Search results for: natural mortality
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6879

Search results for: natural mortality

6459 Modern Cardiac Surgical Outcomes in Nonagenarians: A Multicentre Retrospective Observational Study

Authors: Laurence Weinberg, Dominic Walpole, Dong-Kyu Lee, Michael D’Silva, Jian W. Chan, Lachlan F. Miles, Bradley Carp, Adam Wells, Tuck S. Ngun, Siven Seevanayagam, George Matalanis, Ziauddin Ansari, Rinaldo Bellomo, Michael Yii

Abstract:

Background: There have been multiple recent advancements in the selection, optimization and management of cardiac surgical patients. However, there is limited data regarding the outcomes of nonagenarians undergoing cardiac surgery, despite this vulnerable cohort increasingly receiving these interventions. This study describes the patient characteristics, management and outcomes of a group of nonagenarians undergoing cardiac surgery in the context of contemporary peri-operative care. Methods: A retrospective observational study was conducted of patients 90 to 99 years of age (i.e., nonagenarians) who had undergone cardiac surgery requiring a classic median sternotomy (i.e., open-heart surgery). All operative indications were included. Patients who underwent minimally invasive surgery, transcatheter aortic valve implantation and thoracic aorta surgery were excluded. Data were collected from four hospitals in Victoria, Australia, over an 8-year period (January 2012 – December 2019). The primary objective was to assess six-month mortality in nonagenarians undergoing open-heart surgery and to evaluate the incidence and severity of postoperative complications using the Clavien-Dindo classification system. The secondary objective was to provide a detailed description of the characteristics and peri-operative management of this group. Results: A total of 12,358 adult patients underwent cardiac surgery at the study centers during the observation period, of whom 18 nonagenarians (0.15%) fulfilled the inclusion criteria. The median (IQR) [min-max] age was 91 years (90.0:91.8) [90-94] and 14 patients (78%) were men. Cardiovascular comorbidities, polypharmacy and frailty, were common. The median (IQR) predicted in-hospital mortality by EuroSCORE II was 6.1% (4.1-14.5). All patients were optimized preoperatively by a multidisciplinary team of surgeons, cardiologists, geriatricians and anesthetists. All index surgeries were performed on cardiopulmonary bypass. Isolated coronary artery bypass grafting (CABG) and CABG with aortic valve replacement were the most common surgeries being performed in four and five patients, respectively. Half the study group underwent surgery involving two or more major procedures (e.g. CABG and valve replacement). Surgery was undertaken emergently in 44% of patients. All patients except one experienced at least one postoperative complication. The most common complications were acute kidney injury (72%), new atrial fibrillation (44%) and delirium (39%). The highest Clavien-Dindo complication grade was IIIb occurring once each in three patients. Clavien-Dindo grade IIIa complications occurred in only one patient. The median (IQR) postoperative length of stay was 11.6 days (9.8:17.6). One patient was discharged home and all others to an inpatient rehabilitation facility. Three patients had an unplanned readmission within 30 days of discharge. All patients had follow-up to at least six months after surgery and mortality over this period was zero. The median (IQR) duration of follow-up was 11.3 months (6.0:26.4) and there were no cases of mortality observed within the available follow-up records. Conclusion: In this group of nonagenarians undergoing cardiac surgery, postoperative six-month mortality was zero. Complications were common but generally of low severity. These findings support carefully selected nonagenarian patients being offered cardiac surgery in the context of contemporary, multidisciplinary perioperative care. Further, studies are needed to assess longer-term mortality and functional and quality of life outcomes in this vulnerable surgical cohort.

Keywords: cardiac surgery, mortality, nonagenarians, postoperative complications

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6458 Optimization of Human Hair Concentration for a Natural Rubber Based Composite

Authors: Richu J. Babu, Sony Mathew, Sharon Rony Jacob, Soney C. George, Jibin C. Jacob

Abstract:

Human hair is a non-biodegradable waste available in plenty throughout the world but is rarely explored for applications in engineering fields. Tensile strength of human hair ranges from 170 to 220 MPa. This property of human hair can be made use in the field of making bio-composites[1]. The composite is prepared by commixing the human hair and natural rubber in a two roll mill along with additives followed by vulcanization. Here the concentration of the human hair is varied by fine-tuning the fiber length as 20 mm and sundry tests like tensile, abrasion, tear and hardness were conducted. While incrementing the fiber length up to a certain range the mechanical properties shows superior amendments.

Keywords: human hair, natural rubber, composite, vulcanization, fiber loading

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6457 Mild Hypothermia Versus Normothermia in Patients Undergoing Cardiac Surgery: A Propensity Matched Analysis

Authors: Ramanish Ravishankar, Azar Hussain, Mahmoud Loubani, Mubarak Chaudhry

Abstract:

Background and Aims: Currently, there are no strict guidelines in cardiopulmonary bypass temperature management in cardiac surgery not involving the aortic arch. This study aims to compare patient outcomes undergoing mild hypothermia and normothermia. The aim of this study was to compare patient outcomes between mild hypothermia and normothermia undergoing on-pump cardiac surgery not involving the aortic arch. Methods: This was a retrospective cohort study from January 2015 until May 2023. Patients who underwent cardiac surgery with cardiopulmonary bypass temperatures ≥32oC were included and stratified into mild hypothermia (32oC – 35oC) and normothermia (>35oC) cohorts. Propensity matching was applied through the nearest neighbour method (1:1) using the risk factors detailed in the EuroScore using RStudio. The primary outcome was mortality. Secondary outcomes included post-op stay, intensive care unit readmission, re-admission, stroke, and renal complications. Patients who had major aortic surgery and off-pump operations were excluded. Results: Each cohort had 1675 patients. There was a significant increase in overall mortality with the mild hypothermia cohort (3.59% vs. 2.32%; p=0.04912). There was also a greater stroke incidence (2.09% vs. 1.13%; p=0.0396) and transient ischaemic attack (TIA) risk (3.1% vs. 1.49%; p=0.0027). There was no significant difference in renal complications (9.13% vs. 7.88%; p=0.2155). Conclusions: Patient’s who underwent mild hypothermia during cardiopulmonary bypass have a significantly greater mortality, stroke, and transient ischaemic attack incidence. Mild hypothermia does not appear to provide any benefit over normothermia and does not appear to provide any neuroprotective benefits. This shows different results to that of other major studies; further trials and studies need to be conducted to reach a consensus.

Keywords: cardiac surgery, therapeutic hypothermia, neuroprotection, cardiopulmonary bypass

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6456 Synthesis and Characterization of Nanocellulose Based Bio-Composites

Authors: Krishnakant Bhole, Neerakallu D. Shivakumar, Shakti Singh Chauhan, Sanketh Tonannavar, Rajath S

Abstract:

Synthesis of natural-based composite materials is state of the art. This work discusses the preparation and characterization of cellulose nanofibers (CNF) extracted from the bamboo pulp using TEMPO-oxidization and high-pressure homogenization methods. Bio-composites are prepared using synthesized CNF and bamboo particles. Nanocellulose prepared is characterized using SEM and XRD for morphological and crystallinity analysis, and the formation of fibers at the nano level is ensured. Composite specimens are fabricated using these natural sources and subjected to tensile and flexural tests to characterize the mechanical properties such as modulus of elasticity (MOE), modulus of rupture (MOR), and interfacial strength. Further, synthesized nanocellulose is used as a binding agent to prepare particleboards using various natural sources like bamboo, areca nut, and banana in the form of fibers. From the results, it can be inferred that nanocellulose prepared from bamboo pulp acts as a binding agent for making bio-composites. Hence, the concept of using matrix and reinforcement derived from natural sources can be used to prepare green composites that are highly degradable.

Keywords: nanocellulose, biocomposite, CNF, bamboo

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6455 Improving Dyeability of Cotton Fabric with Juglans regia L. Natural Dyestuff

Authors: M. Heysem Arslan, Ikilem Gocek, U. Kivanc Sahin

Abstract:

Natural dyestuff, extracted from Juglans Regia L., a kind of walnut, was used to dye 100% cotton gabardine fabric. The main goal of this study was to enhance dyeing process of cotton fabric with Juglans Regia L. dyestuff in terms of color fastness values by designing and developing a mordant application process. Within the context of this study, different mordants such as tannic acid, gallic acid, ascorbic acid, potassium sodium tartrate tetrahydrate, calcium carbonate, iron (II) sulphate heptahydrate, aluminum potassium sulphate dodecahydrate and their combinations were applied in the mordanting processes. Spectrophotometric analysis, color fastness to washing and color fastness to light tests were carried out on the fabric samples. In this study, it was shown that by using the right combination of mordants with a proper application process, it is possible to improve color fastness values of cotton fabric samples dyed with natural dyestuff.

Keywords: extraction, Juglans Regia L., mordanting process, natural dyestuff

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6454 Effects of Kenaf and Rice Husk on Water Absorption and Flexural Properties of Kenaf/CaCO3/HDPE and Rice Husk/CaCO3/HDPE Hybrid Composites

Authors: Noor Zuhaira Abd Aziz

Abstract:

Rice husk and kenaf filled with calcium carbonate (CaCO3) and high density polyethylene (HDPE) composite were prepared separately using twin-screw extruder at 50rpm. Different filler loading up to 30 parts of rice husk particulate and kenaf fiber were mixed with the fixed 30% amount of CaCO3 mineral filler to produce rice husk/CaCO3/HDPE and kenaf/CaCO3/HDPE hybrid composites. In this study, the effects of natural fiber for both rice husk and kenaf in CaCO3/HDPE composite on physical and mechanical properties were investigated. The property analyses showed that water absorption increased with the presence of kenaf and rice husk fillers. Natural fibers in composite significantly influence water absorption properties due to natural characters of fibers which contain cellulose, hemicellulose and lignin structures. The result showed that 10% of additional natural fibers into hybrid composite had caused decreased flexural strength, however additional of high natural fiber (>10%) filler loading has proved to increase its flexural strength.

Keywords: Hybrid composites, Water absorption, Mechanical properties

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6453 Regional Variation of Cancer Incidence in Nepal

Authors: Rudra Prasad Khanal

Abstract:

Introduction: Non-communicable disease, such as cancer, has spread all over the world for some last decades. However, every nation has experienced a burden from the development of technology. In the context of Nepal, 10 to 15 thousand new cancer incidences are being registered in different hospitals for treatment. Since the date of starting nuclear medicine at Bir Hospital in 1998, cancer patients have been getting treatment regularly. According to the data of the population-based cancer registry, approximately 60% of the population having a middle-class income is being affected by cancer in Nepal. Methods and Materials: The study is aimed to find out the particular place where the population density of new cancer incidence is highest in Nepal and to inform the concerned regulatory body that is working on cancer screening and early detection for the proper treatment from the beginning. In order to identify the areas with the highest population density of new cancer incidence, all the data of cancer patients were collected from five different renowned hospitals and also from the population-based cancer registry center and then analyzed the data. The history of cancer patients was studied from 2003 to 2020, but here the data are analyzed from 2015 to 2020 only to find the latest trend in cancer incidence. Results: In the five major hospitals in Nepal, the total new cancer incidence was 61783 from 2015 to 2020. Out of those, 34617 were female, and 27176 were male. This research shows that female cancer patients were more every year. In the male, lung cancer patients more than cancer of other organs, but in females, the number of breast cancer patients was greatest. The age-adjusted mortality rate for males in Kathmandu valley was 36.3, and for females was 27.0 per 100,000 population. The cancer incidence and mortality rate were slightly lesser in other districts of Nepal. This rate increased with the increase in the age of people. Over 60 years, cancer incidence and mortality rates have been found to increase rapidly. Conclusion: This research supports conducting the program of cancer screening and early detection at Kathmandu valley with high priority and then Morang, Rukum, SSDM, etc., to control cancer.

Keywords: cancer incidence, research scholar, Tribhuvan University, Bhaktapur Cancer Hospital, Nepal

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6452 Study on Natural Light Distribution Inside the Room by Using Sudare as an Outside Horizontal Blind in Tropical Country of Indonesia

Authors: Agus Hariyadi, Hiroatsu Fukuda

Abstract:

In tropical country like Indonesia, especially in Jakarta, most of the energy consumption on building is for the cooling system, the second one is from lighting electric consumption. One of the passive design strategy that can be done is optimizing the use of natural light from the sun. In this area, natural light is always available almost every day around the year. Natural light have many effect on building. It can reduce the need of electrical lighting but also increase the external load. Another thing that have to be considered in the use of natural light is the visual comfort from occupant inside the room. To optimize the effectiveness of natural light need some modification of façade design. By using external shading device, it can minimize the external load that introduces into the room, especially from direct solar radiation which is the 80 % of the external energy load that introduces into the building. It also can control the distribution of natural light inside the room and minimize glare in the perimeter zone of the room. One of the horizontal blind that can be used for that purpose is Sudare. It is traditional Japanese blind that have been used long time in Japanese traditional house especially in summer. In its original function, Sudare is used to prevent direct solar radiation but still introducing natural ventilation. It has some physical characteristics that can be utilize to optimize the effectiveness of natural light. In this research, different scale of Sudare will be simulated using EnergyPlus and DAYSIM simulation software. EnergyPlus is a whole building energy simulation program to model both energy consumption—for heating, cooling, ventilation, lighting, and plug and process loads—and water use in buildings, while DAYSIM is a validated, RADIANCE-based daylighting analysis software that models the annual amount of daylight in and around buildings. The modelling will be done in Ladybug and Honeybee plugin. These are two open source plugins for Grasshopper and Rhinoceros 3D that help explore and evaluate environmental performance which will directly be connected to EnergyPlus and DAYSIM engines. Using the same model will maintain the consistency of the same geometry used both in EnergyPlus and DAYSIM. The aims of this research is to find the best configuration of façade design which can reduce the external load from the outside of the building to minimize the need of energy for cooling system but maintain the natural light distribution inside the room to maximize the visual comfort for occupant and minimize the need of electrical energy consumption.

Keywords: façade, natural light, blind, energy

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6451 Investigation of FoxM1 Gene Expression in Breast Cancer and Its Relationship with miR-216b-5p Expression Level

Authors: Neda Menbari, Ramin Mehdiabadi

Abstract:

Background: breast cancer remains a critical global health issue, constituting a leading cause of cancer-related mortality in women. MicroRNAs (miRs) are natural RNA molecules that play an important role in cellular processes and regulate post-transcriptional gene expression. MiR-216b-5p is a miR that acts as a tumor suppressor. The expression levels of FoxM1 and miR-216b-5p in malignant and control cells have been evaluated by quantitative polymerase chain reaction (qPCR) technique and flow cytometry. Results: the results of this study revealed a significant downregulation of miR-216b-5p in cancerous cells compared to the control MCF-10A cells (P=0.0004). Interestingly, the expression of miR-216b-5p exhibited an inverse relationship with key clinical indicators such as tumor size, grade, and lymph node invasion. Conclusion: The study's findings showed the prognostic value of miR-216b-5p levels in breast cancer, and its reduced expression correlates with unfavorable tumor characteristics. This research recommends performing more studies on the role of FoxM1 and miR-216b-5p in breast cancer pathology which potentially paving the way for targeted therapeutic interventions.

Keywords: breast cancer, gene expression, FOXM1, microRNA

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6450 Natural Convection of a Nanofluid in a Conical Container

Authors: Brahim Mahfoud, Ali Bendjaghlouli

Abstract:

Natural convection is simulated in a truncated cone filled with nanofluid. Inclined and top walls have constant temperature where the heat source is located on the bottom wall of the conical container which is thermally insulated. A finite volume approach is used to solve the governing equations using the SIMPLE algorithm for different parameters such as Rayleigh number, inclination angle of inclined walls of the enclosure and heat source length. The results showed an enhancement in cooling system by using a nanofluid, when conduction regime is assisted. The inclination angle of inclined sidewall and heat source length affect the heat transfer rate and the maximum temperature.

