Search results for: standard association of Zimbabwe

Authors: Terentes Printzios Dimitrios, Loanna Gourgouli, Vlachopoulos Charalambos

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Aims: Atrial fibrillation (AF) remains one of the major causes of stroke, heart failure, sudden death and cardiovascular morbidity. Ablation techniques are becoming more appealing after the latest results of randomized trials showing the overall clinical benefit. On the other hand, imaging techniques and the frontier application of 3D printing are emerging as a valuable ally for cardiac procedures. However, no randomized trial has directly assessed the impact of preprocedural imaging and especially 3D printing guidance for AF ablation. The present study is designed to investigate for the first time the effect of 3D printing of the heart on the safety and effectiveness of the ablation procedure. Methods and design: The 3D-GALA trial is a randomized, open-label, controlled, multicentre clinical trial of 2 parallel groups designed to enroll a total of 100 patients undergoing ablation using cryo-balloon for paroxysmal and persistent AF. Patients will be randomized with a patient allocation ratio of 1: 1 to preprocedural MRI scan of the heart and 3D printing of left atrium and pulmonary veins and cryoablation versus standard cryoablation without imaging. Patients will be followed up to 6 months after the index procedure. The primary outcome measure is the reduction of radiation dose and contrast amount during pulmonary veins isolation. Secondary endpoints will include the percentage of atrial fibrillation relapse at 24h-Holter electrocardiogram monitoring at 6 months after initial treatment. Discussion: To our knowledge, the 3D-GALA trial will be the first study to provide evidence about the clinical impact of preprocedural imaging and 3D printing before cryoablation.

Keywords: atrial fibrillation, cardiac MRI, cryoablation, 3-d printing

Procedia PDF Downloads 167

Authors: Fares Mahdi

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Background: Infection control is an important concern for all health care professionals, especially nurses. Nurses have a higher risk for both self-acquiring and transmitting infections to other patients. Aim of this study: to assess nurses' knowledge regarding infection control for wound care. Methodology: a descriptive research design was used in the study. The total number studied sample was 200 nurses, were conducting in Amran Public Hospitals in Amran City- Yemen. The study covered sample nurses in the hospital according to the study population; a standard closed-ended questionnaire was used to collect the data. Results: The results showed less than half (37.5 %) of nurses were from 22 May Hospital, also followed by (62.5%) of them were from Maternal and Child Hospital. Also according to the department name. Most (22.5%) of nurses worked in an intensive care unit, followed by (20%) of them were working in the pediatric world, also about (19%) of them were working in the surgical department. While in finally, only about (8.5%) of them worked from another department. According to course training, The results showed about (21%) of nurses had course training in wound care management. At the same time, others (79%) of them have not had course training in wound care management. According to the total nurse's knowledge of infection control for wound care, that find more than two-thirds (68%) of nurses had fair knowledge according to total all of nurse's knowledge of infection control wound care. Conclusion:The results showed that more than two-thirds (68%) of nurses had fair knowledge according to total all of the nurse's knowledge of infection control for wound care. Recommendations: There should be providing training program about infection control masseurs and it's important for new employees of nurses. Providing continuing refreshment training courses about infection control programs and about evidence-based practice in infection control for all health care teams.

Keywords: assessment, knowledge, infection control, wound care, nurses, amran hospitals

Procedia PDF Downloads 78

Authors: G. Martino, F. Silva, E. Marchal

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The control over delivered iron ore blend characteristics is one of the most important aspects of the mining business. The iron ore price is a function of its composition, which is the outcome of the beneficiation process. So, end-to-end integrated planning of mine operations can reduce risks of penalties on the iron ore price. In a standard iron mining company, the production chain is composed of mining, ore beneficiation, and client supply. When mine planning and client supply decisions are made uncoordinated, the beneficiation plant struggles to deliver the best blend possible. Technological improvements in several fields allowed bridging the gap between departments and boosting integrated decision-making processes. Clusterization and classification algorithms over historical production data generate reasonable previsions for quality and volume of iron ore produced for each pile of run-of-mine (ROM) processed. Mathematical modeling can use those deterministic relations to propose iron ore blends that better-fit specifications within a delivery schedule. Additionally, a model capable of representing the whole production chain can clearly compare the overall impact of different decisions in the process. This study shows how flexibilization combined with a planning optimization model between the mine and the ore beneficiation processes can reduce risks of out of specification deliveries. The model capabilities are illustrated on a hypothetical iron ore mine with magnetic separation process. Finally, this study shows ways of cost reduction or profit increase by optimizing process indicators across the production chain and integrating the different plannings with the sales decisions.

