Search results for: quality care
8043 Denial among Women Living with Cancer: An Exploratory Study to Understand the Consequences of Cancer and the Denial Mechanism
Authors: Judith Partouche-Sebban, Saeedeh Rezaee Vessal
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Because of the rising number of new cases of cancer, especially among women, it is more than essential to better understand how women experience cancer in order to bring them adapted to support and care and enhance their well-being and patient experience. Cancer stands for a traumatic experience in which the diagnosis, its medical treatments, and the related side effects lead to deep physical and psychological changes that may arouse considerable stress and anxiety. In order to reduce these negative emotions, women tend to use various defense mechanisms, among which denial has been defined as the most frequent mechanism used by breast cancer patients. This study aims to better understand the consequences of the experience of cancer and their link with the adoption of a denial strategy. The empirical research was done among female cancer survivors in France. Since the topic of this study is relatively unexplored, a qualitative methodology and open-ended interviews were employed. In total, 25 semi-directive interviews were conducted with a female with different cancers, different stages of treatment, and different ages. A systematic inductive method was performed to analyze data. The content analysis enabled to highlight three different denial-related behaviors among women with cancer, which serve a self-protective function. First, women who expressed high levels of anxiety confessed they tended to completely deny the existence of their cancer immediately after the diagnosis of their illness. These women mainly exhibit many fears and a deep distrust toward the medical context and professionals. This coping mechanism is defined by the patient as being unconscious. Second, other women deliberately decided to deny partial information about their cancer, whether this information is related to the stages of the illness, the emotional consequences, or the behavioral consequences of the illness. These women use this strategy as a way to avoid the reality of the illness and its impact on the different aspects of their life as if cancer does not exist. Third, some women tend to reinterpret and give meaning to their cancer as a way to reduce its impact on their life. To this end, they may use magical thinking or positive reframing, or reinterpretation. Because denial may lead to delays in medical treatments, this topic deserves a deep investigation, especially in the context of oncology. As denial is defined as a specific defense mechanism, this study contributes to the existing literature in service marketing which focuses on emotions and emotional regulation in healthcare services which is a crucial issue. Moreover, this study has several managerial implications for healthcare professionals who interact with patients in order to implement better care and support for the patients.Keywords: cancer, coping mechanisms, denial, healthcare services
Procedia PDF Downloads 898042 Quality Assessment and Classification of Recycled Aggregates from CandDW According to the European Standards
Authors: M. Eckert, D. Mendes, J P. Gonçalves, C. Moço, M. Oliveira
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The intensive extraction of natural aggregates leads to both depletion of natural resources and unwanted environmental impacts. On the other hand, uncontrolled disposal of Construction and Demolition Wastes (C&DW) causes the lifetime reduction of landfills. It is known that the European Union produces, each year, about 850 million tons of C&DW. For all the member States of the European Union, one of the milestones to be reached by 2020, according to the Resource Efficiency Roadmap (COM (2011) 571) of the European Commission, is to recycle 70% of the C&DW. In this work, properties of different types of recycled C&DW aggregates and natural aggregates were compared. Assays were performed according to European Standards (EN 13285; EN 13242+A1; EN 12457-4; EN 12620; EN 13139) for the characterization of there: physical, mechanical and chemical properties. Not standardized tests such as water absorption over time, mass stability and post compaction sieve analysis were also carried out. The tested recycled C&DW aggregates were classified according to the requirements of the European Standards regarding there potential use in concrete, mortar, unbound layers of road pavements and embankments. The results of the physical and mechanical properties of recycled C&DW aggregates indicated, in general, lower quality properties when compared to natural aggregates, particularly, for concrete preparation and unbound layers of road pavements. The results of the chemical properties attested that the C&DW aggregates constitute no environmental risk. It was concluded that recycled aggregates produced from C&DW have the potential to be used in many applications.Keywords: recycled aggregate, sustainability, aggregate properties, European Standard Classification
Procedia PDF Downloads 6808041 Environmental Exposure Assessment among Refuellers at Brussels South Charleroi Airport
Authors: Mostosi C., Stéphenne J., Kempeneers E.
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Introduction: Refuellers from Brussels South Charleroi Airport (BSCA) expressed concerns about the risks involved in handling JET-A1 fuel. The HSE Manager of BSCA, in collaboration with the occupational physician and the industrial hygiene unit of the External Service of Occupational Medicine, decided to assess the toxicological exposure of these workers. Materials and methods: Two measurement methods were used. The first was to assay three types of metabolites in urine to highlight the exposure to xylenes, toluene, and benzene in aircraft fuels. Out of 32 refuellers in the department, 26 participated in the sampling, and 23 samples were exploited. The second method targeted the assessment of environmental exposure to certain potentially hazardous substances that refuellers are likely to breathe in work areas at the airport. It was decided to carry out two ambient air measurement campaigns, using static systems on the one hand and, on the other hand, using individual sensors worn by the refuellers at the level of the respiratory tract. Volatile organic compounds and diesel particles were analyzed. Results: Despite the fears that motivated these analyzes, the overall results showed low levels of exposure, far below the existing limit values, both in air quality and in urinary measurements. Conclusion: These results are comparable to a study carried out in several French airports. The staff could be reassured, and then the medical surveillance was modified by the occupational physician. With the aviation development at BSCA, equipment and methods are evolving. Their exposure will have to be reassessed.Keywords: refuelling, airport, exposure, fuel, occupational health, air quality
Procedia PDF Downloads 898040 Marginalized Children's Drawings Speak for Themselves: Self Advocacy for Protecting Their Rights
Authors: Bhavneet Bharti, Prahbhjot Malhi, Vandana Thakur
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Introduction: Children of the urban migrant laborers have great difficulty in accessing government programs which are otherwise routinely available in rural settings. These include programs for child care, nutrition, health and education. There are major communicative fault-lines preventing advocacy for these marginalized children. The overarching aim of this study was to investigate the role of an innovative strategy of children’s drawings in supporting communication between children, social workers, pediatricians and other child advocates to fulfil their fundamental child rights. Materials and Methods: The data was collected over a period of one-year April 2015 to April 2016 during the routine visits by the members of the Social Pediatrics team including a social worker, pediatricians and an artist to the makeshift colony of migrant laborers. Once a week a drawing session was organized where the children including adolescents were asked to any drawing and provide a narrative thereafter. 