Search results for: health system reconstruction
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 25076

Search results for: health system reconstruction

20336 The Effect of the COVID-19 on Alzheimer’s Disease

Authors: Ayşe Defne Öz, Özlem Bozkurt

Abstract:

Alzheimer's Disease (AD) is counted as one of the most important global health problems and the main cause of dementia. The term dementia refers to a wide spectrum of disorders characterized by global, chronic, and generally irreversible cognitive deterioration. It is estimated that %60 % to 80 of the cases of dementia are because of AD. Alzheimer's is a slowly progressive brain disease. The reason for AD is unknown to the author's best knowledge, yet it is one of the topics that is most researched. AD shows the histopathologically abnormal accumulation of the protein beta-amyloid (plague) outside neurons and twisted strands of the protein tau (tangles) inside neurons in the brain. These changes are accompanied by damage to the brain tissue and the death of neurons. AD causes people to have difficulty remembering names or conversations. Some of the later symptoms are difficulty in talking and walking. Alzheimer's Disease is elevated by the illness and mortality of COVID-19. COVID-19 has affected many lives globally and had profound effects on human lives. COVID-19 is caused by SARS-CoV-2, which is a virus that attacks the respiratory and central nervous system and has neuroinvasive potential. More than %80 of COVID-19 patients have ageusia or anosmia, representing the pathognomic features of the disease. Patients with dementia are frail, and with the COVID-19 pandemic, including isolation, cognitive decline may exacerbate. Furthermore, patients with AD can be unable to follow the directions, such as covering their mouth and nose while coughing and can live in nursing homes which makes them more open to being infected. As COVID-19 is highly infectious and its management requires isolation and quarantine, the need for caregivers for AD management conflicts with that of COVID-19 and adds an extra burden on AD patients, caregivers, families, society, and the economy. Due to the entry of SARS-CoV-2 into the central nervous system, inflammation caused by COVID-19, prolonged hospitalization, and delirium, it has been reported that COVID-19 causes many neurological disorders and predisposition to AD.

Keywords: Alzheimer's disease, COVID-19, dementia, SARS-CoV-2

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20335 Deep Learning Approach for Colorectal Cancer’s Automatic Tumor Grading on Whole Slide Images

Authors: Shenlun Chen, Leonard Wee

Abstract:

Tumor grading is an essential reference for colorectal cancer (CRC) staging and survival prognostication. The widely used World Health Organization (WHO) grading system defines histological grade of CRC adenocarcinoma based on the density of glandular formation on whole slide images (WSI). Tumors are classified as well-, moderately-, poorly- or un-differentiated depending on the percentage of the tumor that is gland forming; >95%, 50-95%, 5-50% and <5%, respectively. However, manually grading WSIs is a time-consuming process and can cause observer error due to subjective judgment and unnoticed regions. Furthermore, pathologists’ grading is usually coarse while a finer and continuous differentiation grade may help to stratifying CRC patients better. In this study, a deep learning based automatic differentiation grading algorithm was developed and evaluated by survival analysis. Firstly, a gland segmentation model was developed for segmenting gland structures. Gland regions of WSIs were delineated and used for differentiation annotating. Tumor regions were annotated by experienced pathologists into high-, medium-, low-differentiation and normal tissue, which correspond to tumor with clear-, unclear-, no-gland structure and non-tumor, respectively. Then a differentiation prediction model was developed on these human annotations. Finally, all enrolled WSIs were processed by gland segmentation model and differentiation prediction model. The differentiation grade can be calculated by deep learning models’ prediction of tumor regions and tumor differentiation status according to WHO’s defines. If multiple WSIs were possessed by a patient, the highest differentiation grade was chosen. Additionally, the differentiation grade was normalized into scale between 0 to 1. The Cancer Genome Atlas, project COAD (TCGA-COAD) project was enrolled into this study. For the gland segmentation model, receiver operating characteristic (ROC) reached 0.981 and accuracy reached 0.932 in validation set. For the differentiation prediction model, ROC reached 0.983, 0.963, 0.963, 0.981 and accuracy reached 0.880, 0.923, 0.668, 0.881 for groups of low-, medium-, high-differentiation and normal tissue in validation set. Four hundred and one patients were selected after removing WSIs without gland regions and patients without follow up data. The concordance index reached to 0.609. Optimized cut off point of 51% was found by “Maxstat” method which was almost the same as WHO system’s cut off point of 50%. Both WHO system’s cut off point and optimized cut off point performed impressively in Kaplan-Meier curves and both p value of logrank test were below 0.005. In this study, gland structure of WSIs and differentiation status of tumor regions were proven to be predictable through deep leaning method. A finer and continuous differentiation grade can also be automatically calculated through above models. The differentiation grade was proven to stratify CAC patients well in survival analysis, whose optimized cut off point was almost the same as WHO tumor grading system. The tool of automatically calculating differentiation grade may show potential in field of therapy decision making and personalized treatment.

Keywords: colorectal cancer, differentiation, survival analysis, tumor grading

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20334 Low-Cost Mechatronic Design of an Omnidirectional Mobile Robot

Authors: S. Cobos-Guzman

Abstract:

This paper presents the results of a mechatronic design based on a 4-wheel omnidirectional mobile robot that can be used in indoor logistic applications. The low-level control has been selected using two open-source hardware (Raspberry Pi 3 Model B+ and Arduino Mega 2560) that control four industrial motors, four ultrasound sensors, four optical encoders, a vision system of two cameras, and a Hokuyo URG-04LX-UG01 laser scanner. Moreover, the system is powered with a lithium battery that can supply 24 V DC and a maximum current-hour of 20Ah.The Robot Operating System (ROS) has been implemented in the Raspberry Pi and the performance is evaluated with the selection of the sensors and hardware selected. The mechatronic system is evaluated and proposed safe modes of power distribution for controlling all the electronic devices based on different tests. Therefore, based on different performance results, some recommendations are indicated for using the Raspberry Pi and Arduino in terms of power, communication, and distribution of control for different devices. According to these recommendations, the selection of sensors is distributed in both real-time controllers (Arduino and Raspberry Pi). On the other hand, the drivers of the cameras have been implemented in Linux and a python program has been implemented to access the cameras. These cameras will be used for implementing a deep learning algorithm to recognize people and objects. In this way, the level of intelligence can be increased in combination with the maps that can be obtained from the laser scanner.

