Search results for: TS patient selection

Authors: Anteneh Dagnachew Sewenet, Paola Pisano

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The concept of circular economy, circularity, and sustainability are interconnected and promote a more sustainable future. However, previous studies have mainly focused on each concept individually, neglecting the relationships and gaps in the existing literature. This study aims to integrate and link these concepts to expand the theoretical and practical methods of scholars and professionals in pursuit of sustainability. The aim of this systematic literature review is to comprehensively analyze and summarize the interconnections between circular economy, circularity, and sustainability. Additionally, it seeks to develop a conceptual framework that can guide practitioners and serve as a basis for future research. The review employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. A total of 78 articles were analyzed, utilizing the Scopus and Web of Science databases. The analysis involved summarizing and systematizing the conceptualizations of circularity and its relationship with the circular economy and long-term sustainability. The review provided a comprehensive overview of the interconnections between circular economy, circularity, and sustainability. Key themes, theoretical frameworks, empirical findings, and conceptual gaps in the literature were identified. Through a rigorous analysis of scholarly articles, the study highlighted the importance of integrating these concepts for a more sustainable future. This study contributes to the existing literature by integrating and linking the concepts of circular economy, circularity, and sustainability. It expands the theoretical understanding of how these concepts relate to each other and provides a conceptual framework that can guide future research in this field. The findings emphasize the need for a holistic approach in achieving sustainability goals. The data collection for this review involved identifying relevant articles from the Scopus and Web of Science databases. The selection of articles was made based on predefined inclusion and exclusion criteria. The PRISMA protocol guided the systematic analysis of the selected articles, including summarizing and systematizing their content. This study addressed the question of how circularity is conceptualized and related to both the circular economy and long-term sustainability. It aimed to identify the interconnections between these concepts and bridge the gap in the existing literature. The review provided a comprehensive analysis of the interconnections between the circular economy, circularity, and sustainability. It presented a conceptual framework that can guide practitioners in implementing circular economy strategies and serve as a basis for future research. By integrating these concepts, scholars, and professionals can enhance the theoretical and practical methods in pursuit of a more sustainable future. The findings emphasize the importance of taking a holistic approach to achieve sustainability goals and highlight conceptual gaps that can be addressed in future studies.

Keywords: circularity, circular economy, sustainability, innovation

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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

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Authors: Charléa M. Smith, Raiden L. Schodowski, Arletty Pinel

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Due to the COVID-19 pandemic, the Faculty of Medical Sciences of The University of the West Indies (UWI) Mona in Kingston, Jamaica, had to rapidly migrate to digital and blended learning. Students in the preclinical stage of the program transitioned to full-time online learning, while students in the clinical stage experienced decreased daily patient contact and the implementation of a blend of online lectures and virtual clinical practice. Such sudden changes were coupled with the institutional pressure of the need to introduce a novel approach to education without much time for preparation, as well as additional strain endured by the faculty, who were overwhelmed by serving as frontline workers. During the period July 20 to August 23, 2021, this study surveyed preclinical and clinical students to capture their experiences with these changes and their recommendations for future use of digital modalities of learning to enhance medical education. It was conducted with a fellow student of the 2021 cohort of the MultiPod mentoring program. A questionnaire was developed and distributed digitally via WhatsApp to all medical students of the UWI Mona campus to assess students’ experiences and perceptions of the advantages, challenges, and impact on individual knowledge proficiencies brought about by the transition to predominantly digital learning environments. 108 students replied, 53.7% preclinical and 46.3% clinical. 67.6% of the total were female and 30.6 % were male; 1.8% did not identify themselves by gender. 67.2% of preclinical students preferred blended learning and 60.3% considered that the content presented did not prepare them for clinical work. Only 31% considered that the online classes were interactive and encouraged student participation. 84.5% missed socialization with classmates and friends and 79.3% missed a focused environment for learning. 80% of the clinical students felt that they had not learned all that they expected and only 34% had virtual interaction with patients, mostly by telephone and video calls. Observing direct consultations was considered the most useful, yet this was the least-used modality. 96% of the preclinical students and 100% of the clinical ones supplemented their learning with additional online tools. The main recommendations from the survey are the use of interactive teaching strategies, more discussion time with lecturers, and increased virtual interactions with patients. Universities are returning to face-to-face learning, yet it is unlikely that blended education will disappear. This study demonstrates that students’ perceptions of their experience during mobility restrictions must be taken into consideration in creating more effective, inclusive, and efficient blended learning opportunities.

Keywords: blended learning, digital learning, medical education, student perceptions

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Authors: Osman Turkoglu, Alvin Estilo, Ritu Gupta, Liliam Pineda-Salgado, Rajesh Pandey

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Background: Hepatotoxicity can be linked to a variety of clinical symptoms and histopathological signs, posing a great challenge in the surveillance of suspected drug-induced liver injury (DILI) cases in the safety database. Additionally, the majority of such cases are rare, idiosyncratic, highly unpredictable, and tend to demonstrate unique individual susceptibility; these qualities, in turn, lend to a pharmacovigilance monitoring process that is often tedious and time-consuming. Objective: Develop a multifactorial algorithm to assist pharmacovigilance physicians in identifying high-risk hepatotoxicity cases associated with DILI from the sponsor’s safety database (Argus). Methods: Multifactorial selection criteria were established using Structured Query Language (SQL) and the TIBCO Spotfire® visualization tool, via a combination of word fragments, wildcard strings, and mathematical constructs, based on Hy’s law criteria and pattern of injury (R-value). These criteria excluded non-eligible cases from monthly line listings mined from the Argus safety database. The capabilities and limitations of these criteria were verified by comparing a manual review of all monthly cases with system-generated monthly listings over six months. Results: On an average, over a period of six months, the algorithm accurately identified 92% of DILI cases meeting established criteria. The automated process easily compared liver enzyme elevations with baseline values, reducing the screening time to under 15 minutes as opposed to multiple hours exhausted using a cognitively laborious, manual process. Limitations of the algorithm include its inability to identify cases associated with non-standard laboratory tests, naming conventions, and/or incomplete/incorrectly entered laboratory values. Conclusions: The newly developed multifactorial algorithm proved to be extremely useful in detecting potential DILI cases, while heightening the vigilance of the drug safety department. Additionally, the application of this algorithm may be useful in identifying a potential signal for DILI in drugs not yet known to cause liver injury (e.g., drugs in the initial phases of development). This algorithm also carries the potential for universal application, due to its product-agnostic data and keyword mining features. Plans for the tool include improving it into a fully automated application, thereby completely eliminating a manual screening process.

Keywords: automation, drug-induced liver injury, pharmacovigilance, post-marketing

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Authors: Lillian Musila, Valerie Oundo, Daniel Erwin, Willie Sang

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Staphylococcus aureus infections are a major cause of nosocomial infections in Kenya. Methicillin resistant S. aureus (MRSA) infections are a significant burden to public health and are associated with considerable morbidity and mortality. At a hospital in Western Kenya two clusters of MRSA cases emerged within short periods of time. In this study we explored whether these clusters represented a nosocomial outbreak by characterizing the isolates using phenotypic and molecular assays and examining epidemiological data to identify possible transmission patterns. Specimens from the site of infection of the subjects were collected, cultured and S. aureus isolates identified phenotypically and confirmed by APIStaph™. MRSA were identified by cefoxitin disk screening per CLSI guidelines. MRSA were further characterized based on their antibiotic susceptibility patterns and spa gene typing. Characteristics of cases with MRSA isolates were compared with those with MSSA isolated around the same time period. Two cases of MRSA infection were identified in the two week period between 21 April and 4 May 2015. A further 2 MRSA isolates were identified on the same day on 7 September 2015. The antibiotic resistance patterns of the two MRSA isolates in the 1st cluster of cases were different suggesting that these were distinct isolates. One isolate had spa type t2029 and the other had a novel spa type. The 2 isolates were obtained from urine and an open skin wound. In the 2nd cluster of MRSA isolates, the antibiotic susceptibility patterns were similar but isolates had different spa types: one was t037 and the other a novel spa type different from the novel MRSA spa type in the first cluster. Both cases in the second cluster were admitted into the hospital but one infection was community- and the other hospital-acquired. Only one of the four MRSA cases was classified as an HAI from an infection acquired post-operatively. When compared to other S. aureus strains isolated within the same time period from the same hospital only one spa type t2029 was found in both MRSA and non-MRSA strains. None of the cases infected with MRSA in the two clusters shared any common epidemiological characteristic such as age, sex or known risk factors for MRSA such as prolonged hospitalization or institutionalization. These data suggest that the observed MRSA clusters were multi strain clusters and not an outbreak of a single strain. There was no clear relationship between the isolates by spa type suggesting that no transmission was occurring within the hospital between these cluster cases but rather that the majority of the MRSA strains were circulating in the community. There was high diversity of spa types among the MRSA strains with none of the isolates sharing spa types. Identification of disease clusters in space and time is critical for immediate infection control action and patient management. Spa gene typing is a rapid way of confirming or ruling out MRSA outbreaks so that costly interventions are applied only when necessary.

