Search results for: medical imaging analysis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 30882

Search results for: medical imaging analysis

25992 Spatial Resilience of the Ageing Population in the Romanian Functional Urban Areas

Authors: Marinela Istrate, Ionel Muntele, Alexandru Bănică

Abstract:

The authors propose the identification, analysis and prognosis of the quantitative and qualitative evolution of the elderly population in the functional urban areas. The present paper takes into account the analysis of some representative indicators (the weight of the elderly population, ageing index, dynamic index of economic ageing of productive population etc.) and the elaboration of an integrated indicator that would help differentiate the population ageing forms in the 48 functional urban areas that were defined based on demographic and social-economic criteria for all large and medium cities in Romania.

Keywords: ageing, demographic transition, functional urban areas, spatial resilience

Procedia PDF Downloads 351
25991 Spatial Analysis as a Tool to Assess Risk Management in Peru

Authors: Josué Alfredo Tomas Machaca Fajardo, Jhon Elvis Chahua Janampa, Pedro Rau Lavado

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A flood vulnerability index was developed for the Piura River watershed in northern Peru using Principal Component Analysis (PCA) to assess flood risk. The official methodology to assess risk from natural hazards in Peru was introduced in 1980 and proved effective for aiding complex decision-making. This method relies in part on decision-makers defining subjective correlations between variables to identify high-risk areas. While risk identification and ensuing response activities benefit from a qualitative understanding of influences, this method does not take advantage of the advent of national and international data collection efforts, which can supplement our understanding of risk. Furthermore, this method does not take advantage of broadly applied statistical methods such as PCA, which highlight central indicators of vulnerability. Nowadays, information processing is much faster and allows for more objective decision-making tools, such as PCA. The approach presented here develops a tool to improve the current flood risk assessment in the Peruvian basin. Hence, the spatial analysis of the census and other datasets provides a better understanding of the current land occupation and a basin-wide distribution of services and human populations, a necessary step toward ultimately reducing flood risk in Peru. PCA allows the simplification of a large number of variables into a few factors regarding social, economic, physical and environmental dimensions of vulnerability. There is a correlation between the location of people and the water availability mainly found in rivers. For this reason, a comprehensive vision of the population location around the river basin is necessary to establish flood prevention policies. The grouping of 5x5 km gridded areas allows the spatial analysis of flood risk rather than assessing political divisions of the territory. The index was applied to the Peruvian region of Piura, where several flood events occurred in recent past years, being one of the most affected regions during the ENSO events in Peru. The analysis evidenced inequalities for the access to basic services, such as water, electricity, internet and sewage, between rural and urban areas.

Keywords: assess risk, flood risk, indicators of vulnerability, principal component analysis

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25990 Analysis of the Movie “Life and a Day”

Authors: Mehravar Javid, Katherine Marshall Woods, Joseph Kosowsky, Anna Missner

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In this paper, "Life and a Day" is analyzed psychoanalytically with an emphasis on the ways by which addiction is influenced by personal psychology and familial ties. It explores the influence of parenting on one's sense of self and the function of therapeutic alliances in the treatment of addiction. The analysis also observes the main characters, with a special emphasis on Somayeh, who represents the continuation of her father's role in the family and faces identity and autonomy issues in the face of familial responsibilities. In addressing addiction, the document emphasizes the significance of comprehending family dynamics and individual psychological factors, emphasizing the interaction between personal trauma, family roles, and recovery.

Keywords: addiction, autonomy, family dynamics, identity, life and a day, psychoanalytic

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25989 Regional Adjustment to the Analytical Attenuation Coefficient in the GMPM BSSA 14 for the Region of Spain

Authors: Gonzalez Carlos, Martinez Fransisco

Abstract:

There are various types of analysis that allow us to involve seismic phenomena that cause strong requirements for structures that are designed by society; one of them is a probabilistic analysis which works from prediction equations that have been created based on metadata seismic compiled in different regions. These equations form models that are used to describe the 5% damped pseudo spectra response for the various zones considering some easily known input parameters. The biggest problem for the creation of these models requires data with great robust statistics that support the results, and there are several places where this type of information is not available, for which the use of alternative methodologies helps to achieve adjustments to different models of seismic prediction.

Keywords: GMPM, 5% damped pseudo-response spectra, models of seismic prediction, PSHA

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25988 Lexico-Semantic and Contextual Analysis of the Concept of Joy in Modern English Fiction

Authors: Zarine Avetisyan

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Concepts are part and parcel of everyday text and talk. Their ubiquity predetermines the topicality of the given research which aims at the semantic decomposition of concepts in general and the concept of joy in particular, as well as the study of lexico-semantic variants as means of realization of a certain concept in different “semantic settings”, namely in a certain context. To achieve the stated aim, the given research departs from the methods of componential and contextual analysis, studying lexico-semantic variants /LSVs/ of the concept of joy and the semantic signs embedded in those LSVs, such as the semantic sign of intensity, supporting emotions, etc. in the context of Modern English fiction.