Keywords: autonomous, indoor robot, mechatronic, omnidirectional robot

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20333 From Modeling of Data Structures towards Automatic Programs Generating

Authors: Valentin P. Velikov

Abstract:

Automatic program generation saves time, human resources, and allows receiving syntactically clear and logically correct modules. The 4-th generation programming languages are related to drawing the data and the processes of the subject area, as well as, to obtain a frame of the respective information system. The application can be separated in interface and business logic. That means, for an interactive generation of the needed system to be used an already existing toolkit or to be created a new one.

Keywords: computer science, graphical user interface, user dialog interface, dialog frames, data modeling, subject area modeling

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20332 Detection of Autism Spectrum Disorders in Children Aged 4-6 Years by Municipal Maternal and Child Health Physicians: An Educational Intervention Study

Authors: M. Van 'T Hof, R. V. Pasma, J. T. Bailly, H. W. Hoek, W. A. Ester

Abstract:

Background: The transition into primary school can be challenging for children with an autism spectrum disorder (ASD). Due to the new demands that are made to children in this period, their limitations in social functioning and school achievements may manifest and appear faster. Detection of possible ASD signals mainly takes place by parents, teachers and during obligatory municipal maternal and child health centre visits. Physicians of municipal maternal and child health centres have limited education and instruments to detect ASD. Further education on detecting ASD is needed to optimally equip these doctors for this task. Most research aims to increase the early detection of ASD in children aged 0-3 years and shows positive results. However, there is a lack of research on educational interventions to detect ASD in children aged 4-6 years by municipal maternal and child health physicians. Aim: The aim of this study is to explore the effect of the online educational intervention: Detection of ASD in children aged 4-6 years for municipal maternal and child health physicians. This educational intervention is developed within The Reach-Aut Academic Centre for Autism; Transitions in education, and will be available throughout The Netherlands. Methods: Ninety-two participants will follow the educational intervention: Detection of ASD in children aged 4-6 years for municipal maternal and child health centre physicians. The educational intervention consists of three, one and a half hour sessions, which are offered through an online interactive classroom. The focus and content of the course has been developed in collaboration with three groups of stakeholders; autism scientists, clinical practitioners (municipal maternal and child health doctors and ASD experts) and parents of children with ASD. The primary outcome measure is knowledge about ASD: signals, early detection, communication with parents and referrals. The secondary outcome measures are the number of ASD related referrals, the attitude towards the mentally ill (CAMI), perceived competency about ASD knowledge and detection skills, and satisfaction about the educational intervention. Results and Conclusion: The study started in January 2016 and data collection will end mid 2017.

Keywords: ASD, child, detection, educational intervention, physicians

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20331 The Relation between Vitamin C and Oral Health

Authors: Mai Ashraf Talaat

Abstract:

Background: Vitamin C (ascorbic acid) is an essential nutrient for the development and repair of all body tissues. It can be obtained from a healthy diet or through supplementation. Due to its importance, vitamin C has become a mainstay in the treatment and prevention of many diseases and in maintaining immune, skin, bone and overall health. This review article aims to discuss the studies and case reports conducted to evaluate the effect of Vitamin C on oral health and the recent advances in oral medicine that involve the use of vitamin C. Data/Sources: The review was conducted for clinical studies, case reports and published literature in the English language that addresses this topic. An extensive search in the electronic databases of PubMed, PubMed Central, Web of Science, National Library of Medicine and ResearchGate was performed. Conclusion: Vitamin C is thought to treat periodontal diseases and gingival enlargement. It also affects biofilm formation and therefore, it helps in reducing caries incidence. Recently, vitamin C mesotherapy has been used to treat inflamed gingiva, bleeding gums and gingival hyperpigmentation. More research and randomized controlled trials are needed on this specific topic for more accurate judgment. Clinical significance: A minimally invasive approach - the usage of vitamin C in dental care could drastically reduce the need for surgical intervention.

Keywords: oral health, periodontology, vitamin C, Gingivitis

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20330 Clique and Clan Analysis of Patient-Sharing Physician Collaborations

Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

Abstract:

The collaboration among physicians during episodes of care for a hospitalised patient has a significant contribution towards effective health outcome. This research aims at improving this health outcome by analysing the attributes of patient-sharing physician collaboration network (PCN) on hospital data. To accomplish this goal, we present a research framework that explores the impact of several types of attributes (such as clique and clan) of PCN on hospitalisation cost and hospital length of stay. We use electronic health insurance claim dataset to construct and explore PCNs. Each PCN is categorised as ‘low’ and ‘high’ in terms of hospitalisation cost and length of stay. The results from the proposed model show that the clique and clan of PCNs affect the hospitalisation cost and length of stay. The clique and clan of PCNs show the difference between ‘low’ and ‘high’ PCNs in terms of hospitalisation cost and length of stay. The findings and insights from this research can potentially help the healthcare stakeholders to better formulate the policy in order to improve quality of care while reducing cost.

Keywords: clique, clan, electronic health records, physician collaboration

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20329 Constructing Optimized Criteria of Objective Assessment Indicators among Elderly Frailty

Authors: Shu-Ching Chiu, Shu-Fang Chang

Abstract:

The World Health Organization (WHO) has been actively developing intervention programs to deal with geriatric frailty. In its White Paper on Healthcare Policy 2020, the Department of Health, Bureau of Health Promotion proposed that active aging and the prevention of disability are essential for elderly people to maintain good health. The paper recommended five main policies relevant to this objective, one of which is the prevention of frailty and disability. Scholars have proposed a number of different criteria to diagnose and assess frailty; no consistent or normative standard of measurement is currently available. In addition, many methods of assessment are recursive, which can easily result in recall bias. Due to the relationship between frailty and physical fitness with regard to co-morbidity, it is important that academics optimize the criteria used to assess frailty by objectively evaluating the physical fitness of senior citizens. This study used a review of the literature to identify fitness indicators suitable for measuring frailty in the elderly. This study recommends that measurement criteria be integrated to produce an optimized predictive value for frailty score. Healthcare professionals could use this data to detect frailty at an early stage and provide appropriate care to prevent further debilitation and increase longevity.