Keywords: heat source, truncated cone, nanofluid, natural convection

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6449 Implementation of Enhanced Recovery after Surgery (ERAS) Protocols in Laparoscopic Sleeve Gastrectomy (LSG); A Systematic Review and Meta-analysis

Authors: Misbah Nizamani, Saira Malik

Abstract:

Introduction: Bariatric surgery is the most effective treatment for patients suffering from morbid obesity. Laparoscopic sleeve gastrectomy (LSG) accounts for over 50% of total bariatric procedures. The aim of our meta-analysis is to investigate the effectiveness and safety of Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing laparoscopic sleeve gastrectomy. Method: To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials and cohort studies involving adult patients (≥18 years) undergoing bariatric surgeries, i.e., Laparoscopic sleeve gastrectomy. Outcome measures included LOS, postoperative narcotic usage, postoperative pain score, postoperative nausea and vomiting, postoperative complications and mortality, emergency department visits and readmission rates. RevMan version 5.4 was used to analyze outcomes. Results: Three RCTs and three cohorts with 1522 patients were included in this study. ERAS group and control group were compared for eight outcomes. LOS was reduced significantly in the intervention group (p=0.00001), readmission rates had borderline differences (p=0.35) and higher postoperative complications in the control group, but the result was non-significant (p=0.68), whereas postoperative pain score was significantly reduced (p=0.005). Total MME requirements became significant after performing sensitivity analysis (p= 0.0004). Postoperative mortality could not be analyzed on account of invalid data showing 0% mortality in two cohort studies. Conclusion: This systemic review indicated the effectiveness of the application of ERAS protocols in LSG in reducing the length of stay, post-operative pain and total MME requirements postoperatively, indicating the feasibility and assurance of its application.

Keywords: eras protocol, sleeve gastrectomy, bariatric surgery, enhanced recovery after surgery

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6448 JaCoText: A Pretrained Model for Java Code-Text Generation

Authors: Jessica Lopez Espejel, Mahaman Sanoussi Yahaya Alassan, Walid Dahhane, El Hassane Ettifouri

Abstract:

Pretrained transformer-based models have shown high performance in natural language generation tasks. However, a new wave of interest has surged: automatic programming language code generation. This task consists of translating natural language instructions to a source code. Despite the fact that well-known pre-trained models on language generation have achieved good performance in learning programming languages, effort is still needed in automatic code generation. In this paper, we introduce JaCoText, a model based on Transformer neural network. It aims to generate java source code from natural language text. JaCoText leverages the advantages of both natural language and code generation models. More specifically, we study some findings from state of the art and use them to (1) initialize our model from powerful pre-trained models, (2) explore additional pretraining on our java dataset, (3) lead experiments combining the unimodal and bimodal data in training, and (4) scale the input and output length during the fine-tuning of the model. Conducted experiments on CONCODE dataset show that JaCoText achieves new state-of-the-art results.

Keywords: java code generation, natural language processing, sequence-to-sequence models, transformer neural networks

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6447 Inventory of Aromatic and Medicinal Plants Used in Natural Cosmetics in Western Algeria

Authors: Faiza Chaib, Yasmina-Nadia Bendahmane, Fatima Zohra Ghanemi

Abstract:

In order to know the traditional use of aromatic and medicinal plants in natural cosmetics, we carried out an ethnobotanical study using an online quiz among the Algerian population residing mainly in western Algeria (Oran, Tlemcen, and Mostaganem). Our study identified 37 plant species used as cosmetic plants, divided into 9 botanical families. The families mainly used and the richest in species are the lamiaceae, the apiecea, and the rutaceae. Our study states that the 5 species with the highest frequency of use and highest citation value are lemon, chamomile, turmeric, garlic, and lavender. Lemon takes first place in the order of frequency. The plants listed have been listed in tables grouping the identification of plants by their scientific and vernacular names, frequency of use, parts used, parts of the body concerned, desired action, as well as the main traditional recipes. This study allowed us to highlight the importance of aromatic plants and to appreciate their traditional practices in natural cosmetics.

Keywords: aromatic plants, ethnobotanical survey, traditional use, natural cosmetics, questionnaire, western Algeria

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6446 Modal Analysis of Functionally Graded Materials Plates Using Finite Element Method

Authors: S. J. Shahidzadeh Tabatabaei, A. M. Fattahi

Abstract:

Modal analysis of an FGM plate composed of Al2O3 ceramic phase and 304 stainless steel metal phases was performed in this paper by ABAQUS software with the assumption that the behavior of material is elastic and mechanical properties (Young's modulus and density) are variable in the thickness direction of the plate. Therefore, a sub-program was written in FORTRAN programming language and was linked with ABAQUS software. For modal analysis, a finite element analysis was carried out similar to the model of other researchers and the accuracy of results was evaluated after comparing the results. Comparison of natural frequencies and mode shapes reflected the compatibility of results and optimal performance of the program written in FORTRAN as well as high accuracy of finite element model used in this research. After validation of the results, it was evaluated the effect of material (n parameter) on the natural frequency. In this regard, finite element analysis was carried out for different values of n and in simply supported mode. About the effect of n parameter that indicates the effect of material on the natural frequency, it was observed that the natural frequency decreased as n increased; because by increasing n, the share of ceramic phase on FGM plate has decreased and the share of steel phase has increased and this led to reducing stiffness of FGM plate and thereby reduce in the natural frequency. That is because the Young's modulus of Al2O3 ceramic is equal to 380 GPa and Young's modulus of SUS304 steel is 207 GPa.

