Search results for: resource-limited care environments
1194 An Exploration Survival Risk Factors of Stroke Patients at a General Hospital in Northern Taiwan
Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang
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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.Keywords: stroke, risk, pneumonia, survival
Procedia PDF Downloads 2471193 The Effect of Antibiotic Use on Blood Cultures: Implications for Future Policy
Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor
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Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.Keywords: antibiotics, blood culture, efficacy, inpatient
Procedia PDF Downloads 1771192 Health Ramifications of Workplace Bullying: Gender, Race and Sexual Orientation as Risk Factors
Authors: Kathleen Canul
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Bullying is on the rise according to several recent studies. Workplace bullying has garnered less attention than other forms yet incidence rates range from 35-45%. The consequences of being bullied at work are broad, ranging from physiological to psychological to occupational. As the bullying progresses, employees begin to exhibit physical and psychological symptoms. Blood pressure rises, along with other cardiac related concerns. For men, covert coping with job unfairness was associated with a four-fold risk of heart attack and death. Gastrointestinal distress, headaches, muscle tension, sleep disorders and exhaustion are also common. Workplace bullying appears to contribute to the risk of subsequent psychotropic medication, as well. Emotionally, anxiety and depression increase along with lowered self-esteem and problems concentrating on the duties of the job. In an attempt to cope, individuals may succumb to unhealthy practices involving food, alcohol and other drugs. Patterns of bullying vary by gender, race, and ethnicity, as well as sexual orientation, with women, ethnic minorities and LGBTQ employees reporting higher rates of bullying in the workplace. Not only is this an issue of inequity on the job, but also a problem of health disparities as there are few mental health professionals confident and competent in dealing with workplace bullying issues, and the lack of culturally competent clinicians exacerbates this inequality in receiving adequate care. Alone, the topic of workplace bullying is not unique; however, the diverse experiences of underrepresented groups who disproportionately are affected on the job and suffer untreated, health related concerns represent a significant and emerging problem requiring attention. Conference participants who have experienced, witnessed or help those bullied on the job would benefit most from this review of the literature on the consequences of bullying experienced by diverse and underrepresented groups in the workplace.Keywords: bullying, ethnic minorities, health disparities, workplace conflict
Procedia PDF Downloads 2831191 Cellulolytic and Xylanolytic Enzymes from Mycelial Fungi
Authors: T. Sadunishvili, L. Kutateladze, T. Urushadze, R. Khvedelidze, N. Zakariashvili, M. Jobava, G. Kvesitadze
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Multiple repeated soil-climatic zones in Georgia determines the diversity of microorganisms. Hundreds of microscopic fungi of different genera have been isolated from different ecological niches, including some extreme environments. Biosynthetic ability of microscopic fungi has been studied. Trichoderma ressei, representative of the Ascomycetes secrete cellulolytic and xylanolytic enzymes that act in synergy to hydrolyze polysaccharide polymers to glucose, xylose and arabinose, which can be fermented to biofuels. The other mesophilic strains producing cellulases are Allesheria terrestris, Chaetomium thermophile, Fusarium oxysporium, Piptoporus betulinus, Penicillium echinulatum, P. purpurogenum, Aspergillus niger, A. wentii, A. versicolor, A. fumigatus etc. In the majority of the cases the cellulases produced by strains of genus Aspergillus usually have high β-glucosidase activity and average endoglucanases levels (with some exceptions), whereas strains representing Trichoderma have high endo enzyme and low β-glucosidase, and hence has limited efficiency in cellulose hydrolysis. Six producers of stable cellulases and xylanases from mesophilic and thermophilic fungi have been selected. By optimization of submerged cultivation conditions, high activities of cellulases and xylanases were obtained. For enzymes purification, their sedimentation by organic solvents such as ethyl alcohol, acetone, isopropanol and by ammonium sulphate in different ratios have been carried out. Best results were obtained with precipitation by ethyl alcohol (1:3.5) and ammonium sulphate. The yields of enzyme according to cellulase activities were 80-85% in both cases. Cellulase activity of enzyme preparation obtained from the strain Trichoderma viride X 33 is 126 U/g, from the strain Penicillium canescence D 85–185U/g and from the strain Sporotrichum pulverulentum T 5-0 110 U/g. Cellulase activity of enzyme preparation obtained from the strain Aspergillus sp. Av10 is 120 U/g, xylanase activity of enzyme preparation obtained from the strain Aspergillus niger A 7-5–1155U/g and from the strain Aspergillus niger Aj 38-1250 U/g. Optimum pH and temperature of operation and thermostability, of the enzyme preparations, were established. The efficiency of hydrolyses of different agricultural residues by the microscopic fungi cellulases has been studied. The glucose yield from the residues as a result of enzymatic hydrolysis is highly determined by the ratio of enzyme to substrate, pH, temperature, and duration of the process. Hydrolysis efficiency was significantly increased as a result of different pretreatment of the residues by different methods. Acknowledgement: The Study was supported by the ISTC project G-2117, funded by Korea.Keywords: cellulase, xylanase, microscopic fungi, enzymatic hydrolysis
Procedia PDF Downloads 3991190 Early Influences on Teacher Identity: Perspectives from the USA and Northern Ireland
Authors: Martin Hagan
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Teacher identity has been recognised as a crucial field of research which supports understanding of the ways in which teachers navigate the complexities of professional life in order to grow in competence, knowledge and practice. As a field of study, teacher identity is concerned with understanding: how identity is defined; how it develops; how teachers make sense of their emerging identity; and how the act of teaching is mediated through the individual teacher’s values, beliefs and sense of professional self. By comparing two particular, socially constructed learning contexts or ‘learning milieu’, one in Northern Ireland and the other in the United States of America, this study aims specifically, to gain better understanding of how teacher identity develops during the initial phase of teacher education. The comparative approach was adopted on the premise that experiences are constructed through interactive, socio-historical and cultural negotiations with others within particular environments, situations and contexts. As such, whilst the common goal is to ‘become’ a teacher, the nuances emerging from the different learning milieu highlight variance in discourse, priorities, practice and influence. A qualitative, interpretative research design was employed to understand the world-constructions of the participants through asking open-ended questions, seeking views and perspectives, examining contexts and eventually deducing meaning. Data were collected using semi structured interviews from a purposive sample of student teachers (n14) in either the first or second year of study in their respective institutions. In addition, a sample of teacher educators (n5) responsible for the design, organisation and management of the programmes were also interviewed. Inductive thematic analysis was then conducted, which highlighted issues related to: the participants’ personal dispositions, prior learning experiences and motivation; the influence of the teacher education programme on the participants’ emerging professional identity; and the extent to which the experiences of working with teachers and pupils in schools in the context of the practicum, challenged and changed perspectives on teaching as a professional activity. The study also highlights the varying degrees of influence exercised by the different roles (tutor, host teacher/mentor, student) within the teacher-learning process across the two contexts. The findings of the study contribute to the understanding of teacher identity development in the early stages of professional learning. By so doing, the research makes a valid contribution to the discourse on initial teacher preparation and can help to better inform teacher educators and policy makers in relation to appropriate strategies, approaches and programmes to support professional learning and positive teacher identity formation.Keywords: initial teacher education, professional learning, professional growth, teacher identity
