Search results for: occupational standard

Authors: K. Rajarajeswaran, Krishna Prasad

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Introduction: Refractory shock is a typical consequence of sepsis that does not improve with standard vasopressor therapy. A possible adjuvant therapeutic option for treating refractory shock in sepsis is methylene blue. This study looked at the effects of intravenous methylene blue plus norepinephrine given as a single bolus infusion on mortality and hemodynamic improvement in patients suffering from refractory shock. Methodology: This six-month observational prospective study was carried out at an intensive care unit, teaching hospital, and medical college. It involved 112 patients who had been diagnosed with refractory septic shock and needed vasopressor medication. Group B received injection norepinephrine 0.01 µg/kg/min infusion alone, while Group A received injection methylene blue 2 mg/kg iv single bolus (fixed dose) in addition to injection norepinephrine 0.01 µg/kg/min infusion. Both groups' noradrenaline doses were titrated to reach the desired MAP of 60–75 mm Hg. The amount of norepinephrine needed to sustain a MAP of more than 60 mm Hg was the data gathered. Serum lactate, procalcitonin level, C-reactive protein, length of stay in the intensive care unit (ICU), sequential organ failure assessment (SOFA) score, and duration of mechanical ventilation, incidence of acute kidney injury (AKI), and mortality were compared. Results: A total of 112 patients with refractory shock were included in the study. With the use of IV methylene blue, 36 (59.3%) patients showed significant improvement in MAP within 2 hours (77.12 ± 8.90 vs 74.28 ± 21.84, p = 0.005). Responders were 4.009 times more likely to have vasopressor-free time within 24 hours (19.5% vs 6.1%, p = 0.022, odds ratio 5.017, 95% confidence interval, 1.110–14.283). The serum lactate was lower, and urine output was higher in group I than in group II (p <0.05). Group I had a significantly greater reduction in SOFA score in 12 hours than group II. However, there was no significant difference in terms of mortality, length of ICU stay, ventilator free days, and incidence of AKI. In the responder group, there was a significant increase in the MAP and decrease in vasopressor requirement pre- and post-infusion of methylene blue (p < 0.05). Responder had shorter vasopressor-free days as compared with non-responder (5.44 vs 6.99, p = 0.007). Conclusion: When administered as adjuvant therapy, a single-dose bolus infusion of Methylene Blue plus Norepinephrine may aid in meeting early resuscitation goals for the management of patients with septic shock. But the patients' death rate, ICU stay duration, ventilator-free days, or incidence of AKI were unchanged.

Keywords: norepinephrine, methylene blue, shock, vasopressor

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Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa

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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.

Keywords: clinical outcomes, head and neck, management, paragangliomas

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Authors: Sakshi Gupta, Anupam Agrawal, Ekta Singla

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An exoskeleton design for rehabilitation purpose encounters many challenges, including ergonomically acceptable wearing technology, architectural design human-motion compatibility, actuation type, human-robot interaction, etc. In this paper, a passive architecture for upper limb exoskeleton is proposed for assisting in rehabilitation tasks. Kinematic modelling is detailed for task-based kinematic synthesis of the wearable exoskeleton for self-feeding tasks. The exoskeleton architecture possesses expansion and torsional springs which are able to store and redistribute energy over the human arm joints. The elastic characteristics of the springs have been optimized to minimize the mechanical work of the human arm joints. The concept of hybrid combination of a 4-bar parallelogram linkage and a serial linkage were chosen, where the 4-bar parallelogram linkage with expansion spring acts as a rigid structure which is used to provide the rotational degree-of-freedom (DOF) required for lowering and raising of the arm. The single linkage with torsional spring allows for the rotational DOF required for elbow movement. The focus of the paper is kinematic modelling, analysis and task-based synthesis framework for the proposed architecture, keeping in considerations the essential tasks of self-feeding and self-exercising during rehabilitation of partially healthy person. Rehabilitation of primary functional movements (activities of daily life, i.e., ADL) is routine activities that people tend to every day such as cleaning, dressing, feeding. We are focusing on the feeding process to make people independent in respect of the feeding tasks. The tasks are focused to post-surgery patients under rehabilitation with less than 40% weakness. The challenges addressed in work are ensuring to emulate the natural movement of the human arm. Human motion data is extracted through motion-sensors for targeted tasks of feeding and specific exercises. Task-based synthesis procedure framework will be discussed for the proposed architecture. The results include the simulation of the architectural concept for tracking the human-arm movements while displaying the kinematic and static study parameters for standard human weight. D-H parameters are used for kinematic modelling of the hybrid-mechanism, and the model is used while performing task-based optimal synthesis utilizing evolutionary algorithm.

Keywords: passive mechanism, task-based synthesis, emulating human-motion, exoskeleton

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Authors: Azimollah Aleshzadeh, Enver Vural Yavuz

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The main goal of this study is to produce landslide susceptibility maps using different data-driven bivariate statistical approaches; namely, entropy weight method (EWM), evidence belief function (EBF), and information content model (ICM), at Uzundere county, Erzurum province, in the north-eastern part of Turkey. Past landslide occurrences were identified and mapped from an interpretation of high-resolution satellite images, and earlier reports as well as by carrying out field surveys. In total, 42 landslide incidence polygons were mapped using ArcGIS 10.4.1 software and randomly split into a construction dataset 70 % (30 landslide incidences) for building the EWM, EBF, and ICM models and the remaining 30 % (12 landslides incidences) were used for verification purposes. Twelve layers of landslide-predisposing parameters were prepared, including total surface radiation, maximum relief, soil groups, standard curvature, distance to stream/river sites, distance to the road network, surface roughness, land use pattern, engineering geological rock group, topographical elevation, the orientation of slope, and terrain slope gradient. The relationships between the landslide-predisposing parameters and the landslide inventory map were determined using different statistical models (EWM, EBF, and ICM). The model results were validated with landslide incidences, which were not used during the model construction. In addition, receiver operating characteristic curves were applied, and the area under the curve (AUC) was determined for the different susceptibility maps using the success (construction data) and prediction (verification data) rate curves. The results revealed that the AUC for success rates are 0.7055, 0.7221, and 0.7368, while the prediction rates are 0.6811, 0.6997, and 0.7105 for EWM, EBF, and ICM models, respectively. Consequently, landslide susceptibility maps were classified into five susceptibility classes, including very low, low, moderate, high, and very high. Additionally, the portion of construction and verification landslides incidences in high and very high landslide susceptibility classes in each map was determined. The results showed that the EWM, EBF, and ICM models produced satisfactory accuracy. The obtained landslide susceptibility maps may be useful for future natural hazard mitigation studies and planning purposes for environmental protection.

Keywords: entropy weight method, evidence belief function, information content model, landslide susceptibility mapping

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Authors: Sangho Park, Mansoo Kim, Kyujung Chae, Junhyuk Yang

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The International Maritime Organization (IMO) recognized the problem of invasive species invasion and adopted the "International Convention for the Control and Management of Ships' Ballast Water and Sediments" in 2004, which came into force on September 8, 2017. In 2011, the IMO approved the "Guidelines for the Control and Management of Ships' Biofouling to Minimize the Transfer of Invasive Aquatic Species" to minimize the movement of invasive species by hull-attached organisms and required ships to manage the organisms attached to their hulls. Invasive species enter new environments through ships' ballast water and hull attachment. However, several obstacles to implementing these guidelines have been identified, including a lack of underwater cleaning equipment, regulations on underwater cleaning activities in ports, and difficulty accessing crevices in underwater areas. The shipping industry, which is the party responsible for understanding these guidelines, wants to implement them for fuel cost savings resulting from the removal of organisms attached to the hull, but they anticipate significant difficulties in implementing the guidelines due to the obstacles mentioned above. Robots or people remove the organisms attached to the hull underwater, and the resulting wastewater includes various species of organisms and particles of paint and other pollutants. Currently, there is no technology available to sterilize the organisms in the wastewater or stabilize the heavy metals in the paint particles. In this study, we aim to analyze the characteristics of the wastewater generated from the removal of hull-attached organisms and select the optimal treatment technology. The organisms in the wastewater generated from the removal of the attached organisms meet the biological treatment standard (D-2) using the sterilization technology applied in the ships' ballast water treatment system. The heavy metals and other pollutants in the paint particles generated during removal are treated using stabilization technologies such as thermal decomposition. The wastewater generated is treated using a two-step process: 1) development of sterilization technology through pretreatment filtration equipment and electrolytic sterilization treatment and 2) development of technology for removing particle pollutants such as heavy metals and dissolved inorganic substances. Through this study, we will develop a biological removal technology and an environmentally friendly processing system for the waste generated after removal that meets the requirements of the government and the shipping industry and lays the groundwork for future treatment standards.