5-30 children attended these weekly sessions for one year. All these drawings were then classified into various themes and exhibited on 16th April 2016 in the Govt. College of Art Museum. The forum was used for advocacy of Child Rights of these underprivileged children to Secretary social welfare. Results: Mean (SD) age of children in present observational study was 8.5 (2.5) years, with 60% of the boys. Majority of children demonstrated themes which were local and contextualized to their daily needs, threats and festivals which clearly underscored their fundamental right to basic services and equality of opportunities to achieve their full development Drawings of tap with flowing water, queues of people collecting water from hand pumps reflect the local problem of water availability for these children. Young children talking about fear of rape and murder following their drawings indicate the looming threat of potential abuse and neglect. Besides reality driven drawing, children also echoed supernatural beliefs, dangers and festivities in their drawings. Anyone who watched these children at work with art materials was able to see the intense level of absorption, clearly indicating the enjoyment they received, making it a meaningful activity. Indeed, this self-advocacy through art exhibition led to the successful establishment of mobile Anganwadi (A social safety net programme of the government) in their area of stay. Conclusions: This observational study is an example of how children were able to do self-advocacy to protect their rights. Of particular importance, these drawings address how psychologists and other child advocates can ensure in a child-centered manner that the voice of children is heard and represented in all assessments of their well-being and future care options.Keywords: child advocacy, children drawings, child rights, marginalized children
Procedia PDF Downloads 1808039 Different Roles for Mentors and Mentees in an e-Learning Environment
Authors: Nidhi Gadura
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Given the increase in the number of students and administrators asking for online courses the author developed two partially online courses. One was a biology majors at genetics course while the other was a non-majors at biology course. The student body at Queensborough Community College is generally underprepared and has work and family obligations. As an educator, one has to be mindful about changing the pedagogical approach, therefore, special care was taken when designing the course material. Despite the initial concerns, both of these partially online courses were received really well by students. Lessons learnt were that student engagement is the key to success in an online course. Good practices to run a successful online course for underprepared students are discussed in this paper. Also discussed are the lessons learnt for making the eLearning environment better for all the students in the class, overachievers and underachievers alike.Keywords: partially online course, pedagogy, student engagement, community college
Procedia PDF Downloads 3998038 Interaction between Breathiness and Nasality: An Acoustic Analysis
Authors: Pamir Gogoi, Ratree Wayland
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This study investigates the acoustic measures of breathiness when coarticulated with nasality. The acoustic correlates of breathiness and nasality that has already been well established after years of empirical research. Some of these acoustic parameters - like low frequency peaks and wider bandwidths- are common for both nasal and breathy voice. Therefore, it is likely that these parameters interact when a sound is coarticulated with breathiness and nasality. This leads to the hypothesis that the acoustic parameters, which usually act as robust cues in differentiating between breathy and modal voice, might not be reliable cues for differentiating between breathy and modal voice when breathiness is coarticulated with nasality. The effect of nasality on the perception of breathiness has been explored in earlier studies using synthesized speech. The results showed that perceptually, nasality and breathiness do interact. The current study investigates if a similar pattern is observed in natural speech. The study is conducted on Marathi, an Indo-Aryan language which has a three-way contrast between nasality and breathiness. That is, there is a phonemic distinction between nasals, breathy voice and breathy-nasals. Voice quality parameters like – H1-H2 (Difference between the amplitude of first and second harmonic), H1-A3 (Difference between the amplitude of first harmonic and third formant, CPP (Cepstral Peak Prominence), HNR (Harmonics to Noise ratio) and B1 (Bandwidth of first formant) were extracted. Statistical models like linear mixed effects regression and Random Forest classifiers show that measures that capture the noise component in the signal- like CPP and HNR- can classify breathy voice from modal voice better than spectral measures when breathy voice is coarticulated with nasality.Keywords: breathiness, marathi, nasality, voice quality
Procedia PDF Downloads 998037 Motivation and Quality Teaching of Chinese Language: Analysis of Secondary School Studies
Authors: Robyn Moloney, HuiLing Xu
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Many countries wish to produce Asia-literate citizens, through language education. International contexts of Chinese language education are seeking pedagogical innovation to meet local contextual factors frequently holding back learner success. In multicultural Australia, innovative pedagogy is urgently needed to support motivation in sustained study, with greater strategic integration of technology. This research took a qualitative approach to identify need and solutions. The paper analyses strategies that three secondary school teachers are adopting to meet specific challenges in the Australian context. The data include teacher interviews, classroom observations and student interviews. We highlight the use of task-based learning and differentiated teaching for multilevel classes, and the role which digital technologies play in facilitating both areas. The strategy examples are analysed in reference both to a research-based framework for describing quality teaching, and to current understandings of motivation in language learning. The analysis of data identifies learning featuring deep knowledge, higher-order thinking, engagement, social support, utilisation of background knowledge, and connectedness, all of which work towards the learners having a sense of autonomy and an imagination of becoming an adult Chinese language user.Keywords: Chinese pedagogy, digital technologies, motivation, secondary school
Procedia PDF Downloads 2698036 Reduction in Hospital Acquire Infections after Intervention of Hand Hygiene and Personal Protective Equipment at COVID Unit Indus Hospital Karachi
Authors: Aisha Maroof
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Introduction: Coronavirus Disease 2019 (COVID-19) is spreading rapidly around the world with devastating consequences on patients, health care workers and health systems. Severe 2019 novel coronavirus infectious disease (COVID-19) with pneumonia is associated with high rates of admission to the intensive care unit (ICU) and they are at high risk to obtain the hospital acquire bloodstream infection (HAIs) such as central line associated bloodstream infection (CLABSI), catheter associated urinary tract infections (CAUTI) and laboratory confirm bloodstream infection (LCBSI). The chances of infection transmission increase when healthcare worker’s (HCWs) practice is inappropriate. Risk related to hand hygiene (HH) and personal protective equipment (PPE) as regards multidrug-resistant organism transmission: use of multiple gloving instead of HH and incorrect use of PPE can lead to a significant increase of device-related infections. As it reaches low- and middle-income countries, its effects could be even more, because it will be difficult for them to react aggressively to the pandemic. HAIs are one of the biggest medical concerns, resulting in increased mortality rates. Objective: To assess the effect of intervention on compliance of hand hygiene and PPE among HCWs reduce the rate of HAI in COVID-19 patients. Method: An interventional study was done between July to December, 2020. CLABSI, CAUTI and LCBSI data were collected from the medical record and direct observation. There were total of 50 Nurses, 18 doctors and all patients with laboratory-confirmed severe COVID-19 admitted to the hospital were included in this research study. Respiratory tract specimens were obtained after the first 48 h of ICU admission. Practices were observed after and before intervention. Education was provided based on WHO guidelines. Results: During the six months of study July to December, the rate of CLABSI, CAUTI and LCBSI pre and post intervention was reported. CLABSI rate decreasedd from 22.7 to 0, CAUTI rate was decreased from 1.6 to 0, LCBSI declined from 3.3 to 0 after implementation of intervention. Conclusion: HAIs are an important cause of morbidity and mortality. Most of the device related infections occurs due to lack of correct use of PPE and hand hygiene compliance. Hand hygiene and PPE is the most important measure to protect patients, through education it can be improved the correct use of PPE and hand hygiene compliance and can reduce the bacterial infection in COVID-19 patients.Keywords: hospital acquire infection, healthcare workers, hand hygiene, personal protective equipment
