Search results for: Hayatabad Medical Complex
3631 Outcome Evaluation of a Blended-Learning Mental Health Training Course in South African Public Health Facilities
Authors: F. Slaven, M. Uys, Y. Erasmus
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The South African National Mental Health Education Programme (SANMHEP) was a National Department of Health (NDoH) initiative to strengthen mental health services in South Africa in collaboration with the Foundation for Professional Development (FPD), SANOFI and the various provincial departments of health. The programme was implemented against the backdrop of a number of challenges in the management of mental health in the country related to staff shortages and infrastructure, the intersection of mental health with the growing burden of non-communicable diseases and various forms of violence, and challenges around substance abuse and its relationship with mental health. The Mental Health Care Act (No. 17 of 2002) prescribes that mental health should be integrated into general health services including primary, secondary and tertiary levels to improve access to services and reduce stigma associated with mental illness. In order for the provisions of the Act to become a reality, and for the journey of mental health patients through the system to improve, sufficient and skilled health care providers are critical. SANMHEP specifically targeted Medical Doctors and Professional Nurses working within the facilities that are listed to conduct 72-hour assessments, as well as District Hospitals. The aim of the programme was to improve the clinical diagnosis and management of mental disorders/conditions and the understanding of and compliance with the Mental Health Care Act and related Regulations and Guidelines in the care, treatment and rehabilitation of mental health care users. The course used a blended-learning approach and trained 1 120 health care providers through 36 workshops between February and November 2019. Of those trained, 689 (61.52%) were Professional Nurses, 337 (30.09%) were Medical Doctors, and 91 (8.13%) indicated their occupation as ‘other’ (of these more than half were psychologists). The pre- and post-evaluation of the face-to-face training sessions indicated a marked improvement in knowledge and confidence level scores (both clinical and legislative) in the care, treatment and rehabilitation of mental health care users by participants in all the training sessions. There was a marked improvement in the knowledge and confidence of participants in performing certain mental health activities (on average the ratings increased by 2.72; or 27%) and in managing certain mental health conditions (on average the ratings increased by 2.55; or 25%). The course also required that participants obtain 70% or higher in their formal assessments as part of the online component. The 337 participants who completed and passed the course scored 90% on average. This illustrates that when participants attempted and completed the course, they did very well. To further assess the effect of the course on the knowledge and behaviour of the trained mental health care practitioners a mixed-method outcome evaluation is currently underway consisting of a survey with participants three months after completion, follow-up interviews with participants, and key informant interviews with department of health officials and course facilitators. This will enable a more detailed assessment of the impact of the training on participants' perceived ability to manage and treat mental health patients.Keywords: mental health, public health facilities, South Africa, training
Procedia PDF Downloads 1213630 Development of a Nurse Led Tranexamic Acid Administration Protocol for Trauma Patients in Rural South Africa
Authors: Christopher Wearmouth, Jacob Smith
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Administration of tranexamic acid (TXA) reduces all-cause mortality in trauma patients when given within 3 hours of injury. Due to geographical distance and lack of emergency medical services patients often present late, following trauma, to our emergency department. Additionally, we found patients that may have benefited from TXA did not receive it, often due to lack of staff awareness, staff shortages out of hours and lack of equipment for delivering infusions. Our objective was to develop a protocol for nurse-led administration of TXA in the emergency department. We developed a protocol using physiological observations along with criteria from the South African Triage Scale to allow nursing staff to identify patients with, or at risk of, significant haemorrhage. We will monitor the use of the protocol to ensure appropriate compliance and for any adverse events reported.Keywords: emergency department, emergency nursing, rural healthcare, tranexamic acid, trauma, triage
Procedia PDF Downloads 2333629 Prominence of Biopsychosocial Formulation in Health Care Delivery for Aging Population: Empowering Caregiving through Natural Socio-Environmental Approaches
Authors: Kristine Demilou D. Santiago
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An access to a high-quality health care system is what sets apart industrialized nations, such as the United States from other developing countries, which in this case is specifically pertaining to their older population. But what was the underrated factor in the sphere of quality healthcare rendered to elderly people in the Western context? Will this salient factor could push conviction to prorogue the existing gaps between self-denial patient-client and cheek by jowl medications? Are the natural socio-environmental approaches of caregiving the protracted remedy to healthcare disparities for aging population considering their day to day living? The conceptual framework of this model is primarily associated with addressing health and illness of human beings considering the biological, psychological and socio-environmental factors around them. The relevance of biopsychosocial formulation advancing each of the characteristics in the Biopsychosocial (BPS) model in a balance contemplation is the tumult of this study in an attempt to respond to prevailing disparities in caregiving services for old-aged patients on a day to day living. Caregiving services have been the medium path connecting between the patient and its prescribed medications. Moreover, caregivers serve as positive reinforcers in a patient’s environment. Therefore, caregivers play an important role in healthcare delivery to patients. They are considered significant people whom their acts will give an impact to a patient’s view in life. This research study intends to present the supreme importance of biopsychosocial assessment to old-aged patients with mental health illness and conditions. Biopsychosocial assessment will secure the quality of full medication to an old-aged adult suffering from a mental illness. This is because it offers a recognizably wholesome approach to medical healing of old-aged adult patients. The principle of biopsychosocial supersedes the biomedicine being offered to old-aged adults having mental illness, but it does not take away the high relevance of scientific biomedicine in healing patients. The framework presented an overlapping participation of each of its factors in its BPS model that affects in general a person’s health. The correlation between the biological (physiological), psychological (mental) and social (environment) in a person’s health condition requires equal attention according to BPS, and it always coexist with each other. Indisputably said, bio-medicine has been and is being in its unceasing endeavor to provide scientifically proven health care medications for every individual seeking medical treatments. As we grow older and eventually reach the other side of the median population, not only our physiological aspects change, our psychological and socio-environmental changes happen too. Caregiving is a salient responsibility taking place on these inevitable changes.Keywords: biopsychosocial formulation, caregiving through natural approaches, US health care, BPS in caregiving, caregiving for aging population
Procedia PDF Downloads 1003628 Electrochemical Top-Down Synthesis of Nanostructured Support and Catalyst Materials for Energy Applications
Authors: Peter M. Schneider, Batyr Garlyyev, Sebastian A. Watzele, Aliaksandr S. Bandarenka