Keywords: cluster, Kenya, MRSA, spa typing

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Authors: Omar Romero-Hernandez, Federico Castillo, Armando Sanchez, Sergio Romero, Andrea Romero, Michael Mitchell

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Environmental policies for resource conservation in rural areas include subsidies on services and social programs to cover living expenses. Government's expectation is that rural communities who benefit from social programs, such as payment for ecosystem services, are provided with an incentive to conserve natural resources and preserve natural sinks for greenhouse gases. At the same time, global climate change has affected the lives of people worldwide. The capability to adapt to global warming depends on the available resources and the standard of living, putting rural communities at a disadvantage. This paper explores whether rural entrepreneurship can represent a solution to resource conservation and global warming adaptation in rural communities. The research focuses on a sample of two coffee communities in Oaxaca, Mexico. Researchers used geospatial information contained in aerial photographs of the geographical areas of interest. Households were identified in the photos via the roofs of households and georeferenced via coordinates. From the household population, a random selection of roofs was performed and received a visit. A total of 112 surveys were completed, including questions of socio-demographics, perception to climate change and adaptation activities. The population includes two groups of study: entrepreneurs and non-entrepreneurs. Data was sorted, filtered, and validated. Analysis includes descriptive statistics for exploratory purposes and a multi-regression analysis. Outcomes from the surveys indicate that coffee farmers, who demonstrate entrepreneurship skills and hire employees, are more eager to adapt to climate change despite the extreme adverse socioeconomic conditions of the region. We show that farmers with entrepreneurial tendencies are more creative in using innovative farm practices such as the planting of shade trees, the use of live fencing, instead of wires, and watershed protection techniques, among others. This result counters the notion that small farmers are at the mercy of climate change and have no possibility of being able to adapt to a changing climate. The study also points to roadblocks that farmers face when coping with climate change. Among those roadblocks are a lack of extension services, access to credit, and reliable internet, all of which reduces access to vital information needed in today’s constantly changing world. Results indicate that, under some circumstances, funding and supporting entrepreneurship programs may provide more benefit than traditional social programs.

Keywords: entrepreneurship, global warming, rural communities, climate change adaptation

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Authors: A. G. Akhundov

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Issues of obtaining unbiased data on the status of pipeline systems of oil- and oil product transportation become especially important when laying and operating pipelines under severe nature and climatic conditions. The essential attention is paid here to researching exogenous processes and their impact on linear facilities of the pipeline system. Reliable operation of pipelines under severe nature and climatic conditions, timely planning and implementation of compensating measures are only possible if operation conditions of pipeline systems are regularly monitored, and changes of permafrost soil and hydrological operation conditions are accounted for. One of the main reasons for emergency situations to appear is the geodynamic factor. Emergency situations are proved by the experience to occur within areas characterized by certain conditions of the environment and to develop according to similar scenarios depending on active processes. The analysis of natural and technical systems of main pipelines at different stages of monitoring gives a possibility of making a forecast of the change dynamics. The integration of GIS technologies, traditional means of geotechnical monitoring (in-line inspection, geodetic methods, field observations), and remote methods (aero-visual inspection, aero photo shooting, air and ground laser scanning) provides the most efficient solution of the problem. The united environment of geo information system (GIS) is a comfortable way to implement the monitoring system on the main pipelines since it provides means to describe a complex natural and technical system and every element thereof with any set of parameters. Such GIS enables a comfortable simulation of main pipelines (both in 2D and 3D), the analysis of situations and selection of recommendations to prevent negative natural or man-made processes and to mitigate their consequences. The specifics of such systems include: a multi-dimensions simulation of facilities in the pipeline system, math modelling of the processes to be observed, and the use of efficient numeric algorithms and software packets for forecasting and analyzing. We see one of the most interesting possibilities of using the monitoring results as generating of up-to-date 3D models of a facility and the surrounding area on the basis of aero laser scanning, data of aerophotoshooting, and data of in-line inspection and instrument measurements. The resulting 3D model shall be the basis of the information system providing means to store and process data of geotechnical observations with references to the facilities of the main pipeline; to plan compensating measures, and to control their implementation. The use of GISs for geotechnical monitoring of pipeline systems is aimed at improving the reliability of their operation, reducing the probability of negative events (accidents and disasters), and at mitigation of consequences thereof if they still are to occur.

Keywords: databases, 3D GIS, geotechnical monitoring, pipelines, laser scaning

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Authors: Ahmad S. Darwish, Tarek Lemaoui, Hanifa Taher, Inas M. AlNashef, Fawzi Banat

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This research reports a systematic top-down approach for designing neoteric hydrophobic solvents –particularly, deep eutectic solvents (DES) and ionic liquids (IL)– as furfural extractants from aqueous media for the application of sustainable biomass conversion. The first stage of the framework entailed screening 32 neoteric solvents to determine their efficacy against toluene as the application’s conventional benchmark for comparison. The selection criteria for the best solvents encompassed not only their efficiency in extracting furfural but also low viscosity and minimal toxicity levels. Additionally, for the DESs, their natural origins, availability, and biodegradability were also taken into account. From the screening pool, two neoteric solvents were selected: thymol:decanoic acid 1:1 (Thy:DecA) and trihexyltetradecyl phosphonium bis(trifluoromethylsulfonyl) imide [P₁₄,₆,₆,₆][NTf₂]. These solvents outperformed the toluene benchmark, achieving efficiencies of 94.1% and 97.1% respectively, compared to toluene’s 81.2%, while also possessing the desired properties. These solvents were then characterized thoroughly in terms of their physical properties, thermal properties, critical properties, and cross-contamination solubilities. The selected neoteric solvents were then extensively tested under various operating conditions, and an exceptional stable performance was exhibited, maintaining high efficiency across a broad range of temperatures (15–100 °C), pH levels (1–13), and furfural concentrations (0.1–2.0 wt%) with a remarkable equilibrium time of only 2 minutes, and most notably, demonstrated high efficiencies even at low solvent-to-feed ratios. The durability of the neoteric solvents was also validated to be stable over multiple extraction-regeneration cycles, with limited leachability to the aqueous phase (≈0.1%). Moreover, the extraction performance of the solvents was then modeled through machine learning, specifically multiple non-linear regression (MNLR) and artificial neural networks (ANN). The models demonstrated high accuracy, indicated by their low absolute average relative deviations with values of 2.74% and 2.28% for Thy:DecA and [P₁₄,₆,₆,₆][NTf₂], respectively, using MNLR, and 0.10% for Thy:DecA and 0.41% for [P₁₄,₆,₆,₆][NTf₂] using ANN, highlighting the significantly enhanced predictive accuracy of the ANN. The neoteric solvents presented herein offer noteworthy advantages over traditional organic solvents, including their high efficiency in both extraction and regeneration processes, their stability and minimal leachability, making them particularly suitable for applications involving aqueous media. Moreover, these solvents are more environmentally friendly, incorporating renewable and sustainable components like thymol and decanoic acid. This exceptional efficacy of the newly developed neoteric solvents signifies a significant advancement, providing a green and sustainable alternative for furfural production from biowaste.