Procedia PDF Downloads 1328035 Evaluation of Video Development about Exclusive Breastfeeding as a Nutrition Education Media for Posyandu Cadre
Authors: Ari Istiany, Guspri Devi Artanti, M. Si
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Based on the results Riskesdas, it is known that breastfeeding awareness about the importance of exclusive breastfeeding is still low at only 15.3 %. These conditions resulted in a very infant at risk for infectious diseases, such as diarrhea and acute respiratory infection. Therefore, the aim of this study to evaluate the video development about exclusive breastfeeding as a nutrition education media for posyandu cadre. This research used development methods for making the video about exclusive breastfeeding. The study was conducted in urban areas Rawamangun, East Jakarta. Respondents of this study were 1 media experts from the Department of Educational Technology - UNJ, 2 subject matter experts from Department of Home Economics - UNJ and 20 posyandu cadres to assess the quality of the video. Aspects assessed include the legibility of text, image display quality, color composition, clarity of sound, music appropriateness, duration, suitability of the material and language. Data were analyzed descriptively likes frequency distribution table, the average value, and deviation standard. The result of this study showed that the average score assessment according to media experts, subject matter experts, and posyandu cadres respectively was 3.43 ± 0.51 (good), 4.37 ± 0.52 (very good) and 3.6 ± 0.73 (good). The conclusion is on exclusive breastfeeding video as feasible as a media for nutrition education. While suggestions for the improvement of visual media is multiply illustrations, add material about the correct way of breastfeeding and healthy baby pictures.Keywords: exclusive breastfeeding, posyandu cadre, video, nutrition education
Procedia PDF Downloads 4158034 Reaching the Goals of Routine HIV Screening Programs: Quantifying and Implementing an Effective HIV Screening System in Northern Nigeria Facilities Based on Optimal Volume Analysis
Authors: Folajinmi Oluwasina, Towolawi Adetayo, Kate Ssamula, Penninah Iutung, Daniel Reijer
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Objective: Routine HIV screening has been promoted as an essential component of efforts to reduce incidence, morbidity, and mortality. The objectives of this study were to identify the optimal annual volume needed to realize the public health goals of HIV screening in the AIDS Healthcare Foundation supported hospitals and establish an implementation process to realize that optimal annual volume. Methods: Starting in 2011 a program was established to routinize HIV screening within communities and government hospitals. In 2016 Five-years of HIV screening data were reviewed to identify the optimal annual proportions of age-eligible patients screened to realize the public health goals of reducing new diagnoses and ending late-stage diagnosis (tracked as concurrent HIV/AIDS diagnosis). Analysis demonstrated that rates of new diagnoses level off when 42% of age-eligible patients were screened, providing a baseline for routine screening efforts; and concurrent HIV/AIDS diagnoses reached statistical zero at screening rates of 70%. Annual facility based targets were re-structured to meet these new target volumes. Restructuring efforts focused on right-sizing HIV screening programs to align and transition programs to integrated HIV screening within standard medical care and treatment. Results: Over one million patients were screened for HIV during the five years; 16, 033 new HIV diagnoses and access to care and treatment made successfully for 82 % (13,206), and concurrent diagnosis rates went from 32.26% to 25.27%. While screening rates increased by 104.7% over the 5-years, volume analysis demonstrated that rates need to further increase by 62.52% to reach desired 20% baseline and more than double to reach optimal annual screening volume. In 2011 facility targets for HIV screening were increased to reflect volume analysis, and in that third year, 12 of the 19 facilities reached or exceeded new baseline targets. Conclusions and Recommendation: Quantifying targets against routine HIV screening goals identified optimal annual screening volume and allowed facilities to scale their program size and allocate resources accordingly. The program transitioned from utilizing non-evidence based annual volume increases to establishing annual targets based on optimal volume analysis. This has allowed efforts to be evaluated on the ability to realize quantified goals related to the public health value of HIV screening. Optimal volume analysis helps to determine the size of an HIV screening program. It is a public health tool, not a tool to determine if an individual patient should receive screening.Keywords: HIV screening, optimal volume, HIV diagnosis, routine
Procedia PDF Downloads 2668033 Role of Empirical Evidence in Law-Making: Case Study from India
Authors: Kaushiki Sanyal, Rajesh Chakrabarti
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In India, on average, about 60 Bills are passed every year in both Houses of Parliament – Lok Sabha and Rajya Sabha (calculated from information on websites of both Houses). These are debated in both Lok Sabha (House of Commons) and Rajya Sabha (Council of States) before they are passed. However, lawmakers rarely use empirical evidence to make a case for a law. Most of the time, they support a law on the basis of anecdote, intuition, and common sense. While these do play a role in law-making, without the necessary empirical evidence, laws often fail to achieve their desired results. The quality of legislative debates is an indicator of the efficacy of the legislative process through which a Bill is enacted. However, the study of legislative debates has not received much attention either in India or worldwide due to the difficulty of objectively measuring the quality of a debate. Broadly, three approaches have emerged in the study of legislative debates. The rational-choice or formal approach shows that speeches vary based on different institutional arrangements, intra-party politics, and the political culture of a country. The discourse approach focuses on the underlying rules and conventions and how they impact the content of the debates. The deliberative approach posits that legislative speech can be reasoned, respectful, and informed. This paper aims to (a) develop a framework to judge the quality of debates by using the deliberative approach; (b) examine the legislative debates of three Bills passed in different periods as a demonstration of the framework, and (c) examine the broader structural issues that disincentive MPs from scrutinizing Bills. The framework would include qualitative and quantitative indicators to judge a debate. The idea is that the framework would provide useful insights into the legislators’ knowledge of the subject, the depth of their scrutiny of Bills, and their inclination toward evidence-based research. The three Bills that the paper plans to examine are as follows: 1. The Narcotics Drugs and Psychotropic Substances Act, 1985: This act was passed to curb drug trafficking and abuse. However, it mostly failed to fulfill its purpose. Consequently, it was amended thrice but without much impact on the ground. 2. The Criminal Laws (Amendment) Act, 2013: This act amended the Indian Penal Code to add a section on human trafficking. The purpose was to curb trafficking and penalise traffickers, pimps, and middlemen. However, the crime rate remains high while the conviction rate is low. 3. The Surrogacy (Regulation) Act, 2021: This act bans commercial surrogacy allowing only relatives to act as surrogates as long as there is no monetary payment. Experts fear that instead of preventing commercial surrogacy, it would drive the activity underground. The consequences would be borne by the surrogate, who would not be protected by law. The purpose of the paper is to objectively analyse the quality of parliamentary debates, get insights into how MPs understand the evidence and deliberate on steps to incentivise them to use empirical evidence.Keywords: legislature, debates, empirical, India
Procedia PDF Downloads 908032 A Review on the Challenge and Need of Goat Semen Production and Artificial Insemination in Nepal
