elevated. We attempted to teach the meaning of the Holy Quran to children and adults using a scientific and modern approach using slide presentation and animations. The results showed almost 100% increase in the understanding of the Quran message; all attendees claimed they developed an increased interest in the study of the Holy Quran and did not lose track or develop boredom throughout the lectures. They learnt the information and remembered it more effectively. The love for Allah and Prophet Mohammad (PBUH) increased significantly. The fear of Allah and love of Heaven developed significantly. Historical facts and the stories of the past nations became clearer and the Greatness of the Creator was strongly felt. Several of attendees wanted to become better Muslims and to spread the knowledge of Islam. In this presentation, the adopted teaching method will be first presented and demonstrated to the audience using a short Surah from the Quran, followed by discussion on the results achieved during our study. We will endeavor to convey to the audience that there is a need to adopt a more scientific approach to teach the Quran so that a greater benefit is achieved by all.

Keywords: The Holy Quran, Muslims, presentations, technology

Procedia PDF Downloads 413

Authors: C. Chaillou

Abstract:

The dominant theoretical approaches in Criminology are interested in the phenomenon of delinquency from the question of the management of the risks incurred by the population. Thus, this research advocate prevention of this phenomenon by a tracking of early disorders in children. Treatments offered to rely on medical research (genetics and biology are cited as a reference) and assuming a high naturalization of delinquent behaviour. Programs that are offered also reduce to a recovery of the deviant behaviour, and rely readily on behavioral guidelines, with an educational grant. Public policy then rely on these programs to prevent unwanted behaviour within a given population and to reduce the risk for the company. This is the case in France, with national institutes making (juvenile) violence a public health problem. We consider that other approaches, issues of sociology, are more relevant to the treatment of offenders. These approaches are moving, not on its prevention, but from its inputs and its outputs. Several modalities of entries and exits of delinquency can find and analyze in terms of process. We assume that there is a dynamic inherent in the individual and it is important to take into account the environment of the offender. These different types of processes can illuminate from the derived work of the Psychoanalytical psychopathology and lead to more effective treatment of delinquent acts. Psychoanalytic concepts have enabled us to offer a new look means to treat delinquency, placing several types of relationship with the other and relating to the clinical structure and the uniqueness of the case, we have been able to enter subjective and unconscious logics at work in delinquent acts. This research has facilitated the reduction of these types of subjective responses and proposed others, opening to a reintegration of offenders in a social link them being more favourable and in a longer term.

Keywords: delinquency, insertion, social link, unconscious

Procedia PDF Downloads 370

Authors: Majeda Hammoud

Abstract:

Background: Anemia during pregnancy increases the risk of delivery by cesarean section, low birth weight, preterm birth, perinatal mortality, stillbirth, and maternal mortality. In this study, we aimed to assess the prevalence of anemia in pregnant women and its associated factors in the Kuwait birth cohort study. Methods: The Kuwait birth cohort (N=1108) was a prospective cohort study in which pregnant women were recruited in the third trimester. Data were collected through personal interviews with mothers who attend antenatal care visits, including data on socio-economic status and lifestyle factors. Blood samples were taken after the recruitment to measure multiple laboratory indicators. Clinical data were extracted from the medical records by a clinician including data on comorbidities. Anemia was defined as having Hemoglobin (Hb) <110 g/L with further classification as mild (100-109 g/L), moderate (70-99 g/L), or severe (<70 g/L). Predictors of anemia were classified as underlying or direct factors, and logistic regression was used to investigate their association with anemia. Results: The mean Hb level in the study group was 115.21 g/L (95%CI: 114.56- 115.87 g/L), with significant differences between age groups (p=0.034). The prevalence of anemia was 28.16% (95%CI: 25.53-30.91%), with no significant difference by age group (p=0.164). Of all 1108 pregnant women, 8.75% had moderate anemia, and 19.40% had mild anemia, but no pregnant women had severe anemia. In multivariable analysis, getting pregnant while using contraception, adjusted odds ratio (AOR) 1.73(95%CI:1.01-2.96); p=0.046 and current use of supplements, AOR 0.50 (95%CI: 0.26-0.95); p=0.035 were significantly associated with anemia (underlying factors). From the direct factors group, only iron and ferritin levels were significantly associated with anemia (P<0.001). Conclusion: Although the severe form of anemia is low among pregnant women in Kuwait, mild and moderate anemia remains a significant health problem despite free access to antenatal care.

