Search results for: blood service
2076 Right Ventricular Dynamics During Breast Cancer Chemotherapy in Low Cardiovascular Risk Patients
Authors: Nana Gorgiladze, Tamar Gaprindashvili, Mikheil Shavdia, Zurab Pagava
Abstract:
Introduction/Purpose Chemotherapy is a common treatment for breast cancer, but it can also cause damage to the heart and blood vessels. This damage, known as cancer therapy-related cardiovascular toxicity (CTR-CVT), can increase the risk of heart failure and death in breast cancer patients. The left ventricle is often affected by CTR-CVT, but the right ventricle (RV) may also be vulnerable to CTR-CVT and may show signs of dysfunction before the left ventricle. The study aims to investigate how the RV function changes during chemotherapy for breast cancer by using conventional echocardiographic and global longitudinal strain (GLS) techniques. By measuring the GLS strain of the RV, researchers tend to detect early signs of CTR-CVT and improve the management of breast cancer patients. Methods The study was conducted on 28 women with low cardiovascular risk who received anthracycline chemotherapy for breast cancer. Conventional 2D echocardiography (LVEF, RVS’, TAPSE) and speckle-tracking echocardiography (STE) measurements of the left and right ventricles (LVGLS, RVGLS) were used to assess cardiac function before and after chemotherapy. All patients had normal LVEF at the beginning of the study. Cardiotoxicity was defined as a new LVEF reduction of 10 percentage points to an LVEF of 40-49% and/or a new decline in GLS of 15% from baseline, as proposed by the most recent cardio-oncology guideline. ResultsThe research found that the LVGLS decreased from -21.2%2.1% to -18.6%2.6% (t-test = -4.116; df = 54, p=0.001). The change in value LV-GLS was 2.6%3.0%. The mean percentage change of the LVGLS was 11,6%13,3%; p=0.001. Similarly, the right ventricular global longitudinal strain (RVGLS) decreased from -25.2%2.9% to -21.4%4.4% (t-test = -3.82; df = 54, p=0.001). The RV-GLS value of change was 3.8%3.6%. Likewise, the percentage decrease of the RVGLS was 15,0%14,3%, p=0.001.However, the measurements of the right ventricular systolic function (RVS) and tricuspid annular plane systolic excursion (TAPSE) were insignificant, and the left ventricular ejection fraction ( LVEF) remained unchanged.Keywords: cardiotoxicity, chemotherapy, GLS, right ventricle
Procedia PDF Downloads 722075 Correlation of Material Mechanical Characteristics Obtained by Means of Standardized and Miniature Test Specimens
Authors: Vaclav Mentl, P. Zlabek, J. Volak
Abstract:
New methods of mechanical testing were developed recently that are based on making use of miniature test specimens (e.g. Small Punch Test). The most important advantage of these method is the nearly non-destructive withdrawal of test material and small size of test specimen what is interesting in cases of remaining lifetime assessment when a sufficient volume of the representative material cannot be withdrawn of the component in question. In opposite, the most important disadvantage of such methods stems from the necessity to correlate test results with the results of standardised test procedures and to build up a database of material data in service. The correlations among the miniature test specimen data and the results of standardised tests are necessary. The paper describes the results of fatigue tests performed on miniature tests specimens in comparison with traditional fatigue tests for several steels applied in power producing industry. Special miniature test specimens fixtures were designed and manufactured for the purposes of fatigue testing at the Zwick/Roell 10HPF5100 testing machine. The miniature test specimens were produced of the traditional test specimens. Seven different steels were fatigue loaded (R = 0.1) at room temperature.Keywords: mechanical properties, miniature test specimens, correlations, small punch test, micro-tensile test, mini-charpy impact test
Procedia PDF Downloads 5382074 Review of the Legislative and Policy Issues in Promoting Infrastructure Development to Promote Automation in Telecom Industry
Authors: Marvin Ricardo Awarab
Abstract:
There has never been a greater need for telecom services. The Internet of Things (IoT), 5G networking, and edge computing are the driving forces behind this increased demand. The fierce demand offers communications service providers significant income opportunities. The telecom sector is centered on automation, and realizing a digital operation that functions as a real-time business will be crucial for the industry as a whole. Automation in telecom refers to the application of technology to create a more effective, quick, and scalable alternative to the conventional method of operating the telecom industry. With the promotion of 5G and the Internet of Things (IoT), telecom companies will continue to invest extensively in telecom automation technology. Automation offers benefits in the telecom industry; developing countries such as Namibia may not fully tap into such benefits because of the lack of funds and infrastructural resources to invest in automation. This paper fully investigates the benefits of automation in the telecom industry. Furthermore, the paper identifies hiccups that developing countries such as Namibia face in their quest to fully introduce automation in the telecom industry. Additionally, the paper proposes possible avenues that Namibia, as a developing country, adopt investing in automation infrastructural resources with the aim of reaping the full benefits of automation in the telecom industry.Keywords: automation, development, internet, internet of things, network, telecom, telecommunications policy, 5G
Procedia PDF Downloads 632073 The Transfer of Low-Cost Housing in South Africa: Problems and Impediments
Authors: Gert Van Schalkwyk, Chris Cloete
Abstract:
South Africa is experiencing a massive housing backlog in urban low-cost housing. A backlog in the transfer of low-cost housing units is exacerbated by various impediments and delays that exist in the current legal framework. Structured interviews were conducted with forty-five practicing conveyancers and fifteen deeds office examiners at the Deeds Office in Pretoria, South Africa. One of the largest, the Deeds Office in Pretoria implements a uniform registration process and can be regarded as representative of other deeds offices in South Africa. It was established that a low percentage of low-cost properties are freely transferable. The main economic impediments are the absence of financing and the affordability or payment of rates and taxes to local government. Encroachment of buildings on neighboring stands caused by the enlargement of existing small units on small stands also causes long-term unresolved legal disputes. In addition, as the transfer of properties is dependent on the proper functioning of administrative functions of various government departments, the adverse service delivery of government departments hampers transfer. Addressing the identified problems will contribute to a more sustainable process for the transfer of low-cost housing units in South Africa.Keywords: conveyancing, low-cost housing, South Africa, tenure, titling, transfer
Procedia PDF Downloads 1352072 An Automated Business Process Management for Smart Medical Records
Authors: K. Malak, A. Nourah, S.Liyakathunisa
Abstract:
Nowadays, healthcare services are facing many challenges since they are becoming more complex and more needed. Every detail of a patient’s interactions with health care providers is maintained in Electronic Health Records (ECR) and Healthcare information systems (HIS). However, most of the existing systems are often focused on documenting what happens in manual health care process, rather than providing the highest quality patient care. Healthcare business processes and stakeholders can no longer rely on manual processes, to provide better patient care and efficient utilization of resources, Healthcare processes must be automated wherever it is possible. In this research, a detail survey and analysis is performed on the existing health care systems in Saudi Arabia, and an automated smart medical healthcare business process model is proposed. The business process management methods and rules are followed in discovering, collecting information, analysis, redesign, implementation and performance improvement analysis in terms of time and cost. From the simulation results, it is evident that our proposed smart medical records system can improve the quality of the service by reducing the time and cost and increasing efficiencyKeywords: business process management, electronic health records, efficiency, cost, time
Procedia PDF Downloads 3412071 Patient Perspectives on Telehealth During the Pandemic in the United States
Authors: Manal Sultan Alhussein, Xiang Michelle Liu
Abstract:
Telehealth is an advanced technology using digital information and telecommunication facilities that provide access to health services from a distance. It slows the transmission factor of COVID-19, especially for elderly patients and patients with chronic diseases during the pandemic. Therefore, understanding patient perspectives on telehealth services and the factors impacting their option of telehealth service will shed light on the measures that healthcare providers can take to improve the quality of telehealth services. This study aimed to evaluate perceptions of telehealth services among different patient groups and explore various aspects of telehealth utilization in the United States during the COVID-19 pandemic. An online survey distributed via social media platforms was used to collect research data. In addition to the descriptive statistics, both correlation and regression analyses were conducted to test research hypotheses. The empirical results highlighted that the factors such as accessibility to telehealth services and the type of specialty clinics that the patients required play important roles in the effectiveness of telehealth services they received. However, the results found that patients’ waiting time to receive telehealth services and their annual income did not significantly influence their desire to select receiving healthcare services via telehealth. The limitations of the study and future research directions are discussed.Keywords: telehealth, patient satisfaction, pandemic, healthcare, survey
Procedia PDF Downloads 1122070 Evaluating Effect of Business Process Reengineering Performance of Private Banks
Authors: Elham Fakhrpoor, Daryush Mohammadi Zanjirani, Maziyar Nojaba
Abstract:
Business process reengineering is one of the most important strategies in banks in recent years that not only it increases customers’ satisfaction, but also it increases performance of banks. The purpose of elementary (initial) business process reengineering is reinforcing banks abilities to obtain new customers and making long-term relationships with existed customers and increasing customers’ satisfaction among service quality in global level. Banks specially the private ones are the main streams of state, because cash flow is necessary to survive a state. What guarantees survival and permanency of financial institutes’ activities is providing favorite, certain, and proper services. Capital market being small and state financial system being bank-oriented needs optimum usage from banks. According to this fact and role and importance of developing banking system, the present study tried to offer a constructed model using Lisrel and also spss software to evaluate effects of business process reengineering on performance of private banks. We have one min hypothesis and four sub-hypotheses. The main hypothesis says reengineering factors have positive effects on bank performances (balanced- scores card aspects). These hypotheses were tested by structural equations modeling.Keywords: effect, business, reengineering, private bank
Procedia PDF Downloads 2802069 Optimization of Lubricant Distribution with Alternative Coordinates and Number of Warehouses Considering Truck Capacity and Time Windows
Authors: Taufik Rizkiandi, Teuku Yuri M. Zagloel, Andri Dwi Setiawan
Abstract:
Distribution and growth in the transportation and warehousing business sector decreased by 15,04%. There was a decrease in Gross Domestic Product (GDP) contribution level from rank 7 of 4,41% in 2019 to 3,81% in rank 8 in 2020. A decline in the transportation and warehousing business sector contributes to GDP, resulting in oil and gas companies implementing an efficient supply chain strategy to ensure the availability of goods, especially lubricants. Fluctuating demand for lubricants and warehouse service time limits are essential things that are taken into account in determining an efficient route. Add depots points as a solution so that demand for lubricants is fulfilled (not stock out). However, adding a depot will increase operating costs and storage costs. Therefore, it is necessary to optimize the addition of depots using the Capacitated Vehicle Routing Problem with Time Windows (CVRPTW). This research case study was conducted at an oil and gas company that produces lubricants from 2019 to 2021. The study results obtained the optimal route and the addition of a depot with a minimum additional cost. The total cost remains efficient with the addition of a depot when compared to one depot from Jakarta.Keywords: CVRPTW, optimal route, depot, tabu search algorithm
Procedia PDF Downloads 1362068 Effects of Recognition of Customer Feedback on Relationships between Emotional Labor and Job Satisfaction: Focusing On Call Centers That Offer Professional Services
Authors: Kiyoko Yoshimura, Yasunobu Kino
Abstract:
Focusing on professional call centers where workers with expertise perform services, this study aims to clarify the relationships between emotional labor and job satisfaction and the effects of recognition of customer feedback. Since the professional call center operators consist of professional license holders (qualification holders) and those who do not (non-holders), the following three points are analyzed in the two groups by using covariance structure analysis and simultaneous multi-population analysis: 1) The relationship between emotional labor and job satisfaction, 2) customer feedback and job satisfaction, and 3) The intermediation effect between the emotional labor of customer feedback and job satisfaction. The following results are obtained: i) no direct effect is found between job satisfaction and emotional labor for qualification holders and non-holders, ii) for qualification holders and non-holders, recognition of positive feedback and recognition of negative feedback had positive and negative effects on job satisfaction, respectively, iii) for qualification and non-holders, "consideration for colleagues" influences job satisfaction by recognizing positive feedback, and iv) only for qualification holders, the factors "customer-oriented emotional expression" and "emotional disharmony" have a positive and negative effect on job satisfaction, respectively, through recognition of positive feedback and recognition of negative feedback.Keywords: call center, emotional labor, professional service, job satisfaction, customer feedback
