Search results for: exponentially moving average (EWMA)
996 The Effectiveness of Probiotics in the Treatment of Minimal Hepatic Encephalopathy Among Patients with Cirrhosis: An Expanded Meta-Analysis
Authors: Erwin Geroleo, Higinio Mappala
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Introduction Overt Hepatic Encephalopathy (OHE) is the most dreaded outcome of liver cirrhosis. Aside from the triggering factors which are already known to precipitate OHE, there is growing evidence that an altered gut microbiota profile (dysbiosis) can also trigger OHE. MHE is the mildest form of hepatic encephalopathy(HE), affecting about one-third of patients with cirrhosis, and close 80% of patients with cirrhosis and manifests as abnormalities in central nervous system function. Since these symptoms are subclinical most patients are not being treated to prevent OHE. The gut microbiota have been evaluated by several studies as a therapeutic option for MHE, especially in decreasing the levels of ammonia, thus preventing progression to OHE Objectives This study aims to evaluate the efficacy of probiotics in terms of reduction of ammonia levels in patient with minimal hepatic encephalopathies and to determine if Probiotics has role in the prevention of progression to overt hepatic encephalopathy in adult patients with minimal hepatic encephalopathy (MHE) Methods and Analysis The literature search strategy was restricted to human studies in adults subjects from 2004 to 2022. The Jadad Score Calculation was utilized in the assessment of the final studies included in this study. Eight (8) studies were included. Cochrane’s Revman Web, the Fixed Effects model and the Ztest were all used in the overall analysis of the outcomes. A p value of less than 0.0005 was statistically significant. Results. These results show that Probiotics significantly lowers the level of Ammonia in Cirrhotic patients with OHE. It also shows that the use of Probiotics significantly prevents the progression of MHE to OHE. The overall risk of bias graph indicates low risk of publication bias among the studies included in the meta-analysis. Main findings This research found that plasma ammonia concentration was lower among participants treated with probiotics (p<0.00001).) Ammonia level of the probiotics group is lower by 13.96 μmol/ on the average. Overall risk of developing overt hepatic encephalopathy in the probiotics group is shown to be decreased by 15% as compared to the placebo group Conclusion The analysis showed that compared with placebo, probiotics can decrease serum ammonia, may improve MHE and may prevent OHE.Keywords: minimal hepatic encephalopathy, probiotics, liver cirrhosis, overt hepatic encephalopathy
Procedia PDF Downloads 47995 Description of Reported Foodborne Diseases in Selected Communities within the Greater Accra Region-Ghana: Epidemiological Review of Surveillance Data
Authors: Benjamin Osei-Tutu, Henrietta Awewole Kolson
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Background: Acute gastroenteritis is one of the frequently reported Out-Patient Department (OPD) cases. However, the causative pathogens of these cases are rarely identified at the OPD due to delay in laboratory results or failure to obtain specimens before antibiotics is administered. Method: A retrospective review of surveillance data from the Adentan Municipality, Accra, Ghana that were recorded in the National foodborne disease surveillance system of Ghana, was conducted with the main aim of describing the epidemiology and food practice of cases reported from the Adentan Municipality. The study involved a retrospective review of surveillance data kept on patients who visited health facilities that are involved in foodborne disease surveillance in Ghana, from January 2015 to December 2016. Results: A total of 375 cases were reviewed and these were classified as viral hepatitis (hepatitis A and E), cholera (Vibrio cholerae), dysentery (Shigella sp.), typhoid fever (Salmonella sp.) or gastroenteritis. Cases recorded were all suspected case and the average cases recorded per week was 3. Typhoid fever and dysentery were the two main clinically diagnosed foodborne illnesses. The highest number of cases were observed during the late dry season (Feb to April), which marks the end of the dry season and the beginning of the rainy season. Relatively high number of cases was also observed during the late wet seasons (Jul to Oct) when the rainfall is the heaviest. Home-made food and street vended food were the major sources of suspected etiological food, recording 49.01% and 34.87% of the cases respectively. Conclusion: Majority of cases recorded were classified as gastroenteritis due to the absence of laboratory confirmation. Few cases were classified as typhoid fever and dysentery based on clinical symptoms presented. Patients reporting with foodborne diseases were found to consume home meal and street vended foods as their predominant source of food.Keywords: accra, etiologic food, food poisoning, gastroenteritis, illness, surveillance
Procedia PDF Downloads 219994 Improving the Weekend Handover in General Surgery: A Quality Improvement Project
Authors: Michael Ward, Eliana Kalakouti, Andrew Alabi
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Aim: The handover process is recognized as a vulnerable step in the patient care pathway where errors are likely to occur. As such, it is a major preventable cause of patient harm due to human factors of poor communication and systematic error. The aim of this study was to audit the general surgery department’s weekend handover process compared to the recommended criteria for safe handover as set out by the Royal College of Surgeons (RCS). Method: A retrospective audit of the General Surgery department’s Friday patient lists and patient medical notes used for weekend handover in a London-based District General Hospital (DGH). Medical notes were analyzed against RCS's suggested criteria for handover. A standardized paper weekend handover proforma was then developed in accordance with guidelines and circulated in the department. A post-intervention audit was then conducted using the same methods for cycle 1. For cycle 2, we introduced an electronic weekend handover tool along with Electronic Patient Records (EPR). After a one-month period, a second post-intervention audit was conducted. Results: Following cycle 1, the paper weekend handover proforma was only used in 23% of patient notes. However, when it was used, 100% of them had a plan for the weekend, diagnosis and location but only 40% documented potential discharge status and 40% ceiling of care status. Qualitative feedback was that it was time-consuming to fill out. Better results were achieved following cycle 2, with 100% of patient notes having the electronic proforma. Results improved with every patient having documented ceiling of care, discharge status and location. Only 55% of patients had a past surgical history; however, this was still an increase when compared to paper proforma (45%). When comparing electronic versus paper proforma, there was an increase in documentation in every domain of the handover outlined by RCS with an average relative increase of 1.72 times (p<0.05). Qualitative feedback was that the autofill function made it easy to use and simple to view. Conclusion: These results demonstrate that the implementation of an electronic autofill handover proforma significantly improved handover compliance with RCS guidelines, thereby improving the transmission of information from week-day to weekend teams.Keywords: surgery, handover, proforma, electronic handover, weekend, general surgery
Procedia PDF Downloads 159993 Restoring Total Form and Function in Patients with Lower Limb Bony Defects Utilizing Patient-Specific Fused Deposition Modelling- A Neoteric Multidisciplinary Reconstructive Approach
Authors: Divya SY. Ang, Mark B. Tan, Nicholas EM. Yeo, Siti RB. Sudirman, Khong Yik Chew
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Introduction: The importance of the amalgamation of technological and engineering advances with surgical principles of reconstruction cannot be overemphasized. With earlier detection of cancer, consequences of high-speed living and neglect, like traumatic injuries and infection, resulting in increasingly younger patients with bone defects. This may result in malformations and suboptimal function that is more noticeable and palpable in the younger, active demographic. Our team proposes a technique that encapsulates a mesh of multidisciplinary effort, tissue engineering and reconstructive principles. Methods/Materials: Our patient was a young competitive footballer in his early 30s who was diagnosed with submandibular adenoid cystic carcinoma with bony involvement. He was thus counselled for a right hemi mandibulectomy, the floor of mouth resection, right selective neck dissection, tracheostomy, and free fibular flap reconstruction of his mandible and required post-operative radiotherapy. Being young and in his prime sportsman years, he was unable to accept the morbidities associated with using his fibula to reconstruct his mandible despite it being the gold standard reconstructive option. The fibula is an ideal vascularized bone flap because it’s reliable and easily shaped with relatively minimal impact on functional outcomes. The fibula contributes to 30% of weightbearing and is the attachment for the lateral compartment muscles; it is stronger in footballers concerning lateral bending. When harvesting the fibula, the distal 6-8cm and up to 10% of the total length is preserved to maintain the ankle’s stability, thus, minimizing the impact on daily activities. There are studies that have noted gait variability post-operatively. Therefore, returning to a premorbid competitive level may be doubtful. To improve his functional outcomes, the decision was made to try and restore the fibula's form and function. Using the concept of Fused Deposition Modelling (FDM), our team comprising of Plastics, Otolaryngology, Orthopedics and Radiology, worked with Osteopore to design a 3D bioresorbable implant to regenerate the fibula defect (14.5cm). Bone marrow was harvested via reaming the contralateral hip prior to the wide resection. 