Keywords: sustainable biomass conversion, furfural extraction, ionic liquids, deep eutectic solvents

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Authors: Maria Sciammarella, Uttam M. Shrestha, Youngho Seo, Grant T. Gullberg, Elias H. Botvinick

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Background: Myocardial perfusion imaging (MPI) is typically performed with static imaging protocols and visually assessed for perfusion defects based on the relative intensity distribution. Dynamic cardiac SPECT, on the other hand, is a new imaging technique that is based on time varying information of radiotracer distribution, which permits quantification of myocardial blood flow (MBF). In this abstract, we report a progress and current status of dynamic cardiac SPECT using conventional gamma camera (Infinia Hawkeye 4, GE Healthcare) for estimation of myocardial blood flow and coronary flow reserve. Methods: A group of patients who had high risk of coronary artery disease was enrolled to evaluate our methodology. A low-dose/high-dose rest/pharmacologic-induced-stress protocol was implemented. A standard rest and a standard stress radionuclide dose of ⁹⁹ᵐTc-tetrofosmin (140 keV) was administered. The dynamic SPECT data for each patient were reconstructed using the standard 4-dimensional maximum likelihood expectation maximization (ML-EM) algorithm. Acquired data were used to estimate the myocardial blood flow (MBF). The correspondence between flow values in the main coronary vasculature with myocardial segments defined by the standardized myocardial segmentation and nomenclature were derived. The coronary flow reserve, CFR, was defined as the ratio of stress to rest MBF values. CFR values estimated with SPECT were also validated with dynamic PET. Results: The range of territorial MBF in LAD, RCA, and LCX was 0.44 ml/min/g to 3.81 ml/min/g. The MBF between estimated with PET and SPECT in the group of independent cohort of 7 patients showed statistically significant correlation, r = 0.71 (p < 0.001). But the corresponding CFR correlation was moderate r = 0.39 yet statistically significant (p = 0.037). The mean stress MBF value was significantly lower for angiographically abnormal than that for the normal (Normal Mean MBF = 2.49 ± 0.61, Abnormal Mean MBF = 1.43 ± 0. 0.62, P < .001). Conclusions: The visually assessed image findings in clinical SPECT are subjective, and may not reflect direct physiologic measures of coronary lesion. The MBF and CFR measured with dynamic SPECT are fully objective and available only with the data generated from the dynamic SPECT method. A quantitative approach such as measuring CFR using dynamic SPECT imaging is a better mode of diagnosing CAD than visual assessment of stress and rest images from static SPECT images Coronary Flow Reserve.

Keywords: dynamic SPECT, clinical SPECT/CT, selective coronary angiograph, ⁹⁹ᵐTc-Tetrofosmin

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Authors: A. Julio, R. Caparica, S. Costa Lima, S. Reis, J. G. Costa, P. Fonte, T. Santos De Almeida

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The Mycobacterium leprae causes a chronic and infectious disease called leprosy, which the most common symptoms are peripheral neuropathy and deformation of several parts of the body. The pharmacological treatment of leprosy is a combined therapy with three different drugs, rifampicin, clofazimine, and dapsone. However, clofazimine and dapsone have poor solubility in water and also low bioavailability. Thus, it is crucial to develop strategies to overcome such drawbacks. The use of ionic liquids (ILs) may be a strategy to overcome the low solubility since they have been used as solubility promoters. ILs are salts, liquid below 100 ºC or even at room temperature, that may be placed in water, oils or hydroalcoholic solutions. Another approach may be the encapsulation of drugs into polymeric nanoparticles, which improves their bioavailability. In this study, two different classes of ILs were used, the imidazole- and the choline-based ionic liquids, as solubility enhancers of the poorly soluble antileprotic drugs. Thus, after the solubility studies, it was developed IL-PLGA nanoparticles hybrid systems to deliver such drugs. First of all, the solubility studies of clofazimine and dapsone were performed in water and in water: IL mixtures, at ILs concentrations where cell viability is maintained, at room temperature for 72 hours. For both drugs, it was observed an improvement on the drug solubility and [Cho][Phe] showed to be the best solubility enhancer, especially for clofazimine, where it was observed a 10-fold improvement. Later, it was produced nanoparticles, with a polymeric matrix of poly(lactic-co-glycolic acid) (PLGA) 75:25, by a modified solvent-evaporation W/O/W double emulsion technique in the presence of [Cho][Phe]. Thus, the inner phase was an aqueous solution of 0.2 % (v/v) of the above IL with each drug to its maximum solubility determined on the previous study. After the production, the nanosystem hybrid was physicochemically characterized. The produced nanoparticles had a diameter of around 580 nm and 640 nm, for clofazimine and dapsone, respectively. Regarding the polydispersity index, it was in agreement of the recommended value of this parameter for drug delivery systems (around 0.3). The association efficiency (AE) of the developed hybrid nanosystems demonstrated promising AE values for both drugs, given their low solubility (64.0 ± 4.0 % for clofazimine and 58.6 ± 10.0 % for dapsone), that prospects the capacity of these delivery systems to enhance the bioavailability and loading of clofazimine and dapsone. Overall, the study achievement may signify an upgrading of the patient’s quality of life, since it may mean a change in the therapeutic scheme, not requiring doses of drug so high to obtain a therapeutic effect. The authors would like to thank Fundação para a Ciência e a Tecnologia, Portugal (FCT/MCTES (PIDDAC), UID/DTP/04567/2016-CBIOS/PRUID/BI2/2018).

Keywords: ionic liquids, ionic liquids-PLGA nanoparticles hybrid systems, leprosy treatment, solubility

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Authors: Ella Tyuryumina, Alexey Neznanov

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This study is an attempt to obtain reliable data on the natural history of breast cancer growth. We analyze the opportunities for using classical mathematical models (exponential and logistic tumor growth models, Gompertz and von Bertalanffy tumor growth models) to try to describe growth of the primary tumor and the secondary distant metastases of human breast cancer. The research aim is to improve predicting accuracy of breast cancer progression using an original mathematical model referred to CoMPaS and corresponding software. We are interested in: 1) modelling the whole natural history of the primary tumor and the secondary distant metastases; 2) developing adequate and precise CoMPaS which reflects relations between the primary tumor and the secondary distant metastases; 3) analyzing the CoMPaS scope of application; 4) implementing the model as a software tool. The foundation of the CoMPaS is the exponential tumor growth model, which is described by determinate nonlinear and linear equations. The CoMPaS corresponds to TNM classification. It allows to calculate different growth periods of the primary tumor and the secondary distant metastases: 1) ‘non-visible period’ for the primary tumor; 2) ‘non-visible period’ for the secondary distant metastases; 3) ‘visible period’ for the secondary distant metastases. The CoMPaS is validated on clinical data of 10-years and 15-years survival depending on the tumor stage and diameter of the primary tumor. The new predictive tool: 1) is a solid foundation to develop future studies of breast cancer growth models; 2) does not require any expensive diagnostic tests; 3) is the first predictor which makes forecast using only current patient data, the others are based on the additional statistical data. The CoMPaS model and predictive software: a) fit to clinical trials data; b) detect different growth periods of the primary tumor and the secondary distant metastases; c) make forecast of the period of the secondary distant metastases appearance; d) have higher average prediction accuracy than the other tools; e) can improve forecasts on survival of breast cancer and facilitate optimization of diagnostic tests. The following are calculated by CoMPaS: the number of doublings for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases; tumor volume doubling time (days) for ‘non-visible’ and ‘visible’ growth period of the secondary distant metastases. The CoMPaS enables, for the first time, to predict ‘whole natural history’ of the primary tumor and the secondary distant metastases growth on each stage (pT1, pT2, pT3, pT4) relying only on the primary tumor sizes. Summarizing: a) CoMPaS describes correctly the primary tumor growth of IA, IIA, IIB, IIIB (T1-4N0M0) stages without metastases in lymph nodes (N0); b) facilitates the understanding of the appearance period and inception of the secondary distant metastases.

