Search results for: occupationally exposed individual
2074 Physical Exam-Indicated Cerclage with Mesh Cap Prolonged Gestation on Average for 9 Weeks and 4 Days: 11 Years of Experience
Authors: M. Keršič, M. Lužnik, J. Lužnik
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Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage
Procedia PDF Downloads 1912073 Empirical Examination of High Performance Work System, Organizational Commitment and Organizational Citizen Behavior: A Mediation of Model of Vietnam Organizations
Authors: Giang Vu, Duong Nguyen, Yuan-Ling Chen
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Vietnam is a fast developing country with highly economic growth, and Vietnam organizations strive to utilize high performance work system (HPWS) in reinforcing employee in-role performance. HPWS, a bundle of human resource (HR) practices, are composed of eight sets of HR practices, namely selective staffing, extensive training, internal mobility, employment security, clear job description, result-oriented appraisal, incentive reward, and participation. However, whether HPWS stimulate employee extra-role behaviors remains understudied in a booming economic context. In this study, we aim to investigate organizational citizenship behavior (OCB) in a Vietnam context and, as a central issue, disentangle how HPWS elicits in employee OCB. On the other hand, recently, a deliberation of so-called 'black-box' HPWS issue has explored the role of employee commitment, suggesting that organizational commitment is a compelling source of employee OCB. We draw upon social exchange theory to predict that when employees perceive the organizational investment, like HPWS, in heightening their abilities, knowledge, and motivation, they are more likely to pay back with commitment; consequently, they will take initiatives in OCB. Hence, we hypothesize an individual level framework, in which organizational commitment mediates the positive relationship between HPWS and OCB. We collected data on HPWS, organizational commitment, OCB, and demographic variables, all at line managers of Vietnamese firms in Hanoi and Hochiminh. We conclude with research findings, implications, and future research suggestions.Keywords: high performance work system, organizational citizenship behavior, organizational commitment, Vietnam
Procedia PDF Downloads 3142072 Customised Wellness Solutions Using Health Technological Platforms: An Exploratory Research Protocol
Authors: Elaine Wong Yee-Sing, Liaw Wee Tong
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Rapid transformations in demographic and socioeconomic shifts are leading to a growing global demand for health and beauty products and services that demands holistic concepts of well-being. In addition, technological breakthroughs such as internet of things make it convenient and offer innovative solutions for well-being and engage consumers to track their own health conditions and fitness goals. This 'new health economy' encompasses three key concepts: well-being, well-conditioned and well-shaped; which are shaped by wellness segments and goals that influence purchasing decisions of consumers. The research protocol aims to examine the feasibility, challenges, and capabilities in provision for each customer with an ecosystem, or platform, that organizes data and insights to create an individual health and fitness, nutrition, and beauty profile. Convenience sampling of 100 consumers residing in private housing within five major districts in Singapore will be selected to participate in the study. Statistical Package for Social Science 25 will be used to conduct descriptive statistics for quantitative data while qualitative data results using focus interviews, will be translated and transcribed to identify improvements in provision of these services. Rising income in emerging global markets is fuelling the demand for these general wellbeing products and services. Combined with technological advances, it is imperative to understand how these highly personalized services with integrated technology can be designed better to support consumer preferences; provide greater flexibility and high-quality service, and generate better health awareness among consumers.Keywords: beauty, consumers, health, technology, wellness
Procedia PDF Downloads 1312071 Prevalence of the Double Burden of Malnutrition in Women of Childbearing Age in Morocco: Coexistence of Iron Deficiency Anemia and Overweight
Authors: Fall Abdourahmane, Lazrak Meryem, El Hsaini Houda, El Ammari Laila, Gamih Hasnae, Yahyane Abdelhakim, Benjouad Abdelaziz, Aguenaou Hassan, El Kari Khalid
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Introduction: The double burden of malnutrition (DBM), characterized by the coexistence of undernutrition and overnutrition, is a significant health challenge, particularly in low- and middle-income countries. In Morocco, 61.3% of women of reproductive age (WRA) are overweight or obese, including 30.4% who were obese, while 34.4% were anaemic, and 49.7% have iron deficiency anaemia. Objective: This study aims to determine the prevalence of DBM at the individual level among Moroccan WRA, defined by the coexistence of iron deficiency anaemia and overweight/obesity. Methods: a cross-sectional national survey was conducted among a representative sample of 2090 Moroccan WRA. Data collected included socio-economic parameters, anthropometric measurements, and blood samples. Haemoglobin levels were measured photometrically using Hemocue, while ferritin and CRP were assessed through immunoturbudimetry. Results: The prevalence of overweight/obesity, iron deficiency, anaemia and iron deficiency anaemia among WRA in Morocco were 60.2%, 30.6%, 34.4% and 50.0% respectively. The coexistence of overweight/obesity with anaemia and iron deficiency was observed in 19.2% and 16.3% of women, respectively. Among overweight/obese women, 32.5% were anaemic, 28.4% were iron deficient, and 47.6% had iron deficiency anaemia. the prevalence of DBM was higher in urban areas compared to rural settings. Conclusion: The coexistence of undernutrition and overnutrition among WRA highlights the urgent need for integrated public health interventions addressing both anaemia and obesity simultaneously. Tailored strategies should consider the specific socio-economic and geographical contexts to effectively combat this dual burden.Keywords: the double burden of malnutrition, iron deficiency anaemia, overweight, obesity
Procedia PDF Downloads 432070 Aging-Related Changes in Calf Muscle Function: Implications for Venous Hemodynamic and the Role of External Mechanical Activation
Authors: Bhavatharani S., Boopathy V., Kavin S., Naveethkumar R.