Keywords: frailty, aging, physical fitness, optimized criteria, healthcare

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20328 Risk Management in Islamic Micro Finance Credit System for Poverty Alleviation from Qualitative Perspective

Authors: Liyu Adhi Kasari Sulung

Abstract:

Poverty has been a major problem in Indonesia. Islamic micro finance (IMF) named Baitul Maal Wat Tamwil (Bmt) plays a prominent role to eradicate this. Indonesia as the biggest muslim country has many successful applied products such as worldwide adopt group-based lending approach, flexible financing for farmers, and gold pawning. The Problems related to these models are operation risk management and internal control system (ICS). A proper ICS will help an organization in preventing the occurrence of bad financing through detecting error and irregularities in its operation. This study aims to seek a proper risk management scheme of credit system in Bmt and internal control system’s rank for every stage. Risk management variables are obtained at the first In-Depth Interview (IDI) and Focus Group Discussion (FGD) with Shariah supervisory boards, boards of directors, and operational managers. Survey was conducted covering nationwide data; West Java, South Sulawesi, and West Nusa Tenggara. Moreover, Content analysis is employed to build the relationship among these variables. Research Findings shows that risk management Characteristics in Indonesia involves ex ante, credit process, and ex post strategies to deal with risk in credit system. Ex-ante control consists of Shariah compliance, survey, group leader reference, and islamic forming orientation. Then, credit process involves saving, collateral, joint liability, loan repayment, and credit installment controlling. Finally, ex-post control includes shariah evaluation, credit evaluation, grace period and low installment provisions. In addition, internal control order sort three stages by its priority; Credit process as first rank, then ex-post control as second, and ex ante control as the last rank.

Keywords: internal control system, islamic micro finance, poverty, risk management

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20327 Stigmatization of Individuals Who Receive Mental Health Treatment and the Role of Social Media: A Cross-Generational Cohort Design and Extension

Authors: Denise Ben-Porath, Tracy Masterson

Abstract:

In the past, individuals who struggled with and sought treatment for mental health difficulties were stigmatized. However, the current generation holds more open attitudes around mental health issues. Indeed, public figures such as Demi Lovato, Naomi Osaka, and Simone Biles have taken to social media to break the silence around mental health, discussing their own struggles and the benefits of treatment. Thus, there is considerable reason to believe that this generation would hold fewer stigmatizing attitudes toward mental health difficulties and treatment compared to previous ones. In this study, we explored possible changes in stigma on mental health diagnosis and treatment seeking behavior between two generations: Gen Z, the current generation, and Gen X, those born between 1965-1980. It was hypothesized that Gen Z would hold less stigmatizing views on mental illness than Gen X. To examine possible changes in stigma attitudes between these two generations, we conducted a cross-generational cohort design by using the same methodology employed 20 years ago from the Ben-Porath (2002) study. Thus, participants were randomly assigned to read one of the following four case vignettes employed in the Ben-Porath (2002) study: (a) “Tom” who has received psychotherapy due to depression (b) “Tom” who has been depressed but received no psychological help, (c) “Tom” who has received medical treatment due to a back pain, or (d) “Tom” who had a back pain but did not receive medical attention. After reading the vignette, participants rated “Tom” on various personality dimensions using the IFQ Questionnaire and answered questions about their frequency of social media use and willingness to seek mental health treatment on a scale from 1-10. Identical to the results 20 years prior, a significant main effect was found for diagnosis with “Tom” being viewed in more negative terms when he was described as having depression vs. a medical condition (back pain) [F (1, 376) = 126.53, p < .001]. However, in the study conducted 20 years earlier, a significant interaction was found between diagnosis and help-seeking behavior [F (1, 376) = 8.28, p < .005]. Specifically, “Tom” was viewed in the most negative terms when described as depressed and seeking treatment. Alternatively, the current study failed to find a significant interaction between depression and help seeking behavior. These findings suggest that while individuals who hold a mental health diagnosis may still be stigmatized as they were 20 years prior, seeking treatment for mental health issues may be less so. Findings are discussed in the context of social media use and its impact on destigmatization.

Keywords: stigma, mental illness, help-seeking, social media

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20326 Microalgae Technology for Nutraceuticals

Authors: Weixing Tan

Abstract:

Production of nutraceuticals from microalgae—a virtually untapped natural phyto-based source of which there are 200,000 to 1,000,000 species—offers a sustainable and healthy alternative to conventionally sourced nutraceuticals for the market. Microalgae can be grown organically using only natural sunlight, water and nutrients at an extremely fast rate, e.g. 10-100 times more efficiently than crops or trees. However, the commercial success of microalgae products at scale remains limited largely due to the lack of economically viable technologies. There are two major microalgae production systems or technologies currently available: 1) the open system as represented by open pond technology and 2) the closed system such as photobioreactors (PBR). Each carries its own unique features and challenges. Although an open system requires a lower initial capital investment relative to a PBR, it conveys many unavoidable drawbacks; for example, much lower productivity, difficulty in contamination control/cleaning, inconsistent product quality, inconvenience in automation, restriction in location selection, and unsuitability for cold areas – all directly linked to the system openness and flat underground design. On the other hand, a PBR system has characteristics almost entirely opposite to the open system, such as higher initial capital investment, better productivity, better contamination and environmental control, wider suitability in different climates, ease in automation, higher and consistent product quality, higher energy demand (particularly if using artificial lights), and variable operational expenses if not automated. Although closed systems like PBRs are not highly competitive yet in current nutraceutical supply market, technological advances can be made, in particular for the PBR technology, to narrow the gap significantly. One example is a readily scalable P2P Microalgae PBR Technology at Grande Prairie Regional College, Canada, developed over 11 years considering return on investment (ROI) for key production processes. The P2P PBR system is approaching economic viability at a pre-commercial stage due to five ROI-integrated major components. They include: (1) optimum use of free sunlight through attenuation (patented); (2) simple, economical, and chemical-free harvesting (patent ready to file); (3) optimum pH- and nutrient-balanced culture medium (published), (4) reliable water and nutrient recycling system (trade secret); and (5) low-cost automated system design (trade secret). These innovations have allowed P2P Microalgae Technology to increase daily yield to 106 g/m2/day of Chlorella vulgaris, which contains 50% proteins and 2-3% omega-3. Based on the current market prices and scale-up factors, this P2P PBR system presents as a promising microalgae technology for market competitive nutraceutical supply.

