Search results for: gene expression data analysis
5524 The Per Capita Income, Energy production and Environmental Degradation: A Comprehensive Assessment of the existence of the Environmental Kuznets Curve Hypothesis in Bangladesh
Authors: Ashique Mahmud, MD. Ataul Gani Osmani, Shoria Sharmin
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In the first quarter of the twenty-first century, the most substantial global concern is environmental contamination, and it has gained the prioritization of both the national and international community. Keeping in mind this crucial fact, this study conducted different statistical and econometrical methods to identify whether the gross national income of the country has a significant impact on electricity production from nonrenewable sources and different air pollutants like carbon dioxide, nitrous oxide, and methane emissions. Besides, the primary objective of this research was to analyze whether the environmental Kuznets curve hypothesis holds for the examined variables. After analyzing different statistical properties of the variables, this study came to the conclusion that the environmental Kuznets curve hypothesis holds for gross national income and carbon dioxide emission in Bangladesh in the short run as well as the long run. This study comes to this conclusion based on the findings of ordinary least square estimations, ARDL bound tests, short-run causality analysis, the Error Correction Model, and other pre-diagnostic and post-diagnostic tests that have been employed in the structural model. Moreover, this study wants to demonstrate that the outline of gross national income and carbon dioxide emissions is in its initial stage of development and will increase up to the optimal peak. The compositional effect will then force the emission to decrease, and the environmental quality will be restored in the long run.Keywords: environmental Kuznets curve hypothesis, carbon dioxide emission in Bangladesh, gross national income in Bangladesh, autoregressive distributed lag model, granger causality, error correction model
Procedia PDF Downloads 1575523 Social Workers' Perspectives on Muslim Parents with Intellectual Disabilities
Authors: Ayelet Gur
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Background: Parents with intellectual disability are of great interest to social service professionals. Article 23 of the United Nations Convention on the Rights of Persons with Disabilities aims to ensure that persons with disabilities can create a family by providing adequate supports. The aim of the current investigation was to portray families with parents with intellectual disabilities within Muslim- Arab society in Israel. Method: Qualitative method using semi-structured interviews with nine-teen Muslim Israeli social workers was employed. Thematic analysis was used to identify major themes. Results: Families with parents with intellectual disability are not a rare phenomenon in the Arab society. The common type is of marriage between a man with intellectual disability and a woman without disability. Findings indicated two main motives for the arranged marriage of a man with intellectual disability: the extended family's concerns about his future and their desire for the family continuity. The non-disabled wives' motives for marrying men with intellectual disabilities revolved around their lack of other opportunities to create a family and their desire to leave their parents' household and live independently. Those women were described as partly or fully aware of their husbands' disability prior to the marriage. The family life of those families were described in relation to the fathers' involvement in family life and relation to the wives' high burden and in many cases, acceptance of their life situation. Conclusions: Findings are discussed with respect to religious values on disability, arranged marriage and the status of Muslim women. Services and supports for parents with intellectual disabilities should be developed with respect to the cultural values and norms.Keywords: Arab society in Israel, intellectual and developmental disability, parents with intellectual disability, social work
Procedia PDF Downloads 1595522 Implementation of an Image Processing System Using Artificial Intelligence for the Diagnosis of Malaria Disease
Authors: Mohammed Bnebaghdad, Feriel Betouche, Malika Semmani
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Image processing become more sophisticated over time due to technological advances, especially artificial intelligence (AI) technology. Currently, AI image processing is used in many areas, including surveillance, industry, science, and medicine. AI in medical image processing can help doctors diagnose diseases faster, with minimal mistakes, and with less effort. Among these diseases is malaria, which remains a major public health challenge in many parts of the world. It affects millions of people every year, particularly in tropical and subtropical regions. Early detection of malaria is essential to prevent serious complications and reduce the burden of the disease. In this paper, we propose and implement a scheme based on AI image processing to enhance malaria disease diagnosis through automated analysis of blood smear images. The scheme is based on the convolutional neural network (CNN) method. So, we have developed a model that classifies infected and uninfected single red cells using images available on Kaggle, as well as real blood smear images obtained from the Central Laboratory of Medical Biology EHS Laadi Flici (formerly El Kettar) in Algeria. The real images were segmented into individual cells using the watershed algorithm in order to match the images from the Kaagle dataset. The model was trained and tested, achieving an accuracy of 99% and 97% accuracy for new real images. This validates that the model performs well with new real images, although with slightly lower accuracy. Additionally, the model has been embedded in a Raspberry Pi4, and a graphical user interface (GUI) was developed to visualize the malaria diagnostic results and facilitate user interaction.Keywords: medical image processing, malaria parasite, classification, CNN, artificial intelligence
Procedia PDF Downloads 255521 Challenges of Sustainable Development of Small and Medium-Sized Enterprises in Georgia
Authors: Kharaishvili Eteri
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The article highlights the importance of small and medium-sized enterprises in achieving the goals of sustainable development of the economy and increasing the well-being of the population. The opinion is put forward that it is necessary to adapt the activities of small and medium-sized firms in Georgia to sustainable business models. Therefore, it is important to identify the challenges that will ensure compliance with the goals and requirements of sustainable development of small and mediumsized enterprises. Objectives. The goal of the study is to reveal the challenges of sustainable development in small and medium-sized enterprises in Georgia and to develop recommendations for strategic development opportunities. Methodologies The challenges of sustainable development of small and medium-sized enterprises are investigated with the following methodology: bibliographic research of scientific works and reports of organizations is carried out; Based on the grouping of sustainable development goals, the performance indicators of these goals are studied; Differences with respect to the corresponding indicators of European countries are determined by the comparison method; The matrix scheme establishes the conditions and tools for sustainable development; Challenges of sustainable development are identified by factor analysis. Contributions Trends in the sustainable development of small and medium-sized enterprises are studied from the point of view of economic, social and environmental factors; To ensure sustainability, the conditions and tools for sustainable development are established (certified supply chains and global markets, allocation of financial resources necessary for sustainable development, proper public procurement, highly qualified workforce, etc.); Several main challenges have been identified in the sustainable development of small and medium-sized enterprises, including: limited internal resources; Institutional factors, especially vague and imperfect regulations, bureaucracy; low level of investments; Low level of qualification of human capital and others.Keywords: small and medium-sized enterprises, sustainable development, conditions of sustainable development, strategic directions of sustainable development.
