Search results for: heart failure patient

Authors: Mehrdad Sheikhvatan, Mohammad Ali Boroumand, Mehrdad Behmanesh, Shayan Ziaee

Abstract:

Contradictory results have been obtained regarding the role of integrin, beta 3 (ITGB3) gene polymorphisms in occurrence of acute myocardial infarction (MI) in patients with coronary artery disease (CAD). Hence, we aimed to assess the association between 1565C/T polymorphism of ITGB3 gene and increased risk for acute MI in patients who suffered premature CAD in Iranian population. Our prospective study included 1000 patients (492 men and 508 women aged 21 to 55 years) referred to Tehran Heart center during a period of four years from 2008 to 2011 with the final diagnosis of premature CAD and classified into two groups with history of MI (n = 461) and without of MI (n = 539). The polymorphism variants were determined by PCR-RFLP technique by entering 10% of randomized samples and then genotyping of the polymorphism was also conducted by High Resolution Melting (HRM) method. Among study samples, 640 were followed with a median follow-up time 45.74 months for determining association of long-term major adverse cardiac events (MACE) and genotypes of polymorphisms. There was no significant difference in the frequency of 1565C/T polymorphism between the MI and non-MI groups. The frequency of wild genotype was 69.2% and 72.2%, the frequency of homozygous genotype was 21.3% and 18.4%, and the frequency of mutant genotype was 9.5% and 9.5%, respectively (p=0.505). Results were also similar when adjusted for covariates in a multivariate logistic regression model. No significant difference was also found in total-MACE free survival rate between the patients with different genotypes of 1565C/T polymorphism in both MI and non-MI group. The carriage of the 1565C/T polymorphism of ITGB3 gene seems unlikely to be a significant risk factor for the development of MI in Iranian patients with premature CAD. The presence of this ITGB3 gene polymorphism may not also predict long-term cardiac events.

Keywords: coronary artery disease, myocardial infarction, gene, integrin, beta 3, polymorphism

Procedia PDF Downloads 400

Authors: Georges F. Hatoum, Thomas H. Temple, Silvio Garcia, Xiaodong Wu

Abstract:

Soft Tissue Sarcomas (STS) represent a diverse group of malignancies with heterogeneous clinical and pathological features. The treatment of extremity STS aims to achieve optimal local tumor control, improved survival, and preservation of limb function. The National Comprehensive Cancer Network guidelines, based on the cumulated clinical data, recommend radiation therapy (RT) in conjunction with limb-sparing surgery for large, high-grade STS measuring greater than 5 cm in size. Such treatment strategy can offer a cure for patients. However, when recurrence occurs (in nearly half of patients), the prognosis is poor, with a median survival of 12 to 15 months and with only palliative treatment options available. The spatially-fractionated-radiotherapy (SFRT), with a long history of treating bulky tumors as a non-mainstream technique, has gained new attention in recent years due to its unconventional therapeutic effects, such as bystander/abscopal effects. Combining single fraction of GRID, the original form of SFRT, with conventional RT was shown to have marginally increased the rate of pathological necrosis, which has been recognized to have a positive correlation to overall survival. In an effort to consistently increase the pathological necrosis rate over 90%, multiple fractions of Lattice RT (LRT), a newer form of 3D SFRT, interdigitated with the standard RT as neoadjuvant therapy was conducted in a preliminary clinical setting. With favorable results of over 95% of necrosis rate in a small cohort of patients, a Phase I/II clinical study was proposed to exam the safety and feasibility of this new strategy. Herein the design of the clinical study is presented. In this single-arm, two-stage phase I/II clinical trial, the primary objectives are >80% of the patients achieving >90% tumor necrosis and to evaluation the toxicity; the secondary objectives are to evaluate the local control, disease free survival and overall survival (OS), as well as the correlation between clinical response and the relevant biomarkers. The study plans to accrue patients over a span of two years. All patient will be treated with the new neoadjuvant RT regimen, in which one of every five fractions of conventional RT is replaced by a LRT fraction with vertices receiving dose ≥10Gy while keeping the tumor periphery at or close to 2 Gy per fraction. Surgical removal of the tumor is planned to occur 6 to 8 weeks following the completion of radiation therapy. The study will employ a Pocock-style early stopping boundary to ensure patient safety. The patients will be followed and monitored for a period of five years. Despite much effort, the rarity of the disease has resulted in limited novel therapeutic breakthroughs. Although a higher rate of treatment-induced tumor necrosis has been associated with improved OS, with the current techniques, only 20% of patients with large, high-grade tumors achieve a tumor necrosis rate exceeding 50%. If this new neoadjuvant strategy is proven effective, an appreciable improvement in clinical outcome without added toxicity can be anticipated. Due to the rarity of the disease, it is hoped that such study could be orchestrated in a multi-institutional setting.

Keywords: lattice RT, necrosis, SFRT, soft tissue sarcoma

Procedia PDF Downloads 60

Authors: Mehmet Nefes, Selman Demirel, Hasan H. Ertok, Cenk Sen

Abstract:

A typical reliability engineering problem regarding communication satellites has been considered to determine redundancy allocation scheme of power amplifiers within payload transponder module, whose dominant function is to amplify power levels of the received signals from the Earth, through maximizing reliability against mass, power, and other technical limitations. Adding each redundant power amplifier component increases not only reliability but also hardware, testing, and launch cost of a satellite. This study investigates a multi-objective approach used in order to solve Redundancy Allocation Problem (RAP) for a communication satellite payload transponder, focusing on design cost due to redundancy and reliability factors. The main purpose is to find the optimum power amplifier redundancy configuration satisfying reliability and capacity thresholds simultaneously instead of analyzing respectively or independently. A mathematical model and calculation approach are instituted including objective function definitions, and then, the problem is solved analytically with different input parameters in MATLAB environment. Example results showed that payload capacity and failure rate of power amplifiers have remarkable effects on the solution and also processing time.