30mls of his blood was obtained for extracting platelet rich plasma. These were packed into the Osteopore 3D-printed bone scaffold. This was then secured into the fibula defect with titanium plates and screws. The flexor hallucis longus and soleus were anchored along the construct and intraosseous membrane, done in a single setting. Results: He was reviewed closely as an outpatient over 10 months post operatively. He reported no discernable loss or difference in ankle function. He is satisfied and back in training and our team has video and photographs that substantiate his progress. Conclusion: FDM allows regeneration of long bone defects. However, we aimed to also restore his eversion and inversion that is imperative for footballers and hence reattached his previously dissected muscles along the length of the Osteopore implant. We believe that the reattachment of the muscle stabilizes not only the construct but allows optimum muscle tensioning when moving his ankle. This is a simple but effective technique in restoring complete function and form in a young patient whose minute muscle control is imperative to life.Keywords: fused deposition modelling, functional reconstruction, lower limb bony defects, regenerative surgery, 3D printing, tissue engineering
Procedia PDF Downloads 73992 Sexual Dimorphism in the Sensorial Structures of the Antenna of Thygater aethiops (Hymenoptera: Apidae) and Its Relation with Some Corporal Parameters
Authors: Wendy Carolina Gomez Ramirez, Rodulfo Ospina Torres
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Thygater aethiops is a species of solitary bee with a neotropical distribution that has been adapted to live in urban environments. This species of bee presents a marked sexual dimorphism since the males have antenna almost as long as their body different from the females that present antenna with smaller size. In this work, placoid sensilla were studied, which are structures that appear in the antenna and are involved in the detection of substances both, for reproduction and for the search of food. The aim of this study was to evaluate the differences between these sensory structures in the different sexes, for which males and females were captured. Later some body measures were taken such as fresh weight with abdomen and without it, since the weight could be modified by the stomach content; other measures were taken as the total antenna length and length of the flagellum and flagelomere. After negative imprints of the antenna were made using nail polish, the imprint was cut with a microblade and mounted onto a microscope slide. The placoid sensilla were visible on the imprint, so they were counted manually on the 100x objective lens of the optical microscope. Initially, the males presented a specific distribution pattern in two types of sensilla: trichoid and placoid, the trichoid were found aligned in the dorsal face of the antenna and the placoid were distributed along the entire antenna; that was different to the females since they did not present a distribution pattern the sensilla were randomly organized. It was obtained that the males, because they have a longer antenna, have a greater number of sensilla in relation to the females. Additionally, it was found that there was no relationship between the weight and the number of sensilla, but there was a positive relationship between the length of the antenna, the length of the flagellum and the number of sensilla. The relationship between the number of sensilla per unit area in each of the sexes was also calculated, which showed that, on average, males have 4.2 ± 0.38 sensilla per unit area and females present 2.2 ± 0.20 and likewise a significant difference between sexes. This dimorphism found may be related to the sexual behavior of the species, since it has been demonstrated that males are more adapted to the perception of substances related to reproduction than to the search of food.Keywords: antenna, olfactory organ, sensilla, sexual dimorphism, solitary bees
Procedia PDF Downloads 164991 Food Waste and Sustainable Management
Authors: Farhana Nosheen, Moeez Ahmad
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Throughout the food chain, the food waste from initial agricultural production to final household consumption has become a serious concern for global sustainability because of its adverse impacts on food security, natural resources, the environment, and human health. About a third of tomatoes (Lycopersicon esculentum L.) delivered to processing plants end as processing waste. The amount of such waste material is estimated to have increased with the emergence of mechanical harvesting. Experiments were made to determine the nutritional profile and antioxidant activity of tomato processing waste and to explore the bioactive compound in tomato waste, i.e., Lycopene. Tomato Variety of ‘SAHARA F1’ was used to make tomato waste. The tomatoes were properly cleaned, and then unwanted impurities were removed properly. The tomatoes were blanched at 90 ℃ for 5 minutes. After which, the skin of the tomatoes was removed, and the remaining part passed through the electric pulper. The pulp and seeds were collected separately. The seeds and skin of tomatoes were mixed and saved in a sterilized jar. The samples of tomato waste were found to contain 89.11±0.006 g/100g moisture, 10.13±0.115 g/100g protein, 2.066±0.57 g/100g fat, 4.81±0.10 g/100g crude fiber, and 4.06±0.057 g/100g ash and NFE 78.92±0.066 g/100g. The results confirmed that tomato waste contains a considerable amount of Lycopene 51.0667±0.00577 mg/100g and exhibited good antioxidant properties. Total phenolics showed average contents of 122.9600±0.01000 mg GAE/100g, of which flavonoids accounted for 41.5367±0.00577 mg QE/100g. Antioxidant activity of tomato processing waste was found 0.6833±0.00577 mmol Trolox/100g. Unsaturated fatty acids represent the major portion of total fatty acids, Linoleic acid being the major one. The mineral content of tomato waste showed a good amount of potassium 3030.1767 mg/100g and calcium 131.80 mg/100g, respectively were present in it. These findings suggest that tomato processing waste is rich in nutrients, antioxidants, fatty acids, and minerals. I recommend that this waste should be sun-dried to be used in the combination of feed of the animals. It can also be used in making some other products like lycopene tea or several other health-beneficial products.Keywords: food waste, tomato, bioactive compound, sustainable management
Procedia PDF Downloads 109990 The Concentration of Selected Cosmogenic and Anthropogenic Radionuclides in the Ground Layer of the Atmosphere (Polar and Mid-Latitudes Regions)
Authors: A. Burakowska, M. Piotrowski, M. Kubicki, H. Trzaskowska, R. Sosnowiec, B. Myslek-Laurikainen
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The most important source of atmospheric radioactivity are radionuclides generated as a result of the impact of primary and secondary cosmic radiation, with the nuclei of nitrogen oxygen and carbon in the upper troposphere and lower stratosphere. This creates about thirty radioisotopes of more than twenty elements. For organisms, the four of them are most important: ³H, ⁷Be, ²²Na, ¹⁴C. The natural radionuclides, which are present in Earth crust, also settle on dust and particles of water vapor. By this means, the derivatives of uranium and thorium, and long-life 40K get into the air. ¹³⁷Cs is the most widespread isotope, that is implemented by humans into the environment. To determine the concentration of radionuclides in the atmosphere, high volume air samplers were used, where the aerosol collection took place on a special filter fabric (Petrianov filter tissue FPP-15-1.5). In 2002 the high volume air sampler AZA-1000 was installed at the Polish Polar Observatory of the Polish Academy of Science in Hornsund, Spitsbergen (77°00’N, 15°33’E), designed to operate in all weather conditions of the cold polar region. Since 1991 (with short breaks) the ASS-500 air sampler has been working, which is located in Swider at the Kalinowski Geophysical Observatory of Geophysics Institute of the Polish Academy of Science (52°07’N, 21°15’E). The following results of radionuclides concentrations were obtained from both stations using gamma spectroscopy analysis: ⁷Be, ¹³⁷Cs, ¹³⁴Cs, ²¹⁰Pb, ⁴⁰K. For gamma spectroscopy analysis HPGe (High Purity Germanium) detector were used. These data were compared with each other. The preliminary results gave evidence that radioactivity measured in aerosols is not proportional to the amount of dust for both studied regions. Furthermore, the results indicate annual variability (seasonal fluctuations) as well as a decrease in the average activity of ⁷Be with increasing latitude. The content of ⁷Be in surface air also indicates the relationship with solar activity cycles.Keywords: aerosols, air filters, atmospheric beryllium, environmental radionuclides, gamma spectroscopy, mid-latitude regions radionuclides, polar regions radionuclides, solar cycles
Procedia PDF Downloads 141989 The Communicational Behaviors of the Nurses Towards 'Crying Patient'
Authors: Hacer Kobya Bulut, Kıymet Yeşilçiçek Çalık, Birsel Canan Demirbağ, Hacer Erdöl, Songül Aktaş