Procedia PDF Downloads 761189 Impacts of Ibeju - Lekki New Town on Neighbouring Residents of Ibeju, Lagos Nigeria
Authors: Abolade Olajoke, Adigun Folasade Oyenike, Odunjo Oluronke Omolola Olaleye, Babajide Rotimi
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Against the shortfall associated with unprecedented urbanization in most cities of the world, coupled with rapid expansion of outer boundaries, is the resultant birth of the development of new towns. The paper therefore examines the impacts of Ibeju - Lekki New Town on Neighbouring communities of Ibeju Lekki. Random systematic sampling was employed elicit relevant information from a total number of 269 residents at interval of five buildings in four neighbouring communities. Descriptive statistics was employed to test for the socioeconomic characteristics of respondents, problems faced by government officials during the implementation and monitoring process. Likert scale was employed to ascertain respondents view on the impact of the new town on neighbouring communities. Result from the findings shows that male (56.9%) are the most dominant occupant in the study area of which most (68.1%) fall within the most the active age group (18-39 and 40-59 years). Results further shows that 36% of the total respondents are traders and majority (32%) earn below government salary wage cap of ₦18000 thus indicating that majority of the respondents are petty traders. Results of findings from development authority reveals that the major problem encountered during monitoring and implementation is harassment of government officials (35%). Result of likert scale further show that new town has brought increase in intensity of land use within neighbouring communities (RAI 3.65), provision of job opportunity (RAI 3.57). This have consequently improve standard of living of the neighbouring community (RAI 3.27). On the contrary some (RAI 1.97) opined that attention should paid to provision of power supply and provision of recreation facilities (RAI I.63). The study recommends that government should make adequate provisions for basic facilities such power supply, adequate health care system, basic education and provision of healthy portable water. This should be given utmost priority to enhance the living condition of residents. To forestall attack from residents’ adequate security measures should be provided as backup for Government official during implementation and monitoring. Appropriate sanction to illegal occupants and demolition of illegal structures should be fully implemented, This will indubitably prevent haphazard development and also promote a liveable environment. Against the shortfall associated with unprecedented urbanization in most cities of the world, coupled with rapid expansion of outer boundaries, is the resultant birth of the development of new towns. The paper therefore examines the impacts of Ibeju - Lekki New Town on Neighbouring communities of Ibeju Lekki. Random systematic sampling was employed elicit relevant information from a total number of 269 residents at interval of five buildings in four neighbouring communities. Descriptive statistics was employed to test for the socioeconomic characteristics of respondents, problems faced by government officials during the implementation and monitoring process. Likert scale was employed to ascertain respondents view on the impact of the new town on neighbouring communities. Result from the findings shows that male (56.9%) are the most dominant occupant in the study area of which most (68.1%) fall within the most the active age group (18-39 and 40-59 years). Results further shows that 36% of the total respondents are traders and majority (32%) earn below government salary wage cap of ₦18000 thus indicating that majority of the respondents are petty traders. Results of findings from development authority reveals that the major problem encountered during monitoring and implementation is harassment of government officials (35%) Result of likert scale further show that new town has brought increase in intensity of land use within neighbouring communities (RAI 3.65), provision of job opportunity (RAI 3.57). This have consequently improve standard of living of the neighbouring community (RAI 3.27). On the contrary some (RAI 1.97) opined that attention should paid to provision of power supply and provision of recreation facilities (RAI I.63). The study recommends that government should make adequate provisions for basic facilities such power supply, adequate health care system, basic education and provision of healthy portable water. This should be given utmost priority to enhance the living condition of residents. To forestall attack from residents’ adequate security measures should be provided as backup for Government official during implementation and monitoring. Appropriate sanction to illegal occupants and demolition of illegal structures should be fully implemented, This will indubitably prevent haphazard development and also promote a liveable environment.Keywords: new town, urbanization, infrastructure boundary
Procedia PDF Downloads 4121188 Cumulative Pressure Hotspot Assessment in the Red Sea and Arabian Gulf
Authors: Schröde C., Rodriguez D., Sánchez A., Abdul Malak, Churchill J., Boksmati T., Alharbi, Alsulmi H., Maghrabi S., Mowalad, Mutwalli R., Abualnaja Y.
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Formulating a strategy for sustainable development of the Kingdom of Saudi Arabia’s coastal and marine environment is at the core of the “Marine and Coastal Protection Assessment Study for the Kingdom of Saudi Arabia Coastline (MCEP)”; that was set up in the context of the Vision 2030 by the Saudi Arabian government and aimed at providing a first comprehensive ‘Status Quo Assessment’ of the Kingdom’s marine environment to inform a sustainable development strategy and serve as a baseline assessment for future monitoring activities. This baseline assessment relied on scientific evidence of the drivers, pressures and their impact on the environments of the Red Sea and Arabian Gulf. A key element of the assessment was the cumulative pressure hotspot analysis developed for both national waters of the Kingdom following the principles of the Driver-Pressure-State-Impact-Response (DPSIR) framework and using the cumulative pressure and impact assessment methodology. The ultimate goals of the analysis were to map and assess the main hotspots of environmental pressures, and identify priority areas for further field surveillance and for urgent management actions. The study identified maritime transport, fisheries, aquaculture, oil, gas, energy, coastal industry, coastal and maritime tourism, and urban development as the main drivers of pollution in the Saudi Arabian marine waters. For each of these drivers, pressure indicators were defined to spatially assess the potential influence of the drivers on the coastal and marine environment. A list of hotspots of 90 locations could be identified based on the assessment. Spatially grouped the list could be reduced to come up with of 10 hotspot areas, two in the Arabian Gulf, 8 in the Red Sea. The hotspot mapping revealed clear spatial patterns of drivers, pressures and hotspots within the marine environment of waters under KSA’s maritime jurisdiction in the Red Sea and Arabian Gulf. The cascading assessment approach based on the DPSIR framework ensured that the root causes of the hotspot patterns, i.e. the human activities and other drivers, can be identified. The adapted CPIA methodology allowed for the combination of the available data to spatially assess the cumulative pressure in a consistent manner, and to identify the most critical hotspots by determining the overlap of cumulative pressure with areas of sensitive biodiversity. Further improvements are expected by enhancing the data sources of drivers and pressure indicators, fine-tuning the decay factors and distances of the pressure indicators, as well as including trans-boundary pressures across the regional seas.Keywords: Arabian Gulf, DPSIR, hotspot, red sea
Procedia PDF Downloads 1451187 Implementation of an Induction Programme to Help the International Medical Graduates in the NHS
Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw
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Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.