Keywords: concept, context, lexico-semantic variant, semantic sign

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25987 Using Corpora in Semantic Studies of English Adjectives

Authors: Oxana Lukoshus

Abstract:

The methods of corpus linguistics, a well-established field of research, are being increasingly applied in cognitive linguistics. Corpora data are especially useful for different quantitative studies of grammatical and other aspects of language. The main objective of this paper is to demonstrate how present-day corpora can be applied in semantic studies in general and in semantic studies of adjectives in particular. Polysemantic adjectives have been the subject of numerous studies. But most of them have been carried out on dictionaries. Undoubtedly, dictionaries are viewed as one of the basic data sources, but only at the initial steps of a research. The author usually starts with the analysis of the lexicographic data after which s/he comes up with a hypothesis. In the research conducted three polysemantic synonyms true, loyal, faithful have been analyzed in terms of differences and similarities in their semantic structure. A corpus-based approach in the study of the above-mentioned adjectives involves the following. After the analysis of the dictionary data there was the reference to the following corpora to study the distributional patterns of the words under study – the British National Corpus (BNC) and the Corpus of Contemporary American English (COCA). These corpora are continually updated and contain thousands of examples of the words under research which make them a useful and convenient data source. For the purpose of this study there were no special needs regarding genre, mode or time of the texts included in the corpora. Out of the range of possibilities offered by corpus-analysis software (e.g. word lists, statistics of word frequencies, etc.), the most useful tool for the semantic analysis was the extracting a list of co-occurrence for the given search words. Searching by lemmas, e.g. true, true to, and grouping the results by lemmas have proved to be the most efficient corpora feature for the adjectives under the study. Following the search process, the corpora provided a list of co-occurrences, which were then to be analyzed and classified. Not every co-occurrence was relevant for the analysis. For example, the phrases like An enormous sense of responsibility to protect the minds and hearts of the faithful from incursions by the state was perceived to be the basic duty of the church leaders or ‘True,’ said Phoebe, ‘but I'd probably get to be a Union Official immediately were left out as in the first example the faithful is a substantivized adjective and in the second example true is used alone with no other parts of speech. The subsequent analysis of the corpora data gave the grounds for the distribution groups of the adjectives under the study which were then investigated with the help of a semantic experiment. To sum it up, the corpora-based approach has proved to be a powerful, reliable and convenient tool to get the data for the further semantic study.

Keywords: corpora, corpus-based approach, polysemantic adjectives, semantic studies

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25986 Relationships of Functional Status and Subjective Health Status among Stable Chronic Obstructive Pulmonary Disease Patients Residing in the Community

Authors: Hee-Young Song

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Background and objectives: In 2011, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations proposed a multidimensional assessment of patients’ conditions that included both functional parameters and patient-reported outcomes, with the aim to provide a comprehensive assessment of the disease, thus meeting both the needs of the patient and the role of the physician. However, few studies have evaluated patient-reported outcomes as well as objective functional assessments among individuals with chronic obstructive pulmonary disease (COPD) in clinical practice in Korea. This study was undertaken to explore the relationship between functional status assessed by the 6-minute walking distance (MWD) test and subjective health status reported by stable patients with COPD residing in community. Methods: A cross-sectional descriptive study was conducted with 118 stable COPD patients aged 69.4 years old and selected by a convenient sampling from an outpatient department of pulmonology in a tertiaryhospitals. The 6-MWD test was conducted according to standardized instructions. Participants also completed a constructed questionnaire including general characteristics, smoking history, dyspnea by modified medical research council (mMRC) scale, and health status by COPD assessment test (CAT). Anthropometric measurements were performed for body mass index (BMI). Medical records were reviewed to obtain disease-related characteristics including duration of the disease and forced expiratory volume in 1 second (FEV1). Data were analyzed using PASW statistics 20.0. Results: Mean FEV1% of participants was 63.51% and mean 6-MWD and CAT scores were 297.54m and 17.7, respectively. The 6-MWD and CAT showed significant negative correlations (r= -.280, p=.002); FEV1 and CAT did as well correlations (r= -.347, p < .001). Conclusions: Findings suggest that the better functional status an individual with COPD has, the better subjective health status is, and provide the support for using patient-reported outcomes along with functional parameters to facilitate comprehensive assessment of COPD patients in real clinical practices.

Keywords: chronic obstructive pulmonary disease, COPD assessment test, functional status, patient-reported outcomes

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25985 Design of an Active Compression System for Treating Vascular Disease Using a Series of Silicone Based Inflatable Mini Bladders

Authors: Gayani K. Nandasiri, Tilak Dias, William Hurley

Abstract:

Venous disease of human lower limb could range from minor asymptomatic incompetence of venous valves to chronic venous ulceration. The sheer prevalence of varicose veins and its associated significant costs of treating late complications such as chronic ulcers contribute to a higher burden on health care resources. In most of western countries with developed health care systems, treatment costs associated with Venous disease accounts for a considerable portion of their total health care budget, and it has become a high-cost burden to National Health Service (NHS), UK. The established gold standard of treatment for the venous disease is the graduated compression, where the pressure at the ankle being highest and decreasing towards the knee and thigh. Currently, medical practitioners use two main methods to treat venous disease; i.e. compression bandaging and compression stockings. Both these systems have their own disadvantages which lead to the current programme of research. The aim of the present study is to revolutionize the compression therapy by using a novel active compression system to deliver a controllable and more accurate pressure profiles using a series of inflatable mini bladders. Two types of commercially available silicones were tested for the application. The mini bladders were designed with a special fabrication procedure to provide required pressure profiles, and a series of experiments were conducted to characterise the mini bladders. The inflation/deflation heights of these mini bladders were investigated experimentally and using a finite element model (FEM), and the experimental data were compared to the results obtained from FEM simulations, which showed 70-80% agreement. Finally, the mini bladders were tested for its pressure transmittance characteristics, and the results showed a 70-80% of inlet air pressure transmitted onto the treated surface.