Keywords: clusterization and classification algorithms, integrated planning, mathematical modeling, optimization, penalty minimization

Procedia PDF Downloads 120

Authors: Jesus Salmeron, Carmen De Vega, Maria Soledad Vicente, Mireia Olabarria, Olaia Martinez

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Dysphagia or difficulty in swallowing affects mostly elder people: 56-78% of the institutionalized and 44% of the hospitalized. Liquid food thickening is a necessary measure in this situation because it reduces the risk of penetration-aspiration. Until now, and as proposed by the American Dietetic Association in 2002, possible consistencies have been categorized in three groups attending to their viscosity: nectar (50-350 mPa•s), honey (350-1750 mPa•s) and pudding (>1750 mPa•s). The adequate viscosity level should be identified for every patient, according to her/his impairment. Nevertheless, a systematic review on dysphagia diet performed recently indicated that there is no evidence to suggest that there is any transition of clinical relevance between the three levels proposed. It was also stated that other physical properties of the bolus (slipperiness, density or cohesiveness, among others) could influence swallowing in affected patients and could contribute to the amount of remaining residue. Texture parameters need to be evaluated as possible alternative to viscosity. The aim of this study was to evaluate the instrumental extrusion-compression test as a possible tool to characterize changes along time in water thickened with various products and in the three theoretical consistencies. Six commercial thickeners were used: NM® (NM), Multi-thick® (M), Nutilis Powder® (Nut), Resource® (R), Thick&Easy® (TE) and Vegenat® (V). All of them with a modified starch base. Only one of them, Nut, also had a 6,4% of gum (guar, tara and xanthan). They were prepared as indicated in the instructions of each product and dispensing the correspondent amount for nectar, honey and pudding consistencies in 300 mL of tap water at 18ºC-20ºC. The mixture was stirred for about 30 s. Once it was homogeneously spread, it was dispensed in 30 mL plastic glasses; always to the same height. Each of these glasses was used as a measuring point. Viscosity was measured using a rotational viscometer (ST-2001, Selecta, Barcelona). Extrusion-compression test was performed using a TA.XT2i texture analyzer (Stable Micro Systems, UK) with a 25 mm diameter cylindrical probe (SMSP/25). Penetration distance was set at 10 mm and a speed of 3 mm/s. Measurements were made at 1, 5, 10, 20, 30, 40, 50 and 60 minutes from the moment samples were mixed. From the force (g)–time (s) curves obtained in the instrumental assays, maximum force peak (F) was chosen a reference parameter. Viscosity (mPa•s) and F (g) showed to be highly correlated and had similar development along time, following time-dependent quadratic models. It was possible to predict viscosity using F as an independent variable, as they were linearly correlated. In conclusion, compression-extrusion test could be an alternative and a useful tool to assess physical characteristics of thickened liquids.

Keywords: compression-extrusion test, dysphagia, texture analyzer, thickener

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Authors: Zohar Manber, Ran Elkon

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Accumulation of somatic mutations (SMs) in the genome is a major driving force of cancer development. Most SMs in the tumor's genome are functionally neutral; however, some cause damage to critical processes and provide the tumor with a selective growth advantage (termed cancer driver mutations). Current research on functional significance of SMs is mainly focused on finding alterations in protein coding sequences. However, the exome comprises only 3% of the human genome, and thus, SMs in the noncoding genome significantly outnumber those that map to protein-coding regions. Although our understanding of noncoding driver SMs is very rudimentary, it is likely that disruption of regulatory elements in the genome is an important, yet largely underexplored mechanism by which somatic mutations contribute to cancer development. The expression of most human genes is controlled by multiple enhancers, and therefore, it is conceivable that regulatory SMs are distributed across different enhancers of the same target gene. Yet, to date, most statistical searches for regulatory SMs have considered each regulatory element individually, which may reduce statistical power. The first challenge in considering the cumulative activity of all the enhancers of a gene as a single unit is to map enhancers to their target promoters. Such mapping defines for each gene its set of regulating enhancers (termed "set of regulatory elements" (SRE)). Considering multiple enhancers of each gene as one unit holds great promise for enhancing the identification of driver regulatory SMs. However, the success of this approach is greatly dependent on the availability of comprehensive and accurate enhancer-promoter (E-P) maps. To date, the discovery of driver regulatory SMs has been hindered by insufficient sample sizes and statistical analyses that often considered each regulatory element separately. In this study, we analyzed more than 2,500 whole-genome sequence (WGS) samples provided by The Cancer Genome Atlas (TCGA) and The International Cancer Genome Consortium (ICGC) in order to identify such driver regulatory SMs. Our analyses took into account the combinatorial aspect of gene regulation by considering all the enhancers that control the same target gene as one unit, based on E-P maps from three genomics resources. The identification of candidate driver noncoding SMs is based on their recurrence. We searched for SREs of genes that are "hotspots" for SMs (that is, they accumulate SMs at a significantly elevated rate). To test the statistical significance of recurrence of SMs within a gene's SRE, we used both global and local background mutation rates. Using this approach, we detected - in seven different cancer types - numerous "hotspots" for SMs. To support the functional significance of these recurrent noncoding SMs, we further examined their association with the expression level of their target gene (using gene expression data provided by the ICGC and TCGA for samples that were also analyzed by WGS).