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Context: Resistance training with blood flow restriction (BFR) has increased in clinical rehabilitation due to the substantial benefits observed in augmenting muscle mass and strength using low loads. However, there is a great variability of training pressures for clinical populations as well as methods to estimate it. The aim of this study was to estimate the percentage of maximal BFR that could result by applying different methodologies based on arbitrary or individual occlusion levels using a cuff width between 9 and 13 cm. Design: A secondary analysis was performed on the combined databases of 2 previous larger studies using BFR training. Methods: To estimate these percentages, the occlusion values needed to reach complete BFR (100% limb occlusion pressure [LOP]) were estimated by Doppler ultrasound. Seventy-five participants (age 24.32 [4.86] y; weight: 78.51 [14.74] kg; height: 1.77 [0.09] m) were enrolled in the laboratory study for measuring LOP in the thigh, arm, or calf. Results: When arbitrary values of restriction are applied, a supra-occlusive LOP between 120% and 190% LOP may result. Furthermore, the application of 130% resting brachial systolic blood pressure creates a similar occlusive stimulus as 100% LOP. Conclusions: Methods using 100 mm Hg and the resting brachial systolic blood pressure could represent the safest application prescriptions as they resulted in applied pressures between 60% and 80% LOP. One hundred thirty percent of the resting brachial systolic blood pressure could be used to indirectly estimate 100% LOP at cuff widths between 9 and 13 cm. Finally, methodologies that use standard values of 200 and, 300 mm Hg far exceed LOP and may carry additional risk during BFR exercise.Keywords: lower limb rehabilitation, ESP32, pneumatics for medical, programmed rehabilitation
Procedia PDF Downloads 862069 Deriving Framework for Slum Rehabilitation through Environmental Perspective: Case of Mumbai
Authors: Ashwini Bhosale, Yogesh Patil
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Urban areas are extremely complicated environmental settings, where health and well-being of an individual and population are governed by a large number of bio-physical, socio-economical, and inclusive aspects. Although poverty and slums are the prime issues under UN-HABITAT agenda of environmental sustainability, slums, the inevitable part of urban environment, have not accounted for inclusive city planning. Developing nations, where about 60 % of world slum population resides, are increasingly under pressure to uplift the urban poor, particularly slum dwellers. From a point of advantage, these new slum redevelopment projects have succeeded in providing legitimized and more permanent and stable shelter for the low income people, as well as individualized sanitation and water supply. However, they unfortunately follow the “one type fits all" approach and exhibit no response to the climatic design needs on Mumbai. The thesis focuses on the study of environmental perspectives in the context of Daylight, natural ventilation and social aspects in the design process of Slum-Rehabilitation schemes (SRS) – case of Mumbai. It attempts to investigate into Indian approaches about SRS and concludes upon strategies to be incorporated in SRS to improve the overall SRS environment. The main objectives of this work have been to identify and study the spatial configuration and possibilities of daylight and natural ventilation in Slum Rehabilitated buildings. The performance of the proposed method was evaluated by comparison with the daylight luminance simulated by lighting software, namely ECOTECT, and with measurements under real skies whereas for the ventilation study purpose, software named FLOW DESIGN was used.Keywords: urban environment, slum-rehabilitation, daylight, natural-ventilation, architectural consequences
Procedia PDF Downloads 3952068 Entrepreneur Universal Education System: Future Evolution
Authors: Khaled Elbehiery, Hussam Elbehiery
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The success of education is dependent on evolution and adaptation, while the traditional system has worked before, one type of education evolved with the digital age is virtual education that has influenced efficiency in today’s learning environments. Virtual learning has indeed proved its efficiency to overcome the drawbacks of the physical environment such as time, facilities, location, etc., but despite what it had accomplished, the educational system over all is not adequate for being a productive system yet. Earning a degree is not anymore enough to obtain a career job; it is simply missing the skills and creativity. There are always two sides of a coin; a college degree or a specialized certificate, each has its own merits, but having both can put you on a successful IT career path. For many of job-seeking individuals across world to have a clear meaningful goal for work and education and positively contribute the community, a productive correlation and cooperation among employers, universities alongside with the individual technical skills is a must for generations to come. Fortunately, the proposed research “Entrepreneur Universal Education System” is an evolution to meet the needs of both employers and students, in addition to gaining vital and real-world experience in the chosen fields is easier than ever. The new vision is to empower the education to improve organizations’ needs which means improving the world as its primary goal, adopting universal skills of effective thinking, effective action, effective relationships, preparing the students through real-world accomplishment and encouraging them to better serve their organization and their communities faster and more efficiently.Keywords: virtual education, academic degree, certificates, internship, amazon web services, Microsoft Azure, Google Cloud Platform, hybrid models
Procedia PDF Downloads 992067 The Applicability of Just Satisfaction in Inter-State Cases: A Case Study of Cyprus versus Turkey
Authors: Congrui Chen
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The European Court of Human Rights (hereinafter ECtHR) delivered its judgment of just satisfaction on the case of Cyprus v. Turkey, ordering a lump sum of 9,000,000 euros as the just compensation. It is the first time that the ECtHR applied the Article 41 of just compensation in an inter-state case, and it stands as the highest amount of just compensation awarded in the history of the ECtHR. The Cyprus v. Turkey case, which represents the most crucial contribution to European peace in the history of the court. This thesis uses the methodologies of textual research, comparison analysis, and case law study to go further on the following two questions specifically:(i) whether the just compensation is applicable in an inter-state case; (ii) whether such just compensation is of punitive nature. From the point of view of general international law, the essence of the case is the state's responsibility for the violation of individual rights. In other words, the state takes a similar diplomatic protection approach to seek relief. In the course of the development of international law today, especially with the development of international human rights law, States that have a duty to protect human rights should bear corresponding responsibilities for their violations of international human rights law. Under the specific system of the European Court of Human Rights, the just compensation for article 41 is one of the specific ways of assuming responsibility. At the regulatory level, the European Court of Human Rights makes it clear that the just satisfaction of article 41 of the Convention does not include punitive damages, as it relates to the issue of national sovereignty. Nevertheless, it is undeniable that the relief to the victim and the punishment to the responsible State are two closely integrated aspects of responsibility. In other words, compensatory compensation has inherent "punitive".Keywords: European Court of Human Right, inter-state cases, just satisfaction, punitive damages