Keywords: breast cancer, exponential growth model, mathematical model, metastases in lymph nodes, primary tumor, survival

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Authors: Merilin Ivanova Ivanova, Kalin Dimitrov Atanasov, Stefan Petrov Enchev

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Backgroud: Neuromyelitis optica spectrum disorder, also known as Devic’s disease, is a relapsing demyelinating autoimmune inflammatory disorder of the central nervous system associated with anti-aquaporin 4 (AQP4) antibodies that can manifest with devastating secondary neurological deficits. Most commonly affected are the optic nerves and the spinal cord-clinically this is often presented with optic neuritis (loss of vision), transverse myelitis(weakness or paralysis of extremities),lack of bladder and bowel control, numbness. APS is a core clinical entity of NMOSD and adds to the clinical representation the following symptoms: intractable nausea, vomiting and hiccup, it usually occurs isolated at onset, and can lead to a significant delay in the diagnosis. The condition may have features similar to multiple sclerosis (MS) but the episodes are worse in NMO and it is treated differently. It could be relapsing or monophasic. Possible complications are visual field defects and motor impairment, with potential blindness and irreversible motor deficits. In severe cases, myogenic respiratory failure ensues. The incidence of reported cases is approximately 0.3–4.4 per 100,000. Paediatric cases of NMOSD are rare but have been reported occasionally, comprising less than 5% of the reported cases. Objective: The case serves to show the difficulty when it comes to the diagnostic processes regarding a rare autoimmune disease with non- specific symptoms, taking large interval of rimes to reveal as complete clinical manifestation of the aforementioned syndrome, as well as the necessity of multidisciplinary approach in the setting of а general paediatric department in аn emergency hospital. Methods: itpatient's history, clinical presentation, and information from the used diagnostic tools(MRI with contrast of the central nervous system) lead us to the conclusion .This was later on confirmed by the positive results from the anti-aquaporin 4 (AQP4) antibody serology test. Conclusion: APS is a common symptom of NMOSD and is considered a challenge in a differential-diagnostic plan. Gaining an increased awareness of this disease/syndrome, obtaining a detailed patient history, and performing thorough physical examinations are essential if we are to reduce and avoid misdiagnosis.

Keywords: neuromyelitis, devic's disease, hiccup, autoimmune, MRI

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Authors: Tsitsi Nyukurayi Muparari, Walter Timo De Vries, Jaap Zevenbergen

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The nature of Land administration accommodates diversity in terms of both spatial data handling activities and the expertise involved, which supposedly aims to satisfy the unpredictable demands of land data and the diverse demands of the customers arising from the land. However, it is known that strategic decisions of restructuring are in most cases repelled in favour of complex structures that strive to accommodate professional diversity and diverse roles in the field of Land administration. Yet despite of this widely accepted knowledge, there is scanty theoretical knowledge concerning the psychological methodologies that can extract the deeper perceptions from the diverse spatial expertise in order to explain the invisible control arm of the polarised reception of the ideas of change. This paper evaluates Q methodology in the context of a cadastre and land registry merger (under one agency) using the Swedish cadastral system as a case study. Precisely, the aim of this paper is to evaluate the effectiveness of Q methodology towards modelling the diverse psychological perceptions of spatial professionals who are in a widely contested decision of merging the cadastre and land registry components of Land administration using the Swedish cadastral system as a case study. An empirical approach that is prescribed by Q methodology starts with the concourse development, followed by the design of statements and q sort instrument, selection of the participants, the q-sorting exercise, factor extraction by PQMethod and finally narrative development by logic of abduction. The paper uses 36 statements developed from a dominant competing value theory that stands out on its reliability and validity, purposively selects 19 participants to do the Qsorting exercise, proceeds with factor extraction from the diversity using varimax rotation and judgemental rotation provided by PQMethod and effect the narrative construction using the logic abduction. The findings from the diverse perceptions from cadastral professionals in the merger decision of land registry and cadastre components in Sweden’s mapping agency (Lantmäteriet) shows that focus is rather inclined on the perfection of the relationship between the legal expertise and technical spatial expertise. There is much emphasis on tradition, loyalty and communication attributes which concern the organisation’s internal environment rather than innovation and market attributes that reveals customer behavior and needs arising from the changing humankind-land needs. It can be concluded that Q methodology offers effective tools that pursues a psychological approach for the evaluation and gradations of the decisions of strategic change through extracting the local perceptions of spatial expertise.

Keywords: cadastre, factor extraction, land administration merger, land registry, q-methodology, rotation

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Authors: Ning Chang, Zelong Yuan, Yunpeng Wang, Jianchun Wang

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Large eddy simulation (LES) has been extensively used in the investigation of turbulence. LES calculates the grid-resolved large-scale motions and leaves small scales modeled by sublfilterscale (SFS) models. Among the existing SFS models, the deconvolution model has been used successfully in the LES of the engineering flows and geophysical flows. Despite the wide application of deconvolution models, the effects of subfilter scale dynamics and filter anisotropy on the accuracy of SFS modeling have not been investigated in depth. The results of LES are highly sensitive to the selection of filters and the anisotropy of the grid, which has been overlooked in previous research. In the current study, two critical aspects of LES are investigated. Firstly, we analyze the influence of sub-filter scale (SFS) dynamics on the accuracy of direct deconvolution models (DDM) at varying filter-to-grid ratios (FGR) in isotropic turbulence. An array of invertible filters are employed, encompassing Gaussian, Helmholtz I and II, Butterworth, Chebyshev I and II, Cauchy, Pao, and rapidly decaying filters. The significance of FGR becomes evident, as it acts as a pivotal factor in error control for precise SFS stress prediction. When FGR is set to 1, the DDM models cannot accurately reconstruct the SFS stress due to the insufficient resolution of SFS dynamics. Notably, prediction capabilities are enhanced at an FGR of 2, resulting in accurate SFS stress reconstruction, except for cases involving Helmholtz I and II filters. A remarkable precision close to 100% is achieved at an FGR of 4 for all DDM models. Additionally, the further exploration extends to the filter anisotropy to address its impact on the SFS dynamics and LES accuracy. By employing dynamic Smagorinsky model (DSM), dynamic mixed model (DMM), and direct deconvolution model (DDM) with the anisotropic filter, aspect ratios (AR) ranging from 1 to 16 in LES filters are evaluated. The findings highlight the DDM's proficiency in accurately predicting SFS stresses under highly anisotropic filtering conditions. High correlation coefficients exceeding 90% are observed in the a priori study for the DDM's reconstructed SFS stresses, surpassing those of the DSM and DMM models. However, these correlations tend to decrease as lter anisotropy increases. In the a posteriori studies, the DDM model consistently outperforms the DSM and DMM models across various turbulence statistics, encompassing velocity spectra, probability density functions related to vorticity, SFS energy flux, velocity increments, strain-rate tensors, and SFS stress. It is observed that as filter anisotropy intensify, the results of DSM and DMM become worse, while the DDM continues to deliver satisfactory results across all filter-anisotropy scenarios. The findings emphasize the DDM framework's potential as a valuable tool for advancing the development of sophisticated SFS models for LES of turbulence.

