Search results for: heart failure patient

Authors: B. W. Kenny, D.Mansour, K. G. Mansour, J. Attia, B. Meads

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There is currently insufficient evidence to make a conclusive statement about safety while immobilized in a short arm cast. There is a paucity of published literature on this topic. The purpose of this study is to specifically evaluate short arm casts and their effect on driving abilities, particularly steering and avoidance of obstacles. The ability to drive safely is extrapolated from this data. In this study, a randomised, controlled, crossover design was used to assess 30 subjects randomised into 2 groups. A Logitech force feedback steering column and simulated driving program with a standardised road course was used. Objective outcome measures were the number of times subjects drove off the track, the number of crashes, time to lap completion and subjective assessment on whether wearing a short arm plaster cast impeded their steering. Recruited subjects had no upper limb pathology. The side of the applied plaster cast was randomised. The mean lap completion time reduced with repetition, the difference being statistically significant. There was no significant difference in mean number of times subjects in casts drove off the track (3 with vs. 3.07 without casts), average number of crashes (1.27 vs 0.97). Steering ability was not reduced whilst a subject was immobilised in a short arm Plaster of Paris cast, despite subject’s own impressions that their steering was impeded. This may help guide doctors in their advice to patients regarding driving in these casts.

Keywords: upper limb, arm injury, plaster cast, splint, driving, automobile, bone fracture

Procedia PDF Downloads 247

Authors: Murad A. Channa, Mehdi Khiadani. Yasir Al-Abdeli

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Considering the severity of water scarcity around the world and its widening at an alarming rate, practical improvements in desalination techniques need to be engineered at the earliest. Atomization is the major aspect of flashing phenomena, yet it has been paid less attention to until now. There is a need to test efficient ways of atomization for the flashing process. Flash evaporation together with reverse osmosis is also a commercially matured desalination technique commonly famous as Multi-stage Flash (MSF). Even though reverse osmosis is massively practical, it is not economical or sustainable compared to flash evaporation. However, flashing evaporation has its drawbacks as well such as lower efficiency of water production per higher consumption of power and time. Flash evaporation is simply the instant boiling of a subcooled liquid which is introduced as droplets in a well-maintained negative environment. This negative pressure inside the vacuum increases the temperature of the liquid droplets far above their boiling point, which results in the release of latent heat, and the liquid droplets turn into vapor which is collected to be condensed back into an impurity-free liquid in a condenser. Atomization is the main difference between pool and spray flash evaporation. Atomization is the heart of the flash evaporation process as it increases the evaporating surface area per drop atomized. Atomization can be categorized into many levels depending on its drop size, which again becomes crucial for increasing the droplet density (drop count) per given flow rate. This review comprehensively summarizes the selective results relating to the methods of atomization and their effectiveness on the evaporation rate from earlier works to date. In addition, the reviewers propose using centrifugal atomization for the flashing application, which brings several advantages viz ultra-fine droplets, uniform droplet density, and the swirling geometry of the spray with kinetically more energetic sprays during their flight. Finally, several challenges of using rotary bell atomizer (RBA) and RBA Sprays inside the chamber have been identified which will be explored in detail. A schematic of rotary bell atomizer (RBA) integration with the chamber has been designed. This powerful centrifugal atomization has the potential to increase potable water production in commercial multi-stage flash evaporators, where it would be preferably advantageous.

Keywords: atomization, desalination, flash evaporation, rotary bell atomizer

Procedia PDF Downloads 84

Authors: Majid Alsubaie, Hamed Sarbazhosseini

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Many working environments have experienced increased uncertainty due to the fast-moving and unpredictable world. IT systems development projects, in particular, face several challenges because of their rapidly changing environments and emerging technologies. Information technology organizations within these contexts adapt systems development methodology and new software approaches to address this issue. One of these methodologies is the Agile method, which has gained huge attention in recent years. However, due to failure rates in IT projects, there is an increasing demand for the use of hybrid Agile methods among organizations. The scarce research in the area means that organizations do not have solid evidence-based knowledge for the use of hybrid Agile. This research was designed to provide further insights into the development of hybrid Agile methods within systems development projects, including how frameworks and processes are used and what benefits and challenges are gained and faced as a result of hybrid Agile methods. This paper presents how three organizations (two government and one private) use hybrid Agile methods in their Agile environments. The data was collected through interviews and a review of relevant documents. The results indicate that these organizations do not predominantly use pure Agile. Instead, they are waterfall organizations by virtue of systems nature and complexity, and Agile is used underneath as the delivery model. Prince2 Agile framework, SAFe, Scrum, and Kanban were the identified models and frameworks followed. This study also found that customer satisfaction and the ability to build quickly are the most frequently perceived benefits of using hybrid Agile methods. In addition, team resistance and scope changes are the common challenges identified by research participants in their working environments. The findings can help to understand Agile environmental conditions and projects that can help get better success rates and customer satisfaction.

Keywords: agile, hybrid, IT systems, management, success rate, technology

Procedia PDF Downloads 108

Authors: K. N. Dinesh Babu, P. K. Gargava

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Energization of a transformer results in sudden flow of current which is an effect of core magnetization. This current will be dominated by the presence of second harmonic, which in turn is used to segregate fault and inrush current, thus guaranteeing proper operation of the relay. This additional security in the relay sometimes obstructs or delays differential protection in a specific scenario, when the 2^nd harmonic content was present during a genuine fault. This kind of scenario can result in isolation of the transformer by Buchholz and pressure release valve (PRV) protection, which is acted when fault creates more damage in transformer. Such delays involve a huge impact on the insulation failure, and chances of repairing or rectifying fault of problem at site become very dismal. Sometimes this delay can cause fire in the transformer, and this situation becomes havoc for a sub-station. Such occurrences have been observed in field also when differential relay operation was delayed by 10-15 ms by second harmonic blocking in some specific conditions. These incidences have led to the need for an alternative solution to eradicate such unwarranted delay in operation in future. Modern numerical relay, called as intelligent electronic device (IED), is embedded with advanced protection features which permit higher flexibility and better provisions for tuning of protection logic and settings. Such flexibility in transformer protection IEDs, enables incorporation of alternative methods such as dynamic switching of second harmonic feature for blocking the differential protection with additional security. The analysis and precautionary measures carried out in this case, have been simulated and discussed in this paper to ensure that similar solutions can be adopted to inhibit analogous issues in future.