Keywords: finite element analysis, graduated compression, inflatable bladders, venous disease

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25984 Combining Diffusion Maps and Diffusion Models for Enhanced Data Analysis

Authors: Meng Su

Abstract:

High-dimensional data analysis often presents challenges in capturing the complex, nonlinear relationships and manifold structures inherent to the data. This article presents a novel approach that leverages the strengths of two powerful techniques, Diffusion Maps and Diffusion Probabilistic Models (DPMs), to address these challenges. By integrating the dimensionality reduction capability of Diffusion Maps with the data modeling ability of DPMs, the proposed method aims to provide a comprehensive solution for analyzing and generating high-dimensional data. The Diffusion Map technique preserves the nonlinear relationships and manifold structure of the data by mapping it to a lower-dimensional space using the eigenvectors of the graph Laplacian matrix. Meanwhile, DPMs capture the dependencies within the data, enabling effective modeling and generation of new data points in the low-dimensional space. The generated data points can then be mapped back to the original high-dimensional space, ensuring consistency with the underlying manifold structure. Through a detailed example implementation, the article demonstrates the potential of the proposed hybrid approach to achieve more accurate and effective modeling and generation of complex, high-dimensional data. Furthermore, it discusses possible applications in various domains, such as image synthesis, time-series forecasting, and anomaly detection, and outlines future research directions for enhancing the scalability, performance, and integration with other machine learning techniques. By combining the strengths of Diffusion Maps and DPMs, this work paves the way for more advanced and robust data analysis methods.

Keywords: diffusion maps, diffusion probabilistic models (DPMs), manifold learning, high-dimensional data analysis

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25983 Age-Associated Seroprevalence of Toxoplasma gondii in 10892 Pregnant Women in Senegal between 2016 and 2019

Authors: Ndiaye Mouhamadou, Seck Abdoulaye, Ndiaye Babacar, Diallo Thierno Abdoulaye, Diop Abdou, Seck Mame Cheikh, Diongue Khadim, Badiane Aida Sadikh, Diallo Mamadou Alpha, Kouedvidjin Ekoué, Ndiaye Daouda

Abstract:

Background: Toxoplasmosis is a parasite disease that presents high rates of gestational and congenital infection worldwide and is therefore considered a public health problem and a neglected disease. The aim of this study was to determine the seroprevalence of toxoplasmosis in pregnant women referred to the medical biology laboratory of the Pasteur Institute of Dakar (Senegal) between January 2014 and December 2019. Methodology: This was a cross-sectional, descriptive, retrospective study of 10892 blood samples from pregnant women aged 16 to 46 years. The Architect toxo IgG/IgM from Abbot Laboratories, which is a chemiluminescent microparticle immunoassay (CMIA), was used for the quantitative determination of antibodies against Toxoplasma gondii in human serum. Results: In total, over a period from January 2014 to December 2019, 10892 requests for toxoplasmosis serology in pregnant women were included. The age of the patients included in our series ranged from 16 to 46 years. The mean age was 31.2 ± 5.72 years. The overall seroprevalence of T. gondii in pregnant women was estimated to be 28.9% [28.0-29.7]. In a multivariate logistic regression analysis, after adjustment for a covariate such as a study period, pregnant women aged 36-46 years were more likely to carry IgG antibodies to T. gondii than pregnant women younger than 36 years. Conclusion: T. gondii seroprevalence was significantly higher in pregnant women older than 36 years, leaving younger women more susceptible to primary T. gondii infection and their babies to congenital toxoplasmosis. There will be a need to increase awareness of the risk factors for toxoplasmosis and its different modes of transmission in these high-risk groups, but this should be supported by epidemiologic studies of the distribution of risk factors for toxoplasmosis in pregnant women and women of childbearing age.

Keywords: toxoplasmosis, pregnancy, seroprevalence, Senegal

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25982 Constructing a Bayesian Network for Solar Energy in Egypt Using Life Cycle Analysis and Machine Learning Algorithms

Authors: Rawaa H. El-Bidweihy, Hisham M. Abdelsalam, Ihab A. El-Khodary

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In an era where machines run and shape our world, the need for a stable, non-ending source of energy emerges. In this study, the focus was on the solar energy in Egypt as a renewable source, the most important factors that could affect the solar energy’s market share throughout its life cycle production were analyzed and filtered, the relationships between them were derived before structuring a Bayesian network. Also, forecasted models were built for multiple factors to predict the states in Egypt by 2035, based on historical data and patterns, to be used as the nodes’ states in the network. 37 factors were found to might have an impact on the use of solar energy and then were deducted to 12 factors that were chosen to be the most effective to the solar energy’s life cycle in Egypt, based on surveying experts and data analysis, some of the factors were found to be recurring in multiple stages. The presented Bayesian network could be used later for scenario and decision analysis of using solar energy in Egypt, as a stable renewable source for generating any type of energy needed.

Keywords: ARIMA, auto correlation, Bayesian network, forecasting models, life cycle, partial correlation, renewable energy, SARIMA, solar energy

Procedia PDF Downloads 155
25981 A Morphological Examination of Urban Renewal Processes: The Sample of Konya City

Authors: Muzaffer Ali Yaygın, Mehmet Topçu

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This research aims to investigate morphological changes in urban patterns in urban renewal areas by using geographic information systems and to reveal pattern differences that occur before and after urban renewal processes by applying a morphological analysis. The concept of urban morphology is not involved in urban renewal and urban planning practices in Turkey. This situation destroys the structural characteristic of urban space which appears as a consequence of changes at city, street or plot level. Different approaches and renewal interventions to urban settlements, which are formed as a reflection of cultural issues, may have positive and negative results. A morphological analysis has been applied to an urban renewal area that covers 325 ha. in Konya, in which city urban renewal projects have gained speed with the increasing of economic investments in this study. The study mentions urban renewal and urban morphology relationship, varied academic approach on the urban morphology issue, urban morphology components, changes in lots pattern and numerical differences that occur on road, construction and green space ratios that are before and after the renewal project, and the results of the morphological analysis. It is seen that the built-up area has significant differences when compared to the previous situation. The amount of green areas decreased significantly in quantitative terms; the transportation systems has been changed completely; and the property ownership has been reconstructed without taking the previous situation into account. Findings show that urban renewal projects in Turkey are put into practice with a rent-oriented approach without making an in-depth analysis. The paper discusses the morphological dimension of urban renewal projects in Turkey through a case study from Konya city.

