Search results for: mortality improvement

Authors: V. T. Gerov, D. I. Gerova, I. D. Micheva, N. F. Nazifova-Tasinova, M. N. Nikolova, M. G. Pasheva, B. T. Galunska

Abstract:

Multiple myeloma (MM) is the most frequent plasma cell (PC) dyscrasia that involves the skeleton. Myeloma bone disease (MBD) is characterized by osteolytic bone lesions as a result of increased osteoclasts activity not followed by reactive bone formation due to osteoblasts suppression. Skeletal complications cause significant adverse effects on quality of life and lead to increased morbidity and mortality. Last decade studies revealed the implication of different proteins in osteoclast activation and osteoblast inhibition. The aim of the present study was to determine serum levels of periostin, sRANKL and osteopontin and to evaluate their role as bone markers in MBD. Materials and methods. Thirty-two newly diagnosed MM patients (mean age: 62.2 ± 10.7 years) and 33 healthy controls (mean age: 58.9 ± 7.5 years) were enrolled in the study. According to IMWG criteria 28 patients were with symptomatic MM and 4 with monoclonal gammopathy of undetermined significance (MGUS). In respect to their bone involvement all symptomatic patients were divided into two groups (G): 9 patients with 0-3 osteolytic lesions (G1) and 19 patients with >3 osteolytic lesions and/or pathologic fractures (G2). Blood samples were drawn for routine laboratory analysis and for measurement of periostin, sRANKL and osteopontin serum levels by ELISA kits (Shanghai Sunred Biological Technology, China). Descriptive analysis, Mann-Whitney test for assessment the differences between groups and non-parametric correlation analysis were performed using GraphPad Prism v8.01. Results. The median serum levels of periostin, sRANKL and osteopontin of ММ patients were significantly higher compared to controls (554.7pg/ml (IQR=424.0-720.6) vs 396.9pg/ml (IQR=308.6-471.9), p=0.0001; 8.9pg/ml (IQR=7.1-10.5) vs 5.6pg/ml (IQR=5.1-6.4, p<0.0001 and 514.0ng/ml (IQR=469.3-754.0) vs 387.0ng/ml (IQR=335.9-441.9), p<0.0001, respectively). for assessment of differences between groups and non-parametric correlation analysis were performed using GraphPad Prism v8.01. Statistical significance was found for all tested bone markers between symptomatic MM patients and controls: G1 vs controls (p<0.03), G2 vs controls (p<0.0001) for periostin; G1 vs controls (p<0.0001), G2 vs controls (p<0.0001) for sRANKL; G1 vs controls (p=0.002), G2 vs controls (p<0.0001) for osteopontin, as well between symptomatic MM patients and MGUS patients: G1 vs MGUS (p<0.003), G2 vs MGUS (p=0.003) for periostin; G1 vs MGUS (p<0.05), G2 vs MGUS (p<0.001) for sRANKL; G1 vs MGUS (p=0.011), G2 vs MGUS (p=0.0001) for osteopontin. No differences were detected between MGUS and controls and between patients in G1 and G2 groups. Spearman correlation analysis revealed moderate positive correlation between periostin and beta-2-microglobulin (r=0.416, p=0.018), percentage bone marrow myeloma PC (r=0.432, p=0.014), and serum total protein (r=0.427, p=0.015). Osteopontin levels were also positively related to beta-2-microglobulin (r=0.540, p=0.0014), percentage bone marrow myeloma PC (r=0.423, p=0.016), and serum total protein (r=0.413, p=0.019). Serum sRANKL was only related to beta-2-microglobulin levels (r=0.398, p=0.024). Conclusion: In the present study, serum levels of periostin, sRANKL and osteopontin in newly diagnosed MM patients were evaluated. They gradually increased from MGUS to more advanced stages of MM reflecting the severity of bone destruction. These results support the idea that some new protein markers could be used in monitoring the MBD as a most severe complication of MM.

Keywords: myeloma bone disease, periostin, sRANKL, osteopontin

Procedia PDF Downloads 42

Authors: Kamrun N. Keya, Nasrin A. Kona, Ruhul A. Khan

Abstract:

Sugarcane bagasse (SCB)-reinforced Polypropylene (PP) Based matrix composites (25-45 wt% fiber) were fabricated by a compression molding technique. The SCB surface was chemically modified using 5%-10% sodium hydroxide (NaOH), and after that, mechanical properties, water uptake, and soil degradation of the composites were investigated. Tensile strength (TS), tensile modulus (TM), bending strength (BS), bending modulus (BM) and elongation at break (Eb%) of the 30wt% composites were found to be 35.6 MPa, 10.2 GPa, 56 MPa, 5.6 GPa, and 11%, respectively. The SCB/PP based composites were treated with irradiated under gamma radiation (the source strength 50 kCi Cobalt-60) of various doses (2.5 kGy to 10 kGy). The effect of gamma radiation on the composites was also investigated, and it found that the effect of 5.0 kGy (i.e. units for radiation measurement is 'gray', kGy=kilogray ) gamma dose showed better mechanical properties than other doses. The results revealed that the combination of the chemical modification of the SCB fibers and irradiation of the composites were more effective in compatibility improvement than chemical modification alone. After flexural testing, fracture sides of the untreated and treated both composites were studied by scanning electron microscope (SEM). SEM results of the treated SCB/PP based composites showed better fiber-matrix adhesion than untreated SCB/PP based composites. However, it was found that the treated SCB/PP composite has better mechanical strength, durability, and more receptivity than untreated SCB/PP based composite.

Keywords: sugarcane bagasse (SCB), polypropylene (PP), mechanical properties, scanning electron microscope (SEM), gamma radiation, water uptake tests and soil degradation

Procedia PDF Downloads 124

Authors: Basavaraj Kabade, K. T. Nagaraja, Swathi Ramanathan, A. Veeraragavan, P. S. Reashma

Abstract:

Deteriorating quality of the pedestrian environment and the increasing risk of pedestrian crashes are major concerns for most of the cities in India. The recent shift in the priority to motorized transport and the abating condition of existing pedestrian facilities can be considered as prime reasons for the increasing pedestrian related crashes in India. Bengaluru City – the IT capital hub of the nation is not much different from this. The increase in number of pedestrian crashes in Bengaluru reflects the same. To resolve this issue and to ensure safe, sustainable and pedestrian friendly sidewalks, Govt. of Karnataka, India has implemented newfangled pedestrian sidewalks popularized programme named Tender S.U.R.E. (Specifications for Urban Road Execution) projects. Tender SURE adopts unique urban street design guidelines where the pedestrians are given prime preference. The present study presents an assessment of the quality and performance of the pedestrian side walk and the walkability index of the newly built pedestrian friendly sidewalks. Various physical and environmental factors affecting pedestrian safety are identified and studied in detail. The pedestrian mobility is quantified through Pedestrian Level of Service (PLoS) and the pedestrian walking comfort is measured by calculating the Walkability Index (WI). It is observed that the new initiatives taken in reference to improving pedestrian safety have succeeded in Bengaluru by attaining a level of Service of ‘A’ and with a good WI score.

