Search results for: results of research
Commenced in January 2007
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Paper Count: 50597

Search results for: results of research

6857 Reducing the Risk of Alcohol Relapse after Liver-Transplantation

Authors: Rebeca V. Tholen, Elaine Bundy

Abstract:

Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.

Keywords: alcoholism, liver transplant, quality improvement, substance abuse

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6856 Determinants of Pastoral Women's Demand for Credit: Evidence from Northern Kenya

Authors: Anne Gesare Timu, Megan Sheahan, Andrew Gache Mude, Rupsha Banerjee

Abstract:

Women headed households are among the most vulnerable to negative climatic shocks and are often left poorer as a result. Credit provision has been recognized as one way of alleviating rural poverty and developing poor rural households’ resilience to shocks. Much has been documented about credit demand in small-holder agriculture settings in Kenya. However, little is known about demand for credit among pastoral women. This paper analyzes the determinants of demand for credit in the pastoral regions of Marsabit District of Northern Kenya. Using a five wave balanced panel data set of 820 households, a double hurdle model is employed to analyze if shocks, financial literacy and risk aversion affect credit demand among female and male headed households differently. The results show that borrowing goods on credit and monetary credit from informal market segments are the most common sources of credit in the study area. The impact of livestock loss and financial literacy on the decision to borrow and how much to borrow vary with gender. While the paper suggests that provision of credit is particularly valuable in the aftermath of a negative shock and more so for female-headed households, it also explores alternatives to the provision of credit where credit access is a constraint. It recommends further understanding of systems and institutions which could enhance access to credit, and particularly during times of stress, to enable households in the study area in particular and Northern Kenya in general to invest, engage in meaningful development and growth, and be resilient to persistent shocks.

Keywords: female headed households, pastoralism, rural financing, double hurdle model

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6855 Omni-Modeler: Dynamic Learning for Pedestrian Redetection

Authors: Michael Karnes, Alper Yilmaz

Abstract:

This paper presents the application of the omni-modeler towards pedestrian redetection. The pedestrian redetection task creates several challenges when applying deep neural networks (DNN) due to the variety of pedestrian appearance with camera position, the variety of environmental conditions, and the specificity required to recognize one pedestrian from another. DNNs require significant training sets and are not easily adapted for changes in class appearances or changes in the set of classes held in its knowledge domain. Pedestrian redetection requires an algorithm that can actively manage its knowledge domain as individuals move in and out of the scene, as well as learn individual appearances from a few frames of a video. The Omni-Modeler is a dynamically learning few-shot visual recognition algorithm developed for tasks with limited training data availability. The Omni-Modeler adapts the knowledge domain of pre-trained deep neural networks to novel concepts with a calculated localized language encoder. The Omni-Modeler knowledge domain is generated by creating a dynamic dictionary of concept definitions, which are directly updatable as new information becomes available. Query images are identified through nearest neighbor comparison to the learned object definitions. The study presented in this paper evaluates its performance in re-identifying individuals as they move through a scene in both single-camera and multi-camera tracking applications. The results demonstrate that the Omni-Modeler shows potential for across-camera view pedestrian redetection and is highly effective for single-camera redetection with a 93% accuracy across 30 individuals using 64 example images for each individual.

Keywords: dynamic learning, few-shot learning, pedestrian redetection, visual recognition

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6854 Comparison Between Conventional Ultrafiltration Combined with Modified Ultrafiltration and Conventional Ultrafiltration Only for Adult Open-heart Surgery: Perspective from Systemic Inflammation, Vascular Resistance, and Cardiac Index

Authors: Ratna Farida Soenarto, Anas Alatas, Made Ryan Kharmayani

Abstract:

Background: Conventional ultrafiltration (CUF) system was shown to be helpful in reducing anti-inflammatory mediators for patients who underwent open heart surgery. Additionally, modified ultrafiltration (MUF) has been shown to reduce anti-inflammatory mediators further while reducing interstitial fluid volume at the same time. However, there has been minimal data concerning the efficacy of combining both ultrafiltration methods. This study aims to compare inflammation marker, vascular resistance, and cardiac index on CUF+MUF patients with CUF only patients undergoing open heart surgery. Method: This is a single blind randomized controlled trial on patients undergoing open heart surgery between June 2021 - October 2021 in CiptoMangunkusumo National Referral Hospital and Jakarta Heart Hospital. Patients wererandomized using block randomization into modified ultrafiltration following conventional ultrafiltration (CUF+MUF) and conventional ultrafiltration (CUF) only. Outcome assessed in this study were 24-hoursinterleukin-6 levels, systemic vascular resistance (SVR), pulmonary vascular resistance (PVR), and cardiac index. Results: A total of 38patients were included (19 CUF+MUF and 19 CUF subjects). There was no difference in postoperative IL-6 level between groups (p > 0.05).No difference in PVR was observed between groups.Higher difference in SVR was observed in CUF+MUF group (-646 vs. -261dyn/s/cm-5, p < 0.05). Higher cardiac index was observed on CUF+MUF group (0.93 vs. 0.48, p < 0.05). Conclusion: Patients undergoing open heart surgery with modified ultrafiltration following conventional ultrafiltration had similar systemic inflammatory response and better cardiac response than those having conventional ultrafiltration.

Keywords: open-heart, CUF, MUF, SVR, PVR, IL-6

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6853 Risk Assessment of Contamination by Heavy Metals in Sarcheshmeh Copper Complex of Iran Using Topsis Method

Authors: Hossein Hassani, Ali Rezaei

Abstract:

In recent years, the study of soil contamination problems surrounding mines and smelting plants has attracted some serious attention of the environmental experts. These elements due to the non- chemical disintegration and nature are counted as environmental stable and durable contaminants. Variability of these contaminants in the soil and the time and financial limitation for the favorable environmental application, in order to reduce the risk of their irreparable negative consequences on environment, caused to apply the favorable grading of these contaminant for the further success of the risk management processes. In this study, we use the contaminants factor risk indices, average concentration, enrichment factor and geoaccumulation indices for evaluating the metal contaminant of including Pb, Ni, Se, Mo and Zn in the soil of Sarcheshmeh copper mine area. For this purpose, 120 surface soil samples up to the depth of 30 cm have been provided from the study area. And the metals have been analyzed using ICP-MS method. Comparison of the heavy and potentially toxic elements concentration in the soil samples with the world average value of the uncontaminated soil and shale average indicates that the value of Zn, Pb, Ni, Se and Mo is higher than the world average value and only the Ni element shows the lower value than the shale average. Expert opinions on the relative importance of each indicators were used to assign a final weighting of the metals and the heavy metals were ranked using the TOPSIS approach. This allows us to carry out efficient environmental proceedings, leading to the reduction of environmental ricks form the contaminants. According to the results, Ni, Pb, Mo, Zn, and Se have the highest rate of risk contamination in the soil samples of the study area.