Keywords: anemia, pregnancy, hemoglobin, ferritin

Procedia PDF Downloads 38

Authors: Lian Zeng

Abstract:

Double-Spear 1-H2-1 (DS1-H2-1) is an oncolytic virus and an innovative biological drug candidate. The chemical composition of the drug product is a live attenuated West Nile virus (WNV) containing the human T cell costimulator (CD86) gene. After intratumoral injection, the virus can rapidly self-replicate in the injected site and lyse/kill the tumor by repeated infection among tumor cells. We also established xenograft tumor models in mice to evaluate the drug candidate's efficacy on those tumors. The results from preclinical studies on transplanted tumors in immunodeficient mice showed that DS1-H2-1 had significant oncolytic effects on human-origin cancers: it completely (100%) shrieked human glioma; limited human neuroblastoma growth reached as high as 95% growth inhibition rate (%TGITW). The safety data of preclinical animal experiments confirmed that DS1-H2-1 is safe as a biological drug for clinical use. In the preclinical drug efficacy experiment, virus-drug administration with different doses did not show abnormal signs and disease symptoms in more than 300 tested mice, and no side effects or death occurred through various administration routes. Intravenous administration did not cause acute infectious disease or other side effects. However, the replication capacity of the virus in tumor tissue via intravenous administration is only 1% of that of direct intratumoral administration. The direct intratumoral administration of DS1-H2-1 had a higher rate of viral replication. Therefore, choosing direct intratumoral injection can ensure both efficacy and safety.

Keywords: oncolytic virus, WNV-CD86, immunotherapy drugs, glioma, neuroblastoma

Procedia PDF Downloads 91

Authors: Intanri Kurniati, Raja Iqbal Mulya Harahap, Agustyas Tjiptaningrum, Reni Zuraida

Abstract:

Background: Diabetes mellitus is still increasing and has become a health and social burden in the world. It is known that glycation among various proteins is increased in diabetic patients compared with non-diabetic subjects. Some of these glycated proteins are suggested to be involved in the development and progression of chronic diabetic complications. Among these glycated proteins, glycated hemoglobin (HbA1C) is commonly used as the gold standard index of glycemic control in the clinical setting. HbA1C testing has some methods, and the most commonly used is immunoturbidimetry. This research aimed to compare the HbA1c level between immunoturbidimetry and HbA1C level in T2DM patients. Methods: This research involves 77 patients from Abd Muluk Hospital Bandar Lampung; the patient was asked for consent in this research, then underwent phlebotomy to be tested for HbA1C; the sample was then examined for HbA1C with Turbidimetric Inhibition Immunoassay (TINIA) and High-Performance Liquid Chromatography (HPLC) method. Result: Mean± SD of the samples with the TINIA method was 9.2±1,2; meanwhile, the level HbA1C with the HPLC method is 9.6±1,2. The t-test showed no significant difference between the group subjects. (p<0.05). It was proposed that the two methods have high suitability in testing, and both are eligibly used for the patient. Discussion: There was no significant difference among research subjects, indicating that the high conformity of the two methods is suitable to be used for monitoring patients clinically. Conclusion: There is increasing in HbA1C level in a patient with T2DM measured with HPLC and or Turbidimetric Inhibition Immunoassay (TINIA) method, and there were no significant differences among those methods.

Keywords: diabetes mellitus, glycated albumin, HbA1C, HPLC, immunoturbidimetry

Procedia PDF Downloads 85

Authors: Saimir Heta, Kastriot Haxhirexha, Virtut Velmishi, Nevila Alliu, Ilma Robo

Abstract:

Background: Testicular rotation can occur at any age. The possibility to save the testicle is the fastest possible surgical intervention which is indicated by the presence of acute pain even at rest. The time element is more important to diagnose and proceed further with surgical intervention. Testicular damage is a consequence which mainly depends on the moment of onset of symptoms, at the time when the symptoms are diagnosed, the earliest action to be performed is surgical intervention. Sometimes medical tests are needed to confirm a diagnosis, or to help identify another cause for symptoms; for example, the urine test, that is used to check for infection, associated with the scrotal ultrasound test. Control of blood flow to the longitudinal supply vessels of the testicles is indicated. The sign that indicates testicular rotation is a reduction in blood flow. This is the element which is distinguished from ultrasound examination. Surgery may be needed to determine if the patient’s symptoms are caused by the rotation of the testis or any other condition. Discussion: As a surgical intervention of the emergency, the torsion of the test depends very much on the duration of the torsion, as the success in the life of the testicle depends on the fastest surgical intervention. From the previous clinic, it is noted that in any case presented to the pediatric patient diagnosed with testicular rotation, there is always a link with personal history that the patient refers to the presence of a previous episode of testicular trauma. Literature supports this fact very logically. Conclusions: Salvation without testicular atrophy depends closely on establishing the diagnosis of testicular rotation as soon as possible. Following the logic above, it can be said that the diagnosis for rotation should be performed as soon as possible, to avoid consequences that will not be favorable for the patient.