Procedia PDF Downloads 1391186 Self-Reliant Peer Learning for Nursing Students
Authors: U.-B. Schaer, M. Wehr, R. Hodler
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Background: Most nursing students require more training time for necessary nursing skills than defined by nursing schools curriculum to acquire basic nursing skills. Given skills training lessons are too brief to enable effective student learning, meaning in-depth skills practice and repetition various learning steps. This increases stress levels and the pressure to succeed for a nursing student with slower learning capabilities. Another possible consequence is that nursing students are less prepared in the required skills for future clinical practice. Intervention: The Bern College of Higher Education of Nursing, Switzerland, started the independent peer practice learning program in 2012. A concept was developed which defines specific aims and content as well as student’s rights and obligations. Students enlist beforehand and order the required materials. They organize themselves and train in small groups in allocated training location in the area of Learning Training and Transfer (LTT). During the peer practice, skills and knowledge can be repeatedly trained and reflected in the peer groups without the presence of a tutor. All invasive skills are practiced only on teaching dummies. This allows students to use all their potential. The students may access learning materials as literature and their own student notes. This allows nursing students to practice their skills and to deepen their knowledge on corresponding with their own learning rate. Results: Peer group discussions during the independent peer practice learning support the students in gaining certainty and confidence in their knowledge and skills. This may improve patient safety in future daily care practice. Descriptive statics show that the number of students who take advantage of the independent peer practice learning increased continuously (2012-2018). It has to be mentioned that in 2012, solely students of the first semester attended the independent peer practice learning program, while in 2018 over one-third of the participating students were in their fifth semester and final study year. It is clearly visible that the demand for independent peer practice learning is increasing. This has to be considered in the development of future teaching curricula.Keywords: learning program, nursing students, peer learning, skill training
Procedia PDF Downloads 1251185 Social Norms around Adolescent Girls’ Marriage Practices in Ethiopia: A Qualitative Exploration
Authors: Dagmawit Tewahido
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Purpose: This qualitative study was conducted to explore social norms around adolescent girls’ marriage practices in West Hararghe, Ethiopia, where early marriage is prohibited by law. Methods: Twenty Focus Group Discussions were conducted with Married and Unmarried adolescent girls, adolescent boys and parents of girls using locally developed vignettes. A total of 32 in-depth interviews were conducted with married and unmarried adolescent girls, husbands of adolescent girls and mothers-in-law. Key informant interviews were conducted with 36 district officials. Data analysis was assisted by Open Code computer software. The Social Norms Analysis Plot (SNAP) framework developed by CARE guided the development and analysis of vignettes. A thematic data analysis approach was utilized to summarize the data. Results: Early marriage is seen as a positive phenomenon in our study context, and girls who are not married by the perceived ideal age of 15 are socially sanctioned. They are particularly influenced by their peers to marry. Marrying early is considered a chance given by God and a symbol of good luck. The two common types of marriage are decided: 1) by adolescent girl and boy themselves without seeking parental permission (’Jalaa-deemaa’- meaning ‘to go along’), and 2) by just informing girl’s parents (‘Cabsaa’- meaning ‘to break the culture’). Relatives and marriage brokers also arrange early marriages. Girls usually accept the first marriage proposal regardless of their age. Parents generally tend not to oppose marriage arrangements chosen by their daughters. Conclusions: In the study context social norms encourage early marriage despite the existence of a law prohibiting marriage before the age of eighteen years. Early marriage commonly happens through consensual arrangements between adolescent girls and boys. Interventions to reduce early marriage need to consider the influence of Reference Groups on the decision makers for marriages, especially girls’ own peers.Keywords: adolescent girls, social norms, early marriage, Ethiopia
Procedia PDF Downloads 1451184 Job Stress Among the Nurses of the Emergency Department of Selected Saudi Hospital
Authors: Mahmoud Abdel Hameed Shahin
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Job demands that are incompatible with an employee's skills, resources, or needs cause unpleasant emotional and physical reactions known as job stress. Nurses offer care in hospital emergency rooms all around the world, and since they operate in such a dynamic and unpredictable setting, they are constantly under pressure. It has been discovered that job stress has harmful impacts on nurses' health as well as their capacity to handle the demands of their jobs. The purpose of this study was to evaluate the level of job stress experienced by the emergency department nurses at King Fahad Specialist Hospital in Buraidah City, Saudi Arabia. In October 2021, a cross-sectional descriptive study was conducted. 80 nurses were conveniently selected for the study, the bulk of them worked at King Fahad Specialist Hospital's emergency department. An electronic questionnaire with a sociodemographic data sheet and a job stress scale was given to the participating nurses after ethical approval was received from the Ministry of Health's representative bodies. Using SPSS Version 26, both descriptive and inferential statistics were employed to analyze and tabulate the acquired data. According to the findings, the factors that contributed to the most job stress in the clinical setting were having an excessive amount of work to do and working under arbitrary deadlines, whereas the factors that contributed to the least stress were receiving the proper recognition or rewards for good work. In the emergency room of King Fahad Specialist Hospital, nurses had a moderate level of stress (M=3.32 ± 0.567/5). Based on their experience, emergency nurses' levels of job stress varied greatly, with nurses with less than a year of experience notably experiencing the lowest levels of job stress. The amount of job stress did not differ significantly based on the emergency nurses' age, nationality, gender, marital status, position, or level of education. The causes and impact of stress on emergency nurses should be identified and alleviated by hospitals through the implementation of interventional programs.Keywords: emergency nurses, job pressure, Qassim, Saudi Arabia, job stress
Procedia PDF Downloads 1971183 Biosorption of Nickel by Penicillium simplicissimum SAU203 Isolated from Indian Metalliferous Mining Overburden
Authors: Suchhanda Ghosh, A. K. Paul
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Nickel, an industrially important metal is not mined in India, due to the lack of its primary mining resources. But, the chromite deposits occurring in the Sukinda and Baula-Nuasahi region of Odhisa, India, is reported to contain around 0.99% of nickel entrapped in the goethite matrix of the lateritic iron rich ore. Weathering of the dumped chromite mining overburden often leads to the contamination of the ground as well as the surface water with toxic nickel. Microbes inherent to this metal contaminated environment are reported to be capable of removal as well as detoxification of various metals including nickel. Nickel resistant fungal isolates obtained in pure form from the metal rich overburden were evaluated for their potential to biosorb nickel by using their dried biomass. Penicillium simplicissimum SAU203 was the best nickel biosorbant among the 20 fungi tested and was capable to sorbing 16.85 mg Ni/g biomass from a solution containing 50 mg/l of Ni. The identity of the isolate was confirmed using 18S rRNA gene analysis. The sorption capacity of the isolate was further standardized following Langmuir and Freundlich adsorption isotherm models and the results reflected energy efficient sorption. Fourier-transform infrared spectroscopy studies of the nickel loaded and control biomass in a comparative basis revealed the involvement of hydroxyl, amine and carboxylic groups in Ni binding. The sorption process was also optimized for several standard parameters like initial metal ion concentration, initial sorbet concentration, incubation temperature and pH, presence of additional cations and pre-treatment of the biomass by different chemicals. Optimisation leads to significant improvements in the process of nickel biosorption on to the fungal biomass. P. simplicissimum SAU203 could sorb 54.73 mg Ni/g biomass with an initial Ni concentration of 200 mg/l in solution and 21.8 mg Ni/g biomass with an initial biomass concentration of 1g/l solution. Optimum temperature and pH for biosorption was recorded to be 30°C and pH 6.5 respectively. Presence of Zn and Fe ions improved the sorption of Ni(II), whereas, cobalt had a negative impact. Pre-treatment of biomass with various chemical and physical agents has affected the proficiency of Ni sorption by P. simplicissimum SAU203 biomass, autoclaving as well as treatment of biomass with 0.5 M sulfuric acid and acetic acid reduced the sorption as compared to the untreated biomass, whereas, NaOH and Na₂CO₃ and Twin 80 (0.5 M) treated biomass resulted in augmented metal sorption. Hence, on the basis of the present study, it can be concluded that P. simplicissimum SAU203 has the potential for the removal as well as detoxification of nickel from contaminated environments in general and particularly from the chromite mining areas of Odhisa, India.Keywords: nickel, fungal biosorption, Penicillium simplicissimum SAU203, Indian chromite mines, mining overburden