Keywords: contamination coefficient, geoaccumulation factor, TOPSIS techniques, Sarcheshmeh copper complex

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6852 Assessing Walkability in New Cities around Cairo

Authors: Lobna Ahmed Galal

Abstract:

Modal integration has given minimal consideration in cities of developing countries, as well as the declining dominance of public transport, and predominance of informal transport, the modal share of informal taxis in greater Cairo has increased from 6% in 1987 to 37% in 2001 and this has since risen even higher, informal and non-motorized modes of transport acting as a gap filler by feeding other modes of transport, not by design or choice, but often by lack of accessible and affordable public transport. Yet non-motorized transport is peripheral, with minimal priority in urban planning and investments, lacking of strong polices to support non-motorized transport, for authorities development is associated with technology and motorized transport, and promotion of non-motorized transport may be considered corresponding to development, as well as social stigma against non-motorized transport, as it is seen a travel mode for the poor. Cairo as a city of a developing country, has poor quality infrastructure for non-motorized transport, suffering from absence of dedicated corridors, and when existing they are often encroached for commercial purposes, widening traffic lanes at the expense of sidewalks, absence of footpaths, or being overcrowded, poor lighting, making walking unsafe and yet, lack of financial supply to such facilities as it is often considered beyond city capabilities. This paper will deal with the objective measuring of the built environment relating to walking, in some neighborhoods of new cities around Cairo, In addition to comparing the results of the objective measures of the built environment with the level of self-reported survey. The first paper's objective is to show how the index ‘walkability of community neighborhoods’ works in the contexts in neighborhoods of new cities around Cairo. The procedure of objective measuring is of a high potential to be carried out by using GIS.

Keywords: assessing, built environment, Cairo, walkability

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6851 Impact of a Novel Technique of S-Shaped Tracheostoma in Pediatric Tracheostomy in Intensive Care Unit on Success and Procedure Related Complications

Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

Abstract:

Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

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6850 Artificial Insemination of Bali Cattle with Frozen-Thawed Sexed Sperm Under District AI Station Conditions in Lombok: A Preliminary Trial

Authors: Chairussyuhur Arman, Totti Tjiptosumirat, Muhammad Gunawan, Mastur, Joko Priyono, Baiq Tri Ratna Erawati

Abstract:

The present study was undertaken to synchronize oestrus of bali cattle and artificially inseminated with frozen-thawed sexed-semen. The experiment was carried out at District AI Station. Four pluriparous cows and four nulliparous heifers were used in this study and they were housed in free stall barns. The heifers fed with corn silage supplemented with UMMB, while the cows fed with green fodder. All animals were given 500 mg cloprostenolum i.m. injections PGF2α twice, 11 days apart, to synchronize the occurrence of estrus. Estrus was detected by visual observation twice a day and determined if all cattle accepted mount from other females. All animals were inseminated twice with Bali sexed-semen at 72 and 76 h after observed oestrus. Results suggested that the percentage of calving rate either for pluriparous cows or nulliparous heifers were recorded to be 75 percent. One cow and one heifer did not produce calves because of embryonic lost. Regardless the sex of calves, the mean of birth weight of calves in cows was higher than that of heifers (18.50 ± 2.60 kg vs 13.83 ± 5.20 kg). One female calf from heifer with lower birth weight (8.0 kg) was dead one day after born. In pluriparous group, two cows delivered male calves and the other delivered female calf. Conversely in nulliparous group, two heifers delivered female calves and the other male calf. It is concluded that under the conditions of this preliminary trials, the sex ratio between pluriparous and nulliparous groups was found to be 50:50 (male:female).

Keywords: artificial insemination, bali cattle, calves, sexed sperm

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6849 Modeling Flow and Deposition Characteristics of Solid CO2 during Choked Flow of CO2 Pipeline in CCS

Authors: Teng lin, Li Yuxing, Han Hui, Zhao Pengfei, Zhang Datong

Abstract:

With the development of carbon capture and storage (CCS), the flow assurance of CO2 transportation becomes more important, particularly for supercritical CO2 pipelines. The relieving system using the choke valve is applied to control the pressure in CO2 pipeline. However, the temperature of fluid would drop rapidly because of Joule-Thomson cooling (JTC), which may cause solid CO2 form and block the pipe. In this paper, a Computational Fluid Dynamic (CFD) model, using the modified Lagrangian method, Reynold's Stress Transport model (RSM) for turbulence and stochastic tracking model (STM) for particle trajectory, was developed to predict the deposition characteristic of solid carbon dioxide. The model predictions were in good agreement with the experiment data published in the literature. It can be observed that the particle distribution affected the deposition behavior. In the region of the sudden expansion, the smaller particles accumulated tightly on the wall were dominant for pipe blockage. On the contrary, the size of solid CO2 particles deposited near the outlet usually was bigger and the stacked structure was looser. According to the calculation results, the movement of the particles can be regarded as the main four types: turbulent motion close to the sudden expansion structure, balanced motion at sudden expansion-middle region, inertial motion near the outlet and the escape. Furthermore the particle deposits accumulated primarily in the sudden expansion region, reattachment region and outlet region because of the four type of motion. Also the Stokes number had an effect on the deposition ratio and it is recommended for Stokes number to avoid 3-8St.