Procedia PDF Downloads 1132067 Anti-TNF: Possibilities of Rising Anti-Phosphorylcholine Antibodies
Authors: Md. Mizanur Rahman, Anquan Liu, Anna Frostegård, Johan Frostegård
Abstract:
The role of the human immune system is essential in cardiovascular diseases and atherosclerosis. Activated cells in atherosclerosis produce abundant amounts of cytokines, but the exact mechanisms involved in the effects of these inflammatory cytokines are not clear in atherosclerosis. In a large clinical cohort, we have previously determined that antibodies against phosphorylcholine (anti-PC) are negatively and independently associated with both development of atherosclerosis and also a low risk of cardiovascular disease. Further, we reported that rheumatoid arthritis patients who were non-responders to TNF-inhibitors, where those with low anti-PC levels. Upon anti-TNF treatment, anti-PC levels increased. We, therefore, hypothesised that proinflammatory cytokines such as TNF could play a role in anti-PC regulation. Peripheral blood mononuclear cells (PBMC) were cultured with or without TNF and anti-TNF. The cell supernatants were collected after six days for ELISA measurements. In separate experiments, cells were cultured for 24 hours in both polystyrene plates and ELISPOT plates under a similar condition for ELISA and ELISPOT assays respectively. Total RNA was extracted after 6 hours of cell culture to perform RT-qPCR. Cell viability was confirmed by trypan blue staining and MTT assays. ELISA measurements detected less than 40% of anti-PC in TNF-treated cells, in comparison to control cells, whereas anti-PC production was recovered by anti-TNF treatment. ELISPOT assays showed that TNF suppresses anti-PC production by inhibiting anti-PC producing B-cells. In addition, RT-qPCR and ELISA showed that TNF also has effects also on B-cell activation as BAFF expression was inhibited by TNF treatment. Atherosclerosis is a major cause of cardiovascular diseases, but anti-PC is a protection marker for atherosclerosis development. Our findings show that TNF is a negative regulator of anti-PC production. Immune modulation and rising of anti-PC could be of major significance for the patients.Keywords: anti-PC, Anti-TNF, atherosclerosis, cardiovascular diseases, phosphorylecholine
Procedia PDF Downloads 2442066 High Expression Levels and Amplification of rRNA Genes in a Mentally Retarded Child with 13p+: A Familial Case Study
Authors: Irina S. Kolesnikova, Alexander A. Dolskiy, Natalya A. Lemskaya, Yulia V. Maksimova, Asia R. Shorina, Alena S. Telepova, Alexander S. Graphodatsky, Dmitry V. Yudkin
Abstract:
A cytogenetic and molecular genetic study of the family with a male child who had mental retardation and autistic features revealed an abnormal chromosome 13 bearing an enlarged p-arm with amplified ribosomal DNA (rDNA) in a boy and his father. Cytogenetic analysis using standard G-banding and FISH with labeled rDNA probes revealed an abnormal chromosome 13 with an enlarged p-arms due to rDNA amplification in a male child, who had clinically confirmed mental retardation and an autistic behavior. This chromosome is evidently inherited from the father, who has morphologically the same chromosome, but is healthy. The karyotype of the mother was normal. Ag-NOR staining showed brightly stained large whole-p-arm nucleolus organizer regions (NORs) in a child and normal-sized NORs in his father with 13p+-NOR-amount mosaicism. qRT-PCR with specific primers showed highly increased levels of 18S, 28S and 5,8 S ribosomal RNA (rRNA) in the patient’s blood samples compared to a normal healthy control donor. Both patient’s father and mother had no elevated levels of rRNAs expression. Thus, in this case, rRNA level seems to correlate with mental retardation in familial individuals with 13p+. Our findings of rRNA overexpression in a patient with mental retardation and his parents may show a possible link between the karyotype (p-arm enlargement due to rDNA amplification), rDNA functionality (rRNA overexpression), functional changes in the brain and mental retardation. The study is supported by Russian Science Foundation Grant 15-15-10001.Keywords: mental retardation, ribosomal DNA–rDNA, ribosomal RNA–rRNA, nucleolus organizer region–NOR, chromosome 13
Procedia PDF Downloads 2632065 Effects of Conjugated Linoleic Acid (CLA) on Hormones and Factors Involved in Murine Ovulation
Authors: Leila Karshenas, Hamidreza Khodaei, Behnaz Mahdavi
Abstract:
Ovulation is a physiologic process with an inflammatory response that depends on a coordinated activity of gonadotropins and steroid hormones, as well as inflammatory mediators such as cytokines, prostaglandins, leptin, nitric oxide (NO), etc. Conjugated linoleic acid (CLA) is composed of polyunsaturated fatty acids (PUFA) found in dairy products, beef and lamb. There is strong evidence that dietary CLA affects mediators involved in ovulation. The aim of this study was to determine the effects of different doses of dietary CLA on systemic and local hormones and factors involved in ovulation. In this case-control study, 80 (50±2-day old) female mice were randomly divided into four groups (C as the controls and T1, T2 and T3 as the treatment groups). There were four replicates in each group and there were five mice in every replicate (20 mice, in total). The mice in the control group were fed with no CLA in their diet but the ones in the treatment group received 0.1, 0.3 and 0.5g/kg of CLA (replacing corn oil in the diet), respectively for 120 days. Later on, blood samples were obtained from the tails of animals that displayed estrus signs and estradiol (E2), progesterone (P4), LH, FSH, NO, leptin and TNFα were measured. Furthermore, the effects of CLA on the ovarian production of prostaglandins (PGs) and NO were investigated. The data were analyzed by SAS software.CLA significantly decreased serum levels of FSH (p<0.05), LH, estradiol, NO, leptin and TNFα (p<0.01). In addition, CLA decreased progesterone levels but this effect was statistically insignificant. The significantly negative effects of CLA were seen on the ovarian production of PGE2 and PGF2α (p<0.01).It seems that CLA may play an effective role in reducing the ovulation rate in mice as CLA adversely affected female reproduction and it had negative effects on systemic and local hormones involved in ovulation.Keywords: conjugated linoleic acid, nitric oxide, ovary, ovulation, prostaglandin, gonadotropin
Procedia PDF Downloads 3012064 Cost Analysis of Optimized Fast Network Mobility in IEEE 802.16e Networks
Authors: Seyyed Masoud Seyyedoshohadaei, Borhanuddin Mohd Ali
Abstract:
To support group mobility, the NEMO Basic Support Protocol has been standardized as an extension of Mobile IP that enables an entire network to change its point of attachment to the Internet. Using NEMO in IEEE 802.16e (WiMax) networks causes latency in handover procedure and affects seamless communication of real-time applications. To decrease handover latency and service disruption time, an integrated scheme named Optimized Fast NEMO (OFNEMO) was introduced by authors of this paper. In OFNEMO a pre-establish multi tunnels concept, cross function optimization and cross layer design are used. In this paper, an analytical model is developed to evaluate total cost consisting of signaling and packet delivery costs of the OFNEMO compared with RFC3963. Results show that OFNEMO increases probability of predictive mode compared with RFC3963 due to smaller handover latency. Even though OFNEMO needs extra signalling to pre-establish multi tunnel, it has less total cost thanks to its optimized algorithm. OFNEMO can minimize handover latency for supporting real time application in moving networks.Keywords: fast mobile IPv6, handover latency, IEEE802.16e, network mobility
Procedia PDF Downloads 1972063 Low-Cost Aviation Solutions to Strengthen Counter-Poaching Efforts in Kenya
Authors: Kuldeep Rawat, Michael O'Shea, Maureen McGough
Abstract:
The paper will discuss a National Institute of Justice (NIJ) funded project to provide cost-effective aviation technologies and research to support counter-poaching operations related to endangered, protected, and/or regulated wildlife. The goal of this project is to provide cost-effective aviation technology and research support to Kenya Wildlife Service (KWS) in their counter-poaching efforts. In pursuit of this goal, Elizabeth City State University (ECSU) is assisting the National Institute of Justice (NIJ) in enhancing the Kenya Wildlife Service’s aviation technology and related capacity to meet its counter-poaching mission. Poaching, at its core, is systemic as poachers go to the most extreme lengths to kill high target species such as elephant and rhino. These high target wildlife species live in underdeveloped or impoverished nations, where poachers find fewer barriers to their operations. In Kenya, with fifty-nine (59) parks and reserves, spread over an area of 225,830 square miles (584,897 square kilometers) adequate surveillance on the ground is next to impossible. Cost-effective aviation surveillance technologies, based on a comprehensive needs assessment and operational evaluation, are needed to curb poaching and effectively prevent wildlife trafficking. As one of the premier law enforcement Air Wings in East Africa, KWS plays a crucial role in Kenya, not only in counter-poaching and wildlife conservation efforts, but in aerial surveillance, counterterrorism and national security efforts as well. While the Air Wing has done, a remarkable job conducting aerial patrols with limited resources, additional aircraft and upgraded technology should significantly advance the Air Wing’s ability to achieve its wildlife protection mission. The project includes: (i) Needs Assessment of the KWS Air Wing, to include the identification of resources, current and prospective capacity, operational challenges and priority goals for expansion, (ii) Acquisition of Low-Cost Aviation Technology to meet priority needs, and (iii) Operational Evaluation of technology performance, with a focus on implementation and effectiveness. The Needs Assessment reflects the priorities identified through two site visits to the KWS Air Wing in Nairobi, Kenya, as well as field visits to multiple national parks receiving aerial support and interviewing/surveying KWS Air wing pilots and leadership. Needs Assessment identified some immediate technology needs that includes, GPS with upgrades, including weather application, Night flying capabilities, to include runway lights and night vision technology, Cameras and surveillance equipment, Flight tracking system and/or Emergency Position Indicating Radio Beacon, Lightweight ballistic-resistant body armor, and medical equipment, to include a customized stretcher and standard medical evacuation equipment. Results of this assessment, along with significant input from the KWS Air Wing, will guide the second phase of this project: technology acquisition. Acquired technology will then be evaluated in the field, with a focus on implementation and effectiveness. Results will ultimately be translated for any rural or tribal law enforcement agencies with comparable aerial surveillance missions and operational environments, and jurisdictional challenges, seeking to implement low-cost aviation technology. Results from Needs Assessment phase, including survey results and our ongoing technology acquisition and baseline operational evaluation will be discussed in the paper.Keywords: aerial surveillance mission, aviation technology, counter-poaching, wildlife protection
Procedia PDF Downloads 2752062 Infection Profile of Patients Undergoing Autologous Bone Marrow Transplantation in Tabriz, Iran
Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour
Abstract:
Background and Objective: Hematopoietic stem cell transplantation (HSCT) has been widely used for treating oncological and hematological diseases. Although HSCT has helped to improve patient survival, the risk of developing an infection during hospitalization is an important cause of morbidity and mortality. This study aimed to analyze the infection profile during hospitalization and the associated risk factors among patients undergoing autologous HSCT at the University Hospital, Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects and Methods: This was a cross-sectional study on patients undergoing autologous HSCT at a public university hospital. Methods: Patients with febrile neutropenia between 2015 and 2018 were retrospectively evaluated regarding their infection profile and associated risk factors. This survey included: bacterial culture and blood culture on specific media. Results: Infection occurred in 57.2% of 56 patients with febrile neutropenia. The main source of infection was the central venous catheter (25.9%). Infection was chiefly due to Gram-positive bacteria, although Gram-negative-related infections were more severe and caused a higher death rate. Sex, age, skin color, nutritional status, and underlying disease were not associated with the development of infection. Patients with severe mucositis (Grades III and IV) had a higher infection rate (P < 0.001). Patients who developed pulmonary complications during hospitalization had higher infection rates (P = 0.002). Infection was the main cause of death (57.1%) in the study sample. Conclusion: Strategies aimed at reducing infection-related mortality rates among patients undergoing autologous HSCT are necessary.Keywords: hematopoietic stem cell, autologous bone marrow transplantation, infection profile, tabriz, Iran
Procedia PDF Downloads 1192061 Oral Lichen Planus a Manifestation of Grinspan's Syndrome or a Lichenoid Reaction to Medication
Authors: Sahar Iqrar, Malik Adeel Anwar, Zain Akram, Maria Noor
Abstract:
Introduction: Oral lichen planus is a chronic inflammatory condition of unknown etiology. Oral lichen planus may be related with several other diseases. Grinspan's Syndrome is characterized by a triad of oral lichen planus, hypertension, and diabetes mellitus. Other associations reported in the literature are with chronic liver disease and, with dyslipidemia. The nature of these associations is still not fully understood. Material and methods: Study was conducted in Department of Oral Medicine, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan. A total of n=89 clinically diagnosed patients of oral lichen planus of both gender and all age groups were recruited and detailed history were recorded in the designed performs. Results: A total of n=89 patients were taken with male to female ratio of 3:8 in which 24 were male and 65 females. Mean age was 48.8 ± 13.8 years. Age range of 10-74 years was seen. Among these patients suffering from oral lichen planus, 41.6% (n=37) had a positive history for hypertension with 59.5% (n=22) of these patients were taking different medication for their condition. Whereas Diabetes Mellitus was found in 24.7% (n=22) patients with 72.7% (n=16) of these patients using the hypoglycemic drug (oral or injectable) to control their blood glucose levels. Out of these n=89 lichen planus patients 21.3% had both hypertension and diabetes mellitus (fulfilling the criteria for Grinspan's Syndrome). Out of this Grinspan's Syndrome pool 94.7% (n=19) were taking drug atleast for one of the two conditions. Conclusion: As noticed form the medical history of the patients, most of them were using hypoglycemic drugs for diabetes mellitus and beta blockers, diuretics and calcium channel blockers for hypertension. These drugs are known for lichenoid reaction. Therefore, it should be ruled out at histopathological/ immunological and molecular level whether these patients are suffering from lichen planus or lichenoid drug reaction to truly declare them as patients with Grinspan’s Syndrome.Keywords: diabetes mellitus, grinspan's syndrome, lichenoid drug reaction, oral lichen planus
Procedia PDF Downloads 2412060 Coordinated Renewal Planning of Civil Infrastructure Systems
Authors: Hesham Osman
Abstract:
The challenges facing aging urban infrastructure systems require a more holistic and comprehensive approach to their management. The large number of urban infrastructure renewal activities occurring in cities throughout the world leads to social, economic and environmental impacts on the communities in its vicinity. As such, a coordinated effort is required to streamline these activities. This paper presents a framework to enable temporal (time-based) coordination of water, sewer and road intervention activities. Intervention activities include routine maintenance, renewal, and replacement of physical assets. The coordination framework considers 1) Life-cycle costs, 2) Infrastructure level-of-service, and 3) Risk exposure to system operators. The model enables infrastructure asset managers to trade-off options of delaying versus bringing forward intervention activities of one system in order to be executed in conjunction with another co-located system in the right-of-way. The framework relies on a combination of meta-heuristics and goal-based optimization. In order to demonstrate the applicability of the framework, a case study for a major infrastructure corridor in Cairo, Egypt is taken as an example. Results show that the framework can be scaled-up to include other infrastructure systems located in the right-of-way like electricity, gas and telecom, provided that information can be shared among these entities.Keywords: infrastructure, rehabilitation, construction, optimization
Procedia PDF Downloads 2972059 3D Non-Linear Analyses by Using Finite Element Method about the Prediction of the Cracking in Post-Tensioned Dapped-End Beams
Authors: Jatziri Y. Moreno-Martínez, Arturo Galván, Israel Enrique Herrera Díaz, José Ramón Gasca Tirado
Abstract:
In recent years, for the elevated viaducts in Mexico City, a construction system based on precast/pre-stressed concrete elements has been used, in which the bridge girders are divided in two parts by imposing a hinged support in sections where the bending moments that are originated by the gravity loads in a continuous beam are minimal. Precast concrete girders with dapped ends are a representative sample of a behavior that has complex configurations of stresses that make them more vulnerable to cracking due to flexure–shear interaction. The design procedures for ends of the dapped girders are well established and are based primarily on experimental tests performed for different configurations of reinforcement. The critical failure modes that can govern the design have been identified, and for each of them, the methods for computing the reinforcing steel that is needed to achieve adequate safety against failure have been proposed. Nevertheless, the design recommendations do not include procedures for controlling diagonal cracking at the entrant corner under service loading. These cracks could cause water penetration and degradation because of the corrosion of the steel reinforcement. The lack of visual access to the area makes it difficult to detect this damage and take timely corrective actions. Three-dimensional non-linear numerical models based on Finite Element Method to study the cracking at the entrant corner of dapped-end beams were performed using the software package ANSYS v. 11.0. The cracking was numerically simulated by using the smeared crack approach. The concrete structure was modeled using three-dimensional solid elements SOLID65 capable of cracking in tension and crushing in compression. Drucker-Prager yield surface was used to include the plastic deformations. The longitudinal post-tension was modeled using LINK8 elements with multilinear isotropic hardening behavior using von Misses plasticity. The reinforcement was introduced with smeared approach. The numerical models were calibrated using experimental tests carried out in “Instituto de Ingeniería, Universidad Nacional Autónoma de México”. In these numerical models the characteristics of the specimens were considered: typical solution based on vertical stirrups (hangers) and on vertical and horizontal hoops with a post-tensioned steel which contributed to a 74% of the flexural resistance. The post-tension is given by four steel wires with a 5/8’’ (16 mm) diameter. Each wire was tensioned to 147 kN and induced an average compressive stress of 4.90 MPa on the concrete section of the dapped end. The loading protocol consisted on applying symmetrical loading to reach the service load (180 kN). Due to the good correlation between experimental and numerical models some additional numerical models were proposed by considering different percentages of post-tension in order to find out how much it influences in the appearance of the cracking in the reentrant corner of the dapped-end beams. It was concluded that the increasing of percentage of post-tension decreases the displacements and the cracking in the reentrant corner takes longer to appear. The authors acknowledge at “Universidad de Guanajuato, Campus Celaya-Salvatierra” and the financial support of PRODEP-SEP (UGTO-PTC-460) of the Mexican government. The first author acknowledges at “Instituto de Ingeniería, Universidad Nacional Autónoma de México”.Keywords: concrete dapped-end beams, cracking control, finite element analysis, postension
Procedia PDF Downloads 2262058 Identification of Promiscuous Epitopes for Cellular Immune Responses in the Major Antigenic Protein Rv3873 Encoded by Region of Difference 1 of Mycobacterium tuberculosis
Authors: Abu Salim Mustafa
Abstract:
Rv3873 is a relatively large size protein (371 amino acids in length) and its gene is located in the immunodominant genomic region of difference (RD)1 that is present in the genome of Mycobacterium tuberculosis but deleted from the genomes of all the vaccine strains of Bacillus Calmette Guerin (BCG) and most other mycobacteria. However, when tested for cellular immune responses using peripheral blood mononuclear cells from tuberculosis patients and BCG-vaccinated healthy subjects, this protein was found to be a major stimulator of cell mediated immune responses in both groups of subjects. In order to further identify the sequence of immunodominant epitopes and explore their Human Leukocyte Antigen (HLA)-restriction for epitope recognition, 24 peptides (25-mers overlapping with the neighboring peptides by 10 residues) covering the sequence of Rv3873 were synthesized chemically using fluorenylmethyloxycarbonyl chemistry and tested in cell mediated immune responses. The results of these experiments helped in the identification of an immunodominant peptide P9 that was recognized by people expressing varying HLA-DR types. Furthermore, it was also predicted to be a promiscuous binder with multiple epitopes for binding to HLA-DR, HLA-DP and HLA-DQ alleles of HLA-class II molecules that present antigens to T helper cells, and to HLA-class I molecules that present antigens to T cytotoxic cells. In addition, the evaluation of peptide P9 using an immunogenicity predictor server yielded a high score (0.94), which indicated a greater probability of this peptide to elicit a protective cellular immune response. In conclusion, P9, a peptide with multiple epitopes and ability to bind several HLA class I and class II molecules for presentation to cells of the cellular immune response, may be useful as a peptide-based vaccine against tuberculosis.Keywords: mycobacterium tuberculosis, PPE68, peptides, vaccine
Procedia PDF Downloads 1352057 Preventing Perpetuation of Structural Violence in the Workplace: An Australian Settlement Services Case Study
Authors: Jordan Fallow
Abstract:
Service and advocacy organisations that serve refugee populations are often staffed by a large percentage of former refugees themselves, and this carries a number of implications for refugee rights, specifically economic and social rights. This paper makes an argument for the importance of introducing an understanding of intersectionality theory into organizations who provide services to and employ, refugee staff. The benefits of this are threefold; on an individual level it reduces the risks of burn out, vicarious trauma and compassion fatigue while increasing employee satisfaction and development, at an organizational level services become more effective, and at a systems level it helps reduce structural violence, which may itself have been a contributing factor in the movement of refugee staff from their origin countries. In support of this argument, a case study of an Australian settlement services organization is provided. Mixed methods research, utilising both qualitative and quantitative data, measured the perceived efficacy of diversity management tools at the organization and the impact this had on staff performance, retention and wellbeing. The paper also draws on strategic human resource and reward management, diversity management, international development and intersectionality texts.Keywords: structural violence, employment, human resource management, intersectionality
Procedia PDF Downloads 2202056 Exploring the Effect of Environmental Cues of Food Festival on Visitor Satisfaction
Authors: Tao Zhang
Abstract:
As the competition of all kinds of festival events becomes more and more fierce, more and more event organizers try to design a blended festivalscape by integrating multifaceted environmental cues in order to raise the service quality of festival events and then raise visitors’ satisfaction. As the main type of festival events, food festivals are popular in all over the world. The organizers’ of food festivals also try to mix food with multifaceted environmental cues (e.g., music, stage, light, dance) to design a blended festivalscape. However, until now little studies explore the environmental cues of food festivals and their relationship with visitors’ satisfaction. Therefore, the aim of this study is to ascertain the environmental cues of food festival and their relationship with visitors’ satisfaction by using the blended festivalscape theory. Using convenient sampling method, this study investigated 1,000 food festival visitors in Macau. Factor analysis showed there are mainly six environmental cues (i.e., food, atmosphere, program, staff, facility, and information). All six environmental cues are positively related with visitors’ satisfaction, while the most influential factors are food, atmosphere, and program. This study showed that festival event organizers’ should focus on the topic of their festival event, build festival atmosphere, and create interesting programs in order to design a blended festivalscape and then raise visitors’ satisfaction.Keywords: environmental cue, event, festival, satisfaction
Procedia PDF Downloads 3662055 Suicidal Attempts as a Reason for Emergency Medical Teams’ Call-Outs Based on Examples of Ambulance Service in Siedlce, Poland
Authors: Dawid Jakimiuk, Krzysztof Mitura, Leszek Szpakowski, Sławomir Pilip, Daniel Celiński
Abstract:
The Emergency Medical Teams (EMS) of the Ambulance Service in Siedlce serve the population living in the Mazowieckie Voivodeship (the area of eastern Poland with approximately 550,000 inhabitants). They provide health services at the pre-hospital stage to all life-threatening patients. The analysis covered the interventions of emergency medical teams in cases of suicide attempts that occurred in the years 2015-2018. The study was retrospective. The data was obtained on the basis of digital medical records of completed call-outs. When defining the disease entity, the International Statistical Classification of Diseases and Health Problems ICD-10 prepared by WHO was used. The relationship between selected disease entities and the area of EMT intervention, the patient's sex and age, and the time of occurrence of the event were investigated. Non-urban area was defined as the area inhabited by a population below 10,000 residents. Statistical analysis was performed using Pearson's Chi ^ 2 test and presenting the percentage of cases in the study group. Of all the suicide attempts, drug abuse cases were the most frequent, including: X60 (Intentional self-poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics); X61 (Intentional self-poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonian and psychotropic drugs, not elsewhere classified); X62 (Intentional self-poisoning by and exposure to narcotics and psycholeptics [hallucinogens], not elsewhere classified); X63 (Intentional self-poisoning by and exposure to other drugs acting on the autonomic nervous system); X64 (Intentional self-poisoning by and exposure to other and unspecified drugs, medicaments and biological substance) oraz X70 (Intentional self-harm by hanging, strangulation and suffocation). In total, they accounted for 69.4% of all interventions to suicide attempts in the studied period. Statistical analysis shows significant differences (χ2 = 39.30239, p <0.0001, n = 561) between the area of EMT intervention and the type of suicide attempt. In non-urban areas, a higher percentage of X70 diagnoses was recorded (55.67%), while in urban areas, X60-X64 (72.53%). In non-urban areas, a higher proportion