Procedia PDF Downloads 1931182 Robot-Assisted Laparoscopic Surgeries: Current Use in Pediatric Urology Patients
Authors: Rimel Mwamba, Mohan Gundeti
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Introduction: The use of robot-assisted laparoscopic surgeries (RALS) has largely increased in recent years, offering faster and safer treatment options for pediatric patients. In the field of urology, RALS has shown a significant advantage over laparoscopic and open surgeries but continues to be controversial in pediatric cases due to limited comprehensive data on its use. Methods: In this review, we aim to summarize the factors associated with RALS use in pediatric cases involving pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction. We used PubMed, EMBASE, and the Cochrane Database of Systematic Reviews to systematically search for literature on the topic. We then critically assessed and compiled data on RALS outcomes, complications, and associated factors. Results: To date, numerous comparative studies have been conducted on pediatric RALS, with only one randomized control trial investigating the nuances of robotic use against standard of care treatments. These robotic approaches have shown promise in post-surgical outcomes for pediatric patients undergoing upper and lower urinary tract reconstruction. Barriers to use still persist, however, showcasing a need to increase access to the technology, refine instruments for pediatric use, address cost barriers, and provide proper training for surgeons. Conclusion: RALS providesan opportunity to improve pediatric patient outcomes for numerous urologic complications. Additional studies are required to better compare the use of RALS with current standard practices. Due to the difficult nature of conducting randomized control trials, additional prospective observational studies are needed.Keywords: pediatric urology, robot-assisted laparoscopic surgeries (RALS), pyeloplasty, ureteral reimplantation, heminephrectomy, and lower urinary tract reconstruction
Procedia PDF Downloads 1001181 The Impact of Neuroscience Knowledge on the Field of Education
Authors: Paula Andrea Segura Delgado, Martha Helena Ramírez-Bahena
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Research on how the brain learns has a transcendental application in the educational context. It is crucial for teacher training to understand the nature of brain changes and their direct influence on learning processes. This communication is based on a literature review focused on neuroscience, neuroeducation, and the impact of digital technology on the human brain. Information was gathered from both English and Spanish language sources, using online journals, books and reports. The general objective was to analyze the role of neuroscience knowledge in enriching our understanding of the learning process. In fact, the authors have focused on the impact of digital technology on the human brain as well as its influence in the field of education..Neuroscience knowledge can contribute significantly to improving the training of educators and therefore educational practices. Education as an instrument of change and school as an agent of socialization, it is necessary to understand what it aims to transform: the human brain. Understanding the functioning of the human brain has important repercussions on education: this elucidates cognitive skills, psychological processes and elements that influence the learning process (memory, executive functions, emotions and the circadian cycle); helps identify psychological and neurological deficits that can impede learning processes (dyslexia, autism, hyperactivity); It allows creating environments that promote brain development and contribute to the advancement of brain capabilities in alignment with the stages of neurobiological development. The digital age presents diverse opportunities to every social environment. The frequent use of digital technology (DT) has had a significant and abrupt impact on both the cognitive abilities and physico-chemical properties of the brain, significantly influencing educational processes. Hence, educational community, with the insights from advances in neuroscience, aspire to identify the positive and negative effects of digital technology on the human brain. This knowledge helps ensure the alignment of teacher training and practices with these findings. The knowledge of neuroscience enables teachers to develop teaching methods that are aligned with the way the brain works. For example, neuroscience research has shown that digital technology is having a significant impact on the human brain (addition, anxiety, high levels of dopamine, circadian cycle disorder, decrease in attention, memory, concentration, problems with their social relationships). Therefore, it is important to understand the nature of these changes, their impact on the learning process, and how educators should effectively adapt their approaches based on these brain's changes.Keywords: digital technology, learn process, neuroscience knowledge, neuroeducation, training proffesors
Procedia PDF Downloads 661180 Electrochemical Corrosion and Mechanical Properties of Structural Materials for Oil and Gas Applications in Simulated Deep-Sea Well Environments
Authors: Turin Datta, Kisor K. Sahu
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Structural materials used in today’s oil and gas exploration and drilling of both onshore and offshore oil and gas wells must possess superior tensile properties, excellent resistance to corrosive degradation that includes general, localized (pitting and crevice) and environment assisted cracking such as stress corrosion cracking and hydrogen embrittlement. The High Pressure and High Temperature (HPHT) wells are typically operated at temperature and pressure that can exceed 300-3500F and 10,000psi (69MPa) respectively which necessitates the use of exotic materials in these exotic sources of natural resources. This research investigation is focussed on the evaluation of tensile properties and corrosion behavior of AISI 4140 High-Strength Low Alloy Steel (HSLA) possessing tempered martensitic microstructure and Duplex 2205 Stainless Steel (DSS) having austenitic and ferritic phase. The selection of this two alloys are primarily based on economic considerations as 4140 HSLA is cheaper when compared to DSS 2205. Due to the harsh aggressive chemical species encountered in deep oil and gas wells like chloride ions (Cl-), carbon dioxide (CO2), hydrogen sulphide (H2S) along with other mineral organic acids, DSS 2205, having a dual-phase microstructure can mitigate the degradation resulting from the presence of both chloride ions (Cl-) and hydrogen simultaneously. Tensile properties evaluation indicates a ductile failure of DSS 2205 whereas 4140 HSLA exhibit quasi-cleavage fracture due to the phenomenon of ‘tempered martensitic embrittlement’. From the potentiodynamic polarization testing, it is observed that DSS 2205 has higher corrosion resistance than 4140 HSLA; the former exhibits passivity signifying resistance to localized corrosion while the latter exhibits active dissolution in all the environmental parameters space that was tested. From the Scanning Electron Microscopy (SEM) evaluation, it is understood that stable pits appear in DSS 2205 only when the temperature exceeds the critical pitting temperature (CPT). SEM observation of the corroded 4140 HSLA specimen tested in aqueous 3.5 wt.% NaCl solution reveals intergranular cracking which appears due to the adsorption and diffusion of hydrogen during polarization, thus, causing hydrogen-induced cracking/hydrogen embrittlement. General corrosion testing of DSS 2205 in acidic brine (pH~3.0) solution at ambient temperature using coupons indicate no weight loss even after three months whereas the corrosion rate of AISI 4140 HSLA is significantly higher after one month of testing.Keywords: DSS 2205, polarization, pitting, SEM
Procedia PDF Downloads 2661179 Factors Associated with Skin Injuries Due to the Use of N95 Masks among Brazilian Nursing Professionals
Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Renata Karina Reis, Soraia Assad Nasbine Rabeh, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira e Silva, Sheila Araújo Teles
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Context and significance: Nursing team professionals faced challenges in combating the COVID-19 pandemic around the world. They were subjected to exhausting workloads and prolonged use of Personal Protective Equipment. Using N95 masks for long periods of time can cause skin changes. In this context, health professionals who worked on the front lines of fighting the pandemic were more exposed to possible physical and psychological changes. Objective: The aim of the study was to analyze the factors associated with skin lesions resulting from the use of N95 masks among nursing team professionals. Method: The study was carried out in all regions of Brazil from October to December 2020, with professionals from the nursing team who worked in health care during the COVID-19 pandemic. Participants were recruited via social media, and information was collected electronically and stored on the Survey Monkey platform. Descriptive statistics were used to characterize the sample, association tests (Chi-square), with a statistical significance level of p < 0.05. Factors associated with skin lesions resulting from the use of an N95 mask were determined by Binary Logistic Regression, with a significance level of 5% (α = 0.05). Results: 8,405 nursing professionals participated in the study, 5,492 nurses (65.3%), 2,747 nursing technicians (32.7%), and 7,084 females (84.3%). Female nursing team professionals were 1.4 times more likely to develop skin lesions due to the use of N95 masks when compared to males (OR 1.4 [CI95% 1.22 – 1.59] p < 0.001). The following protective factors were identified: nursing technician (ORA 0.608 [CI95% 0.43 – 0.86] p = 0.005) and not having provided assistance in field hospitals for COVID-19 (0.73 [CI95% 0.65-0.81] p<0.000). Conclusion: It was concluded that female nursing team professionals were more likely to have skin changes related to the use of N95 masks. The need for intervention studies is emphasized in order to explore measures to prevent these types of injuries. Descritores: Nursing professionals; COVID-19; SARS-CoV-2; Brazil.Keywords: nursing professionals, COVID-19, SARS-CoV-2, Brazil
Procedia PDF Downloads 781178 The Influence of Bacteriocins Producing Lactic Acid Bacteria Multiplied in an Alternative Substrate on Calves Blood Parameters
Authors: E. Bartkiene, V. Krungleviciute, J. Kucinskiene, R. Antanaitis, A. Kucinskas
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In calves less than 10-day-old, infection commonly cause severe diarrhoea and high mortality. To prevention of calves diseases a common practice is to treat calves with prophylactic antibiotics, in this case the use of lactic acid bacteria (LAB) is promising. Often LAB strains are incubated in comercial de Man-Rogosa-Sharpe (MRS) medium, the culture are centrifuged, the cells are washing with sterile water, and this suspension is used as a starter culture for animal health care. Juice of potatoe tubers is industrial wastes, wich may constitute a source of digestible nutrients for microorganisms. In our study the ability of LAB to utilize potatoe tubers juice in cell synthesis without external nutrient supplement was investigated, and the influence of multiplied LAB on calves blood parameters was evaluated. Calves were selected based on the analogy principle (treatment group (n=6), control group (n=8)). For the treatment group 14 days was given a 50 ml of fermented potatoe tubers juice containing 9.6 log10 cfu/ml of LAB. Blood parameters (gas and biochemical) were assessed by use of an auto-analyzers (Hitachi 705 and EPOC). Before the experiment, blood pH of treatment group calves was 7.33, control – 7.36, whereas, after 14 days, 7.28 and 7.36, respectively. Calves blood pH in the treatment group remained stable over the all experiment period. Concentration of PCO2 in control calves group blood increased from 63.95 to 70.93, whereas, in the treatment group decreased from 63.08 to 60.71. Concentration of lactate in the treatment group decreased from 3.20 mmol/l to 2.64 mmol/l, whereas, in control - increased from 3.95 mmol/l to 4.29 mmol/l. Concentration of AST in the control calves group increased from 50.18 IU/L to 58.9 IU/L, whereas, in treatment group decreased from 49.82 IU/L to 33.1 IU/L. We conclude that the 50 ml of fermented potatoe tubers juice containing 9.6 log10 cfu/ml of LAB per day, by using 14 days, reduced risk of developing acidosis (stabilizes blood pH (p < 0.05)), reduces lactates and PCO2 concentration (p < 0.05) and risk of liver lesions (reduces AST concentration (p < 0.005)) in blood of calves.Keywords: alternative substrate, blood parameters, calves, lactic acid bacteria
Procedia PDF Downloads 3171177 Effects of Anti-FGL2 Monoclonal Antibody SPF89 on Vascular Inflammation
Authors: Ying Sun, Biao Cheng, Qing Lu, Xuefei Tao, Xiaoyu Lai, Cheng Guo, Dan Wang
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Fibrinogen-like protein 2 (FGL2) has recently been identified to play an important role in inflammatory diseases such as atherosclerosis through a thrombin-dependent manner. Here, a murine monoclonal antibody was raised against the critical residue Ser(89) of FGL2, and the effects of the anti-FGL2 mAb (SPF89) were analyzed in human umbilical vein endothelial cells (HUVECs) and THP-1 cells. Firstly, it was proved that SPF89, which belongs to the IgG1 subtype with a KD value of 44.5 pM, could specifically show the expression levels of protein FGL2 in different cell lines of known target gene status. The lipopolysaccharide (LPS)-mediated endothelial cell proliferation was significantly inhibited with a decline of phosphorylation nuclear factor-κB (NF-κB) in a dose-dependent manner after SPF89 treatment. Furthermore, SPF89 reduced LPS-induced expression of adhesion molecules and inflammatory cytokines such as vascular cell adhesion molecule-1, tumor necrosis factor-α, Matrix metalloproteinase MMP-2, Integrin αvβ3, and interleukin-6 in HUVECs. In macrophage-like THP-1 cells, SPF89 effectively inhibited LPS and low-density lipoprotein-induced foam cell formation. However, these anti-inflammatory and anti-atherosclerotic effects of anti-FGL2 mAb in HUVECs and THP-1 cells were significantly reduced after treatment with an NF-κB inhibitor PDTC. All the above suggest, by efficiently inhibiting LPS-induced pro-inflammatory effects in vascular endothelial cells by attenuating NF-κB dependent pathway, the new anti-FGL2 mAb SPF89 could to be a potential therapeutic candidate for protecting the vascular endothelium against inflammatory diseases such as atherosclerosis. This work was supported by the Program of Sichuan Science and Technology Department (2017FZ0069) and Collaborative Innovation Program of Sichuan for Elderly Care and Health(YLZBZ1511).Keywords: monoclonal antibody, fibrinogen like protein 2, inflammation, endothelial cells
Procedia PDF Downloads 2741176 The Musician as the Athlete: Psychological Response to Injury
Authors: Shulamit Sternin
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Athletes experience injuries that can have both a physical and psychological impact on the individual. In such instances, athletes are able to rely on the established field of sports psychology to facilitate holistic rehabilitation. Musicians, like athletes rely on their bodies to perform in much the same way athletes do and are also susceptible to injury. Due to the similar performative nature of succeeding as an athletes or a musician, these careers share many of the same primary psychological concerns and therefore it is reasonable that athletes and musicians may require similar rehabilitation post-injury. However, musicians face their own unique psychological challenges and understanding the needs of an injured athlete can serve as a foundation for understanding the injured musician but is not enough to fully rehabilitate an injured musician. The current research surrounding musicians and their injuries is primarily focused on physiological aspects of injury and rehabilitation; the psychological aspects have not yet received adequate attention resulting in poor musician rehabilitation post- injury. This review paper uses current models of psychological response to injury in athletes to draw parallels with the psychological response to injury in musicians. Search engines such as Medline and PsycInfo were systematically searched using specific key words, such as psychological response, injury, athlete, and musician. Studies that focused on post-injury psychology of either the musician or the athlete were included. Within the literature there is evidence to support psychological responses, unique to the musician, that are not accounted for by current models of response in athletes. The models of psychological response to injury in athletes are inadequate tools for application to the musician. Future directions for performance arts research that can fill the gaps in our understanding and modeling of musicians’ response to injury are discussed. A better understanding of the psychological impact of injuries on musicians holds significant implications for health care practitioners working with injured musicians. Understanding the unique barriers musicians face post-injury, and how support for this population must be tailored to properly suit musicians’ needs will aid in more holistic rehabilitation and a higher likelihood of musician’s returning to pre-injury performance levels.Keywords: athlete, injury, musician, psychological response