Keywords: biofouling, ballast water treatment system, filtration, sterilization, wastewater

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Authors: Kanika Gupta, Ashok Kumar

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Biofilms are dense, highly hydrated cell clusters that are irreversibly attached to a substratum, to an interface or to each other, and are embedded in a self-produced gelatinous matrix composed of extracellular polymeric substances. Research in biofilm field has become very significant, as biofilm has shown high mechanical resilience and resistance to antibiotic treatment and constituted as a significant problem in both healthcare and other industry related to microorganisms. The massive information both stated and hidden in the biofilm literature are growing exponentially therefore it is not possible for researchers and practitioners to automatically extract and relate information from different written resources. So, the current work proposes and discusses the use of text mining techniques for the extraction of information from biofilm literature corpora containing 34306 documents. It is very difficult and expensive to obtain annotated material for biomedical literature as the literature is unstructured i.e. free-text. Therefore, we considered unsupervised approach, where no annotated training is necessary and using this approach we developed a system that will classify the text on the basis of growth and development, drug effects, radiation effects, classification and physiology of biofilms. For this, a two-step structure was used where the first step is to extract keywords from the biofilm literature using a metathesaurus and standard natural language processing tools like Rapid Miner_v5.3 and the second step is to discover relations between the genes extracted from the whole set of biofilm literature using pubmed.mineR_v1.0.11. We used unsupervised approach, which is the machine learning task of inferring a function to describe hidden structure from 'unlabeled' data, in the above-extracted datasets to develop classifiers using WinPython-64 bit_v3.5.4.0Qt5 and R studio_v0.99.467 packages which will automatically classify the text by using the mentioned sets. The developed classifiers were tested on a large data set of biofilm literature which showed that the unsupervised approach proposed is promising as well as suited for a semi-automatic labeling of the extracted relations. The entire information was stored in the relational database which was hosted locally on the server. The generated biofilm vocabulary and genes relations will be significant for researchers dealing with biofilm research, making their search easy and efficient as the keywords and genes could be directly mapped with the documents used for database development.

Keywords: biofilms literature, classifiers development, text mining, unsupervised learning approach, unstructured data, relational database

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Authors: Erica Siqueira, Adriana Bin, Rachel Stefanuto

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The paper aims to identify and to discuss the impact and results of ex-ante, mid-term and ex-post evaluation initiatives in Brazilian Social Enterprises from the point of view of the entrepreneurs and investors, highlighting the processes involved in these activities and their aftereffects. The study was conducted using a descriptive methodology, primarily qualitative. A multiple-case study was used, and, for that, semi-structured interviews were conducted with ten entrepreneurs in the (i) social finance, (ii) education, (iii) health, (iv) citizenship and (v) green tech fields, as well as three representatives of various impact investments, which are (i) venture capital, (ii) loan and (iii) equity interest areas. Convenience (non-probabilistic) sampling was adopted to select both businesses and investors, who voluntarily contributed to the research. The evaluation is still incipient in most of the studied business cases. Some stand out by adopting well-known methodologies like Global Impact Investing Report System (GIIRS), but still, have a lot to improve in several aspects. Most of these enterprises use nonexperimental research conducted by their own employees, which is ordinarily not understood as 'golden standard' to some authors in the area. Nevertheless, from the entrepreneur point of view, it is possible to identify that most of them including those routines in some extent in their day-by-day activities, despite the difficulty they have of the business in general. In turn, the investors do not have overall directions to establish evaluation initiatives in respective enterprises; they are funding. There is a mechanism of trust, and this is, usually, enough to prove the impact for all stakeholders. The work concludes that there is a large gap between what the literature states in regard to what should be the best practices in these businesses and what the enterprises really do. The evaluation initiatives must be included in some extension in all enterprises in order to confirm social impact that they realize. Here it is recommended the development and adoption of more flexible evaluation mechanisms that consider the complexity involved in these businesses’ routines. The reflections of the research also suggest important implications for the field of Social Enterprises, whose practices are far from what the theory preaches. It highlights the risk of the legitimacy of these enterprises that identify themselves as 'social impact', sometimes without the proper proof based on causality data. Consequently, this makes the field of social entrepreneurship fragile and susceptible to questioning, weakening the ecosystem as a whole. In this way, the top priorities of these enterprises must be handled together with the results and impact measurement activities. Likewise, it is recommended to perform further investigations that consider the trade-offs between impact versus profit. In addition, research about gender, the entrepreneur motivation to call themselves as Social Enterprises, and the possible unintended consequences from these businesses also should be investigated.

Keywords: evaluation practices, impact, results, social enterprise, social entrepreneurship ecosystem

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Authors: Şeyma Saliha Fidan, Ozgur Serin, Ata Mugan

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While performing verification analyses under static and dynamic loads that composite structures used in aviation are exposed to, it is necessary to obtain the bearing strength limit value for mechanically connected composite structures. For this purpose, various tests are carried out in accordance with aviation standards. There are many companies in the world that perform these tests in accordance with aviation standards, but the test costs are very high. In addition, due to the necessity of producing coupons, the high cost of coupon materials, and the long test times, it is necessary to simulate these tests on the computer. For this purpose, various test coupons were produced by using reinforcement and alignment angles of the composite radomes, which were integrated into the aircraft. Glass fiber reinforced and Quartz prepreg is used in the production of the coupons. The simulations of the tests performed according to the American Society for Testing and Materials (ASTM) D5961 Procedure C standard were performed on the computer. The analysis model was created in three dimensions for the purpose of modeling the bolt-hole contact surface realistically and obtaining the exact bearing strength value. The finite element model was carried out with the Analysis System (ANSYS). Since a physical break cannot be made in the analysis studies carried out in the virtual environment, a hypothetical break is realized by reducing the material properties. The material properties reduction coefficient was determined as 10%, which is stated to give the most realistic approach in the literature. There are various theories in this method, which is called progressive failure analysis. Because the hashin theory does not match our experimental results, the puck progressive damage method was used in all coupon analyses. When the experimental and numerical results are compared, the initial damage and the resulting force drop points, the maximum damage load values ​​, and the bearing strength value are very close. Furthermore, low error rates and similar damage patterns were obtained in both test and simulation models. In addition, the effects of various parameters such as pre-stress, use of bushing, the ratio of the distance between the bolt hole center and the plate edge to the hole diameter (E/D), the ratio of plate width to hole diameter (W/D), hot-wet environment conditions were investigated on the bearing strength of the composite structure.

Keywords: puck, finite element, bolted joint, composite

Procedia PDF Downloads 102

Authors: Puneet Goyal, Aarti Agarwal

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Background and Objective: Nutritional support is an integral part of palliative care of advanced non-resectable abdominal malignancy patients, though is frequently neglected aspect. Non-Healing high output Entero-cutaneous fistulas sometimes require long term parenteral nutrition, to take care of catabolism and replacement of nutrients. We present a case of inoperable pancreatic malignancy with high output entero-cutaneous fistula, which was provided parenteral nutritional support with the use of Totally Implantable Venous Access Device (TIVAD). Method and Results: 55 year old man diagnosed with carcinoma pancreas had developed high entero-cutaneous fistula. His tumor was found to be inoperable and was on total parenteral nutrition through routine central line. This line was difficult to maintain as he required it for a long term TPN. He was planned to undergo Totally Implantable Venous Access Device (TIVAD) implantation. 8Fr single lumen catheter with Groshong non-return Valve (Bard Access Systems, Inc. USA) was inserted through right internal jugular vein, under fluoroscopic guidance. The catheter was tunneled subcutaneously and brought towards infraclavicular pocket, cut at appropriate length and connected to port and locked. Port was sutured in floor of pocket. Free flow of blood aspirated, flushed with heparinized saline. There was no kink observed in entire length of catheter under fluoroscopy. Skin over infraclavicular pocket was sutured. Long term catheter care and associated risks were explained to patient and relatives. Patient continued to receive total parenteral nutrition as well as other supportive therapy though TIVAD for next 6 weeks, till his demise. Conclusion: TIVADs are standard of care for long term venous access solutions in cancer patients requiring chemotherapy. In this case, we extended its use for providing parenteral nutrition and other supportive therapy. TIVADs can be implanted in advanced cancer patients for providing venous access solution required for various palliative treatments and medications. This will help in improving quality of life and satisfaction amongst terminally ill cancer patients.