Keywords: Konya, pattern, urban morphology, urban renewal

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25980 Clinicians’ Perspectives on Child Language Brokering

Authors: Carmen Pena-Díaz

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Linguistic and cultural difficulties regarding the access and use of public services, as well as facilitating communication at all levels, are problems which have not yet been tackled by authorities in Spain. In fact, linguistic and cultural issues are often not recognised as an integral part of migratory movements or social integration. While professionals of interlinguistic and intercultural communication (translators, interpreters, mediators) know that language and culture are key components to achieve immigrant integration and consolidate a truly multilingual society, policymakers at local, national, or supranational levels do not always seem aware of the risks and costs of not providing interpreting and translation services, particularly those affecting the health of users. Regarding the services currently used to cover the communication-related needs between the non-Spanish speaking population and healthcare professionals, evidence proves that there are no effective provisions for communication problems at present in Spanish hospitals. An example that suggests the poor management of the situation in relation to the migrants’ access to public healthcare is the fact that relying on a family member (often a minor) in medical consultations is one of the main practices that affects communication. At present, most medical professionals will explain that in their consultations with migrants who do not speak Spanish, they ask them to bring along a family member or friend who speaks Spanish. In fact, an abundant body of literature describes situations in which family members, children, friends, or anyone who speaks or understands a language helps to break language barriers in hospitals, not only in Spain. It is not difficult to see the problems this may cause, from ethical issues to comprehension problems and misunderstandings. This paper will present the results of Narrative Inquiry from a sample of eight clinicians about their perceptions and experiences using child language brokers in their appointments with non-Spanish speaking families. The main aim is to collect information about child language brokering as recalled and perceived by clinicians who present CLB as a routine practice and express their concerns and worries about using children to convey negative news to their parents or family members.

Keywords: child language brokering, community interpreting, healthcare, PSIT

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25979 Energetic and Exergetic Evaluation of Box-Type Solar Cookers Using Different Insulation Materials

Authors: A. K. Areamu, J. C. Igbeka

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The performance of box-type solar cookers has been reported by several researchers but little attention was paid to the effect of the type of insulation material on the energy and exergy efficiency of these cookers. This research aimed at evaluating the energy and exergy efficiencies of the box-type cookers containing different insulation materials. Energy and exergy efficiencies of five box-type solar cookers insulated with maize cob, air (control), maize husk, coconut coir and polyurethane foam respectively were obtained over a period of three years. The cookers were evaluated using water heating test procedures in determining the energy and exergy analysis. The results were subjected to statistical analysis using ANOVA. The result shows that the average energy input for the five solar cookers were: 245.5, 252.2, 248.7, 241.5 and 245.5J respectively while their respective average energy losses were: 201.2, 212.7, 208.4, 189.1 and 199.8J. The average exergy input for five cookers were: 228.2, 234.4, 231.1, 224.4 and 228.2J respectively while their respective average exergy losses were: 223.4, 230.6, 226.9, 218.9 and 223.0J. The energy and exergy efficiency was highest in the cooker with coconut coir (37.35 and 3.90% respectively) in the first year but was lowest for air (11 and 1.07% respectively) in the third year. Statistical analysis showed significant difference between the energy and exergy efficiencies over the years. These results reiterate the importance of a good insulating material for a box-type solar cooker.

Keywords: efficiency, energy, exergy, heating insolation

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25978 Social Capital and Human Capital: An OECD Countries' Analysis

Authors: Shivani Khare

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It is of paramount concern for economists to uncover the factors that determine human capital development, considered now to be one of the major factors behind economic growth and development. However, no human action is isolated but rather works within the set-up of the society. In recent years, a new field of investigation has come up that analyses the relationships that exist between social and human capital. Along these lines, this paper explores the effect of social capital on the indicators of human capital development – life expectancy at birth, mean years of schooling, and per capita income. The applied part of the analysis is performed using a panel data model for OECD countries and by using a series of chronological periods that within the 2005–2020 time frame.

Keywords: social capital, human capital development, trust, social networks, socioeconomics

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25977 Evaluation of Intraoral Complications of Buccal Mucosa Graft in Augmentation Urethroplasty