Keywords: cancer genomics, enhancers, noncoding genome, regulatory elements

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Authors: Okpu Enoh Ndip Nkongho

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The type of political leadership in place impacts a state's economic development or underdevelopment directly and indirectly. One of the main challenges to Cameroon's economic development may be ineffective or misguided political leadership. The economy of the Cameroon state has declined significantly due to a number of factors, including a lack of effective and feasible economic policies, a reliance on crude oil that is excessive, tribal politics, the threat of insurgency, bribery, and corruption, violations of human rights, neglect of other sectors like science, technology, education, and transportation, and a careless attitude on the part of the administrators toward the general public. As a result, the standard of living has decreased, foreign exchange has decreased, and the value of the Cameroonian currency has depreciated. Therefore, from 2000 to 2023, this paper focused on the relationship between political leadership and economic development in Cameroon and offered suggestions for improving political leadership that will, in turn, lead to the country's economy getting back on track. The study employed a qualitative technique, with the framework for the investigation derived from the trait theory of leadership. According to the information provided above, the paper was able to conclude that there is a lack of cooperation between the three branches of government in Cameroon. This is shown in situations when one branch operates independently of the others and refuses to function as a backup when needed. The study recommended that the Executive collaborate closely with the National Assembly to speed action on some key legislation required to stimulate economic development. On the other hand, there is a need for more clarity and consistency in the government's policy orientation. There is no doubt that our current economic troubles are at least partially the result of a lack of economic policy leadership and confidence.

Keywords: politics, leadership, economic, development, Cameroon

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Authors: Mapula Mothomogolo, Anria Clarke

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The ballistic grille has become a mission critical component for protection on an armoured vehicle. They are designed to protect the armoured vehicle against ballistic threats while maintaining sufficient airflow for under-hood thermal management. Improving the ballistic grille for better ballistic protection can compromise the airflow to the engine. This reduces the cooling capacity of the armoured vehicle, thus reducing the overall power performance of the vehicle. This paper investigates the airflow through a grille using a computational fluid dynamics modelling approach. A comparative study was conducted between a standard armoured vehicle grille and a ballistic grille. The results were used as a benchmark for optimising the airflow through the ballistic grille by reducing the pressure drop through the grille. The ballistic grille was modelled as a porous medium to account for the pressure drop in the porous region. The effects of the porous zone were accounted for in the source term of the momentum Navier Stokes equation. The source term defines the pressure drop in the porous region as a function of the velocity. A pressure gradient curve approach was used to determine the Darcy coefficient and inertial resistance coefficient of the source term. The empirically defined coefficients were used as simulation input for a more accurate pressure drop prediction in the porous region. Additionally, the ballistic grille geometry was optimised using an adjoint solver (shape optimisation module in Ansys fluent) to reduce the pressure drop through the ballistic grille by 30%. Based on the simulation results, the optimised ballistic grille geometry will be further tested experimentally to validate the numerical model.

Keywords: ballistic grille, computational fluid modelling, Darcy’s law, porous medium, pressure drop

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Authors: Aferdita Stroka Koka, Laver Stroka, Juna Musa, Samanda Celaj

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Non-melanoma skin cancers (NMSCs) are the most common human malignancies. About 5.4 million basal and squamous cell skin cancers are diagnosed each year in the US and new cases continue to grow. About eight out of ten of these are basal cell cancers. Squamous cell cancers occur less often. NMSC usually are treatable, but treatment is expensive and can leave scars. In 2019, 167 patients of both sexes suffering from NMSC were treated by traditional medicine. Patients who have been diagnosed with Basal Cell Carcinoma were 122 cases, Squamous Cell Carcinoma 32 cases and both of them 13 cases. Of these,122 cases were ulcerated lesions and 45 unulcerated lesions. All patients were treated with the herbal solution called NILS, which contains extracts of some Albanian plants such as Allium sativum, Jugulans regia and Laurus nobilis. The treatment is done locally, on the surface of the tumor, applying the solution until the tumor mass is destroyed and, after that, giving the necessary time to the wound to make the regeneration that coincides with the complete healing of the wound. We have prepared a collection of photos for each case. Since the first sessions, a shrinkage and reduction of the tumor mass were evident, up to the total disappearance of the lesion at the end of treatment. The normal period of treatment lasted 1 to 2 weeks, depending on the size of the tumor, then take care of it until the closure of the wound, taking the whole process from 1 to 3 months. In 7 patients, the lesion failed to be dominated by treatment and they underwent standard treatment with radiotherapy or surgery, while in 10 patients, the lesion recurred and was treated again. The aim of this survey was to put in evidence the good results obtained by treatment of NMSC with Albanian traditional medicine methods.