Keywords: differential protection, intelligent electronic device (IED), 2nd harmonic inhibit, inrush inhibit

Procedia PDF Downloads 300

Authors: Thomas J. Bell III

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Pursuing a business degree is fraught with perplexing questions regarding the rising tuition cost and the immediate value of earning a degree. Any decision to pursue an undergraduate business degree is perceived to have value if it facilitates post-graduate job placement. Business programs have decreased value in the absence of innovation in business programs that close the skills gap between recent graduates and employment opportunities. Industry-based certifications are seemingly becoming a requirement differentiator among job applicants. Texas Wesleyan University offers a Computer Information System (CIS) program with an innovative curriculum that integrates industry-recognized certification training into its traditional curriculum with core subjects and electives. This paper explores a culture of innovation in the CIS business program curriculum that creates sustainable stakeholder value for students, employers, the community, and the university. A quantitative research methodology surveying over one-hundred students in the CIS program will be used to examine factors influencing the success or failure of students taking certification exams. Researchers will analyze control variables to identify specific correlations between practice exams, teaching pedagogy, study time, age, work experience, etc. This study compared various exam preparation techniques to corresponding exam results across several industry certification exams. The findings will aid in understanding control variables with correlations that positively and negatively impact exam results. Such discovery may provide useful insight into pedagogical impact indicators that positively contribute to certification exam success and curriculum enhancement.

Keywords: taking certification exams, exam training, testing skills, exam study aids, certification exam curriculum

Procedia PDF Downloads 88

Authors: Radwa El Shorbagy, Alaa El Din Balbaa, Khaled Ayad, Waleed Reda

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Ankle sprain is a common lower limb injury that is complicated by high recurrence rate. The cause of recurrence is not clear; however, changes in motor control have been postulated.Objective: to determine the contribution of proximal hip strategy to dynamic posture control in patients with recurrent ankle sprain. Methods:Fifteen subjects with recurrent ankle sprain (Group A) and fifteen healthy control subjects (Group B) participated in this study. Abductor-adductor as well as flexor-extensor hip musculature control was abolished by fatigue using the Biodex Isokinatic System. Dynamic posture control was measured before and after fatigue by the Biodex Balance System. Results: Repeated measures MANOVA was used to compare within group differences. In group A fatiguing of hip muscles (flexors-extensors and abductors-adductors) lowered overall stability index (OASI), anteroposterior stability index (APSI) and mediolateral stability index (MLSI) significantly (p=0.00) whereas; in group B fatiguing of hip flexors-extensors lowered significantly OASI and APSI only (p= 0.017, 0.010; respectively) while fatiguing of hip abductors-adductors has no significant effect on these variables. Conclusion: fatiguing of hip muscles has a significant deleterious effect on dynamic posture control in patient with recurrent ankle sprain indicating their increased dependence on hip strategy.

Keywords: ankle sprain, fatigue hip muscles, dynamic balance, ankle sprain

Procedia PDF Downloads 355

Authors: Mehmet Akif Bütüner, İlhan Koşalay

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Hydroelectric power plants (HEPPs) are renewable energy power plants with the highest installed power in the world. While the control systems operating in these power plants ensure that the system operates at the desired operating point, it is also responsible for stopping the relevant unit safely in case of any malfunction. While these control systems are expected not to miss signals that require stopping, on the other hand, it is desired not to cause unnecessary stops. In traditional control systems including modern systems with SCADA infrastructure, alarm conditions to create warnings or trip conditions to put relevant unit out of service automatically are usually generated with predefined limits regardless of different operating conditions. This approach results in alarm/trip conditions to be less likely to detect minimal changes which may result in serious malfunction scenarios in near future. With the methods proposed in this research, routine behavior of the oil circulation of hydraulic governor of a HEPP will be modeled with machine learning methods using historical data obtained from SCADA system. Using the created model and recently gathered data from control system, oil pressure of hydraulic accumulators will be estimated. Comparison of this estimation with the measurements made and recorded instantly by the SCADA system will help to foresee failure before becoming worse and determine remaining useful life. By using model outputs, maintenance works will be made more planned, so that undesired stops are prevented, and in case of any malfunction, the system will be stopped or several alarms are triggered before the problem grows.

Keywords: hydroelectric, governor, anomaly detection, machine learning, regression

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Authors: Safar Ghaedrahmati, Leila Soltani