Authors: Pankaj K. Jha, Ajeet K. Jha, Pravin Mishra
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Goat raising is a popular livestock sub-commodity of mixed farming system in Nepal. Besides food and nutritional security, it has an important role in the economy of many peoples. Goat breeding through AI is commonly practiced worldwide. It is a very basic tool to speed up genetic improvement and increase productivity. For the goat genetic improvement program, the government of Nepal has imported some specialized exotic goat breeds and semen. Some progress has been made in the initiation of selective breeding within the local breeds and practice of AI with imported semen. Importance of AI in goats has drawn more attention among goat farmers. However, importing semen is not a permanent solution at national level; rather, it is more important to develop and establish its own frozen semen production technique. Semen quality and its relationship with fertility are said to be a major concern in animal production, hence accurate measurement of semen fertilizing potential is of great importance. The survivability of sperm cells depends on semen quality. Survivability of sperm cells is assessed through visual and microscopic evaluation of spermatozoal progressive motility and morphology. In Nepal, there is lack of scientific information on seminal attributes of buck semen, its dilution, cooling and freezing technique under management conditions of Nepal. Therefore, the objective of this review was to provide brief information about breeding system, semen production and artificial insemination in Nepalese goat.Keywords: artificial insemination, goat, Nepal, semen
Procedia PDF Downloads 2148031 Developing a Culturally Adapted Family Intervention for Relatives Living with Schizophrenia in Oman
Authors: Aziza Al-Sawafi
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Introduction: The evidence of family interventions in schizophrenia is robust primarily in high-income settings. However, they have been adapted to other settings and cultures to improve effectiveness and acceptability. In Oman, there is limited integration of psychosocial interventions in the treatment of schizophrenia. Therefore, the adaptation of family intervention to the Omani culture may facilitate its uptake. Most service users in Oman live with their families outside the healthcare system, and nothing is known about their experience, needs, or resources. Furthermore, understanding caregivers' and mental health professionals' preferences, perceptions, and experience is a fundamental element in the process of intervention development. Therefore, this study aims to develop a culturally sensitive, feasible, and acceptable family intervention for relatives living with schizophrenia in Oman. Method: The Medical Research Council's framework for the evaluation of complex health care interventions provided the conceptual structure for the study. The development phase was carried out, which involved three stages: 1) systematically reviewing the available literature regarding culturally adapted family interventions in the Arab world 2) In-depth interviews with caregivers to explore their experience and perceived needs and preferences regarding intervention 3) A focus group study involving health professionals to explore the acceptability and feasibility of delivering the family intervention in the Omani context. Data synthesis determined the design of the proposed intervention according to the findings obtained from the previous stages. Results: Stage one: The systematic review found limited evidence of culturally-adapted family interventions in the Arab region. However, the cultural adaptation process was comprehensive, and the implementation was reported to be feasible and acceptable. Stage two: The experience of family caregivers illuminated four main themes: burden, stigma, violence, and family needs. Burdens of care included objective and subjective burdens, positive feelings, and coping mechanisms. Caregivers gave their opinion about the content and preference of the intervention from their personal experiences. Stage three: mental health professionals discussed the delivery system of the intervention from a clinical standpoint concerning issues and barriers to implementation. They recommended modifications to the components of the intervention to ensure its acceptability and feasibility in the local setting. Data synthesis was carried out, and the intervention was designed. Conclusion: This study provides evidence of the potential applicability and acceptability of a culturally sensitive family intervention for families of individuals with schizophrenia in Oman. However, more work needs to be done to test the feasibility of the study and overcome the practical challenges.Keywords: cultural-adaptation, family intervention, Oman, schizophrenia
Procedia PDF Downloads 1508030 Inpatient Glycemic Management Strategies and Their Association with Clinical Outcomes in Hospitalized SARS-CoV-2 Patients
Authors: Thao Nguyen, Maximiliano Hyon, Sany Rajagukguk, Anna Melkonyan
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Introduction: Type 2 Diabetes is a well-established risk factor for severe SARS-CoV-2 infection. Uncontrolled hyperglycemia in patients with established or newly diagnosed diabetes is associated with poor outcomes, including increased mortality and hospital length of stay. Objectives: Our study aims to compare three different glycemic management strategies and their association with clinical outcomes in patients hospitalized for moderate to severe SARS-CoV-2 infection. Identifying optimal glycemic management strategies will improve the quality of patient care and improve their outcomes. Method: This is a retrospective observational study on patients hospitalized at Adventist Health White Memorial with severe SARS-CoV-2 infection from 11/1/2020 to 02/28/2021. The following inclusion criteria were used: positive SARS-CoV-2 PCR test, age >18 yrs old, diabetes or random glucose >200 mg/dL on admission, oxygen requirement >4L/min, and treatment with glucocorticoids. Our exclusion criteria included: ICU admission within 24 hours, discharge within five days, death within five days, and pregnancy. The patients were divided into three glycemic management groups: Group 1, managed solely by the Primary Team, Group 2, by Pharmacy; and Group 3, by Endocrinologist. Primary outcomes were average glucose on Day 5, change in glucose between Days 3 and 5, and average insulin dose on Day 5 among groups. Secondary outcomes would be upgraded to ICU, inpatient mortality, and hospital length of stay. For statistics, we used IBM® SPSS, version 28, 2022. Results: Most studied patients were Hispanic, older than 60, and obese (BMI >30). It was the first CV-19 surge with the Delta variant in an unvaccinated population. Mortality was markedly high (> 40%) with longer LOS (> 13 days) and a high ICU transfer rate (18%). Most patients had markedly elevated inflammatory markers (CRP, Ferritin, and D-Dimer). These, in combination with glucocorticoids, resulted in severe hyperglycemia that was difficult to control. Average glucose on Day 5 was not significantly different between groups primary vs. pharmacy vs. endocrine (220.5 ± 63.4 vs. 240.9 ± 71.1 vs. 208.6 ± 61.7 ; P = 0.105). Change in glucose from days 3 to 5 was not significantly different between groups but trended towards favoring the endocrinologist group (-26.6±73.6 vs. 3.8±69.5 vs. -32.2±84.1; P= 0.052). TDD insulin was not significantly different between groups but trended towards higher TDD for the endocrinologist group (34.6 ± 26.1 vs. 35.2 ± 26.4 vs. 50.5 ± 50.9; P=0.054). The endocrinologist group used significantly more preprandial insulin compared to other groups (91.7% vs. 39.1% vs. 65.9% ; P < 0.001). The pharmacy used more basal insulin than other groups (95.1% vs. 79.5% vs. 79.2; P = 0.047). There were no differences among groups in the clinical outcomes: LOS, ICU upgrade, or mortality. Multivariate regression analysis controlled for age, sex, BMI, HbA1c level, renal function, liver function, CRP, d-dimer, and ferritin showed no difference in outcomes among groups. Conclusion: Given high-risk factors in our population, despite efforts from the glycemic management teams, it’s unsurprising no differences in clinical outcomes in mortality and length of stay.Keywords: glycemic management, strategies, hospitalized, SARS-CoV-2, outcomes
Procedia PDF Downloads 4558029 A Study on the Application of Generative AI Tools for Chinese Writing Feedback in Non-Fiction Writing Instruction
Authors: Stephanie Liu Lu