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Introduction: As an expression of an emotion which always exists in life, crying is regarded as one of the problematic behaviors of patients by nurses. Towards such patients, nurses may exhibit emotional and behavioral reactions such as feeling helpless, anger, indifferent, defense, and opposition. However crying either meets a need, reduces the tension to cope with problems or helps patient to gain strength. Therefore, nurses must accept that crying is a normal mechanism that reduces emotional tension and should approach a crying patient accordingly. Objective: This study was carried out to evaluate the communicational behaviors of the nurses towards ‘crying patient’. Methods: This descriptive study was conducted with the nurses working at a university hospital in a city in the Eastern Black Sea in June-September 2015. The entire universe was tried to be reached without sampling. 90% of the population was reached and the study was completed with 309 nurses who volunteered to participate in the study. Data were collected through a questionnaire which was prepared reviewing the literature by researchers. Data were evaluated in SPSS analysis program using percentages, numbers and chi-square test with the 95% confidence interval and p <0.05significance level. Findings: The findings showed that the average age of nurses was 31.52 ± 7.96, work experience was 10:09 ± 7.69 and only 22.7% had training about ‘approach to crying patient’ during their education. 97.1% of the nurses often faced with crying patients in their professional lives, 62.8% stated that they faced crying women patients. When they see crying patients, 84.8% of the nurses ‘do not want the patient to cry’, 80.9% wonder ‘why they are crying’, % 79.6 ‘feel uneasiness’,% 79.3 ‘feel sorry’ and 41.4% ‘ feel helpless’. The question ‘Why do you think the patient is crying?’ was answered by 93.5% nurses as ‘they are suffering’, by 86.1% ‘they are helpless’, 80.9% ‘they are sad’, 79.6% ‘they need help’, 54.4% ‘because they feel inadequate,’ and 44.7% ‘they fail to control their crying behavior. ‘How do you approach to your patient when she/he is crying?’ question was answered by 82.5% of nurses as ‘I would console’, 77.3% as ‘I would ask the reason’, 63.1% as ‘I would try to stop her from crying’ all of which are actually inappropriate nursing approaches. However, 92.2% of the nurses stated that ‘I do not judge the crying patient’, ‘87.1% said ‘I allocate time to crying patients’ and 85.8% said ‘ I ask patient whether they want to cry alone’. The study showed that educational background and work experience of the nurses affected the appropriate approach to crying patients (P <0.05). Conclusion: As a result of the study, it was found out that nurses do not want patients to cry, so they exhibit inappropriate approach such as consoling the patients and they have difficulty in approaching crying patients.Keywords: approach to patient, communication, crying patient, nurse, Turkey
Procedia PDF Downloads 205988 Identification of Candidate Congenital Heart Defects Biomarkers by Applying a Random Forest Approach on DNA Methylation Data
Authors: Kan Yu, Khui Hung Lee, Eben Afrifa-Yamoah, Jing Guo, Katrina Harrison, Jack Goldblatt, Nicholas Pachter, Jitian Xiao, Guicheng Brad Zhang
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Background and Significance of the Study: Congenital Heart Defects (CHDs) are the most common malformation at birth and one of the leading causes of infant death. Although the exact etiology remains a significant challenge, epigenetic modifications, such as DNA methylation, are thought to contribute to the pathogenesis of congenital heart defects. At present, no existing DNA methylation biomarkers are used for early detection of CHDs. The existing CHD diagnostic techniques are time-consuming and costly and can only be used to diagnose CHDs after an infant was born. The present study employed a machine learning technique to analyse genome-wide methylation data in children with and without CHDs with the aim to find methylation biomarkers for CHDs. Methods: The Illumina Human Methylation EPIC BeadChip was used to screen the genome‐wide DNA methylation profiles of 24 infants diagnosed with congenital heart defects and 24 healthy infants without congenital heart defects. Primary pre-processing was conducted by using RnBeads and limma packages. The methylation levels of top 600 genes with the lowest p-value were selected and further investigated by using a random forest approach. ROC curves were used to analyse the sensitivity and specificity of each biomarker in both training and test sample sets. The functionalities of selected genes with high sensitivity and specificity were then assessed in molecular processes. Major Findings of the Study: Three genes (MIR663, FGF3, and FAM64A) were identified from both training and validating data by random forests with an average sensitivity and specificity of 85% and 95%. GO analyses for the top 600 genes showed that these putative differentially methylated genes were primarily associated with regulation of lipid metabolic process, protein-containing complex localization, and Notch signalling pathway. The present findings highlight that aberrant DNA methylation may play a significant role in the pathogenesis of congenital heart defects.Keywords: biomarker, congenital heart defects, DNA methylation, random forest
Procedia PDF Downloads 158987 Management Practices and Economic Performance of Smallholder Dairy Cattle Farms in Southern Vietnam
Authors: Ngoc-Hieu Vu
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Although dairy production in Vietnam is a relatively new agricultural activity, milk production increased remarkably in recent years. Smallholders are still the main drivers for this development, especially in the southern part of the country. However, information on the farming practices is very limited. Therefore, this study aimed to characterize husbandry practices, educational experiences, decision-making practices, constraints, income and expenses of smallholder dairy farms in Southern Vietnam. A total of 200 farms, located in the regions Ho Chi Minh (HCM, N=80 farms), Lam Dong (N=40 farms), Binh Duong (N=40 farms) and Long An (N=40 farms) were included. Between October 2013 and December 2014 farmers were interviewed twice. On average, farms owned 3.200m2, 2.000m2, and 193m2 of pasture, cropping and housing area, respectively. The number of total, milking and dry cows, heifers, and calves were 20.4, 11.6, 4.7, 3.3, and 2.9 head. The number of lactating dairy cows was higher (p<0.001) in HCM (15.5) and Lam Dong (14.7) than in Binh Duong (6.7) and Long An (10.7). Animals were mainly crossbred Holstein-Friesian (HF) cows with at least 75% HF origin (84%), whereas a higher (P<0.001) percentage of purebred HF was found in HCM and Lam Dong and crossbreds in Binh Duong and Long An. Animals were mainly raised in tie-stalls (94%) and machine-milked (80%). Farmers used their own replacement animals (76%), and both genetic and phenotypic information (67%) for selecting sires. Farmers were predominantly educated at primary school level (53%). Major constraints for dairy farming were the lack of capital (43%), diseases (17%), marketing (22%), lack of knowledge (8%) and feed (7%). Monthly profit per lactating cow was superior in Lam Dong (2,817 thousand VND) and HCM (2,798 thousand VND) compared to other regions in Long An (2,597 thousand VND), and Binh Duong (1,775 thousand VND). Regional differences may be mainly attributed to environmental factors, urbanization, and particularly governmental support and the availability of extension and financial institutions. Results from this study provide important information on farming practices of smallholders in Southern Vietnam that are useful in determining regions that need to be addressed by authorities in order to improve dairy production.Keywords: dairy farms, milk yield, Southern Vietnam, socio-economics
Procedia PDF Downloads 465986 Preparation and Evaluation of Gelatin-Hyaluronic Acid-Polycaprolactone Membrane Containing 0.5 % Atorvastatin Loaded Nanostructured Lipid Carriers as a Nanocomposite Scaffold for Skin Tissue Engineering
Authors: Mahsa Ahmadi, Mehdi Mehdikhani-Nahrkhalaji, Jaleh Varshosaz, Shadi Farsaei
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Gelatin and hyaluronic acid are commonly used in skin tissue engineering scaffolds, but because of their low mechanical properties and high biodegradation rate, adding a synthetic polymer such as polycaprolactone could improve the scaffold properties. Therefore, we developed a gelatin-hyaluronic acid-polycaprolactone scaffold, containing 0.5 % atorvastatin loaded nanostructured lipid carriers (NLCs) for skin tissue engineering. The atorvastatin loaded NLCs solution was prepared by solvent evaporation method and freeze drying process. Synthesized atorvastatin loaded NLCs was added to the gelatin and hyaluronic acid solution, and a membrane was fabricated with solvent evaporation method. Thereafter it was coated by a thin layer of polycaprolactone via spine coating set. The resulting scaffolds were characterized by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) analyses. Moreover, mechanical properties, in vitro degradation in 7 days period, and in vitro drug release of scaffolds were also evaluated. SEM images showed the uniform distributed NLCs with an average size of 100 nm in the scaffold structure. Mechanical test indicated that the scaffold had a 70.08 Mpa tensile modulus which was twofold of tensile modulus of normal human skin. A Franz-cell diffusion test was performed to investigate the scaffold drug release in phosphate buffered saline (pH=7.4) medium. Results showed that 72% of atorvastatin was released during 5 days. In vitro degradation test demonstrated that the membrane was degradated approximately 97%. In conclusion, suitable physicochemical and biological properties of membrane indicated that the developed gelatin-hyaluronic acid-polycaprolactone nanocomposite scaffold containing 0.5 % atorvastatin loaded NLCs could be used as a good candidate for skin tissue engineering applications.Keywords: atorvastatin, gelatin, hyaluronic acid, nano lipid carriers (NLCs), polycaprolactone, skin tissue engineering, solvent casting, solvent evaporation