Procedia PDF Downloads 2702066 Coal Preparation Plant:Technology Overview and New Adaptations
Authors: Amit Kumar Sinha
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A coal preparation plant typically operates with multiple beneficiation circuits to process individual size fractions of coal obtained from mine so that the targeted overall plant efficiency in terms of yield and ash is achieved. Conventional coal beneficiation plant in India or overseas operates generally in two methods of processing; coarse beneficiation with treatment in dense medium cyclones or in baths and fines beneficiation with treatment in flotation cell. This paper seeks to address the proven application of intermediate circuit along with coarse and fines circuit in Jamadoba New Coal Preparation Plant of capacity 2 Mt/y to treat -0.5 mm+0.25 mm size particles in reflux classifier. Previously this size of particles was treated directly in Flotation cell which had operational and metallurgical limitations which will be discussed in brief in this paper. The paper also details test work results performed on the representative samples of TSL coal washeries to determine the top size of intermediate and fines circuit and discusses about the overlapping process of intermediate circuit and how it is process wise suitable to beneficiate misplaced particles from coarse circuit and fines circuit. This paper also compares the separation efficiency (Ep) of various intermediate circuit process equipment and tries to validate the use of reflux classifier over fine coal DMC or spirals. An overview of Modern coal preparation plant treating Indian coal especially Washery Grade IV coal with reference to Jamadoba New Coal Preparation Plant which was commissioned in 2018 with basis of selection of equipment and plant profile, application of reflux classifier in intermediate circuit and process design criteria is also outlined in this paper.Keywords: intermediate circuit, overlapping process, reflux classifier
Procedia PDF Downloads 1392065 Increasing National Health Insurance Scheme Enrolment in Ghana: Pro-Rata Insurance Premium Payment with Mobile Phone as the Answer
Authors: Joseph Marfo Boaheng, Daniel Ansong, Eugenia Amporfo
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Health Insurance is proposed to provide financial protection against catastrophic health care cost arising from disease. Ghana has had a National Health Insurance Scheme (NHIS) since 2003 with the current enrolment/retention rate of 36%. The main goal of the scheme is to provide equity in the health sector as well as ensuring affordable health care for the poor. However, the current payment system is not flexible to attract significant proportion of the poor informal sector onto the scheme. Looking at the extensive use of mobiles in the Ghana where about 29,220,602.00 registered mobile phone lines are actively in used as of June 2014, paying health insurance premium through mobile phone could be feasible to attract larger proportion of the informal sector onto the scheme. Methodology: The quantitative cross-sectional survey was used to solicit the required information from 877 respondents living in Kumasi, the second capital city of Ghana. The magnitude of the effect of Pro-rata system (flexible payment terms) on NHIS enrollment rate was estimated with binary logistic regression model. Results: The odds for an individual to enroll onto NHIS with mobile phone increases about 2 times more when payment of insurance premium is on pro-rata basis ie. flexible payment terms (p=0.008, CI=1.212-3.565). Conclusion: The study advocates the National Health Insurance Authority consider this alternative payment system that has the potential of attracting a greater proportion of the informal sector to be enrolled or retained onto the scheme.Keywords: enrollment, health insurance, mobile phone, pro-rata
Procedia PDF Downloads 4032064 Radiation Protection Assessment of the Emission of a d-t Neutron Generator: Simulations with MCNP Code and Experimental Measurements in Different Operating Conditions
Authors: G. M. Contessa, L. Lepore, G. Gandolfo, C. Poggi, N. Cherubini, R. Remetti, S. Sandri
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Practical guidelines are provided in this work for the safe use of a portable d-t Thermo Scientific MP-320 neutron generator producing pulsed 14.1 MeV neutron beams. The neutron generator’s emission was tested experimentally and reproduced by MCNPX Monte Carlo code. Simulations were particularly accurate, even generator’s internal components were reproduced on the basis of ad-hoc collected X-ray radiographic images. Measurement campaigns were conducted under different standard experimental conditions using an LB 6411 neutron detector properly calibrated at three different energies, and comparing simulated and experimental data. In order to estimate the dose to the operator vs. the operating conditions and the energy spectrum, the most appropriate value of the conversion factor between neutron fluence and ambient dose equivalent has been identified, taking into account both direct and scattered components. The results of the simulations show that, in real situations, when there is no information about the neutron spectrum at the point where the dose has to be evaluated, it is possible - and in any case conservative - to convert the measured value of the count rate by means of the conversion factor corresponding to 14 MeV energy. This outcome has a general value when using this type of generator, enabling a more accurate design of experimental activities in different setups. The increasingly widespread use of this type of device for industrial and medical applications makes the results of this work of interest in different situations, especially as a support for the definition of appropriate radiation protection procedures and, in general, for risk analysis.Keywords: instrumentation and monitoring, management of radiological safety, measurement of individual dose, radiation protection of workers
Procedia PDF Downloads 1372063 Resource Allocation and Task Scheduling with Skill Level and Time Bound Constraints
Authors: Salam Saudagar, Ankit Kamboj, Niraj Mohan, Satgounda Patil, Nilesh Powar
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Task Assignment and Scheduling is a challenging Operations Research problem when there is a limited number of resources and comparatively higher number of tasks. The Cost Management team at Cummins needs to assign tasks based on a deadline and must prioritize some of the tasks as per business requirements. Moreover, there is a constraint on the resources that assignment of tasks should be done based on an individual skill level, that may vary for different tasks. Another constraint is for scheduling the tasks that should be evenly distributed in terms of number of working hours, which adds further complexity to this problem. The proposed greedy approach to solve assignment and scheduling problem first assigns the task based on management priority and then by the closest deadline. This is followed by an iterative selection of an available resource with the least allocated total working hours for a task, i.e. finding the local optimal choice for each task with the goal of determining the global optimum. The greedy approach task allocation is compared with a variant of Hungarian Algorithm, and it is observed that the proposed approach gives an equal allocation of working hours among the resources. The comparative study of the proposed approach is also done with manual task allocation and it is noted that the visibility of the task timeline has increased from 2 months to 6 months. An interactive dashboard app is created for the greedy assignment and scheduling approach and the tasks with more than 2 months horizon that were waiting in a queue without a delivery date initially are now analyzed effectively by the business with expected timelines for completion.Keywords: assignment, deadline, greedy approach, Hungarian algorithm, operations research, scheduling