Authors: Dahna Alkahtani, Faryal Suraya, Fadah Alanazi

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Background: Buccal mucosal graft for urethral augmentation has surpassed other grafting options, and is now considered the standard of choice for substitution Urethroplasty. The graft has gained its popularity due to its excellent short and long-term results, easy harvesting as well as its ability in withstanding wet environments. However, although Buccal mucosal grafts are an excellent option, it is not free of complications, potential intraoral complications are bleeding, pain, swelling, injury to the nerve resulting in numbness, lip deviation or retraction. Objectives: The current study aims to evaluate the intraoral complications of buccal mucosa grafts harvested from one cheek, and used in Augmentation Urethroplasty. Methodology: The study was conducted retrospectively using the medical records of patients who underwent open augmentation urethroplasty with a buccal mucosa graft at King Khalid University Hospital, Saudi Arabia. Data collection of demographics included the type of graft used, presence or absence of strictures and its etiological factors. Pre-operative and post-operative evaluations were carried out on the subjects including the medical history, physical examination, uroflowmetry, retrograde urethrography, voiding cystourethrography and urine cultures were also noted. Further, the quality of life and complications of the procedure including the presence or occurrence of bleeding within 3-days post-procedure, the severity of pain, oral swelling after grafting, length of return to normal daily diet, painful surgical site, intake of painkillers, presence or absence of speech disturbance, numbness in the cheeks and lips were documented. Results: Thirty-two male subjects with ages ranging from 15 years to 72 years were included in the current study. Following the procedure, a hundred percent of the subjects returned to their normal daily diet by the sixth postoperative day. Further, the majority of the patients reported experiencing mild pain accounting for 61.3%, and 90.3% of the subjects reported using painkillers to control the pain. Surgical wound Pain was reportedly more common at the perineal site as 48.4% of the subjects experienced it; on the other hand, 41.9% of the patients experienced pain in the oral mucosa. The presence of speech disorders, as assessed through medical history, was found to be present in 3.2% of patients. The presence of numbness in the cheeks and lips was found in 3.2% of patients. Other complications such as parotid duct injury, delayed wound healing, non-healing wound and suture granuloma were rare as 90.3% of the subjects denied experiencing any of them, there were nonetheless reports of parotid duct injury by 6.5% of the patients, and non-healing wound by the 3.2% of patients. Conclusion: Buccal Mucosa Graft in Augmentation Urethroplasty is an ideal source of allograft, although not entirely painless; it is considerably safe with minimal intra-oral complication and undetectable strain on the patients’ quality of life.

Keywords: augmentation, buccal, graft, oral

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25976 Design and Analysis of Electric Power Production Unit for Low Enthalpy Geothermal Reservoir Applications

Authors: Ildar Akhmadullin, Mayank Tyagi

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The subject of this paper is the design analysis of a single well power production unit from low enthalpy geothermal resources. A complexity of the project is defined by a low temperature heat source that usually makes such projects economically disadvantageous using the conventional binary power plant approach. A proposed new compact design is numerically analyzed. This paper describes a thermodynamic analysis, a working fluid choice, downhole heat exchanger (DHE) and turbine calculation results. The unit is able to produce 321 kW of electric power from a low enthalpy underground heat source utilizing n-Pentane as a working fluid. A geo-pressured reservoir located in Vermilion Parish, Louisiana, USA is selected as a prototype for the field application. With a brine temperature of 126℃, the optimal length of DHE is determined as 304.8 m (1000ft). All units (pipes, turbine, and pumps) are chosen from commercially available parts to bring this project closer to the industry requirements. Numerical calculations are based on petroleum industry standards. The project is sponsored by the Department of Energy of the US.

Keywords: downhole heat exchangers, geothermal power generation, organic rankine cycle, refrigerants, working fluids

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25975 Association between Severe Acidemia before Endotracheal Intubation and the Lower First Attempt Intubation Success Rate

Authors: Keiko Naito, Y. Nakashima, S. Yamauchi, Y. Kunitani, Y. Ishigami, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi

Abstract:

Background: A presence of severe acidemia, defined as pH < 7.2, is common during endotracheal intubation for critically ill patients in the emergency department (ED). Severe acidemia is widely recognized as a predisposing factor for intubation failure. However, it is unclear that acidemic condition itself actually makes endotracheal intubation more difficult. We aimed to evaluate if a presence of severe acidemia before intubation is associated with the lower first attempt intubation success rate in the ED. Methods: This is a retrospective observational cohort study in the ED of an urban hospital in Japan. The collected data included patient demographics, such as age, sex, and body mass index, presence of one or more factors of modified LEMON criteria for predicting difficult intubation, reasons for intubation, blood gas levels, airway equipment, intubation by emergency physician or not, and the use of the rapid sequence intubation technique. Those with any of the following were excluded from the analysis: (1) no blood gas drawn before intubation, (2) cardiopulmonary arrest, and (3) under 18 years of age. The primary outcome was the first attempt intubation success rates between a severe acidemic patients (SA) group and a non-severe acidemic patients (NA) group. Logistic regression analysis was used to test the first attempt success rates for intubations between those two groups. Results: Over 5 years, a total of 486 intubations were performed; 105 in the SA group and 381 in the NA group. The univariate analysis showed that the first attempt intubation success rate was lower in the SA group than in the NA group (71.4% vs 83.5%, p < 0.01). The multivariate logistic regression analysis identified that severe acidemia was significantly associated with the first attempt intubation failure (OR 1.9, 95% CI 1.03-3.68, p = 0.04). Conclusions: A presence of severe acidemia before endotracheal intubation lowers the first attempt intubation success rate in the ED.

Keywords: acidemia, airway management, endotracheal intubation, first-attempt intubation success rate

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25974 Challenges to Quality Primary Health Care in Saudi Arabia and Potential Improvements Implemented by Other Systems

Authors: Hilal Al Shamsi, Abdullah Almutairi

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Introduction: As primary healthcare centres play an important role in implementing Saudi Arabia’s health strategy, this paper offers a review of publications on the quality of the country’s primary health care. With the aim of deciding on solutions for improvement, it provides an overview of healthcare quality in this context and indicates barriers to quality. Method: Using two databases, ProQuest and Scopus, data extracted from published articles were systematically analysed for determining the care quality in Saudi primary health centres and obstacles to achieving higher quality. Results: Twenty-six articles met the criteria for inclusion in this review. The components of healthcare quality were examined in terms of the access to and effectiveness of interpersonal and clinical care. Good access and effective care were identified in such areas as maternal health care and the control of epidemic diseases, whereas poor access and effectiveness of care were shown for chronic disease management programmes, referral patterns (in terms of referral letters and feedback reports), health education and interpersonal care (in terms of language barriers). Several factors were identified as barriers to high-quality care. These included problems with evidence-based practice implementation, professional development, the use of referrals to secondary care and organisational culture. Successful improvements have been implemented by other systems, such as mobile medical units, electronic referrals, online translation tools and mobile devices and their applications; these can be implemented in Saudi Arabia for improving the quality of the primary healthcare system in this country. Conclusion: The quality of primary health care in Saudi Arabia varies among the different services. To improve quality, management programmes and organisational culture must be promoted in primary health care. Professional development strategies are also needed for improving the skills and knowledge of healthcare professionals. Potential improvements can be implemented to improve the quality of the primary health system.