Procedia PDF Downloads 252985 An Investigation of the Operation and Performance of London Cycle Hire Scheme
Authors: Amer Ali, Jessica Cecchinelli, Antonis Charalambous
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Cycling is one of the most environmentally friendly, economic and healthy modes of transport but it needs more efficient cycle infrastructure and more effective safety measures. This paper represents an investigation into the performance and operation of the London Cycle Hire Scheme which started to operate in July 2010 using 5,000 cycles and 315 docking stations and currently has more than 10,000 cycles and over 700 docking stations across London which are available 24/7, 365 days a year. The study, which was conducted during the second half of 2014, consists of two parts; namely, the longitudinal review of the hire scheme between its introduction in 2010 and November 2014, and a field survey in November 2014 in the form of face-face interviews of the users of the cycle scheme to ascertain the existing limitations and difficulties experienced by those users and how it could be improved in terms of capability and safety. The study also includes a correlation between the usage of the cycle scheme and the corresponding weather conditions. The main findings are that on average the number of users (hiring frequency) had increased from just over two millions hires in 2010 to just less than ten millions in 2014. The field survey showed that 80% of the users are satisfied with the performance of the scheme whilst 50% of the users raised concern about the safety level of using the available cycle routes and infrastructure. The study also revealed that a high percentage of the cycle trips were relatively short (less than 30 minutes). Although the weather condition had some effect on cycling, the cost of using the cycle scheme and the main events in London had more effect on the number of cycle hires. The key conclusions are that despite the safety concern and the lack of infrastructure for continuous routes there was an encouraging number of people who opted for cycling as a clean, affordable, and healthy mode of transport. There is a need to expand the scheme by providing more cycles and docking stations and to support that by more well-designed and maintained cycle routes. More details about the development of London Cycle Hire Scheme during the last five years, its performance and the key issues revealed by the surveyed users will be reported in the full version of the paper.Keywords: cycling mode of transport, london cycle hire scheme, safety, environmental and health benefits, user satisfaction
Procedia PDF Downloads 387984 Inviscid Steady Flow Simulation Around a Wing Configuration Using MB_CNS
Authors: Muhammad Umar Kiani, Muhammad Shahbaz, Hassan Akbar
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Simulation of a high speed inviscid steady ideal air flow around a 2D/axial-symmetry body was carried out by the use of mb_cns code. mb_cns is a program for the time-integration of the Navier-Stokes equations for two-dimensional compressible flows on a multiple-block structured mesh. The flow geometry may be either planar or axisymmetric and multiply-connected domains can be modeled by patching together several blocks. The main simulation code is accompanied by a set of pre and post-processing programs. The pre-processing programs scriptit and mb_prep start with a short script describing the geometry, initial flow state and boundary conditions and produce a discretized version of the initial flow state. The main flow simulation program (or solver as it is sometimes called) is mb_cns. It takes the files prepared by scriptit and mb_prep, integrates the discrete form of the gas flow equations in time and writes the evolved flow data to a set of output files. This output data may consist of the flow state (over the whole domain) at a number of instants in time. After integration in time, the post-processing programs mb_post and mb_cont can be used to reformat the flow state data and produce GIF or postscript plots of flow quantities such as pressure, temperature and Mach number. The current problem is an example of supersonic inviscid flow. The flow domain for the current problem (strake configuration wing) is discretized by a structured grid and a finite-volume approach is used to discretize the conservation equations. The flow field is recorded as cell-average values at cell centers and explicit time stepping is used to update conserved quantities. MUSCL-type interpolation and one of three flux calculation methods (Riemann solver, AUSMDV flux splitting and the Equilibrium Flux Method, EFM) are used to calculate inviscid fluxes across cell faces.Keywords: steady flow simulation, processing programs, simulation code, inviscid flux
Procedia PDF Downloads 429983 Comparison of Patient Stay at Withy Bush Same Day Emergency Care and Then Those at the Emergency Department
Authors: Joshua W. Edefo, Shafiul Azam, Murray D. Smith
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Introduction: In April 2022, the Welsh Government introduced the six goals for urgent and emergency care programs. One of these goals was to provide access to clinically safe alternatives, leading to the establishment of the Same Day Emergency Care (SDEC) program. The SDEC initiative aims to offer viable options that maintain patient safety while avoiding unnecessary hospital stays. The aim of the study is to determine the duration of patient stay in SDEC and compare it with that of Emergency department (ED) stay to ascertain if one of the objectives of SDEC is achieved. Methods: Patient stays and attendance datasets were constructed from Withybush SDEC and ED patient records. These records were provided by Hywel Dda University Health Board Informatics. Some hypothetical pathways were identified, notably SDEC visits involving a single attendance and ED visits then immediately transferred to SDEC. Descriptive statistics were used to summarise the data, and hypothesis tests for mean differences used the student t-test. Propensity scoring was employed to match a set of ED patient stays to SDEC patient stays which were then used to determine the average treatment effect (ATE) to compare durations of stay in SDEC with ED. Regression methods were used to model the natural logarithm of the duration of SDEC attendance, and the level of statistical significance was set to 0.05. Results: SDEC visits involving a single attendance (170 of 384; 44.3%) is the most frequently observed pathway with patient length of stay at 256 minutes (95%CI 237.4 - 275.1). The next most frequently observed pathway of patient stay was SDEC attendance after presenting to ED (80 of 384; 20.8%) and gave the length of stay of 440 minutes (95%CI 351.6 - 529.2). Time spent in this pathway significantly increased by 184 minutes (95%CI 118.0 - 250.2, support for no difference p<0.001) compared to the most seen pathway. When SDEC data were compared with ED, the estimate for the ATE from SDEC single attendance was -272 minutes (95%CI -334.1 - -210.5; p<0.001), while that of ED then SDEC pathway was -50.6 min (95%CI -182.7-81.5; p=0.453). Conclusion: When patients are admitted to SDEC and successfully discharged, their stays are significantly shorter, approximately 4.5 hours, compared to patients who spend their entire stay in the Emergency Department. That difference vanishes when the patient stay includes a period spent previously in ED before transfer to SDEC.Keywords: attendance, emergency-department, patient-stay, same-day-emergency-care
Procedia PDF Downloads 46982 Pull-Out Analysis of Composite Loops Embedded in Steel Reinforced Concrete Retaining Wall Panels
Authors: Pierre van Tonder, Christoff Kruger
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Modular concrete elements are used for retaining walls to provide lateral support. Depending on the retaining wall layout, these precast panels may be interlocking and may be tied into the soil backfill via geosynthetic strips. This study investigates the ultimate pull-out load increase, which is possible by adding varied diameter supplementary reinforcement through embedded anchor loops within concrete retaining wall panels. Full-scale panels used in practice have four embedded anchor points. However, only one anchor loop was embedded in the center of the experimental panels. The experimental panels had the same thickness but a smaller footprint (600mm x 600mm x 140mm) area than the full-sized panels to accommodate the space limitations of the laboratory and experimental setup. The experimental panels were also cast without any bending reinforcement as would typically be obtained in the full-scale panels. The exclusion of these reinforcements was purposefully neglected to evaluate the impact of a single bar reinforcement through the center of the anchor loops. The reinforcement bars had of 8 mm, 10 mm, 12 mm, and 12 mm. 30 samples of concrete panels with embedded anchor loops were tested. The panels were supported on the edges and the anchor loops were subjected to an increasing tensile force using an Instron piston. Failures that occurred were loop failures and panel failures and a mixture thereof. There was an increase in ultimate load vs. increasing diameter as expected, but this relationship persisted until the reinforcement diameter exceeded 10 mm. For diameters larger than 10 mm, the ultimate failure load starts to decrease due to the dependency of the reinforcement bond strength to the concrete matrix. Overall, the reinforced panels showed a 14 to 23% increase in the factor of safety. Using anchor loops of 66kN ultimate load together with Y10 steel reinforcement with bent ends had shown the most promising results in reducing concrete panel pull-out failure. The Y10 reinforcement had shown, on average, a 24% increase in ultimate load achieved. Previous research has investigated supplementary reinforcement around the anchor loops. This paper extends this investigation by evaluating supplementary reinforcement placed through the panel anchor loops.Keywords: supplementary reinforcement, anchor loops, retaining panels, reinforced concrete, pull-out failure