Procedia PDF Downloads 1105520 Anatomical and Histological Characters of Cymbopogon nardus Roots and Its Mutagenic Properties
Authors: Pravaree Phuneerub, Chanida Palanuvej, Nijsiri Ruangrungsi
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Cymbopogon nardus Rendel (Family Gramineae) is commonly known as citronella grass. The dried root of C. nardus is used for antipyretic, anti-inflammation, anti-analgesic and anticancer in traditional Thai medicine. Transverse sectional and pulverized C. nardus root were illustrated. The volatile oil was extracted from oil gland by hydrodistillation and analysed by GC/MS. Cymbopogon nardus root was exhaustively extracted by continuously maceration in ethanol and water respectively. The mutagenic and antimutagenic properties of the ethanol extract and fractionated water extract of C. nardus root were evaluated by Ames assay using the S. typhimurium strains TA98 and TA100 as the models. The result indicated that the anatomical character of root transverse section displayed epidermis, parenchyma, oil gland, phloem, xylem vessel, endodermis and pith. Histological characters of root powder showed parenchyma containing oleoresin, parenchyma in longitudinal view, reticulate vessel, annular vessel, starch granules and fragment of fiber. The root volatile oil was rich in sesquiterpenes dominated by elemol (22.87%) and alpha-eudesmol (16.09%). For mutagenic activity, the both extracts of C. nardus were no mutagenic toward S. typhimurium strains TA98 and TA100. Furthermore, the ethanol extract and fractionated water extract of C. nardus root demonstrated strong antimutagenic effect against of nitrite treated 1-aminopyrene to S. typhimurium strains TA98 and TA100. This present investigation suggested that the dried root extract of C. nardus can be further developed as promising antimutagenic agent.Keywords: Cymbopogon nardus, volatile oil analysis, mutagenic, antimutagenic effect, Ames Salmonella assay
Procedia PDF Downloads 3535519 Computational Methods in Official Statistics with an Example on Calculating and Predicting Diabetes Mellitus [DM] Prevalence in Different Age Groups within Australia in Future Years, in Light of the Aging Population
Authors: D. Hilton
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An analysis of the Australian Diabetes Screening Study estimated undiagnosed diabetes mellitus [DM] prevalence in a high risk general practice based cohort. DM prevalence varied from 9.4% to 18.1% depending upon the diagnostic criteria utilised with age being a highly significant risk factor. Utilising the gold standard oral glucose tolerance test, the prevalence of DM was 22-23% in those aged >= 70 years and <15% in those aged 40-59 years. Opportunistic screening in Australian general practice potentially can identify many persons with undiagnosed type 2 DM. An Australian Bureau of Statistics document published three years ago, reported the highest rate of DM in men aged 65-74 years [19%] whereas the rate for women was highest in those over 75 years [13%]. If you consider that the Australian Bureau of Statistics report in 2007 found that 13% of the population was over 65 years of age and that this will increase to 23-25% by 2056 with a further projected increase to 25-28% by 2101, obviously this information has to be factored into the equation when age related diabetes prevalence predictions are calculated. This 10-15% proportional increase of elderly persons within the population demographics has dramatic implications for the estimated number of elderly persons with DM in these age groupings. Computational methodology showing the age related demographic changes reported in these official statistical documents will be done showing estimates for 2056 and 2101 for different age groups. This has relevance for future diabetes prevalence rates and shows that along with many countries worldwide Australia is facing an increasing pandemic. In contrast Japan is expected to have a decrease in the next twenty years in the number of persons with diabetes.Keywords: epidemiological methods, aging, prevalence, diabetes mellitus
Procedia PDF Downloads 3785518 Adsorptive Removal of Cd(II) Ions from Aqueous Systems by Wood Ash-Alginate Composite Beads
Authors: Tichaona Nharingo, Hope Tauya, Mambo Moyo
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Wood ash has been demonstrated to have favourable adsorption capacity for heavy metal ions but suffers the application problem of difficult to separate/isolate from the batch adsorption systems. Fabrication of wood ash beads using multifunctional group and non-toxic carbohydrate, alginate, may improve the applicability of wood ash in environmental pollutant remediation. In this work, alginate-wood ash beads (AWAB) were fabricated and applied to the removal of cadmium ions from aqueous systems. The beads were characterized by FTIR, TGA/DSC, SEM-EDX and their pHZPC before and after the adsorption of Cd(II) ions. Important adsorption parameters i.e. pH, AWAB dosage, contact time and ionic strength were optimized and the effect of initial concentration of Cd(II) ions to the adsorption process was established. Adsorption kinetics, adsorption isotherms, adsorption mechanism and application of AWAB to real water samples spiked with Cd(II) ions were ascertained. The composite adsorbent was characterized by a heterogeneous macro pore surface comprising of metal oxides, multiple hydroxyl groups and carbonyl groups that were involved in electrostatic interaction and Lewis acid-base interactions with the Cd(II) ions. The pseudo second order and the Freundlich isotherm models best fitted the adsorption kinetics and isotherm data respectively suggesting chemical sorption process and surface heterogeneity. The presence of Pb(II) ions inhibited the adsorption of Cd(II) ions (reduced by 40 %) attributed to the competition for the adsorption sites. The Cd(II) loaded beads could be regenerated using 0.1 M HCl and could be applied to four sorption-desorption cycles without significant loss in its initial adsorption capacity. The high maximum adsorption capacity, stability, selectivity and reusability of AWAB make the adsorbent ideal for application in the removal of Cd(II) ions from real water samples. Column type adsorption experiments need to be explored to establish the potential of the adsorbent in removing Cd(II) ions using continuous flow systems.Keywords: adsorption, Cd(II) ions, regeneration, wastewater, wood ash-alginate beads
Procedia PDF Downloads 2505517 The Image of Victim and Criminal in Love Crimes on Social Media in Egypt: Facebook Discourse Analysis
Authors: Sherehan Hamdalla
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Egypt has experienced a series of terrifying love crimes in the last few months. This ‘trend’ of love crimes started with a young man caught on video slaughtering his ex-girlfriend in the street in the city of El Mansoura. The crime shocked all Egyptian citizens at all levels; unfortunately, not less than three similar crimes took place in other different Egyptian cities with the same killing trigger. The characteristics and easy access and reach of social media consider the reason why it is one of the most crucial online communication channels; users utilize social media platforms for sharing and exchanging ideas, news, and many other activities; they can freely share posts that reflect their mindset or personal views regarding any issues, these posts are going viral in all social media account by reposting or numbers of shares for these posts to support the content included, or even to attack. The repetition of sharing certain posts could mobilize other supporters with the same point of view, especially when that crowd’s online participation is confronting a public opinion case’s consequences. The death of that young woman was followed by similar crimes in other cities, such as El Sharkia and Port Said. These love crimes provoked a massive wave of contention among all social classes in Egypt. Strangely, some were supporting the criminal and defending his side for several reasons, which the study will uncover. Facebook, the most popular social media platform for Egyptians, reflects the debate between supporters of the victim and supporters of the criminal. Facebook pages were created specifically to disseminate certain viewpoints online, for example, asking for the maximum penalty to be given to criminals. These pages aimed to mobilize the maximum number of supporters and to affect the outcome of the trials.Keywords: love crimes, victim, criminal, social media