Keywords: carbon capture and storage, carbon dioxide pipeline, gas-particle flow, deposition

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6848 Effects of Intracerebroventricular Injection of Spexin and Its Interaction with Nitric Oxide, Serotonin, and Corticotropin Receptors on Central Food Intake Regulation in Chicken

Authors: Mohaya Farzin, Shahin Hassanpour, Morteza Zendehdel, Bita Vazir, Ahmad Asghari

Abstract:

Aim: There are several differences between birds and mammals in terms of food intake regulation. Therefore, this study aimed to investigate the effects of the intracerebroventricular (ICV) injection of spexin and its interaction with nitric oxide, serotonin, and corticotropin receptors on central food intake regulation in broiler chickens. Materials and Methods: In experiment 1, chickens received ICV injection of saline, PCPA (p-chlorophenyl alanine,1.25 µg), spexin, and PCPA+spexin. In experiments 2-7, 8-OH-DPAT (5-HT1A agonist, 15.25 nmol), SB-242084 (5-HT2C receptor antagonist, 1.5µg), L-arginine (Precursor of nitric oxide, 200 nmol), L-NAME (nitric oxide synthetase inhibitor, 100 nmol), Astressin-B (CRF1/CRF2 receptor antagonist, 30 µg) and Astressin2-B (CRF2 receptor antagonist, 30 µg) were injected to chickens instead of the PCPA. Then, food intake was measured until 120 minutes after the injection. Results: Spexin significantly decreased food consumption (P<0.05). Concomitant injection of SB-242084+spexin attenuated spexin-induced hypophagia (P<0.05). Co-injection of L-arginine+spexin enhanced spexin-induced hypophagia, and this effect was reversed by L-NAME (P<0.05). Also, concomitant injection of Astressin-B + spexin or Astressin2-B + spexin enhanced spexin-induced hypophagia (P<0.05). Conclusions: Based on these observations, spexin-induced hypophagia may be mediated by nitric oxide and 5-HT2C, CRF1, and CRF2 receptors in neonatal broiler chickens.

Keywords: spexin, serotonin, corticotropin, nitric oxide, food intake, chicken

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6847 An Amended Method for Assessment of Hypertrophic Scars Viscoelastic Parameters

Authors: Iveta Bryjova

Abstract:

Recording of viscoelastic strain-vs-time curves with the aid of the suction method and a follow-up analysis, resulting into evaluation of standard viscoelastic parameters, is a significant technique for non-invasive contact diagnostics of mechanical properties of skin and assessment of its conditions, particularly in acute burns, hypertrophic scarring (the most common complication of burn trauma) and reconstructive surgery. For elimination of the skin thickness contribution, usable viscoelastic parameters deduced from the strain-vs-time curves are restricted to the relative ones (i.e. those expressed as a ratio of two dimensional parameters), like grosselasticity, net-elasticity, biological elasticity or Qu’s area parameters, in literature and practice conventionally referred to as R2, R5, R6, R7, Q1, Q2, and Q3. With the exception of parameters R2 and Q1, the remaining ones substantially depend on the position of inflection point separating the elastic linear and viscoelastic segments of the strain-vs-time curve. The standard algorithm implemented in commercially available devices relies heavily on the experimental fact that the inflection time comes about 0.1 sec after the suction switch-on/off, which depreciates credibility of parameters thus obtained. Although the Qu’s US 7,556,605 patent suggests a method of improving the precision of the inflection determination, there is still room for nonnegligible improving. In this contribution, a novel method of inflection point determination utilizing the advantageous properties of the Savitzky–Golay filtering is presented. The method allows computation of derivatives of smoothed strain-vs-time curve, more exact location of inflection and consequently more reliable values of aforementioned viscoelastic parameters. An improved applicability of the five inflection-dependent relative viscoelastic parameters is demonstrated by recasting a former study under the new method, and by comparing its results with those provided by the methods that have been used so far.

Keywords: Savitzky–Golay filter, scarring, skin, viscoelasticity

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6846 Hip Resurfacing Makes for Easier Surgery with Better Functional Outcomes at Time of Revision: A Case Controlled Study

Authors: O. O. Onafowokan, K. Anderson, M. R. Norton, R. G. Middleton

Abstract:

Revision total hip arthroplasty (THA) is known to be a challenging procedure with potential for poor outcomes. Due to its lack of metaphyseal encroachment, hip resurfacing arthroplasty (HRA) is classified as a bone conserving procedure. Although the literature postulates that this is an advantage at time of revision surgery, there is no evidence to either support or refute this claim. We identified 129 hips that had undergone HRA and 129 controls undergoing first revision THA. We recorded the clinical assessment and survivorship of implants in a multi-surgeon, single centre, retrospective case control series for both arms. These were matched for age and sex. Data collected included demographics, indications for surgery, Oxford Hip Score (OHS), length of surgery, length of hospital stay, blood transfusion, implant complexity and further surgical procedures. Significance was taken as p < 0.05. Mean follow up was 7.5 years (1 to 15). There was a significant 6 point difference in postoperative OHS in favour of the revision resurfacing group (p=0.0001). The revision HRA group recorded 48 minutes less length of surgery (p<0.0001), 2 days less in length of hospital stay (p=0.018), a reduced need for blood transfusion (p=0.0001), a need for less complexity in revision implants (p=0.001) and a reduced probability of further surgery being required (P=0.003). Whilst we acknowledge the limitations of this study our results suggest that, in contrast to THA, the bone conservation element of HRA may make for a less traumatic revision procedure with better functional outcomes. Use of HRA has seen a dramatic decline as a result of concerns regarding metallosis. However, this information remains of relevance when counselling young active patients about their arthroplasty options and may become pertinent in the future if the promise of ceramic hip resurfacing is ever realized.

Keywords: hip resurfacing, metallosis, revision surgery, total hip arthroplasty

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6845 Healthcare Workers’ Knowledge and Attitude Toward Telemedicine During the COVID-19 Pandemic: A Global Survey

Authors: Saman Naqvi

Abstract:

Introduction: Telemedicine is the practise of providing remote healthcare to patients via the utilisation of communication technologies. Its application has become increasingly important since the Coronavirus Disease 2019 (COVID-19) pandemic. It is essential to determine the knowledge and attitudes of healthcare professionals concerning its use in order to maximise its application. Purpose: We aim to examine and evaluate the current understanding and perceptions of medical staff toward the use of telemedicine. Methods: In this cross-sectional study, we surveyed 1091 healthcare professionals worldwide. Following an extensive review of the literature, data were gathered using a questionnaire. To depict the participant profile, frequency, percentages, and cumulative percentages were determined. Results: The majority of respondents had either heard of (90.9%), seen (65.3%), or were familiar with (74.6%) how telemedicine is implemented in practice. 72.2% of people were familiar with the tools that could be applied to this technology. Those with a medical degree and experience of under five years were found to be more familiar with telemedicine. Additionally, opinions on providing healthcare remotely were largely favorable, with 80% of respondents stating that it reduced staff burden and 80.6% thinking that it eliminated unnecessary transportation costs. Furthermore, 83% expressed that it saves clinicians' time. However, 20% of participants believed telemedicine adds to staff workload and 40% of healthcare professionals felt it compromises patient privacy and information confidentiality. Conclusion: Despite being a new and developing practice in many countries, telemedicine appears to have a bright future. This is crucial during a pandemic as it provides effective healthcare while maintaining social isolation measures. Moreover, the majority of the participants in this study demonstrated a good understanding and a favorable attitude toward telemedicine.