Procedia PDF Downloads 195981 A Comparative Study of Burnout and Coping Strategies between HIV Counselors: Face to Face and Online Counseling Services in Addis Ababa
Authors: Yemisrach Mihertu Amsale
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The purpose of this study was to compare burnout and coping strategies between HIV counselors in face to face and online counseling settings in Addis Ababa. The study was mixed approach design that was quantitative and qualitative. For the quantitative data the participants involved in this study included 64 face to face and 47 online HIV counselors in both counseling settings. In addition, 23 participants were involved to offer qualitative data from both counseling settings. For the purpose of gathering the quantitative data, the instruments, namely, demographic questionnaire, Maslach Burnout Inventory and the COPE questionnaire, were used to gather quantitative data. Qualitative data was also gathered in the FGD Guide and Interview Guide. Thus, this study revealed that HIV counselors in online counseling settings scored high on emotional exhaustion, depersonalization and low in personal accomplishment dimensions of burnout as compared to HIV counselors in face to face setting and the difference was statistically significant in emotional exhaustion and personal accomplishment, but there was no a significant difference on depersonalization dimension of burnout between the two groups. In addition, the present study revealed a statistically significant difference on problem focused coping strategy between the two groups and yet for on the emotion focused coping strategy the difference was not statistically significant. Statistically negative correlation was observed between some demographic variables such as age with emotional exhaustion and depersonalization dimensions of burnout; years of experiences and personal accomplishment dimension of burnout. A statistically positive correlation was also observed between average number of clients served per day and emotional exhaustion. Sex was having a statistically positive correlation with coping strategy. Lastly, a significant positive correlation was also observed in the emotional exhaustion dimension of the burnout and the emotional focused coping strategy. Generally, this study has shown that HIV counselors suffer from moderate to high level of burnout. Based on the findings, conclusions were made and recommendations were forwarded.Keywords: counseling, burnout management, psychological, behavioral sciences
Procedia PDF Downloads 305980 Application of Groundwater Level Data Mining in Aquifer Identification
Authors: Liang Cheng Chang, Wei Ju Huang, You Cheng Chen
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Investigation and research are keys for conjunctive use of surface and groundwater resources. The hydrogeological structure is an important base for groundwater analysis and simulation. Traditionally, the hydrogeological structure is artificially determined based on geological drill logs, the structure of wells, groundwater levels, and so on. In Taiwan, groundwater observation network has been built and a large amount of groundwater-level observation data are available. The groundwater level is the state variable of the groundwater system, which reflects the system response combining hydrogeological structure, groundwater injection, and extraction. This study applies analytical tools to the observation database to develop a methodology for the identification of confined and unconfined aquifers. These tools include frequency analysis, cross-correlation analysis between rainfall and groundwater level, groundwater regression curve analysis, and decision tree. The developed methodology is then applied to groundwater layer identification of two groundwater systems: Zhuoshui River alluvial fan and Pingtung Plain. The abovementioned frequency analysis uses Fourier Transform processing time-series groundwater level observation data and analyzing daily frequency amplitude of groundwater level caused by artificial groundwater extraction. The cross-correlation analysis between rainfall and groundwater level is used to obtain the groundwater replenishment time between infiltration and the peak groundwater level during wet seasons. The groundwater regression curve, the average rate of groundwater regression, is used to analyze the internal flux in the groundwater system and the flux caused by artificial behaviors. The decision tree uses the information obtained from the above mentioned analytical tools and optimizes the best estimation of the hydrogeological structure. The developed method reaches training accuracy of 92.31% and verification accuracy 93.75% on Zhuoshui River alluvial fan and training accuracy 95.55%, and verification accuracy 100% on Pingtung Plain. This extraordinary accuracy indicates that the developed methodology is a great tool for identifying hydrogeological structures.Keywords: aquifer identification, decision tree, groundwater, Fourier transform
Procedia PDF Downloads 157979 Application of Biomimetic Approach in Optimizing Buildings Heat Regulating System Using Parametric Design Tools to Achieve Thermal Comfort in Indoor Spaces in Hot Arid Regions
Authors: Aya M. H. Eissa, Ayman H. A. Mahmoud
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When it comes to energy efficient thermal regulation system, natural systems do not only offer an inspirational source of innovative strategies but also sustainable and even regenerative ones. Using biomimetic design an energy efficient thermal regulation system can be developed. Although, conventional design process methods achieved fairly efficient systems, they still had limitations which can be overcome by using parametric design software. Accordingly, the main objective of this study is to apply and assess the efficiency of heat regulation strategies inspired from termite mounds in residential buildings’ thermal regulation system. Parametric design software is used to pave the way for further and more complex biomimetic design studies and implementations. A hot arid region is selected due to the deficiency of research in this climatic region. First, the analysis phase in which the stimuli, affecting, and the parameters, to be optimized, are set mimicking the natural system. Then, based on climatic data and using parametric design software Grasshopper, building form and openings height and areas are altered till settling on an optimized solution. Finally, an assessment of the efficiency of the optimized system, in comparison with a conventional system, is determined by firstly, indoors airflow and indoors temperature, by Ansys Fluent (CFD) simulation. Secondly by and total solar radiation falling on the building envelope, which was calculated using Ladybug, Grasshopper plugin. The results show an increase in the average indoor airflow speed from 0.5m/s to 1.5 m/s. Also, a slight decrease in temperature was noticed. And finally, the total radiation was decreased by 4%. In conclusion, despite the fact that applying a single bio-inspired heat regulation strategy might not be enough to achieve an optimum system, the concluded system is more energy efficient than the conventional ones as it aids achieving indoors comfort through passive techniques. Thus demonstrating the potential of parametric design software in biomimetic design.Keywords: biomimicry, heat regulation systems, hot arid regions, parametric design, thermal comfort
Procedia PDF Downloads 294978 A Post-Occupancy Evaluation of Urban Landscape Greenway– A Case Study of the Taiyuan Greenway in Taichung City
Authors: A. Yu-Chen Chien, B. Ying-Ju Su