Keywords: deconvolution model, large eddy simulation, subfilter scale modeling, turbulence

Procedia PDF Downloads 57

Authors: Supria Sarkar, Vasit Sagan, Sourav Bhadra, Meghnath Pokharel, Felix B.Fritschi

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Soybean and their derivatives are very important agricultural commodities around the world because of their wide applicability in human food, animal feed, biofuel, and industries. However, the significance of soybean production depends on the quality of the soybean seeds rather than the yield alone. Seed composition is widely dependent on plant physiological properties, aerobic and anaerobic environmental conditions, nutrient content, and plant phenological characteristics, which can be captured by high temporal resolution remote sensing datasets. Planet scope (PS) satellite images have high potential in sequential information of crop growth due to their frequent revisit throughout the world. In this study, we estimate soybean seed composition while the plants are in the field by utilizing PlanetScope (PS) satellite images and different machine learning algorithms. Several experimental fields were established with varying genotypes and different seed compositions were measured from the samples as ground truth data. The PS images were processed to extract 462 hand-crafted vegetative and textural features. Four machine learning algorithms, i.e., partial least squares (PLSR), random forest (RFR), gradient boosting machine (GBM), support vector machine (SVM), and two recurrent neural network architectures, i.e., long short-term memory (LSTM) and gated recurrent unit (GRU) were used in this study to predict oil, protein, sucrose, ash, starch, and fiber of soybean seed samples. The GRU and LSTM architectures had two separate branches, one for vegetative features and the other for textures features, which were later concatenated together to predict seed composition. The results show that sucrose, ash, protein, and oil yielded comparable prediction results. Machine learning algorithms that best predicted the six seed composition traits differed. GRU worked well for oil (R-Squared: of 0.53) and protein (R-Squared: 0.36), whereas SVR and PLSR showed the best result for sucrose (R-Squared: 0.74) and ash (R-Squared: 0.60), respectively. Although, the RFR and GBM provided comparable performance, the models tended to extremely overfit. Among the features, vegetative features were found as the most important variables compared to texture features. It is suggested to utilize many vegetation indices for machine learning training and select the best ones by using feature selection methods. Overall, the study reveals the feasibility and efficiency of PS images and machine learning for plot-level seed composition estimation. However, special care should be given while designing the plot size in the experiments to avoid mixed pixel issues.

Keywords: agriculture, computer vision, data science, geospatial technology

Procedia PDF Downloads 115

Authors: Fernando Antonio Bacchim Neto, Allan Felipe Fattori Alves, Maria Eugênia Dela Rosa, Regina Moura, Diana Rodrigues De Pina

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Interventional Radiology is the radiology modality that provides the highest dose values to medical staff. Recent researches show that personal dosimeters may underestimate dose values in interventional physicians, especially in extremities (hands and feet) and eye lens. The aim of this work was to study radiation exposure levels of medical staff in different interventional radiology procedures and estimate the annual maximum numbers of procedures (AMN) that each physician could perform without exceed the annual limits of dose established by normative. For this purpose LiF:Mg,Ti (TLD-100) dosimeters were positioned in different body regions of the interventional physician (eye lens, thyroid, chest, gonads, hand and foot) above the radiological protection vests as lead apron and thyroid shield. Attenuation values for lead protection vests were based on international guidelines. Based on these data were chosen as 90% attenuation of the lead vests and 60% attenuation of the protective glasses. 25 procedures were evaluated: 10 diagnostics, 10 angioplasty, and 5-aneurysm treatment. The AMN of diagnostic procedures was 641 for the primary interventional radiologist and 930 for the assisting interventional radiologist. For the angioplasty procedures, the AMN for primary interventional radiologist was 445 and for assisting interventional radiologist was 1202. As for the procedures of aneurism treatment, the AMN for the primary interventional radiologist was 113 and for the assisting interventional radiologist were 215. All AMN were limited by the eye lens doses already considering the use of protective glasses. In all categories evaluated, the higher dose values are found in gonads and in the lower regions of professionals, both for the primary interventionist and for the assisting, but the eyes lens dose limits are smaller than these regions. Additional protections as mobile barriers, which can be positioned between the interventionist and the patient, can decrease the exposures in the eye lens, providing a greater protection for the medical staff. The alternation of professionals to perform each type of procedure can reduce the dose values received by them over a period. The analysis of dose profiles proposed in this work showed that personal dosimeters positioned in chest might underestimate dose values in other body parts of the interventional physician, especially in extremities and eye lens. As each body region of the interventionist is subject to different levels of exposure, dose distribution in each region provides a better approach to what actions are necessary to ensure the radiological protection of medical staff.

Keywords: interventional radiology, radiation protection, occupationally exposed individual, hemodynamic

Procedia PDF Downloads 378

Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

Procedia PDF Downloads 102

Authors: A. Gramza-Michałowska, J. Skręty, M. Antczak, J. Kobus-Cisowska, D. Kmiecik, J. Korczak, Kulczyński Bartosz

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Background: Modern consumer highly appreciates the correlation between eating habits and health. Intensified research showed many proofs confirming that food besides its basic nutritional function, possess also significant prophylactic and therapeutic potential. Preventive potential of selected food is commonly used as improvement factor of patients life standard. World Health Organization indicates that diabetes (Diabetes mellitus) and obesity are two of the most common and dangerous diseases. Diet therapy is an element of diabetes education program and a part of healing process, allowing maintaining and remaining the optimal metabolic state of the system. It must be remembered that diabetes treatment should be individualized to each patient. One of highly recommended vegetable for diabetes is asparagus (Asparagus officinalis L.), low calories common plant, growing in European countries. Objective: To propose the technology of unsweetened muesli production with addition of new components, we investigated the effects of selected vegetable addition on antioxidative capacity and consumer’s acceptance of muesli as representative of breakfast product. Methods: Muesli was formulated from a composition of oat flakes, flaxseed, bran, carrots, broccoli and asparagus. Basic composition of muesli was evaluated as content of protein, lipids, fatty acid composition, ash, selected minerals and caloricity. Antioxidant capacity of muesli was evaluated with use radical scavenging methods (DPPH, ABTS), ORAC value and PCL - photochemiluminescence antiradical potential. Proposed muesli as new product was also characterized with sensory analysis, which included color, scent, taste, consistency and overall acceptance of a product. Results: Results showed that addition of freeze-dried asparagus into muesli allowed to lower the fat content and caloricity of a product according to the base product. No significant loss in antioxidant potential was evaluated, also the sensory value of a product was not negative. Conclusion: Designed muesli would be an answer for obese people looking for healthy snack during the daytime. Results showed that product with asparagus addition would be accepted by the consumers and because of its antidiabetic potential could be a n important factor in prevention of diabetes or obesity. Financial support by the UE Project no PO IG 01.01.00.00-061/09

Keywords: muesli, vegetables, asparagus, antioxidant potential, lipids

Procedia PDF Downloads 295

Authors: Brady, Imelda Katherine, Da Cunha Fanego, Iria

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Today's university students are considered digital natives and the use of Information Technologies (ITs) forms a large part of their study and learning. In the context of language studies, applications that help with revisions of grammar or vocabulary are particularly useful, especially if they are open access. There are studies that show the effectiveness of this type of application in the learning of English as a foreign language and that using IT can help learners become more autonomous in foreign language acquisition, given that these applications can enhance awareness of the learning process; this means that learners are less dependent on the teacher for corrective feedback. We also propose that the exploitation of these technologies also enhances the work of the language instructor wishing to incorporate IT into his/her practice. In this context, the aim of this paper is to present the creation of a repository of tools that provide support in the writing and correction of texts in English and the assessment of their usefulness on behalf of university students enrolled in the English Studies Degree. The project seeks to encourage the development of autonomous learning through the acquisition of skills linked to the self-correction of written work in English. To comply with the above, our methodology follows five phases. First of all, a selection of the main open-access online applications available for the correction of written texts in English is made: AutoCrit, Hemingway, Grammarly, LanguageTool, OutWrite, PaperRater, ProWritingAid, Reverso, Slick Write, Spell Check Plus and Virtual Writing Tutor. Secondly, the functionalities of each of these tools (spelling, grammar, style correction, etc.) are analyzed. Thirdly, explanatory materials (texts and video tutorials) are prepared on each tool. Fourth, these materials are uploaded into a repository of our university in the form of an institutional blog, which is made available to students and the general public. Finally, a survey was designed to collect students’ feedback. The survey aimed to analyse the usefulness of the blog and the quality of the explanatory materials as well as the degree of usefulness that students assigned to each of the tools offered. In this paper, we present the results of the analysis of data received from 33 students in the 1st semester of the 21-22 academic year. One result we highlight in our paper is that the students have rated this resource very highly, in addition to offering very valuable information on the perceived usefulness of the applications provided for them to review. Our work, carried out within the framework of a teaching innovation project funded by our university, emphasizes that teachers need to design methodological strategies that help their students improve the quality of their productions written in English and, by extension, to improve their linguistic competence.