of patients attempting suicide was observed compared to patients living in urban areas. For X70 and X60 - X64 in total, the incidence rates in non-urban areas were 80.8% and 56%, respectively. Significant differences were found (χ2 = 119.3304, p <0.0001, n = 561) depending on the method of attempting suicide in relation to the patient's sex. The percentage of women diagnosed with X60-X64 versus X70 was 87.50%, which was the largest number of patients (n = 154) as compared to men. In the case of X70 in relation to X60-X64, the percentage of men was 62.08%, which was the largest number of patients (n = 239) as compared to women (n = 22). In the case of X70, the percentage of men compared to women was as high as 92%. Significant differences were observed (χ2 = 14.94848, p <0.01058) between the hour of EMT intervention and the type of suicide attempt. The highest percentage of X70 occurred between 04:01 - 08:00 (64.44%), while X60-X64 between 00:01 - 04:00 (70.45%). The largest number of cases of all tested suicide attempts was recorded between 16:01 - 20:00 for X70 (n = 62), X60 - X64 (n = 82), respectively. The highest percentage of patients undertaking all suicide attempts studied at work was observed in the age range of 18-30 (31.5%), while the lowest was in the age group over 60 years of age. (11%). There was no significant correlation between the day of the week or individual months of the year and the type of suicide attempt - respectively (χ2 = 6.281729, p <0.39238, n = 561) and (χ2 = 3.348913, p <0.9857, n = 561). There were also no significant differences in the incidence of suicide attempts for each year in the study period (χ2 = 3.348913, p <0.9857 n = 561). The obtained results suggest the necessity to undertake preventive measures in order to minimize the number of suicide attempts. Such activities should be directed especially at young patients living in non-urban areas.Keywords: emergency med, emergency medical team, attempted suicide, pre-hospital
Procedia PDF Downloads 922054 Qualitative Data Analysis for Health Care Services
Authors: Taner Ersoz, Filiz Ersoz
Abstract:
This study was designed enable application of multivariate technique in the interpretation of categorical data for measuring health care services satisfaction in Turkey. The data was collected from a total of 17726 respondents. The establishment of the sample group and collection of the data were carried out by a joint team from The Ministry of Health and Turkish Statistical Institute (Turk Stat) of Turkey. The multiple correspondence analysis (MCA) was used on the data of 2882 respondents who answered the questionnaire in full. The multiple correspondence analysis indicated that, in the evaluation of health services females, public employees, younger and more highly educated individuals were more concerned and complainant than males, private sector employees, older and less educated individuals. Overall 53 % of the respondents were pleased with the improvements in health care services in the past three years. This study demonstrates the public consciousness in health services and health care satisfaction in Turkey. It was found that most the respondents were pleased with the improvements in health care services over the past three years. Awareness of health service quality increases with education levels. Older individuals and males would appear to have lower expectancies in health services.Keywords: multiple correspondence analysis, multivariate categorical data, health care services, health satisfaction survey
Procedia PDF Downloads 2422053 Chaotic Analysis of Acid Rains with Times Series of pH Degree, Nitrate and Sulphate Concentration on Wet Samples
Authors: Aysegul Sener, Gonca Tuncel Memis, Mirac Kamislioglu
Abstract:
Chaos theory is one of the new paradigms of science since the last century. After determining chaos in the weather systems by Edward Lorenz the popularity of the theory was increased. Chaos is observed in many natural systems and studies continue to defect chaos to other natural systems. Acid rain is one of the environmental problems that have negative effects on environment and acid rains values are monitored continuously. In this study, we aim that analyze the chaotic behavior of acid rains in Turkey with the chaotic defecting approaches. The data of pH degree of rain waters, concentration of sulfate and nitrate data of wet rain water samples in the rain collecting stations which are located in different regions of Turkey are provided by Turkish State Meteorology Service. Lyapunov exponents, reconstruction of the phase space, power spectrums are used in this study to determine and predict the chaotic behaviors of acid rains. As a result of the analysis it is found that acid rain time series have positive Lyapunov exponents and wide power spectrums and chaotic behavior is observed in the acid rain time series.Keywords: acid rains, chaos, chaotic analysis, Lypapunov exponents
Procedia PDF Downloads 1462052 Emotion Mining and Attribute Selection for Actionable Recommendations to Improve Customer Satisfaction
Authors: Jaishree Ranganathan, Poonam Rajurkar, Angelina A. Tzacheva, Zbigniew W. Ras
Abstract:
In today’s world, business often depends on the customer feedback and reviews. Sentiment analysis helps identify and extract information about the sentiment or emotion of the of the topic or document. Attribute selection is a challenging problem, especially with large datasets in actionable pattern mining algorithms. Action Rule Mining is one of the methods to discover actionable patterns from data. Action Rules are rules that help describe specific actions to be made in the form of conditions that help achieve the desired outcome. The rules help to change from any undesirable or negative state to a more desirable or positive state. In this paper, we present a Lexicon based weighted scheme approach to identify emotions from customer feedback data in the area of manufacturing business. Also, we use Rough sets and explore the attribute selection method for large scale datasets. Then we apply Actionable pattern mining to extract possible emotion change recommendations. This kind of recommendations help business analyst to improve their customer service which leads to customer satisfaction and increase sales revenue.Keywords: actionable pattern discovery, attribute selection, business data, data mining, emotion
Procedia PDF Downloads 1992051 A Mixed Integer Programming Model for Optimizing the Layout of an Emergency Department
Authors: Farhood Rismanchian, Seong Hyeon Park, Young Hoon Lee
Abstract:
During the recent years, demand for healthcare services has dramatically increased. As the demand for healthcare services increases, so does the necessity of constructing new healthcare buildings and redesigning and renovating existing ones. Increasing demands necessitate the use of optimization techniques to improve the overall service efficiency in healthcare settings. However, high complexity of care processes remains the major challenge to accomplish this goal. This study proposes a method based on process mining results to address the high complexity of care processes and to find the optimal layout of the various medical centers in an emergency department. ProM framework is used to discover clinical pathway patterns and relationship between activities. Sequence clustering plug-in is used to remove infrequent events and to derive the process model in the form of Markov chain. The process mining results served as an input for the next phase which consists of the development of the optimization model. Comparison of the current ED design with the one obtained from the proposed method indicated that a carefully designed layout can significantly decrease the distances that patients must travel.Keywords: Mixed Integer programming, Facility layout problem, Process Mining, Healthcare Operation Management