Procedia PDF Downloads 805516 Referring to Jordanian Female Relatives in Public
Authors: Ibrahim Darwish, Noora Abu Ain
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Referring to female relatives by male Jordanian speakers in public is governed by various linguistic and social constraints. Although Jordanian society is less conservative than it was a few decades ago, women are still considered the weaker link in society and men still believe that they need to protect them. Conservative Jordanians often avoid referring to their female relatives overtly, i.e., using their real names. Instead, they use covert names, such as pseudonyms, nicknames, pet names, etc. The reason behind such language use has to do with how Arab men, in general, see women as part of their honor. This study intends to investigate to what extent Jordanian males hide their female relatives’ names in public domains. The data was collected from spontaneous informal voice-recorded interviews carried out in the village of Saham in the far north of Jordan. Saham’s dialect is part of a larger Horani dialect used by speakers along a wide area that stretches from Salt in the south to the Syrian borders in the north of Jordan. The voice-recorded interviews were originally carried out as an audio record of some customs and traditions in the village of Saham in 2013. During most of these interviews, the researchers observed how the male participants indirectly referred to their female relatives. Instead of using real names, the male speakers used broad terms to refer to their female relatives, such al-Beit ‘the home,’ al-ciyaal ‘the kids’, um-x ‘the mother of x,’ etc. All tokens related to the issue in question were collected, analyzed and quantified about three age cohorts: young, middle-aged and old speakers. The results show that young speakers are more direct in referring to their female relatives than the other two age groups. This can point to a possible change in progress in the speech community of Saham. It is argued that due to contact with other urban speech communities, the young speakers in Saham do not feel the need to hide the real names of their female relatives as they consider them as equals. Indeed, the young generation is more open to the idea of women's rights and call for expanding Jordanian women’s roles in Jordanian society.Keywords: gender differences, Horan, proper names, social constraints
Procedia PDF Downloads 1465515 Aerial Photogrammetry-Based Techniques to Rebuild the 30-Years Landform Changes of a Landslide-Dominated Watershed in Taiwan
Authors: Yichin Chen
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Taiwan is an island characterized by an active tectonics and high erosion rates. Monitoring the dynamic landscape of Taiwan is an important issue for disaster mitigation, geomorphological research, and watershed management. Long-term and high spatiotemporal landform data is essential for quantifying and simulating the geomorphological processes and developing warning systems. Recently, the advances in unmanned aerial vehicle (UAV) and computational photogrammetry technology have provided an effective way to rebuild and monitor the topography changes in high spatio-temporal resolutions. This study rebuilds the 30-years landform change in the Aiyuzi watershed in 1986-2017 by using the aerial photogrammetry-based techniques. The Aiyuzi watershed, located in central Taiwan and has an area of 3.99 Km², is famous for its frequent landslide and debris flow disasters. This study took the aerial photos by using UAV and collected multi-temporal historical, stereo photographs, taken by the Aerial Survey Office of Taiwan’s Forestry Bureau. To rebuild the orthoimages and digital surface models (DSMs), Pix4DMapper, a photogrammetry software, was used. Furthermore, to control model accuracy, a set of ground control points was surveyed by using eGPS. The results show that the generated DSMs have the ground sampling distance (GSD) of ~10 cm and ~0.3 cm from the UAV’s and historical photographs, respectively, and vertical error of ~1 m. By comparing the DSMs, there are many deep-seated landslides (with depth over 20 m) occurred on the upstream in the Aiyuzi watershed. Even though a large amount of sediment is delivered from the landslides, the steep main channel has sufficient capacity to transport sediment from the channel and to erode the river bed to ~20 m in depth. Most sediments are transported to the outlet of watershed and deposits on the downstream channel. This case study shows that UAV and photogrammetry technology are useful for topography change monitoring effectively.Keywords: aerial photogrammetry, landslide, landform change, Taiwan
Procedia PDF Downloads 1595514 Parental Involvement and Students' Outcomes: A Study in a Special Education School in Singapore
Authors: E. Er, Y. S. Cheng
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The role of parents and caregivers in their children’s education is pivotal. Parental involvement (PI) is often associated with a range of student outcomes. This includes academic achievements, socioemotional development, adaptive skills, physical fitness and school attendance. This study is the first in Singapore to (1) explore the relationship between parental involvement and student outcomes; (2) determine the effects of family structure and socioeconomic status (SES) on parental involvement and (3) investigate factors that inform involvement in parents of children with specific developmental disabilities. Approval for the study was obtained from Nanyang Technological University’s Institutional Review Board in Singapore. The revised version of a comprehensive theoretical model on parental involvement was used as the theoretical framework in this study. Parents were recruited from a SPED school in Singapore which caters to school-aged children (7 to 21 years old). Pearson’s product moment correlation, analysis of variance and multiple regression analyses were used as statistical techniques in this study. Results indicate that there are significant associations between parental involvement and educational outcomes in students with developmental disabilities. Next, SES has a significant impact on levels of parental involvement. In addition, parents in the current study reported being more involved at home, in school activities and the community, when teachers specifically requested their involvement. Home-based involvement was also predicted by parents’ perceptions of their time and energy, efficacy and beliefs in supporting their child’s education, as well as their children’s invitations to be more involved. An interesting and counterintuitive inverse relationship was found between general school invitations and parental involvement at home. Research findings are further discussed, and suggestions are put forth to increase involvement for this specific group of parents.Keywords: autism, developmental disabilities, intellectual disabilities, parental involvement, Singapore
Procedia PDF Downloads 2095513 Development of an Optimised, Automated Multidimensional Model for Supply Chains
Authors: Safaa H. Sindi, Michael Roe