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The course "University Chinese," an essential component of the curriculum in Hong Kong's higher education institutions, plays a crucial role in enhancing students' creative expression, narrative construction, argumentative prowess, and literary skills through its focus on non-fiction writing. Despite its significance, the comprehensive syllabus, coupled with limited classroom time, often restricts adequate practice opportunities and leads to delayed feedback, negatively impacting students' preparation for assessments. This paper investigates the potential of generative artificial intelligence (AI) tools, such as ChatGPT and POE, to provide personalized and immediate feedback for writing tasks. The primary goal of this research is to evaluate student receptiveness to AI-generated feedback and compare it to traditional feedback provided solely by human instructors. To achieve this, participants will be systematically divided into two groups: one receiving feedback from both instructors and AI tools, and a control group that receives feedback exclusively from instructors. The study will thoroughly analyze the revisions made to texts after receiving feedback, focusing particularly on enhancements in the quality of content and language proficiency across three dimensions: content/theme, language, and structural logic. This investigation aims to determine whether AI tools can enhance the efficiency of teaching practices, encourage autonomous learning, and significantly improve the overall quality of students' written work.Keywords: AI-generated feedback, Chinese writing, non-fiction writing, student receptiveness
Procedia PDF Downloads 98028 Effect of Punch and Die Profile Radii on the Maximum Drawing Force and the Total Consumed Work in Deep Drawing of a Flat Ended Cylindrical Brass
Authors: A. I. O. Zaid
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Deep drawing is considered to be the most widely used sheet metal forming processes among the particularly in automobile and aircraft industries. It is widely used for manufacturing a large number of the body and spare parts. In its simplest form it may be defined as a secondary forming process by which a sheet metal is formed into a cylinder or alike by subjecting the sheet to compressive force through a punch with a flat end of the same geometry as the required shape of the cylinder end while it is held by a blank holder which hinders its movement but does not stop it. The punch and die profile radii play In this paper, the effects of punch and die profile radii on the autographic record, the minimum thickness strain location where the cracks normally start and cause the fracture, the maximum deep drawing force and the total consumed work in the drawing flat ended cylindrical brass cups are investigated. Five punches and five dies each having different profile radii were manufactured for this investigation. Furthermore, their effect on the quality of the drawn cups is also presented and discussed. It was found that the die profile radius has more effect on the maximum drawing force and the total consumed work than the punch profile radius.Keywords: punch and die profile radii, deep drawing process, maximum drawing force, total consumed work, quality of produced parts, flat ended cylindrical brass cups
Procedia PDF Downloads 3418027 A Goal-Oriented Approach for Supporting Input/Output Factor Determination in the Regulation of Brazilian Electricity Transmission
Authors: Bruno de Almeida Vilela, Heinz Ahn, Ana Lúcia Miranda Lopes, Marcelo Azevedo Costa
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Benchmarking public utilities such as transmission system operators (TSOs) is one of the main strategies employed by regulators in order to fix monopolistic companies’ revenues. Since 2007 the Brazilian regulator has been utilizing Data Envelopment Analysis (DEA) to benchmark TSOs. Despite the application of DEA to improve the transmission sector’s efficiency, some problems can be pointed out, such as the high price of electricity in Brazil; the limitation of the benchmarking only to operational expenses (OPEX); the absence of variables that represent the outcomes of the transmission service; and the presence of extremely low and high efficiencies. As an alternative to the current concept of benchmarking the Brazilian regulator uses, we propose a goal-oriented approach. Our proposal supports input/output selection by taking traditional organizational goals and measures as a basis for the selection of factors for benchmarking purposes. As the main advantage, it resolves the classical DEA problems of input/output selection, undesirable and dual-role factors. We also provide a demonstration of our goal-oriented concept regarding service quality. As a result, most TSOs’ efficiencies in Brazil might improve when considering quality as important in their efficiency estimation.Keywords: decision making, goal-oriented benchmarking, input/output factor determination, TSO regulation
Procedia PDF Downloads 2008026 Simulation of Laser Structuring by Three Dimensional Heat Transfer Model
Authors: Bassim Shaheen Bachy, Jörg Franke
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In this study, a three dimensional numerical heat transfer model has been used to simulate the laser structuring of polymer substrate material in the Three-Dimensional Molded Interconnect Device (3D MID) which is used in the advanced multi-functional applications. A finite element method (FEM) transient thermal analysis is performed using APDL (ANSYS Parametric Design Language) provided by ANSYS. In this model, the effect of surface heat source was modeled with Gaussian distribution, also the effect of the mixed boundary conditions which consist of convection and radiation heat transfers have been considered in this analysis. The model provides a full description of the temperature distribution, as well as calculates the depth and the width of the groove upon material removal at different set of laser parameters such as laser power and laser speed. This study also includes the experimental procedure to study the effect of laser parameters on the depth and width of the removal groove metal as verification to the modeled results. Good agreement between the experimental and the model results is achieved for a wide range of laser powers. It is found that the quality of the laser structure process is affected by the laser scan speed and laser power. For a high laser structured quality, it is suggested to use laser with high speed and moderate to high laser power.Keywords: laser structuring, simulation, finite element analysis, thermal modeling
Procedia PDF Downloads 3538025 Approved Cyclic Treatment System of Grey Water
Authors: Hanen Filali, Mohamed Hachicha
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Treated grey water (TGW) reuse emerged as an alternative resource to meet the growing demand for water for agricultural irrigation and reduce the pressure on limited existing fresh water. However, this reuse needs adapted management in order to avoid environmental and health risks. In this work, the treatment of grey water (GW) was studied from a cyclic treatment system that we designed and implemented in the greenhouse of National Research Institute for Rural Engineering, Water and Forests (INRGREF). This system is composed of three levels for treatment (TGW 1, TGW 2, and TGW 3). Each level includes a sandy soil box. The use of grey water was moderated depending on the chemical and microbiological quality obtained. Different samples of soils and treated grey water were performed and analyzed for 14 irrigation cycles. TGW through cyclic treatment showed physicochemical parameters like pH, electrical conductivity (EC), chemical oxygen demand (COD), biological oxygen demand (BOD5) in the range of 7,35-7,91, 1,69-5,03 dS/m, 102,6-54,2 mgO2/l, and 31,33-15,74 mgO2/l, respectively. Results showed a reduction in the pollutant load with a significant effect on the three treatment levels; however, an increase in salinity was observed during all irrigation cycles. Microbiological results showed good grey water treatment with low health risk on irrigated soil. Treated water quality was below permissible Tunisian standards (NT106.03), and treated water is suitable for non-potable options.Keywords: treated grey water, irrigation, cyclic treatment, soils, physico-chemical parameters, microbiological parameters
Procedia PDF Downloads 998024 First-Trimester Screening of Preeclampsia in a Routine Care
Authors: Tamar Grdzelishvili, Zaza Sinauridze