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Population centralization in urban area and metropolitans, especially in developing countries such as Iran increase metropolitan's problems. For few decades, the population of cities in developing countries, including Iran had a higher growth rate than the total growth rate of countries’ population. While in developed countries, the development of the big cities began decades ago and generally allowed for controlled and planned urban expansion, the opposite is the case in developing countries, where rapid urbanization process is characterized by an unplanned existing urban expansion. The developing metropolitan cities have enormous difficulties in coping both with the natural population growth and the urban physical expansion. Iranian cities are usually the heart of economic and cultural changes that have occurred after the Islamic revolution in 1979. These cities are increasingly having impacts via political–economical arrangement and chiefly by urban management structures. Structural features have led to the population growth of cities and urbanization (in number, population and physical frame) and the main problems in them. On the other hand, the lack of birth control policies and the deceptive attractions of cities, particularly big cities, and the birth rate has shot up, something which has occurred mainly in rural regions and small cities. The population of Iran has increased rapidly since 1956. The 1956 and 1966 decennial censuses counted the population of Iran at 18.9 million and 25.7 million, respectively, with a 3.1% annual growth rate during the 1956–1966 period. The 1976 and 1986 decennial censuses counted Iran’s population at 33.7 and 49.4 million, respectively, a 2.7% and 3.9% annual growth rate during the 1966–1976 and 1976–1986 periods. The 1996 count put Iran’s population at 60 million, a 1.96% annual growth rate from 1986–1996 and the 2006 count put Iran population at 72 million. A recent major policy of urban economic and industrial decentralization is a persistent program of the government. The policy has been identified as a result of the massive growth of Tehran in the recent years, up to 9 million by 2010. Part of the growth of the capitally resulted from the lack of economic opportunities elsewhere and in order to redress the developing primacy of Tehran and the domestic pressures which it is undergoing, the policy of decentralization is to be implemented as quickly as possible. Type of research is applied and method of data collection is documentary and methods of analysis are; population analysis with urban system analysis and urban distribution system

Keywords: population centralization, cities of Iran, urban centralization, urban system

Procedia PDF Downloads 300

Authors: A. M. John-Otumu, M. M. Rahman, M. C. Onuoha, E. P. Ojonugwa

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A Convolutional Neural Network (CNN) model for predicting Lassa fever was built using Python 3.8.0 programming language, alongside Keras 2.2.4 and TensorFlow 2.6.1 libraries as the development environment in order to reduce the current high risk of Lassa fever in West Africa, particularly in Nigeria. The study was prompted by some major flaws in existing conventional laboratory equipment for diagnosing Lassa fever (RT-PCR), as well as flaws in AI-based techniques that have been used for probing and prognosis of Lassa fever based on literature. There were 15,679 blood smear microscopic image datasets collected in total. The proposed model was trained on 70% of the dataset and tested on 30% of the microscopic images in avoid overfitting. A 3x3x3 convolution filter was also used in the proposed system to extract features from microscopic images. The proposed CNN-based model had a recall value of 96%, a precision value of 93%, an F1 score of 95%, and an accuracy of 94% in predicting and accurately classifying the images into clean or infected samples. Based on empirical evidence from the results of the literature consulted, the proposed model outperformed other existing AI-based techniques evaluated. If properly deployed, the model will assist physicians, medical laboratory scientists, and patients in making accurate diagnoses for Lassa fever cases, allowing the mortality rate due to the Lassa fever virus to be reduced through sound decision-making.

Keywords: artificial intelligence, ANN, blood smear, CNN, deep learning, Lassa fever

Procedia PDF Downloads 120

Authors: Edna Ariste, Richard Standy Coqmar

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Background: Acute respiratory infections are a major public health problem in the world, mainly in vulnerable populations such as newborns, children under five years of age, and the elderly. The objective of this study was to Characterize the cases of acute respiratory infections in infants and under 15 years old hospitalized at the Immaculée Conception Hospital in Cayes from January 1, 2019, to December 31, 2021. Methods: A retrospective descriptive study was conducted on the epidemiology profile of acute respiratory infections hospitalized in the pediatric ward at Immaculée Conception Hospital in Les Cayes from January 2019 to December 2021. The study population consisted of all newborns, infants, and children under 15 years of age diagnosed with respiratory infections at the pediatric service. Data were collected from the hospitalization registers and patient records of this unit. A database was created and used for data collection. Excel and Epi info 7.2 were used for data analysis. Results: A total of 588 cases were identified during the 2019-2021 year. 43.5% (256) were female, and 56.5% (332) were male. The average age was 4, 3. The most affected age group was 1-4 years. The male/female sex ratio was 1.2. The most frequent respiratory infections were respectively pneumonia 44.9%, bronchitis 16.5%, and respiratory distress 10.5%. The mortality rate recorded during this period was 4.4%. Conclusion: Acute respiratory infections are more frequent in young children. It is, therefore, necessary to practice hand hygiene. Reinforce the surveillance of severe acute respiratory infections.

Keywords: acute respiratory infections, pediatrics, cayes, haiti

Procedia PDF Downloads 86

Authors: Alireza Monzavi Chaleshtori, Mahnaz Aliakbari Dehkordi, Maryam Aliakbari, Solmaz Seyed Mostafaii

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Objective: Considering the growing obesity among children and the role of mother's psychological factors as well as the need to prevent childhood obesity, this study aimed to investigate the mediating role of mother's self-efficacy in the relationship between mother's stress and depression and child obesity. Method: For this purpose, in a descriptive-correlation study, 222 mothers and children aged 1 to 5 years in Tehran, who had the opportunity to answer an online questionnaire, were selected by random sampling and to the depression scales of the Kroenke and Spitzer Patient Health Questionnaire, Cohen's stress and Self-efficacy of Berkeley mothers answered. Pearson correlation test and path analysis were used for data analysis. Findings: The findings showed that maternal depression had an indirect and significant effect on child obesity, and the effect of stress and depression on child obesity was indirect and non-significant. Therefore, the model has a good fit with the research data, and stress and depression indirectly predicted child obesity with the mediating role of self-efficacy. Conclusion: The hypothesized model tested based on mother's stress and depression with the mediating role of mother's self-efficacy was a good model in explaining the prediction of child obesity. Based on the findings of this research, a practical framework can be provided to explain the psychological factors of the mother in relation to child obesity and its treatment.