Keywords: microalgae technology, nutraceuticals, open pond, photobioreactor PBR, return on investment ROI, technological advances

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20325 [Keynote Talk]: Photocatalytic Cleaning Performance of Air Filters for a Binary Mixture

Authors: Lexuan Zhong, Chang-Seo Lee, Fariborz Haghighat, Stuart Batterman, John C. Little

Abstract:

Ultraviolet photocatalytic oxidation (UV-PCO) technology has been recommended as a green approach to health indoor environment when it is integrated into mechanical ventilation systems for inorganic and organic compounds removal as well as energy saving due to less outdoor air intakes. Although much research has been devoted to UV-PCO, limited information is available on the UV-PCO behavior tested by the mixtures in literature. This project investigated UV-PCO performance and by-product generation using a single and a mixture of acetone and MEK at 100 ppb each in a single-pass duct system in an effort to obtain knowledge associated with competitive photochemical reactions involved in. The experiments were performed at 20 % RH, 22 °C, and a gas flow rate of 128 m3/h (75 cfm). Results show that acetone and MEK mutually reduced each other’s PCO removal efficiency, particularly negative removal efficiency for acetone. These findings were different from previous observation of facilitatory effects on the adsorption of acetone and MEK on photocatalyst surfaces.

Keywords: by-products, inhibitory effect, mixture, photocatalytic oxidation

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20324 Performance Analysis of 5G for Low Latency Transmission Based on Universal Filtered Multi-Carrier Technique and Interleave Division Multiple Access

Authors: A. Asgharzadeh, M. Maroufi

Abstract:

5G mobile communication system has drawn more and more attention. The 5G system needs to provide three different types of services, including enhanced Mobile BroadBand (eMBB), massive machine-type communication (mMTC), and ultra-reliable and low-latency communication (URLLC). Universal Filtered Multi-Carrier (UFMC), Filter Bank Multicarrier (FBMC), and Filtered Orthogonal Frequency Division Multiplexing (f-OFDM) are suggested as a well-known candidate waveform for the coming 5G system. Themachine-to-machine (M2M) communications are one of the essential applications in 5G, and it involves exchanging of concise messages with a very short latency. However, in UFMC systems, the subcarriers are grouped into subbands but f-OFDM only one subband covers the entire band. Furthermore, in FBMC, a subband includes only one subcarrier, and the number of subbands is the same as the number of subcarriers. This paper mainly discusses the performance of UFMC with different parameters for the UFMC system. Also, paper shows that UFMC is the best choice outperforming OFDM in any case and FBMC in case of very short packets while performing similarly for long sequences with channel estimation techniques for Interleave Division Multiple Access (IDMA) systems.

Keywords: universal filtered multi-carrier technique, UFMC, interleave division multiple access, IDMA, fifth-generation, subband

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20323 Comparative Studies of Distributed and Aggregated Energy Storage Configurations in Direct Current Microgrids

Authors: Frimpong Kyeremeh, Albert Y. Appiah, Ben B. K. Ayawli

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Energy storage system (ESS) is an essential part of a microgrid (MG) because of its immense benefits to the economics and the stability of MG. For a direct current (DC) MG (DCMG) in which the generating units are mostly variable renewable energy generators, DC bus voltage fluctuation is inevitable; hence ESS is vital in managing the mismatch between load demand and generation. Besides, to accrue the maximum benefits of ESS in the microgrid, there is the need for proper sizing and location of the ESSs. In this paper, a performance comparison is made between two configurations of ESS; distributed battery energy storage system (D-BESS) and an aggregated (centralized) battery energy storage system (A-BESS), on the basis of stability and operational cost for a DCMG. The configuration consists of four households with rooftop PV panels and a wind turbine. The objective is to evaluate and analyze the technical efficiencies, cost effectiveness as well as controllability of each configuration. The MG is first modelled with MATLAB Simulink then, a mathematical model is used to determine the optimal size of the BESS that minimizes the total operational cost of the MG. The performance of the two configurations would be tested with simulations. The two configurations are expected to reduce DC bus voltage fluctuations, but in the cases of voltage stability and optimal cost, the best configuration performance will be determined at the end of the research. The work is in progress, and the result would help MG designers and operators to make the best decision on the use of BESS for DCMG configurations.

Keywords: aggregated energy storage system, DC bus voltage, DC microgrid, distributed battery energy storage, stability

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20322 Exploring Communities of Practice through Public Health Walks for Nurse Education

Authors: Jacqueline P. Davies

Abstract:

Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: education, innovation, nursing, urban

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20321 Ecosystem, Environment Being Threatened by the Activities of Major Industries

Authors: Charles Akinola Imolehin

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According to the news on world population record, over 6.6 billion people on earth, and almost a quarter million added each day, the scale of human activity and environmental impact is unprecedented. Soaring human population growth over the past century has created a visible challenge to earth’s life support systems. Critical natural resources such as clean ground water, fertile topsoil, and biodiversity are diminishing at an exponential rate, orders of magnitude above that at which they can be regenerated. In addition, the world faces an onslaught of other environmental threats including degenerated global climate change, global warming, intensified acid rain, stratospheric ozone depletion and health threatening pollution. Overpopulation and the use of deleterious technologies combine to increase the scale of human activities to a level that underlies these entire problems. These intensifying trends cannot continue indefinitely, hopefully, through increased understanding and valuation of ecosystems and their services, earth’s basic life-support system will be protected for the future. To say the fact, human civilization is now the dominant cause of change in the global environment. Now that human relationship to the earth has change so utterly, there is need to see to that change and understand its implication. These are two aspects to the challenges which all should believe. The first is to realize that human activity has power to harm the earth and can indeed have global and even permanent effects. Second is to realize that the only way to understand human new role as a co-architect of nature is to see human activities as part of a complex system that does operate according to the same simple rules of cause and effect commonly used to. So, understanding the physical/biological dimension of earth system is an important precondition for making sensible policy to protect our environment. Because believing in Sustainable Development is a matter of reconciling respect for the environment, social equity, and economic profitability. Also, there is strong believe that environmental protection is naturally about reducing air and water pollution, but it also includes the improvement of the environmental performance of existing process. That is why is important to always have it at the heart of business policy that the environmental problem is not our effect on the environment so much as the relationship of production activities on the environment. There should be this positive thinking in all operation to always be environmentally friendly especially in projection and considering Sustainable ALL awareness in all sites of operation.