Procedia PDF Downloads 1512062 Effects of Lung Protection Ventilation Strategies on Postoperative Pulmonary Complications After Noncardiac Surgery: A Network Meta-Analysis of Randomized Controlled Trials
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Background: Mechanical ventilation has been confirmed to increase the incidence of postoperative pulmonary complications (PPCs), and several studies have shown that low tidal volumes combined with positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RM) reduce the incidence of PPCs. However, the optimal lung-protective ventilatory strategy remains unclear. Methods: Multiple databases were searched for randomized controlled trials (RCTs) published prior to October 2023. The association between individual PEEP (iPEEP) or other forms of lung-protective ventilation and the incidence of PPCs was evaluated by Bayesian network meta-analysis. Results: We included 58 studies (11610 patients) in this meta-analysis. The network meta-analysis showed that low ventilation (LVt) combined with iPEEP and RM was associated with significantly lower incidences of PPCs [HVt: OR=0.38 95CrI (0.19, 0.75), LVt: OR=0.33, 95% CrI (0.12, 0.82)], postoperative atelectasis, and pneumonia than was HVt or LVt. In abdominal surgery, LVT combined with iPEEP or medium-to-high PEEP and RM were associated with significantly lower incidences of PPCs, postoperative atelectasis, and pneumonia. LVt combined with iPEEP and RM was ranked the highest, which was based on SUCRA scores. Conclusion: LVt combined with iPEEP and RM decreased the incidences of PPCs, postoperative atelectasis, and pneumonia in noncardiac surgery patients. iPEEP-guided ventilation was the optimal lung protection ventilation strategy. The quality of evidence was moderate.Keywords: protection ventilation strategies, postoperative pulmonary complications, network meta-analysis, noncardiac surgery
Procedia PDF Downloads 422061 The Effectiveness of Kinesiotaping Methods in Rehabilitation Therapy
Authors: Ana-Katarina Nikich
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Background: The kinesiotaping method is often used in physiotherapy and rehabilitation. The purpose of this study was to evaluate the effectiveness of taping in the rehabilitation process of patients. Materials and methods: The study involved 90 male and female patients (the average age was 40-50 years) with various conditions requiring rehabilitation, such as injuries of the musculoskeletal system, sports injuries and other ailments. All patients were divided into two groups: experimental (n=40) and control (n=50). Both groups received 20 days of standard rehabilitation. In the experimental group, kinesiotaping methods were used, taking into account the individual characteristics of each patient. The control group performed regular exercises and physical therapy, but without using kinesiotape. During the study, physical parameters were monitored, interviews were conducted and the conditions of patients from both groups were compared. Results and discussion: The use of the kinesiotaping method in the rehabilitation process led to a significant improvement in physical parameters and pain reduction in patients. Significant improvement (p <0.005) was observed in all evaluated parameters among the patients of the experimental group. The control group also showed sufficient improvement (p <0.005), but the percentage of the experimental group was higher. As a result of the observation, the patients of the experimental group showed faster and more complete rehabilitation compared to the control group. The use of the kinesiotaping method allows to reduce the load on the damaged areas, improve blood circulation and lymphatic drainage, as well as increase stability and coordination of movements. Conclusions: Kinesiotaping as one of the modern therapeutic methods has shown its effectiveness in the rehabilitation process, contributing to the optimal recovery of patients with various conditions requiring rehabilitation. The use of tapes should be included in a comprehensive rehabilitation program to achieve the best results and reduce recovery time.Keywords: kinesiotaping, rehabilitation, therapy, pain
Procedia PDF Downloads 782060 Evaluation of Role of Surgery in Management of Pediatric Germ Cell Tumors According to Risk Adapted Therapy Protocols
Authors: Ahmed Abdallatif
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Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.Keywords: extragonadal, germ cell tumors, gonadal, pediatric
Procedia PDF Downloads 2212059 The Amorphousness of the Exposure Sphere
Authors: Nipun Ansal
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People guard their beliefs and opinions with their lives. Beliefs that they’ve formed over a period of time, and can go to any lengths to defy, desist from, resist and negate any outward stimulus that has the potential to shake them. Cognitive dissonance is term used to describe it in theory. And every human being, in order to defend himself from cognitive dissonance applies 4 rings of defense viz. Selective Exposure, Selective Perception, Selective Attention, and Selective Retention. This paper is a discursive analysis on how the onslaught of social media, complete with its intrusive weaponry, has amorphized the external ring of defense: the selective exposure. The stimulus-response model of communication is one of the most inherent model that encompasses communication behaviours of children and elderly, individual and masses, humans and animals alike. The paper deliberates on how information bombardment through the uncontrollable channels of the social media, Facebook and Twitter in particular, have dismantled our outer sphere of exposure, leading users online to a state of constant dissonance, and thus feeding impulsive action-taking. It applies case study method citing an example to corroborate how knowledge generation has given in to the information overload and the effect it has on decision making. With stimulus increasing in number of encounters, opinion formation precedes knowledge because of the increased demand of participation and decrease in time for the information to permeate from the outer sphere of exposure to the sphere of retention, which of course, is through perception and attention. This paper discusses the challenge posed by this fleeting, stimulus rich, peer-dominated media on the traditional models of communication and meaning-generation.Keywords: communication, discretion, exposure, social media, stimulus
Procedia PDF Downloads 4112058 AER Model: An Integrated Artificial Society Modeling Method for Cloud Manufacturing Service Economic System
Authors: Deyu Zhou, Xiao Xue, Lizhen Cui