Keywords: communication satellite payload, multi-objective optimization, redundancy allocation problem, reliability, transponder

Procedia PDF Downloads 261

Authors: E.A. Kuchma

Abstract:

Photodynamic therapy (PDT) is considered an alternative and minimally invasive cancer treatment modality compared to chemotherapy and radiation therapy. PDT includes three main components: a photosensitizer (PS), oxygen, and a light source. PS is injected into the patient's body and then selectively accumulates in the tumor. However, the light used in PDT (spectral range 400–700 nm) is limited to superficial lesions, and the light penetration depth does not exceed a few cm. The problem of PDT (poor visible light transmission) can be solved by using X-rays. The penetration depth of X-rays is ten times greater than that of visible light. Therefore, X-ray radiation easily penetrates through the tissues of the body. The aim of this work is to develop universal nanocomposites for X-ray photodynamic therapy of deep and superficial tumors using scintillation nanoparticles of gadolinium fluoride (GdF3), doped with Tb3+, coated with a biocompatible coating (PEG) and photosensitizer RB (Rose Bengal). PEG@GdF3:Tb3+(15%) – RB could be used as an effective X-ray, UV, and photoluminescent mediator to excite a photosensitizer for generating reactive oxygen species (ROS) to kill tumor cells via photodynamic therapy. GdF3 nanoparticles can also be used as contrast agents for computed tomography (CT) and magnetic resonance imaging (MRI).

Keywords: X-ray induced photodynamic therapy, scintillating nanoparticle, radiosensitizer, photosensitizer

Procedia PDF Downloads 80

Authors: Amina Bayazid, Habiba Fetati, Houari Toumi

Abstract:

Introduction: The clinical value of vitamin K antagonists (VKA) has been widely demonstrated in numerous indications. Unfortunately, VKA are not devoid of drawbacks and risk of serious bleeding. The iatrogenic induced by these drugs is a major public health problem. Patients & Methods: We conducted a retrospective study period extending from February 2012 to August 2013 in the pharmacovigilance service of EHUO (clinical pharmacology unit). The prescription of painkillers was analyzed in patients on VKA followed at our level. The influence of these analgesics on the evolution of the INR is an important component in our work. Results: We counted a total of 195 patients, of whom 32 (or 16.41% of the total population) had received analgesic treatment. The frequencies of different categories of analgesics administered were: • Analgesics opioids: 0% • Analgesics weak opioids: Tramadol: 21.87% • The non-opioid analgesics: -AINS: 71.87% (indomethacin: 68.75% ibuprofen: 3.12%) - Paracetamol: 6.25% -Salicyles (Acetylsalicylic acid): 0%. Conclusion: The management of pain in patients under vitamin K antagonists has special features, given their many drug interactions with analgesics and their influence on the evolution of the INR which can have dramatic consequences. As such, special attention must be paid to the use of analgesics in this type of patient.

Keywords: vitamin K antagonists, pain killers, interactions, INR

Procedia PDF Downloads 300

Authors: Ayobami Kehinde

Abstract:

The literary representations of the family, tradition and change in African literature offer an immense, and as yet little theorised area of literary scholarship. Therefore, this paper explores the nexus among the family, tradition and change in five purposively selected post-colonial African fiction: Chimamanda Adichie’s Purple Hibiscus, Wale Okediran’s Tenants of the House, J. M. Coetzee’s In the Heart of the Country, Tsitsi Dangrembga’s Nervous Condition and Meja Mwangi’s Striving for the Wind. The methodology centres on analysing, questioning, undermining and celebrating the family and its contemporary vicissitudes as depicted in the texts. This is with a view to exploring the postcolonial novel with references to concepts developed by major theorists in the field of postcolonial studies, including Frantz Fanon, Edward Said, Gayatri Spivak, Homi Bhabha, Kwame Appiah and Achille Mbembe. It is revealed that in spite of the fact that the family is a vital institution, the primary social unit in any community, an agent of acculturation and the first focus of development, independence and growth, the texts reflect a diversity of problems confronting the family unit in Africa. These include the multiple problems of disrupted family lives, enforced family separation, political and personal violence with the domestic environment. It is concluded that the post-colonial African novel is a quintessential weapon to analyse the continent, opening up to the reader the specific expressions and experiences of human lives and their wider contexts. Therefore, the post-colonial African novel is a primary socio-cultural indicator representing an immense variety of lived realities in the continent. The study, therefore, suggests a concerted concern with the preservation of traditional family structures and other related aspects, such as cultural values, spirituality, gender roles and mutual trust.

Keywords: family, African fiction, postcolonialism, African tradition, domestic dissonance

Procedia PDF Downloads 335

Authors: Altayeb Qasem, Mousa Bani Baker, Amani Nawafleh

Abstract:

The complexity of the sand-bentonite liner barrier system calls for an adequate model that reflects the conditions depending on the barrier materials and the characteristics of the permeates which lead to hydraulic conductivity changes when liners infiltrated with polar, no-polar, miscible and immiscible liquids. This paper is dedicated to developing a model for evaluating the hydraulic conductivity in the form of a simple indicator for the compatibility of the liner versus leachate. Based on two liner compositions (95% sand: 5% bentonite; and 90% sand: 10% bentonite), two pressures (40 kPa and 100 kPa), and three leachates: water, ethanol and biofuel. Two characteristics of the leacahtes were used: viscosity of permeate and its octanol-water partitioning coefficient (Kow). Three characteristics of the liners mixtures were evaluated which had impact on the hydraulic conductivity of the liner system: the initial content of bentonite (%), the free swelling index, and the shrinkage limit of the initial liner’s mixture. Engineers can use this modest tool to predict a potential liner failure in sand-bentonite barriers.