Keywords: acute scrotum, test torsion, newborns, clinical presentation

Procedia PDF Downloads 135

Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, Aakash Pai

Abstract:

Introduction: Radical prostatectomy and radiotherapy are both viable options for the treatment of localised prostate cancer. Over the years medicine has evolved towards a patient-centred approach. Patient decision-making is not motivated by clinical outcomes alone. Geographical location and ease of access to treating clinician are contributory factors. With the development of robotic surgery, prostatectomy has been centralised into tertiary centres. This has impacted on the distances that patients and their families are expected to travel. Methods: A single centre retrospective study was undertaken over a five-year period. All patients with localised prostate cancer, undergoing radical radiotherapy or prostatectomy were collected pre-centralisation. This was compared to the total number undergoing these treatments post centralisation. Results: Pre-centralisation, both radiotherapy and prostatectomy groups had to travel a median of less than five miles for treatment. Post-centralisation of pelvic surgery, prostatectomy patients had to travel a median of more than 40 miles, whilst travel distance for the radiotherapy group was unchanged. In the post centralisation cohort, there was a 63% decline in the number of patients undergoing radical prostatectomy per month from a mean of 5.1 to 1.9. The radical radiotherapy group had a concurrent 41% increase in patient numbers with a mean increase from 13.3 to 18.8 patients per month. Conclusion: Choice of radical treatment in localised prostate cancer is based on multiple factors. This study infers that local availability can influence choice of radical treatment. It is imperative that efforts are made to maintain accessibility to all viable options for prostate cancer patients, so that patient choice is not compromised.

Keywords: prostate, prostatectomy, radiotherapy, centralisation

Procedia PDF Downloads 82

Authors: Khadeeja Munawar, Shamsul Haque

Abstract:

The claim that traumatic events influence the recalled memories and mental health has received mixed empirical support. This study examines the memories of a sample drawn from Pakistan, a country that has witnessed many life-changing socio-political events, wars, and natural disasters in 72 years of its history. A sample of 210 senior citizens (Mage = 64.35, SD = 6.33) was recruited from Pakistan. The aim was to investigate if participants retrieved more memories related to past traumatic events using a word-cueing technique. Each participant reported ten memories to ten neutral cue words. The results revealed that past traumatic events were not adversely affecting the memories and mental health of participants. When memories were plotted with respect to the ages at which the events happened, a pronounced bump at 11-20 years of age was seen. Memories within as well as outside of the bump were mostly positive. The multilevel logistic regression modelling showed that the memories recalled were personally important and played a role in enhancing resilience. The findings revealed that despite facing an array of ethnic, religious, political, economic, and social conflicts, the participants were resilient, recalled predominantly positive memories, and had intact mental health. The findings have clinical implications in Cognitive Behavioral Therapy (CBT). The patients can be made aware of their negative emotions, troublesome/traumatic memories, and the distorted thinking patterns and their memories can be restructured. The findings can also be used to teach Memory Specificity Training (MEST) by psycho-educating the patients around changes in memory functioning and enhancing the recall of memories, which are more specific, vivid, and filled with sensory details.

Keywords: cognitive behavioral therapy, memories, mental health, resilience, trauma

Procedia PDF Downloads 136

Authors: Eman G. Alayad, Mazen G. Aleyad, Mohammed Alshahrani, Ibrahim Alnaami

Abstract:

Introduction: Cerebral venous thrombosis (CVT) is a rare type of cerebrovascular disease that can occur at any age. Patients with CVT commonly present with headache, focal neurological deficit, decreased level of consciousness and seizures. Many etiologic risk factors have been reported for CVT, high altitude and oral contraceptive pill some of them. Case Presentation: A 37-year-old woman living in Abha city in the southeastern area of Saudi Arabia. (about 10,000 feet-3000 m) over the sea. complaining acute onset of severe diffuse headache and generalized tonic clonic convulsions. Followed by loss of consciousness. She was on contraceptive pills for the last 3 years. No significant Medical or surgical history. Brain CT revealed subarachnoid hemorrhage, with MRI findings showing thrombosis in transvers sinus. There was no vascular malformations such as aneurysm, arteriovenous malformation (AVM), or dural arteriovenous fistula. A CVT with subarachnoid hemorrhage was our final diagnosis based on clinical presentation and radiographic findings. Discussion: Patients with CVT had evidence of cortical SAH by 10 of 233, others found 3% of SAH was caused by CVT, indicating that the presence of cortical SAH without involvement of the basal cisterns may provide an early sign of underlying CVT. However, what is more interesting in this case, is the relationship of high altitude with CVT and SAH, which previously undescribed. Conclusion: High-altitude climbing per se was described as a risk factor for the development of CVT, though its occurrence was probably rare. Whether it is primary in etiology due to high altitude induced hypercoagulable state of unknown origin or due to cerebrovascular disturbances there is a need for further investigation especially at this unusual presentation of subarachnoid hemorrhage.