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Functional nanostructures such as nanoparticles are a promising class of materials for energy applications due to their unique properties. Bottom-up synthetic routes for nanostructured materials often involve multiple synthesis steps and the use of surfactants, reducing agents, or stabilizers. This results in complex and extensive synthesis protocols. In recent years, a novel top-down synthesis approach to form metal nanoparticles has been established, in which bulk metal wires are immersed in an electrolyte (primarily alkali earth metal based) and subsequently subjected to a high alternating potential. This leads to the generation of nanoparticles dispersed in the electrolyte. The main advantage of this facile top-down approach is that there are no reducing agents, surfactants, or precursor solutions. The complete synthesis can be performed in one pot involving one main step with consequent washing and drying of the nanoparticles. More recent studies investigated the effect of synthesis parameters such as potential amplitude, frequency, electrolyte composition, and concentration on the size and shape of the nanoparticles. Here, we investigate the electrochemical erosion of various metal wires such as Ti, Pt, Pd, and Sn in various electrolyte compositions via this facile top-down technique and its experimental optimization to successfully synthesize nanostructured materials for various energy applications. As an example, for Pt and Pd, homogeneously distributed nanoparticles on carbon support can be obtained. These materials can be used as electrocatalyst materials for the oxygen reduction reaction (ORR) and hydrogen evolution reaction (HER), respectively. In comparison, the top-down erosion of Sn wires leads to the formation of nanoparticles, which have great potential as oxygen evolution reaction (OER) support materials. The application of the technique on Ti wires surprisingly leads to the formation of nanowires, which show a high surface area and demonstrate great potential as an alternative support material to carbon.Keywords: ORR, electrochemistry, electrocatalyst, synthesis
Procedia PDF Downloads 853627 The Influence of the Visual and the Direct Physical Accessibility on the Sense of Control of Saudi Women in the Home Environment
Authors: Ahdab H. Mahdaly, Debajyoti Pati, Sharran Parkinson, Lee S. Duemer
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The importance of providing employed mothers with the right physical environment inside the home is not an easy task, especially when the culture is involved. This study examines the typical Saudi home as a personal, emotional, social and cultural setting, especially on the interactions between the physical design and perceived control of working mothers. However, owing to the scarcity of published literature on Saudi homes, American employed mothers were included in the study to provide a baseline. With the ongoing transformations in women’s role in Saudi Arabia, there is a perception that traditional home designs may not afford the appropriate sense of control inside the home. Saudi Arabia has numerous interacting layers of socio-cultural-religious forces that affect residential design, and understanding the moderating role of the Saudi home is vital to the ongoing national policy transition on women. The study investigated one narrow, albeit critical, influence of home design on ones sense of control – direct visual and physical accessibility between sets of rooms. Ten subjects, five Saudis and five American, examined visual and physical access between 171 room sets, and provided qualitative responses on how each access influences their sense of control. Three main themes emerged, with potential effects on control: 1- Openness, 2- Proximity, and 3- Separation. Data suggest that although the Saudi home is a substantially more complex setting than the American ones, a class of spaces that can be termed as ‘Neutral Rooms’ serving as cultural separators may represent the ideal solution for optimizing sense of control, without ignoring cultural-religious traditions, during the transition of the Saudi women.Keywords: direct physical accessibility, home environment, sense of control, visual accessibility, working mothers
Procedia PDF Downloads 3133626 Diagnosis and Resolution of Intermittent High Vibration Spikes at Exhaust Bearing of Mitsubishi H-25 Gas Turbine using Shaft Vibration Analysis and Detailed Root Cause Analysis
Authors: Fahad Qureshi
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This paper provides detailed study on the diagnosis of intermittent high vibration spikes at exhaust bearing (Non-Drive End) of Mitsubishi H-25 gas turbine installed in a petrochemical plant in Pakistan. The diagnosis is followed by successful root cause analysis of the issue and recommendations for improving the reliability of machine. Engro Polymer and Chemicals (EPCL), a Chlor Vinyl complex, has a captive power plant consisting of one combined cycle power plant (CCPP), having two gas turbines each having 25 MW capacity (make: Hitachi) and one extraction condensing steam turbine having 15 MW capacity (make: HTC). Besides, one 6.75 MW SGT-200 1S gas turbine (make: Alstom) is also available. In 2018, the organization faced an issue of intermittent high vibration at exhaust bearing of one of H-25 units having tag GT-2101 A, which eventually led to tripping of machine at configured securities. Since the machine had surpassed 64,000 running hours and major inspection was also due, so bearings inspection was performed. Inspection revealed excessive coke deposition at labyrinth where evidence of rotor rub was also present. Bearing clearance was also at upper limit, and slight babbitt (soft metal) chip off was observed at one of its pads so it was preventively replaced. The unit was restated successfully and exhibited no abnormality until October 2020, when these spikes reoccurred, leading to machine trip. Recurrence of the issue within two years indicated that root cause was not properly addressed, so this paper furthers the discussion on in-depth analysis of findings and establishes successful root cause analysis, which captured significant learnings both in terms of machine design deficiencies and gaps in operation & maintenance (O & M) regime. Lastly, revised O& M regime along with set of recommendations are proposed to avoid recurrence.Keywords: exhaust side bearing, Gas turbine, rubbing, vibration
Procedia PDF Downloads 1893625 Tourism as Benefactor to Peace amidst the Structural Conflict: An Exploratory Case Study of Nepal
Authors: Pranil Kumar Upadhayaya
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While peace is dividend to tourism, tourism can also be a vital force for world peace. The existing body of knowledge on a tripartite complex nexus between tourism, peace and conflict reveals that tourism is benefactor to peace and sensitive to conflict. By contextualizing the ongoing sporadic structural conflict in the transitional phase in the aftermath of a decade long (1996-2006), Maoist armed conflict in Nepal, the purpose of this study is to explore the potentials of tourism in peace-building. The outcomes of this research paper is based on the mixed methods of research (qualitative and quantitative). Though the armed conflict ended with the comprehensive peace agreement in 2006 but there is constant manifestations of non-violent structural conflicts, which continue to threaten the sustainability of tourism industry. With the persistent application of coping strategies, tourism is found resilient during the ongoing structural political conflict. The strong coping abilities of the private sector of tourism industry have also intersected with peace-building efforts with more reactive and less proactive (pro-peace) engagements. This paper ascertains about the application of the ‘theory of tourism security’ by Nepalese tourism industry while coping with conflict and reviving, and sustaining. It reveals that the multiple verities of tourism at present has heterogeneous degree of peace potentials. The opportunities of ‘peace through tourism’ can be promoted subject to its molding with responsible, sustainable and participatory characteristics. This paper comes out with pragmatic policy recommendations for strengthening the position of tourism as a true peace-builder: (a) a broad shift from mainstream conventional tourism to the community based rural with local participation and ownership to fulfill Nepal’s potentials for peace, and (b) building and applications of the managerial and operational codes of conducts for owners and workers (labor unions) at all tourism enterprises and strengthen their practices.Keywords: code of conduct, community based tourism, conflict, peace-building, tourism
Procedia PDF Downloads 2663624 Radiofrequency Ablation: A Technique in the Management of Low Anal Fistula
Authors: R. Suresh, C. B. Singh, A. K. Sarda