Keywords: stress, self-efficacy, child obesity, depression

Procedia PDF Downloads 71

Authors: S. M. P Manjula, Ishara Amarathunga, Aryan Nath Koura, Jaideepraj Rao

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Background: Laparoscopic D2 Gastrectomy for non metastatic advanced Gastric cancer (AGC) has become a controversial topic as there are confronting ideas from experts in the field. Lack of consensus are mainly due to non feasibility of the dissection and safety and efficacy. Method: Data from all D2 Gastrectomies performed (both Subtotal and Total Gastrectomies) in our unit from 2009 December to 2013 December were retrospectively analysed. Computor database was prospectively maintained. Pathological stage two A (iiA) and above considered advanced Gastric cancers, who underwent curative intent D2 Gastrectomy were included for analysis(n=46). Four patients excluded from the study as peritoneal fluid cytology came positive for cancer cells and one patient exempted as microscopic resection margin positive(R1) after curative resection. Thirty day morbidity and mortality, operative time, lymph nodes harvest and survival (disease free and overall) analyzed. Results: Complete curative resection achieved in 40 patients. Mean age of the study population was 62.2 (32-88) and male to female ratio was 23: 17. Thirty day mortality (1/40) and morbidity (6/40). Average operative time 203.7 minutes (185- 400) and average lymphnodes harvest was 40.5 (18-91). Disease free survival of the AGC in this study population was 16.75 months (1-49). Average hospital stay was 6.8 days (3-31). Conclusion: Laparoscopic dissection is effective feasible and safe in AGC.

Keywords: laparoscopy, advanced gastric cancer, safety, efficacy

Procedia PDF Downloads 336

Authors: Alan Walsh, Peter Walker, Michael Ellis

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There is a real danger that both practitioners and researchers considering risks associated with megaprojects ignore or underestimate the impacts of cultural risk. The paper investigates the potential impacts of a failure to achieve cultural unity between the principal actors executing a megaproject. The principle relationships include the relationships between the principle Contractors and the project stakeholders or the project stakeholders and their principle advisors, Western Consultants. This study confirms that cultural dissonance between these parties can delay or disrupt the megaproject execution and examines why cultural issues should be prioritized as a significant risk factor in megaproject delivery. This paper addresses the practical impacts and potential mitigation measures, which may reduce cultural dissonance for a megaproject's delivery. This information is retrieved from on-going case studies in live infrastructure megaprojects in Europe and the Middle East's GCC states, from Western Consultants' perspective. The collaborating researchers each have at least 30 years of construction experience and are engaged in architecture, project management and contracts management, dealing with megaprojects in Europe or the GCC. After examining the cultural interfaces they have observed during the execution of megaprojects, they conclude that globally, culture significantly influences their efficient delivery. The study finds that cultural risk is ever-present, where different nationalities co-manage megaprojects and that cultural conflict poses a real threat to the timely delivery of megaprojects. The study indicates that the higher the cultural distance between the principal actors, the more pronounced the risk, with the risk of cultural dissonance more prominent in GCC megaprojects. The findings support a more culturally aware and cohesive team approach and recommend cross-cultural training to mitigate the effects of cultural disparity.

Keywords: cultural risk underestimation, cultural distance, megaproject characteristics, megaproject execution

Procedia PDF Downloads 106

Authors: Bicky Agarwal, Ambika Behl, Rajiv Kumar, Ashish Dhamaniya

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India ranks second for having the largest road network in the world after the United States (U.S.). According to the National Asphalt Pavement Association (NAPA), the U.S. produced about 94.6 million tons of Reclaimed Asphalt Pavement (RAP) in 2021. Despite the benefits of RAP usage, it is not widely adopted in many countries, including India. Rising asphalt binder costs and environmental concerns have spurred interest in using RAP material in asphalt mixtures. However, increasing RAP content may have adverse effects on certain characteristics of asphalt mixtures, such as cracking resistance. Cracking is a common pavement issue that affects the lifespan and durability of hot-mix asphalt pavements. Assessing cracking resistance is crucial in pavement design. Various laboratory tests and performance indicators are utilized to evaluate cracking resistance. This study aims to use the Texas Overlay Tester (TOT) to assess the impact of reclaimed asphalt pavement (RAP) on the cracking resistance of Bituminous Concrete (BC-II) mixes. Following the Marshall Mix Design method, asphalt mixes with RAP contents of 0% (Control), 30%, 40%, 50%, and 60% were prepared and tested at their Optimum Binder Content (OBC). The ITS results showed that the control mix had an ITS value of 1.2 MPa, with slight decreases observed in mixes containing up to 60% RAP, although these changes were not statistically significant (p=0.538>0.05). The TSR tests indicated that all mixes exceeded the minimum requirement of 80%. The Texas Overlay Test (TOT) was used to evaluate cracking performance and revealed that higher RAP contents had a negative impact on fatigue resistance. The 50% RAP mix exhibited the highest CFE, indicating that it has the best resistance to crack propagation despite having a lower number of cycles to failure. All mixes were categorized as falling into the Soft-crack-resistant quadrant, indicating their ability to resist crack propagation while being more susceptible to crack initiation.

Keywords: RAP, BC-II, HMA, TOT

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Authors: Ling Xu, Giuseppe Loprencipe, Antonio D'Andrea

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Asphalt pavement with recycled and sustainable materials has become the most commonly adopted strategy for road construction, including reclaimed asphalt pavement (RAP) and crumb rubber (CR) from waste tires. However, the adhesion and cohesion characteristics of rubberized reclaimed asphalt pavement were still ambiguous, resulting in deteriorated adhesion behavior and life performance. This research investigated the effect of bonding characteristics on rutting resistance and moisture susceptibility of rubberized reclaimed asphalt pavement in terms of two RAP sources with different oxidation levels and two tire rubber with different particle sizes. Firstly, the binder bond strength (BBS) test and bonding failure distinguishment were conducted to analyze the surface behaviors of binder-aggregate interaction. Then, the compatibility and penetration grade of rubberized RAP binder were evaluated by rotational viscosity test and penetration test, respectively. Hamburg wheel track (HWT) test with high-temperature viscoelastic deformation analysis was adopted, which illustrated the rutting resistance. Additionally, a water boiling test was employed to evaluate the moisture susceptibility of the mixture and the texture features were characterized with the statistical parameters of image colors. Finally, the colloid structure model of rubberized RAP binder with surface interaction was proposed, and statistical analysis was established to release the correlation among various indexes. This study concluded that the gel-phase colloid structure and molecular diffusion of the free light fraction would affect the surface interpretation with aggregate, determining the bonding characteristic of rubberized RAP asphalt.