Keywords: liner performance, sand-bentonite barriers, viscosity, free swelling index, shrinkage limit, octanol-water partitioning coefficient, hydraulic conductivity, theoretical modeling

Procedia PDF Downloads 414

Authors: Sophie Laurence, Catherine Rivard

Abstract:

The assessment of acquired language disorders in the adult population, whether for a bilingual or monolingual adult, is a complex process that requires the speech-language pathologist (SLP) to make a judicious choice when selecting the assessment method and tools. However, this task is even more complex with Ontario's bilingual population due to the lack of linguistically and culturally appropriate tools for this population. Numerous researches examined language assessment of the pediatric bilingual population; however, few studies have focused on assessing acquired language disorders in bilingual adults. This study's main objective is to identify the challenges that SLPs encounter when assessing language in the bilingual English-French adult population in Ontario to ultimately be able to serve this population in the future better. An online questionnaire was made available to 1325 members of the College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO) who work with the adult population. The answers to this questionnaire (n = 71) allowed us to identify the tools and strategies most commonly used by SLPs in current practice, identify the assessment challenges faced by SLPs, and determine the causes of these challenges as well as potential solutions. In an English and French assessment, the Western Aphasia Battery, the Boston Diagnostic Aphasia Examination, and the Boston Naming Test were the three tools that respondents deemed to be the most relevant for the assessment. Besides, the results revealed that limited access to SLPs and interpreters who speak the client's language and the lack of standardized and normalized assessment tools for Ontario's French-speaking and bilingual English-French clientele are at the heart of the challenges of current SLP practice. Consistent with these findings, respondents highlighted two potential solutions to address these challenges: SLPs have access to standardized/normalized tools for the population under study and better access to SLPs and interpreters who speak the client's language.

Keywords: assessment, acquired language disorders, bilingualism, speech-Language pathology, adult population

Procedia PDF Downloads 139

Authors: Huong M. T. Nguyen, Hoa A. P. Nguyen, Chi V. Phan, Mai P. T. Nguyen, Ngoc D. Ngo, Van T. Ta, Hai T. Le

Abstract:

Wilson’s disease is an autosomal recessive disorder of copper metabolism, which is caused by mutation in copper- transporting P-type ATPase (ATP7B). The mechanism of this disease is a failure of hepatic excretion of copper to the bile, and it leads to copper deposits in the liver and other organs. Most clinical symptoms of Wilson’s disease can present as liver disease and/or neurologic disease. Objective: The goal of the study is prenatal diagnosis for pregnant women at high risk of Wilson’s disease in Northern Vietnam. Material and method: Three probands with clinically diagnosed liver disease were detected in the mutations of 21 exons and exon-intron boundaries of the ATP7B gene by direct Sanger-sequencing. Prenatal diagnoses were performed by amniotic fluid sampling from pregnant women in the 16th-18th weeks of pregnancy after the genotypes of parents with the probands were identified. Result: A total of three different mutations of the probands, including of S105*, P1052L, P1273G, were detected. Among three fetuses which underwent prenatal genetic testing, one fetus was homozygote; two fetuses were carriers. Conclusion: Genetic testing provided a useful method for prenatal diagnosis, and is a basis for genetic counseling.

Keywords: ATP7B gene, genetic testing, prenatal diagnosis, pedigree, Wilson disease

Procedia PDF Downloads 455

Authors: Vito Telesca, Giuseppina A. Giorgio

Abstract:

The earth system is subject to a wide range of human activities that have changed the ecosystem more rapidly and extensively in the last five decades. These global changes have a large impact on human health. The relationship between extreme weather events and mortality are widely documented in different studies. In particular, a number of studies have investigated the relationship between climatological variations and the cardiovascular and respiratory system. The researchers have become interested in the evaluation of the effect of environmental variations on the occurrence of different diseases (such as infarction, ischemic heart disease, asthma, respiratory problems, etc.) and mortality. Among changes in weather conditions, the heat waves have been used for investigating the association between weather conditions and cardiovascular events and cerebrovascular, using thermal indices, which combine air temperature, relative humidity, and wind speed. The effects of heat waves on human health are mainly found in the urban areas and they are aggravated by the presence of atmospheric pollution. The consequences of these changes for human health are of growing concern. In particular, meteorological conditions are one of the environmental aspects because cardiovascular diseases are more common among the elderly population, and such people are more sensitive to weather changes. In addition, heat waves, or extreme heat events, are predicted to increase in frequency, intensity, and duration with climate change. In this context, are very important public health and climate change connections increasingly being recognized by the medical research, because these might help in informing the public at large. Policy experts claim that a growing awareness of the relationships of public health and climate change could be a key in breaking through political logjams impeding action on mitigation and adaptation. The aims of this study are to investigate about the importance of interactions between weather variables and your effects on human health, focusing on Italy. Also highlighting the need to define strategies and practical actions of monitoring, adaptation and mitigation of the phenomenon.

Keywords: climate change, illness, Italy, temperature, weather

Procedia PDF Downloads 247

Authors: Y. Chiang, J. R. Wang, J. H. Yang, Y. S. Tseng, C. Shih, S. W. Chen

Abstract:

Kuosheng nuclear power plant (NPP) is a BWR/6 plant in Taiwan. There is more concern for the safety of Spent Fuel Pools (SFPs) in Taiwan after Fukushima event. In order to estimate the safety of Kuosheng NPP SFP, by using MELCOR2.1 and SNAP, the safety analysis of Kuosheng NPP SFP was performed combined with the mitigation strategy of NEI 06-12 report. There were several steps in this research. First, the Kuosheng NPP SFP models were established by MELCOR2.1/SNAP. Second, the Station Blackout (SBO) analysis of Kuosheng SFP was done by TRACE and MELCOR under the cooling system failure condition. The results showed that the calculations of MELCOR and TRACE were very similar in this case. Second, the mitigation strategy analysis was done with the MELCOR model by following the NEI 06-12 report. The results showed the effectiveness of NEI 06-12 strategy in Kuosheng NPP SFP. Finally, a sensitivity study of SFP quenching was done to check the differences of different water injection time and the phenomena during the quenching. The results showed that if the cladding temperature was over 1600 K, the water injection may have chance to cause the accident more severe with more hydrogen generation. It was because of the oxidation heat and the “Breakaway” effect of the zirconium-water reaction. An animation model built by SNAP was also shown in this study.