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Background: Over the decades, several surgical techniques have been developed to treat anal fistulas with variable success rates and complications. Large amount of work has been done in radiofrequency excision of the fistula for several years but no work has been done for ablating the tract. Therefore one can consider for obliteration ofanal fistula by Radiofrequency ablation (RFA). Material and Methods: A randomized controlled clinical trial was conducted at Lok Nayak Hospital, where a total of 40 patients were enrolled in the study and they were randomly assigned to Group I (fistulectomy)(n=20) and Group II (RFA) (n=20). Aim of the study was to compare the efficacy of RFA of fistula versus fistulectomy in the treatment of a low anal fistula and to evaluate RFA as an effective alternative to fistulectomy with respect to time taken for wound healing as primary outcome and post-operative pain, time taken to return to work as secondary outcomes. Patients with simple low anal fistulas, single internal and external opening, not more than two secondary tracts were included. Patients with high complex fistula, fistulas communicating with cavity, fistula due to condition like tuberculosis, Crohn's, malignancy were excluded from the study. Results: Both groups were comparable with respect to age, sex ratio, type of fistula. Themean healing time was significantly shorter in group II (41.02 days) than in group I(62.68 days).The mean operative time was significantly shorter in groupII (21.40 min) than in group I(28.50 min). The mean time taken to return to work was significantly shorter in group II(8.30 days)than in group I(12.01 days).There was no significant difference in the post operative hospital stay, mean postoperative pain score, wound infection and recurrence between the two groups. Conclusion: The patients who underwent RFA of fistula had shorter wound healing time, operative time and time taken to return to work when compared to those who underwent fistulectomy and therefore RFA shows outcome comparable to fistulectomy in the treatment of low anal fistula.Keywords: fistulectomy, low anal fistula, radio frequency ablation, wound healing
Procedia PDF Downloads 3473623 Factors Associated with Oral Cavity Colonization by Candida albicans
Authors: Nwafia Ifeyinwa Nkeiruka, Nwafia Walter Chukwuma
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Since the early 1980’s fungi have emerged as major causes of human diseases, especially among immunocompromised. The most commonly isolated yeast is Candida albicans and constitutes the 4th most common nosocomial BSI in humans. It is progressive and cumulative and become more complex over time.It can even lead to leaky gut syndrome that causes food and environmental allergies. It is worthy of note that all the available data on oral Candida risk factors in humans were documented essentially using data from studies conducted in other areas, hence there is need for comparative and complementary information from the South eastern part of Nigeria. Method: 200 subjects of all age groups of both sexes were randomly examined,by swabbing their palatine mucosa and dorsal tongue with sterile cotton wool,then cultured into Sabouraud dextrose agar plates supplemented with antibiotics and incubated aerobically at 37 degree for 48 hrs. Identification of Candida albicans was done by germ tubes tests, chlamydospores production on cornmeal agar supplemented with 1% Tween 80.Sugar and nitrogen assimilation test using API 20C Auxanogram and potassium nitrate agar. Results: Out of 30 samples that were positive for candida, 15 (50%) were candida albicans. Using the anova test (P < 0.05) this variation is significant (P = 0016). followed by C. dublinensis 3 (13%), C. tropicalis 3 (10%), C. pseudotropicalis 3 (10%), C, glabrata 2 (7%), C. parapsilosis 2 (7%) and lastly C. krusei 1 (3%).However, 53% of the patients were female while 47% were male. Among the HIV positive isolates.67% were HIV isolates not on drugs while 33% positives isolates were on drugs and the percentages of candida species in these patients were as follows C. albicans were 45% followed by C. glabrata and C.tropicalis which were 17% each, C.parapsilosis, C.dubliensis and C.pseudotropicalis were all 8% each. Conclusion: Oral Candidiasis is a marker of systemic diseases and in some cases, it may be the first clinical presentation. There is need for more intensive clinical and laboratory monitoring and possible early intervention to prevent the reoccurrence and resistance to treatment.Keywords: oral cavity, Candida species, oral Candidiasis, risk factors
Procedia PDF Downloads 3653622 Determinants of Stone Free Status After a Single Session of Flexible Ureteroscopy with Laser Lithotripsy for Renal Calculi
Authors: Mohamed Elkoushy, Sameer Munshi, Waseem Tayeb
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Background: Flexible ureteroscopy (fURS) has dramatically improved the minimally invasive management of complex nephrolithiasis. fUR is increasingly being used as the first-line treatment for patients with renal stones. Stone-free status (SFS) is the primary goal in the management of patients with urolithiasis. However, substantial variations exist in the reported SFS following fURS. Objectives: This study determines the predictors of SFS after a single session of fURS with holmium laser lithotripsy (HLL) for renal calculi. Methods: A retrospective review of prospectively collected data was performed for all consecutive patients undergoing fURS and HLL for renal calculi at a tertiary care center. Patients with previous ipsilateral URS for the same stones were excluded. All patients underwent JJ ureteral stent insertion at the end of the procedure. SFS was defined as the presence of no residuals or ≤4-mm non-obstructing stone and was assessed by CT/KUB imaging after 3-4 weeks post-operatively. Multivariate logistic regression was used to detect possible predictors of SFS. Results: A total of 212 patients were included with a mean age of 52.3±8.3 years and a stone burden <20 mm (49.1%), 20-30 mm (41.0%) and >30 mm (9.9%). Overall SFS after a single session of fURS was 71.7%, 92% and 52% for stones less and larger than 20 mm, respectively. Patients with stones> 20 mm need retreatment with a mean number of 1.8 (1.3-2.7) fURS. SFS was significantly associated with male gender, stone bulk <20 mm (95.7% vs. 56.2%), non-lower pole stones, hydronephrotic kidney, low stone intensity, ureteral access sheath, and preoperative stenting. SFS was associated with a lower readmission rate (5.9% vs. 38.9%) and urinary tract infections (3.8% vs. 25.9%). In multivariate regression analysis, SFS maintains its significant association with low stone burden of <20 mm (OR: 5.21), stone intensity <600 HFU (OR: 2.87), and non-lower caliceal stones (OR: 3.84). Conclusion: Best results after a single-session fURS for renal stone were obtained for the stone burden of less than 20 mm and low stone attenuation. Lower calyceal stones may influence stone clearance and need a different approach than fURS, especially for higher stone burden.Keywords: ureteroscopy, kidney stone, lithotripsy, stone-free, predictors
Procedia PDF Downloads 213621 Promises versus Realities: A Critical Assessment of the Integrated Design Process
Authors: Firdous Nizar, Carmela Cucuzzella
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This paper explores how the integrated design process (IDP) was adopted for an architectural project. The IDP is a relatively new approach to collaborative design in architectural design projects in Canada. It has gained much traction recently as the closest possible approach to the successful management of low energy building projects and has been advocated as a productive method for multi-disciplinary collaboration within complex projects. This study is based on the premise that there are explicit and implicit dimensions of power within the integrated design process (IDP) in the green building industry that may or may not lead to irreconcilable differences in a process that demands consensus. To gain insight on the potential gap between the theoretical promises and practical realities of the IDP, a review of existing IDP literature is compared with a case study analysis of a competition-based architectural project in Canada, a first to incorporate the IDP in its overall design format. This paper aims to address the undertheorized power relations of the IDP in a real project. It presents a critical assessment through the lens of the combined theories of deliberative democracy by Jürgen Habermas, with that of agonistic pluralism by political theorist Chantal Mouffe. These two theories are intended to more appropriately embrace the conflictual situations in collaborative environments, and shed light on the relationships of power, between engineers, city officials, architects, and designers in this conventional consensus-based model. In addition, propositions for a shift in approach that embraces conflictual differences among its participants are put forth based on concepts of critical spatial practice by Markus Meissen. As IDP is a relatively new design process, it requires much deliberation on its structure from the theoretical framework built in this paper in order to unlock its true potential.Keywords: agonistic pluralism, critical spatial practice, deliberative democracy, integrated design process