Keywords: healthcare system, global survey, knowledge, attitude, covid 19, telemedicine

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6844 The Population Death Model and Influencing Factors from the Data of The "Sixth Census": Zhangwan District Case Study

Authors: Zhou Shangcheng, Yi Sicen

Abstract:

Objective: To understand the mortality patterns of Zhangwan District in 2010 and provide the basis for the development of scientific and rational health policy. Methods: Data are collected from the Sixth Census of Zhangwan District and disease surveillance system. The statistical analysis include death difference between age, gender, region and time and the related factors. Methods developed for the Global Burden of Disease (GBD) Study by the World Bank and World Health Organization (WHO) were adapted and applied to Zhangwan District population health data. DALY rate per 1,000 was calculated for varied causes of death. SPSS 16 is used by statistic analysis. Results: From the data of death population of Zhangwan District we know the crude mortality rate was 6.03 ‰. There are significant differences of mortality rate in male and female population which was respectively 7.37 ‰ and 4.68 ‰. 0 age group population life expectancy in Zhangwan District in 2010 was 78.40 years old(Male 75.93, Female 81.03). The five leading causes of YLL in descending order were: cardiovascular diseases(42.63DALY/1000), malignant neoplasm (23.73DALY/1000), unintentional injuries (5.84DALY/1000), Respiratory diseases(5.43 DALY/1000), Respiratory infections (2.44DALY/1000). In addition, there are strong relation between the marital status , educational level and mortality in some to a certain extend. Conclusion Zhangwan District, as city level, is at lower mortality levels. The mortality of the total population of Zhangwan District has a downward trend and life expectancy is rising.

Keywords: sixth census, Zhangwan district, death level differences, influencing factors, cause of death

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6843 Electrospun Fibers Made from Biopolymers (Cellulose Acetate/Chitosan) for Metals Recovery

Authors: Mauricio Gómez, Esmeralda López, Ian Becar, Jaime Pizarro, Paula A. Zapata

Abstract:

A biodegradable material is developed with adsorptive capacity for metals ion for intended use in mining tailings mitigating the environmental impact with economic retribution, two types of fibers were elaborated by electrospinning: (1) a cellulose acetate (CA) matrix and (2) a cellulose acetate (CA)/chitosan (CH) matrix evaluating the effect of CH in CA on its physicochemical properties. Through diffuse reflectance infrared fourier transform spectroscopy (DRIFTS) the incorporation of chitosan in the matrix was identified, observing the band of the amino group at 1500 - 1600 [cm-1]. By scanning electron microscopy (SEM), Hg porosimetry, and CO2 isotherm at 273 [K], the intrafiber microporosity and interfiber macroporosity were identified, with an increase in the distribution of macropores for CA/CH fibers. In the tensile test, CH into the matrix produces a more ductile and tenacious behavior, where the % elongation at break increased by 33% with the other parameters constant. Thermal analysis by differential scanning calorimetry (DSC) and Thermogravimetric Analysis (TGA) showed that the incorporation of chitosan produces higher retention of water molecules due to the functional groups (amino groups (- NH3)), but there is a decrease in the specific heat and thermoplastic properties of the matrix since the glass transition temperature and softening temperature disappear. The effect of the optimum pH for CA and CA/CH fibers were studied in a batch system. In the adsorption kinetic study, the best isotherm model adapted to the experimental results corresponds to the Sips model and the kinetics corresponds to pseudo-second order

Keywords: environmental materials, wastewater treatment, electrospun fibers, biopolymers (cellulose acetate/chitosan), metals recovery

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6842 Short-Term Forecast of Wind Turbine Production with Machine Learning Methods: Direct Approach and Indirect Approach

Authors: Mamadou Dione, Eric Matzner-lober, Philippe Alexandre

Abstract:

The Energy Transition Act defined by the French State has precise implications on Renewable Energies, in particular on its remuneration mechanism. Until then, a purchase obligation contract permitted the sale of wind-generated electricity at a fixed rate. Tomorrow, it will be necessary to sell this electricity on the Market (at variable rates) before obtaining additional compensation intended to reduce the risk. This sale on the market requires to announce in advance (about 48 hours before) the production that will be delivered on the network, so to be able to predict (in the short term) this production. The fundamental problem remains the variability of the Wind accentuated by the geographical situation. The objective of the project is to provide, every day, short-term forecasts (48-hour horizon) of wind production using weather data. The predictions of the GFS model and those of the ECMWF model are used as explanatory variables. The variable to be predicted is the production of a wind farm. We do two approaches: a direct approach that predicts wind generation directly from weather data, and an integrated approach that estimâtes wind from weather data and converts it into wind power by power curves. We used machine learning techniques to predict this production. The models tested are random forests, CART + Bagging, CART + Boosting, SVM (Support Vector Machine). The application is made on a wind farm of 22MW (11 wind turbines) of the Compagnie du Vent (that became Engie Green France). Our results are very conclusive compared to the literature.

Keywords: forecast aggregation, machine learning, spatio-temporal dynamics modeling, wind power forcast

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6841 Series Network-Structured Inverse Models of Data Envelopment Analysis: Pitfalls and Solutions

Authors: Zohreh Moghaddas, Morteza Yazdani, Farhad Hosseinzadeh

Abstract:

Nowadays, data envelopment analysis (DEA) models featuring network structures have gained widespread usage for evaluating the performance of production systems and activities (Decision-Making Units (DMUs)) across diverse fields. By examining the relationships between the internal stages of the network, these models offer valuable insights to managers and decision-makers regarding the performance of each stage and its impact on the overall network. To further empower system decision-makers, the inverse data envelopment analysis (IDEA) model has been introduced. This model allows the estimation of crucial information for estimating parameters while keeping the efficiency score unchanged or improved, enabling analysis of the sensitivity of system inputs or outputs according to managers' preferences. This empowers managers to apply their preferences and policies on resources, such as inputs and outputs, and analyze various aspects like production, resource allocation processes, and resource efficiency enhancement within the system. The results obtained can be instrumental in making informed decisions in the future. The top result of this study is an analysis of infeasibility and incorrect estimation that may arise in the theory and application of the inverse model of data envelopment analysis with network structures. By addressing these pitfalls, novel protocols are proposed to circumvent these shortcomings effectively. Subsequently, several theoretical and applied problems are examined and resolved through insightful case studies.