Keywords: bonding characteristics, reclaimed asphalt pavement, rubberized asphalt, sustainable material

Procedia PDF Downloads 62

Authors: Pavan K. Emani, Shashank Kothari, V. S. Phanikanth

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The ultimate load analysis of RC pile groups has assumed a lot of significance under liquefying soil conditions, especially due to post-earthquake studies of 1964 Niigata, 1995 Kobe and 2001 Bhuj earthquakes. The present study reports the results of numerical simulations on pile groups subjected to monotonically increasing lateral loads under design amounts of pile axial loading. The soil liquefaction has been considered through the non-linear p-y relationship of the soil springs, which can vary along the depth/length of the pile. This variation again is related to the liquefaction potential of the site and the magnitude of the seismic shaking. As the piles in the group can reach their extreme deflections and rotations during increased amounts of lateral loading, a precise modeling of the inelastic behavior of the pile cross-section is done, considering the complete stress-strain behavior of concrete, with and without confinement, and reinforcing steel, including the strain-hardening portion. The possibility of the inelastic buckling of the individual piles is considered in the overall collapse modes. The model is analysed using Riks analysis in finite element software to check the post buckling behavior and plastic collapse of piles. The results confirm the kinds of failure modes predicted by centrifuge test results reported by researchers on pile group, although the pile material used is significantly different from that of the simulation model. The extension of the present work promises an important contribution to the design codes for pile groups in liquefying soils.

Keywords: collapse load analysis, inelastic buckling, liquefaction, pile group

Procedia PDF Downloads 162

Authors: Fatima M. Jadu, Asmaa A. Alzahrani, Maha A. Almutairi, Salma O. Al-Amoudi, Mawya A. Khafaji

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Introduction: Estimating the potential radiation risk for a widely used imaging technique such as cone beam CT (CBCT) is crucial. The aim of this study was to examine the effect of varying two CBCT technical factors, the voxel size (VOX) and the Field-of-View (FOV) centralization, on the radiation dose. Methodology: The head and neck slices of a RANDO® man phantom (Alderson Research Laboratories) were used with nanoDot™ OSLD dosimeters to measure the absorbed radiation dose at 25 predetermined sites. Imaging was done using the i-CAT® (Imaging Science International, Hatfield, PA, USA) CBCT unit. The VOX was changed for every three cycles of exposures from 0.2mm to 0.3mm and then 0.4mm. Then the FOV was centered on the maxilla and mandible alternatively while holding all other factors constant. Finally, the effective radiation dose was calculated for each view and voxel setting. Results: The effective radiation dose was greatest when the smallest VOX was chosen. When the FOV was centered on the maxilla, the highest radiation doses were recorded in the eyes and parotid glands. While on the mandible, the highest radiation doses were recorded in the sublingual and submandibular glands. Conclusion: Minor variations in the CBCT exposure factors significantly affect the effective radiation dose and thus the radiation risk to the patient. Therefore, extreme care must be taken when choosing these parameters especially for vulnerable patients such as children.

Keywords: CBCT, cone beam CT, effective dose, field of view, mandible, maxilla, resolution, voxel

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Authors: D. Suman, M. Venkateshwara Rao

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Cancer is a disease caused by an uncontrolled division of abnormal cells in a part of the body, which is affecting millions of people leading to death. Even though there have been tremendous developments taken place over the last few decades the effective therapy for cancer is still not a reality. The existing techniques of cancer therapy are chemotherapy and radio therapy which are having their limitations in terms of the side effects, patient discomfort, radiation hazards and the localization of treatment. This paper describes a novel method for cancer therapy by using RF-hyperthermia application of nanoparticles. We have synthesized ferromagnetic nanoparticles and characterized by using XRD and TEM. These nanoparticles after the biocompatibility studies will be injected in to the body with a suitable tracer element having affinity to the specific tumor site. When RF energy is applied to the nanoparticles at the tumor site it produces heat of excess room temperature and nearly 41-45°C is sufficient to kill the tumor cells. We have designed a RF source generator provided with a temperature feedback controller to control the radiation induced temperature of the tumor site. The temperature control is achieved through a negative feedback mechanism of the thermocouple and a relay connected to the power source of the RF generator. This method has advantages in terms of its effect like localized therapy, less radiation, and no side effects. It has several challenges in designing the RF source provided with coils suitable for the tumour site, biocompatibility of the nanomaterials, cooling system design for the RF coil. If we can overcome these challenges this method will be a huge benefit for the society.

Keywords: hyperthermia, cancer therapy, RF source generator, nanoparticles

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Authors: Adina Dudau, Georgios Kominis, Melinda Szocs

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This paper links distinct bodies of literature around innovation and public services by examining a case of perceived innovation failure. Through a mixed methodology investigating student attitudes to, and behaviour around, technological innovation in higher education, the paper makes a contribution to the public service innovation literature by focusing on the duality of innovation outcomes, suggestive of an innovation typology in public services. The study was conducted in a UK Russell Group university and it focused on a technological process innovation. The innovation consisted of the provision of feedback to students in the form of a digital video (mp4), tailored to each individual submission, with extended voice-over commentary from the course coordinator and visual cues intended to help students see the relevance of comments to their submissions. The sample of the study consisted of a class of 79 undergraduate students. To investigate student attainment, we designed a field (also known as quasi or natural) experiment, essentially a manipulation of a social setting (in this case, the form of feedback given to students), but as part of a naturally occurring social arrangement (a real course which students attend and in which they are assessed). A two group control group design (see figure 3) was utilised to examine the effectiveness of the feedback innovation (video feedback). Two outcome variables of the service innovation were measured: student satisfaction and student attainment. In other words, the study examined not only students’ perceptions of whether VF was deemed to be beneficial towards their subsequent assignments; but also evidence of actual incremental benefits in students’ performance from one assignment to the next after VF was provided. The results were baffling and indicating competing agendas in higher education.