Procedia PDF Downloads 1783620 Rheological Evaluation of Wall Materials and β-Carotene Loaded Microencapsules
Authors: Gargi Ghoshal, Ashay Jain, Deepika Thakur, U. S. Shivhare, O. P. Katare
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The main objectives of this work were the rheological characterization of dispersions, emulsions at different pH used in the microcapsules preparation and the microcapsules obtain from gum arabic (A), guar gum (G), casein (C) and whey protein isolate (W) to keep β-carotene protected from degradation using the complex coacervation microencapsulation technique (CCM). The evaluation of rheological properties of dispersions, emulsions of different pH and so obtained microencapsules manifest the changes occur in the molecular structure of wall materials during the encapsulation process of β-carotene. These dispersions, emulsions of different pH and formulated microencapsules were subjected to go through various conducted experiments (flow curve test, amplitude sweep, and frequency sweep test) using controlled stress dynamic rheometer. Flow properties were evaluated as a function of apparent viscosity under steady shear rate ranging from 0.1 to 100 s-1. The frequency sweep test was conducted to determine the extent of viscosity and elasticity present in the samples at constant strain under changing angular frequency range from 0.1 to 100 rad/s at 25ºC. The dispersions and emulsion exhibited a shear thinning non-Newtonian behavior whereas microencapsules are considered as shear-thickening respectively. The apparent viscosity for dispersion, emulsions were decreased at low shear rates 20 s-1 and for microencapsules, it decreases up to ~50 s-1 besides these value, it has shown constant pattern. Oscillatory shear experiments showed a predominant viscous liquid behavior up to crossover frequencies of dispersions of C, W, A at 49.47 rad/s, 57.60 rad/s and 21.45 rad/s emulsion sample of AW at pH 5.0 it was 17.85 rad/s and GW microencapsules 61.40 rad/s respectively whereas no such crossover was found in G dispersion, emulsion with C and microencapsules still it showed more viscous behavior. Storage and loss modulus decreases with time also a shift of the crossover towards lower frequencies for A, W and C was observed respectively. However, their microencapsules showed more viscous behavior as compared to samples prior to blending.Keywords: viscosity, gums, proteins, frequency sweep test, apparent viscosity
Procedia PDF Downloads 2483619 Autonomic Threat Avoidance and Self-Healing in Database Management System
Authors: Wajahat Munir, Muhammad Haseeb, Adeel Anjum, Basit Raza, Ahmad Kamran Malik
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Databases are the key components of the software systems. Due to the exponential growth of data, it is the concern that the data should be accurate and available. The data in databases is vulnerable to internal and external threats, especially when it contains sensitive data like medical or military applications. Whenever the data is changed by malicious intent, data analysis result may lead to disastrous decisions. Autonomic self-healing is molded toward computer system after inspiring from the autonomic system of human body. In order to guarantee the accuracy and availability of data, we propose a technique which on a priority basis, tries to avoid any malicious transaction from execution and in case a malicious transaction affects the system, it heals the system in an isolated mode in such a way that the availability of system would not be compromised. Using this autonomic system, the management cost and time of DBAs can be minimized. In the end, we test our model and present the findings.Keywords: autonomic computing, self-healing, threat avoidance, security
Procedia PDF Downloads 5073618 Communication Skills for Physicians: Adaptation to the Third Gender and Language Cross Cultural Influences
Authors: Virginia Guillén Cañas, Miren Agurtzane Ortiz-Jauregi, Sonia Ruiz De Azua, Naiara Ozamiz
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We want to focus on relationship of the communicational skills in several key aspects of medicine. The most relevant competencies of a health professional are an adequate communication capacity, which will influence the satisfaction of professionals and patients, therapeutic compliance, conflict prevention, clinical outcomes’ improvement and efficiency of health services. We define empathy as it as Sympathy and connection to others and capability to communicate this understanding. Some outcomes favoring empathy are female gender, younger age, and specialty choice. Third gender or third sex is a concept in which allows a person not to be categorized in a dual way but as a continuous variable, giving the choice of moving along it. This point of view recognizes three or more genders. The subject of Ethics and Clinical Communication is dedicated to sensitizing students about the importance and effectiveness of a good therapeutic relationship. We are also interested in other communicational aspects related to empathy as active listening, assertivity and basic and advanced Social Skills. Objectives: 1. To facilitate the approach of the student in the Medicine Degree to the reality of the medical profession 2. Analyze interesting outcome variables in communication 3. Interactive process to detect the areas of improvement in the learning process of the Physician throughout his professional career needs. Design: A comparative study with a cross-sectional approach was conducted in successive academic year cohorts of health professional students at a public Basque university. Four communicational aspects were evaluated through these questionnaires in Basque, Spanish and English: The active listening questionnaire, the TECA empathy questionnaire, the ACDA questionnaire and the EHS questionnaire Social Skills Scale. Types of interventions for improving skills: Interpersonal skills training intervention, Empathy intervention, Writing about experiential learning, Drama through role plays, Communicational skills training, Problem-based learning, Patient interviews ´videos, Empathy-focused training, Discussion. Results: It identified the need for a cross cultural adaptation and no gender distinction. The students enjoyed all the techniques in comparison to the usual master class. There was medium participation but these participative methodologies are not so usual in the university. According to empathy, men have a greater empathic capacity to fully understand women (p < 0.05) With regard to assertiveness there have been no differences between men and women in self-assertiveness but nevertheless women are more heteroassertive than men. Conclusions: These findings suggest that educational interventions with adequate feedback can be effective in maintaining and enhancing empathy in undergraduate medical students.Keywords: physician's communicational skills, patient satisfaction, third gender, cross cultural adaptation
Procedia PDF Downloads 1943617 Plant Mediated RNAi Approach to Knock Down Ecdysone Receptor Gene of Colorado Potato Beetle
Authors: Tahira Hussain, Ilhom Rahamkulov, Muhammad Aasim, Ugur Pirlak, Emre Aksoy, Mehmet Emin Caliskan, Allah Bakhsh
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RNA interference (RNAi) has proved its usefulness in functional genomic research on insects recently and is considered potential strategy in crop improvement for the control of insect pests. The different insect pests incur significant losses to potato yield worldwide, Colorado Potato Beetle (CPB) being most notorious one. The present study focuses to knock down highly specific 20-hydroxyecdysone hormone-receptor complex interaction by using RNAi approach to silence Ecdysone receptor (EcR) gene of CPB in transgenic potato plants expressing dsRNA of EcR gene. The partial cDNA of Ecdysone receptor gene of CPB was amplified using specific primers in sense and anti-sense orientation and cloned in pRNAi-GG vector flanked by an intronic sequence (pdk). Leaf and internodal explants of Lady Olympia, Agria and Granola cultivars of potato were infected with Agrobacterium strain LBA4404 harboring plasmid pRNAi-CPB, pRNAi-GFP (used as control). Neomycin phosphotransferase (nptII) gene was used as a plant selectable marker at a concentration of 100 mg L⁻¹. The primary transformants obtained have shown proper integration of T-DNA in plant genome by standard molecular analysis like polymerase chain reaction (PCR), real-time PCR, Sothern blot. The transgenic plants developed out of these cultivars are being evaluated for their efficacy against larvae as well adults of CPB. The transgenic lines are expected to inhibit expression of EcR protein gene, hindering their molting process, hence leading to increased potato yield.Keywords: plant mediated RNAi, molecular strategy, ecdysone receptor, insect metamorphosis