Keywords: inverse models of data envelopment analysis, series network, estimation of inputs and outputs, efficiency, resource allocation, sensitivity analysis, infeasibility

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6840 The Effects of an Exercise Program Integrated with the Transtheoretical Model on Pain and Trunk Muscle Endurance of Rice Farmers with Chronic Low Back Pain

Authors: Thanakorn Thanawat, Nomjit Nualnetr

Abstract:

Background and Purpose: In Thailand, rice farmers have the most prevalence of low back pain when compared with other manual workers. Exercises have been suggested to be a principal part of treatment programs for low back pain. However, the programs should be tailored to an individual’s readiness to change categorized by a behavioral approach. This study aimed to evaluate a difference between the responses of rice farmers with chronic low back pain who received an exercise program integrated with the transtheoretical model of behavior change (TTM) and those of the comparison group regarding severity of pain and trunk muscle endurance. Materials and Methods: An 8-week exercise program was conducted to rice farmers with chronic low back pain who were randomized to either the TTM (n=62, 52 woman and 10 men, mean age ± SD 45.0±5.4 years) or non-TTM (n=64, 53 woman and 11 men, mean age ± SD 44.7±5.4 years) groups. All participants were tested for their severity of pain and trunk (abdominal and back) muscle endurance at baseline (week 0) and immediately after termination of the program (week 8). Data were analysed by using descriptive statistics and student’s t-tests. The results revealed that both TTM and non-TTM groups could decrease their severity of pain and improve trunk muscle endurance after participating in the 8-week exercise program. When compared with the non-TTM group, however, the TTM showed a significantly greater increase in abdominal muscle endurance than did the non-TTM (P=0.004, 95% CI -12.4 to -2.3). Conclusions and Clinical Relevance: An exercise program integrated with the TTM could provide benefits to rice farmers with chronic low back pain. Future studies with a longitudinal design and more outcome measures such as physical performance and quality of life are suggested to reveal further benefits of the program.

Keywords: chronic low back pain, transtheoretical model, rice farmers, exercise program

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6839 Preventive Behaviors of Exposure to ‎Secondhand Smoke among Women: A Study Based on the Health Belief Model

Authors: Arezoo Fallahi

Abstract:

Introduction: Exposure to second-hand smoke is an important global health problem and threatens the health of people, especially children and women. The aim of this study was to determine the effect of education based on the Health Belief Model on preventive behaviors of exposure to secondhand smoke in women. Materials and Methods: This experimental study was performed in 2023in Sanandaj, west of Iran. Seventy-four people were selected by simple random sampling and divided into an intervention group (37 people) and a control group (37 people). Data collection tools included demographic characteristics and a second-hand smoke exposure questionnaire based on the Health Beliefs Model. The training in the intervention group was conducted in three one-hour sessions in the comprehensive health service centers in the form of lectures, pamphlets, and group discussions. Data were analyzed using SPSS software version 21 and statistical tests such as correlation, paired t-test, and independent t-test. Results: The intervention and control groups were homogeneous before education. They were similar in terms of mean scores of the Health Belief Model. However, after an educational intervention, some of the scores increased, including the mean perceived sensitivity score (from 17.62±2.86 to 19.75±1.23), perceived severity score (28.40±4.45 to 31.64±2), perceived benefits score (27.27±4.89 to 31.94±2.17), practice score (32.64±4.68 to 36.91±2.32) perceived barriers from 26.62±5.16 to 31.29±3.34, guide for external action (from 17.70±3.99 to 22/89 ±1.67), guide for internal action from (16.59±2.95 to 1.03±18.75), and self-efficacy (from 19.83 ±3.99 to 23.37±1.43) (P <0.05). Conclusion: The educational intervention designed based on the Health Belief Model in women was effective in performing preventive behaviors against exposure to secondhand smoke.

Keywords: women, health behaviour, smoke, belive

Procedia PDF Downloads 43
6838 The Impact of Continuous Exercise on Depression Levels Among Young Female Athletes in Hamadan Province, Iran

Authors: Mahboubeh Varmaziar

Abstract:

Depression is a significant public health concern affecting people of all ages and genders. Physical activity has been shown to have a positive effect on mental health, particularly in alleviating symptoms of depression. This study aims to explore the impact of continuous exercise on depression levels among young female athletes in Hamadan Province, Iran. In this randomized controlled trial, 72 women aged 20 to 35 years attending sports centers in Hamadan Province were selected through convenient sampling and randomly assigned to either the control or experimental group. The experimental group participated in a continuous exercise program consisting of 20 sessions over six weeks, with each session lasting 30 minutes. In contrast, the control group maintained their usual daily activities at the sports center. Both groups completed demographic and Beck Depression Inventory questionnaires. Data were analyzed using descriptive and inferential statistics, including two-way ANOVA. The results of the two-way ANOVA, after controlling for the pre-test effect, revealed a significant difference in the mean depression scores between the control and experimental groups (p < 0.001). This suggests that the continuous exercise program significantly reduced depression levels in the young female athletes. The findings suggest that continuous exercise is an effective non-pharmacological intervention for reducing depression in young female athletes. Incorporating regular physical activity into treatment plans may serve as a complementary therapy alongside conventional treatments, offering a low-risk and beneficial approach to managing depression.