Keywords: earth's ocean, marine animals life under treat, flooding, ctritical natiural resouces polluted

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20320 Utilization of Informatics to Transform Clinical Data into a Simplified Reporting System to Examine the Analgesic Prescribing Practices of a Single Urban Hospital’s Emergency Department

Authors: Rubaiat S. Ahmed, Jemer Garrido, Sergey M. Motov

Abstract:

Clinical informatics (CI) enables the transformation of data into a systematic organization that improves the quality of care and the generation of positive health outcomes.Innovative technology through informatics that compiles accurate data on analgesic utilization in the emergency department can enhance pain management in this important clinical setting. We aim to establish a simplified reporting system through CI to examine and assess the analgesic prescribing practices in the EDthrough executing a U.S. federal grant project on opioid reduction initiatives. Queried data points of interest from a level-one trauma ED’s electronic medical records were used to create data sets and develop informational/visual reporting dashboards (on Microsoft Excel and Google Sheets) concerning analgesic usage across several pre-defined parameters and performance metrics using CI. The data was then qualitatively analyzed to evaluate ED analgesic prescribing trends by departmental clinicians and leadership. During a 12-month reporting period (Dec. 1, 2020 – Nov. 30, 2021) for the ongoing project, about 41% of all ED patient visits (N = 91,747) were for pain conditions, of which 81.6% received analgesics in the ED and at discharge (D/C). Of those treated with analgesics, 24.3% received opioids compared to 75.7% receiving opioid alternatives in the ED and at D/C, including non-pharmacological modalities. Demographics showed among patients receiving analgesics, 56.7% were aged between 18-64, 51.8% were male, 51.7% were white, and 66.2% had government funded health insurance. Ninety-one percent of all opioids prescribed were in the ED, with intravenous (IV) morphine, IV fentanyl, and morphine sulfate immediate release (MSIR) tablets accounting for 88.0% of ED dispensed opioids. With 9.3% of all opioids prescribed at D/C, MSIR was dispensed 72.1% of the time. Hydrocodone, oxycodone, and tramadol usage to only 10-15% of the time, and hydromorphone at 0%. Of opioid alternatives, non-steroidal anti-inflammatory drugs were utilized 60.3% of the time, 23.5% with local anesthetics and ultrasound-guided nerve blocks, and 7.9% with acetaminophen as the primary non-opioid drug categories prescribed by ED providers. Non-pharmacological analgesia included virtual reality and other modalities. An average of 18.5 ED opioid orders and 1.9 opioid D/C prescriptions per 102.4 daily ED patient visits was observed for the period. Compared to other specialties within our institution, 2.0% of opioid D/C prescriptions are given by ED providers, compared to the national average of 4.8%. Opioid alternatives accounted for 69.7% and 30.3% usage, versus 90.7% and 9.3% for opioids in the ED and D/C, respectively.There is a pressing need for concise, relevant, and reliable clinical data on analgesic utilization for ED providers and leadership to evaluate prescribing practices and make data-driven decisions. Basic computer software can be used to create effective visual reporting dashboards with indicators that convey relevant and timely information in an easy-to-digest manner. We accurately examined our ED's analgesic prescribing practices using CI through dashboard reporting. Such reporting tools can quickly identify key performance indicators and prioritize data to enhance pain management and promote safe prescribing practices in the emergency setting.

Keywords: clinical informatics, dashboards, emergency department, health informatics, healthcare informatics, medical informatics, opioids, pain management, technology

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20319 Challenges over Two Semantic Repositories - OWLIM and AllegroGraph

Authors: Paria Tajabor, Azin Azarbani

Abstract:

The purpose of this research study is exploring two kind of semantic repositories with regards to various factors to find the best approaches that an artificial manager can use to produce ontology in a system based on their interaction, association and research. To this end, as the best way to evaluate each system and comparing with others is analysis, several benchmarking over these two repositories were examined. These two semantic repositories: OWLIM and AllegroGraph will be the main core of this study. The general objective of this study is to be able to create an efficient and cost-effective manner reports which is required to support decision making in any large enterprise.

Keywords: OWLIM, allegrograph, RDF, reasoning, semantic repository, semantic-web, SPARQL, ontology, query

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20318 Experimental Investigation of Heat Transfer on Vertical Two-Phased Closed Thermosyphon

Authors: M. Hadi Kusuma, Nandy Putra, Anhar Riza Antariksawan, Ficky Augusta Imawan

Abstract:

Heat pipe is considered to be applied as a passive system to remove residual heat that generated from reactor core when incident occur or from spent fuel storage pool. The objectives are to characterized the heat transfer phenomena, performance of heat pipe, and as a model for large heat pipe will be applied as passive cooling system on nuclear spent fuel pool storage. In this experimental wickless heat pipe or two-phase closed thermosyphon (TPCT) is used. Variation of heat flux are 611.24 Watt/m2 - 3291.29 Watt/m2. Variation of filling ratio are 45 - 70%. Variation of initial pressure are -62 to -74 cm Hg. Demineralized water is used as working fluid in the TPCT. The results showed that increasing of heat load leads to an increase of evaporation of the working fluid. The optimum filling ratio obtained for 60% of TPCT evaporator volume, and initial pressure variation gave different TPCT wall temperature characteristic. TPCT showed best performance with 60% filling ratio and can be consider to be applied as passive residual heat removal system or passive cooling system on spent fuel storage pool.