Procedia PDF Downloads 1723616 Unsupervised Classification of DNA Barcodes Species Using Multi-Library Wavelet Networks
Authors: Abdesselem Dakhli, Wajdi Bellil, Chokri Ben Amar
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DNA Barcode, a short mitochondrial DNA fragment, made up of three subunits; a phosphate group, sugar and nucleic bases (A, T, C, and G). They provide good sources of information needed to classify living species. Such intuition has been confirmed by many experimental results. Species classification with DNA Barcode sequences has been studied by several researchers. The classification problem assigns unknown species to known ones by analyzing their Barcode. This task has to be supported with reliable methods and algorithms. To analyze species regions or entire genomes, it becomes necessary to use similarity sequence methods. A large set of sequences can be simultaneously compared using Multiple Sequence Alignment which is known to be NP-complete. To make this type of analysis feasible, heuristics, like progressive alignment, have been developed. Another tool for similarity search against a database of sequences is BLAST, which outputs shorter regions of high similarity between a query sequence and matched sequences in the database. However, all these methods are still computationally very expensive and require significant computational infrastructure. Our goal is to build predictive models that are highly accurate and interpretable. This method permits to avoid the complex problem of form and structure in different classes of organisms. On empirical data and their classification performances are compared with other methods. Our system consists of three phases. The first is called transformation, which is composed of three steps; Electron-Ion Interaction Pseudopotential (EIIP) for the codification of DNA Barcodes, Fourier Transform and Power Spectrum Signal Processing. The second is called approximation, which is empowered by the use of Multi Llibrary Wavelet Neural Networks (MLWNN).The third is called the classification of DNA Barcodes, which is realized by applying the algorithm of hierarchical classification.Keywords: DNA barcode, electron-ion interaction pseudopotential, Multi Library Wavelet Neural Networks (MLWNN)
Procedia PDF Downloads 3203615 Listening to the Voices of Teachers Who Are Dyslexic: The Careers, Professional Development, and Strategies Used by of Teachers Who Are Dyslexic
Authors: Jane Mullen
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Little research has been undertaken on adult dyslexia and the impact it has on those who have professional careers. There are many complexities behind the career decisions people make, but for teachers who are dyslexic, it can be even more complex. Dyslexia particularly impacts on written and verbal communication, as well as planning and organisation skills which are essential skills for a teacher. As the teachers are aware of their areas of weakness many, make the conscious decision not to disclose their disability at work. In England, the reduction to three attempts to pass the compulsory English and Maths tests prior to undertaking teacher training may mean that dyslexics are now excluded from trying to enter the profession. Together with the fact that dyslexic teachers often chose to remain ‘hidden’ the situation appears to be counter to the inclusive rhetoric that dominates the current educational discourse. This paper is based on in-depth narrative research that has been undertaken with a small group of teachers who are dyslexic in England and firstly explores the strategies and resources that the teachers have found useful. The narratives of the teachers are full of difficulties as well as diversity, consequently, the paper secondly examines how life experiences have impacted on the way the teachers see their dyslexia and how it affects them professionally. Using a narrative methodology enables the teachers to tell their ‘stories’ of how they feel their dyslexia impacts on their lives professionally. The first interview centred around a limited number of semi structured questions about family background, educational experiences, career development, management roles and professional disclosure. The second interview focused on the complexities of being a teacher who is dyslexic and to ‘unlock’ some of their work based narratives visual elicitation was used. Photographs of work-based strategies, issues or concerns were sent to the researcher and these were used as the basis for discussion in the second interview. The paper concludes by discussing possible reasonable adjustments and professional development that might benefit teachers who are dyslexic.Keywords: dyslexia, life history, narrative, professional, professional development, strategies, teachers
Procedia PDF Downloads 2233614 Diversity and Taxonomy: Malaysian Marine Algae Genus Halimeda (Halimedaceae, Chlorophyta)
Authors: Nur Farah Ain Zainee, Ahmad Ismail, Nazlina Ibrahim, Asmida Ismail
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The study of genus Halimeda in Malaysia is in the early stage due to less specific study on its taxonomy. Most of the previous research tend to choose other genus such as Caulerpa and Gracilaria because of the potential of being utilized. The identification of Halimeda is complex by the high morphological variation within individual species due to different types of habitat and the changes in composition of seawater. The study was completed to study the diversity and distribution of Halimeda in Malaysia and to identify the morphological and anatomical differences between Halimeda species. The methods which have been used for this study are collection of Halimeda and seawater, preservation of specimen, identification of the specimen including the preparation of the temporary slide and decalcification of the calcium layer by using diluted hydrochloric acid. The specimen were processed in laboratory and kept as herbarium specimen in Algae Herbarium, Universiti Kebangsaan Malaysia. Environmental parameters were tested by using YSI multiparameter probe and the recorded data were temperature, salinity, pH and dissolved oxygen. The nutrient content of seawater such as nitrate and phosphate were analysed by using Hach kit model DR 2000. In the present study, out of 330 herbarium specimen, ten species were identified as Halimeda cuneata, H. discoidea, H. macroloba, H. macrophysa, H. opuntia, H. simulans, H. stuposa, H. taenicola, H. tuna and H. velasquezii. Of these, five species were new record to Malaysia. They are Halimeda cuneata, H. macrophysa, H. stuposa, H. taenicola and H. velasquezii. H. opuntia was found as the most abundance species with wide distribution in Malaysia coastal area. Meanwhile, from the study of their distribution, two localities in which Pulau Balak Balak, Kudat and Pulau Langkawi, Kedah, were noted having high number of Halimeda species. As a conclusion, this study has successfully identified ten species of Halimeda of Malaysia with full description of morphological characteristics that may assist further researcher to differentiate and identify Halimeda.Keywords: Distribution, diversity, Halimeda, morphological, taxonomy
Procedia PDF Downloads 3553613 Elucidating Microstructural Evolution Mechanisms in Tungsten via Layerwise Rolling in Additive Manufacturing: An Integrated Simulation and Experimental Approach
Authors: Sadman Durlov, Aditya Ganesh-Ram, Hamidreza Hekmatjou, Md Najmus Salehin, Nora Shayesteh Ameri