Keywords: academic blog, open access tools, online self-correction, written production in English, university learning

Procedia PDF Downloads 84

Authors: Abraham Ampong

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BACKGROUND AND SIGNIFICANCE OF THE STUDY: The development of information technology and its influence today is inevitable in the world of education. The development of information technology and communication (ICT) has an impact on the use of teaching aids such as computers and the Internet, for example, E-learning. E-learning is a learning process attained through electronic means. But learning is not merely technology because learning is essentially more about the process of interaction between teacher, student, and source study. The main purpose of the study is to investigate learners’ online learning experiences in a blended learning approach, evaluate how learners’ experience of an online learning environment affects the blended learning approach and examine the future of online learning in a blended learning environment. Blended learning pedagogies have been recognized as a path to improve teacher’s instructional strategies for teaching using technology. Blended learning is perceived to have many advantages for teachers and students, including any-time learning, anywhere access, self-paced learning, inquiry-led learning and collaborative learning; this helps institutions to create desired instructional skills such as critical thinking in the process of learning. Blended learning as an approach to learning has gained momentum because of its widespread integration into educational organizations. METHODOLOGY: Based on the research objectives and questions of the study, the study will make use of the qualitative research approach. The rationale behind the selection of this research approach is that participants are able to make sense of their situations and appreciate their construction of knowledge and understanding because the methods focus on how people understand and interpret their experiences. A case study research design is adopted to explore the situation under investigation. The target population for the study will consist of selected students from selected universities. A simple random sampling technique will be used to select the targeted population. The data collection instrument that will be adopted for this study will be questions that will serve as an interview guide. An interview guide is a set of questions that an interviewer asks when interviewing respondents. Responses from the in-depth interview will be transcribed into word and analyzed under themes. Ethical issues to be catered for in this study include the right to privacy, voluntary participation, and no harm to participants, and confidentiality. INDICATORS OF THE MAJOR FINDINGS: It is suitable for the study to find out that online learning encourages timely feedback from teachers or that online learning tools are okay to use without issues. Most of the communication with the teacher can be done through emails and text messages. It is again suitable for sampled respondents to prefer online learning because there are few or no distractions. Learners can have access to technology to do other activities to support their learning”. There are, again, enough and enhanced learning materials available online. CONCLUSION: Unlike the previous research works focusing on the strengths and weaknesses of blended learning, the present study aims at the respective roles of its two modalities, as well as their interdependencies.

Keywords: online learning, blended learning, technologies, teaching methods

Procedia PDF Downloads 70

Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

Procedia PDF Downloads 89

Authors: Neeti Rustagi, Naveen Dutt, Arvind Sinha, Mahaveer S. Rhodha, Pankaja R. Raghav

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Background: Pre-hospital trauma care services are in developing stage in fast-urbanizing cities of India including Jodhpur. Training of health professionals in providing necessary pre-hospital trauma care is an essential step in decreasing accident related morbidity and mortality. The current study explores the response of a medical graduate toward helping an accident victim in a pre-hospital setting before patient can be transferred to definitive trauma facility. Methodology: This study examines the perceived competence in predicting response to an accident victim by medical graduates in Jodhpur, Rajasthan. Participants completed measures of attitude, normative influence and perceived behavior control toward providing pre-hospital care to an accident victim. Likert scale was used to measure the participant responses. Preliminary and descriptive analysis were used using SPSS 21.0. Internal consistency of the responses received was measured using Cronbach’s alpha. Results: Almost all medical graduates agreed that road accidents are common in their area (male: 92%; female: 78%). More male medical graduates (28%) reported helping an accident victim as compared to female physicians (9%) in the previous three months. Majority of study participants (96%) reported that providing immediate care to an accident victim is essential to save the life of an individual. Experience of helping an accident victim was considered unpleasant by the majority of female participants (70%) as compared to male participants (36%). A large number of participants believed that their friends (80%) and colleagues (96%) would appreciate them helping an accident victim in a pre-hospital setting. A large number of participants also believed that they possess the necessary skills and competencies (80%) towards helping a roadside accident victim in the pre-hospital care environment. Perceived competence of helping a roadside accident victim until they are transferred to a health facility was reported by less than half of the participants (male: 56%; female: 43%). Conclusion: Medical graduates have necessary attitude, competencies, and intention of helping a roadside accident victim. The societal response towards helping a road side accident victim is also supportive. In spite of positive determinants, a large proportion of medical graduates have perceived lack of competence in helping a roadside accident victim. This is essential to explore further as providing pre-hospital care to a roadside accident victim is an essential step in establishing the continuum of care to an accident victim especially in countries where pre-hospital services are in developing phase.

Keywords: prehospital care, perceived behavior, perceived competence, medical graduates

Procedia PDF Downloads 117

Authors: Jana Andzane, Gunta Kunakova, Margarita Baitimirova, Mikelis Marnauza, Floriana Lombardi, Donats Erts

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Bismuth selenide (Bi₂Se₃) is known as a narrow band gap semiconductor with pronounced thermoelectric (TE) and topological insulator (TI) properties. Unique TI properties offer exciting possibilities for fundamental research as observing the exciton condensate and Majorana fermions, as well as practical application in spintronic and quantum information. In turn, TE properties of this material can be applied for wide range of thermoelectric applications, as well as for broadband photodetectors and near-infrared sensors. Nanostructuring of this material results in improvement of TI properties due to suppression of the bulk conductivity, and enhancement of TE properties because of increased phonon scattering at the nanoscale grains and interfaces. Regarding TE properties, crystallographic growth direction, as well as orientation of the nanostructures relative to the growth substrate, play significant role in improvement of TE performance of nanostructured material. For instance, Bi₂Se₃ layers consisting of randomly oriented nanostructures and/or of combination of them with planar nanostructures show significantly enhanced in comparison with bulk and only planar Bi₂Se₃ nanostructures TE properties. In this work, a catalyst-free vapour-solid deposition technique was applied for controlled obtaining of different types of Bi₂Se₃ nanostructures and continuous nanostructured layers for targeted applications. For example, separated Bi₂Se₃ nanoplates, nanobelts and nanowires can be used for investigations of TI properties; consisting from merged planar and/or randomly oriented nanostructures Bi₂Se₃ layers are useful for applications in heat-to-power conversion devices and infrared detectors. The vapour-solid deposition was carried out using quartz tube furnace (MTI Corp), equipped with an inert gas supply and pressure/temperature control system. Bi₂Se₃ nanostructures/nanostructured layers of desired type were obtained by adjustment of synthesis parameters (process temperature, deposition time, pressure, carrier gas flow) and selection of deposition substrate (glass, quartz, mica, indium-tin-oxide, graphene and carbon nanotubes). Morphology, structure and composition of obtained Bi₂Se₃ nanostructures and nanostructured layers were inspected using SEM, AFM, EDX and HRTEM techniques, as well as home-build experimental setup for thermoelectric measurements. It was found that introducing of temporary carrier gas flow into the process tube during the synthesis and deposition substrate choice significantly influence nanostructures formation mechanism. Electrical, thermoelectric, and topological insulator properties of different types of deposited Bi₂Se₃ nanostructures and nanostructured coatings are characterized as a function of thickness and discussed.