Keywords: parenteral nutrition, totally implantable venous access device, long term venous access, interventions in anesthesiology

Procedia PDF Downloads 247

Authors: Taiwo O. Margaret, Olaoluwa O. Olaoluwa

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Moraceae family has immense phytochemical constituents and significant pharmacological properties, hence have great medicinal values. The aim of this study was to screen and quantify phytochemicals as well as the antioxidant activities of the leaf and stem bark extracts and fractions (crude ethanol extracts, n-hexane, ethyl acetate and aqueous ethanol fractions) of Ficus sagittifolia. Leaf and stem bark of F. sagittifolia were extracted by maceration method using ethanol to give ethanol crude extract. The ethanol crude extract was partitioned by n-hexane and ethyl-acetate to give their respective fractions. All the extracts were screened for their phytochemicals using standard methods. The total phenolic, flavonoid, tannin, saponin contents and antioxidant activity were determined by spectrophotometric method while the alkaloid content was evaluated by titrimetric method. The amount of total phenolic in extracts and fractions were estimated in comparison to gallic acid, whereas total flavonoids, tannins and saponins were estimated corresponding to quercetin, tannic acid and saponin respectively. 2, 2-diphenylpicryl hydrazyl radical (DPPH)* and phosphomolybdate methods were used to evaluate the antioxidant activities of leaf and stem bark of F. sagittifolia. Phytochemical screening revealed the presence of flavonoids, saponins, terpenoids/steroids, alkaloids for both extracts of leaf and stem bark of F. sagittifolia. The phenolic content of F. sagittifolia was most abundant in leaf ethanol crude extract as 3.53 ± 0.03 mg/g equivalent of gallic acid. Total flavonoids and tannins content were highest in stem bark aqueous ethanol fraction of F. sagittifolia estimated as 3.41 ± 0.08 mg/g equivalent of quercetin and 1.52 ± 0.05 mg/g equivalent of tannic acid respectively. The hexane leaf fraction of F. sagittifolia had the utmost saponin and alkaloid content as 5.10 ± 0.48 mg/g equivalent of saponins and 0.171 ± 0.39 g of alkaloids. Leaf aqueous ethanol fraction of F. sagittifolia showed high antioxidant activity (IC₅₀ value of 63.092 µg/mL) and stem ethanol crude extract (227.43 ± 0.78 mg/g equivalent of ascorbic acid) for DPPH and phosphomolybdate method respectively and the least active was found to be the stem hexane fraction using both methods (313.32 µg/mL; 16.21 ± 1.30 mg/g equivalent of ascorbic acid). The presence of these phytochemicals in the leaf and stem bark of F. sagittifolia are responsible for their therapeutic importance as well as the ability to scavenge free radicals in living systems.

Keywords: Moraceae, Ficus sagittifolia, phytochemicals, antioxidant

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Authors: A. G. Pershina, P. S. Postnikov, M. E. Trusova, D. O. Burlakova, A. E. Sazonov

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Invention of magnetic-fluorescent nanocomposites is a rapidly developing area of research. The magnetic-fluorescent nanocomposite attractiveness is connected with the ability of simultaneous management and control of such nanocomposites by two independent methods based on different physical principles. These nanocomposites are applied for the solution of various essential scientific and experimental biomedical problems. The aim of this research is development of principle approach to nanobiohybrid structures with magnetic and fluorescent properties design. The surface of carbon-coated iron nanoparticles (Fe@C) were covalently modified by 4-carboxy benzenediazonium tosylate. Recombinant fluorescent protein TagGFP2 (Eurogen) was obtained in E. coli (Rosetta DE3) by standard laboratory techniques. Immobilization of TagGFP2 on the nanoparticles surface was provided by the carbodiimide activation. The amount of COOH-groups on the nanoparticle surface was estimated by elemental analysis (Elementar Vario Macro) and TGA-analysis (SDT Q600, TA Instruments. Obtained nanocomposites were analyzed by FTIR spectroscopy (Nicolet Thermo 5700) and fluorescence microscopy (AxioImager M1, Carl Zeiss). Amount of the protein immobilized on the modified nanoparticle surface was determined by fluorimetry (Cary Eclipse) and spectrophotometry (Unico 2800) with the help of preliminary obtained calibration plots. In the FTIR spectra of modified nanoparticles the adsorption band of –COOH group around 1700 cm-1 and bands in the region of 450-850 cm-1 caused by bending vibrations of benzene ring were observed. The calculated quantity of active groups on the surface was equal to 0,1 mmol/g of material. The carbodiimide activation of COOH-groups on nanoparticles surface results to covalent immobilization of TagGFP2 fluorescent protein (0.2 nmol/mg). The success of immobilization was proved by FTIR spectroscopy. Protein characteristic adsorption bands in the region of 1500-1600 cm-1 (amide I) were presented in the FTIR spectrum of nanocomposite. The fluorescence microscopy analysis shows that Fe@C-TagGFP2 nanocomposite possesses fluorescence properties. This fact confirms that TagGFP2 protein retains its conformation due to immobilization on nanoparticles surface. Magnetic-fluorescent nanocomposite was obtained as a result of unique design solution implementation – the fluorescent protein molecules were fixed to the surface of superparamagnetic carbon-coated iron nanoparticles using original diazonium salts.

Keywords: carbon-coated iron nanoparticles, diazonium salts, fluorescent protein, immobilization

Procedia PDF Downloads 342

Authors: Phenias Nsabimana, Jérôme W. Some, Hilda Vasanthakaalam, Stefaan De Henauw, Souheila Abbeddou

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Tools for the dietary assessment in adults are limited in low- and middle-income settings. The objective of this study was to develop and validate a semi-quantitative food frequency questionnaire (FFQ) against the multiple pass-24 h recall tool for use in urban and rural Rwanda. A total of 212 adults (154 females and 58 males), 18-49 aged, including 105 urban and 107 rural residents, from the four regions of Rwanda, were recruited in the present study. A multiple-pass 24- H recall technique was used to collect dietary data in both urban and rural areas in four different rounds, on different days (one weekday and one weekend day), separated by a period of three months, from November 2020 to October 2021. The details of all the foods and beverages consumed over the 24h period of the day prior to the interview day were collected during face-to-face interviews. A list of foods, beverages, and commonly consumed recipes was developed by the study researchers and ten research assistants from the different regions of Rwanda. Non-standard recipes were collected when the information was available. A single semi-quantitative FFQ was also developed in the same group discussion prior to the beginning of the data collection. The FFQ was collected at the beginning and the end of the data collection period. Data were collected digitally. The amount of energy and macro-nutrients contributed by each food, recipe, and beverage will be computed based on nutrient composition reported in food composition tables and weight consumed. Median energy and nutrient contents of different food intakes from FFQ and 24-hour recalls and median differences (24-hour recall –FFQ) will be calculated. Kappa, Spearman, Wilcoxon, and Bland-Altman plot statistics will be conducted to evaluate the correlation between estimated nutrient and energy intake found by the two methods. Differences will be tested for their significance and all analyses will be done with STATA 11. Data collection was completed in November 2021. Data cleaning is ongoing and the data analysis is expected to be completed by July 2022. A developed and validated semi-quantitative FFQ will be available for use in dietary assessment. The developed FFQ will help researchers to collect reliable data that will support policy makers to plan for proper dietary change intervention in Rwanda.