Keywords: higher education, audio-video, feedback, innovation

Procedia PDF Downloads 359

Authors: Mariana Mangas, Yaroslava Martins, Ana Charraz, Ana Matos Pires

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Introduction: Health literacy empowers people of knowledge, motivation and skills to access, understand, evaluate and mobilize information relating to health. Although the benefits of public knowledge of physical disease are widely accepted, knowledge about mental disorder has been compatibly neglected. Nowadays there is considerably evidence that literacy is of great importance for the promotion of health and prevention of mental illness. Objective: Disclosure the concept and importance of mental health literacy and introduce the literacy program of Psychiatry Service of Hospital José Joaquim Fernandes. Methodology: A search was conducted on PubMed, using keywords “literacy” and “mental health”. A description of mental health literacy interventions implemented on Psychiatry Service of Hospital José Joaquim Fernandes was performed, namely, psychoeducation programs for depression and bipolar disorder. Results and discussion: Health literacy enables patient to be able to actively participate in his treatment. The improving of mental health literacy can promote early identification of mental disorders, improve treatment results, increase the use of health services and allow the community to take action to achieve better mental health. Psychoeducation is very useful in improving the course of disease and in reducing the number of episodes and hospitalizations. Bipolar patients who received psychoeducation and pharmacotherapy have no relapses during the program and last year. Conclusion: Mental health literacy is not simply a matter of having knowledge, rather, it is knowledge linked to action which can benefit mental health.

Keywords: mental health, literacy, psychoeducation, knowledge, empowerment

Procedia PDF Downloads 547

Authors: Walaa H. Salama, Azza M. Abdel-Aty, Afaf S. Fahmy

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Background: Egyptian Cobra; Naja haje (Elapidae) is one of most common snakes, widely distributed in Egypt and its envenomation causes multi-organ failure leading to rapid death. Thus, Different medicinal plants showed a protective effect against venom toxicity and may complement the conventional antivenom therapy. Aim: The present study was designed to assess both the antioxidant capacity of methanolic extract of rosemary leaves and evaluate the neutralizing ability of the extract against hepatotoxicity induced by Naja haje venom. Methods: The total phenolic and flavonoid contents and the antioxidant capacity of the methanolic rosemary extract were estimated by DPPH and ABTS Scavenging methods. In addition, the rosemary extract were assessed for anti-venom properties under in vitro and in vivo standard assays. Results: The rosemary extract had high total phenolic and flavonoid content as 12 ± 2 g of gallic acid equivalent per 100 gram of dry weight (g GAE/100g dw) and 5.5 ± 0.8 g of catechin equivalent per 100 grams of dry weight (g CE/100g dw), respectively. In addition, the rosemary extract showed high antioxidant capacity. Furthermore, The rosemary extract were inhibited in vitro the enzymatic activities of phospholipase A₂, L-amino acid oxidase, and hyaluronidase of the venom in a dose-dependent manner. Moreover, indirect hemolytic activity, hepatotoxicity induced by venom were completely neutralized as shown by histological studies. Conclusion: The phenolic compounds of rosemary extract with potential antioxidant activity may be considered as a promising candidate for future therapeutics in snakebite therapy.

Keywords: antioxidant activity, neutralization, phospholipase A₂ enzyme, snake venom

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Authors: Fatemeh Moosavi, Tumelo Franck Nkoshwane

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Peter Drucker the renowned management guru once said, “The best way to predict the future is to create it.” Mr. Drucker is also the man who placed human capital as the most vital resource of any institution. As such any institution bent on creating a better future, requires a competent human capital, one that is able to execute with efficiency and effectiveness the objective a society aspires to. Technology today is accelerating the rate at which many societies transition to knowledge based societies. In this accelerated paradigm, it is imperative that those in leadership establish a platform capable of sustaining the planned future; intellectual capital. The capitalist economy going into the future will not just be sustained by dollars and cents, but by individuals who possess the creativity to enterprise, innovate and create wealth from ideas. This calls for cities of the future, to have this premise at the heart of their future plan, if the objective of designing sustainable and liveable future cities will be realised. The knowledge economy, now transitioning to the creative economy, requires cities of the future to be ‘gardens’ of inspiration, to be places where knowledge, creativity, and innovation can thrive as these instruments are becoming critical assets for creating wealth in the new economic system. Developing nations must accept that learning is a lifelong process that requires keeping abreast with change and should invest in teaching people how to keep learning. The need to continuously update one’s knowledge, turn these cities into vibrant societies, where new ideas create knowledge and in turn enriches the quality of life of the residents. Cities of the future must have as one of their objectives, the ability to motivate their citizens to learn, share knowledge, evaluate the knowledge and use it to create wealth for a just society. The five functional factors suggested by Kevin Lynch;-vitality, meaning/sense, adaptability, access, control, and monitoring should form the basis on which policy makers and urban designers base their plans for future cities. The authors of this paper believe that developing nations “creative economy clusters”, cities where creative industries drive the need for constant new knowledge creating sustainable learning creative cities. Obviously the form, shape and size of these districts should be cognisant of the environmental, cultural and economic characteristics of each locale. Gaborone city in the republic of Botswana is presented as the case study for this paper.