Keywords: pedestrian safety, pedestrian level of service (PLoS), Right of Way (RoW), Tender S.U.R.E (Specifications for Urban Road Execution), walkability index (WI), walkway facilities

Procedia PDF Downloads 178

Authors: Ibrahim A. Alhammad, Suleiman A. Al-Otaibi, Khalid S. Al-Gahtani, Naïf Al-Otaibi, Abdulaziz A. Bubshait

Abstract:

In the last decade, the use of project delivery system of design build engineering contracts is increasing in North America due to the reasons of reducing the project duration and minimizing costs. The shift from traditional approach of Design-Bid-Build to Design-Build contracts have been attributed to many factors such as evolution of the regulatory and legal frameworks governing the engineering contracts and improvement in integrating design and construction. The aforementioned practice of contracting is more appropriate in North America; yet, it may not be the case in Saudi Arabia where the traditional approach of construction contracting remains dominant. The authors believe there are number of factors related to the gaps in the level of sophistication of the engineering and management of the construction projects in both countries. A step towards improving the Saudi construction practice by adopting the new trend of construction contracting, this paper identifies the reasons why Design/Build form of contracting are not frequently utilized. A field survey, which includes the questionnaire addressing the research problem, is distributed to three main parties of the construction contracts: clients, consultants, and contractors. The analyzed collected data were statistically sufficient to finding the reasons of not adopting the new trend of good practice of deign build approach in Saudi Arabia. In addition, the reasons are: (1) lack of regulation and legal framework; (2) absence of clear criteria of the owner for the trade-off between competing contractors, (3) and lack of experience, knowledge and skill.

Keywords: design built projects, Saudi Arabia, GCC, mega projects

Procedia PDF Downloads 209

Authors: Silvia Arrate, Waldo Salud, Eloy París

Abstract:

The wear of cutting tools is one of the most decisive elements when planning tunneling works, programming the maintenance stops and saving the optimum stock of spare parts during the evolution of the excavation. Being able to predict the behavior of cutting tools can give a very competitive advantage in terms of costs and excavation performance, optimized to the needs of the TBM itself. The incredible evolution of data science in recent years gives the option to implement it at the time of analyzing the key and most critical parameters related to machinery with the purpose of knowing how the cutting head is performing in front of the excavated ground. Taking this as a case study, Metro Line 3 of Guadalajara in Mexico will develop the feasibility of using Specific Energy versus data science applied over parameters of Torque, Penetration, and Contact Force, among others, to predict the behavior and status of cutting tools. The results obtained through both techniques are analyzed and verified in the function of the wear and the field situations observed in the excavation in order to determine its effectiveness regarding its predictive capacity. In conclusion, the possibilities and improvements offered by the application of digital tools and the programming of calculation algorithms for the analysis of wear of cutting head elements compared to purely empirical methods allow early detection of possible damage to cutting tools, which is reflected in optimization of excavation performance and a significant improvement in costs and deadlines.

Keywords: cutting tools, data science, prediction, TBM, wear

Procedia PDF Downloads 34

Authors: B. B. S. Pereira, M. O. Souza, L. P. Zanetti, L. C. S. Oliveira, J. R. P. Moreno, M. P. Souza, V. R. Colturato, C. M. Machado

Abstract:

Background: The introduction of prophylactic or preemptive therapies has effectively decreased the CMV mortality rates after hematopoietic stem cell transplantation (HSCT). CMV antigenemia (pp65) or quantitative PCR are methods currently approved for CMV surveillance in pre-emptive strategies. Commercial assays are preferred as cut-off levels defined by in-house assays may vary among different protocols and in general show low reproducibility. Moreover, comparison of published data among different centers is only possible if international standards of quantification are included in the assays. Recently, the World Health Organization (WHO) established the first international standard for CMV detection. The real time PCR COBAS Ampliprep/ CobasTaqMan (CAP/CTM) (Roche®) was developed using the WHO standard for CMV quantification. However, the cut-off for the introduction of antiviral has not been determined yet. Methods: We conducted a retrospective study to determine: 1) the sensitivity and specificity of the new CMV CAP/CTM test in comparison with pp65 antigenemia to detect episodes of CMV infection/reactivation, and 2) the cut-off of viral load for introduction of ganciclovir (GCV). Pp65 antigenemia was performed and the corresponding plasma samples were stored at -20°C for further CMV detection by CAP/CTM. Comparison of tests was performed by kappa index. The appearance of positive antigenemia was considered the state variable to determine the cut-off of CMV viral load by ROC curve. Statistical analysis was performed using SPSS software version 19 (SPSS, Chicago, IL, USA.). Results: Thirty-eight patients were included and followed from August 2014 through May 2015. The antigenemia test detected 53 episodes of CMV infection in 34 patients (89.5%), while CAP/CTM detected 37 episodes in 33 patients (86.8%). AG and PCR results were compared in 431 samples and Kappa index was 30.9%. The median time for first AG detection was 42 (28-140) days, while CAP/CTM detected at a median of 7 days earlier (34 days, ranging from 7 to 110 days). The optimum cut-off value of CMV DNA was 34.25 IU/mL to detect positive antigenemia with 88.2% of sensibility, 100% of specificity and AUC of 0.91. This cut-off value is below the limit of detection and quantification of the equipment which is 56 IU/mL. According to CMV recurrence definition, 16 episodes of CMV recurrence were detected by antigenemia (47.1%) and 4 (12.1%) by CAP/CTM. The duration of viremia as detected by antigenemia was shorter (60.5% of the episodes lasted ≤ 7 days) in comparison to CAP/CTM (57.9% of the episodes lasting 15 days or more). This data suggests that the use of antigenemia to define the duration of GCV therapy might prompt early interruption of antiviral, which may favor CMV reactivation. The CAP/CTM PCR could possibly provide a safer information concerning the duration of GCV therapy. As prolonged treatment may increase the risk of toxicity, this hypothesis should be confirmed in prospective trials. Conclusions: Even though CAP/CTM by ROCHE showed great qualitative correlation with the antigenemia technique, the fully automated CAP/CTM did not demonstrate increased sensitivity. The cut-off value below the limit of detection and quantification may result in delayed introduction of pre-emptive therapy.

Keywords: antigenemia, CMV COBAS/TAQMAN, cytomegalovirus, antiviral cut-off

Procedia PDF Downloads 180

Authors: Trung Le Thanh

Abstract:

Bored piles are always the optimal solution for high-rise building foundations. They have many advantages, such as large diameter, large pile length and construction in all different geological conditions. However, due to construction characteristics, the load-bearing capacity of bored piles is not optimal because wall friction is reduced due to poor contact between the pile and the surrounding soil. Therefore, grouting technology along the pile body helps improve the load-bearing capacity of bored piles significantly through increasing the skin resistance of the pile and surrounding soil. The improvement of pile skin resistance depends on the parameters of grouting technology, especially grouting volume, mortar viscosity, mortar strength,... and different geological conditions. Studies show that the technology of grouting piles on sandy soil is more effective than on clay. This article presents an experimental model to determine the load-bearing capacity of bored piles with a diameter of 400 mm and a length of 3 m on sand with different slurry volume in Tan Uyen city, Binh Duong province. On that basis, analyze the correlation between the increase in load-bearing capacity of bored piles without and with shaft grouting pile. Research results show that the wall resistance of shaft grouted piles increases 2-3 times compared to piles without grouting, and the pile's load-bearing capacity increases significantly. The article's research provides scientific value for consulting work on the design of bored piles when grouted along the pile body.