Keywords: food frequency questionnaire, reproducibility, 24-H recall questionnaire, validation

Procedia PDF Downloads 141

Authors: Miguel Llorens-Marin, Adolfo Hernandez, Maria Puelles-Gallo

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The increasing influence of Online Travel Agencies (OTAs) on hotel bookings and the electronic word-of-mouth (eWOM) contained in them has been featured by many scientific studies as a major factor in the booking decision. The main reason is that nowadays, in the hotel sector, consumers first come into contact with the offer through the web and the online environment. Due to the nature of the hotel product and the fact that it is booked in advance to actually seeing it, there is a lack of knowledge about its actual features. This makes eWOM a major channel to help consumers to reduce their perception of risk when making their booking decisions. This research studies the relationship between aspects of customer influenceability by reading eWOM communications, at the time of booking a hotel, with the propensity to write a review. In other words, to test relationships between the reading and the writing of eWOM. Also investigates the importance of different underlying motivations for writing eWOM. Online surveys were used to obtain the data from a sample of hotel customers, with 739 valid questionnaires. A measurement model and Path analysis were carried out to analyze the chain of relationships among the independent variable (influenceability from reading reviews) and the dependent variable (propensity to write a review) with the mediating effects of additional variables, which help to explain the relationship. The authors also tested the moderating effects of age and gender in the model. The study considered three different underlying motivations for writing a review on a hotel experience, namely hedonic, altruistic and conflicted. Results indicate that the level of influenceability by reading reviews has a positive effect on the propensity to write reviews; therefore, we manage to link the reading and the writing of reviews. Authors also discover that the main underlying motivation to write a hotel review is the altruistic motivation, being the one with the higher Standard regression coefficient above the hedonic motivation. The authors suggest that the propensity to write reviews is not related to sociodemographic factors (age and gender) but to attitudinal factors such as ‘the most influential factor when reading’ and ‘underlying motivations to write. This gives light on the customer engagement motivations to write reviews. The implications are that managers should encourage their customers to write eWOM reviews on altruistic grounds to help other customers to make a decision. The most important contribution of this work is to link the effect of reading hotel reviews with the propensity to write reviews.

Keywords: hotel reviews, electronic word-of-mouth (eWOM), online consumer reviews, digital marketing, social media

Procedia PDF Downloads 100

Authors: Arjun Prakash, Vinutha H., Karthik N.

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BACKGROUND: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy with an estimated prevalence of 0.6 - 5.8% in the general adult population. It is caused by compression of the Median Nerve (MN) at the wrist as it passes through a narrow osteofibrous canal. Presently, the diagnosis is established by the clinical symptoms and physical examination and Nerve conduction study (NCS) is used to assess its severity. However, it is considered to be painful, time consuming and expensive, with a false-negative rate between 16 - 34%. Ultrasonography (USG) is now increasingly used as a diagnostic tool in CTS due to its non-invasive nature, increased accessibility and relatively low cost. Elastography is a newer modality in USG which helps to assess stiffness of tissues. However, there is limited available literature about its applications in peripheral nerves. OBJECTIVES: Our objectives were to measure the Cross-Sectional Area (CSA) and elasticity of MN at the carpal tunnel using Grey scale Ultrasonography (USG), Strain Elastography (SE) and Shear Wave Elastography (SWE). We also made an attempt to independently evaluate the role of Gray scale USG, SE and SWE in grading the severity of CTS, keeping NCS as the gold standard. MATERIALS AND METHODS: After approval from the Institutional Ethics Review Board, we conducted a comparative cross sectional study for a period of 18 months. The participants were divided into two groups. Group A consisted of 54 patients with clinically diagnosed CTS who underwent NCS, and Group B consisted of 50 controls without any clinical symptoms of CTS. All Ultrasound examinations were performed on SAMSUNG RS 80 EVO Ultrasound machine with 2 - 9 Mega Hertz linear probe. In both groups, CSA of the MN was measured on Grey scale USG, and its elasticity was measured at the carpal tunnel (in terms of Strain ratio and Shear Modulus). The variables were compared between both groups by using ‘Independent t test’, and subgroup analyses were performed using one-way analysis of variance. Receiver operating characteristic curves were used to evaluate the diagnostic performance of each variable. RESULTS: The mean CSA of the MN was 13.60 + 3.201 mm2 and 9.17 + 1.665 mm2 in Group A and Group B, respectively (p < 0.001). The mean SWE was 30.65 + 12.996 kPa and 17.33 + 2.919 kPa in Group A and Group B, respectively (p < 0.001), and the mean Strain ratio was 7.545 + 2.017 and 5.802 + 1.153 in Group A and Group B respectively (p < 0.001). CONCLUSION: The combined use of Gray scale USG, SE and SWE is extremely useful in grading the severity of CTS and can be used as a painless and cost-effective alternative to NCS. Early diagnosis and grading of CTS and effective treatment is essential to avoid permanent nerve damage and functional disability.

Keywords: carpal tunnel, ultrasound, elastography, nerve conduction study

Procedia PDF Downloads 101

Authors: Ketevan Janashia, Tamar Tsibadze, Levan Tvildiani, Nikoloz Invia, Elguja Kubaneishvili, Vasili Kukhianidze, George Ramishvili

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This study considers the possible effects of geomagnetic activity (GMA) on humans situated on Earth by performing experiments concerning specific sensitive reactions in humans in both: natural conditions during different GMA and by the simulation of different GMA in the lab. The measurements of autonomic nervous system (ANS) responses to different GMA via measuring the heart rate variability (HRV) indices and stress index (SI) and their comparison with the K-index of GMA have been presented and discussed. The results of experiments indicate an intensification of the sympathetic part of the ANS as a stress reaction of the human organism when it is exposed to high level of GMA as natural as well as in simulated conditions. Aim: We tested the hypothesis whether the GMF when disturbed can have effects on human ANS causing specific sensitive stress-reactions depending on the initial type of ANS. Methods: The study focuses on the effects of different GMA on ANS by comparing of HRV indices and stress index (SI) of n= 78, 18-24 years old healthy male volunteers. Experiments were performed as natural conditions on days of low (K= 1-3) and high (K= 5-7) GMA as well as in the lab by the simulation of different GMA using the device of geomagnetic storm (GMS) compensation and simulation. Results: In comparison with days of low GMA (K=1-3) the initial values of HRV shifted towards the intensification of the sympathetic part (SP) of the ANS during days of GMSs (K=5-7) with statistical significance p-values: HR (heart rate, p= 0.001), SDNN (Standard deviation of all Normal to Normal intervals, p= 0.0001), RMSSD (The square root of the arithmetical mean of the sum of the squares of differences between adjacent NN intervals, p= 0.0001). In comparison with conditions during GMSs compensation mode (K= 0, B= 0-5nT), the ANS balance was observed to shift during exposure to simulated GMSs with intensities in the range of natural GMSs (K= 7, B= 200nT). However, the initial values of the ANS resulted in different dynamics in its variation depending of GMA level. In the case of initial balanced regulation type (HR > 80) significant intensification of SP was observed with p-values: HR (p= 0.0001), SDNN (p= 0.047), RMSSD (p= 0.28), LF/HF (p=0.03), SI (p= 0.02); while in the case of initial parasympathetic regulation type (HR < 80), an insignificant shift to the intensification of the parasympathetic part (PP) was observed. Conclusions: The results indicate an intensification of SP as a stress reaction of the human organism when it is exposed to high level of GMA in both natural and simulated conditions.

Keywords: autonomic nervous system, device of magneto compensation/simulation, geomagnetic storms, heart rate variability

Procedia PDF Downloads 141

Authors: R. Kaleeswari

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An investigation was carried out to assess the soil biological quality parameters in rice soils under rainfed and to compare soil quality indexing methods viz., Principal component analysis, Minimum data set and Indicator scoring method and to develop soil quality indices for formulating soil and crop management strategies.Soil samples were collected and analyzed for soil biological properties by adopting standard procedure. Biological indicators were determined for soil quality assessment, viz., microbial biomass carbon and nitrogen (MBC and MBN), potentially mineralizable nitrogen (PMN) and soil respiration and dehydrogenease activity. Among the methods of rice cultivation, Organic nutrition, Integrated Nutrient Management (INM) and System of Rice Intensification (SRI ), rice cultivation registered higher values of MBC, MBN and PMN. Mechanical and conventional rice cultivation registered lower values of biological quality indicators. Organic nutrient management and INM enhanced the soil respiration rate. SRI and aerobic rice cultivation methods increased the rate of soil respiration, while conventional and mechanical rice farming lowered the soil respiration rate. Dehydrogenase activity (DHA) was registered to be higher in soils under organic nutrition and Integrated Nutrient Management INM. System of Rice Intensification SRI and aerobic rice cultivation enhanced the DHA; while conventional and mechanical rice cultivation methods reduced DHA. The microbial biomass carbon (MBC) of the rice soils varied from 65 to 244 mg kg-1. Among the nutrient management practices, INM registered the highest available microbial biomass carbon of 285 mg kg-1.Potentially mineralizable N content of the rice soils varied from 20.3 to 56.8 mg kg-1. Aerobic rice farming registered the highest potentially mineralizable N of 78.9 mg kg-1..The soil respiration rate of the rice soils varied from 60 to 125 µgCO2 g-1. Nutrient management practices ofINM practice registered the highest. soil respiration rate of 129 µgCO2 g-1.The dehydrogenase activity of the rice soils varied from 38.3 to 135.3µgTPFg-1 day-1. SRI method of rice cultivation registered the highest dehydrogenase activity of 160.2 µgTPFg-1 day-1. Soil variables from each PC were considered for minimum soil data set (MDS). Principal component analysis (PCA) was used to select the representative soil quality indicators. In intensive rice cultivating regions, soil quality indicators were selected based on factor loading value and contribution percentage value using principal component analysis (PCA).Variables having significant difference within production systems were used for the preparation of minimum data set (MDS).