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Greenway is a type of linear park which links the planar parklands and connects the open spaces. In the urban environment, except for providing open spaces with recreational function as well as effectively improve the appearance of the surrounding environment, greenway and parkland also creates benefits to the social and psychological aspects of human. In 2014, the statistics of The Ministry of Home Affairs show that citizens in Taichung enjoy the green area at an average of 4.27 square kilometers per person. How to use the existing green space system effectively and enhance the quality of leisure life thus become the major issues today. The study here points out that greenway and parkland and other open spaces are closely related to the daily life of urban residents. Whether the operation could be executed in accordance with the design is our major concern. To explore the issue, we implemented the Post-Occupancy Evaluation of Taiyuan Greenway in Taichung City. In 1956, Taichung city carried out the urban plan according to Howard’s concept about “Garden City” and built the Taiyuan greenway to restrain the urban expansion. 50-year past, due to the population growth and new demands, the government started to reconstruct the program. It is a three stage modification project of “The Townspace Renaissance project in Taiwan” since 2009, of which the greenway construction is the main point. In this research, we mainly focus on the third stage of this program to investigate the user’s preference and degree of satisfaction based on the Post-Occupancy Evaluation about the finished, unfinished, and undergoing construction sectors as well as facilities. We collected and analyzed the data based on the questionnaires and explored the possible facts that might have affected the degree of satisfaction about the greenway modification project based on the chi-square test. We hope to inspect the purpose of the demonstration projects and provide reference to the Taichung government for the modification planning and the greenway design in the future.Keywords: greenway, landscape greenway, post-occupancy evaluation, Taichung city
Procedia PDF Downloads 330977 Investigation of Nucleation and Thermal Conductivity of Waxy Crude Oil on Pipe Wall via Particle Dynamics
Authors: Jinchen Cao, Tiantian Du
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As waxy crude oil is easy to crystallization and deposition in the pipeline wall, it causes pipeline clogging and leads to the reduction of oil and gas gathering and transmission efficiency. In this paper, a mesoscopic scale dissipative particle dynamics method is employed, and constructed four pipe wall models, including smooth wall (SW), hydroxylated wall (HW), rough wall (RW), and single-layer graphene wall (GW). Snapshots of the simulation output trajectories show that paraffin molecules interact with each other to form a network structure that constrains water molecules as their nucleation sites. Meanwhile, it is observed that the paraffin molecules on the near-wall side are adsorbed horizontally between inter-lattice gaps of the solid wall. In the pressure range of 0 - 50 MPa, the pressure change has less effect on the affinity properties of SS, HS, and GS walls, but for RS walls, the contact angle between paraffin wax and water molecules was found to decrease with the increase in pressure, while the water molecules showed the opposite trend, the phenomenon is due to the change in pressure, leading to the transition of paraffin wax molecules from amorphous to crystalline state. Meanwhile, the minimum crystalline phase pressure (MCPP) was proposed to describe the lowest pressure at which crystallization of paraffin molecules occurs. The maximum number of crystalline clusters formed by paraffin molecules at MCPP in the system showed NSS (0.52 MPa) > NHS (0.55 MPa) > NRS (0.62 MPa) > NGS (0.75 MPa). The MCPP on the graphene surface, with the least number of clusters formed, indicates that the addition of graphene inhibited the crystallization process of paraffin deposition on the wall surface. Finally, the thermal conductivity was calculated, and the results show that on the near-wall side, the thermal conductivity changes drastically due to the occurrence of adsorption crystallization of paraffin waxes; on the fluid side the thermal conductivity gradually tends to stabilize, and the average thermal conductivity shows: ĸRS(0.254W/(m·K)) > ĸRS(0.249W/(m·K)) > ĸRS(0.218W/(m·K)) > ĸRS(0.188W/(m·K)).This study provides a theoretical basis for improving the transport efficiency and heat transfer characteristics of waxy crude oil in terms of wall type, wall roughness, and MCPP.Keywords: waxy crude oil, thermal conductivity, crystallization, dissipative particle dynamics, MCPP
Procedia PDF Downloads 72976 Quality of Life in People with Hearing Loss: A Study of Patients Referred to an Audiological Service
Authors: Peder O. Laugen Heggdal, Oyvind Nordvik, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad
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Background: Hearing loss (HL) affect people of all ages and stages in life. To author's best knowledge, if patients with an HL have reduced Generic Quality of life (QoL), has yet not been answered. Aim: The aim of the present study was to investigate the relationship between HL and generic and disease-specific Health Related Quality of Life (HRQoL) in adult patients (aged 18–78 years) with an HL, seeking Hearing Aid (HA). Material and Methods: 158 adult (aged 18-78 years) patients with HL, referred for HA fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals, were included. First-time users had been pre-examined by an Ear Nose and Throat specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2 and 4 kHz) was determined for each ear. The generic European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire general part and a shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) were answered. In addition, EORTC HRQoL answers from a general population and patients with former head and neck cancer served as comparison. Results: In general, no lowered HRQoL scores were determined among HL patients compared to the general population. Patients with unilateral HL to some extent showed lower HRQoL than those with bilateral HL (social function and fatigue). The APHAB scores correlated significantly with the EORTC HRQoL scores. By stepwise linear regression analysis, the APHAB scores were scored secondary to PTA (best ear), cognitive and physical function. Conclusion: HRQoL scores in HL patients, in general, seems to be at the population level, but the unilateral HL patients scored to some extent lower than the bilateral HI patients. APHAB and generic QoL scores levels are associated. Both HRQoL and APHAB scores are generated more complexly than anticipated.Keywords: quality of life, hearing loss, hearing impairment, distress, depression, anxiety, hearing aid
Procedia PDF Downloads 293975 An Association Model to Correlate the Experimentally Determined Mixture Solubilities of Methyl 10-Undecenoate with Methyl Ricinoleate in Supercritical Carbon Dioxide
Authors: V. Mani Rathnam, Giridhar Madras
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Fossil fuels are depleting rapidly as the demand for energy, and its allied chemicals are continuously increasing in the modern world. Therefore, sustainable renewable energy sources based on non-edible oils are being explored as a viable option as they do not compete with the food commodities. Oils such as castor oil are rich in fatty acids and thus can be used for the synthesis of biodiesel, bio-lubricants, and many other fine industrial chemicals. There are several processes available for the synthesis of different chemicals obtained from the castor oil. One such process is the transesterification of castor oil, which results in a mixture of fatty acid methyl esters. The main products in the above reaction are methyl ricinoleate and methyl 10-undecenoate. To separate these compounds, supercritical carbon dioxide (SCCO₂) was used as a green solvent. SCCO₂ was chosen as a solvent due to its easy availability, non-toxic, non-flammable, and low cost. In order to design any separation process, the preliminary requirement is the solubility or phase equilibrium data. Therefore, the solubility of a mixture of methyl ricinoleate with methyl 10-undecenoate in SCCO₂ was determined in the present study. The temperature and pressure range selected for the investigation were T = 313 K to 333 K and P = 10 MPa to 18 MPa. It was observed that the solubility (mol·mol⁻¹) of methyl 10-undecenoate varied from 2.44 x 10⁻³ to 8.42 x 10⁻³ whereas it varied from 0.203 x 10⁻³ to 6.28 x 10⁻³ for methyl ricinoleate within the chosen operating conditions. These solubilities followed a retrograde behavior (characterized by the decrease in the solubility values with the increase in temperature) throughout the range of investigated operating conditions. An association theory model, coupled with regular solution theory for activity coefficients, was developed in the present study. The deviation from the experimental data using this model can be quantified using the average absolute relative deviation (AARD). The AARD% for the present compounds is 4.69 and 8.08 for methyl 10-undecenoate and methyl ricinoleate, respectively in a mixture of methyl ricinoleate and methyl 10-undecenoate. The maximum solubility enhancement of 32% was observed for the methyl ricinoleate in a mixture of methyl ricinoleate and methyl 10-undecenoate. The highest selectivity of SCCO₂ was observed to be 12 for methyl 10-undecenoate in a mixture of methyl ricinoleate and methyl 10-undecenoate.Keywords: association theory, liquid mixtures, solubilities, supercritical carbon dioxide
Procedia PDF Downloads 134974 Discriminating Between Energy Drinks and Sports Drinks Based on Their Chemical Properties Using Chemometric Methods
Authors: Robert Cazar, Nathaly Maza