Keywords: local treatment, nils, NMSC, traditional medicine

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Authors: David Ryan, Martin Breugst, Turlough Downes, Peter A. Byrne, Gerard P. McGlacken

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An ambident nucleophile is a nucleophile that possesses two or more distinct nucleophilic sites that are linked through resonance and are effectively “in competition” for reaction with an electrophile. Examples include enolates, pyridone anions, and nitrite anions, among many others. Reactions of ambident nucleophiles and electrophiles are extremely prevalent at all levels of organic synthesis. The principle of hard and soft acids and bases (the “HSAB principle”) is most commonly cited in the explanation of selectivities in such reactions. Although this rationale is pervasive in any discussion on ambident reactivity, the HSAB principle has received considerable criticism. As a result, the principle’s supplantation has become an area of active interest in recent years. This project focuses on developing a model for rationalizing ambident reactivity. Presented here is an approach that incorporates computational calculations and experimental kinetic data to construct Gibbs energy profile diagrams. The preferred site of alkylation of nitrite anion with a range of ‘hard’ and ‘soft’ alkylating agents was established by ¹H NMR spectroscopy. Pseudo-first-order rate constants were measured directly by ¹H NMR reaction monitoring, and the corresponding second-order constants and Gibbs energies of activation were derived. These, in combination with computationally derived standard Gibbs energies of reaction, were sufficient to construct Gibbs energy wells. By representing the ambident system as a series of overlapping Gibbs energy wells, a more intuitive picture of ambident reactivity emerges. Here, previously unexplained switches in reactivity in reactions involving closely related electrophiles are elucidated.

Keywords: ambident, Gibbs, nucleophile, rates

Procedia PDF Downloads 74

Authors: Carlos A. Martins de Jesus

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The Greek anthology, first put together in the tenth century AD, gathers in two separate books a large number of epigrams devoted to love and its consequences, both of hetero (book V) and homosexual (book XII) nature. While some poets wrote epigrams of only one genre –that is the case of Strato (II cent. BC), the organizer of a wide-spread garland of homosexual epigrams –, several others composed within both categories, often using the same topics of love and suffering. Using Plato’s theorization of two different kinds of Eros (Symp. 180d-182a), the popular (pandemos) and the celestial (ouranios), homoerotic epigrammatic love is more often associated with the first one, while heterosexual poetry tends to be connected to a higher form of love. This paper focuses on the epigrammatic production of a single first-century BC poet, Meleager, aiming to look for the similarities and differences on singing both kinds of love. From Meleager, the Greek Anthology –a garland whose origins have been traced back to the poet’s garland itself– preserves more than sixty heterosexual and 48 homosexual epigrams, an important and unprecedented amount of poems that are able to trace a complete profile of his way of singing love. Meleager’s poetry deals with personal experience and emotions, frequently with love and the unhappiness that usually comes from it. Most times he describes himself not as an active and engaged lover, but as one struck by the beauty of a woman or boy, i.e., in a stage prior to erotic consummation. His epigrams represent the unreal and fantastic (literally speaking) world of the lover, in which the imagery and wordplays are used to convey emotion in the epigrams of both genres. Elsewhere Meleager surprises the reader by offering a surrealist or dreamlike landscape where everyday adventures are transcribed into elaborate metaphors for erotic feeling. For instance, in 12.81, the lovers are shipwrecked, and as soon as they have disembarked, they are promptly kidnapped by a figure who is both Eros and a beautiful boy. Particularly –and worth-to-know why significant – in the homosexual poems collected in Book XII, mythology also plays an important role, namely in the figure and the scene of Ganimedes’ kidnap by Zeus for his royal court (12. 70, 94). While mostly refusing the Hellenistic model of dramatic love epigram, in which a small everyday scene is portrayed –and 5. 182 is a clear exception to this almost rule –, Meleager actually focuses on the tumultuous inside of his (poetic) lovers, in the realm of a subject that feels love and pain far beyond his/her erotic preferences. In relation to loving and suffering –mostly suffering, it has to be said –, Meleager’s love is therefore completely democratic. There is no real place in his epigrams for the traditional association mentioned before between homoeroticism and a carnal-erotic-pornographic love, while the heterosexual one being more evenly and pure, so to speak.