Keywords: bored pile, shaft grouting, bearing capacity, pile shaft resistance

Procedia PDF Downloads 51

Authors: Precious Barnes, Abraham Mensah, Leonard Derkyi-Kwarteng, Benjamin Amoani, George Adjei, Ernest Adankwah, Faustina Pappoe, Kwabena Dankwah, Daniel Amoako-Sakyi, Samuel Victor Nuvor, Dorcas Obiri-Yeboah, Ewura Seidu Yahaya, Patrick Kafui Akakpo, Roland Osei Saahene

Abstract:

Context: Breast cancer is a prevalent and aggressive type of cancer among African women, with high mortality rates in Ghana. Nuclear factor kappa B (NF-kB) is a transcription factor that has been associated with tumor progression in breast cancer. However, there is a lack of published data on NF-kB in breast cancer patients in Ghana or other African countries. Research Aim: The aim of this study was to assess the prognostic significance of NF-kB (p65) expression and its association with various clinicopathological features in breast cancer patients at the Cape Coast Teaching Hospital in Ghana. Methodology: A total of 90 formalin-fixed breast cancer tissues and 15 normal breast tissues were used in this study. The expression level of NF-kB (p65) was examined using immunohistochemical techniques. Correlation analysis between NF-kB (p65) expression and clinicopathological features was performed using SPSS version 25. Findings: The study found that NF-kB (p65) was expressed in 86.7% of breast cancer tissues. There was a significant relationship between NF-kB (p65) expression and tumor grade, proliferation index (Ki67), and molecular subtype. High-level expression of NF-kB (p65) was more common in tumor grade 3 compared to grade 1, and Ki67 > 20 had higher expression of NF-kB (p65) compared to Ki67 ≤ 20. Triple-negative breast cancer patients had the highest overexpression of NF-kB (p65) compared to other molecular subtypes. There was no significant association between NF-kB (p65) expression and other clinicopathological parameters. Theoretical Importance: This study provides important insights into the expression of NF-kB (p65) in breast cancer patients in Ghana, particularly in relation to tumor grade and proliferation index. The findings suggest that NF-kB (p65) could serve as a potential biological marker for cancer stage, progression, prognosis and as a therapeutic target. Data Collection and Analysis Procedures: Formalin-fixed breast cancer tissues and normal breast tissues were collected and analyzed using immunohistochemical techniques. Correlation analysis between NF-kB (p65) expression and clinicopathological features was performed using SPSS version 25. Question Addressed: This study addressed the question of the prognostic significance of NF-kB (p65) expression and its association with clinicopathological features in breast cancer patients in Ghana. Conclusion: This study, the first of its kind in Ghana, demonstrates that NF-kB (p65) is highly expressed among breast cancer patients at the Cape Coast Teaching Hospital, especially in triple-negative breast cancer patients. The expression of NF-kB (p65) is associated with tumor grade and proliferation index. NF-kB (p65) could potentially serve as a biological marker for cancer stage, progression, prognosis, and as a therapeutic target.

Keywords: breast cancer, Ki67, NF-kB (p65), tumor grade

Procedia PDF Downloads 59

Authors: Yasir Karabacak

Abstract:

Objective: The aim of periodontal therapy is to control and eliminate inflammation in order halt disease progression. The initial periodontal therapy (IPT) including scaling and root planing (SRP) can control periodontal disease in most cases of periodontitis; also maintaining good oral hygiene by the patient is fundamental. The aim of this case report is to present IPT and to present 3-month follow-up results in a patient with periodontitis. Materials and Methods IPT of a 63-year-old non-smoker male with generalized periodontitis is presented. The patient had no history of systemic disease. The intraoral examination reveals marked gingival inflammation as well as plaque accumulation and significant calculus deposits. On radiographic examination, severe bone loss was evident. The patient was diagnosed with generalized advanced periodontitis. Initial periodontal therapy including oral hygiene instructions and quadrant-based SRP under local anesthesia was performed using hand and ultrasonic instruments. No antibiotics were prescribed. The patient was recalled 4 weeks after IPT. Results Favorable clinical improvement was obtained. Gingival inflammation was resolved significantly. A reduction of the mean probing depth from 2.4 mm at baseline to 1.9 mm was observed. The patient presented with a good standard of oral hygiene. The plaque scores decreased from 54.0% at baseline to 17.0%. In addition, the percentage of sites with bleeding on probing decreased from 80.0% at baseline to 44.0%. The patient was scheduled for maintenance therapy every three months. Conclusion: The level of oral hygiene has a great impact on periodontal treatment outcome and supports periodontal therapy properly.

Keywords: initial periodontal, therapy and follow-up in a periodontitis, patient, a case report

Procedia PDF Downloads 60

Authors: Kldiashvili Ekaterina, Burduli Archil, Ghortlishvili Gocha

Abstract:

Introduction – Medical information system (MIS) is at the heart of information technology (IT) implementation policies in healthcare systems around the world. Different architecture and application models of MIS are developed. Despite of obvious advantages and benefits, application of MIS in everyday practice is slow. Objective - On the background of analysis of the existing models of MIS in Georgia has been created a multi-user web-based approach. This presentation will present the architecture of the system and its application for image based second opinion consultations. Methods – The MIS has been created with .Net technology and SQL database architecture. It realizes local (intranet) and remote (internet) access to the system and management of databases. The MIS is fully operational approach, which is successfully used for medical data registration and management as well as for creation, editing and maintenance of the electronic medical records (EMR). Five hundred Georgian language electronic medical records from the cervical screening activity illustrated by images were selected for second opinion consultations. Results – The primary goal of the MIS is patient management. However, the system can be successfully applied for image based second opinion consultations. Discussion – The ideal of healthcare in the information age must be to create a situation where healthcare professionals spend more time creating knowledge from medical information and less time managing medical information. The application of easily available and adaptable technology and improvement of the infrastructure conditions is the basis for eHealth applications. Conclusion - The MIS is perspective and actual technology solution. It can be successfully and effectively used for image based second opinion consultations.