Keywords: soil quality, rice, biological properties, PCA analysis

Procedia PDF Downloads 110

Authors: Omid Allan

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The advent of ultra-narrow diameter implants initially offered an alternative to wider conventional implants. However, their design limitations have restricted their applicability primarily to overdentures and cement-retained fixed prostheses, often with unpredictable long-term outcomes. The introduction of the new Miniature Implants has revolutionized the field of implant dentistry, leading to a more streamlined approach. The utilization of Miniature Implants has emerged as a promising alternative to the traditional approach that entails the traumatic sequential bone drilling procedures and the use of conventional implants for full and partial arch restorations. The innovative "BioMiniatures Implant System serves as a groundbreaking bridge connecting mini implants with standard implant systems. This system allows practitioners to harness the advantages of ultra-small implants, enabling minimally invasive insertion and facilitating the application of fixed screw-retained prostheses, which were only available to conventional wider implant systems. This approach streamlines full and partial arch rehabilitation with minimal or even no bone drilling, significantly reducing surgical risks and complications for clinicians while minimizing patient morbidity. The ultra-narrow diameter and self-advancing features of these implants eliminate the need for invasive and technically complex procedures such as bone augmentation and guided bone regeneration (GBR), particularly in cases involving thin alveolar ridges. Furthermore, the absence of a microcap between the implant and abutment eliminates the potential for micro-leakage and micro-pumping effects, effectively mitigating the risk of marginal bone loss and future peri-implantitis. The cumulative experience of restoring over 50 full and partial arch edentulous cases with this system has yielded an outstanding success rate exceeding 97%. The long-term success with a stable marginal bone level in the study firmly establishes these implants as a dependable alternative to conventional implants, especially for full arch rehabilitation cases. Full arch rehabilitation with these implants holds the promise of providing a simplified solution for edentulous patients who typically present with atrophic narrow alveolar ridges, eliminating the need for extensive GBR and bone augmentation to restore their dentition with fixed prostheses.

Keywords: mini-implant, biominiatures, miniature implants, minimally invasive dentistry, full arch rehabilitation

Procedia PDF Downloads 74

Authors: Ghada Mahmoud El Kassas, Maged Atta El Wakeel

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Background: Environmental enteric dysfunction (EED) is impending trouble that flared up in the last decades to be pervasive in infants and children. EED is asymptomatic villous atrophy of the small bowel that is prevalent in the developing world and is associated with altered intestinal function and integrity. Evidence has suggested that supplementary zinc might ameliorate this damage by reducing gastrointestinal inflammation and may also benefit cognitive development. Objective: We tested whether zinc supplementation improves intestinal integrity, growth, and cognitive function in stunted children predicted to have EED. Methodology: This case–control prospective interventional study was conducted on 120 Egyptian Stunted children aged 1-10 years who recruited from the Nutrition clinic, the National research center, and 100 age and gender-matched healthy children as controls. At the primary phase of the study, Full history taking, clinical examination, and anthropometric measurements were done. Standard deviation score (SDS) for all measurements were calculated. Serum markers as Zonulin, Endotoxin core antibody (EndoCab), highly sensitive C-reactive protein (hsCRP), alpha1-acid glycoprotein (AGP), Tumor necrosis factor (TNF), and fecal markers such as myeloperoxidase (MPO), neopterin (NEO), and alpha-1-anti-trypsin (AAT) (as predictors of EED) were measured. Cognitive development was assessed (Bayley or Wechsler scores). Oral zinc at a dosage of 20 mg/d was supplemented to all cases and followed up for 6 months, after which the 2ry phase of the study included the previous clinical, laboratory, and cognitive assessment. Results: Serum and fecal inflammatory markers were significantly higher in cases compared to controls. Zonulin (P < 0.01), (EndoCab) (P < 0.001) and (AGP) (P < 0.03) markedly decreased in cases at the end of 2ry phase. Also (MPO), (NEO), and (AAT) showed a significant decline in cases at the end of the study (P < 0.001 for all). A significant increase in mid-upper arm circumference (MUAC) (P < 0.01), weight for age z-score, and skinfold thicknesses (P< 0.05 for both) was detected at end of the study, while height was not significantly affected. Cases also showed significant improvement of cognitive function at phase 2 of the study. Conclusion: Intestinal inflammatory state related to EED showed marked recovery after zinc supplementation. As a result, anthropometric and cognitive parameters showed obvious improvement with zinc supplementation.

Keywords: stunting, cognitive function, environmental enteric dysfunction, zinc

Procedia PDF Downloads 190

Authors: Markus Rütten, Olaf Wünsch

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Non-Newtonian fluid properties can change the flow behaviour significantly, its prediction is more difficult when thermal effects come into play. Hence, the focal point of this work is the wake flow behind a heated circular cylinder in the laminar vortex shedding regime for thermo-viscous shear thinning fluids. In the case of isothermal flows of Newtonian fluids the vortex shedding regime is characterised by a distinct Reynolds number and an associated Strouhal number. In the case of thermo-viscous shear thinning fluids the flow regime can significantly change in dependence of the temperature of the viscous wall of the cylinder. The Reynolds number alters locally and, consequentially, the Strouhal number globally. In the present CFD study the temperature dependence of the Reynolds and Strouhal number is investigated for the flow of a Carreau fluid around a heated cylinder. The temperature dependence of the fluid viscosity has been modelled by applying the standard Williams-Landel-Ferry (WLF) equation. In the present simulation campaign thermal boundary conditions have been varied over a wide range in order to derive a relation between dimensionless heat transfer, Reynolds and Strouhal number. Together with the shear thinning due to the high shear rates close to the cylinder wall this leads to a significant decrease of viscosity of three orders of magnitude in the nearfield of the cylinder and a reduction of two orders of magnitude in the wake field. Yet the shear thinning effect is able to change the flow topology: a complex K´arm´an vortex street occurs, also revealing distinct characteristic frequencies associated with the dominant and sub-dominant vortices. Heating up the cylinder wall leads to a delayed flow separation and narrower wake flow, giving lesser space for the sequence of counter-rotating vortices. This spatial limitation does not only reduce the amplitude of the oscillating wake flow it also shifts the dominant frequency to higher frequencies, furthermore it damps higher harmonics. Eventually the locally heated wake flow smears out. Eventually, the CFD simulation results of the systematically varied thermal flow parameter study have been used to describe a relation for the main characteristic order parameters.