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Introduction: Preeclampsia is a complication of the second trimester of pregnancy, which is characterized by high morbidity and multiorgan damage. Many complex pathogenic mechanisms are now implicated to be responsible for this disease (1). Preeclampsia is one of the leading causes of maternal mortality worldwide. Statistics are enough to convince you of the seriousness of this pathology: about 100,000 women die of preeclampsia every year. It occurs in 3-14% (varies significantly depending on racial origin or ethnicity and geographical region) of pregnant women, in 75% of cases - in a mild form, and in 25% - in a severe form. During severe pre-eclampsia-eclampsia, perinatal mortality increases by 5 times and stillbirth by 9.6 times. Considering that the only way to treat the disease is to end the pregnancy, the main thing is timely diagnosis and prevention of the disease. Identification of high-risk pregnant women for PE and giving prophylaxis would reduce the incidence of preterm PE. First-trimester screening model developed by the Fetal Medicine Foundation (FMF), which uses the Bayes-theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, has been proven to be effective and have superior screening performance to that of traditional risk factor-based approach for the prediction of PE (2) Methods: Retrospective single center screening study. The study population consisted of women from the Tbilisi maternity hospital “Pineo medical ecosystem” who met the following criteria: they spoke Georgian, English, or Russian and agreed to participate in the study after discussing informed consent and answering questions. Prior to the study, the informed consent forms approved by the Institutional Review Board were obtained from the study subjects. Early assessment of preeclampsia was performed between 11-13 weeks of pregnancy. The following were evaluated: anamnesis, dopplerography of the uterine artery, mean arterial blood pressure, and biochemical parameter: Pregnancy-associated plasma protein A (PAPP-A). Individual risk assessment was performed with performed by Fast Screen 3.0 software ThermoFisher scientific. Results: A total of 513 women were recruited and through the study, 51 women were diagnosed with preeclampsia (34.5% in the pregnant women with high risk, 6.5% in the pregnant women with low risk; P<0.000 1). Conclusions: First-trimester screening combining maternal factors with uterine artery Doppler, blood pressure, and pregnancy-associated plasma protein-A is useful to predict PE in a routine care setting. More patient studies are needed for final conclusions. The research is still ongoing.Keywords: first-trimester, preeclampsia, screening, pregnancy-associated plasma protein
Procedia PDF Downloads 808023 Application of Compressed Sensing and Different Sampling Trajectories for Data Reduction of Small Animal Magnetic Resonance Image
Authors: Matheus Madureira Matos, Alexandre Rodrigues Farias
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Magnetic Resonance Imaging (MRI) is a vital imaging technique used in both clinical and pre-clinical areas to obtain detailed anatomical and functional information. However, MRI scans can be expensive, time-consuming, and often require the use of anesthetics to keep animals still during the imaging process. Anesthetics are commonly administered to animals undergoing MRI scans to ensure they remain still during the imaging process. However, prolonged or repeated exposure to anesthetics can have adverse effects on animals, including physiological alterations and potential toxicity. Minimizing the duration and frequency of anesthesia is, therefore, crucial for the well-being of research animals. In recent years, various sampling trajectories have been investigated to reduce the number of MRI measurements leading to shorter scanning time and minimizing the duration of animal exposure to the effects of anesthetics. Compressed sensing (CS) and sampling trajectories, such as cartesian, spiral, and radial, have emerged as powerful tools to reduce MRI data while preserving diagnostic quality. This work aims to apply CS and cartesian, spiral, and radial sampling trajectories for the reconstruction of MRI of the abdomen of mice sub-sampled at levels below that defined by the Nyquist theorem. The methodology of this work consists of using a fully sampled reference MRI of a female model C57B1/6 mouse acquired experimentally in a 4.7 Tesla MRI scanner for small animals using Spin Echo pulse sequences. The image is down-sampled by cartesian, radial, and spiral sampling paths and then reconstructed by CS. The quality of the reconstructed images is objectively assessed by three quality assessment techniques RMSE (Root mean square error), PSNR (Peak to Signal Noise Ratio), and SSIM (Structural similarity index measure). The utilization of optimized sampling trajectories and CS technique has demonstrated the potential for a significant reduction of up to 70% of image data acquisition. This result translates into shorter scan times, minimizing the duration and frequency of anesthesia administration and reducing the potential risks associated with it.Keywords: compressed sensing, magnetic resonance, sampling trajectories, small animals
Procedia PDF Downloads 778022 Use of Polymeric Materials in the Architectural Preservation
Authors: F. Z. Benabid, F. Zouai, A. Douibi, D. Benachour
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These Fluorinated polymers and polyacrylics have known a wide use in the field of historical monuments. PVDF provides a great easiness to processing, a good UV resistance and good chemical inertia. Although the quality of physical characteristics of the PMMA and its low price with a respect to PVDF, its deterioration against UV radiations limits its use as protector agent for the stones. On the other hand, PVDF/PMMA blend is a compromise of a great development in the field of architectural restoration, since it is the best method in term of quality and price to make new polymeric materials having enhanced properties. Films of different compositions based on the two polymers within an adequate solvent (DMF) were obtained to perform an exposition to artificial ageing and to the salted fog, a spectroscopic analysis (FTIR and UV) and optical analysis (refractive index). Based on its great interest in the field of building, a variety of standard tests has been elaborated for the first time at the central laboratory of ENAP (Souk-Ahras) in order to evaluate our blend performance. The obtained results have allowed observing the behavior of the different compositions of the blend under various tests. The addition of PVDF to PMMA enhances the properties of this last to know the exhibition to the natural and artificial ageing and to the saline fog. On the other hand, PMMA enhances the optical properties of the blend. Finally, 70/30 composition of the blend is in concordance with results of previous works and it is the adequate proportion for an eventual application.Keywords: blend, PVDF, PMMA, preservation, historic monuments
Procedia PDF Downloads 3108021 Material and Parameter Analysis of the PolyJet Process for Mold Making Using Design of Experiments
Authors: A. Kampker, K. Kreisköther, C. Reinders
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Since additive manufacturing technologies constantly advance, the use of this technology in mold making seems reasonable. Many manufacturers of additive manufacturing machines, however, do not offer any suggestions on how to parameterize the machine to achieve optimal results for mold making. The purpose of this research is to determine the interdependencies of different materials and parameters within the PolyJet process by using design of experiments (DoE), to additively manufacture molds, e.g. for thermoforming and injection molding applications. Therefore, the general requirements of thermoforming molds, such as heat resistance, surface quality and hardness, have been identified. Then, different materials and parameters of the PolyJet process, such as the orientation of the printed part, the layer thickness, the printing mode (matte or glossy), the distance between printed parts and the scaling of parts, have been examined. The multifactorial analysis covers the following properties of the printed samples: Tensile strength, tensile modulus, bending strength, elongation at break, surface quality, heat deflection temperature and surface hardness. The key objective of this research is that by joining the results from the DoE with the requirements of the mold making, optimal and tailored molds can be additively manufactured with the PolyJet process. These additively manufactured molds can then be used in prototyping processes, in process testing and in small to medium batch production.Keywords: additive manufacturing, design of experiments, mold making, PolyJet, 3D-Printing
Procedia PDF Downloads 2598020 Consumers’ Willingness to Pay for Organic Vegetables in Oyo State
Authors: Olanrewaju Kafayat, O., Salman Kabir, K.