Keywords: digital images, medical information system, second opinion consultations, electronic medical record

Procedia PDF Downloads 434

Authors: Lei Zhou, Dan Li, Ruiqi Ren, Chao Li, Yali Wang, Daxin Ni, Zijian Feng, Timothy M. Uyeki, Qun Li

Abstract:

Since the first human infections with avian influenza A(H7N9) virus were identified in early 2013, 1533 cases of laboratory-confirmed A(H7N9) virus infections were reported and confirmed as of September 13, 2017. The fifth epidemic was defined as starting from September 1, 2016, and the number of A(H7N9) cases has surged since the end of December in 2016. On February 18, 2017, the A(H7N9) cases who were infected with highly pathogenic avian influenza (HPAI) virus was reported from Southern China. The HPAI A(H7N9) cases were identified and then an investigation and analyses were conducted to assess whether disease severity in humans has changed with HPAI A(H7N9) compared with low pathogenic avian influenza (LPAI) A(H7N9) virus infection. Methods: All confirmed cases with A(H7N9) virus infections reported throughout mainland China from September 1, 2016, to September 13, 2017, were included. Cases' information was extracted from field investigation reports and the notifiable infectious surveillance system to describe the demographic, clinical, and epidemiologic characteristics. Descriptive statistics were used to compare HPAI A(H7N9) cases with all LPAI A(H7N9) cases reported during the fifth epidemic. Results: A total of 27 cases of HPAI A(H7N9) virus were identified infection from five provinces, including Guangxi (44%), Guangdong (33%), Hunan (15%), Hebei (4%) and Shangxi (4%). The median age of cases of HPAI A(H7N9) virus infection was 60 years (range, 15 to 80) and most of them were male (59%) and lived in rural areas (78%). All 27 cases had live poultry related exposures within 10 days before their illness onset. In comparison with LPAI A(H7N9) case-patients, HPAI A(H7N9) case-patients were significantly more likely to live in rural areas (78% vs. 51%; p = 0.006), have exposure to the sick or dead poultry (56% vs. 19%; p = 0.000), and be hospitalized earlier (median 3 vs. 4 days; p = 0.007). No significant differences were observed in median age, sex, prevalence of underlying chronic medical conditions, median time from illness onset to first medical service seeking, starting antiviral treatment, and diagnosis. Although the median time from illness onset to death (9 vs. 13 days) was shorter and the overall case-fatality proportion (48% vs. 38%) was higher for HPAI A(H7N9) case-patients than for LPAI A(H7N9) case-patients, these differences were not statistically significant. Conclusions: Our findings indicate that HPAI A(H7N9) virus infection was associated with exposure to sick and dead poultry in rural areas when visited live poultry market or in the backyard. In the fifth epidemic in mainland China, HPAI A (H7N9) case-patients were hospitalized earlier than LPAI A(H7N9) case-patients. Although the difference was not statistically significant, the mortality of HPAI A (H7N9) case-patients was obviously higher than that of LPAI A(H7N9) case-patients, indicating a potential severity change of HPAI A(H7N9) virus infection.

Keywords: Avian influenza A (H7N9) virus, highly pathogenic avian influenza (HPAI), case-patients, poultry

Procedia PDF Downloads 147

Authors: Florence Roselle Adalin, Misha Louise Delariarte, Fabbette Laire Lagas, Sarah Emanuelle Mejia, Lika Mizukoshi, Irish Paullen Palomeno, Gibrianne Alistaire Ramos, Danica Pauline Ramos, Josefina Tuazon, Jo Leah Flores

Abstract:

Pain, often a missed and undertreated symptom, affects the quality of life of individuals. Nurses are key players in providing effective pain management to decrease morbidity and mortality of patients in pain. Nurses’ knowledge and attitude on pain greatly affect their ability on assessment and management. The Pain Society of the Philippines recognized the inadequacy and inaccessibility of data on the knowledge, skills, and attitude of nurses on pain management in the country. This study may be the first of its kind in the county, giving it the potential to contribute greatly to nursing education and practice through providing valuable baseline data. Objectives: This study aims to describe the level of knowledge and attitude, and current practices of nurses on pain assessment and management; and determine the relationship of nurses’ knowledge and attitude with years of experience, training on pain management and clinical area of practice. Methodology: A survey research design was employed. Four hospitals were selected through purposive sampling. A total of 235 Medical-Surgical Unit and Intensive Care Unit (ICU) nurses participated in the study. The tool used is a combination of demographic survey, Nurses’ Knowledge and Attitude Survey Regarding Pain (NKASRP), Acute Pain Evidence Based Practice Questionnaire (APEBPQ) with self-report questions on non-pharmacologic pain management. The data obtained was analysed using descriptive statistics, two sample T-tests for clinical areas and training; and Pearson product correlation to identify relationship of level of knowledge and attitude with years of experience. Results and Analysis: The mean knowledge and attitude score of the nurses was 47.14%. Majority answered ‘most of the time’ or ‘all the time’ on 84.12% of practice items on pain assessment, implementation of non-pharmacologic interventions, evaluation and documentation. Three of 19 practice items describing morphine and opioid administration in special populations were only done ‘a little of the time’. Most utilized non-pharmacologic interventions were deep breathing exercises (79.66%), massage therapy (27.54%), and ice therapy (26.69%). There was no significant relationship between knowledge scores and years of clinical experience (p = 0.05, r= -0.09). Moreover, there was not enough evidence to show difference in nurses’ knowledge and attitude scores in relation to presence of training (p = 0.41) or areas (Medical-Surgical or ICU) of clinical practice (p = 0.53). Conclusion and Recommendations: Findings of the study showed that the level of knowledge and attitude of nurses on pain assessment and management is suboptimal; and no relationship between nurses’ knowledge and attitude and years of experience. It is recommended that further studies look into the nursing curriculum on pain education, culture-specific pain management protocols and evidence-based practices in the country.

Keywords: knowledge and attitude, nurses, pain management, practices on pain management

Procedia PDF Downloads 332

Authors: Matthew Fleet, Savannah Elliott

Abstract:

Background: This study investigates the use of teaching and learning to meet the needs of deaf children in the UK PE curriculum. Research has illustrated that deaf students in mainstream schools do not receive sufficient support from teachers in lessons. This research examines the impact of different types of hearing loss and its implications within Physical Education (PE) in secondary schools. Purpose: The purpose of this study is to highlight challenges PE teachers face and make recommendations for more inclusive learning environments for deaf students. The aims and objectives of this research are: to critically analyse the current situation for deaf students accessing the PE curriculum, by identifying barriers deaf students face; to identify the challenges for PE teachers in providing appropriate support for deaf students; to provide recommendations for deaf awareness training, to enhance PE teachers’ understanding and knowledge. Method: Semi-structured interviews collected data from both PE teachers and deaf students, to examine: the support available and coping mechanisms deaf students use when they do not receive support; strategies PE teachers use to provide support for deaf students; areas for improvement and potential strategies PE teachers can apply to their practice. Results & Conclusion: The findings from the study concluded that PE teachers were inconsistent in providing appropriate support for deaf students in PE lessons. Evidence illustrated that PE teachers had limited exposure to deaf awareness training. This impacted on their ability to support deaf students effectively. Communication was a frequent barrier for deaf students, affecting their ability to retain and learn information. Also, the use of assistive technology was found to be compromised in practical PE lessons.