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In the field of additive manufacturing, tungsten stands out for its exceptional resistance to high temperatures, making it an ideal candidate for use in extreme conditions. However, its inherent brittleness and vulnerability to thermal cracking pose significant challenges to its manufacturability. This study explores the microstructural evolution of tungsten processed through layer-wise rolling in laser powder bed fusion additive manufacturing, utilizing a comprehensive approach that combines advanced simulation techniques with empirical research. We aim to uncover the complex processes of plastic deformation and microstructural transformations, with a particular focus on the dynamics of grain size, boundary evolution, and phase distribution. Our methodology employs a combination of simulation and experimental data, allowing for a detailed comparison that elucidates the key mechanisms influencing microstructural alterations during the rolling process. This approach facilitates a deeper understanding of the material's behavior under additive manufacturing conditions, specifically in terms of deformation and recrystallization. The insights derived from this research not only deepen our theoretical knowledge but also provide actionable strategies for refining manufacturing parameters to improve the tungsten components' mechanical properties and functional performance. By integrating simulation with practical experimentation, this study significantly enhances the field of materials science, offering a robust framework for the development of durable materials suited for challenging operational environments. Our findings pave the way for optimizing additive manufacturing techniques and expanding the use of tungsten across various demanding sectors.Keywords: additive manufacturing, layer wise rolling, refractory materials, in-situ microstructure modifications
Procedia PDF Downloads 623612 Genetic Programming: Principles, Applications and Opportunities for Hydrological Modelling
Authors: Oluwaseun K. Oyebode, Josiah A. Adeyemo
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Hydrological modelling plays a crucial role in the planning and management of water resources, most especially in water stressed regions where the need to effectively manage the available water resources is of critical importance. However, due to the complex, nonlinear and dynamic behaviour of hydro-climatic interactions, achieving reliable modelling of water resource systems and accurate projection of hydrological parameters are extremely challenging. Although a significant number of modelling techniques (process-based and data-driven) have been developed and adopted in that regard, the field of hydrological modelling is still considered as one that has sluggishly progressed over the past decades. This is majorly as a result of the identification of some degree of uncertainty in the methodologies and results of techniques adopted. In recent times, evolutionary computation (EC) techniques have been developed and introduced in response to the search for efficient and reliable means of providing accurate solutions to hydrological related problems. This paper presents a comprehensive review of the underlying principles, methodological needs and applications of a promising evolutionary computation modelling technique – genetic programming (GP). It examines the specific characteristics of the technique which makes it suitable to solving hydrological modelling problems. It discusses the opportunities inherent in the application of GP in water related-studies such as rainfall estimation, rainfall-runoff modelling, streamflow forecasting, sediment transport modelling, water quality modelling and groundwater modelling among others. Furthermore, the means by which such opportunities could be harnessed in the near future are discussed. In all, a case for total embracement of GP and its variants in hydrological modelling studies is made so as to put in place strategies that would translate into achieving meaningful progress as it relates to modelling of water resource systems, and also positively influence decision-making by relevant stakeholders.Keywords: computational modelling, evolutionary algorithms, genetic programming, hydrological modelling
Procedia PDF Downloads 3013611 An Improved Circulating Tumor Cells Analysis Method for Identifying Tumorous Blood Cells
Authors: Salvador Garcia Bernal, Chi Zheng, Keqi Zhang, Lei Mao
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Circulating Tumor Cells (CTC) is used to detect tumoral cell metastases using blood samples of patients with cancer (lung, breast, etc.). Using an immunofluorescent method a three channel image (Red, Green, and Blue) are obtained. These set of images usually overpass the 11 x 30 M pixels in size. An aided tool is designed for imaging cell analysis to segmented and identify the tumorous cell based on the three markers signals. Our Method, it is cell-based (area and cell shape) considering each channel information and extracting and making decisions if it is a valid CTC. The system also gives information about number and size of tumor cells found in the sample. We present results in real-life samples achieving acceptable performance in identifying CTCs in short time.Keywords: Circulating Tumor Cells (CTC), cell analysis, immunofluorescent, medical image analysis
Procedia PDF Downloads 2163610 Preliminary Study of Hand Gesture Classification in Upper-Limb Prosthetics Using Machine Learning with EMG Signals
Authors: Linghui Meng, James Atlas, Deborah Munro
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There is an increasing demand for prosthetics capable of mimicking natural limb movements and hand gestures, but precise movement control of prosthetics using only electrode signals continues to be challenging. This study considers the implementation of machine learning as a means of improving accuracy and presents an initial investigation into hand gesture recognition using models based on electromyographic (EMG) signals. EMG signals, which capture muscle activity, are used as inputs to machine learning algorithms to improve prosthetic control accuracy, functionality and adaptivity. Using logistic regression, a machine learning classifier, this study evaluates the accuracy of classifying two hand gestures from the publicly available Ninapro dataset using two-time series feature extraction algorithms: Time Series Feature Extraction (TSFE) and Convolutional Neural Networks (CNNs). Trials were conducted using varying numbers of EMG channels from one to eight to determine the impact of channel quantity on classification accuracy. The results suggest that although both algorithms can successfully distinguish between hand gesture EMG signals, CNNs outperform TSFE in extracting useful information for both accuracy and computational efficiency. In addition, although more channels of EMG signals provide more useful information, they also require more complex and computationally intensive feature extractors and consequently do not perform as well as lower numbers of channels. The findings also underscore the potential of machine learning techniques in developing more effective and adaptive prosthetic control systems.Keywords: EMG, machine learning, prosthetic control, electromyographic prosthetics, hand gesture classification, CNN, computational neural networks, TSFE, time series feature extraction, channel count, logistic regression, ninapro, classifiers
Procedia PDF Downloads 393609 Exploring the Energy Saving Benefits of Solar Power and Hot Water Systems: A Case Study of a Hospital in Central Taiwan
Authors: Ming-Chan Chung, Wen-Ming Huang, Yi-Chu Liu, Li-Hui Yang, Ming-Jyh Chen
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introduction: Hospital buildings require considerable energy, including air conditioning, lighting, elevators, heating, and medical equipment. Energy consumption in hospitals is expected to increase significantly due to innovative equipment and continuous development plans. Consequently, the environment and climate will be adversely affected. Hospitals should therefore consider transforming from their traditional role of saving lives to being at the forefront of global efforts to reduce carbon dioxide emissions. As healthcare providers, it is our responsibility to provide a high-quality environment while using as little energy as possible. Purpose / Methods: Compare the energy-saving benefits of solar photovoltaic systems and solar hot water systems. The proportion of electricity consumption effectively reduced after the installation of solar photovoltaic systems. To comprehensively assess the potential benefits of utilizing solar energy for both photovoltaic (PV) and solar thermal applications in hospitals, a solar PV system was installed covering a total area of 28.95 square meters in 2021. Approval was obtained from the Taiwan Power Company to integrate the system into the hospital's electrical infrastructure for self-use. To measure the performance of the system, a dedicated meter was installed to track monthly power generation, which was then converted into area output using an electric energy conversion factor. This research aims to compare the energy efficiency of solar PV systems and solar thermal systems. Results: Using the conversion formula between electrical and thermal energy, we can compare the energy output of solar heating systems and solar