Keywords: MELCOR, SNAP, spent fuel pool, quenching

Procedia PDF Downloads 359

Authors: B. M. Pardeshi

Abstract:

Introduction: Minerals and trace elements are chemical elements required by our bodies for numerous biological and physiological processes that are necessary for the maintenance of health. Medicinal plants are highly beneficial for the maintenance of good health and prevention of diseases. They are known as potential sources of minerals and vitamins. 30 to 40% of today’s conventional drugs used in the medicinal and curative properties of various plants are employed in herbal supplement botanicals, nutraceuticals and drug. Aim: The authors explored the mineral element content of some herbs, because mineral elements may have significant role in the development and treatment of gastrointestinal diseases, and a close connection between the presence or absence of mineral elements and inflammatory mediators was noted. Methods: Present study deals with the elemental analysis of medicinal plants by Instrumental Neutron activation Analysis and Atomic Absorption Spectroscopy. Medicinal herbals prescribed for skin diseases were purchased from markets and were analyzed by Instrumental Neutron Activation Analysis (INAA) using 252Cf Californium spontaneous fission neutron source (flux* 109 n s-1) and the induced activities were counted by γ-ray spectrometry and Atomic Absorption Spectroscopy (AAS) techniques (Perkin Elmer 3100 Model) available at Department of Chemistry University of Pune, India, was used for the measurement of major, minor and trace elements. Results: 15 elements viz. Al, K, Cl, Na, Mn by INAA and Cu, Co, Pb Ni, Cr, Ca, Fe, Zn, Hg and Cd by AAS were analyzed from different medicinal plants from India. A critical examination of the data shows that the elements Ca , K, Cl, Al, and Fe are found to be present at major levels in most of the samples while the other elements Na, Mn, Cu, Co, Pb, Ni, Cr, Ca, Zn, Hg and Cd are present in minor or trace levels. Conclusion: The beneficial therapeutic effect of the studied herbs may be related to their mineral element content. The elemental concentration in different medicinal plants is discussed.

Keywords: instrumental neutron activation analysis, atomic absorption spectroscopy, medicinal plants, trace elemental analysis, mineral contents

Procedia PDF Downloads 333

Authors: Mohsin Shahab, Shagufta Rehmat, Faisal F. Khan

Abstract:

Background: The global COVID-19 pandemic has generated health problems worldwide. Health care workers are the front-line warriors against the pandemic. The aim of this study was to find out the prevalence of COVID-19 (7th May 2021 to 3rd August 2021) amongst Health Care Workers (HCWs) and to assess the complications associated with it and its effects on their quality of life. Material and Method: The study was conducted in healthcare facilities which serve as pandemic hospitals in district Swat. A total of 140 healthcare workers, who were employed in the COVID-19 health care facilities, including the department of Pulmonology, Intensive Care Unit (ICU), and COVID-19 wards. Participants were tested for COVIID-19 using RT PCR test. A Case Report Form (CRF) for conditions during and post COVID-19 was filled to assess the complications and quality of life of health care workers. Results: A total of 140 Health Care Workers were studied, out of which 40% were doctors, 22% nursing staff, 17% paramedic staff, 9% cleaning staff, lab technologist 6%, 2% operation theater staff, administration staff, and pharmacist. The respondents were also investigated for pre-existing illness prior to SARS-CoV-2 infection, hypertension was the most prevalent, followed by chronic heart diseases and neurological disorders. Fever was the most common symptom, recorded 76.42% in the participants, while 55.71% of participants had dry cough, 55% had a sore throat, following by chest pain 43.56%. Reinfection rate was 10%, with chest pain being recorded in 85.71%. Post disease complication analysis showed that 47.14% of the participants were diagnosed with a new diagnosis after the COVID-19 recovery. Pulmonological diseases were recorded the most as a new diagnosis in, followed by gastrointestinal and psychological problems. Conclusions: The results of the study illustrates how COVID-19 has affected the overall health and quality of life of HCWs in District Swat of Khyber Pakhtunkhwa, Pakistan.

Keywords: SARS-CoV-2, COVID-19, HCW's, symptoms, questionnaire, post COVID-19

Procedia PDF Downloads 275

Authors: Tsietsi J. Pilusa, Tumisang G. Seodigeng

Abstract:

This study evaluates the benefits of advanced waste management practices in unlocking waste-to-energy opportunities within the solid waste industry. The key drivers of sustainable waste management practices, specifically with respect to packaging waste-to-energy technology options are discussed. The success of a waste-to-energy system depends significantly on the appropriateness of available technologies, including those that are well established as well as those that are less so. There are hard and soft interventions to be considered when packaging an integrated waste treatment solution. Technology compatibility with variation in feedstock (waste) quality and quantities remains a key factor. These factors influence the technology reliability in terms of production efficiencies and product consistency, which in turn, drives the supply and demand network. Waste treatment technologies rely on the waste material as feedstock; the feedstock varies in quality and quantities depending on several factors; hence, the technology fails, as a result. It is critical to design an advanced waste treatment technology in an integrated approach to minimize the possibility of technology failure due to unpredictable feedstock quality, quantities, conversion efficiencies, and inconsistent product yield or quality. An integrated waste-to-energy approach offers a secure system design that considers sustainable waste management practices.

Keywords: emerging markets, evaluation tool, interventions, waste treatment technologies

Procedia PDF Downloads 273

Authors: Souad Romdhane, Lotfi Belkacem

Abstract:

When referring to actuarial analysis of lifetime, only models accounting for observable risk factors have been developed. Within this context, Cox proportional hazards model (CPH model) is commonly used to assess the effects of observable covariates as gender, age, smoking habits, on the hazard rates. These covariates may fail to fully account for the true lifetime interval. This may be due to the existence of another random variable (frailty) that is still being ignored. The aim of this paper is to examine the shared frailty issue in the Cox proportional hazard model by including two different parametric forms of frailty into the hazard function. Four estimated methods are used to fit them. The performance of the parameter estimates is assessed and compared between the classical Cox model and these frailty models through a real-life data set from the Quebec Pension Plan and then using a more general simulation study. This performance is investigated in terms of the bias of point estimates and their empirical standard errors in both fixed and random effect parts. Both the simulation and the real dataset studies showed differences between classical Cox model and shared frailty model.