Keywords: depression, exercise, female athletes, yong women

Procedia PDF Downloads 36
6837 Qualitative Profiling Model and Competencies Evaluation to Fighting Unemployment

Authors: Francesca Carta, Giovanna Linfante, Laura Agneni, Debora Radicchia, Camilla Micheletta, Angelo Del Cimmuto

Abstract:

Overtaking competence mismatches and fostering career pathways congruent with the individual skills profile would significantly contribute to fighting unemployment. The aim of this paper is to examine the usefulness and efficiency of qualitative tools in supporting and improving the quality of caseworkers’ activities during the jobseekers’ profile analysis and career guidance process. The selected target groups are long-term and middle term unemployed, job seekers, young people at the end of the vocational training pathway and unemployed woman with social disadvantages. The experimentation is conducted in Italy at public employment services in 2017. In the framework of Italian labour market reform, the experimentation represents the first step to develop a customized qualitative model profiling; the final general object is to improve the public employment services quality. The experimentation tests the transferability of an OECD self-assessment competences tool in the Italian public employment services. On one hand, the first analysis results will indicate the user’s perception concerning the tool’s application and their different competence levels (literacy, numeracy, problem solving, career interest, subjective well-being and health, behavioural competencies) with reference to the specific target. On the other hand, the experimentation outcomes will show caseworkers understanding regarding the tool’s usability and efficiency for career guidance and reskilling and upskilling programs.

Keywords: career guidance, evaluation competences, reskilling pathway, unemployment

Procedia PDF Downloads 302
6836 Cultural Reflection within Contemporary Residential Interior in India

Authors: Icy Vinod Sanghvi

Abstract:

In the light of rising modernism within the residential design industry, a significant growth of the western concepts of maximalism or minimalism is observed in the Indian housings. Although dynamism in design styles is natural due to the constant emergence of new innovations, it is imperative that local houses reflect cultural identity. This paper highlights the importance of ‘Indian Modernism’, and how to incorporate the same in residential design. Thus, helping the Indian culture to flourish and become a significant part of housing design in the future. A literature review was conducted to analyze and derive effective methods to build cultural value whilst catering to the urban and contemporary design industry. Alongside, a questionnaire survey was conducted to observe how the local houses are designed and to understand the preferences of people with regards to the design styles incorporated in their homes. In addition, their opinions on the excessive use of contemporary styles in home designs was recorded. The results of the same provided a better understanding of the local audience, their demands, and their willingness to adapt to contemporary designs. Studying color, materials, ornamentation, symbolism, detail, and structure offers an in-depth understanding of the essence of traditional Indian homes. These variables further provided effective solutions for design ideation and mockups for efficient traditional yet contemporary spaces. Design interventions like these can build a revolutionary set of practices that involve creating a balance between contemporary and traditional styles. The emergence of this synergy will not only make contemporary homes communicative but also allow India to compete within the global residential architecture industry with a strong foundation of its rich heritage.

Keywords: balance, contemporary design, cultural identity, Indian modernism

Procedia PDF Downloads 134
6835 Agent-Based Modeling to Simulate the Dynamics of Health Insurance Markets

Authors: Haripriya Chakraborty

Abstract:

The healthcare system in the United States is considered to be one of the most inefficient and expensive systems when compared to other developed countries. Consequently, there are persistent concerns regarding the overall functioning of this system. For instance, the large number of uninsured individuals and high premiums are pressing issues that are shown to have a negative effect on health outcomes with possible life-threatening consequences. The Affordable Care Act (ACA), which was signed into law in 2010, was aimed at improving some of these inefficiencies. This paper aims at providing a computational mechanism to examine some of these inefficiencies and the effects that policy proposals may have on reducing these inefficiencies. Agent-based modeling is an invaluable tool that provides a flexible framework to model complex systems. It can provide an important perspective into the nature of some interactions that occur and how the benefits of these interactions are allocated. In this paper, we propose a novel and versatile agent-based model with realistic assumptions to simulate the dynamics of a health insurance marketplace that contains a mixture of private and public insurers and individuals. We use this model to analyze the characteristics, motivations, payoffs, and strategies of these agents. In addition, we examine the effects of certain policies, including some of the provisions of the ACA, aimed at reducing the uninsured rate and the cost of premiums to move closer to a system that is more equitable and improves health outcomes for the general population. Our test results confirm the usefulness of our agent-based model in studying this complicated issue and suggest some implications for public policies aimed at healthcare reform.

Keywords: agent-based modeling, healthcare reform, insurance markets, public policy

Procedia PDF Downloads 127
6834 Removal of Lead Ions from Aqueous Medium Using Devised Column Filters Packed with Chitosan from Trash Crab Shells: A Characterization Study

Authors: Charles Klein O. Gorit, Mark Tristan J. Quimque Jr., M. Cecilia V. Almeda, Concepcion M. Salvana

Abstract:

Chitosan is a promising biopolymer commonly found in crustacean shells that has plausible effects in water purification and wastewater treatment. It is a primary derivative of chitin and considered second of the most abundant biopolymer prior to cellulose. Morphological analysis had been done using Scanning Electron Microscopy with Energy Dispersive Microscopy (SEM/EDS), and due to its porous nature, it showcases a certain degree of porosity, hence, larger adsorption site of heavy metal. The Energy Dispersive Spectroscopy of the chitosan and ‘lead-bound’ chitosan, shows a relative increase of percent abundance of lead cation from 1.44% to 2.08% hence, adsorption occurs. Chitosan, as a nitrogenous polysaccharide, subjected to Fourier transform infrared spectroscopy (FTIR) analysis shows amide bands ranging from 1635.36 cm⁻¹ for amide 1 band and 1558.40 cm-1 for amide 2 band with NH stretching. For ‘lead-bound’ chitosan, the FT-IR analysis shows a change in peaks upon adsorption of Pb(II) cation. The spectrum shows broadening of OH and NH stretching band. Such observation can be attributed to the probability that the attachment of Pb(II) ions is in these functional groups. A column filter was devised with lead-bound chitosan to determine the zero point charge (pHzpc) of the biopolymer. The results show that at pH 8.34, below than the zpc level of literatures cited for lead which ranges from pH 4 to 7, favors the adsorption site of chitosan and its capability to adsorb traces amount of aqueous lead.