Keywords: quality, primary health care, Saudi Arabia, health centres, general medical

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25973 Role of Human Epididymis Protein 4 as a Biomarker in the Diagnosis of Ovarian Cancer

Authors: Amar Ranjan, Julieana Durai, Pranay Tanwar

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Background &Introduction: Ovarian cancer is one of the most common malignant tumor in the female. 70% of the cases of ovarian cancer are diagnosed at an advanced stage. The five-year survival rate associated with ovarian cancer is less than 30%. The early diagnosis of ovarian cancer becomes a key factor in improving the survival rate of patients. Presently, CAl25 (carbohydrate antigen125) is used for the diagnosis and therapeutic monitoring of ovarian cancer, but its sensitivity and specificity is not ideal. The introduction of HE4, human epididymis protein 4 has attracted much attention. HE4 has a sensitivity and specificity of 72.9% and 95% for differentiating between benign and malignant adnexal masses, which is better than CA125 detection.  Methods: Serum HE4 and CA -125 were estimated using the chemiluminescence method. Our cases were 40 epithelial ovarian cancer, 9 benign ovarian tumor, 29 benign gynaecological diseases and 13 healthy individuals. This group include healthy woman those who have undergoing family planning and menopause-related medical consultations and they are negative for ovarian mass. Optimal cut off values for HE4 and CA125 were 55.89pmol/L and 40.25U/L respectively (determined by statistical analysis). Results: The level of HE4 was raised in all ovarian cancer patients (n=40) whereas CA125 levels were normal in 6/40 ovarian cancer patients, which were the cases of OC confirmed by histopathology. There is a significant decrease in the level of HE4 with comparison to CA125 in benign ovarian tumor cases. Both the levels of HE4 and CA125 were raised in the nonovarian cancer group, which includes cancer of endometrium and cervix. In the healthy group, HE4 was normal in all patients except in one case of the rudimentary horn, and the reason for this raised HE4 level is due to the incomplete development of uterus whereas CA125 was raised in 3 cases. Conclusions: Findings showed that the serum level of HE4 is an important indicator in the diagnosis of ovarian cancer, and it also distinguishes between benign and malignant pelvic masses. However, a combination of HE4 and CA125 panel will be extremely valuable in improving the diagnostic efficiency of ovarian cancer. These findings of our study need to be validated in the larger cohort of patients.

Keywords: human epididymis protein 4, ovarian cancer, diagnosis, benign lesions

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25972 Identifying Metabolic Pathways Associated with Neuroprotection Mediated by Tibolone in Human Astrocytes under an Induced Inflammatory Model

Authors: Daniel Osorio, Janneth Gonzalez, Andres Pinzon

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In this work, proteins and metabolic pathways associated with the neuroprotective response mediated by the synthetic neurosteroid tibolone under a palmitate-induced inflammatory model were identified by flux balance analysis (FBA). Three different metabolic scenarios (‘healthy’, ‘inflamed’ and ‘medicated’) were modeled over a gene expression data-driven constructed tissue-specific metabolic reconstruction of mature astrocytes. Astrocyte reconstruction was built, validated and constrained using three open source software packages (‘minval’, ‘g2f’ and ‘exp2flux’) released through the Comprehensive R Archive Network repositories during the development of this work. From our analysis, we predict that tibolone executes their neuroprotective effects through a reduction of neurotoxicity mediated by L-glutamate in astrocytes, inducing the activation several metabolic pathways with neuroprotective actions associated such as taurine metabolism, gluconeogenesis, calcium and the Peroxisome Proliferator Activated Receptor signaling pathways. Also, we found a tibolone associated increase in growth rate probably in concordance with previously reported side effects of steroid compounds in other human cell types.

Keywords: astrocytes, flux balance analysis, genome scale metabolic reconstruction, inflammation, neuroprotection, tibolone

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25971 Assessment on the Improvement of the Quality of Life after One Year of Regular Physical Activity and Treatment in Patients with Postmenopausal Osteoporosis

Authors: Stoyanka Georgieva Vladeva, Elena Kirilova Kirilova, Nikola Kirilov Kirilov

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Summary: WHO (World Health Organization) recommends the elder people a certain amount of regular physical activity in order to prevent some of the health issues. Postmenopausal osteoporosis is one of the chronic diseases which requires the maintaining of regular physical activity. The regular activity combined with an adequate medical treatment greatly improves the quality of life of the patient. Objectives: Assessment of the effect of the regular physical activity recommended by WHO on the quality of life in patients with postmenopausal osteoporosis. Material and methods: For the period of one year 68 female patients treated with Denosumab have been monitored. The bone density has been measured with the DEXA method in accordance to the T-score. No patients having any oncologic diseases and secondary osteoporosis have been included in the study. The subjects have been divided into groups by their age. The first group – women aged under 65 years (27 subjects) and the second group – women aged over 65 years (41 subjects). All patients have been advised to maintain regular physical activity included in the recommendations of the WHO in accordance with the age and the disease. The quality of life has been assessed in the beginning and at the end of the one-year period using the SF 36V2 questionnaire. Results: Only 31% of the subjects have engaged into regular increased physical activities for the whole period. Among them are mostly patients of the second group (aged over 65 years, 71%). The women from the both groups who were engaging into regular activities for this one-year period all experience an improvement of the quality of life. These results show that older patients understand the necessity of the physical activity for their health. The comparison of the output data to the scales of physical activity, durability, body pain, vitality, social activity and emotional stability has found an improvement at the end of the period in all patients. The osteodensitometry showed general improvement of the T-score. Patients with additional visits to their rheumatologist have better results. Conclusion: Combination of regular physical activity in accordance to the recommendations of WHO and medical treatment including anti-osteoporotic drugs improves the quality of life of women with postmenopausal osteoporosis.