Keywords: learning city, sustainable creative city, creative industry, good city form

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Authors: Gopika Rajagopal, Sudheesh Thiyyakkandi

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Back-to-back reinforced earth (RE) walls are extensively used in these days as bridge abutments and highway ramps, owing to their cost efficiency and ease of construction. High quality select fill is the most suitable backfill material due to its excellent engineering properties and constructability. However, industries are compelled to use low quality, locally available soil because of its ample availability on site. However, several failure cases of such walls are reported, especially subsequent to rainfall events. The stiffness of reinforcement is one of the major factors affecting the performance of RE walls. The present study focused on analyzing the effect of reinforcement stiffness on the performance of complete select fill, complete marginal fill, and hybrid-fill (i.e., combination of select and marginal fills) back-to-back RE walls, immediately after construction and upon rainwater infiltration through finite element modelling. A constant width to height (W/H) ratio of 3 and height (H) of 6 m was considered for the numerical analysis and the stiffness of reinforcement layers was varied from 500 kN/m to 10000 kN/m. Results showed that reinforcement stiffness had a noticeable influence on the response of RE wall, subsequent to construction as well as rainwater infiltration. Facing displacement was found to decrease and maximum reinforcement tension and factor of safety were observed to increase with increasing the stiffness of reinforcement. However, beyond a stiffness of 5000 kN/m, no significant reduction in facing displacement was observed. The behavior of fully marginal fill wall considered in this study was found to be reasonable even after rainwater infiltration when the high stiffness reinforcement layers are used.

Keywords: back-to-back reinforced earth wall, finite element modelling, rainwater infiltration, reinforcement stiffness

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Authors: Ezeugwunne Ifeoma Priscilla, Charles Chinedum Onyenekwe, Joseph Eberendu Ahaneku, Rosemary Adanma Analike, Adesuwa Peace Eidangbe

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This study was designed to assess the effect of malaria parasitaemia on serum reproductive hormone levels of asymptomatic HIV adult subjects. A total of 271 participants aged between 17 and 58 ears were conveniently recruited. 135 asymptomatic HIV-infected subjects participated in the study; 67 of them had malaria parasitaemia. 136 HIV seropositive control subjects, 68 of them had malaria parasitaemia. Blood samples were collected from the participants for the determination of HIV status by immunoassay and immunochromatography. Enzyme-linked immunosorbent assay (ELISA) was used to assay for serum LH, FSH, Estrogen, testosterone, progesterone, prolactin, and PSA levels, CD4+T cell counts by Cyflow method, thick and thin films determination of malaria parasitaemia count and density by WHO. Student's t-tests and ANOVA were used to compare means. P<0.05 was considered statistically significant. The results showed significant differences in serum levels of LH, FSH, PSA, estrogen, progesterone, and testosterone amongst the groups at P<0.05, respectively. The serum levels of LH, FSH, and PSA were significantly higher in malaria-infected asymptomatic HIV subjects than in asymptomatic HIV subjects with malaria parasitaemia (P<0.05 in each case). Also, the serum levels of LH, FSH, PSA, estrogen, and progesterone were significantly higher in malaria-infected asymptomatic HIV subjects compared with malaria-infected HIV seronegative subjects (P<0.05, respectively). The mean MP counts and MP density were significantly higher in asymptomatic HIV subjects compared to HIV seronegative subjects (P<0.05, in each case). The mean serum levels of testosterone were significantly lower in both malaria-infected and malaria uninfected HIV seronegative subjects (P<0.05, in each case). In conclusion, Malaria and HIV co-infection might increase the burden of hypogonadism as well as primary testicular failure, hyperprogesteronaemia, elevated levels of estrogen, and PSA in adult males asymptomatic HIV subjects.

Keywords: malaria parasitaemia, HIV, CD4, reproductive hormones

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Authors: Cleto J. Sauer Jr

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Introduction: Brazil’s new national curriculum guidelines (NCG) for medical education were published in 2014, presenting active learning methodologies as a cornerstone. Simulation was initially applied for aviation pilots’ training and is currently applied in health sciences. The high-fidelity simulator replicates human body anatomy in detail, also reproducing physiological functions and its use is increasing in medical schools. Realistic Simulation (RS) has pedagogical aspects that are aligned with Brazil’s NCG teaching concepts. The main objective of this study is to carry on a narrative review on RS’s aspects that are aligned with Brazil’s new NCG teaching concepts. Methodology: A narrative review was conducted, with search in three databases (PubMed, Embase and BVS) of studies published between 2010 and 2020. Results: After systematized search, 49 studies were selected and divided into four thematic groups. RS is aligned with new Brazilian medical curriculum as it is an active learning methodology, providing greater patient safety, uniform teaching, and student's emotional skills enhancement. RS is based on reflective learning, a teaching concept developed for adult’s education. Conclusion: RS is a methodology aligned with NCG teaching concepts and has potential to assist in the implementation of new Brazilian medical school’s curriculum. It is an immersive and interactive methodology, which provides reflective learning in a safe environment for students and patients.

Keywords: curriculum, high-fidelity simulator, medical education, realistic simulation

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Authors: Angelika Magiera, Weronika Penar, Czesław Klocek

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Intellectual disability (ID) affects approximately 1.55% of children and adults in the society of developed countries. Depending on the ID degree, the patient is burdened with additional disease entities. Intellectual disability does not only limits a person’s opportunities to participate in social life but also affects whole families. People with ID belong to the group of risk of mental illnesses, they are less emotionally stable, while families are predisposed to depression. The study was held in a day care center for people with intellectual disabilities (of various degrees of disability) on 26 people. Nurses and carers also took part. The age range of study groups ranged from 22 to 67 years. Therapeutic classes were held for four independent mixed groups (sex and intellectual disability degree) from 6 to 7 people each, lasting no more than 30 minutes. They were created by the facility's staff to make sure that a group is stable. The animal assisted activity took place with a 2.5-year-old Ragdoll cat. The animal has passed the exam (certificate entitling her to take part in felinotherapy) and had 1.5 years of work experience. Due to the different degrees of ID, an individual emotional state survey was conducted among the caregivers of those who were involved in the activity, to assess the impact of animal assisted activity with a cat on patients. A positive effect on the emotional state of people with different types of intellectual disability was observed. Caregivers and nurses of those participating in the study express willingness to continue these types of classes and consider them necessary for this group of people.