Keywords: chitosan, biopolymer, FT-IR, SEM, zero-point charge, heavy metal, lead ions

Procedia PDF Downloads 146
6833 Effects of Dietary Protein and Lipid Levels on Growth and Body Composition of Juvenile Fancy Carp, Cyprinus carpio var. Koi

Authors: Jin Choi, Zahra Aminikhoei, Yi-Oh Kim, Sang-Min Lee

Abstract:

A 4 × 2 factorial experiment was conducted to determine the optimum dietary protein and lipid levels for juvenile fancy carp, Cyprinus carpio var. koi. Eight experimental diets were formulated to contain four protein levels (200, 300, 400, and 500 g kg-1) with two lipid levels (70 and 140 g kg-1). Triplicate groups of fish (initial weight, 12.1±0.2 g fish-1) were hand-fed the diets to apparent satiation for 8 weeks. Weight gain, daily feed intake, feed efficiency ratio and protein efficiency ratio were significantly (P < 0.0001) affected by dietary protein level, but not by dietary lipid level (P > 0.05). Weight gain and feed efficiency ratio tended to increase as dietary protein level increased up to 400 and 500 g kg-1, respectively. Daily feed intake of fish decreased with increasing dietary protein level and that of fish fed diet contained 500 g kg-1 protein was significantly lower than other fish groups. The protein efficiency ratio of fish fed 400 and 500 g kg-1 protein was lower than that of fish fed 200 and 300 g kg-1 protein. Moisture, crude protein and crude lipid contents of muscle and liver were significantly affected by dietary protein, but not by dietary lipid level (P > 0.05). The increase in dietary lipid level resulted in an increase in linoleic acid in liver and muscle paralleled with a decrease in n-3 highly unsaturated fatty acids content in muscle of fish. In considering these results, it was concluded that the diet containing 400 g kg-1 protein with 70 g kg-1 lipid level is optimal for growth and efficient feed utilization of juvenile fancy carp.

Keywords: fancy carp, dietary protein, dietary lipid, Cyprinus carpio, fatty acid

Procedia PDF Downloads 393
6832 Accounting and Prudential Standards of Banks and Insurance Companies in EU: What Stakes for Long Term Investment?

Authors: Sandra Rigot, Samira Demaria, Frederic Lemaire

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The starting point of this research is the contemporary capitalist paradox: there is a real scarcity of long term investment despite the boom of potential long term investors. This gap represents a major challenge: there are important needs for long term financing in developed and emerging countries in strategic sectors such as energy, transport infrastructure, information and communication networks. Moreover, the recent financial and sovereign debt crises, which have respectively reduced the ability of financial banking intermediaries and governments to provide long term financing, questions the identity of the actors able to provide long term financing, their methods of financing and the most appropriate forms of intermediation. The issue of long term financing is deemed to be very important by the EU Commission, as it issued a 2013 Green Paper (GP) on long-term financing of the EU economy. Among other topics, the paper discusses the impact of the recent regulatory reforms on long-term investment, both in terms of accounting (in particular fair value) and prudential standards for banks. For banks, prudential and accounting standards are also crucial. Fair value is indeed well adapted to the trading book in a short term view, but this method hardly suits for a medium and long term portfolio. Banks’ ability to finance the economy and long term projects depends on their ability to distribute credit and the way credit is valued (fair value or amortised cost) leads to different banking strategies. Furthermore, in the banking industry, accounting standards are directly connected to the prudential standards, as the regulatory requirements of Basel III use accounting figures with prudential filter to define the needs for capital and to compute regulatory ratios. The objective of these regulatory requirements is to prevent insolvency and financial instability. In the same time, they can represent regulatory constraints to long term investing. The balance between financial stability and the need to stimulate long term financing is a key question raised by the EU GP. Does fair value accounting contributes to short-termism in the investment behaviour? Should prudential rules be “appropriately calibrated” and “progressively implemented” not to prevent banks from providing long-term financing? These issues raised by the EU GP lead us to question to what extent the main regulatory requirements incite or constrain banks to finance long term projects. To that purpose, we study the 292 responses received by the EU Commission during the public consultation. We analyze these contributions focusing on particular questions related to fair value accounting and prudential norms. We conduct a two stage content analysis of the responses. First, we proceed to a qualitative coding to identify arguments of respondents and subsequently we run a quantitative coding in order to conduct statistical analyses. This paper provides a better understanding of the position that a large panel of European stakeholders have on these issues. Moreover, it adds to the debate on fair value accounting and its effects on prudential requirements for banks. This analysis allows us to identify some short term bias in banking regulation.

Keywords: basel 3, fair value, securitization, long term investment, banks, insurers

Procedia PDF Downloads 279
6831 Prevalence of Human Papillomavirus in Squamous Intraepithelial Lesions and Cervical Cancer in Women of the North of Chihuahua, Mexico

Authors: Estefania Ponce-Amaya, Ana Lidia Arellano-Ortiz, Cecilia Diaz-Hernandez, Jose Alberto Lopez-Diaz, Antonio De La Mora-Covarrubias, Claudia Lucia Vargas-Requena, Mauricio Salcedo-Vargas, Florinda Jimenez-Vega

Abstract:

Cervical Cancer (CC) is the second leading cause of death among women worldwide and it had been associated with a persistent infection of human papillomavirus (HPV). The goal of the current study was to identify the prevalence of HPV infection in women with abnormal Pap smear who were attended at Dysplasia Clinic of Ciudad Juarez, Mexico. Methods: Cervical samples from 146 patients, who attended the Colposcopy Clinic at Sanitary Jurisdiction II of Cd Juarez, were collected for histopathology and molecular study. DNA was isolated for the HPV detection by Polymerase Chain Reaction (PCR) using MY09/011 and GP5/6 primers. The associated risk factors were assessed by a questionnaire. The statistical analysis was performed by ANOVA, using EpiINFO V7 software. Results: HPV infection was present in 142 patients (97.3 %). The prevalence of HPV infection was distributed in a 96% of all evaluated groups, low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HISIL) and CC. We found a statistical significance (α = <0.05) between gestation and number of births as risk factors. The median values showed an ascending tend according with the lesion progression. However, CC showed a statistically significant difference with respect to the pre-carcinogenic stages. Conclusions: In these Mexican patients exists a high prevalence of HPV infection, and for that reason, we are studying the most prevalent HPV genotypes in this population.