Keywords: epigram, erotic epigram, Greek Anthology, Meleager

Procedia PDF Downloads 248

Authors: Mrinal Kanti Bhowmik, Kakali Das Jr., Barin Kumar De, Debotosh Bhattacharjee

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Breast cancer is the most common cancer and a leading cause of death for women in the 35 to 55 age group. Early detection of breast cancer can decrease the mortality rate of breast cancer. Mammography is considered as a ‘Gold Standard’ for breast cancer detection and a very popular modality, presently used for breast cancer screening and detection. The screening of digital mammograms often leads to over diagnosis and a consequence to unnecessary traumatic & painful biopsies. For that reason recent studies involving the use of thermal imaging as a screening technique have generated a growing interest especially in cases where the mammography is limited, as in young patients who have dense breast tissue. Tumor is a significant sign of breast cancer in both mammography and thermography. The tumors are complex in structure and they also exhibit a different statistical and textural features compared to the breast background tissue. Fractal geometry is a geometry which is used to describe this type of complex structure as per their main characteristic, where traditional Euclidean geometry fails. Over the last few years, fractal geometrics have been applied mostly in many medical image (1D, 2D, or 3D) analysis applications. In breast cancer detection using digital mammogram images, also it plays a significant role. Fractal is also used in thermography for early detection of the masses using the thermal texture. This paper presents an overview of the recent aspects and initiatives of fractals in breast cancer detection in both mammography and thermography. The scope of fractal geometry in automatic breast cancer detection using digital mammogram and thermogram images are analysed, which forms a foundation for further study on application of fractal geometry in medical imaging for improving the efficiency of automatic detection.

Keywords: fractal, tumor, thermography, mammography

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Authors: Hamid Hanifi, Adel Azar, Alireza Booshehri

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In order to know about the capability level of R & D units in automotive industry, it is essential that organizations always compare themselves with standard level and higher than themselves so that to be improved continuously. In this research, with respect to the importance of this issue, we have tried to present an assessment model for R & D capabilities having reviewed on new products development in automotive industry of Iran. Iran Khodro Company was selected for the case study. To this purpose, first, having a review on the literature, about 200 indicators effective in R & D capabilities and new products development were extracted. Then, of these numbers, 29 indicators which were more important were selected by industry and academia experts and the questionnaire was distributed among statistical population. Statistical population was consisted of 410 individuals in Iran Khodro Company. We used the 410 questionnaires for exploratory factor analysis and then used the data of 308 questionnaires from the same population randomly for confirmatory factor analysis. The results of exploratory factor analysis led to categorization of dimensions in 9 secondary dimensions. Naming the dimensions was done according to a literature review and the professors’ opinion. Using structural equation modeling and AMOS software, confirmatory factor analysis was conducted and ultimate model with 9 secondary dimensions was confirmed. Meanwhile, 9 secondary dimensions of this research are as follows: 1) Research and design capability, 2) Customer and market capability, 3) Technology capability, 4) Financial resources capability, 5) Organizational chart, 6) Intellectual capital capability, 7) NPD process capability, 8) Managerial capability and 9) Strategy capability.

Keywords: research and development, new products development, structural equations, exploratory factor analysis, confirmatory factor analysis

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Authors: Sani M. Lawal, Idris Musa, Aliyu D. Usman

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The Pareto approach of optimal solutions in a search space that evolved in multi-objective optimization problems is adopted in this paper, which stands for a set of solutions in the search space. This paper aims at presenting an optimal placement of Distributed Generation (DG) in radial distribution networks with an optimal size for minimization of power loss and voltage deviation as well as maximizing voltage profile of the networks. And these problems are formulated using particle swarm optimization (PSO) as a constraint nonlinear optimization problem with both locations and sizes of DG being continuous. The objective functions adopted are the total active power loss function and voltage deviation function. The multiple nature of the problem, made it necessary to form a multi-objective function in search of the solution that consists of both the DG location and size. The proposed PSO algorithm is used to determine optimal placement and size of DG in a distribution network. The output indicates that PSO algorithm technique shows an edge over other types of search methods due to its effectiveness and computational efficiency. The proposed method is tested on the standard IEEE 34-bus and validated with 33-bus test systems distribution networks. Results indicate that the sizing and location of DG are system dependent and should be optimally selected before installing the distributed generators in the system and also an improvement in the voltage profile and power loss reduction have been achieved.

Keywords: distributed generation, pareto, particle swarm optimization, power loss, voltage deviation

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Authors: Cigdem Safak Saglam

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Most thermal power plants use steam as working fluid in their power cycle. Therefore, in addition to fuel, water is the other main input for thermal plants. Water and steam must be highly pure in order to protect the systems from corrosion, scaling and biofouling. Pure process water is produced in water treatment plants having many several treatment methods. Treatment plant design is selected depending on raw water source and required water quality. Although working principle of fossil-fuel fired thermal power plants are same, there is no standard design and equipment arrangement valid for all thermal power plant utility systems. Besides that, there are many other technology evaluation and selection criteria for designing the most optimal water systems meeting the requirements such as local conditions, environmental restrictions, electricity and other consumables availability and transport, process water sources and scarcity, land use constraints etc. Aim of this study is explaining the adopted methodology for technology selection for process water preparation and industrial waste water treatment plant in a thermal power plant project located in Tufanbeyli, Adana Province in Turkey. Thermal power plant is fired with indigenous lignite coal extracted from adjacent lignite reserves. This paper addresses all above-mentioned factors affecting the thermal power plant water treatment facilities (demineralization + waste water treatment) design and describes the ultimate design of Tufanbeyli Thermal Power Plant Water Treatment Plant.