Keywords: bismuth seleinde, nanostructures, topological insulator, vapour-solid deposition

Procedia PDF Downloads 215

Authors: Liane J. Ioannou, Jonathan Serpell, Joanne Dean, Cino Bendinelli, Jenny Gough, Dean Lisewski, Julie Miller, Win Meyer-Rochow, Stan Sidhu, Duncan Topliss, David Walters, John Zalcberg, Susannah Ahern

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Background: The occurrence of thyroid cancer is increasing throughout the developed world, including Australia and New Zealand, and since the 1990s has become the fastest increasing malignancy. Following the success of a number of institutional databases that monitor outcomes after thyroid surgery, the Australian and New Zealand Endocrine Surgeons (ANZES) agreed to auspice the development of a bi-national thyroid cancer registry. Objectives: To establish a bi-national population-based clinical quality registry with the aim of monitoring and improving the quality of care provided to patients diagnosed with thyroid cancer in Australia and New Zealand. Patients and Methods: The Australian and New Zealand Thyroid Cancer Registry (ANZTCR) captures clinical data for all patients, over the age of 18 years, diagnosed with thyroid cancer, confirmed by histopathology report, that have been diagnosed, assessed or treated at a contributing hospital. Data is collected by endocrine surgeons using a web-based interface, REDCap, primarily via direct data entry. Results: A multi-disciplinary Steering Committee was formed, and with operational support from Monash University the ANZTCR was established in early 2017. The pilot phase of the registry is currently operating in Victoria, New South Wales, Queensland, Western Australia and South Australia, with over 30 sites expected to come on board across Australia and New Zealand in 2018. A modified-Delphi process was undertaken to determine the key quality indicators to be reported by the registry, and a minimum dataset was developed comprising information regarding thyroid cancer diagnosis, pathology, surgery, and 30-day follow up. Conclusion: There are very few established thyroid cancer registries internationally, yet clinical quality registries have shown valuable outcomes and patient benefits in other cancers. The establishment of the ANZTCR provides the opportunity for Australia and New Zealand to further understand the current practice in the treatment of thyroid cancer and reasons for variation in outcomes. The engagement of endocrine surgeons in supporting this initiative is crucial. While the pilot registry has a focus on early clinical outcomes, it is anticipated that future collection of longer-term outcome data particularly for patients with the poor prognostic disease will add significant further value to the registry.

Keywords: thyroid cancer, clinical registry, population health, quality improvement

Procedia PDF Downloads 176

Authors: Benito Minjarez, Jesse Haramati, Yury Rodriguez-Yanez, Florencio Recendiz-Hurtado, Juan-Pedro Luna-Arias, Salvador Mena-Munguia

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During the last decades, the world has experienced a rapid industrialization and an expanding economy favoring a demographic boom. As a consequence, countries around the world have focused on developing new strategies related to the production of different farm products in order to meet future demands. Consequently, different strategies have been developed seeking to improve the major food products for both humans and livestock. Corn, after wheat and rice, is the third most important crop globally and is the primary food source for both humans and livestock in many regions around the globe. In addition, maize (Zea mays) is an important source of protein accounting for up to 60% of the daily human protein supply. Generally, many of the cereal grains have proteins with relatively low nutritional value, when they are compared with proteins from meat. In the case of corn, much of the protein is found in the endosperm (75 to 85%) and is deficient in two essential amino acids, lysine, and tryptophan. This deficiency results in an imbalance of amino acids and low protein content; normal maize varieties have less than half of the recommended amino acids for human nutrition. In addition, studies have shown that this deficiency has been associated with symptoms of growth impairment, anemia, hypoproteinemia, and fatty liver. Due to the fact that most of the presently available maize varieties do not contain the quality and quantity of proteins necessary for a balanced diet, different countries have focused on the research of quality protein maize (QPM). Researchers have characterized QPM noting that these varieties may contain between 70 to 100% more residues of the amino acids essential for animal and human nutrition, lysine, and tryptophan, than common corn. Several countries in Africa, Latin America, as well as China, have incorporated QPM in their agricultural development plan. Large parts of these countries have chosen a specific QPM variety based on their local needs and climate. Reviews have described the breeding methods of maize and have revealed the lack of studies on genetic and proteomic diversity of proteins in QPM varieties, and their genetic relationships with normal maize varieties. Therefore, molecular marker identification using tools such as mass spectrometry may accelerate the selection of plants that carry the desired proteins with high lysine and tryptophan concentration. To date, QPM maize lines have played a very important role in alleviating the malnutrition, and better characterization of these lines would provide a valuable nutritional enhancement for use in the resource-poor regions of the world. Thus, the objectives of this study were to identify proteins in QPM maize in comparison with a common maize line as a control.

Keywords: corn, mass spectrometry, QPM, tryptophan

Procedia PDF Downloads 268

Authors: Onesmus Nyaude

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The aim of the study was to investigate participants’ views on how corruption can be combated to enhance learner academic achievement. The study was undertaken on three select public secondary institutions in Zimbabwe. This study also focuses on exploring the various views of educators; parents and the learners on the role played by corruption in perpetuating the seemingly existing learner academic achievement disparities in various educational institutions. The study further interrogates and examines the nexus between the prevalence of corruption in schools and the subsequent influence on the academic achievement of learners. Corruption is considered a form of social injustice; hence in Zimbabwe, the general consensus is that it is perceived rife to the extent that it is overtaking the traditional factors that contributed to the poor academic achievement of learners. Coupled to this, have been the issue of gross abuse of power and some malpractices emanating from concealment of essential and official transactions in the conduct of business. Through proposing robust anti-corruption mechanisms, teaching and learning resources poured in schools would be put into good use. This would prevent the unlawful diversion and misappropriation of the resources in question which has always been the culture. This study is of paramount significance to curriculum planners, teachers, parents, and learners. The study was informed by the interpretive paradigm; thus qualitative research approaches were used. Both probability and non-probability sampling techniques were adopted in ‘site and participants’ selection. A representative sample of (150) participants was used. The study found that the majority of the participants perceived corruption as a social problem and a human right threat affecting the quality of teaching and learning processes in the education sector. It was established that corruption prevalence within institutions is as a result of the perpetual weakening of ethical values and other variables linked to upholding of ‘Ubuntu’ among general citizenry. It was further established that greediness and weak systems are major causes of rampant corruption within institutions of higher learning and are manifesting through abuse of power, bribery, misappropriation and embezzlement of material and financial resources. Therefore, there is great need to collectively address the problem of corruption in educational institutions and society at large. The study additionally concludes that successful combating of corruption will promote successful moral development of students as well as safeguarding their human rights entitlements. The study recommends the adoption of principles of good corporate governance within educational institutions in order to successfully curb corruption. The study further recommends the intensification of interventionist strategies and strengthening of systems in educational institutions as well as regular audits to overcome the problem associated with rampant corruption cases.

Keywords: academic achievement, combating, corruption, good corporate governance, qualitative study

Procedia PDF Downloads 221

Authors: Samantha Meyerholz

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MSKCC offers patients cutting edge cancer care with the highest quality standards. However, many patients and industry members do not realize that the operations of the Immunology Histology Lab (IHC) are the backbone for carrying out this mission. The IHC lab manufactures blocks and slides containing critical tissue samples that will be read by a Pathologist to diagnose and dictate a patient’s treatment course. The lab processes 200 requests daily, leading to the generation of approximately 2,000 slides and 1,100 blocks each day. Lab material is transported through labeling, cutting, staining and sorting manufacturing stations, while being managed by multiple techs throughout the space. The quality of the stain as well as wait times associated with processing requests, is directly associated with patients receiving rapid treatments and having a wider range of care options. This project aims to improve slide request turnaround time for rush and non-rush cases, while increasing the quality of each request filled (no missing slides or poorly stained items). Rush cases are to be filled in less than 24 hours, while standard cases are allotted a 48 hour time period. Reducing turnaround times enable patients to communicate sooner with their clinical team regarding their diagnosis, ultimately leading faster treatments and potentially better outcomes. Additional project goals included streamlining tech and material workflow, while reducing waste and increasing efficiency. This project followed a DMAIC structure with emphasis on lean and ergonomic principles that could be integrated into an evolving lab culture. Load times and batching processes were analyzed using process mapping, FMEA analysis, waste analysis, engineering observation, 5S and spaghetti diagramming. Reduction of lab technician movement as well as their body position at each workstation was of top concern to pathology leadership. With new equipment being brought into the lab to carry out workflow improvements, screen and tool placement was discussed with the techs in focus groups, to reduce variation and increase comfort throughout the workspace. 5S analysis was completed in two phases in the IHC lab, helping to drive solutions that reduced rework and tech motion. The IHC lab plans to continue utilizing these techniques to further reduce the time gap between tissue analysis and cancer care.