Keywords: physical education, deaf, inclusion, education

Procedia PDF Downloads 140

Authors: Raj Kishore Swain, Kamdev Sethy, Sumanta Kumar Mishra

Abstract:

Selenium is an essential trace element for the chicken with a variety of biological functions like growth, fertility, immune system, hormone metabolism, and antioxidant defense systems. Selenium deficiency in chicken causes exudative diathesis, pancreatic dystrophy and nutritional muscle dystrophy of the gizzard, heart and skeletal muscle. Additionally, insufficient immunity, lowering of production ability, decreased feathering of chickens and increased embryo mortality may occur due to selenium deficiency. Nano elemental selenium, which is bright red, highly stable, soluble and of nano meter size in the redox state of zero, has high bioavailability and low toxicity due to the greater surface area, high surface activity, high catalytic efficiency and strong adsorbing ability. To assess the effect of dietary nano-Se on performance and expression of gene in Vencobb broiler birds in comparison to its inorganic form (sodium selenite), four hundred fifty day-old Vencobb broiler chicks were randomly distributed into 9 dietary treatment groups with two replicates with 25 chicks per replicate. The dietary treatments were: T1 (Control group): Basal diet; T2: Basal diet with 0.3 ppm of inorganic Se; T3: Basal diet with 0.01875 ppm of nano-Se; T4: Basal diet with 0.0375 ppm of nano-Se; T5: Basal diet with 0.075 ppm of nano-Se, T6: Basal diet with 0.15 ppm of nano-Se, T7: Basal diet with 0.3 ppm of nano-Se, T8: Basal diet with 0.60 ppm of nano-Se, T9: Basal diet with 1.20 ppm of nano-Se. Nano selenium was synthesized by mixing sodium selenite with reduced glutathione and bovine serum albumin. The experiment was carried out in two phases: starter phase (0-3 wks), finisher phase (4-5 wk) in deep litter system. The body weight at the 5th week was best observed in T4. The best feed conversion ratio at the end of 5th week was observed in T4. Erythrocytic catalase, glutathione peroxidase and superoxide dismutase activity were significantly (P < 0.05) higher in all the nano selenium treated groups at 5th week. The antibody titers (log2) against Ranikhet diseases vaccine immunization of 5th-week broiler birds were significantly higher (P < 0.05) in the treatments T4 to T7. The selenium levels in liver, breast, kidney, brain, and gizzard were significantly (P < 0.05) increased with increasing dietary nano-Se indicating higher bioavailability of nano-Se compared to inorganic Se. The real time polymer chain reaction analysis showed an increase in the expression of antioxidative gene in T4 and T7 group. Therefore, it is concluded that supplementation of nano-selenium at 0.0375 ppm over and above the basal level can improve the body weight, antioxidant enzyme activity, Se bioavailability and expression of the antioxidative gene in broiler birds.

Keywords: chicken, growth, immunity, nano selenium

Procedia PDF Downloads 163

Authors: J. Samuel, S. Al-Enezi, A. Al-Banna

Abstract:

High-density polyethylene reinforced with carbon nanofibers (HDPE/CNF) have been prepared via melt processing using dialkylimidazolium tetrafluoroborate (ionic liquid) as a dispersion agent. The prepared samples were characterized by thermogravimetric (TGA) and differential scanning calorimetric (DSC) analyses. The samples blended with imidazolium ionic liquid exhibit higher thermal stability. DSC analysis showed clear miscibility of ionic liquid in the HDPE matrix and showed single endothermic peak. The melt rheological analysis of HDPE/CNF composites was performed using an oscillatory rheometer. The influence of CNF and ionic liquid concentration (ranging from 0, 0.5, and 1 wt%) on the viscoelastic parameters was investigated at 200 °C with an angular frequency range of 0.1 to 100 rad/s. The rheological analysis shows the shear-thinning behavior for the composites. An improvement in the viscoelastic properties was observed as the nanofiber concentration increases. The progress in the modulus values was attributed to the structural rigidity imparted by the high aspect ratio CNF. The modulus values and complex viscosity of the composites increased significantly at low frequencies. Composites blended with ionic liquid exhibit slightly lower values of complex viscosity and modulus over the corresponding HDPE/CNF compositions. Therefore, reduction in melt viscosity is an additional benefit for polymer composite processing as a result of wetting effect by polymer-ionic liquid combinations.

Keywords: high-density polyethylene, carbon nanofibers, ionic liquid, complex viscosity

Procedia PDF Downloads 111

Authors: Douglas E. Mainhart, Alejandro Fierro-Cabo, Bradley Christoffersen, Charlotte Reemts

Abstract:

Semi-arid ecosystems across the globe have faced land conversion for agriculture and resource extraction activities, posing a threat to the important ecosystem services they provide. Revegetation-centered restoration efforts in these regions face low success rates due to limited soil water availability and high temperatures leading to elevated seedling mortality after planting. Typical methods to alleviate these stresses require costly post-planting interventions aimed at improving soil moisture status. We set out to evaluate the efficacy of applying in-nursery treatments to address transplant shock. Four native Tamaulipan thornscrub species were compared. Three treatments were applied: elevated CO2, drought hardening (four-week exposure each), and antitranspirant foliar spray (the day prior to planting). Our goal was to answer two primary questions: (1) Do treatments improve survival and growth of seedlings in the early period post-planting? (2) If so, what underlying physiological changes are associated with this improved performance? To this end, we measured leaf gas exchange (stomatal conductance, light saturated photosynthetic rate, water use efficiency), leaf morphology (specific leaf area), and osmolality before and upon the conclusion of treatments. A subset of seedlings from all treatments have been planted, which will be monitored in coming months for in-field survival and growth.First month field survival for all treatment groups were high due to ample rainfall following planting (>85%). Growth data was unreliable due to high herbivory (68% of all sampled plants). While elevated CO2 had infrequent or no detectable influence on all aspects of leaf gas exchange, drought hardening reduced stomatal conductance in three of the four species measured without negatively impacting photosynthesis. Both CO2 and drought hardening elevated leaf osmolality in two species. Antitranspirant application significantly reduced conductance in all species for up to four days and reduced photosynthesis in two species. Antitranspirants also increased the variability of water use efficiency compared to controls. Collectively, these results suggest that antitranspirants and drought hardening are viable treatments for reducing short-term water loss during the transplant shock period. Elevated CO2, while not effective at reducing water loss, may be useful for promoting more favorable water status via osmotic adjustment. These practices could improve restoration outcomes in Tamaulipan thornscrub and other semi-arid systems. Further research should focus on evaluating combinations of these treatments and their species-specific viability.

Keywords: conservation, drought conditioning, semi-arid restoration, plant physiology

Procedia PDF Downloads 71

Authors: Musa Ogah Ari

Abstract:

Poverty has engaged the attention of the global community. Both the rich and poor countries are concerned about its prevalence and impacts. This phenomenon is more pervasive among developing countries with the greater challenges manifesting among African countries. In Nigeria people live with very low income, and so decent three-square meals, clothes, shelter and other basic necessities are very difficult to come by for most of the population. Qualitative health facilities are seriously lacking to over 160 million population in the state. Equally lacking are educational and social infrastructures that can be available to the people at affordable rates. Roads linking the interior parts of the state are generally in deplorable conditions, particularly in the rainy season. Safe drinking water is hard to come by as the state is not properly placed and equipped to function in full capacity to serve the interest of the people. The challenges of poverty is definitely enormous for both the national and state governments consequently, debilitating scourge of poverty. As the ruling elites in Nigeria claim to reduce the rising profile of poverty through series of policies and programmes, food production, promotion and funding of co-operatives for agriculture, improvement of infrastructures at the rural areas to guaranteeing employment through skill acquisition, assistance of rural women to break away from poverty and the provision of small scale credit facilities to poor members of the public were abysmally low. It is observed that the poverty alleviation programmes and policies failed because they were by nature, character and implementation pro-elites and anti-masses. None of the programmes or policies engaged the rural poor either in terms of formulation or implementation.