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Energy drinks and sports drinks are quite popular among young adults and teenagers worldwide. Some concerns regarding their health effects – particularly those of the energy drinks - have been raised based on scientific findings. Differentiating between these two types of drinks by means of their chemical properties seems to be an instructive task. Chemometrics provides the most appropriate strategy to do so. In this study, a discrimination analysis of the energy and sports drinks has been carried out applying chemometric methods. A set of eleven samples of available commercial brands of drinks – seven energy drinks and four sports drinks – were collected. Each sample was characterized by eight chemical variables (carbohydrates, energy, sugar, sodium, pH, degrees Brix, density, and citric acid). The data set was standardized and examined by exploratory chemometric techniques such as clustering and principal component analysis. As a preliminary step, a variable selection was carried out by inspecting the variable correlation matrix. It was detected that some variables are redundant, so they can be safely removed, leaving only five variables that are sufficient for this analysis. They are sugar, sodium, pH, density, and citric acid. Then, a hierarchical clustering `employing the average – linkage criterion and using the Euclidian distance metrics was performed. It perfectly separates the two types of drinks since the resultant dendogram, cut at the 25% similarity level, assorts the samples in two well defined groups, one of them containing the energy drinks and the other one the sports drinks. Further assurance of the complete discrimination is provided by the principal component analysis. The projection of the data set on the first two principal components – which retain the 71% of the data information – permits to visualize the distribution of the samples in the two groups identified in the clustering stage. Since the first principal component is the discriminating one, the inspection of its loadings consents to characterize such groups. The energy drinks group possesses medium to high values of density, citric acid, and sugar. The sports drinks group, on the other hand, exhibits low values of those variables. In conclusion, the application of chemometric methods on a data set that features some chemical properties of a number of energy and sports drinks provides an accurate, dependable way to discriminate between these two types of beverages.Keywords: chemometrics, clustering, energy drinks, principal component analysis, sports drinks
Procedia PDF Downloads 109973 Improvement of Cardiometabolic after 8 Weeks of Weight Loss Intervention
Authors: Boris Bajer, Andrea Havranova, Miroslav Vlcek, Richard Imrich, Adela Penesova
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Lifestyle interventions can prevent the deterioration of impaired glucose tolerance to manifest type 2 diabetes, and also prevent cardiovascular diseases, as it showed many studies (the Finnish Diabetes Prevention Study, Diabetes Prevention Program (DPP), . the China Da Qing Diabetes Prevention Study, etc.) Therefore the aim of our study was to compare the effect of intensified lifestyle intervention on cardiometabolic parameters. Methods: It is an ongoing randomized interventional clinical study (NCT02325804) focused on the reduction of body weight/fat. Intervention: hypocaloric diet (30% restriction of calories) and physical activity 150 minutes/week. Before and after 8 weeks of intervention all patients underwent complete medical examination (measurement of physical fitness, resting metabolic rate (RMR), body composition analysis, oral glucose tolerance test, parameters of lipid metabolism, and other cardiometabolic risk factors. Results: So far 39 patients finished the intervention. The average reduction of body weight was 6,8 + 4,9 kg (0-15 kg; p=0,0006), accompanied with significant reduction of body fat percentage (p ≤ 0,0001), amount of fat mass (p=0,03), waist circumference (p=0.02). Amount of lean mass and RMR remained unchanged. Heart rate (p=0,02), systolic and diastolic blood pressure was reduced (p=0,01 p=0,02 resp.) as well as insulin sensitivity was improved. Lipid parameters also changed - cholesterol, LDL decreased (p=0,05, p=0,04 resp.), while triglycerides showed tendency to decrease (p=0,055). Liver function improved, alanine aminotrasnferase (ALT) were reduced (p=0,01). Physical fitness significantly improved (as measure VO2 max (p=0,02). Conclusion: Results of our study are in line with previous results about the beneficial effect of intensive lifestyle changes on the reduction of cardiometabolic risk factors and improvement of liver function. Supported by grants APVV 15-0228; VEGA 2/0161/16Keywords: obesity, weight loss, diet lipids, blood pressure, liver enzymes
Procedia PDF Downloads 166972 Topographic Characteristics Derived from UAV Images to Detect Ephemeral Gully Channels
Authors: Recep Gundogan, Turgay Dindaroglu, Hikmet Gunal, Mustafa Ulukavak, Ron Bingner
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A majority of total soil losses in agricultural areas could be attributed to ephemeral gullies caused by heavy rains in conventionally tilled fields; however, ephemeral gully erosion is often ignored in conventional soil erosion assessments. Ephemeral gullies are often easily filled from normal soil tillage operations, which makes capturing the existing ephemeral gullies in croplands difficult. This study was carried out to determine topographic features, including slope and aspect composite topographic index (CTI) and initiation points of gully channels, using images obtained from unmanned aerial vehicle (UAV) images. The study area was located in Topcu stream watershed in the eastern Mediterranean Region, where intense rainfall events occur over very short time periods. The slope varied between 0.7 and 99.5%, and the average slope was 24.7%. The UAV (multi-propeller hexacopter) was used as the carrier platform, and images were obtained with the RGB camera mounted on the UAV. The digital terrain models (DTM) of Topçu stream micro catchment produced using UAV images and manual field Global Positioning System (GPS) measurements were compared to assess the accuracy of UAV based measurements. Eighty-one gully channels were detected in the study area. The mean slope and CTI values in the micro-catchment obtained from DTMs generated using UAV images were 19.2% and 3.64, respectively, and both slope and CTI values were lower than those obtained using GPS measurements. The total length and volume of the gully channels were 868.2 m and 5.52 m³, respectively. Topographic characteristics and information on ephemeral gully channels (location of initial point, volume, and length) were estimated with high accuracy using the UAV images. The results reveal that UAV-based measuring techniques can be used in lieu of existing GPS and total station techniques by using images obtained with high-resolution UAVs.Keywords: aspect, compound topographic index, digital terrain model, initial gully point, slope, unmanned aerial vehicle
Procedia PDF Downloads 114971 The Revival of Cultural Heritage through Social Space Upliftment: Case Study of the Walled City of Ajmer, India
Authors: Vaishali Sharma
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The research is an attempt to hunt a scientific and objective method to transform Ajmer's traditional walled city into a living cultural heritage space, exploring urban management methods to elevate local economy and social space in relation to specific cultural-based initiatives. Ajmer is among the oldest and religiously diverse settlements in Rajasthan, that has seen superimposed developments through the eras. With numerous agencies operating towards the development of the town core of Ajmer, it becomes essential to structure development changes in tune with the transformations and the existing heritage. The study was radio-controlled by the subsequent analysis question: What is the way to overcome the genetic social and economic stress inside the communities and revive public life? In order to create necessary interventions at the neighbourhood level, fifteen neighbourhoods were identified. Each of those was analyzed relatively on three major dimensions: Heritage, Social and Local Economy. Each dimension was further broken down into multiple sub-aspects for an overall and exhaustive understanding. The average median values of the responses were used to develop a color-coded matrix to represent the scores in an exceedingly structured quantified manner, moreover, linking it to the spatial structure. Respondent perceptions on numerous dimensions were additionally recorded, so that the proposals are inclusive in nature. The goals are targeted at Ajmer's traditional walled towns, which will make it easier for the community to regulate the rapid transformations and commercialization occurring within the space. The study recommends the necessity for accrued support in methods and policies from the non-public sector, businesses as well as local stakeholders. An expansion, revitalization and maintenance of the major business and heritage corridors, for an increased local and visitor experience, can produce an impetus for promotion of the intangible heritage, to spur the local economic processes, conservation of heritage precincts and upward development.Keywords: cultural heritage, economic revitalization, neighbourhoods in walled cities, social space, tangible and intangible heritage
Procedia PDF Downloads 160970 The Nubian Ibex’s Distribution, Population, Habitat, and Conservation Status in Sudan’s Red Sea State Over the Past Decade
Authors: Lubna M. A. Hassan, Nasir Brema, Abdallah Mamy, Insaf Yahya, Tanzil A. G., Ahmed M. M. Hasoba, Omer A. Suliman