Keywords: two-phase closed term syphon, heat pipe, passive cooling, spent fuel storage pool

Procedia PDF Downloads 326
20317 The Relationship between Fluctuation of Biological Signal: Finger Plethysmogram in Conversation and Anthropophobic Tendency

Authors: Haruo Okabayashi

Abstract:

Human biological signals (pulse wave and brain wave, etc.) have a rhythm which shows fluctuations. This study investigates the relationship between fluctuations of biological signals which are shown by a finger plethysmogram (i.e., finger pulse wave) in conversation and anthropophobic tendency, and identifies whether the fluctuation could be an index of mental health. 32 college students participated in the experiment. The finger plethysmogram of each subject was measured in the following conversation situations: Fun memory talking/listening situation and regrettable memory talking/ listening situation for three minutes each. Lyspect 3.5 was used to collect the data of the finger plethysmogram. Since Lyspect calculates the Lyapunov spectrum, it is possible to obtain the largest Lyapunov exponent (LLE). LLE is an indicator of the fluctuation and shows the degree to which a measure is going away from close proximity to the track in a dynamical system. Before the finger plethysmogram experiment, each participant took the psychological test questionnaire “Anthropophobic Scale.” The scale measures the social phobia trend close to the consciousness of social phobia. It is revealed that there is a remarkable relationship between the fluctuation of the finger plethysmography and anthropophobic tendency scale in talking about a regrettable story in conversation: The participants (N=15) who have a low anthropophobic tendency show significantly more fluctuation of finger pulse waves than the participants (N=17) who have a high anthropophobic tendency (F (1, 31) =5.66, p<0.05). That is, the participants who have a low anthropophobic tendency make conversation flexibly using large fluctuation of biological signal; on the other hand, the participants who have a high anthropophobic tendency constrain a conversation because of small fluctuation. Therefore, fluctuation is not an error but an important drive to make better relationships with others and go towards the development of interaction. In considering mental health, the fluctuation of biological signals would be an important indicator.

Keywords: anthropophobic tendency, finger plethymogram, fluctuation of biological signal, LLE

Procedia PDF Downloads 236
20316 The Relation between Urbanization and Forestry Policies in Turkey

Authors: Azize Serap Tuncer

Abstract:

Turkey is one of the most outstanding figures among the Mediterranean countries from the natural and historical point at view. It is relatively rich country as regards the flora and vegetation. But at the same time as a result of improper and unplanned usage of the land for centuries, its forests and fertile soils have been exposed to great damages. While rapid and uncontrolled urbanization has important effects on the environment, urban development legislations, have become very unsufficient for the protection of these areas. Some of them have been completely eradicated, and some others have lost their fertility. Besides Turkey has a high main land with a rough surface and its soils areas exposed to heavy erosion. On the other hand as a developing country, it is not willing to endanger the goals of industrialization and avoid foreign direct investment by implementing strict environmental policies. Although this kind of pressure on forestland resources threatens the stability of forest land and land use management, in recent years, there has been an obvious increase in public concern about environmental problems like over global warming, environmental pollution, deforestation and their potential effects on natural resources. To protect the ecological balance and prevention of naturel resources from the unplanned intervention of human-beıng is only possible establishing conservation areas wıth co-operation at the national and the internatıonal levels. This study was carried out to evaluate the relation between urbanization and forestry policies in Turkey. While it elaborates the normative arrangements resulting in power conflicts, it also addresses which shortages and discrepancies are responsible for the said conflicts. The present urban reconstruction and transformation practices and their aesthetic and functional aspects were studied with some examples in a country level and evaluated within the assistance of literature researches, analyses, and observations. Atatürk Forest Farm and ODTU Forest examples were negotiated as two famous cases. Obtained findings were supported by charts and photos.

Keywords: deforestration, environmental policies, metropolitan, pollution, urbanization

Procedia PDF Downloads 155
20315 Evaluation of a Higher Diploma in Mental Health Nursing Using Qualitative and Quantitative Methods: Effects on Student Behavior, Attitude and Perception

Authors: T. Frawley, G. O'Kelly

Abstract:

The UCD School of Nursing, Midwifery and Health Systems Higher Diploma in Mental Health (HDMH) nursing programme commenced in January 2017. Forty students successfully completed the programme. Programme evaluation was conducted from the outset. Research ethics approval was granted by the UCD Human Research Ethics Committee – Sciences in November 2016 (LS-E-16-163). Plan for Sustainability: Each iteration of the programme continues to be evaluated and adjusted accordingly. Aims: The ultimate purpose of the HDMH programme is to prepare registered nurses (registered children’s nurse (RCN), registered nurse in intellectual disability (RNID) and registered general nurse (RGN)) to function as effective registered psychiatric nurses in all settings which provide care and treatment for people experiencing mental health difficulties. Curriculum evaluation is essential to ensure that the programme achieves its purpose, that aims and expected outcomes are met and that required changes are highlighted for the programme’s continuing positive development. Methods: Both quantitative and qualitative methods were used in the evaluation. A series of questionnaires were used (the majority pre and post programme) to determine student perceptions of the programme, behaviour and attitudinal change from commencement to completion. These included the student assessment of learning gains (SALG); mental health knowledge schedule (MAKS); mental health clinician attitudes scale (MICA); reported and intended behaviour scale (RIBS); and community attitudes towards the mentally ill (CAMI). In addition, student and staff focus groups were conducted. Evaluation methods also incorporated module feedback. Outcome/Results: The evaluation highlighted a very positive response in relation to the achievement of programme outcomes and preparation for future work as registered psychiatric nursing. Some areas were highlighted for further development, which have been taken cognisance of in the 2019 iteration of the programme.

Keywords: learning gains, mental health, nursing, stigma

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20314 Assessment of Chromium Concentration and Human Health Risk in the Steelpoort River Sub-Catchment of the Olifants River Basin, South Africa

Authors: Abraham Addo-Bediako

Abstract:

Many freshwater ecosystems are facing immense pressure from anthropogenic activities, such as agricultural, industrial and mining. Trace metal pollution in freshwater ecosystems has become an issue of public health concern due to its toxicity and persistence in the environment. Trace elements pose a serious risk not only to the environment and aquatic biota but also humans. Chromium is one of such trace elements and its pollution in surface waters and groundwaters represents a serious environmental problem. In South Africa, agriculture, mining, industrial and domestic wastes are the main contributors to chromium discharge in rivers. The common forms of chromium are chromium (III) and chromium (VI). The latter is the most toxic because it can cause damage to human health. The aim of the study was to assess the contamination of chromium in the water and sediments of two rivers in the Steelpoort River sub-catchment of the Olifants River Basin, South Africa and human health risk. The concentration of Cr was analyzed using inductively coupled plasma–optical emission spectrometry (ICP-OES). The concentration of the metal was found to exceed the threshold limit, mainly in areas of high human activities. The hazard quotient through ingestion exposure did not exceed the threshold limit of 1 for adults and children and cancer risk for adults and children computed did not exceed the threshold limit of 10-4. Thus, there is no potential health risk from chromium through ingestion of drinking water for now. However, with increasing human activities, especially mining, the concentration could increase and become harmful to humans who depend on rivers for drinking water. It is recommended that proper management strategies should be taken to minimize the impact of chromium on the rivers and water from the rivers should properly be treated before domestic use.