Keywords: the state, poverty, government policies, strategies, social amenities, corruption

Procedia PDF Downloads 334

Authors: Mehrdad Kamali-Sanzighi, Maziar Kamali-sanzighi

Abstract:

Effect of waste date meal (WDM) addition to the diet on body chemical composition and fatty acids profile of fingerling cyprinus carpio were evaluated. Four treatments with 3 replication such as control treatment (no additional WDM; T1), 5% WDM (50 gr/kg; T2), 10% WDM (100 gr/kg; T3) and 15% WDM (150 gr/kg; T4) were done. 168 fish with initial weight of 2.48±0.06 gr were fed 3 times per day according to 5 % of fish body weight for 12 weeks. The body composition results showed that there is no significant differences between treatments (P>0.05). All of Fatty acids profile parameters show significant differences between different treatments (P<0.05). Although, the highest value of MUFA+PUFA, PUFA/SFA, MUFA+PUFA/SFA, W3, EPA+DHA parameters belong to control treatment (T1) and 5% WDM treatment (T2) had lowest value of MUFA, PUFA, MUFA+PUFA, PUFA/SFA, MUFA+PUFA/SFA, W3, W3/W6, DHA/EPA and EPA+DHA parameters except of SFA and W6/W3 that show highest value than other treatments. Atherogenic index (AI) had no significant differences between different treatments (P>0.05) but Thrombogenic index (TI) had significant differences between different experimental treatments (P<0.05). The 5% WDM and control treatment show highest and lowest values. Generally, treatments of 10 and 15% WDM (T3-T4) had moderate performance than the other experimental treatments. Finally, addition of WDM to common carp fingerlings diets help to insignificant improvement of chemical body composition and the saturated and unsaturated fatty acids profile of them were significant.

Keywords: waste, date, common carp, nutrition value

Procedia PDF Downloads 74

Authors: Ajay Kumar Singh, Arvind Kumar, S. P. Singh

Abstract:

Cellulose nanofibrils (CNF) have shown potential of their extensive use in various fields, including papermaking, due to their unique characteristics. In this study, CNF’s were prepared by fibrillating the pulp obtained from raw materials e.g. bagasse, hardwood and softwood using enzymatic pretreatment followed by mechanical refining. These nanofibrils, when examined under FE-SEM, show that partial fibrillation on fiber surface has resulted in production of nanofibers. Mixing these nanofibers with the unrefined and normally refined fibers show their reinforcing effect. This effect is manifested in observing the improvement in the physical and mechanical properties e.g. tensile index and burst index of paper. Tear index, however, was observed to decrease on blending with nanofibers. The optical properties of paper sheets made from blended fibers showed no significant change in comparison to those made from only mechanically refined pulp. Mixing of normal pulp fibers with nanofibers show increase in ºSR and consequent decrease in drainage rate. These changes observed in mechanical, optical and other physical properties of the paper sheets made from nanofibrils blended pulp have been tried to explain considering the distribution of the nanofibrils alongside microfibrils in the fibrous network. Since usually, paper/boards with higher strength are observed to have diminished optical properties which is a drawback in their quality, the present work has the potential for developing paper/boards having improved strength alongwith undiminished optical properties utilising the concepts of nanoscience and nanotechnology.

Keywords: enzymatic pretreatment, mechanical refining, nanofibrils, paper properties

Procedia PDF Downloads 340

Authors: Muna Shalan

Abstract:

Climate change is a systemic challenge for cities, with its impacts not happening in isolation but rather intertwined, thus increasing hazards and the vulnerability of the exposed population. The increase in the frequency and intensity of heat waves, for example, is associated with multiple repercussions on the quality of life of city inhabitants, including health discomfort, a rise in mortality and morbidity, increasing energy demand for cooling, and shrinking of green areas due to drought. To address the multi-faceted impact of urbanisation-induced warming, municipalities and local governments are challenged with devising strategies and implementing effective response measures. Municipalities are recognising the importance of guiding urban concepts to drive climate action in the urban environment. An example is climate proofing, which refers to a process of mainstreaming climate change into development strategies and programs, i.e., urban planning is viewed through a climate change lens. There is a multitude of interconnected aspects that are critical to paving the path toward climate-proofing of urban areas and avoiding poor planning of layouts and spatial arrangements. Navigating these aspects through an analysis of the overarching practices governing municipal planning processes, which is the focus of this research, will highlight entry points to improve procedures, methods, and data availability for optimising planning processes and municipal actions. By employing a case study approach, the research investigates how municipalities in different contexts, namely in the city of Sahab in Jordan, Chililabombwe in Zambia, and the city of Dortmund in Germany, are integrating guiding urban concepts to shrink the deficit in adaptation and mitigation and achieve climate proofing goals in their respective local contexts. The analysis revealed municipal strategies and measures undertaken to optimize existing building and urban design regulations by introducing key performance indicators and improving in-house capacity. Furthermore, the analysis revealed that establishing or optimising interdepartmental communication frameworks or platforms is key to strengthening the steering structures governing local climate action. The most common challenge faced by municipalities is related to their role as a regulator and implementers, particularly in budget analysis and instruments for cost recovery of climate action measures. By leading organisational changes related to improving procedures and methods, municipalities can mitigate the various challenges that may emanate from uncoordinated planning and thus promote action against urbanisation-induced warming.

Keywords: urbanisation-induced warming, response measures, municipal planning processes, key performance indicators, interdepartmental communication frameworks, cost recovery

Procedia PDF Downloads 55

Authors: John-Nelson Ekumah, Xu Han, Qiufang Liang, Benxi Wei, Arif Rashid, Muhammad Safiullah, Abdul Qayum, Selorm Yao-Say Solomon Adade, Nana Adwoa Nkuma Johnson, Abdur Rehman, Xiaofeng Ren

Abstract:

Producing starch gels with superior mechanical attributes remains a challenging pursuit. This research sought to develop a simple method using ethanol exposure to produce robust starch gels. The gels’ mechanical properties, rheology, structural characteristics, and digestion were assessed through textural, rheological, structural, and in vitro digestion analyses. it investigation revealed an improvement in gel’s strength from 62.22 to178.82 g. The thermal transitions were accelerated when ethanol was elevated. The exposure to ethanol resulted in a reduction in syneresis from 11% to 9.5% over a period of 6 hours with noticeable change in size and color. Rheologically, the dominating storage modulus and tan delta (<0.55) emphasized the gel’s improved elasticity. X-ray analysis showed a stable B + V-type pattern after ethanol exposure, with increasing relative crystallinity to 7.9%. Digestibility revealed an ethanol induced resistance, through increased resistant starch from 1.87 to 8.73%. In general, the exposure to ethanol played a crucial role in enhancing the mechanical characteristics of kudzu starch gels, while simultaneously preserving higher levels of resistant starch fractions. These findings have wide-ranging implications in the fields of food and pharmaceuticals, underscoring the extensive academic and industrial importance of this study.