Keywords: thermal power plant, lignite coal, pretreatment, demineralization, electrodialysis, recycling, ash dampening

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Authors: Bahador Bardshiri, Omid Moradi, Amir Komeilian, Nima Panahifar

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Formation of a conjunctival membrane over the corneal surface is a condition unique to rabbits that has been labeled aberrant corneal occlusion or pseudopterygium. In the summer of 2013, a five years old male Standard Chinchilla rabbit were presented to Karaj Central Veterinary hospital and the owner complained that his rabbit shows degrees of blindness and there were opacities on both eyes of the presented rabbit. Ophthalmic examination of the affected eyes revealed a conjunctival fold stretching over the cornea of both eyes. The fold originated from limbus and it was vascularized and centrally thickened. There were no attachments to the corneal epithelium and the fold could be easily lifted. Surgery was performed under general anesthesia. The conjunctival fold was incised centrifugally up to its attachment at the limbus and the lid margin using small scissors. The central rim of the segment was then replaced to its normal position in the fornix and fixed with mattress sutures (7/0) passing through outside skin. After the surgery, eye drops containing dexamethasone, gentamicin and polymixin were applied twice daily up to 3 weeks. Within the observation period (8 months) no recurrence was noted. "Pseudo" in the term pseudopterygium refers to the fact that the conjunctival membrane is not adhering to the underlying cornea, but growing over it. In rare cases, the membrane may be loosely attached to the cornea, but can be easily separated without causing damage. It can cover only a small part of the cornea with an annular peripheral opacification of the cornea, or cover it almost fully, leading to blindness. Ethiopathogenesis remains unclear and recurrence of the problem is very likely. The surgical technique that used here decreases probability of recurrence of conjunctival fold.

Keywords: rabbit, cornea, aberrant corneal occlusion, pseudopterygium

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Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires was returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age range from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge. However, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non-significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: gene profiling, knowledge, Malaysia, physician

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Authors: Javad Saeidaskari, Nader Khalafian

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The undesirable impact of vibrations induced by road and railway traffic is an important concern in modern world. These vibrations are transmitted through soil and cause disturbances to the residence area and high-tech production facilities alongside the train/traffic lines. In this paper for the first time a new method of soil improvement with vibration absorber material, is used to increase the damping factor, in other word, to reduce the ability of wave transitions in sand. In this study standard Firoozkooh No. 161 sand is used as the host sand. The semi rigid polyurethane (PU) foam which used in this research is one of the common materials for vibration absorbing purposes. Series of cyclic triaxial tests were conducted on remolded samples with identical relative density of 70% of maximum dry density for different volume percentage of shredded PU foam. The frequency of tests was 0.1 Htz with shear strain of 0.37% and 0.75% and also the effective confining pressures during the tests were 100 kPa and 350 kPa. In order to find out the best soil-PU foam mixture, different volume percent of PU foam varying from 10% to 30% were examined. The results show that adding PU foam up to 20%, as its optimum content, causes notable enhancement in damping ratio for both shear strains of 0.37% (52.19% and 69% increase for effective confining pressures of 100 kPa and 350 kPa, respectively) and 0.75% (59.56% and 59.11% increase for effective confining pressures of 100 kPa and 350 kPa, respectively). The results related to shear modulus present significant reduction for both shear strains of 0.37% (82.22% and 56.03% decrease for effective confining pressures of 100 kPa and 350 kPa, respectively) and 0.75% (89.32% and 39.9% decrease for effective confining pressures of 100 kPa and 350 kPa, respectively). In conclusion, shredded PU foams effectively affect the dynamic properties of sand and act as vibration absorber in soil.

Keywords: polyurethane foam, sand, damping ratio, shear modulus

Procedia PDF Downloads 445

Authors: Lovesh Goyal, Pushkar Dave, Prajyot Jadhav, GonnaYaswanth, Sakshi Giri, Sahil Dharme, Rushika Joshi, Rishabh Verma, Shital Chiddarwar

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With the rising need for human-robot interaction, researchers have proposed and tested multiple models with varying degrees of success. A few of these models performed on aerial platforms are commonly known as Tethered Aerial Systems. These aerial vehicles may be powered continuously by a tether cable, which addresses the predicament of the short battery life of quadcopters. This system finds applications to minimize humanitarian efforts for industrial, medical, agricultural, and service uses. However, a significant challenge in employing such systems is that it necessities attaining smooth and secure robot-human interaction while ensuring that the forces from the tether remain within the standard comfortable range for the humans. To tackle this problem, a hybrid control method that could switch between two control techniques: constant control input and the steady-state solution, is implemented. The constant control approach is implemented when a person is far from the target location, and error is thought to be eventually constant. The controller switches to the steady-state approach when the person reaches within a specific range of the goal position. Both strategies take into account human velocity feedback. This hybrid technique enhances the outcomes by assisting the person to reach the desired location while decreasing the human's unwanted disturbance throughout the process, thereby keeping the interaction between the robot and the subject smooth.