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With the increasing collaboration among various services and the growing complexity of user demands, there are more and more factors affecting the stable development of the cloud manufacturing service economic system (CMSE). This poses new challenges to the evolution analysis of the CMSE. Many researchers have modeled and analyzed the evolution process of CMSE from the perspectives of individual learning and internal factors influencing the system, but without considering other important characteristics of the system's individuals (such as heterogeneity, bounded rationality, etc.) and the impact of external environmental factors. Therefore, this paper proposes an integrated artificial social model for the cloud manufacturing service economic system, which considers both the characteristics of the system's individuals and the internal and external influencing factors of the system. The model consists of three parts: the Agent model, environment model, and rules model (Agent-Environment-Rules, AER): (1) the Agent model considers important features of the individuals, such as heterogeneity and bounded rationality, based on the adaptive behavior mechanisms of perception, action, and decision-making; (2) the environment model describes the activity space of the individuals (real or virtual environment); (3) the rules model, as the driving force of system evolution, describes the mechanism of the entire system's operation and evolution. Finally, this paper verifies the effectiveness of the AER model through computational and experimental results.Keywords: cloud manufacturing service economic system (CMSE), AER model, artificial social modeling, integrated framework, computing experiment, agent-based modeling, social networks
Procedia PDF Downloads 852057 Public Space, Environmental Violence and Female Vulnerability in Radwa Ashour’s Specters and Betool Khadiri’s Absent
Authors: Jihan Zakarriya
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This paper aims at examining the concepts of gender vulnerability, militarized spaces and environmental degradation in Egyptian novelist Radwa Ashour’s Specters (1999) and Iraqi novelist Betool Khadiri’s Absent (2005). Although the socio-economic, environmental and political conditions in the 1990s- Egypt and Iraq are different, this paper argues that Ashour’s Specters and Khadiri’s Absent show the two societies as sharing a concern with the politics of public participation, individual freedom and political violence. For example, while Specters exposes the planned processes of economic-political and cultural violence towards Egyptian environment and people that undermine concepts of justice, equality and democracy, Absent shows the destructive effects of the systematic, successive waves of (international) militarized interferences and socio-economic sanctions imposed on Iraq following the Gulf War that hinder efforts of social development and kindle ethnic-religious violence and polarization in the country. This paper investigates and relates issues of gender, environmental and political violence and repression in Ashour’s Specters and Khadiri’s Absent in relation to the concepts of public space and security in the two countries. The paper argues that the selected novels articulate a particular awareness of the political-international conflicts and difficulties in the 1990s-Egypt and Iraq, with the aim both to emphasize the issue of gender as a tool of oppression and power hierarchy worldwide and to figure out new notions of public participation and change.Keywords: gender violence, public space, environment, change
Procedia PDF Downloads 1482056 Numerical Investigation of Pressure Drop in Core Annular Horizontal Pipe Flow
Authors: John Abish, Bibin John
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Liquid-liquid flow in horizontal pipe is investigated in order to reveal the flow patterns arising from the co-existed flow of oil and water. The main focus of the study is to identify the feasibility of reducing the pumping power requirements of petroleum transportation lines by having an annular flow of water around the thick oil core. This idea makes oil transportation cheaper and easier. The present study uses computational fluid dynamics techniques to model oil-water flows with liquids of similar density and varying viscosity. The simulation of the flow is conducted using commercial package Ansys Fluent. Flow domain modeling and grid generation accomplished through ICEM CFD. The horizontal pipe is modeled with two different inlets and meshed with O-Grid mesh. The standard k-ε turbulence scheme along with the volume of fluid (VOF) multiphase modeling method is used to simulate the oil-water flow. Transient flow simulations carried out for a total period of 30s showed significant reduction in pressure drop while employing core annular flow concept. This study also reveals the effect of viscosity ratio, mass flow rates of individual fluids and ration of superficial velocities on the pressure drop across the pipe length. Contours of velocity and volume fractions are employed along with pressure predictions to assess the effectiveness of this proposed concept quantitatively as well as qualitatively. The outcome of the present study is found to be very relevant for the petrochemical industries.Keywords: computational fluid dynamics, core-annular flows, frictional flow resistance, oil transportation, pressure drop
Procedia PDF Downloads 4112055 Biodiversity and Climate Change: Consequences for Norway Spruce Mountain Forests in Slovakia
Authors: Jozef Mindas, Jaroslav Skvarenina, Jana Skvareninova
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Study of the effects of climate change on Norway Spruce (Picea abies) forests has mainly focused on the diversity of tree species diversity of tree species as a result of the ability of species to tolerate temperature and moisture changes as well as some effects of disturbance regime changes. The tree species’ diversity changes in spruce forests due to climate change have been analyzed via gap model. Forest gap model is a dynamic model for calculation basic characteristics of individual forest trees. Input ecological data for model calculations have been taken from the permanent research plots located in primeval forests in mountainous regions in Slovakia. The results of regional scenarios of the climatic change for the territory of Slovakia have been used, from which the values are according to the CGCM3.1 (global) model, KNMI and MPI (regional) models. Model results for conditions of the climate change scenarios suggest a shift of the upper forest limit to the region of the present subalpine zone, in supramontane zone. N. spruce representation will decrease at the expense of beech and precious broadleaved species (Acer sp., Sorbus sp., Fraxinus sp.). The most significant tree species diversity changes have been identified for the upper tree line and current belt of dwarf pine (Pinus mugo) occurrence. The results have been also discussed in relation to most important disturbances (wind storms, snow and ice storms) and phenological changes which consequences are little known. Special discussion is focused on biomass production changes in relation to carbon storage diversity in different carbon pools.Keywords: biodiversity, climate change, Norway spruce forests, gap model
Procedia PDF Downloads 2922054 Anthelmintic Property of Pomegranate Peel Aqueous Extraction Against Ascaris Suum: An In-vitro Analysis
Authors: Edison Ramos, John Peter V. Dacanay, Milwida Josefa Villanueva