Procedia PDF Downloads 2091175 Teleconsultations and The Need of Onsite Additional Medical Services
Authors: Cristina Hotoleanu
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Introduction: The recent Covid-19 pandemic accelerated the development of e-health, including telemedicine, smartphone applications, and medical wearable devices. Providing remote teleconsultations supposes challenges which may require further face-to-face medical interactions. The aim of this study was to assess the correlation between the types of teleconsultations and the need of onsite medical services (investigations and medical visits) for the diagnosis and treatment. Methods: a retrospective study including all the teleconsultations using the platform offered by a telehealth provider in Romania (Telios Care SA) between May 1, 2021- April 30, 2022, was performed. Binary data were analysed using the chi-square test with a significance level of p < 0.05. Results: out of 7163 consultations, 3961 were phone calls, 1981 were online messages, and 1221 were video calls. Onsite medical services were indicated in 3327 (46.44%) cases; the onsite investigations or the onsite visits were recommended for 2908 patients as follows: 2326 in case of phone calls, 582 in case of online messages, none in case of video calls. Both onsite investigations and visits were indicated for 419 patients. The need for onsite additional medical services was significantly higher in the case of phone calls than in the other 2 types of teleconsultations (Chi square= 1207.06, p= 0.00001). The indication for onsite services was done mainly after teleconsultations covering medical specialties (87.34%), significantly higher than the other specialties (Chi square=914.59, p=0.00001). Teleconsultations in surgical specialties and other fields (pharmacy, dentistry, psychology, wellbeing- nutrition, fitness) resulted in 12.13%, respective less than 1%, indication for onsite investigations or visits, explained by using of video calls in most of the cases. Conclusion: a further onsite medical service was necessary in less than a half of the teleconsultations. This indication was done mainly after phone calls and teleconsultations in medical specialties. Video calls were used mostly in psychology, nutrition, and fitness teleconsultations and did not require a further onsite medical service. Other studies are necessary to assess better the types of teleconsultations and the specialties bringing the biggest benefit for the patients.Keywords: onsite medical services, phone calls, teleconsultations, telemedicine
Procedia PDF Downloads 1031174 An Experience of HIV Testing and Counseling Services at a Tertiary Care Center of Bangladesh
Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti
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Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior
Procedia PDF Downloads 2991173 Probabilistic Building Life-Cycle Planning as a Strategy for Sustainability
Authors: Rui Calejo Rodrigues
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Building Refurbishing and Maintenance is a major area of knowledge ultimately dispensed to user/occupant criteria. The optimization of the service life of a building needs a special background to be assessed as it is one of those concepts that needs proficiency to be implemented. ISO 15686-2 Buildings and constructed assets - Service life planning: Part 2, Service life prediction procedures, states a factorial method based on deterministic data for building components life span. Major consequences result on a deterministic approach because users/occupants are not sensible to understand the end of components life span and so simply act on deterministic periods and so costly and resources consuming solutions do not meet global targets of planet sustainability. The estimation of 2 thousand million conventional buildings in the world, if submitted to a probabilistic method for service life planning rather than a deterministic one provide an immense amount of resources savings. Since 1989 the research team nowadays stating for CEES–Center for Building in Service Studies developed a methodology based on Montecarlo method for probabilistic approach regarding life span of building components, cost and service life care time spans. The research question of this deals with the importance of probabilistic approach of buildings life planning compared with deterministic methods. It is presented the mathematic model developed for buildings probabilistic lifespan approach and experimental data is obtained to be compared with deterministic data. Assuming that buildings lifecycle depends a lot on component replacement this methodology allows to conclude on the global impact of fixed replacements methodologies such as those on result of deterministic models usage. Major conclusions based on conventional buildings estimate are presented and evaluated under a sustainable perspective.Keywords: building components life cycle, building maintenance, building sustainability, Montecarlo Simulation
Procedia PDF Downloads 2081172 Development of a Model for Predicting Radiological Risks in Interventional Cardiology
Authors: Stefaan Carpentier, Aya Al Masri, Fabrice Leroy, Thibault Julien, Safoin Aktaou, Malorie Martin, Fouad Maaloul
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Introduction: During an 'Interventional Radiology (IR)' procedure, the patient's skin-dose may become very high for a burn, necrosis, and ulceration to appear. In order to prevent these deterministic effects, a prediction of the peak skin-dose for the patient is important in order to improve the post-operative care to be given to the patient. The objective of this study is to estimate, before the intervention, the patient dose for ‘Chronic Total Occlusion (CTO)’ procedures by selecting relevant clinical indicators. Materials and methods: 103 procedures were performed in the ‘Interventional Cardiology (IC)’ department using a Siemens Artis Zee image intensifier that provides the Air Kerma of each IC exam. Peak Skin Dose (PSD) was measured for each procedure using radiochromic films. Patient parameters such as sex, age, weight, and height were recorded. The complexity index J-CTO score, specific to each intervention, was determined by the cardiologist. A correlation method applied to these indicators allowed to specify their influence on the dose. A predictive model of the dose was created using multiple linear regressions. Results: Out of 103 patients involved in the study, 5 were excluded for clinical reasons and 2 for placement of radiochromic films outside the exposure field. 96 2D-dose maps were finally used. The influencing factors having the highest correlation with the PSD are the patient's diameter and the J-CTO score. The predictive model is based on these parameters. The comparison between estimated and measured skin doses shows an average difference of 0.85 ± 0.55 Gy for doses of less than 6 Gy. The mean difference between air-Kerma and PSD is 1.66 Gy ± 1.16 Gy. Conclusion: Using our developed method, a first estimate of the dose to the skin of the patient is available before the start of the procedure, which helps the cardiologist in carrying out its intervention. This estimation is more accurate than that provided by the Air-Kerma.Keywords: chronic total occlusion procedures, clinical experimentation, interventional radiology, patient's peak skin dose
Procedia PDF Downloads 1421171 Minimally Invasive versus Conventional Sternotomy for Aortic Valve Replacement: A Systematic Review and Meta-Analysis
Authors: Ahmed Shaboub, Yusuf Jasim Althawadi, Shadi Alaa Abdelaal, Mohamed Hussein Abdalla, Hatem Amr Elzahaby, Mohamed Mohamed, Hazem S. Ghaith, Ahmed Negida
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Objectives: We aimed to compare the safety and outcomes of the minimally invasive approaches versus conventional sternotomy procedures for aortic valve replacement. Methods: We conducted a PRISMA-compliant systematic review and meta-analysis. We ran an electronic search of PubMed, Cochrane CENTRAL, Scopus, and Web of Science to identify the relevant published studies. Data were extracted and pooled as standardized mean difference (SMD) or risk ratio (RR) using StataMP version 17 for macOS. Results: Forty-one studies with a total of 15,065 patients were included in this meta-analysis (minimally invasive approaches n=7231 vs. conventional sternotomy n=7834). The pooled effect size showed that minimally invasive approaches had lower mortality rate (RR 0.76, 95%CI [0.59 to 0.99]), intensive care unit and hospital stays (SMD -0.16 and -0.31, respectively), ventilation time (SMD -0.26, 95%CI [-0.38 to -0.15]), 24-h chest tube drainage (SMD -1.03, 95%CI [-1.53 to -0.53]), RBCs transfusion (RR 0.81, 95%CI [0.70 to 0.93]), wound infection (RR 0.66, 95%CI [0.47 to 0.92]) and acute renal failure (RR 0.65, 95%CI [0.46 to 0.93]). However, minimally invasive approaches had longer operative time, cross-clamp, and bypass times (SMD 0.47, 95%CI [0.22 to 0.72], SMD 0.27, 95%CI [0.07 to 0.48], and SMD 0.37, 95%CI [0.20 to 0.45], respectively). There were no differences between the two groups in blood loss, endocarditis, cardiac tamponade, stroke, arrhythmias, pneumonia, pneumothorax, bleeding reoperation, tracheostomy, hemodialysis, or myocardial infarction (all P>0.05). Conclusion: Current evidence showed higher safety and better operative outcomes with minimally invasive aortic valve replacement compared to the conventional approach. Future RCTs with long-term follow-ups are recommended.Keywords: aortic replacement, minimally invasive, sternotomy, mini-sternotomy, aortic valve, meta analysis