Keywords: heat transfer, thermo-viscous fluids, shear thinning, vortex shedding

Procedia PDF Downloads 297

Authors: M. N. Ofokansi, Onyemelukwe Chisom, Amauche Chukwuemeka, Ezema Onyinye

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The leaves of Clerodendrumcapitatum(Lamiaceae) is mostly used in the treatment of gastric ulcer in Nigerian folk medicine. The aim of this study was to evaluate the antiulcer activity of its crude methanol leaf extract and its ethyl acetate fraction in white albino rats. The effect of crude methanol leaf extract and its ethyl acetate fraction(250mg/kg, 500mg/kg) was evaluated using an absolute ethanol induced ulcer model. Crude methanol leaf extract and the ethyl acetate fraction was treated with distilled water and 6% Tween 80, respectively. crude methanol leaf extract was further investigated using a pylorus ligation induced ulcer model. Omeprazole was used as the standard treatment. Four groups of five albino rats of either sex were used. Parameters such as mean ulcer index and percentage ulcer protection were assessed in the ethanol-induced ulcer model, while the gastric volume, pH, and total acidity were assessed in the pyloric ligation induced ulcer model. Crude methanol leaf extract of Clerodendrumcapitatum(500mg/kg) showed a very highly significant reduction in mean ulcer index(p<0.001) in the absolute ethanol-induced model. ethyl acetate fraction of crude methanol leaf extract of Clerodendrumcapitatum(250mg/kg,500mg/kg) showed a very highly significant dose-dependent reduction in mean ulcer indices (p<0.001) in the absolute ethanol-induced model. The mean ulcer indices (1.6,2.2) with dose concentration (250mg/kg, 500mg/kg) of ethyl acetate fraction increased with ulcer protection (82.85%,76.42%) respectively when compared to the control group in the absolute ethanol-induced ulcer model. Crude methanol leaf extract of Clerodendrumcapitatum(250mg/kg, 500mg/kg) treated animals showed a highly significant dose-dependent reduction in mean ulcer index(p<0.01) with an increase in ulcer protection (56.77%,63.22%) respectively in pyloric ligated induced, ulcer model. Gastric parameters such as volume of gastric juice, pH, and total acidity were of no significance in the different doses of the crude methanol leaf extract when compared to the control group. The phytochemical investigation showed that the crude methanol leaf extracts Possess Saponins and Flavonoids while its ethyl acetate fraction possess only Flavonoids. The results of the study indicate that the crude methanol leaf extract and its ethyl acetate fraction is effective and has gastro protective and ulcer healing capacity. Ethyl acetate fraction is more potent than crude methanol leaf extract against ethanol-induced This result provides scientific evidence as a validation for its folkloric use in the treatment of gastric ulcer.

Keywords: gastroprotective, herbal medicine, anti-ulcer, pharmacology

Procedia PDF Downloads 162

Authors: Ahmed A. El-Gindy, Elham S. El-Nashar, Abdallah Nafaa, Sameh El-Kafrawy

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The generation of energy from marine energy became one of the most preferable resources since it is a clean source and friendly to environment. Egypt has long shores along Mediterranean with important cities that need energy resources with significant wave energy. No detailed studies have been done on wave energy distribution in the Egyptian waters. The objective of this paper is to assess the energy wave power available in the Egyptian waters for the choice of the most suitable devices to be used in this area. This paper deals the characteristics and power of the offshore waves in the Egyptian waters. Since the field observations of waves are not frequent and need much technical work, the European Centre for Medium-Range Weather Forecasts (ECMWF) interim reanalysis data in Mediterranean, with a grid size 0.75 degree, which is a relatively course grid, are considered in the present study for preliminary assessment of sea waves characteristics and power. The used data covers the period from 2012 to 2014. The data used are significant wave height (swh), mean wave period (mwp) and wave direction taken at six hourly intervals, at seven chosen stations, and at grid points covering the Egyptian waters. The wave power (wp) formula was used to calculate energy flux. Descriptive statistical analysis including monthly means and standard deviations of the swh, mwp, and wp. The percentiles of wave heights and their corresponding power are done, as a tool of choice of the best technology suitable for the site. The surfer is used to show spatial distributions of wp. The analysis of data at chosen 7 stations determined the potential of wp off important Egyptian cities. Offshore of Al Saloum and Marsa Matruh, the highest wp occurred in January and February (16.93-18.05) ± (18.08-22.12) kw/m while the lowest occurred in June and October (1.49-1.69) ± (1.45-1.74) kw/m. In front of Alexandria and Rashid, the highest wp occurred in January and February (16.93-18.05) ± (18.08-22.12) kw/m while the lowest occurred in June and September (1.29-2.01) ± (1.31-1.83) kw/m. In front of Damietta and Port Said, the highest wp occurred in February (14.29-17.61) ± (21.61-27.10) kw/m and the lowest occurred in June (0.94-0.96) ± (0.71-0.72) kw/m. In winter, the probabilities of waves higher than 0.8 m in percentage were, at Al Saloum and Marsa Matruh (76.56-80.33) ± (11.62-12.05), at Alexandria and Rashid (73.67-74.79) ± (16.21-18.59) and at Damietta and Port Said (66.28-68.69) ± (17.88-17.90). In spring, the percentiles were, at Al Saloum and Marsa Matruh, (48.17-50.92) ± (5.79-6.56), at Alexandria and Rashid, (39.38-43.59) ± (9.06-9.34) and at Damietta and Port Said, (31.59-33.61) ± (10.72-11.25). In summer, the probabilities were, at Al Saloum and Marsa Matruh (57.70-66.67) ± (4.87-6.83), at Alexandria and Rashid (59.96-65.13) ± (9.14-9.35) and at Damietta and Port Said (46.38-49.28) ± (10.89-11.47). In autumn, the probabilities were, at Al Saloum and Marsa Matruh (58.75-59.56) ± (2.55-5.84), at Alexandria and Rashid (47.78-52.13) ± (3.11-7.08) and at Damietta and Port Said (41.16-42.52) ± (7.52-8.34).

Keywords: distribution of sea waves energy, Egyptian Mediterranean waters, waves characteristics, waves power

Procedia PDF Downloads 191

Authors: Nicole Harley, Mahmoud Eid, Abdurahman Tarmal, Vishal Dey

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Histological sampling plays an integral role in the diagnostic process of renal diseases. Percutaneous native renal biopsy is typically performed under ultrasound guidance, with this service usually being provided by nephrologists. In some centers, there is a role for radiologists in performing renal biopsies. Previous comparative studies have demonstrated non-inferiority between outcomes of percutaneous native renal biopsies performed by nephrologists compared with radiologists. We sought to compare biopsy adequacy between nephrologists and radiologists in University Hospital Crosshouse. The online system SERPR (Scottish Electronic Renal Patient Record) contains information pertaining to patients who have undergone renal biopsies. An online search was performed to acquire a list of all patients who underwent renal biopsy between 2013 and 2020 in University Hospital Crosshouse. 355 native renal biopsies were performed in total across this 7-year period. A retrospective analysis was performed on these cases, with records and reports being assessed for: the total number of glomeruli obtained per biopsy, whether the number of glomeruli obtained was adequate for diagnosis, as per an internationally agreed standard, and whether a histological diagnosis was achieved. Nephrologists performed 43.9% of native renal biopsies (n=156) and radiologists performed 56.1% (n=199). The mean number of glomeruli obtained by nephrologists was 17.16+/-10.31. The mean number of glomeruli obtained by radiologists was 18.38+/-10.55. T-test demonstrated no statistically significant difference between specialties comparatively (p-value 0.277). Native renal biopsies are required to obtain at least 8 glomeruli to be diagnostic as per internationally agreed criteria. Nephrologists met these criteria in 88.5% of native renal biopsies (n=138) and radiologists met this criteria in 89.5% (n=178). T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.663 and 0.922, respectively). Biopsies performed by nephrologists yielded tissue that was diagnostic in 91.0% (n=142) of sampling. Biopsies performed by radiologists yielded tissue that was diagnostic in 92.4% (n=184) of sampling. T-test and Chi-squared analysis demonstrate there was no statistically significant difference between the specialties comparatively (p-value 0.625 and 0.889, respectively). This project demonstrates that at University Hospital Crosshouse, there is no statistical difference between radiologists and nephrologists in terms of glomeruli acquisition or samples achieving a histological diagnosis. Given the non-inferiority between specialties demonstrated by previous studies and this project, this evidence could support the restructuring of services to allow more renal biopsies to be performed by renal services and allow reallocation of radiology department resources.