photovoltaic systems. The comparative study draws upon data from February 2021 to February 2023, wherein the solar heating system generated an average of 2.54 kWh of energy per panel per day, while the solar photovoltaic system produced 1.17 kWh of energy per panel per day, resulting in a difference of approximately 2.17 times between the two systems. Conclusions: After conducting statistical analysis and comparisons, it was found that solar thermal heating systems offer higher energy and greater benefits than solar photovoltaic systems. Furthermore, an examination of literature data and simulations of the energy and economic benefits of solar thermal water systems and solar-assisted heat pump systems revealed that solar thermal water systems have higher energy density values, shorter recovery periods, and lower power consumption than solar-assisted heat pump systems. Through monitoring and empirical research in this study, it has been concluded that a heat pump-assisted solar thermal water system represents a relatively superior energy-saving and carbon-reducing solution for medical institutions. Not only can this system help reduce overall electricity consumption and the use of fossil fuels, but it can also provide more effective heating solutions.Keywords: sustainable development, energy conservation, carbon reduction, renewable energy, heat pump system
Procedia PDF Downloads 853608 Study of Radiation Response in Lactobacillus Species
Authors: Kanika Arora, Madhu Bala
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The small intestine epithelium is highly sensitive and major targets of ionizing radiation. Radiation causes gastrointestinal toxicity either by direct deposition of energy or indirectly (inflammation or bystander effects) generating free radicals and reactive oxygen species. Oxidative stress generated as a result of radiation causes active inflammation within the intestinal mucosa leading to structural and functional impairment of gut epithelial barrier. As a result, there is a loss of tolerance to normal dietary antigens and commensal flora together with exaggerated response to pathogens. Dysbiosis may therefore thought to play a role in radiation enteropathy and can contribute towards radiation induced bowel toxicity. Lactobacilli residing in the gut shares a long conjoined evolutionary history with their hosts and by doing so these organisms have developed an intimate and complex symbiotic relationships. The objective behind this study was to look for the strains with varying resistance to ionizing radiation and to see whether the niche of the bacteria is playing any role in radiation resistance property of bacteria. In this study, we have isolated the Lactobacillus spp. from probiotic preparation and murine gastrointestinal tract, both of which were supposed to be the important source for its isolation. Biochemical characterization did not show a significant difference in the properties, while a significant preference was observed in carbohydrate utilization capacity by the isolates. Effect of ionizing radiations induced by Co60 gamma radiation (10 Gy) on lactobacilli cells was investigated. A cellular survival curve versus absorbed doses was determined. Radiation resistance studies showed that the response of isolates towards cobalt-60 gamma radiation differs from each other and significant decrease in survival was observed in a dose-dependent manner. Thus the present study revealed that the property of radioresistance in Lactobacillus depends upon the source from where they have been isolated.Keywords: dysbiosis, lactobacillus, mitigation, radiation
Procedia PDF Downloads 1413607 TNFRSF11B Gene Polymorphisms A163G and G11811C in Prediction of Osteoporosis Risk
Authors: I. Boroňová, J.Bernasovská, J. Kľoc, Z. Tomková, E. Petrejčíková, D. Gabriková, S. Mačeková
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Osteoporosis is a complex health disease characterized by low bone mineral density, which is determined by an interaction of genetics with metabolic and environmental factors. Current research in genetics of osteoporosis is focused on identification of responsible genes and polymorphisms. TNFRSF11B gene plays a key role in bone remodeling. The aim of this study was to investigate the genotype and allele distribution of A163G (rs3102735) osteoprotegerin gene promoter and G1181C (rs2073618) osteoprotegerin first exon polymorphisms in the group of 180 unrelated postmenopausal women with diagnosed osteoporosis and 180 normal controls. Genomic DNA was isolated from peripheral blood leukocytes using standard methodology. Genotyping for presence of different polymorphisms was performed using the Custom Taqman®SNP Genotyping assays. Hardy-Weinberg equilibrium was tested for each SNP in the groups of participants using the chi-square (χ2) test. The distribution of investigated genotypes in the group of patients with osteoporosis were as follows: AA (66.7%), AG (32.2%), GG (1.1%) for A163G polymorphism; GG (19.4%), CG (44.4%), CC (36.1%) for G1181C polymorphism. The distribution of genotypes in normal controls were follows: AA (71.1%), AG (26.1%), GG (2.8%) for A163G polymorphism; GG (22.2%), CG (48.9%), CC (28.9%) for G1181C polymorphism. In A163G polymorphism the variant G allele was more common among patients with osteoporosis: 17.2% versus 15.8% in normal controls. Also, in G1181C polymorphism the phenomenon of more frequent occurrence of C allele in the group of patients with osteoporosis was observed (58.3% versus 53.3%). Genotype and allele distributions showed no significant differences (A163G: χ2=0.270, p=0.605; χ2=0.250, p=0.616; G1181C: χ2= 1.730, p=0.188; χ2=1.820, p=0.177). Our results represents an initial study, further studies of more numerous file and associations studies will be carried out. Knowing the distribution of genotypes is important for assessing the impact of these polymorphisms on various parameters associated with osteoporosis. Screening for identification of “at-risk” women likely to develop osteoporosis and initiating subsequent early intervention appears to be most effective strategy to substantially reduce the risks of osteoporosis.Keywords: osteoporosis, real-time PCR method, SNP polymorphisms
Procedia PDF Downloads 3363606 Locating Potential Site for Biomass Power Plant Development in Central Luzon Philippines Using GIS-Based Suitability Analysis
Authors: Bryan M. Baltazar, Marjorie V. Remolador, Klathea H. Sevilla, Imee Saladaga, Loureal Camille Inocencio, Ma. Rosario Concepcion O. Ang
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Biomass energy is a traditional source of sustainable energy, which has been widely used in developing countries. The Philippines, specifically Central Luzon, has an abundant source of biomass. Hence, it could supply abundant agricultural residues (rice husks), as feedstock in a biomass power plant. However, locating a potential site for biomass development is a complex process which involves different factors, such as physical, environmental, socio-economic, and risks that are usually diverse and conflicting. Moreover, biomass distribution is highly dispersed geographically. Thus, this study develops an integrated method combining Geographical Information Systems (GIS) and methods for energy planning; Multi-Criteria Decision Analysis (MCDA) and Analytical Hierarchy Process (AHP), for locating suitable site for biomass power plant development in Central Luzon, Philippines by considering different constraints and factors. Using MCDA, a three level hierarchy of factors and constraints was produced, with corresponding weights determined by experts by using AHP. Applying the results, a suitability map for Biomass power plant development in Central Luzon was generated. It showed that the central part of the region has the highest potential for biomass power plant development. It is because of the characteristics of the area such as the abundance of rice fields, with generally flat land surfaces, accessible roads and grid networks, and low risks to flooding and landslide. This study recommends the use of higher accuracy resource maps, and further analysis in selecting the optimum site for biomass power plant development that would account for the cost and transportation of biomass residues.Keywords: analytic hierarchy process, biomass energy, GIS, multi-criteria decision analysis, site suitability analysis
Procedia PDF Downloads 4343605 A Serious Game to Upgrade the Learning of Organizational Skills in Nursing Schools
Authors: Benoit Landi, Hervé Pingaud, Jean-Benoit Culie, Michel Galaup