Procedia PDF Downloads 1241170 Real-Time Working Environment Risk Analysis with Smart Textiles
Authors: Jose A. Diaz-Olivares, Nafise Mahdavian, Farhad Abtahi, Kaj Lindecrantz, Abdelakram Hafid, Fernando Seoane
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Despite new recommendations and guidelines for the evaluation of occupational risk assessments and their prevention, work-related musculoskeletal disorders are still one of the biggest causes of work activity disruption, productivity loss, sick leave and chronic work disability. It affects millions of workers throughout Europe, with a large-scale economic and social burden. These specific efforts have failed to produce significant results yet, probably due to the limited availability and high costs of occupational risk assessment at work, especially when the methods are complex, consume excessive resources or depend on self-evaluations and observations of poor accuracy. To overcome these limitations, a pervasive system of risk assessment tools in real time has been developed, which has the characteristics of a systematic approach, with good precision, usability and resource efficiency, essential to facilitate the prevention of musculoskeletal disorders in the long term. The system allows the combination of different wearable sensors, placed on different limbs, to be used for data collection and evaluation by a software solution, according to the needs and requirements in each individual working environment. This is done in a non-disruptive manner for both the occupational health expert and the workers. The creation of this solution allows us to attend different research activities that require, as an essential starting point, the recording of data with ergonomic value of very diverse origin, especially in real work environments. The software platform is here presented with a complimentary smart clothing system for data acquisition, comprised of a T-shirt containing inertial measurement units (IMU), a vest sensorized with textile electronics, a wireless electrocardiogram (ECG) and thoracic electrical bio-impedance (TEB) recorder and a glove sensorized with variable resistors, dependent on the angular position of the wrist. The collected data is processed in real-time through a mobile application software solution, implemented in commercially available Android-based smartphones and tablet platforms. Based on the collection of this information and its analysis, real-time risk assessment and feedback about postural improvement is possible, adapted to different contexts. The result is a tool which provides added value to ergonomists and occupational health agents, as in situ analysis of postural behavior can assist in a quantitative manner in the evaluation of work techniques and the occupational environment.Keywords: ergonomics, mobile technologies, risk assessment, smart textiles
Procedia PDF Downloads 1211169 Factors Adversely Associated with Breastfeeding among Obese Mothers in Malaysia
Authors: Syahrul Bariah Abdul Hamid, Colin W. Binns, Jun Hui Chih
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The total of obese mothers is growing throughout Asia. Breastfeeding provides the perfect nutrition for infants, by promoting a higher IQ and protecting against childhood and adult diseases. A prospective cohort study was carried out of mothers attending eight antenatal clinics run by the Ministry of Health in Selangor, Malaysia to document the prevalence of obesity and its relationship with breastfeeding outcomes. Mothers were enrolled during the antenatal period and followed up until 6 months postpartum to document breastfeeding outcomes. A total of 652 Malay mothers were recruited for the study a response rate of 93.1 %. The pre-pregnancy body mass index (BMI) of the mothers showed that 36.5% of the mothers were overweight or obese. There were a total of 78 obese mothers in the sample and 41 (52.6%) of these mothers were able to initiate breastfeeding within one hour of birth compared to 238/337 (70.6 %, χ² 9.35, p<0.001) of those with a normal BMI. At 6 months, 23.1 % of obese mothers were exclusively breastfeeding their infants, compared to 56.0 % of the normal BMI mothers. On the other hand, the rate of infant formula feeding was higher in the obese mothers by 53.8 % compared to 19.0 % among normal weight mothers, χ² 37.6, p<0.001). Further analysis suggested these factors were found to be positively associated with discontinued exclusive breastfeeding at 6 months among obese mothers; mothers whom delayed breastfeeding initiation, had health problems during pregnancy, caesarean delivery, reported had insufficient colostrum/milk and babies had sucking problems at or before 4 weeks. Besides that, mothers who perceived their biological mothers had preference towards formula feeding or were ambivalent about the feeding method and had biological mothers without experience in breastfeeding for more than 1 month also were more likely to discontinue exclusive breastfeeding at 6 months. These findings suggested that the greater the pre-pregnant BMI, the earlier the cessation of exclusive breastfeeding and they were also less likely to initiate breastfeeding and have less adequate milk supply. Future investigations of the effects of maternal obesity on breastfeeding outcomes should be conducted along with effective interventions to advance the care of obese women at reproductive age and their children.Keywords: exclusive breastfeeding, body mass index (BMI), breastfeeding discontinuation, maternal obesity
Procedia PDF Downloads 1961168 Improving Predictions of Coastal Benthic Invertebrate Occurrence and Density Using a Multi-Scalar Approach
Authors: Stephanie Watson, Fabrice Stephenson, Conrad Pilditch, Carolyn Lundquist
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Spatial data detailing both the distribution and density of functionally important marine species are needed to inform management decisions. Species distribution models (SDMs) have proven helpful in this regard; however, models often focus only on species occurrences derived from spatially expansive datasets and lack the resolution and detail required to inform regional management decisions. Boosted regression trees (BRT) were used to produce high-resolution SDMs (250 m) at two spatial scales predicting probability of occurrence, abundance (count per sample unit), density (count per km2) and uncertainty for seven coastal seafloor taxa that vary in habitat usage and distribution to examine prediction differences and implications for coastal management. We investigated if small scale regionally focussed models (82,000 km2) can provide improved predictions compared to data-rich national scale models (4.2 million km2). We explored the variability in predictions across model type (occurrence vs abundance) and model scale to determine if specific taxa models or model types are more robust to geographical variability. National scale occurrence models correlated well with broad-scale environmental predictors, resulting in higher AUC (Area under the receiver operating curve) and deviance explained scores; however, they tended to overpredict in the coastal environment and lacked spatially differentiated detail for some taxa. Regional models had lower overall performance, but for some taxa, spatial predictions were more differentiated at a localised ecological scale. National density models were often spatially refined and highlighted areas of ecological relevance producing more useful outputs than regional-scale models. The utility of a two-scale approach aids the selection of the most optimal combination of models to create a spatially informative density model, as results contrasted for specific taxa between model type and scale. However, it is vital that robust predictions of occurrence and abundance are generated as inputs for the combined density model as areas that do not spatially align between models can be discarded. This study demonstrates the variability in SDM outputs created over different geographical scales and highlights implications and opportunities for managers utilising these tools for regional conservation, particularly in data-limited environments.Keywords: Benthic ecology, spatial modelling, multi-scalar modelling, marine conservation.