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This project divides supply chain (SC) models into seven Eras, according to the evolution of the market’s needs throughout time. The five earliest Eras describe the emergence of supply chains, while the last two Eras are to be created. Research objectives: The aim is to generate the two latest Eras with their respective models that focus on the consumable goods. Era Six contains the Optimal Multidimensional Matrix (OMM) that incorporates most characteristics of the SC and allocates them into four quarters (Agile, Lean, Leagile, and Basic SC). This will help companies, especially (SMEs) plan their optimal SC route. Era Seven creates an Automated Multidimensional Model (AMM) which upgrades the matrix of Era six, as it accounts for all the supply chain factors (i.e. Offshoring, sourcing, risk) into an interactive system with Heuristic Learning that helps larger companies and industries to select the best SC model for their market. Methodologies: The data collection is based on a Fuzzy-Delphi study that analyses statements using Fuzzy Logic. The first round of Delphi study will contain statements (fuzzy rules) about the matrix of Era six. The second round of Delphi contains the feedback given from the first round and so on. Preliminary findings: both models are applicable, Matrix of Era six reduces the complexity of choosing the best SC model for SMEs by helping them identify the best strategy of Basic SC, Lean, Agile and Leagile SC; that’s tailored to their needs. The interactive heuristic learning in the AMM of Era seven will help mitigate error and aid large companies to identify and re-strategize the best SC model and distribution system for their market and commodity, hence increasing efficiency. Potential contributions to the literature: The problematic issue facing many companies is to decide which SC model or strategy to incorporate, due to the many models and definitions developed over the years. This research simplifies this by putting most definition in a template and most models in the Matrix of era six. This research is original as the division of SC into Eras, the Matrix of Era six (OMM) with Fuzzy-Delphi and Heuristic Learning in the AMM of Era seven provides a synergy of tools that were not combined before in the area of SC. Additionally the OMM of Era six is unique as it combines most characteristics of the SC, which is an original concept in itself.Keywords: Leagile, automation, heuristic learning, supply chain models
Procedia PDF Downloads 3965512 Microstructure, Mechanical, Electrical and Thermal Properties of the Al-Si-Ni Ternary Alloy
Authors: Aynur Aker, Hasan Kaya
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In recent years, the use of the aluminum based alloys in the industry and technology are increasing. Alloying elements in aluminum have further been improving the strength and stiffness properties that provide superior compared to other metals. In this study, investigation of physical properties (microstructure, microhardness, tensile strength, electrical conductivity and thermal properties) in the Al-12.6wt.%Si-%2wt.Ni ternary alloy were investigated. Al-Si-Ni alloy was prepared in a graphite crucible under vacuum atmosphere. The samples were directionally solidified upwards with different growth rate (V) at constant temperature gradient G (7.73 K/mm). The microstructures (flake spacings, λ), microhardness (HV), ultimate tensile strength, electrical resistivity and thermal properties enthalpy of fusion and specific heat and melting temperature) of the samples were measured. Influence of the growth rate and flake spacings on microhardness, ultimate tensile strength and electrical resistivity were investigated and relationships between them were experimentally obtained by using regression analysis. According to results, λ values decrease with increasing V, but microhardness, ultimate tensile strength, electrical resistivity values increase with increasing V. Variations of electrical resistivity for cast samples with the temperature in the range of 300-1200 K were also measured by using a standard dc four-point probe technique. The enthalpy of fusion and specific heat for the same alloy was also determined by means of differential scanning calorimeter (DSC) from heating trace during the transformation from liquid to solid. The results obtained in this work were compared with the previous similar experimental results obtained for binary and ternary alloys.Keywords: electrical resistivity, enthalpy, microhardness, solidification, tensile stress
Procedia PDF Downloads 3815511 Hydromagnetic Linear Instability Analysis of Giesekus Fluids in Taylor-Couette Flow
Authors: K. Godazandeh, K. Sadeghy
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In the present study, the effect of magnetic field on the hydrodynamic instability of Taylor-Couette flow between two concentric rotating cylinders has been numerically investigated. At the beginning the basic flow has been solved using continuity, Cauchy equations (with regards to Lorentz force) and the constitutive equations of a viscoelastic model called "Giesekus" model. Small perturbations, considered to be normal mode, have been superimposed to the basic flow and the unsteady perturbation equations have been derived consequently. Neglecting non-linear terms, the general eigenvalue problem obtained has been solved using pseudo spectral method (combination of Chebyshev polynomials). The objective of the calculations is to study the effect of magnetic fields on the onset of first mode of instability (axisymmetric mode) for different dimensionless parameters of the flow. The results show that the stability picture is highly influenced by the magnetic field. When magnetic field increases, it first has a destabilization effect which changes to stabilization effect due to more increase of magnetic fields. Therefor there is a critical magnetic number (Hartmann number) for instability of Taylor-Couette flow. Also, the effect of magnetic field is more dominant in large gaps. Also based on the results obtained, magnetic field shows a more considerable effect on the stability at higher Weissenberg numbers (at higher elasticity), while the "mobility factor" changes show no dominant role on the intense of suction and injection effect on the flow's instability.Keywords: magnetic field, Taylor-Couette flow, Giesekus model, pseudo spectral method, Chebyshev polynomials, Hartmann number, Weissenberg number, mobility factor
Procedia PDF Downloads 3935510 How to Prevent From Skin Complications in Diabetes Type 2 in View Point of Student of Shiraz University of Medical Sciences
Authors: Zahra Abdi, Roghayeh Alipour, Babak Farahi Ghasraboonasr
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Introduction: Diabetes is a serious medical condition that requires constant care. People with type 2 diabetes may also be likely to experience dry, itchy skin and poor wound healing. Some people with diabetes will have a skin problems at some time in their lives and for those not yet diagnosed with diabetes, a skin problem can be an indication of the disease. our purpose was to assess the capability and knowledge of students of Shiraz University of Medical Sciences about prevent from skin complications in diabetes type 2. Methods: In this descriptive cross-sectional study, knowledge of 360 students of Shiraz University of Medical Sciences was evaluated about different ways to avoid skin complications in diabetes type 2. Data were analyzed by spss19.(P<0.05) was considered significant. Results: 360 students of Shiraz University of Medical Sciences participated in this study. 45% of students agree with the effect of Moisturize skin daily, If Diabetics have sensitive skin, choose a fragrance-free, dye-free moisturizer that won’t irritate skin. 52% believe that Protect skin from sun can be so useful, Sun exposure is drying and aging. Use sunscreen with SPF 30 or higher whenever you’re outside. Wear gloves when doing yardwork to protect the skin on your hands. 62% of students strongly agree with Carefully clean any cuts and scrapes, If diabetics notice any sign of infection skin that’s red, swollen, or warm to the touch, or has a foul-smelling drainage or pus should consulting with a doctor immediately. Diabetics should be careful about any injury that takes longer than normal to heal and they should consulting with doctor about them too. 72% of students believe that diabetics should be diligent about daily foot care. Clean and moisturize feet each day and check each foot closely, top and bottom, for wounds even a tiny cut, blisters, or cracked skin. Conclusions: The risk of getting these diabetes complications can be lessened by controlling blood sugar. Skin complications can cause serious consequences. Taking care of skin is so important and using these tips are remarkable effective and help diabetics to look after their skin easier.Keywords: skin complications, diabetes type 2, Shiraz University of Medical Sciences, diabetics