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The role of organic agriculture in providing food and income is now gaining wider recognition (Van Elzakker et al 2007). The increasing public concerns about food safety issues on the use of fertilizers, pesticide residues, growth hormones, GM organisms, and increasing awareness of environmental quality issues have led to an expanding demand for environmentally friendly products (Thompson, 1998; Rimal et al., 2005). As a result national governments are concerned about diet and health, and there has been renewed recognition of the role of public policy in promoting healthy diets, thus to provide healthier, safer, more confident citizens (Poole et al., 2007), With these benefits, a study into organic vegetables is very vital to all the major stakeholders. This study analyzed the willingness of consumers to pay for organic vegetables in Oyo state, Nigeria. Primary data was collected with the aid of structured questionnaire administered to 168 respondents. These were selected using multistage random sampling. The first stage involved the selection two (2) ADP zones out of the three (3) ADP zones in Oyo state, The second stage involved the random selection of two (2) local government areas each out of the two (2) ADP zones which are; Ibadan South West and Ogbomoso North and random selection of 4 wards each from the local government areas. The third stage involved random selection of 42 household each from of the local government areas. Descriptive statistics, the principal component analysis, and the logistic regression were used to analyze the data. Results showed 55 percent of the respondents were female while 80 percent were 50 years. 74 percent of the respondents agreed that organic vegetables are of better quality. 31 percent of the respondents were aware of organic vegetables as against 69 percent who were not aware. From the logistic model, educational attainment, amount spent on organic vegetables monthly, better quality of organic vegetables and accessibility to organic vegetables were significant and had a positive relationship on willingness to pay for organic vegetable. The variables that were significant and had a negative relationship with WTP are less attractiveness of organic vegetables and household size of the respondents. This study concludes that consumers with higher level of education were more likely to be aware and willing to pay for organic vegetables than those with low levels of education, the study therefore recommends creation of awareness on the relevance of consuming organic vegetables through effective marketing and educational campaigns.Keywords: consumers awareness, willingness to pay, organic vegetables, Oyo State
Procedia PDF Downloads 2778019 Quality of Age Reporting from Tanzania 2012 Census Results: An Assessment Using Whipple’s Index, Myer’s Blended Index, and Age-Sex Accuracy Index
Authors: A. Sathiya Susuman, Hamisi F. Hamisi
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Background: Many socio-economic and demographic data are age-sex attributed. However, a variety of irregularities and misstatement are noted with respect to age-related data and less to sex data because of its biological differences between the genders. Noting the misstatement/misreporting of age data regardless of its significance importance in demographics and epidemiological studies, this study aims at assessing the quality of 2012 Tanzania Population and Housing Census Results. Methods: Data for the analysis are downloaded from Tanzania National Bureau of Statistics. Age heaping and digit preference were measured using summary indices viz., Whipple’s index, Myers’ blended index, and Age-Sex Accuracy index. Results: The recorded Whipple’s index for both sexes was 154.43; male has the lowest index of about 152.65 while female has the highest index of about 156.07. For Myers’ blended index, the preferences were at digits ‘0’ and ‘5’ while avoidance were at digits ‘1’ and ‘3’ for both sexes. Finally, Age-sex index stood at 59.8 where sex ratio score was 5.82 and age ratio scores were 20.89 and 21.4 for males and female respectively. Conclusion: The evaluation of the 2012 PHC data using the demographic techniques has qualified the data inaccurate as the results of systematic heaping and digit preferences/avoidances. Thus, innovative methods in data collection along with measuring and minimizing errors using statistical techniques should be used to ensure accuracy of age data.Keywords: age heaping, digit preference/avoidance, summary indices, Whipple’s index, Myer’s index, age-sex accuracy index
Procedia PDF Downloads 4798018 Nanoparticles in Drug Delivery and Therapy of Alzeheimer's Disease
Authors: Nirupama Dixit, Anyaa Mittal, Neeru Sood
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Alzheimer’s disease (AD) is a progressive form of dementia, contributing to up to 70% of cases, mostly observed in elderly but is not restricted to old age. The pathophysiology of the disease is characterized by specific pathological changes in brain. The changes (i.e. accumulation of metal ions in brain, formation of extracellular β-amyloid (Aβ) peptide aggregates and tangle of hyper phosphorylated Tau protein inside neurons) damage the neuronal connections irreversibly. The current issues in improvement of life quality of Alzheimer's patient lies in the fact that the diagnosis is made at a late stage of the disease and the medications do not treat the basic causes of Alzheimer's. The targeted delivery of drug through the blood brain barrier (BBB) poses several limitations via traditional approaches for treatment. To overcome these drug delivery limitation, nanoparticles provide a promising solution. This review focuses on current strategies for efficient targeted drug delivery using nanoparticles and improving the quality of therapy provided to the patient. Nanoparticles can be used to encapsulate drug (which is generally hydrophobic) to ensure its passage to brain; they can be conjugated to metal ion chelators to reduce the metal load in neural tissue thus lowering the harmful effects of oxidative damage; can be conjugated with drug and monoclonal antibodies against BBB endogenous receptors. Finally this review covers how the nanoparticles can play a role in diagnosing the disease.Keywords: Alzheimer's disease, β-amyloid plaques, blood brain barrier, metal chelators, nanoparticles
Procedia PDF Downloads 4968017 A Study of Heavy Hydrocarbons Upgrading by Microwave Pyrolysis
Authors: Thanida Sritangthong, Suksun Amornraksa
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By-product upgrading is crucial in hydrocarbon industries as it can increase overall profit margin of the business. Microwave-assisted pyrolysis is relatively new technique which induces heat directly to raw materials. This results in a more energy saving and more energy-efficient process. It is also a promising method to enhance and accelerate chemical reactions, thus reducing the pyrolysis reaction time and increasing the quality of value-added products from different kinds of feedstocks. In this study, upgrading opportunity of fuel oil by-product from an olefins plant is investigated by means of microwave pyrolysis. The experiment was conducted in a lab-scale quartz reactor placed inside a 1,100 watts household microwave oven. Operating temperature was varied from 500 to 900C to observe the consequence on the quality of pyrolysis products. Several microwave receptors i.e. activated carbon, silicon carbide (SiC) and copper oxide (CuO) were used as a material to enhance the heating and reaction in the reactor. The effect of residence time was determined by adjusting flow rate of N2 carrier gas. The chemical composition and product yield were analyzed by using gas chromatography (GC) and gas chromatography/mass spectrometry (GC/MS). The results showed that hydrogen, methane, ethylene, and ethane were obtained as the main gaseous products from all operating temperatures while the main liquid products were alkane, cycloalkane and polycyclic aromatic groups. The results indicated that microwave pyrolysis has a potential to upgrade low value hydrocarbons to high value products.Keywords: fuel oil, heavy hydrocarbons, microwave pyrolysis, pyrolysis
Procedia PDF Downloads 3228016 Cardiac Arrest after Cardiac Surgery
Authors: Ravshan A. Ibadov, Sardor Kh. Ibragimov