Keywords: life insurance-pension plan, survival analysis, risk factors, cox proportional hazards model, multivariate failure-time data, shared frailty, simulations study

Procedia PDF Downloads 359

Authors: Tony Jehi, Sujatha Rajaram, Nader majzoub, Joan Sabate

Abstract:

Aging significantly increases the incidence of various cardiometabolic diseases, including cardiovascular disease (CVD). To combat CVD and its associated risk factors, it is imperative to adopt a healthy dietary pattern that is rife with beneficial nutrient and non-nutrient compounds. Unsaturated fats, specifically n-3 polyunsaturated fatty acids (n-3 PUFA), have cardio-protective effects; the opposite is true for saturated fatty acids. What role, if any, does the biomarker of fatty acid intake (specific fatty acids in the erythrocyte) play in predicting cardiometabolic risk among the elderly, a population highly susceptible to increased mortality and morbidity from CVD risk factors, remains unclear. This was a secondary analysis of the Walnuts and Healthy Aging Study. Briefly, elderly (n=192, mean age 69 y) participants followed their usual diet and were randomized into two groups to either eat walnuts daily or abstain from eating walnuts for a period of 2 years. The purpose was to identify potential associations between erythrocyte membrane fatty acids and cardiometabolic risk factors (body weight, blood pressure, blood lipids, and fasting glucose). Erythrocyte n-3 PUFA were inversely associated with total cholesterol (ß = -3.83; p= 0.02), triglycerides (ß = -7.66; p= <0.01), and fasting glucose (ß = -0.19; p=0.03). Specifically, erythrocyte ALA (ß= -1.59; P = 0.04) and DPA (ß= -0.62; P=0.04) were inversely associated with diastolic blood pressure and fasting glucose, respectively. N-6 PUFAs were positively associated with systolic blood pressure (ß=1.10; P=0.02). Mono-unsaturated fatty acids were positively associated with TAG (ß = 4.16; P=0.03). Total saturated fatty acids were not associated with any cardiometabolic risk factors. No association was found between any erythrocyte fatty acid and body weight. In conclusion, erythrocyte n-3 PUFA may be used as a biomarker to predict the cardiometabolic risk among healthy elders, providing support for the American Heart Association guidelines for including n-3 PUFA for preventing CVD.

Keywords: cardiometabolic diseases, erythrocyte fatty acids, elderly, n-3 PUFA

Procedia PDF Downloads 71

Authors: Yun-Ching Tu, Yu-Chun Chih

Abstract:

People with aphasia (PWA) may have communicative difficulties in their daily lives, but research on functional communication in aphasia is still limited in Taiwan. The aim of the study was to investigate the impact of aphasia-related factors on functional communication assessment. This study adopted a convenience sampling method. Thirty aphasic participants participated in the study. During the test, the examiner would ask questions that are encountered in daily life and record the participant‘s responses. Some questions would provide pictures to simulate situations in daily life. The results showed that the non-fluent aphasia group performed significantly worse than the fluent aphasia group. In addition, patients with severe aphasia performed significantly lower scores than patients with moderate aphasia and mild aphasia. However, group differences in the chronic stage and acute stage were not significant. In sum, since communication in daily life is diverse and language is still needed in the communication process, patients with aphasia who have better language ability may have relatively better functional communication. In contrast, the more severely impaired the language ability of a patient with aphasia is, the more functional communication will be affected, resulting in poor communication performance in daily life.

Keywords: adult, aphasia, assessment, functional communication

Procedia PDF Downloads 75

Authors: Öznur Saribaş, Si̇bel Kahraman Çeti̇ntaş

Abstract:

It is aimed to compare target volume and critical organ doses by using CyberKnife (CK) in accelerated partial breast irradiation (APBI) in patients with early stage breast cancer. Three different virtual plans were made for Iris, fixed and multi-leaf collimator (MLC) for 5 patients who received radiotherapy in the CyberKnife system. CyberKnife virtual plans were created, with 6 Gy per day totaling 30 Gy. Dosimetric parameters for the three collimators were analyzed according to the restrictions in the NSABP-39/RTOG 0413 protocol. The plans ensured critical organs were protected and GTV received 95 % of the prescribed dose. The prescribed dose was defined by the isodose curve of a minimum of 80. Homogeneity index (HI), conformity index (CI), treatment time (min), monitor unit (MU) and doses taken by critical organs were compared. As a result of the comparison of the plans, a significant difference was found for the duration of treatment, MU. However, no significant difference was found for HI, CI. V30 and V15 values of the ipsi-lateral breast were found in the lowest MLC. There was no significant difference between Dmax values for lung and heart. However, the mean MU and duration of treatment were found in the lowest MLC. As a result, the target volume received the desired dose in each collimator. The contralateral breast and contralateral lung doses were the lowest in the Iris. Fixed collimator was found to be more suitable for cardiac doses. But these values did not make a significant difference. The use of fixed collimators may cause difficulties in clinical applications due to the long treatment time. The choice of collimator in breast SBRT applications with CyberKnife may vary depending on tumor size, proximity to critical organs and tumor localization.

Keywords: APBI, CyberKnife, early stage breast cancer, radiotherapy.

Procedia PDF Downloads 118

Authors: Enemeri George Uweiyohowo

Abstract:

Improved achievement with respect to output control of photovoltaic (PV) systems is one of the major focus of PV in recent times. This is evident to its low carbon emission and efficiency. Power failure or outage from commercial providers, in general, does not promote development to public and private sector, these basically limit the development of industries. The need for a well-structured PV system is of importance for an efficient and cost-effective monitoring system. The purpose of this paper is to validate the maximum power point of an off-grid PV system taking into consideration the most effective tilt and orientation angles for PV's in the southern hemisphere. This paper is based on analyzing the system using a solar charger with MPPT from a pulse width modulation (PWM) perspective. The power conditioning device chosen is a solar charger with MPPT. The practical setup consists of a PV panel that is set to an orientation angle of 0∘N, with a corresponding tilt angle of 36∘, 26∘ and 16∘. Preliminary results include regression analysis (normal probability plot) showing the maximum power point in the system as well the best tilt angle for maximum power point tracking.