Procedia PDF Downloads 821167 Monitoring Deforestation Using Remote Sensing And GIS
Authors: Tejaswi Agarwal, Amritansh Agarwal
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Forest ecosystem plays very important role in the global carbon cycle. It stores about 80% of all above ground and 40% of all below ground terrestrial organic carbon. There is much interest in the extent of tropical forests and their rates of deforestation for two reasons: greenhouse gas contributions and the impact of profoundly negative biodiversity. Deforestation has many ecological, social and economic consequences, one of which is the loss of biological diversity. The rapid deployment of remote sensing (RS) satellites and development of RS analysis techniques in the past three decades have provided a reliable, effective, and practical way to characterize terrestrial ecosystem properties. Global estimates of tropical deforestation vary widely and range from 50,000 to 170,000km2 /yr Recent FAO tropical deforestation estimates for 1990–1995 cite 116,756km2 / yr globally. Remote Sensing can prove to be a very useful tool in monitoring of forests and associated deforestation to a sufficient level of accuracy without the need of physically surveying the forest areas as many of them are physically inaccessible. The methodology for the assessment of forest cover using digital image processing (ERDAS) has been followed. The satellite data for the study was procured from Indian institute of remote Sensing (IIRS), Dehradoon in the digital format. While procuring the satellite data, care was taken to ensure that the data was cloud free and did not belong to dry and leafless season. The Normalized Difference Vegetation Index (NDVI) has been used as a numerical indicator of the reduction in ground biomass. NDVI = (near I.R - Red)/ (near I.R + Red). After calculating the NDVI variations and associated mean, we have analysed the change in ground biomass. Through this paper, we have tried to indicate the rate of deforestation over a given period of time by comparing the forest cover at different time intervals. With the help of remote sensing and GIS techniques, it is clearly shown that the total forest cover is continuously degrading and transforming into various land use/land cover category.Keywords: remote sensing, deforestation, supervised classification, NDVI, change detection
Procedia PDF Downloads 12131166 Machine Learning in Patent Law: How Genetic Breeding Algorithms Challenge Modern Patent Law Regimes
Authors: Stefan Papastefanou
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Artificial intelligence (AI) is an interdisciplinary field of computer science with the aim of creating intelligent machine behavior. Early approaches to AI have been configured to operate in very constrained environments where the behavior of the AI system was previously determined by formal rules. Knowledge was presented as a set of rules that allowed the AI system to determine the results for specific problems; as a structure of if-else rules that could be traversed to find a solution to a particular problem or question. However, such rule-based systems typically have not been able to generalize beyond the knowledge provided. All over the world and especially in IT-heavy industries such as the United States, the European Union, Singapore, and China, machine learning has developed to be an immense asset, and its applications are becoming more and more significant. It has to be examined how such products of machine learning models can and should be protected by IP law and for the purpose of this paper patent law specifically, since it is the IP law regime closest to technical inventions and computing methods in technical applications. Genetic breeding models are currently less popular than recursive neural network method and deep learning, but this approach can be more easily described by referring to the evolution of natural organisms, and with increasing computational power; the genetic breeding method as a subset of the evolutionary algorithms models is expected to be regaining popularity. The research method focuses on patentability (according to the world’s most significant patent law regimes such as China, Singapore, the European Union, and the United States) of AI inventions and machine learning. Questions of the technical nature of the problem to be solved, the inventive step as such, and the question of the state of the art and the associated obviousness of the solution arise in the current patenting processes. Most importantly, and the key focus of this paper is the problem of patenting inventions that themselves are developed through machine learning. The inventor of a patent application must be a natural person or a group of persons according to the current legal situation in most patent law regimes. In order to be considered an 'inventor', a person must actually have developed part of the inventive concept. The mere application of machine learning or an AI algorithm to a particular problem should not be construed as the algorithm that contributes to a part of the inventive concept. However, when machine learning or the AI algorithm has contributed to a part of the inventive concept, there is currently a lack of clarity regarding the ownership of artificially created inventions. Since not only all European patent law regimes but also the Chinese and Singaporean patent law approaches include identical terms, this paper ultimately offers a comparative analysis of the most relevant patent law regimes.Keywords: algorithms, inventor, genetic breeding models, machine learning, patentability
Procedia PDF Downloads 1121165 NDVI as a Measure of Change in Forest Biomass
Authors: Amritansh Agarwal, Tejaswi Agarwal
Abstract:
Forest ecosystem plays very important role in the global carbon cycle. It stores about 80% of all above ground and 40% of all below ground terrestrial organic carbon. There is much interest in the extent of tropical forests and their rates of deforestation for two reasons: greenhouse gas contributions and the impact of profoundly negative biodiversity. Deforestation has many ecological, social and economic consequences, one of which is the loss of biological diversity. The rapid deployment of remote sensing (RS) satellites and development of RS analysis techniques in the past three decades have provided a reliable, effective, and practical way to characterize terrestrial ecosystem properties. Global estimates of tropical deforestation vary widely and range from 50,000 to 170,000 km2 /yr Recent FAO tropical deforestation estimates for 1990–1995 cite 116,756km2 / yr globally. Remote Sensing can prove to be a very useful tool in monitoring of forests and associated deforestation to a sufficient level of accuracy without the need of physically surveying the forest areas as many of them are physically inaccessible. The methodology for the assessment of forest cover using digital image processing (ERDAS) has been followed. The satellite data for the study was procured from USGS website in the digital format. While procuring the satellite data, care was taken to ensure that the data was cloud and aerosol free by making using of FLAASH atmospheric correction technique. The Normalized Difference Vegetation Index (NDVI) has been used as a numerical indicator of the reduction in ground biomass. NDVI = (near I.R - Red)/ (near I.R + Red). After calculating the NDVI variations and associated mean we have analysed the change in ground biomass. Through this paper we have tried to indicate the rate of deforestation over a given period of time by comparing the forest cover at different time intervals. With the help of remote sensing and GIS techniques it is clearly shows that the total forest cover is continuously degrading and transforming into various land use/land cover category.Keywords: remote sensing, deforestation, supervised classification, NDVI change detection
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