Keywords: elderly patients, osteoporosis, physical activity, quality of life

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25970 Drugstore Control System Design and Realization Based on Programmable Logic Controller (PLC)

Authors: Muhammad Faheem Khakhi, Jian Yu Wang, Salman Muhammad, Muhammad Faisal Shabir

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Population growth and Chinese two-child policy will boost pharmaceutical market, and it will continue to maintain the growth for a period of time in the future, the traditional pharmacy dispensary has been unable to meet the growing medical needs of the peoples. Under the strong support of the national policy, the automatic transformation of traditional pharmacies is the inclination of the Times, the new type of intelligent pharmacy system will continue to promote the development of the pharmaceutical industry. Under this background, based on PLC control, the paper proposed an intelligent storage and automatic drug delivery system; complete design of the lower computer's control system and the host computer's software system has been present. The system can be applied to dispensing work for Chinese herbal medicinal and Western medicines. Firstly, the essential of intelligent control system for pharmacy is discussed. After the analysis of the requirements, the overall scheme of the system design is presented. Secondly, introduces the software and hardware design of the lower computer's control system, including the selection of PLC and the selection of motion control system, the problem of the human-computer interaction module and the communication between PC and PLC solves, the program design and development of the PLC control system is completed. The design of the upper computer software management system is described in detail. By analyzing of E-R diagram, built the establish data, the communication protocol between systems is customize, C++ Builder is adopted to realize interface module, supply module, main control module, etc. The paper also gives the implementations of the multi-threaded system and communication method. Lastly, each module of the lower computer control system is tested. Then, after building a test environment, the function test of the upper computer software management system is completed. On this basis, the entire control system accepts the overall test.

Keywords: automatic pharmacy, PLC, control system, management system, communication

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25969 Location Quotient Analysis: Case Study

Authors: Seyed Habib A. Rahmati, Mohamad Hasan Sadeghpour, Parsa Fallah Sheikhlari

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Location quotient (LQ) is a comparison technique that represents emphasized economic structure of single zone versus the standard area to identify specialty for every zone. In another words, the exact calculation of this metric can show the main core competencies and critical capabilities of an area to the decision makers. This research focus on the exact calculation of the LQ for an Iranian Province called Qazvin and within a case study introduces LQ of the capable industries of Qazvin. Finally, through different graphs and tables, it creates an opportunity to compare the recognized capabilities.

Keywords: location quotient, case study, province analysis, core competency

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25968 Research Progress of the Relationship between Urban Rail Transit and Residents' Travel Behavior during 1999-2019: A Scientific Knowledge Mapping Based on Citespace and Vosviewer

Authors: Zheng Yi

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Among the attempts made worldwide to foster urban and transport sustainability, transit-oriented development certainly is one of the most successful. Residents' travel behavior is a concern in the researches about the impacts of transit-oriented development. The study takes 620 English journal papers in the core collection database of Web of Science as the study objects; the paper tries to map out the scientific knowledge mapping in the field and draw the basic conditions by co-citation analysis, co-word analysis, a total of citation network analysis and visualization techniques. This study teases out the research hotspots and evolution of the relationship between urban rail transit and resident's travel behavior from 1999 to 2019. According to the results of the analysis of the time-zone view and burst-detection, the paper discusses the trend of the next stage of international study. The results show that in the past 20 years, the research focuses on these keywords: land use, behavior, model, built environment, impact, travel behavior, walking, physical activity, smart card, big data, simulation, perception. According to different research contents, the key literature is further divided into these topics: the attributes of the built environment, land use, transportation network, transportation policies. The results of this paper can help to understand the related researches and achievements systematically. These results can also provide a reference for identifying the main challenges that relevant researches need to address in the future.

Keywords: urban rail transit, travel behavior, knowledge map, evolution of researches

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25967 The Model Establishment and Analysis of TRACE/FRAPTRAN for Chinshan Nuclear Power Plant Spent Fuel Pool

Authors: J. R. Wang, H. T. Lin, Y. S. Tseng, W. Y. Li, H. C. Chen, S. W. Chen, C. Shih

Abstract:

TRACE is developed by U.S. NRC for the nuclear power plants (NPPs) safety analysis. We focus on the establishment and application of TRACE/FRAPTRAN/SNAP models for Chinshan NPP (BWR/4) spent fuel pool in this research. The geometry is 12.17 m × 7.87 m × 11.61 m for the spent fuel pool. In this study, there are three TRACE/SNAP models: one-channel, two-channel, and multi-channel TRACE/SNAP model. Additionally, the cooling system failure of the spent fuel pool was simulated and analyzed by using the above models. According to the analysis results, the peak cladding temperature response was more accurate in the multi-channel TRACE/SNAP model. The results depicted that the uncovered of the fuels occurred at 2.7 day after the cooling system failed. In order to estimate the detailed fuel rods performance, FRAPTRAN code was used in this research. According to the results of FRAPTRAN, the highest cladding temperature located on the node 21 of the fuel rod (the highest node at node 23) and the cladding burst roughly after 3.7 day.