Procedia PDF Downloads 3585509 Cytotoxic Activity of Acetone and Ethanol Overripe Tempe Extracts against MCF-7 Breast Cancer Cells and Their Antioxidant Property
Authors: Dian Muzdalifah, Anastasia F. Devi, Zatil A. Athaillah, Linar Z. Udin
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Tempe is a functional food prepared from soybeans through Rhizopus spp fermentation. It is well known as functional food, originated from Indonesia. Most studies on tempe functionalities refer to ripe (48 h fermentation) tempe and only limited studies discuss overripe tempe while longer fermentation time possibly increased tempe health benefit. Hence, the present study was performed to investigate the cytotoxic activity againts MCF-7 breast cancer cells and antioxidant property of tempe prepared from 0–156 h of fermentation. Tempe samples were dried and extracted with acetone and ethanol, respectively. Their extracts were used for subsequent analysis. The cytotoxic activity was assessed on MCF 7 breast cancer cells using Alamar Blue method. The antioxidant activity was determined by DPPH free radical scavenging assay. The results indicated that acetone extracts of 108 h tempe had a potent cytotoxic activity against MCF-7 breast cancer cells (IC50 = 2.54 ± 0,30 μg/mL). Ethanol extracts of 108 h tempe also showed the potency, but at slightly higher IC50 (5.20 ± 1.01 μg/mL). Both acetone and ethanol extracts of 108 and 120 h tempe showed high antioxidant activity expressed as percent inhibition with no significant difference. However, acetone extracts of 120 h tempe (81.31 ± 3.70 %) had better ability to inhibit oxidation reaction than that of ethanol extracts (75.77 ± 6.00 %). It can be concluded that the cytotoxic activity of tempe from 0–156 h of fermentation is positively correlated to their corresponding antioxidant property. Longer fermentation time, up to 108 h, increased the ability of tempe to inhibit the growth of MCF-7 breast cancer cells and oxidative reaction. But extended fermentation time, up to 156 h, tends to decrease its ability. Further studies are encouraged to identify the active components contained in each extract.Keywords: antioxidant property, cytotoxic activity, extracts, overripe tempeh
Procedia PDF Downloads 2785508 Job Satisfaction and Associated factors of Urban Health Extension Professionals in Addis Ababa City, Ethiopia
Authors: Metkel Gebremedhin, Biruk Kebede, Guash Abay
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Job satisfaction largely determines the productivity and efficiency of human resources for health. There is scanty evidence on factors influencing the job satisfaction of health extension professionals (HEPs) in Addis Ababa. The objective of this study was to determine the level of and factors influencing job satisfaction among extension health workers in Addis Ababa city. This was a cross-sectional study conducted in Addis Ababa, Ethiopia. Among all public health centers found in the Addis Ababa city administration health bureau that would be included in the study, a multistage sampling technique was employed. Then we selected the study health centers randomly and urban health extension professionals from the selected health centers. In-depth interview data collection methods were carried out for a comprehensive understanding of factors affecting job satisfaction among Health extension professionals (HEPs) in Addis Ababa. HEPs working in Addis Ababa areas are the primary study population. Multivariate logistic regression with 95% CI at P ≤ 0.05 was used to assess associated factors to job satisfaction. The overall satisfaction rate was 10.7% only, while 89.3%% were dissatisfied with their jobs. The findings revealed that variables such as marital status, staff relations, community support, supervision, and rewards have a significant influence on the level of job satisfaction. For those who were not satisfied, the working environment, job description, low salary, poor leadership and training opportunities were the major causes. Other factors influencing the level of satisfaction were lack of medical equipment, lack of transport facilities, lack of training opportunities, and poor support from woreda experts. Our study documented a very low level of overall satisfaction among health extension professionals in Addis Ababa city public health centers. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of extension health professionals as they represent a sensitive domain of the health system of Addis Ababa city. Improving the overall work environment, review of job descriptions and better salaries might bring about a positive change.Keywords: job satisfaction, extension health professionals, Addis Ababa
Procedia PDF Downloads 855507 Efficiency for Enzyme Production of Fungi Isolated from the Stomach of Buffalo
Authors: Suphalucksana, Wichai, Sangsoponjit Settasit, Soytong Kasem
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A study on the efficiency for enzyme production of fungi isolated from stomach of buffalo was conducted. The fungi were collected from 4 parts of stomach as rumen, reticulum, omasum and abomasums. The objective to study the efficiency of fungi from stomach of buffalo had effected to produced enzyme and to selected fungi for their ability to produced enzyme cellulase, hemicellulase and ligninase. Results shown that the fungi isolated from rumen were: Eupenicillium sp. (B-RU-01-1), Eupenicillium sp. (B-RU-02-3G), Rhyzopus stolonifer (B-RU-01-4) and Trichoderma sp. (B-RU-01-2). From the reticulum, Aspergillus glaucus (B-RET-02-3), Aspergillus orchraceus (B-RET-02-2) and Penicillium sp. (B-RET-02-4) were found. In the omasum Aspergillus fumigatus (B-OMA-01-1G), Eurotium sp. (B-OMA-01-4) and Rhizopus stolonifer (B-OMA-02-3) were isolated and in the abomasums Aspergillus flavas (B-ABO-02-3), Aspergillus fumigatus (B-ABO-02-1), Aspergillus niger (B-ABO-01-3G), Aspergillius terreus (B-ABO-02-4) and Mucor sp. (B-ABO-02-4G). Results of enzyme analysis revealed that cellulase was produced by isolated: Eupenicillium sp. (B-RU-02-3G), Eupenicillium sp. (B-RU-01-1), Penicillium sp. (B-RET-02-4), Aspergillius glaucus (B-RET-02-3), Aspergillus ochraceus (B-RET-02-2), Aspergillius fumigatus (B-OMA-01-1G), Eurotium sp. (B-OMA-01-4), Aspergillius flavus (B-ABO-02-3), Aspergillius fumigatus (B-ABO-02-1), Aspergillius niger (B-ABO-01-3G), Aspergillius terreus (B-ABO-02-4). Hemicellulase was produced Eupenicillium sp. (B-RU-02-3G), Eupenicillium sp. (B-RU-01-1), Rhizopus stolonifer (B-RU-01-4), Trichoderma sp. (B-RU-01-2), Aspergillius glaucus (B-RET-02-3), Aspergillus ochraceus (B-RET-02-2), Penicillium sp. (B-RET-02-4), Aspergillius fumigatus (B-OMA-01-1G), Eurotium sp. (B-OMA -01-4), Aspergillius flavus (B-ABO-02-3), Aspergillius fumigatus (B-ABO-02-1) Aspergillius niger (B-ABO-01-3G), Aspergillius terreus (B-ABO-02-4), Mucor sp. (B-ABO-02-4G). For the enzyme ligninase, two isolates were found to produced this enzyme namely : Trichoderma sp. (B-RU-01-2) and Mucor sp. (B-ABO-02-4G).Keywords: enzyme production from fungi, enzyme production, fungi, agricultural technology
Procedia PDF Downloads 3965506 The Study of Tourism Destination Management Factors for Sustainable Tourism: Case Study of Haikou, Hainan Province
Authors: Jiaying Gao, Thammananya Sakcharoen, Wilailuk Niyommaneerat