Keywords: cerebral venous thrombosis, high-altitude, subarachnoid hemorrhage, stroke

Procedia PDF Downloads 228

Authors: Vladyslav Povoroznyuk, Anna Musiienko, Nataliia Zaverukha, Roksolana Povoroznyuk

Abstract:

Along with the global aging of population, the number of people with somatic diseases is increasing, including such interrelated pathologies as obesity, osteoarthritis (OA) and osteoporosis (OP). The objective of the study is to examine the connection between body mass index (BMI), OA and bone mineral density (BMD) of lumbar spine, femoral neck and trabecular bone score (TBS) in postmenopausal women with OA. We have observed 359 postmenopausal women (50-89 years old) and divided them into four groups by age: 50-59 yrs, 60-69 yrs, 70-79 yrs and over 80 years old. In addition, according to the American College of Rheumatology (ACR) Clinical classification criteria for knee and hip OA, we divided them into 2 groups: group I – 117 females with symptomatic OA (including 89 patients with knee OA, 28 patients with hip OA) and group II –242 women with a normal functional activity of large joints. Analysis of data was performed taking into account their BMI, classified by World Health Organization (WHO). Diagnosis of obesity was established when BMI was above 30 kg/m². In woman with obesity, a symptomatic OA was detected in 44 postmenopausal women (41.1%), a normal functional activity of large joints - in 63 women (58.9%). However, in women with normal BMI – 73 women, who account for 29.0% of cases, a symptomatic OA was detected. According to a chi-squared (χ2) test, a significantly higher level of BMI was detected in postmenopausal women with OA (χ2 = 5.05, p = 0.02). Women with a symptomatic OA had a significantly higher BMD of lumbar spine compared with women who had a normal functional activity of large joints. No significant differences of BMD of femoral necks or TBS were detected in either the group with OA or with a normal functional activity of large joints.

Keywords: bone mineral density, body mass index, obesity, overweight, postmenopausal women, osteoarthritis

Procedia PDF Downloads 103

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 150

Authors: Vadim A. Kuznetsov, Anna M. Soldatova, Tatyana N. Enina, Elena A. Gorbatenko, Dmitrii V. Krinochkin

Abstract:

The aim of the study was to evaluate potential parameters related with super-response to CRT. Methods: 60 CRT patients (mean age 54.3 ± 9.8 years; 80% men) with congestive heart failure (CHF) II-IV NYHA functional class, left ventricular ejection fraction < 35% were enrolled. At baseline, 1 month, 3 months and each 6 months after implantation clinical, electrocardiographic and echocardiographic parameters, NT-proBNP level were evaluated. According to the best decrease of left ventricular end-systolic volume (LVESV) (mean follow-up period 33.7 ± 15.1 months) patients were classified as super-responders (SR) (n=28; reduction in LVESV ≥ 30%) and non-SR (n=32; reduction in LVESV < 30%). Results: At baseline groups differed in age (58.1 ± 5.8 years in SR vs 50.8 ± 11.4 years in non-SR; p=0.003), gender (female gender 32.1% vs 9.4% respectively; p=0.028), width of QRS complex (157.6 ± 40.6 ms in SR vs 137.6 ± 33.9 ms in non-SR; p=0.044). Percentage of LBBB was equal between groups (75% in SR vs 59.4% in non-SR; p=0.274). All parameters of mechanical dyssynchrony were higher in SR, but only difference in left ventricular pre-ejection period (LVPEP) was statistically significant (153.0 ± 35.9 ms vs. 129.3 ± 28.7 ms p=0.032). NT-proBNP level was lower in SR (1581 ± 1369 pg/ml vs 3024 ± 2431 pg/ml; p=0.006). The survival rates were 100% in SR and 90.6% in non-SR (log-rank test P=0.002). Multiple logistic regression analysis showed that LVPEP (HR 1.024; 95% CI 1.004–1.044; P = 0.017), baseline NT-proBNP level (HR 0.628; 95% CI 0.414–0.953; P=0.029) and age at baseline (HR 1.094; 95% CI 1.009-1.168; P=0.30) were independent predictors for CRT super-response. ROC curve analysis demonstrated sensitivity 71.9% and specificity 82.1% (AUC=0.827; p < 0.001) of this model in prediction of super-response to CRT. Conclusion: Super-response to CRT is associated with better survival in long-term period. Presence of LBBB was not associated with super-response. LVPEP, NT-proBNP level, and age at baseline can be used as independent predictors of CRT super-response.

Keywords: cardiac resynchronisation therapy, superresponse, congestive heart failure, left bundle branch block

Procedia PDF Downloads 378