Procedia PDF Downloads 3392050 Characterization of Filled HNBR Elastomers for Sealing Application in Cold Climate Areas
Authors: Anton G. Akulichev, Avinash Tiwari, Ben Alcock, Andreas Echtermeyer
Abstract:
Low temperatures are known to pose a major threat for polymers; many are prone to excessive stiffness or even brittleness. There is a technology gap between the properties of existing elastomeric sealing materials and the properties needed for service in extremely cold regions. Moreover, some aspects of low temperature behaviour of rubber are not thoroughly studied and understood. The paper presents results of laboratory testing of a conventional oilfield HNBR (hydrogenated nitrile butadiene rubber) elastomer at low climatic temperatures above and below its glass transition point, as well as the performance of some filled HNBR formulations. Particular emphasis in the experiments is put on rubber viscoelastic characteristics studied by Dynamic Mechanical Analysis (DMA) and quasi-static mechanical testing results at low temperatures. As demonstrated by the stress relaxation and DMA experiments the transition region near Tg of the studied compound has the most striking features, like rapid stress relaxation, as compared to the glassy and rubbery plateau. In addition the quasi-static experiments show that molecular movement below Tg is not completely frozen, but rather evident and manifested in a certain stress decay as well. The effect of temperature and filler additions on typical mechanical and other properties of the materials is also discussed.Keywords: characterization, filled elastomers, HNBR, low temperature
Procedia PDF Downloads 3132049 Interpersonal Emotion Regulation in Adolescence: An Enhanced Critical Incident Study
Authors: Setareh Shayanfar
Abstract:
Given the increasing importance of peer relationships during adolescence, the present study aimed to examine peer interactions that facilitate or hinder adolescents’ regulation of negative emotions. Using the Enhanced Critical Incident Technique, 1-hour semi-structured interviews were conducted with 16 junior high school adolescents. Participants were asked to recall situations when they experienced strong negative emotions during the past school year, indicate the peer interactions that helped or hindered their emotion regulation, and identify prospective interactions with the potential to help regulate their emotions. Data analysis extracted 182 critical incidents, including 109 helping incidents, 45 hindering incidents, and 28 wish list items, which generated 10 categories nested within four overarching themes: Positive Personal Support included (a) supportive presence, (b) expressing concern, (c) empathizing, and (d) encouraging and cheering up; while Strategy Transmission included (e) sharing perspective, and (f) giving advice; Activated Support included (g) taking action, and (h) distracting; while Negative Personal Interactions included (i) withdrawing and (j) punishing. Implications for mental health and service providers, as well as recommendations for future research, are presented.Keywords: adolescence, emotion regulation, enhanced critical incident technique, peers
Procedia PDF Downloads 1442048 A Case of Mantle Cell Lymphoma Presenting With GI Symptoms and Noted to Have Extranodal Involvement of the Stomach and Colon on Presentation
Authors: Saba Amreen Syeda, Summaiah Asim, Syeda, Hafsa, Essam Quraishi
Abstract:
Mantle Cell Lymphoma (MCL) is a relatively uncommon type of lymphoma that comprises approximately 7 percent of non hodgkin's lymphomas (NHL), Classic MCL presents mostly in lymph nodes and occasionally in extranodal sites. About 26 % of MCL is present primarily in the Gastrointestinal tract. While both the upper GI tract and the lower GI tract could be involved, it is rare to present with concurrent upper and lower GI involvement with MCL. We present the case of a 51-year-old Asian Indian male that presented to our clinic with complaints of chronic diarrhea for the last one year, progressively worsening over the past three months. The Patient also reported black stool as well as bright red blood per rectum. Patient reported severe fatigue on minimal exertion. On a physical exam, the patient was noted to have matted lymphadenopathy in the neck. Patient was noted to be anemic with a hemoglobin to be 8 g/dl. Esophagogastroduodenoscopy and colonoscopy was performed. EGD showed a large 4 cm ulcer in the gastric antrum with thick heaped up edges. There was bleeding on contact. Colonoscopy showed a large 35 mm multilobulated polyp in the ascending colon, which was biopsied. The patient was also noted to have nodular proctitis in the mid rectum. This was localized and extended to about 5 cm. This area was biopsied as well. Biopsies from the stomach, colon, as well as the rectum, returned with findings of mantle cell lymphoma on pathology. Lymphoid cells in the biopsy were stained strongly positive for CD 20, cyclin D1, and CD 5. There was the absence of stain for CD 3 and CD 10. The IHC stain for CD 23 was negative. Biopsies from neck LAD were obtained and were also positive for MCL. The patient was referred to oncology for staging and treatment.Keywords: mantle cell lymphoma, GI bleed, diarrhea, gastric ulcer, colon polyp
Procedia PDF Downloads 1572047 Government Credit Card in State Financial Management: Public Sector Innovation in Indonesia
Authors: Paramita Nur Kurniati, Stanislaus Riyanta
Abstract:
In the midst of the heightened usage of electronic money (e-money), Indonesian government expenditure is yet governed through cash-basis transactions. This conventional system brings about a number of potential risks and obstacles to operational conduct, including state financial liquidity issue. Consequently, Ministry of Finance is currently establishing the cashless payment methods for State Budget (APBN). Included in those advance methods is credit card facility as a government expenditure payment scheme. This policy is one of the innovations within the public sector learned from other countries’ best practices. Moreover, this particular method is already prominent within the private-sector realm. Qualitative descriptive analysis technique is implemented to evaluate the contemporary innovation of using government credit card in the path towards cashless society. This approach is expected to generate several benefits for the government, particularly in minimizing corruption within the state financial management. Effective coordination among policy makers and policy implementers is essential for the success of this policy’s exercise, without neglecting prudence and public transparency aspects. Government credit card usage shall be the potent resolution for enhancing the government’s overall public service performance.Keywords: cashless basis, cashless society, government credit card, public sector innovation
Procedia PDF Downloads 149