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Soil-Transmitted Helminth (STH) infections caused by helminths are the most prevalent neglected tropical diseases (NTDs). They are commonly found in warm, humid regions and developing countries, particularly in rural areas with poor hygiene. Occasionally, human hosts exposed to pig manure may harbor Ascaris suum parasites without experiencing any symptoms. To address the significant issue of helminth infections, an effective anthelmintic is necessary. However, the effectiveness of various medications as anthelmintics can be reduced due to mutations. In recent years, there has been a growing interest in using plants as a source of medicine due to their natural origin, accessibility, affordability, and potential lack of complications. Herbal medicine has been advocated as an alternative treatment for helminth infections, especially in underdeveloped countries, considering the numerous adverse effects and drug resistance associated with commercially available anthelmintics. Medicinal plants are considered suitable replacements for current anthelmintics due to their historical usage in treating helminth infections. The objective of this research was to investigate the effects of aqueous extraction of pomegranate peel (Punica granatum L.) as an anthelmintic on female Ascaris suum in vitro. The in vitro assay involved observing the motility of Ascaris suum in different concentrations (25%, 50%, 75%, and 100%) of pomegranate peel aqueous extraction, along with mebendazole as a positive control. The results indicated that as the concentration of the extract increased, the time required to paralyze the worms decreased. At 25% concentration, the average time for paralysis was 362.0 minutes, which decreased to 181.0 minutes at 50% concentration, 122.7 minutes at 75% concentration, and 90.0 minutes at 100% concentration. The time of death for the worms was directly proportional to the concentration of the pomegranate peel extract. Death was observed at an average time of 240.7 minutes at 75% concentration and 147.7 minutes at 100% concentration. The findings suggest that as the concentration of pomegranate peel extract increases, the time required for paralysis and death of Ascaris suum decreases. This indicates a concentration-dependent relationship, where higher concentrations of the extract exhibit greater effectiveness in inducing paralysis and causing the death of the worms. These results emphasize the potential anthelmintic properties of pomegranate peel extract and its ability to effectively combat Ascaris suum infestations. There was no significant difference in the anthelmintic effectiveness between the pomegranate peel extract and Mebendazole. These findings highlight the potential of pomegranate peel extract as an alternative anthelmintic treatment for Ascaris suum infections. The researchers recommend determining the optimal dose and administration route to maximize the effectiveness of pomegranate peel as an anthelmintic therapeutic against Ascaris suum.Keywords: pomegranate peel, aqueous extract, anthelmintic, in vitro
Procedia PDF Downloads 1192053 Psychological Assessment of Living Kidney Donors: A Systematic Review
Authors: Valentina Colonnello, Paolo Maria Russo
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Living kidney donation requires psychological evaluation and ongoing follow-up. A crucial aspect of this evaluation is assessing the social functioning of donors after donation. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a review of quantitative and qualitative studies on the psychological assessment of living kidney donors' social functioning. The majority of quantitative studies examining the long-term social health post-donation have primarily utilized the Short Form Health Survey (SF) and the World Health Organization Quality of Life-BREF (WHOQoL-BREF) questionnaires. These studies have indicated that donors' social functioning and relationships either remained stable post-donation or returned to pre-donation levels. In some instances, donors' social functioning even surpassed that of the general population. Qualitative studies, conducted through interviews and focus groups, have revealed donors' experiences and emotional concerns that are often overlooked in quantitative analyses. Specifically, qualitative analysis has identified two main themes: "connecting to others" and "acknowledgment and social support." Our review highlights that the majority of published quantitative studies on donors have employed measures of social functioning that may not fully capture donors' experiences and needs. It underscores the importance of further investigation in quantitative studies to assess donors' actual social health and psychological needs accurately. Overall, this review provides valuable insights into specific constructs that warrant deeper exploration in quantitative studies concerning the assessment of donors' social health and psychological well-being.Keywords: reported outcomes, personalized medicine, individual differences, emotions, psychological assessment
Procedia PDF Downloads 712052 Power, Pluralism, and History: Norms in International Societies
Authors: Nicole Cervenka
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On the question of norms in international politics, scholars are divided over whether norms are a tool for power politics or a genuine reflection of an emergent international society. The line is drawn between rationalism and idealism, but this dialectical relationship needs to be broken down if we hope to come to a comprehensive understanding of how norms play out in international society. The concept of an elusive international society is a simplification of a more pluralistic, cosmopolitan, and diverse collection of international societies. The English School effectively overcomes realist-idealist dichotomies and provides a pluralistic, comprehensive explanation and description of international societies through its application to two distinct areas: human rights as well as security and war. We argue that international norms have always been present in human rights, war, and international security, forming international societies that can be complimentary or oppositional, beneficial or problematic. Power politics are present, but they can only be regarded as partially explanatory of the role of norms in international politics, which must also include history, international law, the media, NGOs, and others to fully represent the normative influences in international societies. A side-by-side comparison of international norms of war/security and human rights show how much international societies converge. World War II was a turning point in terms of international law, these forces of international society have deeper historical roots. Norms of human rights and war/security are often norms of restraint, guiding appropriate treatment of individuals. This can at times give primacy to the individual over the sovereign state. However, state power politics and hegemony are still intact. It cannot be said that there is an emergent international society—international societies are part of broader historical backdrops. Furthermore, states and, more generally, power politics, are important components in international societies, but international norms are far from mere tools of power politics. They define a more diverse, complicated, and ever-present conception of international societies.Keywords: English school, international societies, norms, pluralism
Procedia PDF Downloads 3872051 Simulation-Based Control Module for Offshore Single Point Mooring System
Authors: Daehyun Baek, Seungmin Lee, Minju Kim Jangik Park, Hyeong-Soon Moon