Keywords: TRACE, FRAPTRAN, BWR, spent fuel pool

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25966 Comprehending the Relationship between the Red Blood Cells of a Protein 4.1 -/- Patient and Those of Healthy Controls: A Comprehensive Analysis of Tandem Mass Spectrometry Data

Authors: Ahmed M. Hjazi, Bader M. Hjazi

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Protein 4.1 is a crucial component of complex interactions between the cytoskeleton and other junctional complex proteins. When the gene encoding this protein is altered, resulting in reduced expression, or when the protein is absent, the red cell undergoes a significant structural change. This research aims to achieve a deeper comprehension of the biochemical effects of red cell protein deficiency. A Tandem Mass Spectrometry Analysis (TMT-MS/MS) of patient cells lacking protein 4.1 compared to three healthy controls was achieved by the Proteomics Institute of the University of Bristol. The SDS-PAGE and Western blotting were utilized on the original patient sample and controls to partially confirm TMT MS/MS data analysis of the protein-4.1-deficient cells. Compared to healthy controls, protein levels in samples lacking protein 4.1 had a significantly higher concentration of proteins that probably originated from reticulocytes. This could occur if the patient has an elevated reticulocyte count. The increase in chaperone and reticulocyte-associated proteins was most notable in this study. This may result from elevated quantities of reticulocytes in patients with hereditary elliptocytosis.

Keywords: hereditary elliptocytosis, protein 4.1, red cells, tandem mass spectrometry data.

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25965 Improvement in Oral Health-Related Quality of Life of Adult Patients After Rehabilitation With Partial Dentures: A Systematic Review and Meta-Analysis

Authors: Adama NS Bah

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Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.

Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review

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25964 Efficacy and Safety of Probiotic Treatment in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis

Authors: Samir Malhotra, Rajan K. Khandotra, Rakesh K. Dhiman, Neelam Chadha

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There is paucity of data about safety and efficacy of probiotic treatment on patient outcomes in cirrhosis. Specifically, it is important to know whether probiotics can improve mortality, hepatic encephalopathy (HE), number of hospitalizations, ammonia levels, quality of life, and adverse events. Probiotics may improve outcomes in patients with acute or chronic HE. However, it is also important to know whether probiotics can prevent development of HE, even in situations where patients do not have acute HE at the time of administration. It is also important to know if probiotics are useful as primary prophylaxis of HE. We aimed to conduct an updated systematic review and meta-analysis to evaluate the safety and efficacy of probiotics in patients with cirrhosis. We searched PubMed, Cochrane library, Embase, Scopus, SCI, Google Scholar, conference proceedings, and references of included studies till June 2017 to identify randomised clinical trials comparing probiotics with other treatments in cirrhotics. Data was analyzed using MedCalc. Probiotics had no effect on mortality but significantly reduced HE (14 trials, 1073 patients, OR 0.371; 95% CI 0.282 to 0.489). There was not enough data to conduct a meta-analysis on outcomes like hospitalizations and quality of life. The effect on plasma ammonia levels was not significant (SMD -0.429; 95%CI -1.034 – 0.177). There was no difference in adverse events. To conclude, although the included studies had a high risk of bias, the available evidence does suggest a beneficial effect on HE. Larger studies with longer periods of follow-up are needed to determine if probiotics can reduce all-cause mortality.

Keywords: cirrhosis, hepatic encephalopathy, meta-analysis, probiotic

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25963 Comparison of the Toxicity of Silver and Gold Nanoparticles in Murine Fibroblasts

Authors: Šárka Hradilová, Aleš Panáček, Radek Zbořil

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Nanotechnologies are considered the most promising fields with high added value, brings new possibilities in various sectors from industry to medicine. With the growing of interest in nanomaterials and their applications, increasing nanoparticle production leads to increased exposure of people and environment with ‘human made’ nanoparticles. Nanoparticles (NPs) are clusters of atoms in the size range of 1–100 nm. Metal nanoparticles represent one of the most important and frequently used types of NPs due to their unique physical, chemical and biological properties, which significantly differ from those of bulk material. Biological properties including toxicity of metal nanoparticles are generally determined by their size, size distribution, shape, surface area, surface charge, surface chemistry, stability in the environment and ability to release metal ions. Therefore, the biological behavior of NPs and their possible adverse effect cannot be derived from the bulk form of material because nanoparticles show unique properties and interactions with biological systems just due to their nanodimensions. Silver and gold NPs are intensively studied and used. Both can be used for instance in surface enhanced Raman spectroscopy, a considerable number of applications of silver NPs is associated with antibacterial effects, while gold NPs are associated with cancer treatment and bio imaging. Antibacterial effects of silver ions are known for centuries. Silver ions and silver-based compounds are highly toxic to microorganisms. Toxic properties of silver NPs are intensively studied, but the mechanism of cytoxicity is not fully understood. While silver NPs are considered toxic, gold NPs are referred to as toxic but also innocuous for eukaryotic cells. Therefore, gold NPs are used in various biological applications without a risk of cell damaging, even when we want to suppress the growth of cancer cells. Thus, gold NPs are toxic or harmless. Because most studies comparing particles of various sizes prepared in various ways, and testing is performed on different cell lines, it is very difficult to generalize. The novelty and significance of our research is focused to the complex biological effects of silver and gold NPs prepared by the same method, have the same parameters and the same stabilizer. That is why we can compare the biological effects of pure nanometals themselves based on their chemical nature without the influence of other variable. Aim of our study therefore is to compare the cytotoxic effect of two types of noble metal NPs focusing on the mechanisms that contribute to cytotoxicity. The study was conducted on murine fibroblasts by selected common used tests. Each of these tests monitors the selected area related to toxicity and together provides a comprehensive view on the issue of interactions of nanoparticles and living cells.

Keywords: cytotoxicity, gold nanoparticles, mechanism of cytotoxicity, silver nanoparticles

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