Keywords: biopsy, medical imaging, nephrology, radiology

Procedia PDF Downloads 81

Authors: Ibrahim Abouelkhir

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Background: Prior to this project, the number of CT aorta requests from our Emergency Department (ED) was reported by the radiology department to be high with a low positive event rate: only 1- 2% of CT aortas performed were positive for acute aortic syndrome. This trend raised concerns about the time required to process and report these scans, potentially impacting the timely reporting of other high-priority imaging, such as trauma-related scans. Other harms identified were unnecessary radiation, patients spending longer in ED contributing to overcrowding, and, most importantly, the patient not getting the right care the first time. The radiology department also raised the problem of reporting bias because they expected our CT aortas to be normal. Aim: The main aim of this project was to reduce the number of unnecessary CT aortas requested, which would be shown by 1. Number of CT aortas requested and 2. Positive event rate. Methodology: This was a quality improvement project carried out in the ED at Frimley Park Hospital, UK. Starting from 1 st January 2024, we recorded the number of days required to reach 35 CT aorta requests. We looked at all patients presenting to the ED over the age of 16 for whom a CT aorta was requested by the ED team. We looked at how many of these scans were positive for acute aortic syndrome. The intervention was a change in practice: all CT aortas should be approved by an ED consultant or ST4+ registrar (5th April 2024). We then reviewed the number of days it took to reach a total of 35 CT aorta requests following the intervention and again reviewed how many were positive. Results: Prior to the intervention, 35 CT Aorta scans were performed over a 20-day period. Following the implementation of the ED senior doctor vetting process, the same number of CT Aorta scan requests was observed over 50 days - more than twice the pre-intervention period. This indicates a significant reduction in the rate of CT Aorta scans being requested. During the pre-intervention phase, there were two positive cases of acute aortic syndrome. In the post-intervention period, there were zero. Conclusion: The mandatory review of CT Aorta scan requested by the ED consultant effectively reduced the number of scans requested. However, this intervention did not lead to an increase in positive scan results. We noted that post-intervention, approximately 50% of scans had been approved by registrar-grade doctors and, only 50% had been approved by ED consultants, and the majority were not in-person reviews. We wonder if restricting the approval to consultant grade only might improve the results, and furthermore, in person reviews should be the gold standard.

Keywords: quality improvement project, CT aorta scans, emergency department, radiology department, aortic dissection, scan request vetting, clinical outcomes, imaging efficiency

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Authors: Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee

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Objective: To compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. The three positions were: semi-recumbent, squatting, and squatting with the aid of ergonomically designed ankle supports. Methods: A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women in their 38th to 42nd gestational week. None of the participants received epidural analgesia during labor and all were free of pregnancy and labor-related complications. Intervention: During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while wearing the ergonomically designed ankle supports; comparison group A was asked to push in the squatting position without the use of these supports; and comparison group B was asked to push in a standard semi-recumbent position. Measures: The participants completed a demographic and obstetrics datasheet, the Short Form McGill Pain Questionnaire (MPQ-SF), and the Labor Pushing Experience scale within 4-hours postpartum. Conclusion: In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.52 minutes less (F =6.02, p< .05) than the time for comparison group B (semi-recumbent). Furthermore, the duration between the start of pushing to infant birth averaged 25.21 minutes less for the experimental group than for comparison group B (F =6.14, p< .05). Moreover, the experimental group had a lower average VAS pain score (5.05±3.22) than comparison group B and the average McGill pain score for the experimental group was lower than both comparison groups (F=18.12, p< .001). In summary, the participants in the group that delivered from a squatting position with ankle supports had better labor pushing experiences than their peers in the comparison groups. Results: In comparison to both unsupported squatting and semi-recumbent pushing, squatting with the aid of ergonomically designed ankle supports reduced pushing times, ameliorated labor pain, and improved the pushing experience. Clinical application and suggestion: The squatting with ankle-support intervention introduced in the present study may significantly reduce tiredness and difficulties in maintaining balance as well as increase pushing efficiency. Thus, this intervention may reduce the caring needs of women during the second stage of labor. This intervention may be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

Keywords: second stage of labor, pushing, squatting with ankle supports, squatting

Procedia PDF Downloads 275

Authors: Charles Ruffner, Michael Manton, Gintautas Kibirkstis, Gediminas Brazaitas, Vitas Marozas, Ekaterine Makrickiene, Rutile Pukiene, Per Angelstam

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In dynamic boreal forests, fire is an important natural disturbance, which drives regeneration and mortality of living and dead trees, and thus successional trajectories. However, current forest management practices focusing on wood production only have effectively eliminated fire as a stand-level disturbance. While this is generally well studied across much of Europe, in Lithuania, little is known about the historic fire regime and the role fire plays as a management tool towards the sustainable management of future landscapes. Focusing on Scots pine forests, we explore; i) the relevance of fire disturbance regimes on forestlands of Lithuania; ii) fire occurrence in the Dzukija landscape for dry upland and peatland forest sites, and iii) correlate tree-ring data with climate variables to ascertain climatic influences on growth and fire occurrence. We sampled and cross-dated 132 Scots pine samples with fire scars from 4 dry pine forest stands and 4 peatland forest stands, respectively. The fire history of each sample was analyzed using standard dendrochronological methods and presented in FHAES format. Analyses of soil moisture and nutrient conditions revealed a strong probability of finding forests that have a high fire frequency in Scots pine forests (59%), which cover 34.5% of Lithuania’s current forestland. The fire history analysis revealed 455 fire scars and 213 fire events during the period 1742-2019. Within the Dzukija landscape, the mean fire interval was 4.3 years for the dry Scots pine forest and 8.7 years for the peatland Scots pine forest. However, our comparison of fire frequency before and after 1950 shows a marked decrease in mean fire interval. Our data suggest that hemi-boreal forest landscapes of Lithuania provide strong evidence that fire, both human and lightning-ignited fires, has been and should be a natural phenomenon and that the examination of biological archives can be used to guide sustainable forest management into the future. Currently, fire use is prohibited by law as a tool for forest management in Lithuania. We recommend introducing trials that use low-intensity prescribed burning of Scots pine stands as a regeneration tool towards mimicking natural forest disturbance regimes.

Keywords: biodiversity conservation, cultural burning, dendrochronology, forest dynamics, forest management, succession

Procedia PDF Downloads 200

Authors: Stephanie Lehmann, Esther Ruf, Sabina Misoch

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Background: Due to demographic change and shortage of skilled nursing staff, assistive robots are built to support older adults at home and nursing staff in care institutions. When assistive robots facilitate tasks that are usually performed by humans, user acceptance is essential. Even though they are an important aspect of acceptance, emotions towards different assistive robots and different situations of robot-use have so far not been examined in detail. The appearance of assistive robots can trigger emotions that affect their acceptance. Acceptance of robots is assumed to be greater when they look more human-like; however, too much human similarity can be counterproductive. Regarding different groups, it is assumed that older adults have a more negative attitude towards robots than younger adults. Within the framework of a simulated robot study, the aim was to investigate emotions of older adults compared to students towards robots with different appearances and in different situations and so contribute to a deeper view of the emotions influencing acceptance. Methods: In a questionnaire study, vignettes were used to assess emotions toward robots in different situations and of different appearance. The vignettes were composed of two situations (service and care) shown by video and four pictures of robots varying in human similarity (machine-like to android). The combination of the vignettes was randomly distributed to the participants. One hundred forty-two older adults and 35 bachelor students of nursing participated. They filled out a questionnaire that surveyed 30 positive and 30 negative emotions. For each group, older adults and students, a sum score of “positive emotions” and a sum score of “negative emotions” was calculated. Mean value, standard deviation, or n for sample size and % for frequencies, according to the scale level, were calculated. For differences in the scores of positive and negative emotions for different situations, t-tests were calculated. Results: Overall, older adults reported significantly more positive emotions than students towards robots in general. Students reported significantly more negative emotions than older adults. Regarding the two different situations, the results were similar for the care situation, with older adults reporting more positive emotions than students and less negative emotions than students. In the service situation, older adults reported significantly more positive emotions; negative emotions did not differ significantly from the students. Regarding the appearance of the robot, there were no significant differences in emotions reported towards the machine-like, the mechanical-human-like and the human-like appearance. Regarding the android robot, students reported significantly more negative emotions than older adults. Conclusion: There were differences in the emotions reported by older adults compared to students. Older adults reported more positive emotions, and students reported more negative emotions towards robots in different situations and with different appearances. It can be assumed that older adults have a different attitude towards the use of robots than younger people, especially young adults in the health sector. Therefore, the use of robots in the service or care sector should not be rejected rashly based on the attitudes of younger persons, without considering the attitudes of older adults equally.