Keywords: unmanned aerial vehicle, tethered system, physical human-robot interaction, hybrid control

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Authors: Sushma Ghildyal, Sanjay Kumar Singh

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The present study was undertaken with the purpose to understand the relationship of lifestyle and Socio-Economic status with child obesity among 1000 boys aged from 16 to 18 years of Varanasi District of Uttar Pradesh State in India. The study was conducted in both urban and rural area of the District. Ten schools i.e. five from urban area and five from rural area were selected by using purposive sampling. Healthy boys of class 10th, 11th and 12th were taken as subjects for the study. Prior consent was obtained from school authority. Anthropometric measurements were taken from each subject. Anthropometric measurements were Standing Height, Weight, Biceps skin folds, Triceps skin folds, Sub-scapular skin folds and Supra-iliac skin folds taken by Lange’s skin fold caliper. Lifestyle and Socio-Economic Status were obtained by questionnaires. In order to assess the BMI, Body fat %, Lifestyle and Socio-Economic Status; descriptive analyses were done. To find out the significant association of obesity with lifestyle and Socio-Economic Status Chi-square test was used. To find out significant difference between obesity of Urban and Rural children t-test was applied. Level of significance was set at 0.05 level. The conclusions drawn were: (1) The result showed that in urban area Varanasi District of Uttar Pradesh 0.6% children were in very high level adaptive lifestyle, 6.2% were in high level adaptive lifestyle, 25.4% above average level adaptive lifestyle, 47.8% moderately adaptive lifestyle, 3.6% and 0.4% low and very low level adaptive lifestyle. (2) In rural area Varanasi District of Uttar Pradesh 0.00% children were in very high level adaptive lifestyle, 9.4% were in high level adaptive lifestyle, 24.8% average level adaptive lifestyle, 47.0% moderately adaptive lifestyle, 15.2% below average and 3.0% very low level adaptive lifestyle.(3) In urban area 12.8% were in upper class Socio-Economic Status, 56.6% in upper middle class Socio-Economic Status, 30.2% in middle class Socio-Economic Status and 0.2% in lower middle class Socio-Economic Status. (4) In rural area 1.4% were in upper class Socio-Economic Status, 15.2% in upper middle class Socio-Economic Status, 51.6% in middle class Socio-Economic Status and 0.8% in lower middle class Socio-Economic Status. (5) In urban area 21.2% children of 16-18 years were obese. (6) In rural area 0.2% children of 16-18 years were obese. (7) In overall Varanasi District of Uttar Pradesh 10.7% children of 16-18 years were obese. (8) There was no significant relationship of obesity with Lifestyle of urban area children of 16-18 years. (9) There was significant relationship of obesity with Socio-Economic Status of urban area children of 16-18 years (10) There was no significant relationship of obesity with Lifestyle of rural area children of 16-18 years of Varanasi District Uttar Pradesh. (11) There was significant relationship of obesity with Socio-Economic Status of rural area children of 16-18 years. (12) Results showed significant difference between urban and rural area children of 16-18 years in respect to obesity of Varanasi District of Uttar Pradesh.

Keywords: lifestyle, obesity, rural area, socio-economic status, urban area

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Authors: Sangeeta Pilkhwal Sah, C. S. Mathela, Kanwaljit Chopra

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Valeriana wallichii DC, an ayurvedic traditional medicine, popularly named as Indian valerian exist as three chemotypes. GC-MS analysis of V. wallichii essential oil in present study showed maaliol as the major constituent followed by the presence of β-gurjunene, acoradiene, guaiol and α-santalene. The results thus confirmed it to be a maaliol chemotype. Further, the antidepressant-like effect of root essential oil (10, 20 and 40 mg/kg p.o.) was investigated in both acute and chronic treatment study using forced swim test in mice. Single administration of different doses produced an inverted U shaped curve and significantly inhibited the immobility period (39.7% and 58%) at doses 10 and 40 mg/kg respectively. Standard drug imipramine significantly decreased immobility period (59.8%). None of the doses altered locomotor activity except a significant decrease of 44.9% was observed with 40 mg/kg (p < 0.05). Similarly, daily administration of essential oil for 14 days produced a dose dependent effect with significantly reduced immobility period (70.9%) at 40 mg/kg dose only whereas imipramine produced 86% decrease (p < 0.05). The neurotransmitter levels in mouse brain were estimated on day 14 after the behavioral study. Significant increase in the level of norepinephrine (10%) and dopamine (23%) (p < 0.05) was found at 40 mg/kg dose, while no change was observed at 10 and 20 mg/kg doses. The antidepressant-like effect of essential oil (40 mg/kg) was prevented by pretreatment of mice with L-arginine (750 mg/kg i.p.) and sildenafil (5 mg/kg i.p). On the contrary, pretreatment of mice with L-NAME (10 mg/kg i.p.) or methylene blue (10 mg/kg i.p.) potentiated the antidepressant action of essential oil (20 mg/kg). The findings thus demonstrated that nitric oxide pathway is involved in mediating antidepressant like effect of essential oil from this chemotype.