Keywords: kudzu starch gels, mechanical properties, rheological properties, submerged ethanol exposure, In vitro digestion

Procedia PDF Downloads 7

Authors: Rajkumar Ghosh

Abstract:

The study presents an overview of the many uses and approaches for estimating out-of-sequence thrust movement in earthquake mitigation. The study investigates how knowing and forecasting thrust movement during seismic occurrences might assist to effective earthquake mitigation measures. The review begins by discussing out-of-sequence thrust movement and its importance in earthquake mitigation strategies. It explores how typical techniques of estimating thrust movement may not capture the full complexity of seismic occurrences and emphasizes the benefits of include out-of-sequence data in the analysis. A thorough review of existing research and studies on out-of-sequence thrust movement estimates for earthquake mitigation. The study demonstrates how to estimate out-of-sequence thrust movement using multiple data sources such as GPS measurements, satellite imagery, and seismic recordings. The study also examines the use of out-of-sequence thrust movement estimates in earthquake mitigation measures. It investigates how precise calculation of thrust movement may help improve structural design, analyse infrastructure risk, and develop early warning systems. The potential advantages of using out-of-sequence data in these applications to improve the efficiency of earthquake mitigation techniques. The difficulties and limits of estimating out-of-sequence thrust movement for earthquake mitigation. It addresses data quality difficulties, modelling uncertainties, and computational complications. To address these obstacles and increase the accuracy and reliability of out-of-sequence thrust movement estimates, the authors recommend topics for additional study and improvement. The study is a helpful resource for seismic monitoring and earthquake risk assessment researchers, engineers, and policymakers, supporting innovations in earthquake mitigation measures based on a better knowledge of thrust movement dynamics.

Keywords: earthquake mitigation, out-of-sequence thrust, satellite imagery, seismic recordings, GPS measurements

Procedia PDF Downloads 67

Authors: Hatharasinghe Liyanage Saneetha Chathaurika, Shreenika De Silva Weliange

Abstract:

Background and Significance of the Study: Natural and human-induced disasters have become more common due to rapid development and climate change. Therefore hospitalization due to injuries has increased in the midst of advancement in medicine. Prehospital trauma care is critical in reducing morbidity and mortality following injury. Army soldiers are one of the first responder categories after a major disaster causing injury. Thus, basic life support measures taken by trained lay first responders is life-saving, it is important to build up their capacities by updating their knowledge and practices while cultivating positive attitudes toward it. Objective: To describe knowledge, attitudes and practices on prehospital trauma care among army soldiers in Matara District. Methodology: A descriptive cross sectional study was carried out among army soldiers in Matara district. The whole population was studied belonging to the above group during the study period. Self-administered questionnaire was used as the study instrument. Cross tabulations were done to identify the possible associations using chi square statistics. Knowledge and practices were categorized in to two groups as “Poor” and “Good” taking 50% as the cut off. Results: The study population consists of 266 participants (response rate 97.79%).The overall level of knowledge on prehospital trauma care is poor (78.6%) while knowledge on golden hour of trauma (77.1%), triage system (74.4%), cardio pulmonary resuscitation (92.5%) and transportation of patients with spinal cord injury (69.2%) was markedly poor. Good knowledge is significantly associated with advance age, higher income and higher level of education whereas it has no significant association with work duration. More than 80% of them had positive attitudes on most aspects of prehospital trauma care while majority thinks it is good to have knowledge on this topic and they would have performed better in disaster situations if they were trained on pre-hospital trauma care. With regard to the practice, majority (62.8%) is included in the group of poor level of practice. They lack practice on first-aid, cardiopulmonary resuscitation and safe transportation of the patients. Moreover, they had less opportunity to participate in drills/simulation programs done on disaster events. Good practice is significantly associated with advance age and higher level of education but not associated with level of income and working duration of army soldiers. Highly significant association was observed between the level of knowledge and level of practice on prehospital trauma care of army soldiers. It is observed that higher the knowledge practices become better. Conclusion: A higher proportion of army soldiers had poor knowledge and practice on prehospital trauma care while majority had positive attitudes regarding it. Majority lacks knowledge and practice in first-aid and cardiopulmonary resuscitation. Due to significant association observed between knowledge and practice it can be recommended to include a training session on prehospital trauma care in the basic military curriculum which will enhance the ability to act as first responders effectively. Further research is needed in this area of prehospital trauma care to enhance the qualitative outcome.

Keywords: disaster, prehospital trauma care, first responders, army soldiers

Procedia PDF Downloads 216

Authors: Naila Awan, Shahrukh Inam

Abstract:

This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.

Keywords: community health session, basic health units, outpatient department, tuberculosis

Procedia PDF Downloads 70

Authors: K. Kong, E. Ferrier, L. Michel

Abstract:

The purpose of this research was to investigate the creep behaviour of the heterogeneous Timber-UHPFRC beams. New developments have been done to further improve the structural performance, such as strengthening of the timber (glulam) beam by bonding composite material combine with an ultra-high performance fibre reinforced concrete (UHPFRC) internally reinforced with or without carbon fibre reinforced polymer (CFRP) bars. However, in the design of wooden structures, in addition to the criteria of strengthening and stiffness, deformability due to the creep of wood, especially in horizontal elements, is also a design criterion. Glulam, UHPFRC and CFRP may be an interesting composite mix to respond to the issue of creep behaviour of composite structures made of different materials with different rheological properties. In this paper, we describe an experimental and analytical investigation of the creep performance of the glulam-UHPFRC-CFRP beams assembled by bonding. The experimental investigations creep behaviour was conducted for different environments: in- and outside under constant loading for approximately a year. The measured results are compared with numerical ones obtained by an analytical model. This model was developed to predict the creep response of the glulam-UHPFRC-CFRP beams based on the creep characteristics of the individual components. The results show that heterogeneous glulam-UHPFRC beams provide an improvement in both the strengthening and stiffness, and can also effectively reduce the creep deflection of wooden beams.

Keywords: carbon fibre-reinforced polymer (CFRP) bars, creep behaviour, glulam, ultra-high performance fibre reinforced concrete (UHPFRC)

Procedia PDF Downloads 393

Authors: Nathalia Andrea Calderon Lesmes, Eduardo Barragan Parada, Diego Fernando Villegas Bermudez

Abstract:

Spasticity in the plantiflexor muscles as a product of stroke (CVA-Cerebrovascular accident) restricts the mobility and independence of the affected people. Commonly, physiotherapists are in charge of manually performing the rehabilitation therapy known as Sustained Mechanical Stretching, rotating the affected foot of the patient in the sagittal plane. However, this causes a physical wear on the professional because it is a fatiguing movement. In this article, a mechanical device is developed to implement this rehabilitation therapy more efficiently. The device consists of a worm-crown mechanism that is driven by a crank to gradually rotate a platform in the sagittal plane of the affected foot, in order to achieve dorsiflexion. The device has a range of sagittal rotation up to 150° and has velcro located on the footplate that secures the foot. The design of this device was modeled by using CAD software and was checked structurally with a general purpose finite element software to be sure that the device is safe for human use. As a measurement system, a goniometer is used in the lateral part of the device and load cells are used to measure the force in order to determine the opposing torque exerted by the muscle. Load cells sensitivity is 1.8 ± 0.002 and has a repeatability of 0.03. Validation of the effectiveness of the device is measured by reducing the opposition torque and increasing mobility for a given patient. In this way, with a more efficient therapy, an improvement in the recovery of the patient's mobility and therefore in their quality of life can be achieved.