Keywords: intellectual disabilities, animal-assisted activity, cat, feline, emotions

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Authors: Mohammad Rawashdeh, Mark McEntee, Maha Zaitoun, Mostafa Abdelrahman, Patrick Brennan, Haytham Alewaidat, Sarah Lewis, Charbel Saade

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Despite the tremendous advancements that have been generated by Computed Tomography (CT) in the field of diagnosis, concerns have been raised about the potential cancer induction risk from CT because of the exponentially increased use of it in medicine. This study aims at investigating the application and knowledge of practicing radiographers in Jordan about CT radiation. In order to collect the primary data of this study, a questionnaire was designed and distributed by social media using a snow-balling sampling method. The respondents (n=54) have answered 36 questions including the questions about their demographic information, knowledge about Diagnostic Reference Levels (DRLs), CT exposure and adaptation of pediatric patients exposure. The educational level of the respondents was either at a diploma degree (35.2%) or bachelor (64.8%). The results of this study have indicated a good level of general knowledge between radiographers about the relationship between image quality, exposure parameters, and patient dose. The level of knowledge related to DRL was poor where less than 7.4 percent of the sample members were able to give specific values for a number of common anatomical fields, including abdomen, brain, and chest. Overall, Jordanian radiographers need to gain more knowledge about the expected levels of the dose when applying good practice. Additional education on DRL or DRL inclusion in educational programs is highlighted.

Keywords: computed tomography, CT scan, DRLs, exposure parameters, image quality, radiation dose

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Authors: Ragy Raafat Gaber Attaalla

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Background: We looked at acute poisonings brought on by illegal drugs and pharmaceuticals that influence the nervous system at Assiut University Hospitals. Methods: Between January 2010 and December 2015, we conducted a retrospective examination of patient records from the largest tertiary toxicology referral center in Assiut. We examined the frequency, pattern, and distribution of ages and genders of acute nervous system agent poisoning. Results: 29,083 individuals total—16,657 (57.27%) males and 12,426 (42.73%) females—were included in the current study. Men's and women's median ages were 29 and 26, respectively (p < 0.0001). 10,326 (83.10%) women and 12,071 (72.47%) men under 40 were present (p < 0.001). 44.10% of cases had a history of poisoning, and the majority of cases (69.38% in men and 79.00% in women, p<0.001) were purposeful. Between various age groups and nervous system agents, there were notable variations in the ratios of men and women. The most often used agent for women was alprazolam, whereas methadone was more popular for men. Overall, there was a rising tendency in acute poisoning associated with alcohol and opioids used to treat addiction disorders, but a declining trend with benzodiazepines and antidepressants. Conclusion: Addiction to methadone was widespread, particularly in young males, and the majority of these cases were self-inflicted. Alprazolam and clonazepam poisoning most commonly affect women and males in the 20–29 age range, respectively. Opium was utilized by men over 30 and women over 60. Over half of the deaths were related to illicit narcotics, with opium being the most common. This research could raise awareness and lead to the development of gender- and age-specific local programs for education and prevention.

Keywords: acute poisonings, illegal drugs, pharmaceuticals, nerve system

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Authors: Rezky Rifaini, Raden Bagus Fajriya Hakim

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This research was conducted at the Bolo primary health Care in Bima Regency. The purpose of the research is to find out the association pattern that is formed of medical record database from Bolo Primary health care’s patient. The data used is secondary data from medical records database PHC. Sequential pattern mining technique is the method that used to analysis. Transaction data generated from Patient_ID, Check_Date and diagnosis. Sequential Pattern Discovery Algorithms Using Equivalent Classes (SPADE) is one of the algorithm in sequential pattern mining, this algorithm find frequent sequences of data transaction, using vertical database and sequence join process. Results of the SPADE algorithm is frequent sequences that then used to form a rule. It technique is used to find the association pattern between items combination. Based on association rules sequential analysis with SPADE algorithm for minimum support 0,03 and minimum confidence 0,75 is gotten 3 association sequential pattern based on the sequence of patient_ID, check_Date and diagnosis data in the Bolo PHC.

Keywords: diagnosis, primary health care, medical record, data mining, sequential pattern mining, SPADE algorithm

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Authors: Abraham J. Rizkalla, Joanne F. Irons, Christopher Q. Cao

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Purpose: Lobectomy was considered the standard of care for early-stage non-small lung cancer (NSCLC) after the Lung Cancer Study Group trial demonstrated increased locoregional recurrence for sublobar resections. However, there has been heightened interest in segmentectomies for selected patients with peripheral lesions ≤2cm, as investigated by the JCOG0802 and CALGB140503 trials. Minimally invasive robotic surgery facilitates segmentectomies with improved maneuverability and visualization of intersegmental planes using indocyanine green. We hereby present a patient who underwent robotic lingulectomy for an undiagnosed ground-glass opacity. Methodology: This video demonstrates a robotic portal lingulectomy using three 8mm ports and a 12mm port. Stereoscopic direct vision facilitated the identification of the lingula artery and vein, and intra-operative bronchoscopy was performed to confirm the lingula bronchus. The intersegmental plane was identified by indocyanine green and a near-infrared camera. Thorough lymph node sampling was performed in accordance with international standards. Results: The 18mm lesion was successfully excised with clear margins to achieve R0 resection with no evidence of malignancy in the 8 lymph nodes sampled. Histopathological examination revealed lepidic predominant adenocarcinoma, pathological stage IA. Conclusion: This video presentation exemplifies the standard approach for robotic portal lingulectomy in appropriately selected patients.

Keywords: lung cancer, robotic segmentectomy, indocyanine green, lingulectomy

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