Keywords: poly-crystalline PV panels, information technology (IT), maximum power point tracking (MPPT), pulse width modulation (PWM)

Procedia PDF Downloads 213

Authors: John Chau, Tzvi Aviv

Abstract:

Cardiometabolic conditions (hypertension, diabetes, and hyperlipidemia) are major public health concerns. Analysis of all prescription records from about 10 million patients at the largest network of pharmacies in Canada reveals small year-over-year increases in the treatment prevalence of cardiometabolic diseases prior to the COVID-19 pandemic. Cardiometabolic treatment rates increase with age and are higher in males than females. Hypertension treatment rates were 24% in males and 19% in females in 2021. Diabetes treatment rates were 10% in males and 7% in females in 2021. Geospatial analysis using patient addresses reveals interesting differences among provinces and neighborhoods in Canada. Using digital surveys distributed among 8,504 Canadian adults, an increase in hypertension awareness with age and female gender was observed. However, 7% of seniors and 6% of middle-aged Canadians reported uncontrolled blood pressure (>140/90 mmHg). In addition, elevated blood pressure (130-139/80-89 mmHg) was reported by 20% of seniors and 14% of middle-aged Canadians.

Keywords: cardiometabolic conditions, diabetes, hypertension, precision public health

Procedia PDF Downloads 116

Authors: Ram Sharan Mehta

Abstract:

The number of new cancer cases annually is estimated to rise from 10.9 million in 2002 to more than 16 million by 2020, if current trends continue. Much of this increase in absolute numbers derives from the ageing of populations worldwide. The objectives of this study were to find out the demographic characteristics of the admitted cancer patients in BPKIHS. It was hospital based descriptive cross-sectional study conducted reviewing all the records of admitted diagnosed cancer patients in BPKIHS from 15th October 2004 to 14th October 2012. Using total enumerative sampling technique all 1379 diagnosed cancer patients record were reviewed after obtaining the permission from concerned authorities. Using SPSS-15 software package data was analyzed. It was found that majority (71%) of cancer patients were of age more than 40 years and equal of both sexes. Most of the clients were form Sunsari (31.1%), Morang (16.6%) and Jhapa (17%) districts. The mean hospitalization day is 8.32 and very few patients (5.2%) were only cured. The numbers of cancer patients are markedly increases in BPKIHS, especially in advanced stage. It is mandatory to start the cancer information and education programme in eastern region of Nepal and proper management of cancer patients using chemotherapy, radiotherapy and surgery at BPKIHS for quality patient care.

Keywords: lung, cancer, patients, Nepal

Procedia PDF Downloads 375

Authors: Hafiz Atif Iqbal

Abstract:

It is a confirmed historical fact that Pakistan is an ideological state, and religion has played a very important and vital role in the establishment of Pakistan. This is the reason why the slogan "What does Pakistan mean is "la ilaha illa Allah" is embedded in the heart of every Muslim. This slogan became so popular in the dimensions of India that Movement of Pakistan and this slogan became inseparable, and that is why Quaid-e-Azam said: "Twenty-five percent share in Movement of Pakistan belongs to the creator of this slogan, Asghar Soudai Sialkoti." This slogan later formed the basis of the two-nation theory, whereby the Hindus and Muslims of the sub-continent were declared to be two separate and complete nations, completely different from each other in terms of their religion, affairs, dress, lifestyle, and values. In this regard, on March 23, 1940, at the historic meeting of the Muslim League in Lahore, in which the Lahore Resolution was passed, Quaid-e-Azam said: Islam and Hinduism are not just religions, but actually two different social systems. Therefore, this desire should be called a dream and a dream that Hindus and Muslims will be able to create a common nationality together. These people do not marry each other, nor do they eat at the same table. I say in a nutshell that they belong to two different civilizations, and these civilizations are based on concepts and facts that contradict each other and are against each other. Quaid-e-Azam, while addressing Peshawar in January 1948, said: "We did not demand Pakistan just to get a separate piece of land, but we wanted to get a laboratory where we can test the principles of Islam. The distinction of the concept of Islamic government should be kept in mind that the authority of obedience and loyalty in it is God Almighty, whose practical means of compliance are the rules and principles of the Holy Quran. Only the rules of the Holy Quran can determine the limits of our freedom and restrictions in the state and society. In other words, the Islamic government is the government of Quranic principles and rules. All these facts make it clear that religion has played a fundamental and important role in the establishment of Pakistan.

Keywords: la ilaha illa allah, asghar soudai sialkoti, lahore resolution, quaid-e-azam

Procedia PDF Downloads 99

Authors: G. A. Rombach, A. Faron

Abstract:

Crack formation and growth in reinforced concrete members are, in many cases, the cause of the collapse of technical structures. Such serious failures impair structural behavior and can also damage property and persons. An intensive investigation of the crack propagation is indispensable. Numerical methods are being developed to analyze crack growth in an element and to detect fracture failure at an early stage. For reinforced concrete components, however, further research and action are required in the analysis of shear cracks. This paper presents numerical simulations and continuum mechanical modeling of bending shear crack propagation in a three-dimensional reinforced concrete beam without transverse reinforcement. The analysis will provide a further understanding of crack growth and redistribution of inner forces in concrete members. As a numerical method to map discrete cracks, the extended finite element method (XFEM) is applied. The crack propagation is compared with the smeared crack approach using concrete damage plasticity. For validation, the crack patterns of real experiments are compared with the results of the different finite element models. The evaluation is based on single span beams under bending. With the analysis, it is possible to predict the fracture behavior of concrete members.

Keywords: concrete damage plasticity, crack propagation, extended finite element method, fracture mechanics

Procedia PDF Downloads 119

Authors: Muhammad Suradi, Sugiarto, Abdullah Latip

Abstract:

Many roadside slope failures occur during the rainy season, particularly in the period of extreme rainfall along Connecting National Road of Salubatu-Mambi, West Sulawesi, Indonesia. These occurrences cause traffic obstacles and endanger people along and around the road. Research collaboration between P2JN (National Road Construction Board) West Sulawesi Province, who authorize to supervise the road condition, and Ujung Pandang State Polytechnic (Applied University) was established to cope with the landslide problem. This research aims to determine factors triggering roadside slope failures and their optimum stabilizing solution. To achieve this objective, site observation and soil investigation were carried out to obtain parameters for analyses of rainfall-induced slope instability and reinforcement design using the SV Flux and SV Slope software. The result of this analysis will be taken into account for the next analysis to get an optimum design of the slope reinforcement. The result indicates some factors such as steep slopes, sandy soils, and unvegetated slope surface mainly contribute to the slope failures during intense rainfall. With respect to the contributing factors as well as construction material and technology, cantilever/butressing retaining wall becomes the optimum solution for the roadside slope reinforcement.