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Serious games have been widely disseminated in the field of digital learning. They have proved their utility in improving skills through virtual environments that simulate the field where new competencies have to be improved and assessed. This paper describes how we created CLONE, a serious game whose purpose is to help nurses create an efficient work plan in a hospital care unit. In CLONE, the number of patients to take care of is similar to the reality of their job, going far beyond what is currently practiced in nurse school classrooms. This similarity with the operational field increases proportionally the number of activities to be scheduled. Moreover, very often, the team of nurses is composed of regular nurses and nurse assistants that must share the work with respect to the regulatory obligations. Therefore, on the one hand, building a short-term planning is a complex task with a large amount of data to deal with, and on the other, good clinical practices have to be systematically applied. We present how reference planning has been defined by addressing an optimization problem formulation using the expertise of teachers. This formulation ensures the gameplay feasibility for the scenario that has been produced and enhanced throughout the game design process. It was also crucial to steer a player toward a specific gaming strategy. As one of our most important learning outcomes is a clear understanding of the workload concept, its factual calculation for each caregiver along time and its inclusion in the nurse reasoning during planning elaboration are focal points. We will demonstrate how to modify the game scenario to create a digital environment in which these somewhat abstract principles can be understood and applied. Finally, we give input on an experience we had on a pilot of a thousand undergraduate nursing students.Keywords: care planning, workload, game design, hospital nurse, organizational skills, digital learning, serious game
Procedia PDF Downloads 1923604 Construction of a Dynamic Migration Model of Extracellular Fluid in Brain for Future Integrated Control of Brain State
Authors: Tomohiko Utsuki, Kyoka Sato
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In emergency medicine, it is recognized that brain resuscitation is very important for the reduction of mortality rate and neurological sequelae. Especially, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) are most required for stabilizing brain’s physiological state in the treatment for such as brain injury, stroke, and encephalopathy. However, the manual control of BT, ICP, and CBF frequently requires the decision and operation of medical staff, relevant to medication and the setting of therapeutic apparatus. Thus, the integration and the automation of the control of those is very effective for not only improving therapeutic effect but also reducing staff burden and medical cost. For realizing such integration and automation, a mathematical model of brain physiological state is necessary as the controlled object in simulations, because the performance test of a prototype of the control system using patients is not ethically allowed. A model of cerebral blood circulation has already been constructed, which is the most basic part of brain physiological state. Also, a migration model of extracellular fluid in brain has been constructed, however the condition that the total volume of intracranial cavity is almost changeless due to the hardness of cranial bone has not been considered in that model. Therefore, in this research, the dynamic migration model of extracellular fluid in brain was constructed on the consideration of the changelessness of intracranial cavity’s total volume. This model is connectable to the cerebral blood circulation model. The constructed model consists of fourteen compartments, twelve of which corresponds to perfused area of bilateral anterior, middle and posterior cerebral arteries, the others corresponds to cerebral ventricles and subarachnoid space. This model enable to calculate the migration of tissue fluid from capillaries to gray matter and white matter, the flow of tissue fluid between compartments, the production and absorption of cerebrospinal fluid at choroid plexus and arachnoid granulation, and the production of metabolic water. Further, the volume, the colloid concentration, and the tissue pressure of/in each compartment are also calculable by solving 40-dimensional non-linear simultaneous differential equations. In this research, the obtained model was analyzed for its validation under the four condition of a normal adult, an adult with higher cerebral capillary pressure, an adult with lower cerebral capillary pressure, and an adult with lower colloid concentration in cerebral capillary. In the result, calculated fluid flow, tissue volume, colloid concentration, and tissue pressure were all converged to suitable value for the set condition within 60 minutes at a maximum. Also, because these results were not conflict with prior knowledge, it is certain that the model can enough represent physiological state of brain under such limited conditions at least. One of next challenges is to integrate this model and the already constructed cerebral blood circulation model. This modification enable to simulate CBF and ICP more precisely due to calculating the effect of blood pressure change to extracellular fluid migration and that of ICP change to CBF.Keywords: dynamic model, cerebral extracellular migration, brain resuscitation, automatic control
Procedia PDF Downloads 1573603 Linking Temporal Changes of Climate Factors with Staple Cereal Yields in Southern Burkina Faso
Authors: Pius Borona, Cheikh Mbow, Issa Ouedraogo
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In the Sahel, climate variability has been associated with a complex web of direct and indirect impacts. This natural phenomenon has been an impediment to agro-pastoral communities who experience uncertainty while involving in farming activities which is also their key source of livelihood. In this scenario, the role of climate variability in influencing the performance, quantity and quality of staple cereals yields, vital for food and nutrition security has been a topic of importance. This response of crops and subsequent yield variability is also a subject of immense debate due to the complexity of crop development at different stages. This complexity is further compounded by influence of slowly changing non-climatic factors. With these challenges in mind, the present paper initially explores the occurrence of climate variability at an inter annual and inter decadal level in South Burkina Faso. This is evidenced by variation of the total annual rainfall and the number of rainy days among other climatic descriptors. Further, it is shown how district-scale cereal yields in the study area including maize, sorghum and millet casually associate variably to the inter-annual variation of selected climate variables. Statistical models show that the three cereals widely depict sensitivity to the length of the growing period and total dry days in the growing season. Maize yields on the other hand relate strongly to the rainfall amount variation (R2=51.8%) showing high moisture dependence during critical growth stages. Our conclusions emphasize on adoption of efficient water utilization platforms especially those that have evidently increased yields and strengthening of forecasts dissemination.Keywords: climate variability, cereal yields, seasonality, rain fed farming, Burkina Faso, rainfall
Procedia PDF Downloads 2053602 Seroprevalence of Cytomegalovirus among Pregnant Women in Islamabad, Pakistan
Authors: Hassan Waseem
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Cytomegalovirus (CMV) is ubiquitously distributed viral agent responsible for different clinical manifestations that may vary according to the immunologic status of the patient. CMV can cause morbidity and mortality among fetuses and patients with compromised immune system. A cross-sectional study was carried out in Islamabad to investigate the prevalence and risk factors associated with CMV infection among pregnant women. Blood samples of 172 pregnant women visiting Mother and Child Healthcare, Pakistan Institute of Medical Sciences (PIMS) Islamabad were taken. In present study, serum samples of the women were checked for CMV-specific IgG and IgM antibodies by enzyme linked immunosorbent assay (ELISA). Clinical, obstetrical and socio-demographical characteristics of the women were collected by using structured questionnaires. Out of 172 pregnant women included in the study, 171 (99.4%) were CMV specific IgG positive and 30 (17.4%) were found positive for CMV-IgM antibodies. The CMV has taken an endemic form in Pakistan so, routine screening of CMV among pregnant women is recommended.Keywords: Cytomegalovirus, blood transfusion, ELISA, seroprevalence
Procedia PDF Downloads 371