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The Nubian ibex species has been categorized as vulnerable by the International Union for Conservation of Nature (IUCN) due to a lack of population data in specific regions within their habitat. This species faces numerous challenges, including habitat loss caused by agricultural practices, livestock rearing, mining activity, and infrastructure development. Additionally, competition with non-native species and hunting pose significant threats to their survival. Unfortunately, studies on the distribution, conservation status, ecology, and health of the ibex are limited and primarily descriptive in nature. In order to bridge this knowledge gap, recent surveys were conducted in the Red Sea State of Sudan during specific periods in 2015, 2016, 2019, and 2021. These surveys have provided valuable insights into the distribution, habitats, and conservation status of the Nubian ibex in the Red Sea State. The findings indicate that the Capra nubiana ibex can be found across more than 17 mountains in the Red Sea State. However, the total population estimate from recent years suggests that there are fewer than 250 individuals remaining. The study has also identified the highest altitude at which the Nubian ibex habitats existed in Sudan's Red Sea State, measuring 1675 m. This area harbors a diverse array of Nubian ibex habitats, encompassing a total of 21 wild plant species from 10 distinct families. The region experiences an average annual temperature ranging from 20.64°C in January to 33.30°C in August. Precipitation occurs in November and December, although it is characterized by unreliability and erratic patterns. It is important to note that these population estimates were obtained through surveys conducted in collaboration with rangers and local communities, and adjustments to survey methods are necessary to accommodate the challenging mountainous terrain, such as utilizing aerial surveys. To effectively address these threats, it is imperative to establish comprehensive long-term monitoring programs.Keywords: Nubian ibex, distribution, population, habitats
Procedia PDF Downloads 86969 Nurses' Perception and Core Competencies for Disaster Preparedness: A Study from the Western Region of Turkey
Authors: Gülcan Taşkıran, Ülkü Tatar Baykal
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Aim: To identify nurses’ perceived competencies for disaster preparedness. Background: Recently, the number of disasters has increased worldwide. Since disasters often strike without warning, healthcare providers, especially nurses must be prepared with appropriate competencies for disaster procedures. Nurses’ perceptions of their own competencies for disaster preparedness need to be evaluated to aid in the creation of effective national plans and educational programs. Design: This study was conducted with a descriptive and cross-sectional design. Methods: Nurses’ perceptions were assessed using the 13-item Demographic Profile Questionnaire that is based on previous literature and the 45-item Nurses’ Perception of Core Competencies for Disaster Preparedness Scale (NPCDPS). Data were collected from June to September 2014 from 406 (79.9% return rate) Turkish nurses working in the western region of Turkey. Results: At the end of the study, it was found that out of the nurses whose mean age was 31.27 ± 5.86 and mean of working time was 8.07 ± 6.60 by the time vast majority of the nurses were women (85.7%), married (59.4%), bachelor’s degree holder (88.2%) and service nurses (56.2%). The most potential disaster that nurses think is an earthquake (70.9%) by the time majority of nurses consider having a role as a nurse at every stage of disasters. The mean total point score of nurses’ perception of disaster preparedness was 4.62. The mean total point score of the nurses from the Nurses’ Perception of Core Competencies for Disaster Preparedness Scale was 133.96. When the subscales’ mean scores are examined, the highest average of the mean score is for Technical Skills (44.52), and the lowest is for Critical Thinking Skills (10.47). When the subscales of Nurses’ Perception of Core Competencies for Disaster Preparedness Scale compared with sex, marital status and education level out of independent variable of nurses there is no significant difference (p > 0.05); compared with age group, working years, duty and being with a disaster out of independent variable of nurses there is a significant difference (p ≤ 0.05). Conclusion: Nurses generally perceive themselves as sufficient at a ‘medium level’ in terms of meeting the core competencies that are required for disaster preparedness. Nurses are not adequately prepared for disasters, but they are aware of the need for such preparation and disaster education. Disaster management training should be given to all nurses in their basic education.Keywords: disaster competencies, disaster management, disaster nursing, disaster preparedness, nursing, nursing administration, Turkish nurses
Procedia PDF Downloads 368968 The Examination of Parents’ Perceptions and Motivations Regarding Type 1 Diabetes Management Technologies
Authors: Maria Dora Horvath, Norbert Buzas, Zsanett Tesch
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Diabetes management poses many unique challenges for children and their parents. The use of a diabetes management device should not be one of these challenges as the purpose of these devices is to make the management more convenient. The objective of our study was to examine how demographical, psychological and diabetes-related factors determine the choices parents make regarding their child’s diabetes management technologies and how they perceive advanced devices. We conducted the study using an online questionnaire with 318 parents (mostly mothers). The questions of the survey were about demographical, diabetes-related and psychological factors (diabetes management problems, diabetes management competence). In addition, we asked the parents opinions about advanced diabetes management devices. We expanded our data with semi-structured in-depth interviews. 61 % of the participants Self-Monitored Blood Glucose (SMBG), and 39 % used a Continuous Glucose Monitoring System (CGM). Considering insulin administration, 58 % used Multiple Daily Insulin Injections (MDII) and 42 % used Continuous Subcutaneous Insulin Infusion (CSII). Parents who used diverse combinations of diabetes management devices showed significant differences in age (parents’ and child’s), the monthly cost of diabetes, the duration of diabetes, the highest level of education and average monthly household income. CGM users perceived diabetes management problems significantly more severe than SMBG users and CSII users felt significantly more competent in diabetes management than MDII users. Avoiding CGM use due to lack of financial resources was determined by diagnosis duration. While avoiding its use by the cause of the child rejecting, it was determined by the child’s age and diabetes competence. Using MDII instead of CSII because of the child’s rejection was determined by the monthly cost of diabetes and child’s age. We conducted a complex empirical study in which we examined perceptions and experiences of advanced and less advanced diabetes management technologies comprehensively. Our study highlights the factors that fundamentally influence parents’ motivations and choices about diabetes management technologies. These results could contribute to developing diabetes management technologies more suitable for children living with type 1 diabetes and their parents.Keywords: advanced diabetes management technologies, children living with type 1 diabetes, diabetes management, motivation, parents
Procedia PDF Downloads 135967 Organic Paddy Production as a Coping Strategy to the Adverse Impact of Climate Change
Authors: Thapa M., J.P. Dutta, K.R. Pandey, R.R. Kattel
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Nepal is extremely vulnerable to the impact of climate change. To mitigate the climate change effects on agricultural production and productivity a range of adaptive strategies needs to be considered. The study was conducted to assess organic paddy production as a coping strategy to the adverse impact of climate change in Phulbari, VDC of Chitwan district. Altogether, 120 respondents (60 adopters of organic farming and 60 from non adopter) were selected using snowball technique of sampling. Pre- tested interview schedule, direct observation, focus group discussion, key informant interview as well as secondary data were used to collect the required information. Factors determining the adoption of organic farming were found to be age, year of schooling, training, frequency of extension contact, perception about climate change, economically active members and poor. A unit increase in these factors except poor would increase the probability of adoption by 4.1%, 7.5%, 7.8%, 43.1%, 41.8% and 7% respectively. However, for poor, it would decrease the probability of adoption of organic farming by 5.1%. Average organic matter content in the adopters' field was higher (2.7%) than the non-adopters' field (2.5%). The regression result showed that type of farmer, price and area under rice cultivation had positive and significant relationship with income; however dependency ratio had negative relationship. As the year of adoption of organic farming increases, the production of rice decline in the first two years then after goes on increasing but the cost of production goes on decreasing with the year of adoption. The respondents adapted to the changing climate through diversification of crops, use of resistance varieties and following good cropping pattern. Gradually growing consumers' awareness about health, preference towards quality food products are the strong points behind organic farming, whereas lacks of bio-fertilizers, lack of effective extension services, no price differentiation between organic and inorganic products were the weak points. There is need for more training and education to change the attitude of farmers and enhance their confidence about the role of organic farming to cope with climate change impact.Keywords: Organic farming, climate change, sustainable development
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