Keywords: roadside slope, failure, rainfall, slope reinforcement, optimum solution

Procedia PDF Downloads 106

Authors: Onosedeba Mary Ayayia

Abstract:

Inclusive education has emerged as a critical global imperative, aiming to provide equitable educational opportunities for all, regardless of their abilities or disabilities. In Africa, the pursuit of inclusive education faces significant challenges, particularly concerning the development and implementation of inclusive curricula tailored to the diverse needs of students with disabilities. This study delves into the heart of this issue, seeking to address the pressing problem of exclusion and marginalization of students with disabilities in mainstream educational systems across the continent. The problem is complex, entailing issues of limited access to tailored curricula, shortages of qualified teachers in special needs education, stigmatization, limited research and data, policy gaps, inadequate resources, and limited community awareness. These challenges perpetuate a system where students with disabilities are systematically excluded from quality education, limiting their future opportunities and societal contributions. This research proposes a comprehensive examination of the current state of inclusive curriculum development and implementation in Africa. Through an innovative and explicit exploration of the problem, the study aims to identify effective strategies, guidelines, and best practices that can inform the development of inclusive curricula. These curricula will be designed to address the diverse learning needs of students with disabilities, promote teacher capacity building, combat stigmatization, generate essential data, enhance policy coherence, allocate adequate resources, and raise community awareness. The goal of this research is to contribute to the advancement of inclusive education in Africa by fostering an educational environment where every student, regardless of ability or disability, has equitable access to quality education. Through this endeavor, the study aligns with the broader global pursuit of social inclusion and educational equity, emphasizing the importance of inclusive curricula as a foundational step towards a more inclusive and just society.

Keywords: inclusive education, special education, curriculum development, Africa

Procedia PDF Downloads 64

Authors: John Pomerat, Aviv Segev

Abstract:

Recently, deep learning has had many theoretical breakthroughs. For deep learning to be successful in the industry, however, there need to be practical algorithms capable of handling many real-world hiccups preventing the immediate application of a learning algorithm. Although AI promises to revolutionize the healthcare industry, getting access to patient data in order to train learning algorithms has not been easy. One proposed solution to this is data- sharing. In this paper, we propose an alternative protocol, based on multi-party computation, to train deep learning models while maintaining both the privacy and security of training data. We examine three methods of training neural networks in this way: Transfer learning, average ensemble learning, and series network learning. We compare these methods to the equivalent model obtained through data-sharing across two different experiments. Additionally, we address the security concerns of this protocol. While the motivating example is healthcare, our findings regarding multi-party computation of neural network training are purely theoretical and have use-cases outside the domain of healthcare.

Keywords: neural network aggregation, multi-party computation, transfer learning, average ensemble learning

Procedia PDF Downloads 162

Authors: Wei-Han Wang, Hsiang-Yu Yu, Mau-Sun Hua

Abstract:

Theory of Mind (ToM) refers to the ability to infer another’s mental state. With appropriate ToM, one can behave well in social interactions. A growing body of evidence has demonstrated that patients with temporal lobe epilepsy (TLE) may have damaged ToM due to impact on regions of the underlying neural network of ToM. However, the question of whether there is cerebral laterality for ToM functions remains open. This study aimed to examine whether there is cerebral lateralization for ToM abilities in TLE patients. Sixty-seven adult TLE patients and 30 matched healthy controls (HC) were recruited. Patients were classified into right (RTLE), left (LTLE), and bilateral (BTLE) TLE groups on the basis of a consensus panel review of their seizure semiology, EEG findings, and brain imaging results. All participants completed an intellectual test and four tasks measuring basic and advanced ToM. The results showed that, on all ToM tasks; (1)each patient group performed worse than HC; (2)there were no significant differences between LTLE and RTLE groups; (3)the BTLE group performed the worst. It appears that the neural network responsible for ToM is distributed evenly between the cerebral hemispheres.

Keywords: cerebral lateralization, social cognition, temporal lobe epilepsy, theory of mind

Procedia PDF Downloads 420

Authors: Samantha Ramachandra, Avanthi Rupasinghe

Abstract:

Demographic transition from lower to higher percentage of elderly population eventually coupled with epidemiological transition from communicable to non-communicable diseases (NCD). Higher percentage of NCD overload the health system as NCD survivors claims continuous health care. The demands are challenging to a resource constrained setting but reorganizing the system may find solutions. The study focused on the facilities available and their utilization at outpatient department (OPD) setting of the public hospitals of Sri Lanka for continuous medical care. This will help in identifying steps of reorganizing the system to provide better care with the maximum utilization of available facilities. The study was conducted as a situation analysis with secondary data at hospital planning units. Variable were identified according to the world health organization (WHO) recommendation on continuous health care for elders in “age-friendly primary health care toolkit”. Data were collected from secondary and tertiary care hospitals of Sri Lanka where most of the continuous care services are available. Out of 58 secondary and tertiary care hospitals, 16 were included in the study to represent each hospital categories. Average number of patient attending for episodic treatment at OPD and Clinical follow-up of chronic conditions shows vast disparity according to the category of the hospital ranging from 3750 – 800 per day at OPD and 1250 – 200 per clinic session. Average time spent per person at OPD session is low, range from 1.54 - 2.28 minutes, the time was increasing as the hospital category goes down. 93.7% hospitals had special arrangements for providing acute care on chronic conditions such as catheter, feeding tube and wound care. 25% hospitals had special clinics for elders, 81.2% hospitals had healthy lifestyle clinics (HLC), 75% hospitals had physical rehabilitation facilities and 68.8% hospitals had facilities for counselling. Elderly clinics and HLC were mostly available at lower grade hospitals where as rehabilitation and counselling facilities were mostly available at bigger hospitals. HLC are providing health education for both patients and their family members, refer patients for screening of complication but not provide medical examinations, investigations or treatments even though they operate in the hospital setting. Physical rehabilitation is basically offered for patients with rheumatological conditions but utilization of centers for injury rehabilitation and rehabilitation of survivors following major illness such as myocardial infarctions, stroke, cancer is not satisfactory (12.5%). Human Resource distribution within hospital shows vast disparity and there are 103 physiotherapists in the biggest hospital where only 36 physiotherapists available at the next level hospital. Counselling facilities also provided mainly for the patient with psychological conditions (100%) but they were not providing counselling for newly diagnosed patients with major illnesses (0%). According to results, most of the public-sector hospitals in Sri Lanka have basic facilities required in providing continuous care but the utilization of services need more focus. Hospital administration or the government need to have initial steps in proper utilization of them in improving continuous health care incorporating team approach of rehabilitation. The author wishes to acknowledge that this paper was made possible by the support and guidance given by the “Australia Awards Fellowships Program for Sri Lanka – 2017,” which was funded by the Department of Foreign Affairs and Trade, Australia, and co-hosted by Monash University, Australia and the Sri Lanka Institute of Development Administration.