Keywords: engineering, ergonomics, healthcare, lean

Procedia PDF Downloads 212

Authors: Anis Al-Yakhiri

Abstract:

Introduction: The World Health Organization (WHO) classifies malignant epithelial thyroid tumors into four major groups (papillary, follicular, medullar and undifferentiated) . Papillary thyroid carcinoma (PTC) is the most common type, for about eight out of ten thyroid cancers belong to this histological type. Radioactive iodine (RAI) is considered effective for patients with total or nearly total thyroidectomy, but the beneficial effects of RAI are still controversial. War conditions forced us to study alternative methods of using radioactive iodine in the treatment of patients with PTC. Material and methods: Between January 2014 and June 2021, in Al-Yakhiri hospital, 57 Total Thyroidectomy with Radical BilateralNeckDissection (RBND) were performed, 50 for malignant disease,7 for false positive cytology.RBND involves surgical clearance of Levels II-VI. Mean age was 40.7 years old and 92% of the patients were female. 7(14%) patients had hypothyroidism which required preoperative thyroid hormone treatment. The Thyroid Stimulating Hormone- Suppression Therapy (TSH-ST) immediately started after RBND for mostpatients on the first day. It consisted in reducing the level of TSH< 0.1 mIU/L. Results: The Apron flap was used on most operations (40)80% and with lateral extensions had 10(20%). RBND involves surgical clearance of Levels II-VI performed in all operated patients, besides that, 4(8%) of them had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV) withclearance of Levels IB. The PTC was the most common 80.9% (38 patients from 47)by histopathological report. and 4(8%) patients of 50 had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV). The postoperative mortality rate not observed (0%). The postoperative morbidity rate was 22.8% (n =13).Seroma(8.7%),Hypocalcimia(7%), Wound infection(5.3%), Bleeding(1.8%). To suppress TSH and growth of any residual thyroid theTSH-ST (levothyroxine150 – 600mcg)was performed in all patients 57(100%) on the first day afterRBND. We tracked the results of treatment for two years in 30 patients with PTC, only 3 of them received radioactive iodine abroad. Biennial Recurrence rate for PTC appeared in one woman (2%), who had RAI postoperatively in the form of neck lymph nodes metastasis. Conclusion: For patients with PTC, thyroidectomy plus prophylacticRBND is a safe and efficient procedure and it results in lower recurrence rate. Postoperative treatment with exogenous thyroid hormone in doses sufficient to suppress TSH (not less than 150mcg), decreases incidence of recurrence. Total Thyroidectomy with RBND followed by TSH-ST, in our opinion, applicable optimal treatment scheme care for this patient population.

Keywords: thyroid cancer, Yemen war, absence of radioactive iodine, neck dissection, surgery results

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Authors: Rahul Patel, S. P. Dave, M. V Shah

Abstract:

Ahmedabad is a rapidly growing city in western India that is experiencing significant urbanization and industrialization. With projections indicating that it will become a metropolitan city in the near future, various construction activities are taking place, making soil testing a crucial requirement before construction can commence. To achieve this, construction companies and contractors need to periodically conduct soil testing. This study focuses on the process of creating a spatial database that is digitally formatted and integrated with geotechnical data and a Geographic Information System (GIS). Building a comprehensive geotechnical Geo-database involves three essential steps. Firstly, borehole data is collected from reputable sources. Secondly, the accuracy and redundancy of the data are verified. Finally, the geotechnical information is standardized and organized for integration into the database. Once the Geo-database is complete, it is integrated with GIS. This integration allows users to visualize, analyze, and interpret geotechnical information spatially. Using a Topographic to Raster interpolation process in GIS, estimated values are assigned to all locations based on sampled geotechnical data values. The study area was contoured for SPT N-Values, Soil Classification, Φ-Values, and Bearing Capacity (T/m2). Various interpolation techniques were cross-validated to ensure information accuracy. The GIS map generated by this study enables the calculation of SPT N-Values, Φ-Values, and bearing capacities for different footing widths and various depths. This approach highlights the potential of GIS in providing an efficient solution to complex phenomena that would otherwise be tedious to achieve through other means. Not only does GIS offer greater accuracy, but it also generates valuable information that can be used as input for correlation analysis. Furthermore, this system serves as a decision support tool for geotechnical engineers. The information generated by this study can be utilized by engineers to make informed decisions during construction activities. For instance, they can use the data to optimize foundation designs and improve site selection. In conclusion, the rapid growth experienced by Ahmedabad requires extensive construction activities, necessitating soil testing. This study focused on the process of creating a comprehensive geotechnical database integrated with GIS. The database was developed by collecting borehole data from reputable sources, verifying its accuracy and redundancy, and organizing the information for integration. The GIS map generated by this study is an efficient solution that offers greater accuracy and generates valuable information that can be used as input for correlation analysis. It also serves as a decision support tool for geotechnical engineers, allowing them to make informed decisions during construction activities.

Keywords: arcGIS, borehole data, geographic information system (GIS), geo-database, interpolation, SPT N-value, soil classification, φ-value, bearing capacity

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Authors: Deepti Kumari, Upamanyu Hore

Abstract:

Cities are an example of a human-modified environment with few fragments of urban green spaces, which are widely considered for urban biodiversity. The study aims to address the avifaunal diversity in urban parks based on the park size and their urbanization intensity. Also, understanding the key factors affecting species composition and structure as birds are a good indicator of a healthy ecosystem, and they are sensitive to changes in the environment. A 50 m-long line-transect method is used to survey birds in 39 urban parks in Delhi, India. Habitat variables, including vegetation (percentage of non-native trees, percentage of native trees, top canopy cover, sub-canopy cover, diameter at breast height, ground vegetation cover, shrub height) were measured using the quadrat method along the transect, and disturbance variables (distance from water, distance from road, distance from settlement, park area, visitor rate, and urbanization intensity) were measured using ArcGIS and google earth. We analyzed species data for diversity and richness. We explored the relation of species diversity and richness to habitat variables using the multi-model inference approach. Diversity and richness are found significant in different park sizes and their urbanization intensity. Medium size park supports more diversity, whereas large size park has more richness. However, diversity and richness both declined with increasing urbanization intensity. The result of CCA revealed that species composition in urban parks was positively associated with tree diameter at breast height and distance from the settlement. On the model selection approach, disturbance variables, especially distance from road, urbanization intensity, and visitors are the best predictors for the species richness of birds in urban parks. In comparison, multiple regression analysis between habitat variables and bird diversity suggested that native tree species in the park may explain the diversity pattern of birds in urban parks. Feeding guilds such as insectivores, omnivores, carnivores, granivores, and frugivores showed a significant relation with vegetation variables, while carnivores and scavenger bird species mainly responded with disturbance variables. The study highlights the importance of park size in urban areas and their urbanization intensity. It also indicates that distance from the settlement, distance from the road, urbanization intensity, visitors, diameter at breast height, and native tree species can be important determining factors for bird richness and diversity in urban parks. The study also concludes that the response of feeding guilds to vegetation and disturbance in urban parks varies. Therefore, we recommend that park size and surrounding urban matrix should be considered in order to increase bird diversity and richness in urban areas for designing and planning.

Keywords: diversity, feeding guild, urban park, urbanization intensity

Procedia PDF Downloads 87