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Objective. The aim of the study was to optimize the protocol of cardiopulmonary resuscitation (CPR) after cardiovascular surgical interventions. Methods. The experience of CPR conducted on patients after cardiovascular surgical interventions in the Department of Intensive Care and Resuscitation (DIR) of the Republican Specialized Scientific-Practical Medical Center of Surgery named after Academician V. Vakhidov is presented. The key to the new approach is the rapid elimination of reversible causes of cardiac arrest, followed by either defibrillation or electrical cardioversion (depending on the situation) before external heart compression, which may damage sternotomy. Careful use of adrenaline is emphasized due to the potential recurrence of hypertension, and timely resternotomy (within 5 minutes) is performed to ensure optimal cerebral perfusion through direct massage. Out of 32 patients, cardiac arrest in the form of asystole was observed in 16 (50%), with hypoxemia as the cause, while the remaining 16 (50%) experienced ventricular fibrillation caused by arrhythmogenic reactions. The age of the patients ranged from 6 to 60 years. All patients were evaluated before the operation using the ASA and EuroSCORE scales, falling into the moderate-risk group (3-5 points). CPR was conducted for cardiac activity restoration according to the American Heart Association and European Resuscitation Council guidelines (Ley SJ. Standards for Resuscitation After Cardiac Surgery. Critical Care Nurse. 2015;35(2):30-38). The duration of CPR ranged from 8 to 50 minutes. The ARASNE II scale was used to assess the severity of patients' conditions after CPR, and the Glasgow Coma Scale was employed to evaluate patients' consciousness after the restoration of cardiac activity and sedation withdrawal. Results. In all patients, immediate chest compressions of the necessary depth (4-5 cm) at a frequency of 100-120 compressions per minute were initiated upon detection of cardiac arrest. Regardless of the type of cardiac arrest, defibrillation with a manual defibrillator was performed 3-5 minutes later, and adrenaline was administered in doses ranging from 100 to 300 mcg. Persistent ventricular fibrillation was also treated with antiarrhythmic therapy (amiodarone, lidocaine). If necessary, infusion of inotropes and vasopressors was used, and for the prevention of brain edema and the restoration of adequate neurostatus within 1-3 days, sedation, a magnesium-lidocaine mixture, mechanical intranasal cooling of the brain stem, and neuroprotective drugs were employed. A coordinated effort by the resuscitation team and proper role allocation within the team were essential for effective cardiopulmonary resuscitation (CPR). All these measures contributed to the improvement of CPR outcomes. Conclusion. Successful CPR following cardiac surgical interventions involves interdisciplinary collaboration. The application of an optimized CPR standard leads to a reduction in mortality rates and favorable neurological outcomes.Keywords: cardiac surgery, cardiac arrest, resuscitation, critically ill patients
Procedia PDF Downloads 558015 The Levels of Neurosteroid 7β-Hydroxy-Epiandrosterone in Men and Pregnant Women
Authors: J. Vitku, L. Kolatorova, T. Chlupacova, J. Heracek, M. Hill, M. Duskova, L. Starka
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Background: 7β-hydroxy-epiandrosterone (7β–OH-EpiA) is an endogenous steroid, that has been shown to exert neuroprotective and anti-inflammatory effects in vitro as well as in animal models. However, to the best of our knowledge no information is available about concentration of this androgen metabolite in human population. The aim of the study was to measure and compare levels of 7β–OH-EpiA in men and pregnant women in different biological fluids and evaluate the relationship between 7β–OH-EpiA in men and their sperm quality. Methods: First, a sensitive isotope dilution high performance liquid chromatography-mass spectrometry method for measurement of 7β–OH-EpiA in different biological fluids was developed. Validation of the method met the requirements of FDA guidelines. Afterwards 7β–OH-EpiA in plasma and seminal plasma of 191 men with different degree of infertility (healthy men, lightly infertile men, moderately infertile men, severely infertile men) was analysed. Furthermore, the levels of 7β–OH-EpiA in plasma of 34 pregnant women in 37th week of gestation and corresponding cord plasma that reflects steroid levels in the fetus were measured. Results: Concentrations of 7β–OH-EpiA in seminal plasma were significantly higher in severely infertile men in comparison with healthy men and lightly infertile men. The same trend was observed when blood plasma was evaluated. Furthermore, plasmatic 7β –OH-EpiA negatively correlated with concentration (-0.215; p < 0.01) and total count (-0.15; p < 0.05). Seminal 7β–OH-EpiA was negatively associated with motility (-0.26; p < 0.01), progressively motile sperms (-0.233; p < 0.01) and nonprogressively motile sperms (-0.188; p < 0.05). Plasmatic 7β –OH-EpiA levels in men were generally higher in comparison with pregnant women. Levels 7β–OH-EpiA were under the lower limit of quantification (LLOQ) in majority of samples of pregnant women and cord plasma. Only 4 plasma samples of pregnant women and 7 cord blood plasma samples were above LLOQ and where in range of units of pg/ml. Conclusion: Based on available information, this is the first study measuring 7β–OH-EpiA in human samples. 7β–OH-EpiA is associated with lower sperm quality and certainly it is worth to explore its role in this field thoroughly. Interestingly, levels of 7β–OH-EpiA in pregnant women were extremely low despite the fact that steroid levels including androgens are generally higher during pregnancy. Acknowledgements: This work was supported by the project MH CR 17-30528 A from the Czech Health Research Council, MH CZ - DRO (Institute of Endocrinology - EU, 00023761) and by the MEYS CR (OP RDE, Excellent research - ENDO.CZ).Keywords: 7β-hydroxy-epiandrosterone, steroid, sperm quality, pregnancy
Procedia PDF Downloads 2578014 Application of the Building Information Modeling Planning Approach to the Factory Planning
Authors: Peggy Näser
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Factory planning is a systematic, objective-oriented process for planning a factory, structured into a sequence of phases, each of which is dependent on the preceding phase and makes use of particular methods and tools, and extending from the setting of objectives to the start of production. The digital factory, on the other hand, is the generic term for a comprehensive network of digital models, methods, and tools – including simulation and 3D visualisation – integrated by a continuous data management system. Its aim is the holistic planning, evaluation and ongoing improvement of all the main structures, processes and resources of the real factory in conjunction with the product. Digital factory planning has already become established in factory planning. The application of Building Information Modeling has not yet been established in factory planning but has been used predominantly in the planning of public buildings. Furthermore, this concept is limited to the planning of the buildings and does not include the planning of equipment of the factory (machines, technical equipment) and their interfaces to the building. BIM is a cooperative method of working, in which the information and data relevant to its lifecycle are consistently recorded, managed and exchanged in a transparent communication between the involved parties on the basis of digital models of a building. Both approaches, the planning approach of Building Information Modeling and the methodical approach of the Digital Factory, are based on the use of a comprehensive data model. Therefore it is necessary to examine how the approach of Building Information Modeling can be extended in the context of factory planning in such a way that an integration of the equipment planning, as well as the building planning, can take place in a common digital model. For this, a number of different perspectives have to be investigated: the equipment perspective including the tools used to implement a comprehensive digital planning process, the communication perspective between the planners of different fields, the legal perspective, that the legal certainty in each country and the quality perspective, on which the quality criteria are defined and the planning will be evaluated. The individual perspectives are examined and illustrated in the article. An approach model for the integration of factory planning into the BIM approach, in particular for the integrated planning of equipment and buildings and the continuous digital planning is developed. For this purpose, the individual factory planning phases are detailed in the sense of the integration of the BIM approach. A comprehensive software concept is shown on the tool. In addition, the prerequisites required for this integrated planning are presented. With the help of the newly developed approach, a better coordination between equipment and buildings is to be achieved, the continuity of the digital factory planning is improved, the data quality is improved and expensive implementation errors are avoided in the implementation.Keywords: building information modeling, digital factory, digital planning, factory planning
Procedia PDF Downloads 273