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Haikou is the capital of Hainan, a major tourism province in China with rich ecotourism resources. There is a need to strengthen tourism destination management in Haikou toward sustainable development as a tourism city. The purpose of this study was to investigate the relationship between tourism destination management and sustainable tourism in Haikou. Exploratory factor analysis was used to extract six dimensions of this study. Three dimensions (10 factors) of tourism destination management were analyzed in terms of economic development, social and cultural development, and conservation of ecosystem. Sustainability awareness, tourism development experience, and tourism public infrastructure in three dimensions (12 factors) of sustainable tourism. There were 426 questionnaire respondents, including 225 tourists, 172 residents, 12 tourism agency persons, 10 government persons, 3 self-employed, and 4 others. The Structural equation modeling (SEM) model was finally conducted to test the hypotheses empirically and explore the impact relationship. The study found a significant relationship between tourism destination management and sustainable tourism: social and cultural development had the greatest significant positive impact on the tourism development experience (0.788***). Social and cultural development also showed a significant positive impact and great impetus on tourism public infrastructure (0.561***). A negative effect relationship (-0.096***) emerged between ecosystem conversion and tourism development experience. It showed a positive relationship between economic development and social and cultural development of tourism destination management in promoting sustainable tourism. There are still some gaps for improvement, such as the need for sustainable ecological management to promote local sustainable tourism trends and enhance tourism experience development, which may require a long-term process of mitigation.Keywords: Haikou (Hainan, China), influence relationship, sustainable tourism, tourism destination management
Procedia PDF Downloads 1485505 Predictors of Ante-Natal Care and Health Facility Delivery Services Utilization in a Rural Area in Plateau State
Authors: Lilian A. Okeke, I. Okeke, N. Waziri, S. Balogun, P. Nguku, O. Fawole
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Background: Access to ante-natal care services promotes safe motherhood and delivery with improved maternal and neonatal outcome. We conducted this study to identify factors influencing the utilization of antenatal care (ANC) and health delivery services. Methods: We conducted a cross sectional study. Households were numbered and a one in three sample was selected using a systematic sampling method. One hundred and ninety eight women who were either pregnant or had previous deliveries were interviewed using pretested structured questionnaires to obtain information on their socio-demographic characteristics, and reasons for non-utilization of ANC and health delivery services. We performed univariate and bivariate analysis using Epi info version 3.5.3. Results: The age of respondents ranged from (17-55 years) with a median age of 29 years. One hundred and ninety two (97%) utilized antenatal care services. Ninety three (47.9%) attended ANC at second trimester. More than half (58.6%) had ≥ 4 visits to ANC. One hundred and thirty one (66.2%) had their last delivery at home by a traditional birth attendant. Factors associated with ANC and health facility delivery services utilization were: age group 45-55 (OR 0.01; 95% CI: 0.00-0.16) and > 55 years (OR 0.03; 95% CI: 0.00-0.60), wife’s educational status (OR 3.17; 95% CI: 1.66-8.30), husband’s permission (OR 11.8; 95% CI 2.19-63.62), and distance ≥ 5km (OR 0.33; 95% CI: 0.16-0.60). Conclusion: ANC services were well utilized. Most women did not book early and had their last delivery at home. Predictors of ANC use and health facility delivery were age, wife’s educational status, husband's permission and long distance from health facility. A one-day health sensitization of the benefits of ANC utilization and the dangers of delivering at home was implemented.Keywords: ante natal care, health facility, delivery services, rural area, Plateau state
Procedia PDF Downloads 3805504 Optimal Approach for Siewert Type Ⅱ Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Metanalysis
Authors: Maatouk Mohamed, Nouira Mariem
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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross sectional study at the CNH with a unique passage per department (OctoberDecember 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included with a mean age of 52 years and a sex ratio (Female/Male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent sites infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261), revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased significantly the risk of HAIs. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under 2 or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an Antibiotic stewardship program with continuous monitoring using repeated prevalence surveys must be implemented to limit the frequency of these infections effectively.Keywords: tumors, oesophagectomy, esophagogastric junction, systematic review
Procedia PDF Downloads 865503 Lexical Collocations in Medical Articles of Non-Native vs Native English-Speaking Researchers
Authors: Waleed Mandour
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This study presents multidimensional scrutiny of Benson et al.’s seven-category taxonomy of lexical collocations used by Egyptian medical authors and their peers of native-English speakers. It investigates 212 medical papers, all published during a span of 6 years (from 2013 to 2018). The comparison is held to the medical research articles submitted by native speakers of English (25,238 articles in total with over 103 million words) as derived from the Directory of Open Access Journals (a 2.7 billion-word corpus). The non-native speakers compiled corpus was properly annotated and marked-up manually by the researcher according to the standards of Weisser. In terms of statistical comparisons, though, deployed were the conventional frequency-based analysis besides the relevant criteria, such as association measures (AMs) in which LogDice is deployed as per the recommendation of Kilgariff et al. when comparing large corpora. Despite the terminological convergence in the subject corpora, comparison results confirm the previous literature of which the non-native speakers’ compositions reveal limited ranges of lexical collocations in terms of their distribution. However, there is a ubiquitous tendency of overusing the NS-high-frequency multi-words in all lexical categories investigated. Furthermore, Egyptian authors, conversely to their English-speaking peers, tend to embrace more collocations denoting quantitative rather than qualitative analyses in their produced papers. This empirical work, per se, contributes to the English for Academic Purposes (EAP) and English as a Lingua Franca in Academic settings (ELFA). In addition, there are pedagogical implications that would promote a better quality of medical research papers published in Egyptian universities.Keywords: corpus linguistics, EAP, ELFA, lexical collocations, medical discourse
Procedia PDF Downloads 1345502 In Vivo Assessment of Biogenically Synthesized Silver Nanoparticles
Authors: Muhammad Shahzad Tufail, Iram Liaqat
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Silver nanoparticles (AgNPs) have wider biomedical applications due to their intensive antimicrobial activities. However, toxicity and side effects of nanomaterials like AgNPs is a subject of great controversy towards the further studies in this direction. In this study, biogenically synthesized AgNPs, previously characterized via ultraviolet (UV) visible spectroscopy, scanning electron microscopy (SEM), X-ray diffraction (XRD) and fourier transform infrared spectroscopy (FTIR), were subjected to toxicity evaluation using mice model. Albino male mice (BALB/c) were administered with 50 mgkg-1, 100 mgkg-1 and 150 mgkg-1 of AgNPs, respectively, except for control for 30 days. Log-probit regression analysis was used to measure the dosage response to determine the median lethal dose (LD50). Exposure to AgNPs caused significant changes in the levels of serum AST (P ˂ 0.05) at the 100mgkg-1 and 150mgkg-1 of AgNPs exposure, while ALT and serum creatinine (P ˃ 0.05) levels remained normal. Histopathology of male albino mice liver and kidney was studied after 30 days experimental period. Results revealed that mice exposed to heavy dose (150 mgkg-1) of AgNPs showed cell distortion, necrosis and detachment of hepatocytes in the liver. Regarding kidney, at lower concentration, normal renal structure with normal glomeruli was observed. However, at higher concentration (150 mgkg-1), kidneys showed smooth surface and dark red colour with proliferation of podocytes. It can be concluded from present study that biologically synthesized AgNPs are small to be eliminated easily by kidney and therefore the liver and kidney did not show toxicity at low concentrations.Keywords: silver nanoparticles, pseudomonas aeruginosa, male albino mice, toxicity assessment