Keywords: FGM plates, modal analysis, natural frequency, finite element method

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6445 Study of Natural Patterns on Digital Image Correlation Using Simulation Method

Authors: Gang Li, Ghulam Mubashar Hassan, Arcady Dyskin, Cara MacNish

Abstract:

Digital image correlation (DIC) is a contactless full-field displacement and strain reconstruction technique commonly used in the field of experimental mechanics. Comparing with physical measuring devices, such as strain gauges, which only provide very restricted coverage and are expensive to deploy widely, the DIC technique provides the result with full-field coverage and relative high accuracy using an inexpensive and simple experimental setup. It is very important to study the natural patterns effect on the DIC technique because the preparation of the artificial patterns is time consuming and hectic process. The objective of this research is to study the effect of using images having natural pattern on the performance of DIC. A systematical simulation method is used to build simulated deformed images used in DIC. A parameter (subset size) used in DIC can have an effect on the processing and accuracy of DIC and even cause DIC to failure. Regarding to the picture parameters (correlation coefficient), the higher similarity of two subset can lead the DIC process to fail and make the result more inaccurate. The pictures with good and bad quality for DIC methods have been presented and more importantly, it is a systematic way to evaluate the quality of the picture with natural patterns before they install the measurement devices.

Keywords: Digital Image Correlation (DIC), deformation simulation, natural pattern, subset size

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6444 Assessment of Very Low Birth Weight Neonatal Tracking and a High-Risk Approach to Minimize Neonatal Mortality in Bihar, India

Authors: Aritra Das, Tanmay Mahapatra, Prabir Maharana, Sridhar Srikantiah

Abstract:

In the absence of adequate well-equipped neonatal-care facilities serving rural Bihar, India, the practice of essential home-based newborn-care remains critically important for reduction of neonatal and infant mortality, especially among pre-term and small-for-gestational-age (Low-birth-weight) newborns. To improve the child health parameters in Bihar, ‘Very-Low-Birth-Weight (vLBW) Tracking’ intervention is being conducted by CARE India, since 2015, targeting public facility-delivered newborns weighing ≤2000g at birth, to improve their identification and provision of immediate post-natal care. To assess the effectiveness of the intervention, 200 public health facilities were randomly selected from all functional public-sector delivery points in Bihar and various outcomes were tracked among the neonates born there. Thus far, one pre-intervention (Feb-Apr’2015-born neonates) and three post-intervention (for Sep-Oct’2015, Sep-Oct’2016 and Sep-Oct’2017-born children) follow-up studies were conducted. In each round, interviews were conducted with the mothers/caregivers of successfully-tracked children to understand outcome, service-coverage and care-seeking during the neonatal period. Data from 171 matched facilities common across all rounds were analyzed using SAS-9.4. Identification of neonates with birth-weight ≤ 2000g improved from 2% at baseline to 3.3%-4% during post-intervention. All indicators pertaining to post-natal home-visits by frontline-workers (FLWs) improved. Significant improvements between baseline and post-intervention rounds were also noted regarding mothers being informed about ‘weak’ child – at the facility (R1 = 25 to R4 = 50%) and at home by FLW (R1 = 19%, to R4 = 30%). Practice of ‘Kangaroo-Mother-Care (KMC)’– an important component of essential newborn care – showed significant improvement in postintervention period compared to baseline in both facility (R1 = 15% to R4 = 31%) and home (R1 = 10% to R4=29%). Increasing trend was noted regarding detection and birth weight-recording of the extremely low-birth-weight newborns (< 1500 g) showed an increasing trend. Moreover, there was a downward trend in mortality across rounds, in each birth-weight strata (< 1500g, 1500-1799g and >= 1800g). After adjustment for the differential distribution of birth-weights, mortality was found to decline significantly from R1 (22.11%) to R4 (11.87%). Significantly declining trend was also observed for both early and late neonatal mortality and morbidities. Multiple regression analysis identified - birth during immediate post-intervention phase as well as that during the maintenance phase, birth weight > 1500g, children of low-parity mothers, receiving visit from FLW in the first week and/or receiving advice on extra care from FLW as predictors of survival during neonatal period among vLBW newborns. vLBW tracking was found to be a successful and sustainable intervention and has already been handed over to the Government.

Keywords: weak newborn tracking, very low birth weight babies, newborn care, community response

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6443 Fungal Pigments For Fabrics Dyeing: Initial Tests Using Industrial Dyeing Conditions

Authors: Vicente A. Hernandez, Felipe Galleguillos, Rene Thibaut, Alejandro Muller

Abstract:

Natural pigments have been proposed as an eco-friendly alternative to artificial pigments. Among the diverse organisms able to synthesize natural pigments, several wood colonizing fungi produce extracellular pigments which have been tested to dye fabrics at laboratory conditions with good results. However, the dyeing conditions used at laboratory level not necessary meet the real conditions in which dyeing of fabrics is conducted at industrial level. In this work, yellow and red pigments from the fungi Penicillium murcianum and Talaromyces australis, respectively, were used to dye yarn and linen fabrics using dyeing processes optimized according to the standard conditions used at industrial level. After dyeing treatments, fabrics were tested for color fastness to wash and to wet and dry rubbing, but also to tensile strength tests. Satisfactory result was obtained with both yellow and red pigments in yarn and linen, when used alone or mixed to different proportions. According to these results, natural pigments synthesized by both wood colonizing fungi have a great potential to be used in dyeing processes at industrial level.