Keywords: emotions, robots, seniors, young adults

Procedia PDF Downloads 465

Authors: Madhuka G. P. D. Udantha, Gihan V. Dias, Surangika Ranathunga

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Today Websites contain very interesting applications. But there are only few methodologies to analyze User navigations through the Websites and formulating if the Website is put to correct use. The web logs are only used if some major attack or malfunctioning occurs. Web Logs contain lot interesting dealings on users in the system. Analyzing web logs has become a challenge due to the huge log volume. Finding interesting patterns is not as easy as it is due to size, distribution and importance of minor details of each log. Web logs contain very important data of user and site which are not been put to good use. Retrieving interesting information from logs gives an idea of what the users need, group users according to their various needs and improve site to build an effective and efficient site. The model we built is able to detect attacks or malfunctioning of the system and anomaly detection. Logs will be more complex as volume of traffic and the size and complexity of web site grows. Unsupervised techniques are used in this solution which is fully automated. Expert knowledge is only used in validation. In our approach first clean and purify the logs to bring them to a common platform with a standard format and structure. After cleaning module web session builder is executed. It outputs two files, Web Sessions file and Indexed URLs file. The Indexed URLs file contains the list of URLs accessed and their indices. Web Sessions file lists down the indices of each web session. Then DBSCAN and EM Algorithms are used iteratively and recursively to get the best clustering results of the web sessions. Using homogeneity, completeness, V-measure, intra and inter cluster distance and silhouette coefficient as parameters these algorithms self-evaluate themselves to input better parametric values to run the algorithms. If a cluster is found to be too large then micro-clustering is used. Using Cluster Signature Module the clusters are annotated with a unique signature called finger-print. In this module each cluster is fed to Associative Rule Learning Module. If it outputs confidence and support as value 1 for an access sequence it would be a potential signature for the cluster. Then the access sequence occurrences are checked in other clusters. If it is found to be unique for the cluster considered then the cluster is annotated with the signature. These signatures are used in anomaly detection, prevent cyber attacks, real-time dashboards that visualize users, accessing web pages, predict actions of users and various other applications in Finance, University Websites, News and Media Websites etc.

Keywords: anomaly detection, clustering, pattern recognition, web sessions

Procedia PDF Downloads 288

Authors: S. Vivek, Sharad Sharan, R. Arvind, D. V. Praveen, J. Vigneshwar, S. Ajith, V. R. Sanal Kumar

Abstract:

In this paper numerical studies have been carried out to examine the starting transient flow features of high-performance solid propellant rocket motors with different port geometries but with same propellant loading density. Numerical computations have been carried out using a 3D SST k-ω turbulence model. This code solves standard k-omega turbulence equations with shear flow corrections using a coupled second order implicit unsteady formulation. In the numerical study, a fully implicit finite volume scheme of the compressible, Reynolds-Averaged, Navier-Stokes equations are employed. We have observed from the numerical results that in solid rocket motors with highly loaded propellants having divergent port geometry the hot igniter gases can create pre-ignition thrust oscillations due to flow unsteadiness and recirculation. Under these conditions the convective flux to the surface of the propellant will be enhanced, which will create reattachment point far downstream of the transition region and it will create a situation for secondary ignition and formation of multiple-flame fronts. As a result the effective time required for the complete burning surface area to be ignited comes down drastically giving rise to a high pressurization rate (dp/dt) in the second phase of starting transient. This in effect could lead to starting thrust oscillations and eventually a hard start of the solid rocket motor. We have also observed that the igniter temperature fluctuations will be diminished rapidly and will reach the steady state value faster in the case of solid propellant rocket motors with convergent port than the divergent port irrespective of the igniter total pressure. We have concluded that the thrust oscillations and unexpected thrust spike often observed in solid rockets with non-uniform ports are presumably contributed due to the joint effects of the geometry dependent driving forces, transient burning and the chamber gas dynamics forces. We also concluded that the prudent selection of the port geometry, without altering the propellant loading density, for damping the total temperature fluctuations within the motor is a meaningful objective for the suppression and control of instability and/or pressure/thrust oscillations often observed in solid propellant rocket motors with non-uniform port geometry.

Keywords: ignition transient, solid rockets, starting transient, thrust transient

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Authors: Tasleem Zafar, Jiwan Sidhu

Abstract:

Introduction: Chickpea flour is known to offer many benefits to diabetic persons, especially in maintaining their blood sugar levels in the acceptable range. Under this project we have studied the chemical composition and antioxidant capacity of white flour (WF), whole wheat flour (WWF) and chickpea flour (BF), in addition to the effect of replacement of WF and WWF with BF on the rheological characteristics of these flour blends, with the ultimate objective of producing acceptable quality flat as well as pan-bread for the diabetic consumers. Methods: WF and WWF were replaced with BF ranging from 0 to 40%, to investigate its effect on the rheological properties and functionality of blended flour dough using farinograph, viscoamylograph, mixograph and falling number apparatus as per the AACC standard methods. Texture Profile Analysis (TPA) was carried on the WF, WWF, and their blends with BF using Stable Micro System Texture Analyzer. Effect of certain additives, such as freeze-dried amla fruit powder (Phyllanthus emblica L.), guar gum, and xanthan gum on the dough rheological properties were also studied. Results: Freeze-dried amla fruit powder was found to be very rich in ascorbic acid and other phenolics having higher antioxidant activity. A decreased farinograph water absorption, increased dough development time, higher mixing tolerance index (i.e., weakening of dough), decreased resistance to extension, lower ratio numbers were obtained when the replacement with BF was increased from 0 to 40%. The BF gave lower peak viscosity, lower paste breakdown, and lower setback values when compared with WF. The falling number values were significantly lower in WWF (meaning higher α-amylase activity) than both the WF and BF. Texture Profile Analysis (TPA) carried on the WF, WWF, and their blends with BF showed significant variations in hardness and compressibility values, dough becoming less hard and less compressible when the replacement of WF and WWF with BF was increased from 0 to 40%. Conclusions: To overcome the deleterious effects of adding BF to WF and WWF on the rheological properties will be an interesting challenge when good quality pan bread and Arabic flatbread have to be commercially produced in a bakery. Use of freeze-dried amla fruit powder, guar gum, and xanthan gum did show some promise to improve the mixing characteristics of WF, WWF, and their blends with BF, and these additives are expected to be useful in producing an acceptable quality flat as well as pan-bread on a commercial scale.

Keywords: wheat flour, chickpea flour, amla fruit, rheology

Procedia PDF Downloads 159

Authors: Pichaya Poonlarp, Danai Boonyakiat, C. Chuamuangphan, M. Chanta

Abstract:

Current consumers’ behavior trends have changed towards more health awareness, the well-being of society and interest of nature and environment. The Royal Project Foundation is, therefore, well aware of organic agriculture. The project only focused on using natural products and utilizing its highland biological merits to increase resistance to diseases and insects for the produce grown. The project also brought in basic knowledge from a variety of available research information, including, but not limited to, improvement of soil fertility and a control of plant insects with biological methods in order to lay a foundation in developing and promoting farmers to grow quality produce with a high health safety. This will finally lead to sustainability for future highland agriculture and a decrease of chemical use on the highland area which is a source of natural watershed. However, there are still shortcomings of the postharvest management in term of quality and losses, such as bruising, rottenness, wilting and yellowish leaves. These losses negatively affect the maintenance and a shelf life of organic vegetables. Therefore, it is important that a research study of the appropriate and effective postharvest management is conducted for an individual organic vegetable to minimize product loss and find root causes of postharvest losses which would contribute to future postharvest management best practices. This can be achieved through surveys and data collection from postharvest processes in order to conduct analysis for causes of postharvest losses of organic pak-choi, baby pak-choi, and choy sum. Consequently, postharvest losses reduction strategies of organic vegetables can be achieved. In this study, postharvest losses of organic pak choi, baby pak-choi, and choy sum were determined at each stage of the supply chain starting from the field after harvesting, at the Development Center packinghouse, at Chiang Mai packinghouse, at Bangkok packing house and at the Royal Project retail shop in Chiang Mai. The results showed that postharvest losses of organic pak-choi, baby pak-choi, and choy sum were 86.05, 89.05 and 59.03 percent, respectively. The main factors contributing to losses of organic vegetables were due to mechanical damage and underutilized parts and/or short of minimum quality standard. Good practices had been developed after causes of losses were identified. Appropriate postharvest handling and management, for example, temperature control, hygienic cleaning, and reducing the duration of the supply chain, postharvest losses of all organic vegetables should be able to remarkably reduced postharvest losses in the supply chain.

Keywords: postharvest losses, organic vegetables, handling improvement, shelf life, supply chain

Procedia PDF Downloads 475