Procedia PDF Downloads 835501 A Real-Time Moving Object Detection and Tracking Scheme and Its Implementation for Video Surveillance System
Authors: Mulugeta K. Tefera, Xiaolong Yang, Jian Liu
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Detection and tracking of moving objects are very important in many application contexts such as detection and recognition of people, visual surveillance and automatic generation of video effect and so on. However, the task of detecting a real shape of an object in motion becomes tricky due to various challenges like dynamic scene changes, presence of shadow, and illumination variations due to light switch. For such systems, once the moving object is detected, tracking is also a crucial step for those applications that used in military defense, video surveillance, human computer interaction, and medical diagnostics as well as in commercial fields such as video games. In this paper, an object presents in dynamic background is detected using adaptive mixture of Gaussian based analysis of the video sequences. Then the detected moving object is tracked using the region based moving object tracking and inter-frame differential mechanisms to address the partial overlapping and occlusion problems. Firstly, the detection algorithm effectively detects and extracts the moving object target by enhancing and post processing morphological operations. Secondly, the extracted object uses region based moving object tracking and inter-frame difference to improve the tracking speed of real-time moving objects in different video frames. Finally, the plotting method was applied to detect the moving objects effectively and describes the object’s motion being tracked. The experiment has been performed on image sequences acquired both indoor and outdoor environments and one stationary and web camera has been used.Keywords: background modeling, Gaussian mixture model, inter-frame difference, object detection and tracking, video surveillance
Procedia PDF Downloads 4835500 The Safety Transfer in Acute Critical Patient by Telemedicine (START) Program at Udonthani General Hospital
Authors: Wisit Wichitkosoom
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Objective:The majority of the hisk-risk patients (ST-elevation myocardial infarction (STEMI), Acute cerebrovascular accident, Sepsis, Acute Traumatic patient ) are admitted to district or lacal hospitals (average 1-1.30 hr. from Udonthani general hospital, Northeastern province, Thailand) without proper facilities. The referral system was support to early care and early management at pre-hospital stage and prepare for the patient data to higher hospital. This study assessed the reduction in treatment delay achieved by pre-hospital diagnosis and referral directly to Udonthani General Hospital. Methods and results: Four district or local hospitals without proper facilities for treatment the very high-risk patient were serving the study region. Pre-hospital diagnoses were established with the simple technology such as LINE, SMS, telephone and Fax for concept of LEAN process and then the telemedicine, by ambulance monitoring (ECG, SpO2, BT, BP) in both real time and snapshot mode was administrated during the period of transfer for safety transfer concept (inter-hospital stage). The standard treatment for patients with STEMI, Intracranial injury and acute cerebrovascular accident were done. From 1 October 2012 to 30 September 2013, the 892 high-risk patients transported by ambulance and transferred to Udonthani general hospital were registered. Patients with STEMI diagnosed pre-hospitally and referred directly to the Udonthani general hospital with telemedicine closed monitor (n=248). The mortality rate decreased from 11.69% in 2011 to 6.92 in 2012. The 34 patients were arrested on the way and successful to CPR during transfer with the telemedicine consultation were 79.41%. Conclusion: The proper innovation could apply for health care system. The very high-risk patients must had the closed monitoring with two-way communication for the “safety transfer period”. It could modified to another high-risk group too.Keywords: safety transfer, telemedicine, critical patients, medical and health sciences
Procedia PDF Downloads 3085499 Community Participation in Decentralized Management of Natural Resources in the Sudano-Sahelian Zone of West Africa
Authors: Clarisse Umutoni, Augustine Ayantunde, Matthew Turner, Germain J. Sawadogo
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Decentralized governance of natural resources is considered one of the key strategies for promoting sustainable management of natural resources at local level. The rationale behind decentralization of natural resources is that local populations are both better situated and more highly motivated than outside agencies to manage the resources in an ecologically and economically sustainable manner. Effective decentralized natural resource management requires strong local natural resource institutions. Therefore, strengthening local institutions governing natural resource management is essential to promoting strong participation of local communities in managing their resources. This paper investigated the existing local institutions (rules, norms and or local conventions) governing the management of natural resources and forms of community participation in the development of these natural resource institutions. Group discussions and individual interviews were conducted to collect data. Our findings showed significant variation within the study sites regarding the level of knowledge of existing local rules and norms governing the management of natural resources by the respondents. The results also show that participation was dominated by a small group of individuals, often community leaders and elites. The results suggest that women are marginalized. In general, factors which influence the level of participation include; age, year of residence in the community, gender and education level. This study also highlights the strengths of local natural resource institutions especially if enforced. Presently, the big challenge that faces the institutions governing natural resource use in the study area is the system of representativeness in the community in the development of local rules and norms as community leaders and household heads often dominate, which does not encourage active participation of community members. Therefore, for effective implementation of local natural resource institutions, the interest of key natural resource users should be taken into account. It is also important to promote rules and norms that attempt to protect or strengthen women’s access to natural resources in the community.Keywords: decentralization, land use plan, local institutions, Mali
Procedia PDF Downloads 3905498 Mitochondrial DNA Copy Number in Egyptian Patients with Hepatitis C Virus Related Hepatocellular Carcinoma
Authors: Doaa Hashad, Amany Elyamany, Perihan Salem