Keywords: natural pigments, fungal pigments, yarn, linen

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6442 Varying Frequency Application of Vermicast as Supplemented with 19-19-19+Me in the Agronomic Performance of Lettuce (Lactuca sativa)

Authors: Jesryl B. Paulite, Eixer Niel V. Enesco

Abstract:

Lettuce is not well known in the lowland locality in the tropical countries like Philippines. Farmers thought that this crop is not adaptable to the climate that we have in lowland. But some new varieties can tolerate warmer conditions. The massive use of pesticides in lettuce production might chronically affect human health and environment. The move of the Philippine government is toward organic. One of the organic material is vermicompost. It is an organic fertilizer that serves as soil conditioner and enhances soil fertility and promotes vigorous and healthy crop growth and Supplementation of 19-19-19+M.E. will make it better since it contains N-P-K and selected microelements to meet the nutritive requirements of the crop. The experiment was conducted at Purok 3, Brgy. Tiburcia, Kapalong, Davao del Norte from February 6, 2014 to March 4, 2014. The study was conducted to determine the effect of varying frequency application of vermicast as supplemented with 19-19-19+M.E. in lettuce. Specifically, this aimed to 1.) Identify the agronomic performance of lettuce as affected by varying frequency application of vermicast as supplemented with 19-19-19+M.E.; 2.) Assess the economic profitability of lettuce as applied with vermicast as supplemented with 19-19-19+M.E. The study was laid out in Randomized Complete Block Design (RCBD) with four treatments and three replications. The treatments were as follow: T1 – Untreated, T2 - Weekly Application, T3- Bi-weekly Application, and T4- Monthly Application. The data on percent (%) mortality were transformed using square root of transformation before Analysis of Variance (ANOVA). Results revealed not significant in terms of percent mortality in weekly and monthly application of the treatment having a mean of 1.76 % and 3.09 %. However, Significant differences were observed in agronomic performances such as; plant height with a mean of 10.63 cm in weekly application and 6.40 cm for the untreated, leaf width with a mean of 10.80 cm for the weekly application and 6.03 for the untreated, fresh weight with a mean of 25.67 g for the weekly application and 6.83 g for the untreated, and yield with a mean of 1,208.33 kg/ha for the weekly application and 327.08 kg/ha for the untreated, respectively. Results further exposed that profitability of lettuce in terms of Return of Production Cost (RPC) were; bi-weekly with 91.01 %, monthly with 68.20 %, weekly with 25.34 % and untreated (control) with 16.69 %.

Keywords: agronomic performance, economic profitability, vermicast, percent mortality, 19-19-19+ME

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6441 Parametric Analysis and Optimal Design of Functionally Graded Plates Using Particle Swarm Optimization Algorithm and a Hybrid Meshless Method

Authors: Foad Nazari, Seyed Mahmood Hosseini, Mohammad Hossein Abolbashari, Mohammad Hassan Abolbashari

Abstract:

The present study is concerned with the optimal design of functionally graded plates using particle swarm optimization (PSO) algorithm. In this study, meshless local Petrov-Galerkin (MLPG) method is employed to obtain the functionally graded (FG) plate’s natural frequencies. Effects of two parameters including thickness to height ratio and volume fraction index on the natural frequencies and total mass of plate are studied by using the MLPG results. Then the first natural frequency of the plate, for different conditions where MLPG data are not available, is predicted by an artificial neural network (ANN) approach which is trained by back-error propagation (BEP) technique. The ANN results show that the predicted data are in good agreement with the actual one. To maximize the first natural frequency and minimize the mass of FG plate simultaneously, the weighted sum optimization approach and PSO algorithm are used. However, the proposed optimization process of this study can provide the designers of FG plates with useful data.

Keywords: optimal design, natural frequency, FG plate, hybrid meshless method, MLPG method, ANN approach, particle swarm optimization

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6440 Segregation Patterns of Trees and Grass Based on a Modified Age-Structured Continuous-Space Forest Model

Authors: Jian Yang, Atsushi Yagi

Abstract:

Tree-grass coexistence system is of great importance for forest ecology. Mathematical models are being proposed to study the dynamics of tree-grass coexistence and the stability of the systems. However, few of the models concentrates on spatial dynamics of the tree-grass coexistence. In this study, we modified an age-structured continuous-space population model for forests, obtaining an age-structured continuous-space population model for the tree-grass competition model. In the model, for thermal competitions, adult trees can out-compete grass, and grass can out-compete seedlings. We mathematically studied the model to make sure tree-grass coexistence solutions exist. Numerical experiments demonstrated that a fraction of area that trees or grass occupies can affect whether the coexistence is stable or not. We also tried regulating the mortality of adult trees with other parameters and the fraction of area trees and grass occupies were fixed; results show that the mortality of adult trees is also a factor affecting the stability of the tree-grass coexistence in this model.