Keywords: continuous care, outpatient department, non communicable diseases, rehabilitation

Procedia PDF Downloads 167

Authors: Rubaiat S. Ahmed, Jemer Garrido, Sergey M. Motov

Abstract:

Clinical informatics (CI) enables the transformation of data into a systematic organization that improves the quality of care and the generation of positive health outcomes.Innovative technology through informatics that compiles accurate data on analgesic utilization in the emergency department can enhance pain management in this important clinical setting. We aim to establish a simplified reporting system through CI to examine and assess the analgesic prescribing practices in the EDthrough executing a U.S. federal grant project on opioid reduction initiatives. Queried data points of interest from a level-one trauma ED’s electronic medical records were used to create data sets and develop informational/visual reporting dashboards (on Microsoft Excel and Google Sheets) concerning analgesic usage across several pre-defined parameters and performance metrics using CI. The data was then qualitatively analyzed to evaluate ED analgesic prescribing trends by departmental clinicians and leadership. During a 12-month reporting period (Dec. 1, 2020 – Nov. 30, 2021) for the ongoing project, about 41% of all ED patient visits (N = 91,747) were for pain conditions, of which 81.6% received analgesics in the ED and at discharge (D/C). Of those treated with analgesics, 24.3% received opioids compared to 75.7% receiving opioid alternatives in the ED and at D/C, including non-pharmacological modalities. Demographics showed among patients receiving analgesics, 56.7% were aged between 18-64, 51.8% were male, 51.7% were white, and 66.2% had government funded health insurance. Ninety-one percent of all opioids prescribed were in the ED, with intravenous (IV) morphine, IV fentanyl, and morphine sulfate immediate release (MSIR) tablets accounting for 88.0% of ED dispensed opioids. With 9.3% of all opioids prescribed at D/C, MSIR was dispensed 72.1% of the time. Hydrocodone, oxycodone, and tramadol usage to only 10-15% of the time, and hydromorphone at 0%. Of opioid alternatives, non-steroidal anti-inflammatory drugs were utilized 60.3% of the time, 23.5% with local anesthetics and ultrasound-guided nerve blocks, and 7.9% with acetaminophen as the primary non-opioid drug categories prescribed by ED providers. Non-pharmacological analgesia included virtual reality and other modalities. An average of 18.5 ED opioid orders and 1.9 opioid D/C prescriptions per 102.4 daily ED patient visits was observed for the period. Compared to other specialties within our institution, 2.0% of opioid D/C prescriptions are given by ED providers, compared to the national average of 4.8%. Opioid alternatives accounted for 69.7% and 30.3% usage, versus 90.7% and 9.3% for opioids in the ED and D/C, respectively.There is a pressing need for concise, relevant, and reliable clinical data on analgesic utilization for ED providers and leadership to evaluate prescribing practices and make data-driven decisions. Basic computer software can be used to create effective visual reporting dashboards with indicators that convey relevant and timely information in an easy-to-digest manner. We accurately examined our ED's analgesic prescribing practices using CI through dashboard reporting. Such reporting tools can quickly identify key performance indicators and prioritize data to enhance pain management and promote safe prescribing practices in the emergency setting.

Keywords: clinical informatics, dashboards, emergency department, health informatics, healthcare informatics, medical informatics, opioids, pain management, technology

Procedia PDF Downloads 144

Authors: April Love Palad, Charita B. Lasala

Abstract:

Mastery on English language is one of the important goals of all English language teachers. This goal can be seen based from the students’ actual performance using the target language which is English. Learning the English language includes hard work where efforts need to be exerted and this can be attained gradually over a long period of time. It is extremely important for all English language teachers to know the effects of incorporating games in teaching. Whether this strategy can have positive or negative effects in students learning, teachers should always consider what is best for their learners. Games may help and provide confidents language learners. These games help teachers to create context in which the language is suitable and significant. Focusing in accuracy and fluency is the heart of this study and this will be obtain in either teaching English using the traditional method or teaching English using language games. It is very important for all English teachers to know which strategy is effective in teaching English to be able to cope with students’ underachievement in this subject. This study made use of the comparative-experimental method. It made use of the pre-post test design with the aim to explore the effectiveness of the language games as strategy used in language teaching for high school students. There were two groups of students being observed, the controlled and the experimental, employing the two strategies in teaching English –traditional and with the use of language games. The scores obtained by two samples were compared to know the effectiveness of the two strategies in teaching English. In this study, it found out that language games help improve students’ fluency and accuracy in the use of target language and this is very evident in the results obtained in the pre-test and post –test result as well the mean gain scores by the two groups of students. In addition, this study also gives us a clear view on the positive effects on the use of language games in teaching which also supported by the related studies based from this research. The findings of the study served as the bases for the creation of the proposed learning plan that integrated language games that teachers may use in their own teaching. This study further concluded that language games are effective in developing students’ fluency in using the English language. This justifies that games help encourage students to learn and be entertained at the same time. Aside from that, games also promote developing language competency. This study will be very useful to teachers who are in doubt in the use of this strategy in their teaching.

Keywords: language games, experimental, comparative, strategy, language teaching, methodology

Procedia PDF Downloads 421