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Introduction: Hepatitis C virus infection (HCV) constitutes a serious dilemma that has an impact on the health of millions of Egyptians. Hepatitis C virus related hepatocellular carcinoma (HCV-HCC) is a crucial consequence of HCV that represents the third cause of cancer-related deaths worldwide. Aim of the study: assess the use of mitochondrial DNA (mtDNA) content as a non-invasive molecular biomarker in hepatitis c virus related hepatocellular carcinoma (HCV-HCC). Methods: A total of 135 participants were enrolled in the study. Volunteers were assigned to one of three groups equally; a group of HCV related cirrhosis (HCV-cirrhosis), a group of HCV-HCC and a control group of age- and sex- matched healthy volunteers with no evidence of liver disease. mtDNA was determined using a quantitative real-time PCR technique. Results: mtDNA content was lowest in HCV-HCC cases. No statistically significant difference was observed between the group of HCV-cirrhosis and the control group as regards mtDNA level. HCC patients with multi-centric hepatic lesions had significantly lower mtDNA content. On using receiver operating characteristic curve analysis, a cutoff of 34 was assigned for mtDNA content to distinguish between HCV-HCC and HCV-cirrhosis patients who are not yet complicated by malignancy. Lower mtDNA was associated with greater HCC risk on using healthy controls, HCV-cirrhosis, or combining both groups as a reference group. Conclusions: mtDNA content might constitute a non-invasive molecular biomarker that reflects tumor burden in HCV-HCC cases and could be used as a predictor of HCC risk in patients of HCV-cirrhosis. In addition, the non significant difference of mtDNA level between HCV-cirrhosis patients and healthy controls could eliminate the grey zone created by the use of AFP in some cirrhotic patients.Keywords: DNA copy number, HCC, HCV, mitochondrial
Procedia PDF Downloads 3275497 Bacterial Causes of Cerebral Abscess and Impact on Long Term Patient Outcomes
Authors: Umar Rehman, Holly Roy, K. T. Tsang, D. S. Jeyaretna, W Singleton, B. Fisher, P. A. Glew, J. Greig, Peter C. Whitfield
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Introduction: A brain abscess is a life-threatening condition, carrying significant mortality. It requires rapid identification and treatment. Management involves a combination of antibiotics and surgery. The aim of the current study was to identify common bacteria responsible for cerebral abscesses as well as the long term functional and neurological outcomes of patients following treatment in a retrospective series at a single UK neurosurgical centre. Methodology: We analysed patients that had received a diagnosis of 'cerebral abscess' or 'subdural empyema' between June 2002 and June 2018. This was done in the form of a retrospective review. The search resulted in a total of 180 patients; with 37 patients being excluded (spinal abscess, below 18 or non-abscess related admissions). Data were collected from medical case notes including information about demographics, comorbidities, immunosuppression, presentation, size/location of lesions, pathogens, treatment, and outcomes. Results: In total, we analysed 143 patients between the ages of 18-90. Focal neurological deficit and headaches were seen in 84% and 68% of patients respectively. 108 positive brain cultures were seen; with the largest proportion, 59.2% being gram-positive cocci, with strep intermedius being the most common pathogen identified in 13.9% of patients. Of the patients with positive blood cultures (n=11), 72.7% showed the same organism both in the blood and on the brain cultures. Long term outcomes (n=72) revealed that 48% of patients seizure-free without requiring anti-epileptics, 51.3% of patients had full recovery of their neurological symptoms. There was a mortality rate of 13.9% in the series. Conclusion: In conclusion, the largest bacterial cause of abscess within our population was due to gram-positive cocci. The majority of the patient demonstrated full neurological recovery with close to half of patients not requiring anti-epileptics following discharge.Keywords: bacteria, cerebral abscess, long term outcome, neurological deficit
Procedia PDF Downloads 1225496 A Cost-Benefit Analysis of Routinely Performed Transthoracic Echocardiography in the Setting of Acute Ischemic Stroke
Authors: John Rothrock
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Background: The role of transthoracic echocardiography (TTE) in the diagnosis and management of patients with acute ischemic stroke remains controversial. While many stroke subspecialist reserve TTE for selected patients, others consider the procedure obligatory for most or all acute stroke patients. This study was undertaken to assess the cost vs. benefit of 'routine' TTE. Methods: We examined a consecutive series of patients who were admitted to a single institution in 2019 for acute ischemic stroke and underwent TTE. We sought to determine the frequency with which the results of TTE led to a new diagnosis of cardioembolism, redirected therapeutic cerebrovascular management, and at least potentially influenced the short or long-term clinical outcome. We recorded the direct cost associated with TTE. Results: There were 1076 patients in the study group, all of whom underwent TTE. TTE identified an unsuspected source of possible/probable cardioembolism in 62 patients (6%), confirmed an initially suspected source (primarily endocarditis) in an additional 13 (1%) and produced findings that stimulated subsequent testing diagnostic of possible/probable cardioembolism in 7 patients ( < 1%). TTE results potentially influenced the clinical outcome in a total of 48 patients (4%). With a total direct cost of $1.51 million, the mean cost per case wherein TTE results potentially influenced the clinical outcome in a positive manner was $31,375. Diagnostically and therapeutically, TTE was most beneficial in 67 patients under the age of 55 who presented with 'cryptogenic' stroke, identifying patent foramen ovale in 21 (31%); closure was performed in 19. Conclusions: The utility of TTE in the setting of acute ischemic stroke is modest, with its yield greatest in younger patients with cryptogenic stroke. Given the greater sensitivity of transesophageal echocardiography in detecting PFO and evaluating the aortic arch, TTE’s role in stroke diagnosis would appear to be limited.Keywords: cardioembolic, cost-benefit, stroke, TTE
Procedia PDF Downloads 1365495 Bone Mineral Density in Long-Living Patients with Coronary Artery Disease
Authors: Svetlana V. Topolyanskaya, Tatyana A. Eliseeva, Olga N. Vakulenko, Leonid I. Dvoretski
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Introduction: Limited data are available on osteoporosis in centenarians. Therefore, we evaluated bone mineral density in long-living patients with coronary artery disease (CAD). Methods: 202 patients hospitalized with CAD were enrolled in this cross-sectional study. The patients' age ranged from 90 to 101 years. The majority of study participants (64.4%) were women. The main exclusion criteria were any disease or medication that can lead to secondary osteoporosis. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results: Normal lumbar spine BMD was observed in 40.9%, osteoporosis – in 26.9%, osteopenia – in 32.2% of patients. Normal proximal femur BMD values were observed in 21.3%, osteoporosis – in 39.9%, and osteopenia – in 38.8% of patients. Normal femoral neck BMD was registered only in 10.4% of patients, osteoporosis was observed in 60.4%, osteopenia in 29.2%. Significant positive correlation was found between all BMD values and body mass index of patients (p < 0.001). Positive correlation was registered between BMD values and serum uric acid (p=0.0005). The likelihood of normal BMD values with hyperuricemia increased 3.8 times, compared to patients with normal uric acid, who often have osteoporosis (Odds Ratio=3.84; p = 0.009). Positive correlation was registered between all BMD values and body mass index (p < 0.001). Positive correlation between triglycerides levels and T-score (p=0.02), but negative correlation between BMD and HDL-cholesterol (p=0.02) were revealed. Negative correlation between frailty severity and BMD values (p=0.01) was found. Positive correlation between BMD values and functional abilities of patients assessed using Barthel index (r=0,44; p=0,000002) and IADL scale (r=0,36; p=0,00008) was registered. Fractures in history were observed in 27.6% of patients. Conclusions: The study results indicate some features of BMD in long-livers. In the study group, significant relationships were found between bone mineral density on the one hand, and patients' functional abilities on the other. It is advisable to further study the state of bone tissue in long-livers involving a large sample of patients.Keywords: osteoporosis, bone mineral density, centenarians, coronary artery disease
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