Keywords: land use, health risk, metal pollution, water quality

Procedia PDF Downloads 83
20313 Design of Bidirectional Wavelength Division Multiplexing Passive Optical Network in Optisystem Environment

Authors: Ashiq Hussain, Mahwash Hussain, Zeenat Parveen

Abstract:

Now a days the demand for broadband service has increased. Due to which the researchers are trying to find a solution to provide a large amount of service. There is a shortage of bandwidth because of the use of downloading video, voice and data. One of the solutions to overcome this shortage of bandwidth is to provide the communication system with passive optical components. We have increased the data rate in this system. From experimental results we have concluded that the quality factor has increased by adding passive optical networks.

Keywords: WDM-PON, optical fiber, BER, Q-factor, eye diagram

Procedia PDF Downloads 501
20312 Quantitative Texture Analysis of Shoulder Sonography for Rotator Cuff Lesion Classification

Authors: Chung-Ming Lo, Chung-Chien Lee

Abstract:

In many countries, the lifetime prevalence of shoulder pain is up to 70%. In America, the health care system spends 7 billion per year about the healthy issues of shoulder pain. With respect to the origin, up to 70% of shoulder pain is attributed to rotator cuff lesions This study proposed a computer-aided diagnosis (CAD) system to assist radiologists classifying rotator cuff lesions with less operator dependence. Quantitative features were extracted from the shoulder ultrasound images acquired using an ALOKA alpha-6 US scanner (Hitachi-Aloka Medical, Tokyo, Japan) with linear array probe (scan width: 36mm) ranging from 5 to 13 MHz. During examination, the postures of the examined patients are standard sitting position and are followed by the regular routine. After acquisition, the shoulder US images were drawn out from the scanner and stored as 8-bit images with pixel value ranging from 0 to 255. Upon the sonographic appearance, the boundary of each lesion was delineated by a physician to indicate the specific pattern for analysis. The three lesion categories for classification were composed of 20 cases of tendon inflammation, 18 cases of calcific tendonitis, and 18 cases of supraspinatus tear. For each lesion, second-order statistics were quantified in the feature extraction. The second-order statistics were the texture features describing the correlations between adjacent pixels in a lesion. Because echogenicity patterns were expressed via grey-scale. The grey-scale co-occurrence matrixes with four angles of adjacent pixels were used. The texture metrics included the mean and standard deviation of energy, entropy, correlation, inverse different moment, inertia, cluster shade, cluster prominence, and Haralick correlation. Then, the quantitative features were combined in a multinomial logistic regression classifier to generate a prediction model of rotator cuff lesions. Multinomial logistic regression classifier is widely used in the classification of more than two categories such as the three lesion types used in this study. In the classifier, backward elimination was used to select a feature subset which is the most relevant. They were selected from the trained classifier with the lowest error rate. Leave-one-out cross-validation was used to evaluate the performance of the classifier. Each case was left out of the total cases and used to test the trained result by the remaining cases. According to the physician’s assessment, the performance of the proposed CAD system was shown by the accuracy. As a result, the proposed system achieved an accuracy of 86%. A CAD system based on the statistical texture features to interpret echogenicity values in shoulder musculoskeletal ultrasound was established to generate a prediction model for rotator cuff lesions. Clinically, it is difficult to distinguish some kinds of rotator cuff lesions, especially partial-thickness tear of rotator cuff. The shoulder orthopaedic surgeon and musculoskeletal radiologist reported greater diagnostic test accuracy than general radiologist or ultrasonographers based on the available literature. Consequently, the proposed CAD system which was developed according to the experiment of the shoulder orthopaedic surgeon can provide reliable suggestions to general radiologists or ultrasonographers. More quantitative features related to the specific patterns of different lesion types would be investigated in the further study to improve the prediction.

Keywords: shoulder ultrasound, rotator cuff lesions, texture, computer-aided diagnosis

Procedia PDF Downloads 283
20311 Deep Q-Network for Navigation in Gazebo Simulator

Authors: Xabier Olaz Moratinos

Abstract:

Drone navigation is critical, particularly during the initial phases, such as the initial ascension, where pilots may fail due to strong external interferences that could potentially lead to a crash. In this ongoing work, a drone has been successfully trained to perform an ascent of up to 6 meters at speeds with external disturbances pushing it up to 24 mph, with the DQN algorithm managing external forces affecting the system. It has been demonstrated that the system can control its height, position, and stability in all three axes (roll, pitch, and yaw) throughout the process. The learning process is carried out in the Gazebo simulator, which emulates interferences, while ROS is used to communicate with the agent.

Keywords: machine learning, DQN, Gazebo, navigation

Procedia PDF Downloads 72
20310 Effect Of E-banking On Performance Efficiency Of Commercial Banks In Pakistan

Authors: Naeem Hassan

Abstract:

The study intended to investigate the impact of the e banking system on the performance efficiency of the commercial banks in KP, Pakistan. In addition to this main purpose, the study also aimed at analyzing the impact of e banking on the service quality as well as satisfaction of the customers using e banking system. More over, the focus was also given to highlight the risks involved in the e banking system. The researcher has adopted the quantitative methodology in the study. in order to reach concrete finding, the researcher has analyzed the secondary data taken from the annual reports of selected banks and State bank of Pakistan as well as the primary data collected through the self-administrated questionnaire from the participants selected for the current study. The study highlighted that there is a significant impact of e banking on the financial efficiency on the commercial banks in KP, Pakistan. Additionally, the results of the study also show that the online banking is having significant effects on the customer satisfaction. The researcher recommends on the bases of findings that commercial banks should continue to adopt new technologies which will improve their margins and hence their net profit after tax in order to attract more investors. Additionally, commercial bank needs to minimize the time and risk in e-banking to attract more customers which will improve their net profit. Furthermore, the study findings also recommend the banking policy makers should also review policies related to promotion of innovation adoption and transfer of technology. Commercial banking system should encourage adoption of innovations that will improve profit of the banking industry.