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SPM (Single Point Mooring) is one of the mooring buoy facilities installed on a coast near oil and gas terminal which is not able to berth FPSO or large oil tankers under the condition of high draft due to geometrical limitation. Loading and unloading of crude oil and gas through a subsea pipeline can be carried out between the mooring buoy, ships and onshore facilities. SPM is an offshore-standalone system which has to withstand the harsh marine environment with harsh conditions such as high wind, current and so on. Therefore, SPM is required to have high stability, reliability and durability. Also, SPM is comprised to be integrated systems which consist of power management, high pressure valve control, sophisticated hardware/software and a long distance communication system. In order to secure required functions of SPM system, a simulation model for the integrated system of SPM using MATLAB Simulink and State flow tool has been developed. The developed model consists of configuration of hydraulic system for opening and closing of PLEM (Pipeline End Manifold) valves and control system logic. To verify functions of the model, an integrated simulation model for overall systems of SPM was also developed by considering handshaking variables between individual systems. In addition to the dynamic model, a self-diagnostic function to determine failure of the system was configured, which enables the SPM system itself to alert users about the failure once a failure signal comes to arise. Controlling and monitoring the SPM system is able to be done by a HMI system which is capable of managing the SPM system remotely, which was carried out by building a communication environment between the SPM system and the HMI system.Keywords: HMI system, mooring buoy, simulink simulation model, single point mooring, stateflow
Procedia PDF Downloads 4212050 The Effects of Pride Therapy on the Level of Self-Esteem among Physically Challenged Adolescents
Authors: Canapi Patricia Joy, Canlas Tracy Gabriella, Canseco Teresa, Capistrano Reena Marie, Carandang Vernon, Carbonel Khiara Claudine
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Research problem: The main problem of the study was to determine the effect of Projecting the Reflection of the Individual’s Self-esteem (PRIDE) therapy on the level of self-esteem of physically challenged adolescents. Objectives of the Study: The study determined the effect of PRIDE (Projecting the Reflection of the Individuals Self-esteem) therapy on the level of self-esteem among physically challenged adolescents. Methodology: A quasi-experimental study was used which involved 30 randomly-assigned subjects, 15 in the experimental group and 15 in the control group. The Projecting the reflection of the Individuals’ Self-Esteem (PRDIE) therapy was administered to the experimental group. The researchers utilized the Sorensen Self-Esteem test tool as a pretest and posttest questionnaire and yielded a Cronbach’s alpha of .912. Paired T-test was used to analyze the gathered data. Results: The results showed that after the administration of PRIDE therapy, there was an increase on the level of self-esteem. The experimental group had a value of 3.590, which was significant and meant that the level of self-esteem is significantly increased. On the other hand, the control group, had a value of -2.207 which was also significant, therefore, the level of self esteem significantly decreased. Conclusion: the PRIDE Therapy is effective in increasing the level of self-esteem among physically challenged adolescent. Recommendations: The researchers recommend the use of PRIDE Therapy as an intervention in handling physically challenged patients, especially adolescents, in order to enhance their self-esteem. Also, the researchers recommend that nursing students be informed on the efficacy of PRIDE Therapy in enhancing the self-esteem of physically challenged patients. Furthermore, the inclusion of a psychologist during the implementation of PRIDE Therapy, specifically art therapy, to be able to have a more focused interpretation of the drawings and really be able to see the projection of their self-esteem is also recommended.Keywords: adolescents, PRIDE therapy, physically challenged, self-esteem
Procedia PDF Downloads 3142049 Trading off Accuracy for Speed in Powerdrill
Authors: Filip Buruiana, Alexander Hall, Reimar Hofmann, Thomas Hofmann, Silviu Ganceanu, Alexandru Tudorica
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In-memory column-stores make interactive analysis feasible for many big data scenarios. PowerDrill is a system used internally at Google for exploration in logs data. Even though it is a highly parallelized column-store and uses in memory caching, interactive response times cannot be achieved for all datasets (note that it is common to analyze data with 50 billion records in PowerDrill). In this paper, we investigate two orthogonal approaches to optimize performance at the expense of an acceptable loss of accuracy. Both approaches can be implemented as outer wrappers around existing database engines and so they should be easily applicable to other systems. For the first optimization we show that memory is the limiting factor in executing queries at speed and therefore explore possibilities to improve memory efficiency. We adapt some of the theory behind data sketches to reduce the size of particularly expensive fields in our largest tables by a factor of 4.5 when compared to a standard compression algorithm. This saves 37% of the overall memory in PowerDrill and introduces a 0.4% relative error in the 90th percentile for results of queries with the expensive fields. We additionally evaluate the effects of using sampling on accuracy and propose a simple heuristic for annotating individual result-values as accurate (or not). Based on measurements of user behavior in our real production system, we show that these estimates are essential for interpreting intermediate results before final results are available. For a large set of queries this effectively brings down the 95th latency percentile from 30 to 4 seconds.Keywords: big data, in-memory column-store, high-performance SQL queries, approximate SQL queries
Procedia PDF Downloads 2632048 Nutrition Strategy Using Traditional Tibetan Medicine in the Preventive Measurement
Authors: Ngawang Tsering
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Traditional Tibetan medicine is primarily focused on promoting health and keeping away diseases from its unique in prescribing specific diet and lifestyle. The prevalence of chronic diseases has been rising day by day and kills a number of people due to the lack of proper nutritional design in modern times. According to traditional Tibetan medicine, chronic diseases such as diabetes, cancer, cardiovascular diseases, respiratory diseases, and arthritis are heavily associated with an unwholesome diet and inappropriate lifestyles. Diet and lifestyles are the two main conditions of diseases and healthy life. The prevalence of chronic diseases is one of the challenges, with massive economic impact and expensive health issues. Though chronic diseases are challenges, it has a solution in the preventive measurements by using proper nutrition design based on traditional Tibetan medicine. Until today, it is hard to evaluate whether traditional Tibetan medicine nutrition strategy could play a major role in preventive measurement as of the lack of current research evidence. However, compared with modern nutrition, it has an exclusive valuable concept, such as a holistic way and diet or nutrition recommendation based on different aspects. Traditional Tibetan medicine is one of the oldest ancient existing medical systems known as Sowa Rigpa (Science of Healing) highlights different aspects of dietetics and nutrition, namely geographical, seasonal, age, personality, emotional, food combination, the process of individual metabolism, potency, and amount of food. This article offers a critical perspective on the preventive measurement against chronic diseases through nutrition design using traditional Tibetan medicine and also needs attention for a deeper understanding of traditional Tibetan medicine in the modern world.Keywords: traditional Tibetan medicine, nutrition, chronic diseases, preventive measurement, holistic approach, integrative