Keywords: population-structured models, stabilities of ecosystems, thermal competitions, tree-grass coexistence systems

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6439 Traumatic Brain Injury Neurosurgical Care Continuum Delays in Mulago Hospital in Kampala Uganda

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Patients with traumatic brain injury (TBI) can develop rapid neurological deterioration from swelling and intracranial hematomas, which can result in focal tissue ischemia, brain compression, and herniation. Moreover, delays in management increase the risk of secondary brain injury from hypoxemia and hypotension. Therefore, in TBI patients with subdural hematomas (SDHs) and epidural hematomas (EDHs), surgical intervention is both necessary and time sensitive. Significant delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of TBI in Sub Saharan Africa (SSA). While many LMICs have subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold: logistical and financial barriers. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified 'three delays' framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, traumatic brain injury

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6438 Challenging Clinical Scenario of Blood Stream Candida Infections – An Indian Experience

Authors: P. Uma Devi, S. Sujith, K. Rahul, T. S. Dipu, V. Anil Kumar , Vidya Menon

Abstract:

Introduction: Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The epidemiology of Candida infection is also changing, mainly in relation to the number of episodes caused by species Candida non-albicans. However, in India, the true burden of candidemia is not clear. Thus, this study was conducted to evaluate the clinical characteristics, species distribution, antifungal susceptibility and outcome of candidemia at our hospital. Methodology: Between January 2012 and April 2014, adult patients with at least one positive blood culture for Candida species were identified through the microbiology laboratory database (for each patient only the first episode of candidemia was recorded). Patient data was collected by retrospective chart review of clinical characteristics including demographic data, risk factors; species distribution, resistance to antifungals and survival. Results: A total of 165 episodes of Candida BSI were identified, with 115 episodes occurring in adult patients. Most of the episodes occurred in males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive care unit (65.2%) at the time of diagnosis. On admission, 26.1% and 18.3% patients had pneumonia and urinary tract infection, respectively. Majority of the candidemia episodes were found in the general medicine department (23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & haematology (13%). Risk factors identified were prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinary catheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilation (43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C. albicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C. krusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans). Mortality was noted in 51 patients (44.3%). Early mortality (within 7 days) was noted in 32 patients while late mortality (between 7 and 30 days) was noted in 19 patients. Conclusion: In recent years, candidemia has been flourishing in critically ill patients. Comparison of data from our own hospital from 2005 shows a doubling of the incidence. Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious BSI. High index of suspicion and sensitive diagnostics are essential to improve outcomes in resource limited settings with emergence of non-albicans Candida.

Keywords: antifungal susceptibility, candida albicans, candidemia, non-albicans candida

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6437 LES Investigation of the Natural Vortex Length in a Small-Scale Gas Cyclone

Authors: Dzmitry Misiulia, Sergiy Antonyuk

Abstract:

Small-scale cyclone separators are widely used in aerosol sampling. The flow field in a cyclone sampler is very complex, especially the vortex behavior. Most of the existing models for calculating cyclone efficiency use the same stable vortex structure while the vortex demonstrates dynamic variations rather than the steady-state picture. It can spontaneously ‘end’ at some point within the body of the separator. Natural vortex length is one of the most critical issues when designing and operating gas cyclones and is crucial to proper cyclone performance. The particle transport along the wall to the grid pot is not effective beyond this point. The flow field and vortex behavior inside the aerosol sampler have been investigated for a wide range of Reynolds numbers using Large Eddy Simulations. Two characteristics types of vortex behavior have been found with simulations. At low flow rates the vortex created in the cyclone dissipates in free space (without attaching to a surface) while at higher flow rates it attaches to the cyclone wall. The effects of the Reynolds number on the natural vortex length and the rotation frequency of the end of the vortex have been revealed.

Keywords: cyclone, flow field, natural vortex length, pressure drop

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6436 Spontaneous Pneumothorax in Mixed Poisoning Presented as Daisley Barton Syndrome

Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam

Abstract:

Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.

Keywords: pneumothorax, suicide, dithionate, OPC, herbicide

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6435 On Dialogue Systems Based on Deep Learning

Authors: Yifan Fan, Xudong Luo, Pingping Lin

Abstract:

Nowadays, dialogue systems increasingly become the way for humans to access many computer systems. So, humans can interact with computers in natural language. A dialogue system consists of three parts: understanding what humans say in natural language, managing dialogue, and generating responses in natural language. In this paper, we survey deep learning based methods for dialogue management, response generation and dialogue evaluation. Specifically, these methods are based on neural network, long short-term memory network, deep reinforcement learning, pre-training and generative adversarial network. We compare these methods and point out the further research directions.

Keywords: dialogue management, response generation, deep learning, evaluation

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6434 Extraction, Characterization and Application of Natural Dyes from the Fresh Rind of Index Colour 5 Mangosteen (Garcinia mangostana L.)

Authors: Basitah Taif

Abstract:

This study was to explore and utilize the fresh rind of mangosteen Index Colour 5 as an upcoming raw material for the production of natural dyes. Rind from the fresh mangosteen Index Colour 5 was utilized to extract the dyes. The established extracts were experimented on silk fabrics via three types of mordanting and dyeing procedures; pre-mordanting, simultaneous mordanting and post-mordanting. As a result, the applications of the freeze-drying methodology and mechanizable equipment have helped to produce excellent range of natural colours. Silk fabric treated simultaneously with mordanting and dyeing with extract dye Index Colour 5 produced a brilliant shade of the red colour and the colour from this index is also discovered sensitive to light and washing during the fastness tests. The preliminary evaluation and instrumentation analysis allowed us to examine whether the application of different mordanting and dyeing procedures with the same extract samples and concentrations affected the colours and shades of the fabric samples.