Keywords: E-banking, performance efficiency, commercial banks, effect

Procedia PDF Downloads 66
20309 Book Exchange System with a Hybrid Recommendation Engine

Authors: Nilki Upathissa, Torin Wirasinghe

Abstract:

This solution addresses the challenges faced by traditional bookstores and the limitations of digital media, striking a balance between the tactile experience of printed books and the convenience of modern technology. The book exchange system offers a sustainable alternative, empowering users to access a diverse range of books while promoting community engagement. The user-friendly interfaces incorporated into the book exchange system ensure a seamless and enjoyable experience for users. Intuitive features for book management, search, and messaging facilitate effortless exchanges and interactions between users. By streamlining the process, the system encourages readers to explore new books aligned with their interests, enhancing the overall reading experience. Central to the system's success is the hybrid recommendation engine, which leverages advanced technologies such as Long Short-Term Memory (LSTM) models. By analyzing user input, the engine accurately predicts genre preferences, enabling personalized book recommendations. The hybrid approach integrates multiple technologies, including user interfaces, machine learning models, and recommendation algorithms, to ensure the accuracy and diversity of the recommendations. The evaluation of the book exchange system with the hybrid recommendation engine demonstrated exceptional performance across key metrics. The high accuracy score of 0.97 highlights the system's ability to provide relevant recommendations, enhancing users' chances of discovering books that resonate with their interests. The commendable precision, recall, and F1score scores further validate the system's efficacy in offering appropriate book suggestions. Additionally, the curve classifications substantiate the system's effectiveness in distinguishing positive and negative recommendations. This metric provides confidence in the system's ability to navigate the vast landscape of book choices and deliver recommendations that align with users' preferences. Furthermore, the implementation of this book exchange system with a hybrid recommendation engine has the potential to revolutionize the way readers interact with printed books. By facilitating book exchanges and providing personalized recommendations, the system encourages a sense of community and exploration within the reading community. Moreover, the emphasis on sustainability aligns with the growing global consciousness towards eco-friendly practices. With its robust technical approach and promising evaluation results, this solution paves the way for a more inclusive, accessible, and enjoyable reading experience for book lovers worldwide. In conclusion, the developed book exchange system with a hybrid recommendation engine represents a progressive solution to the challenges faced by traditional bookstores and the limitations of digital media. By promoting sustainability, widening access to printed books, and fostering engagement with reading, this system addresses the evolving needs of book enthusiasts. The integration of user-friendly interfaces, advanced machine learning models, and recommendation algorithms ensure accurate and diverse book recommendations, enriching the reading experience for users.

Keywords: recommendation systems, hybrid recommendation systems, machine learning, data science, long short-term memory, recurrent neural network

Procedia PDF Downloads 87
20308 A Game of Information in Defense/Attack Strategies: Case of Poisson Attacks

Authors: Asma Ben Yaghlane, Mohamed Naceur Azaiez

Abstract:

In this paper, we briefly introduce the concept of Poisson attacks in the case of defense/attack strategies where attacks are assumed to be continuous. We suggest a game model in which the attacker will combine both criteria of a sufficient confidence level of a successful attack and a reasonably small size of the estimation error in order to launch an attack. Here, estimation error arises from assessing the system failure upon attack using aggregate data at the system level. The corresponding error is referred to as aggregation error. On the other hand, the defender will attempt to deter attack by making one or both criteria inapplicable. The defender will build his/her strategy by both strengthening the targeted system and increasing the size of error. We will formulate the defender problem based on appropriate optimization models. The attacker will opt for a Bayesian updating in assessing the impact on the improvement made by the defender. Then, the attacker will evaluate the feasibility of the attack before making the decision of whether or not to launch it. We will provide illustrations to better explain the process.

Keywords: attacker, defender, game theory, information

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20307 Reproductive Health of Women After Taking Chemotherapy for Gestational Trophoblastic Disease

Authors: Ezeh Chukwunonso Peter Excel, Akruti Vg

Abstract:

Aim/Background: To show that even after undergoing 1-5 courses of chemotherapy for Gestational Trophoblastic Disease (GTD) reproductive health of women is intact and they conceive successfully after it. Method: Retrospective cohort analysis using data from the Lugansk regional maternity hospital database of years 1993-2013, which shows n=18 females had GTD and underwent 1-5 courses of chemotherapy. Results and Discussion: Frequency of GTD was rare. All 18 patients (pts) belong to age group of 17-39 years, covering wide range of reproductive age. Out of 18 pts, 15 had hydatidiform mole (HM) while other 3 had choriocarcinoma (CC). In anamnesis, among CC pts, 1 had early pre-eclampsia at 24 weeks and 1 had 4th week of late postpartum (PP) bleeding, while all HM pts had genital inflammatory diseases, 1 pt of HM during follow-up had High hCG and 3 times curettage in 5 months. 18 women became pregnant for 25 times after chemotherapy. Chemotherapy was given under indication of either high level of HCG, luteal cyst >6cm or path-morphological results of curettage. CC 3 pts had (2 spontaneous abortions (SA), 2 term cesarean section (CS), 1 preterm CS). HM 15 pts had (3 artificial abortion, 2 SA, 7CS (5 term and 2 preterm), 8 vaginal deliveries (7 term and 1 preterm)). Conclusion: During our research we got 22.2% preterm deliveries and 55.6% CS which is higher than the normal cases, but still all the 18 women were able to have kids successfully after chemotherapy. So we can conclude that chemotherapy for GTD was successful in keeping the reproductive health of women intact.

Keywords: reproductive health, chemotherapy, gestational trophoblastic disease, women

Procedia PDF Downloads 388