Procedia PDF Downloads 1612047 Investigating of Predisposing Factors for Domestic Violence against Women
Authors: Mozhgan Sigarchian, Shiva Alizadeh, Seyedeh Akram Nazarkardeh
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Introduction: The one of the most common forms of violence against women is domestic violence and it is one of the most acute social problems that affecting the individual physical and mental health and, in turn, the health of the family and the community. In all of the world especially in developing country, women suffer violent during her lifetime. Violence against women and girls is a serious threat to health and human rights. Several factors such as low literacy, the low income and poverty affects violence. The purpose of this study was to determine the factors conducive to domestic violence against women in Rasht, Iran, So that based on the findings, preventive measures can be taken to reduce violence and increase support for women. Methods: This is a descriptive-analytic study that was performed on 300 eligible women referred to clinics and physicians' offices in Rasht, Iran, 2017, by convenience sampling method. The questionnaire used included demographic questionnaires and domestic violence with 3 domains: physical, psychological, and sexual violence. Data were analyzed by SPSS software using independent t-test, Chi-square and Mann-Whitney tests. Result: The mean age in the group with and without domestic violence was 28.31 ± 6.097 and 32.52 ± 9.8, respectively. 168 women (56%) were reported to be violent. The results indicate that there is a significant relationship between age, husband's age, number of family members, and educational level of women with violence. But, there was no significant relationship between the duration of marriage, the education of husbands, the occupation of women and their husbands, housing situation, smoking with violence. Conclusion: The results showed that some factors such as education, age, and the number of families can affect the level of violence. According to the results, as well as a high prevalence of domestic violence among women in this study, it is suggested that training be given to families to increase women's empowerment and prevent violence against women.Keywords: domestic violence, predisposing factors, violence, women
Procedia PDF Downloads 2052046 Current Epizootic Situation of Q Fever in Polish Cattle
Authors: Monika Szymańska-Czerwińska, Agnieszka Jodełko, Krzysztof Niemczuk
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Q fever (coxiellosis) is an infectious disease of animals and humans causes by C. burnetii and widely distributed throughout the world. Cattle and small ruminants are commonly known as shedders of C. burnetii. The aims of this study were the evaluation of seroprevalence and shedding of C. burnetii in cattle. Genotypes of the pathogen present in the tested specimens were also identified using MLVA (Multiple Locus Variable-Number Tandem Repeat Analysis) and MST (multispacer sequence typing) methods. Sampling was conducted in different regions of Poland in 2018-2021. In total, 2180 bovine serum samples from 801 cattle herds were tested by ELISA (enzyme-linked immunosorbent assay). 489 specimens from 157 cattle herds such as: individual milk samples (n=407), bulk tank milk (n=58), vaginal swabs (n=20), placenta (n=3) and feces (n=1) were subjected to C. burnetii specific qPCR. The qPCR (IS1111 transposon-like repetitive region) was performed using Adiavet COX RealTime PCR kit. Genotypic characterization of the strains was conducted utilizing MLVA and MST methods. MLVA was performed using 6 variable loci. The overall herd-level seroprevalence of C. burnetii infection was 36.74% (801/2180). Shedders were detected in 29.3% (46/157) cattle herds in all tested regions. ST 61 sequence type was identified in 10 out of 18 genotyped strains. Interestingly one strain represents sequence type which has never been recorded previously. MLVA method identified three previously known genotypes: most common was J but also I and BE were recognized. Moreover, a one genotype has never been described previously. Seroprevalence and shedding of C. burnetii in cattle is common and strains are genetically diverse.Keywords: Coxiella burnetii, cattle, MST, MLVA, Q fever
Procedia PDF Downloads 892045 Relationship between Different Heart Rate Control Levels and Risk of Heart Failure Rehospitalization in Patients with Persistent Atrial Fibrillation: A Retrospective Cohort Study
Authors: Yongrong Liu, Xin Tang
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Background: Persistent atrial fibrillation is a common arrhythmia closely related to heart failure. Heart rate control is an essential strategy for treating persistent atrial fibrillation. Still, the understanding of the relationship between different heart rate control levels and the risk of heart failure rehospitalization is limited. Objective: The objective of the study is to determine the relationship between different levels of heart rate control in patients with persistent atrial fibrillation and the risk of readmission for heart failure. Methods: We conducted a retrospective dual-centre cohort study, collecting data from patients with persistent atrial fibrillation who received outpatient treatment at two tertiary hospitals in central and western China from March 2019 to March 2020. The collected data included age, gender, body mass index (BMI), medical history, and hospitalization frequency due to heart failure. Patients were divided into three groups based on their heart rate control levels: Group I with a resting heart rate of less than 80 beats per minute, Group II with a resting heart rate between 80 and 100 beats per minute, and Group III with a resting heart rate greater than 100 beats per minute. The readmission rates due to heart failure within one year after discharge were statistically analyzed using propensity score matching in a 1:1 ratio. Differences in readmission rates among the different groups were compared using one-way ANOVA. The impact of varying levels of heart rate control on the risk of readmission for heart failure was assessed using the Cox proportional hazards model. Binary logistic regression analysis was employed to control for potential confounding factors. Results: We enrolled a total of 1136 patients with persistent atrial fibrillation. The results of the one-way ANOVA showed that there were differences in readmission rates among groups exposed to different levels of heart rate control. The readmission rates due to heart failure for each group were as follows: Group I (n=432): 31 (7.17%); Group II (n=387): 11.11%; Group III (n=317): 90 (28.50%) (F=54.3, P<0.001). After performing 1:1 propensity score matching for the different groups, 223 pairs were obtained. Analysis using the Cox proportional hazards model showed that compared to Group I, the risk of readmission for Group II was 1.372 (95% CI: 1.125-1.682, P<0.001), and for Group III was 2.053 (95% CI: 1.006-5.437, P<0.001). Furthermore, binary logistic regression analysis, including variables such as digoxin, hypertension, smoking, coronary heart disease, and chronic obstructive pulmonary disease as independent variables, revealed that coronary heart disease and COPD also had a significant impact on readmission due to heart failure (p<0.001). Conclusion: The correlation between the heart rate control level of patients with persistent atrial fibrillation and the risk of heart failure rehospitalization is positive. Reasonable heart rate control may significantly reduce the risk of heart failure rehospitalization.Keywords: heart rate control levels, heart failure rehospitalization, persistent atrial fibrillation, retrospective cohort study
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