Keywords: natural dye, freeze-drying, Garcinia mangostana Linn, mordanting

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6433 The Advancement of Environmental Impact Assessment for 5th Transmission Natural Gas Pipeline Project in Thailand

Authors: Penrug Pengsombut, Worawut Hamarn, Teerawuth Suwannasri, Kittiphong Songrukkiat, Kanatip Ratanachoo

Abstract:

PTT Public Company Limited or simply PTT has played an important role in strengthening national energy security of the Kingdom of Thailand by transporting natural gas to customers in power, industrial and commercial sectors since 1981. PTT has been constructing and operating natural gas pipeline system of over 4,500-km network length both onshore and offshore laid through different area classifications i.e., marine, forest, agriculture, rural, urban, and city areas. During project development phase, an Environmental Impact Assessment (EIA) is conducted and submitted to the Office of Natural Resources and Environmental Policy and Planning (ONEP) for approval before project construction commencement. Knowledge and experiences gained and revealed from EIA in the past projects definitely are developed to further advance EIA study process for newly 5th Transmission Natural Gas Pipeline Project (5TP) with approximately 415 kilometers length. The preferred pipeline route is selected and justified by SMARTi map, an advance digital one-map platform with consists of multiple layers geographic and environmental information. Sensitive area impact focus (SAIF) is a practicable impact assessment methodology which appropriate for a particular long distance infrastructure project such as 5TP. An environmental modeling simulation is adopted into SAIF methodology for impact quantified in all sensitive areas whereas other area along pipeline right-of-ways is typically assessed as an impact representative. Resulting time and cost deduction is beneficial to project for early start.

Keywords: environmental impact assessment, EIA, natural gas pipeline, sensitive area impact focus, SAIF

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6432 Biomarkers in a Post-Stroke Population: Allied to Health Care in Brazil

Authors: Michael Ricardo Lang, AdriéLle Costa, Ivana Iesbik, Karine Haag, Leonardo Trindade Buffara, Oscar Reimann Junior, Chelin Auswaldt Steclan

Abstract:

Stroke affects not only the individual, but has significant impacts on the social and family context. Therefore, it is necessary to know the peculiarities of each region, in order to contribute to regional public health policies effectively. Thus, the present study discusses biomarkers in a post-stroke population, admitted to a stroke unit (U-stroke) of reference in the southern region of Brazil. Biomarkers were analyzed, such as age, length of stay, mortality rate, survival time, risk factors and family history of stroke in patients after ischemic stroke. In this studied population, comparing men and women, it was identified that men were more affected than women, and the average age of women affected was higher, as they also had the highest mortality rate and the shortest hospital stay. The risk factors identified here were according to the global scenario; with SAH being the most frequent and those associated with sedentary lifestyle in women the most frequent (dyspilipidemia, heart disease and obesity). In view of this, the importance of studies that characterize populations regionally is evident, strengthening the strategic planning of policies in favor of health care.

Keywords: biomarkers, sex, stroke, stroke unit, population

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6431 Effect of Fibres-Chemical Treatment on the Thermal Properties of Natural Composites

Authors: J. S. S. Neto, R. A. A. Lima, D. K. K. Cavalcanti, J. P. B. Souza, R. A. A. Aguiar, M. D. Banea

Abstract:

In the last decade, investments in sustainable processes and products have gained space in several segments, such as in the civil, automobile, textile and other industries. In addition to increasing concern about the development of environmentally friendly materials that reduce, energy costs and reduces environmental impact in the production of these products, as well as reducing CO2 emissions. Natural fibers offer a great alternative to replace synthetic fibers, totally or partially, because of their low cost and their renewable source. The purpose of this research is to study the effect of surface chemical treatment on the thermal properties of hybrid fiber reinforced natural fibers (NFRC), jute + ramie, jute + sisal, jute + curauá, and jute fiber in polymer matrices. Two types of chemical treatment: alkalinization and silanization were employed, besides the condition without treatment. Differential scanning calorimetry (DSC), thermogravimetry (TG) and dynamic-mechanical analysis (DMA) were performed to explore the thermal stability and weight loss in the natural fiber reinforced composite as a function of chemical treatment.

Keywords: chemical treatment, hybrid composite, jute, thermal

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6430 Revising Our Ideas on Revisions: Non-Contact Bridging Plate Fixation of Vancouver B1 and B2 Periprosthetic Femoral Fractures

Authors: S. Ayeko, J. Milton, C. Hughes, K. Anderson, R. G. Middleton

Abstract:

Background: Periprosthetic femoral fractures (PFF) in association with hip hemiarthroplasty or total hip arthroplasty is a common and serious complication. In the Vancouver Classification system algorithm, B1 fractures should be treated with Open Reduction and Internal Fixation (ORIF) and preferentially revised in combination with ORIF if B2 or B3. This study aims to assess patient outcomes after plate osteosynthesis alone for Vancouver B1 and B2 fractures. The main outcome is the 1-year re-revision rate, and secondary outcomes are 30-day and 1-year mortality. Method: This is a retrospective single-centre case-series review from January 2016 to June 2021. Vancouver B1 and B2, non-malignancy fractures in adults over 18 years of age treated with polyaxial Non-Contact Bridging plate osteosynthesis, have been included. Outcomes were gathered from electronic notes and radiographs. Results: There were 50 B1 and 64 B2 fractures. 26 B2 fractures were managed with ORIF and revision, 39 ORIF alone. Of the revision group, one died within 30 days (3.8%), one at one year (3.8%), and two were revised within one year (7.7). Of the B2 ORIF group, three died within 30-day mortality (7.96%), eight at one year (21.1%), and 0 were revised in 1 year. Conclusion: This study has demonstrated that satisfactory outcomes can be achieved with ORIF, excluding revision in the management of B2 fractures.

Keywords: arthroplasty, bridging plate, periprosthetic fracture, revision surgery

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