Keywords: cervical cancer, HPV, prevalence hpv, squamous intraepithelial lesion

Procedia PDF Downloads 309
6830 Association between Severe Acidemia before Endotracheal Intubation and the Lower First Attempt Intubation Success Rate

Authors: Keiko Naito, Y. Nakashima, S. Yamauchi, Y. Kunitani, Y. Ishigami, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

Abstract:

Background: A presence of severe acidemia, defined as pH < 7.2, is common during endotracheal intubation for critically ill patients in the emergency department (ED). Severe acidemia is widely recognized as a predisposing factor for intubation failure. However, it is unclear that acidemic condition itself actually makes endotracheal intubation more difficult. We aimed to evaluate if a presence of severe acidemia before intubation is associated with the lower first attempt intubation success rate in the ED. Methods: This is a retrospective observational cohort study in the ED of an urban hospital in Japan. The collected data included patient demographics, such as age, sex, and body mass index, presence of one or more factors of modified LEMON criteria for predicting difficult intubation, reasons for intubation, blood gas levels, airway equipment, intubation by emergency physician or not, and the use of the rapid sequence intubation technique. Those with any of the following were excluded from the analysis: (1) no blood gas drawn before intubation, (2) cardiopulmonary arrest, and (3) under 18 years of age. The primary outcome was the first attempt intubation success rates between a severe acidemic patients (SA) group and a non-severe acidemic patients (NA) group. Logistic regression analysis was used to test the first attempt success rates for intubations between those two groups. Results: Over 5 years, a total of 486 intubations were performed; 105 in the SA group and 381 in the NA group. The univariate analysis showed that the first attempt intubation success rate was lower in the SA group than in the NA group (71.4% vs 83.5%, p < 0.01). The multivariate logistic regression analysis identified that severe acidemia was significantly associated with the first attempt intubation failure (OR 1.9, 95% CI 1.03-3.68, p = 0.04). Conclusions: A presence of severe acidemia before endotracheal intubation lowers the first attempt intubation success rate in the ED.

Keywords: acidemia, airway management, endotracheal intubation, first-attempt intubation success rate

Procedia PDF Downloads 239
6829 Artificial Cells Capable of Communication by Using Polymer Hydrogel

Authors: Qi Liu, Jiqin Yao, Xiaohu Zhou, Bo Zheng

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The first artificial cell was produced by Thomas Chang in the 1950s when he was trying to make a mimic of red blood cells. Since then, many different types of artificial cells have been constructed from one of the two approaches: a so-called bottom-up approach, which aims to create a cell from scratch, and a top-down approach, in which genes are sequentially knocked out from organisms until only the minimal genome required for sustaining life remains. In this project, bottom-up approach was used to build a new cell-free expression system which mimics artificial cell that capable of protein expression and communicate with each other. The artificial cells constructed from the bottom-up approach are usually lipid vesicles, polymersomes, hydrogels or aqueous droplets containing the nucleic acids and transcription-translation machinery. However, lipid vesicles based artificial cells capable of communication present several issues in the cell communication research: (1) The lipid vesicles normally lose the important functions such as protein expression within a few hours. (2) The lipid membrane allows the permeation of only small molecules and limits the types of molecules that can be sensed and released to the surrounding environment for chemical communication; (3) The lipid vesicles are prone to rupture due to the imbalance of the osmotic pressure. To address these issues, the hydrogel-based artificial cells were constructed in this work. To construct the artificial cell, polyacrylamide hydrogel was functionalized with Acrylate PEG Succinimidyl Carboxymethyl Ester (ACLT-PEG2000-SCM) moiety on the polymer backbone. The proteinaceous factors can then be immobilized on the polymer backbone by the reaction between primary amines of proteins and N-hydroxysuccinimide esters (NHS esters) of ACLT-PEG2000-SCM, the plasmid template and ribosome were encapsulated inside the hydrogel particles. Because the artificial cell could continuously express protein with the supply of nutrients and energy, the artificial cell-artificial cell communication and artificial cell-natural cell communication could be achieved by combining the artificial cell vector with designed plasmids. The plasmids were designed referring to the quorum sensing (QS) system of bacteria, which largely relied on cognate acyl-homoserine lactone (AHL) / transcription pairs. In one communication pair, “sender” is the artificial cell or natural cell that can produce AHL signal molecule by synthesizing the corresponding signal synthase that catalyzed the conversion of S-adenosyl-L-methionine (SAM) into AHL, while the “receiver” is the artificial cell or natural cell that can sense the quorum sensing signaling molecule form “sender” and in turn express the gene of interest. In the experiment, GFP was first immobilized inside the hydrogel particle to prove that the functionalized hydrogel particles could be used for protein binding. After that, the successful communication between artificial cell-artificial cell and artificial cell-natural cell was demonstrated, the successful signal between artificial cell-artificial cell or artificial cell-natural cell could be observed by recording the fluorescence signal increase. The hydrogel-based artificial cell designed in this work can help to study the complex communication system in bacteria, it can also be further developed for therapeutic applications.

Keywords: artificial cell, cell-free system, gene circuit, synthetic biology

Procedia PDF Downloads 137
6828 Quality of Bali Beef and Broiler after Immersion in Liquid Smoke on Different Concentrations and Storage Times

Authors: E. Abustam, M. Yusuf, H. M. Ali, M. I. Said, F. N. Yuliati

Abstract:

The aim of this study was to improve the durability and quality of Bali beef (M. Longissimus dorsi) and broiler carcass through the addition of liquid smoke as a natural preservative. This study was using Longissimus dorsi muscle from male Bali beef aged 3 years, broiler breast and thigh aged 40 days. Three types of meat were marinated in liquid smoke with concentrations of 0, 5, and 10% for 30 minutes at the level of 20% of the sample weight (w/w). The samples were storage at 2-5°C for 1 month. This study designed as a factorial experiment 3 x 3 x 4 based on a completely randomized design with 5 replications; the first factor was meat type (beef, chicken breast and chicken thigh); the 2nd factor was liquid smoke concentrations (0, 5, and 10%), and the 3rd factor was storage duration (1, 2, 3, and 4 weeks). Parameters measured were TBA value, total bacterial colonies, water holding capacity (WHC), shear force value both before and after cooking (80°C – 15min.), and cooking loss. The results showed that the type of meat produced WHC, shear force value, cooking loss and TBA differed between the three types of meat. Higher concentration of liquid smoke, the WHC, shear force value, TBA, and total bacterial colonies were decreased; at a concentration of 10% of liquid smoke, the total bacterial colonies decreased by 57.3% from untreated with liquid smoke. Longer storage, the total bacterial colonies and WHC were increased, while the shear force value and cooking loss were decreased. It can be concluded that a 10% concentration of liquid smoke was able to maintain fat oxidation and bacterial growth in Bali beef and chicken breast and thigh.

Keywords: Bali beef, chicken meat, liquid smoke, meat quality

Procedia PDF Downloads 385