Keywords: biomechanics, mechanical device, plantiflexor muscles, rehabilitation, spastic hemiplegia, sustained mechanical stretching

Procedia PDF Downloads 149

Authors: Muhammad A. Alsubaie, Mubarak K. H. Alhajri, Tarek S. Altowaim

Abstract:

A repetitive controller designed to accommodate periodic disturbances via state feedback is discussed. Periodic disturbances can be represented by a time delay model in a positive feedback loop acting on system output. A direct use of the small gain theorem solves the periodic disturbances problem via 1) isolating the delay model, 2) finding the overall system representation around the delay model and 3) designing a feedback controller that assures overall system stability and tracking error convergence. This paper addresses uncertainty conditions for the repetitive controller designed in state feedback in either past error feedforward or current error feedback using singular values. The uncertainty investigation is based on the overall system found and the stability condition associated with it; depending on the scheme used, to set an upper/lower limit weighting parameter. This creates a region that should not be exceeded in selecting the weighting parameter which in turns assures performance improvement against system uncertainty. Repetitive control problem can be described in lifted form. This allows the usage of singular values principle in setting the range for the weighting parameter selection. The Simulation results obtained show a tracking error convergence against dynamic system perturbation if the weighting parameter chosen is within the range obtained. Simulation results also show the advantage of weighting parameter usage compared to the case where it is omitted.

Keywords: model mismatch, repetitive control, singular values, state feedback

Procedia PDF Downloads 139

Authors: Esther M. Folarin, Evans Osabuohien, Ademola Onabote

Abstract:

Agriculture constitutes an important part of development and poverty mitigation in lower-middle-income countries, like Nigeria. The level of agricultural productivity in the Nigerian economy in line with the level of demand necessary to meet the desired expectation of the Nigerian populace is threatening to meeting the standard of the United Nations (UN) Sustainable Development Goals (SDGs); This includes the SDG-2 (achieve food security through agricultural productivity). The overall objective of the study is to reveal the performance of the interaction variable in the model among other factors that help in the achievement of greater Nigerian agricultural productivity. The study makes use of Wave 4 (2018/2019) of the Living Standard Measurement Studies, Integrated Survey on Agriculture (LSMS-ISA). Qualitative analysis of the information was also used to provide complimentary answers to the quantitative analysis done in the study. The study employed human capital theory and Grossman’s theory of health Demand in explaining the relationships that exist between the variables within the model of the study. The study engages the Instrumental Variable Regression technique in achieving the broad objectives among other techniques for the other specific objectives. The estimation results show that there exists a positive relationship between female healthcare and the level of female agricultural productivity in Nigeria. In conclusion, the study emphasises the need for more provision and empowerment for greater female access to healthcare and educational attainment levels that aids higher female agricultural productivity and consequently an improvement in the total agricultural productivity of the Nigerian economy.

Keywords: agricultural productivity, education, female, healthcare, investment

Procedia PDF Downloads 64

Authors: Muluwerk Ayele Derebe

Abstract:

Background: Antenatal care (ANC) is an essential element in the continuum of reproductive health care for preventing preventable pregnancy-related morbidity and mortality. Objective: The aim of this study is to assess the spatial pattern and predictors of ANC visits in Ethiopia. Method: This study was done using Ethiopian Demographic and Health Survey data of 2016 among 7,174 pregnant women aged 15-49 years which was a nationwide community-based cross-sectional survey. Spatial analysis was done using Getis-Ord Gi* statistics to identify hot and cold spot areas of ANC visits. Multilevel glmmTMB packages adjusted for spatial effects were used in R software. Spatial multilevel count regression was conducted to identify predictors of antenatal care visits for pregnant women, and proportional change in variance was done to uncover the effect of individual and community-level factors of ANC visits. Results: The distribution of ANC visits was spatially clustered Moran’s I = 0.271, p<.0.001, ICC = 0.497, p<0.001). The highest spatial outlier areas of ANC visit was found in Amhara (South Wollo, Weast Gojjam, North Shewa), Oromo (west Arsi and East Harariga), Tigray (Central Tigray) and Benishangul-Gumuz (Asosa and Metekel) regions. The data was found with excess zeros (34.6%) and over-dispersed. The expected ANC visit of pregnant women with pregnancy complications was higher at 0.7868 [ARR= 2.1964, 95% CI: 1.8605, 2.5928, p-value <0.0001] compared to pregnant women who had no pregnancy complications. The expected ANC visit of a pregnant woman who lived in a rural area was 1.2254 times higher [ARR=3.4057, 95% CI: 2.1462, 5.4041, p-value <0.0001] as compared to a pregnant woman who lived in an urban. The study found dissimilar clusters with a low number of zero counts for a mean number of ANC visits surrounded by clusters with a higher number of counts of an average number of ANC visits when other variables held constant. Conclusion: This study found that the number of ANC visits in Ethiopia had a spatial pattern associated with socioeconomic, demographic, and geographic risk factors. Spatial clustering of ANC visits exists in all regions of Ethiopia. The predictor age of the mother, religion, mother’s education, husband’s education, mother's occupation, husband's occupation, signs of pregnancy complication, wealth index and marital status had a strong association with the number of ANC visits by each individual. At the community level, place of residence, region, age of the mother, sex of the household head, signs of pregnancy complications and distance to health facility factors had a strong association with the number of ANC visits.

Keywords: Ethiopia, ANC, spatial, multilevel, zero inflated Poisson

Procedia PDF Downloads 61

Authors: Yanping Liao, Congcong He, Ruigang Zhao

Abstract:

The application of magnetocardiography signals to detect cardiac electrical function is a new technology developed in recent years. The magnetocardiography signal is detected with Superconducting Quantum Interference Devices (SQUID) and has considerable advantages over electrocardiography (ECG). It is difficult to extract Magnetocardiography (MCG) signal which is buried in the noise, which is a critical issue to be resolved in cardiac monitoring system and MCG applications. In order to remove the severe background noise, the Total Variation (TV) regularization method is proposed to denoise MCG signal. The approach transforms the denoising problem into a minimization optimization problem and the Majorization-minimization algorithm is applied to iteratively solve the minimization problem. However, traditional TV regularization method tends to cause step effect and lacks constraint adaptability. In this paper, an improved TV regularization method for denoising MCG signal is proposed to improve the denoising precision. The improvement of this method is mainly divided into three parts. First, high-order TV is applied to reduce the step effect, and the corresponding second derivative matrix is used to substitute the first order. Then, the positions of the non-zero elements in the second order derivative matrix are determined based on the peak positions that are detected by the detection window. Finally, adaptive constraint parameters are defined to eliminate noises and preserve signal peak characteristics. Theoretical analysis and experimental results show that this algorithm can effectively improve the output signal-to-noise ratio and has superior performance.

Keywords: constraint parameters, derivative matrix, magnetocardiography, regular term, total variation

Procedia PDF Downloads 140