Keywords: Valeriana wallichii DC chemotype, essential oil, forced swim test, nitric oxide modulators, neurotransmitters

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Authors: Juliet Udoudom

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Inappropriate complement selection constitutes one of the major features of non-standard complementation in the Nigerian users of English output of sentence construction. This paper investigates complement clause choice in Written Educated Nigerian English (ENE) and offers some results. It aims at determining preferred and dispreferred patterns of complement clause selection in respect of verb heads in English by selected Nigerian users of English. The complementation data analyzed in this investigation were obtained from experimental tasks designed to elicit complement categories of Verb – Noun -, Adjective – and Prepositional – heads in English. Insights from the Government – Binding relations were employed in analyzing data, which comprised responses obtained from one hundred subjects to a picture elicitation exercise, a grammaticality judgement test, and a free composition task. The findings indicate a general tendency for clausal complements (CPs) introduced by the complementizer that to be preferred by the subjects studied. Of the 235 tokens of clausal complements which occurred in our corpus, 128 of them representing 54.46% were CPs headed by that, while whether – and if-clauses recorded 31.07% and 8.94%, respectively. The complement clause-type which recorded the lowest incidence of choice was the CP headed by the Complementiser, for with a 5.53% incident of occurrence. Further findings from the study indicate that semantic features of relevant embedding verb heads were not taken into consideration in the choice of complementisers which introduce the respective complement clauses, hence the that-clause was chosen to complement verbs like prefer. In addition, the dispreferred choice of the for-clause is explicable in terms of the fact that the respondents studied regard ‘for’ as a preposition, and not a complementiser.

Keywords: complement, complement clause complement selection, complementisers, government-binding

Procedia PDF Downloads 181

Authors: Sudhir K. Gupta

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Introduction: When a forensic doctor determines that a suspicious death is a suicide, homicide, or accident, the decision virtually becomes incontestable by the investigating police officer, and it becomes an issue whether the medical opinion was created with necessary checks and balances on the other probabilities of the case. It is suggested that the opinion of Forensic Medical experts is conventional, mutable, and shifting from one expert to another. The determination of suicide, accident, or homicide is mandatorily required, which is the Gold Standard for conducting death investigations. Forensic investigations serve many audiences, but the court is by far the most critical. The likely questions on direct and cross-examination determine how forensic doctors gather and handle evidence and what conclusions they reach. Methodology: The author interacted with the investigative authority, and a crime scene visit was also done along with the perusal of the Postmortem report, subsequent opinion, and crime scene photographs and statements of the witness and accused. Further analysis of all relevant scientific documents and opinions of other forensic doctors, forensic scientists, and ballistic experts involved in these cases was done to arrive at an opinion with scientific justification. Findings: The opinions arrived at by the author and how they helped the judiciary in delivering justice in these cases have been discussed in this article. This can help the readers to understand the process involved in formulating a credible forensic medical expert opinion for investigators and the judiciary. Conclusion: A criminal case might be won or lost over doubt cast on the chain of custody. Medically trained forensic doctors, therefore, learn to practice their profession in legally appropriate ways, and opinions must be based on medical justifications with credible references.

Keywords: forensic doctor, professional credibility, investigation, expert opinion

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Authors: Vedansh More, Lalatendu Bal, Ronak Panchal, Atharva Kulkarni

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The project aims at developing a cost-effective test bench capable of testing and validating the complete powertrain package of an electric vehicle. Emrax 228 high voltage synchronous motor was selected as the prime mover for study. A tandem type dynamometer comprising of two loading methods; inertial, using standard inertia rollers and absorptive, using a separately excited DC generator with resistive coils was developed. The absorptive loading of the prime mover was achieved by implementing a converter circuit through which duty of the input field voltage level was controlled. This control was efficacious in changing the magnetic flux and hence the generated voltage which was ultimately dropped across resistive coils assembled in a load bank with all parallel configuration. The prime mover and loading elements were connected via a chain drive with a 2:1 reduction ratio which allows flexibility in placement of components and a relaxed rating of the DC generator. The development will aid in determination of essential characteristics like torque-RPM, power-RPM, torque factor, RPM factor, heat loads of devices and battery pack state of charge efficiency but also provides a significant financial advantage over existing versions of dynamometers with its cost-effective solution.

Keywords: absorptive load, chain drive, chordal action, DC generator, dynamometer, electric vehicle, inertia rollers, load bank, powertrain, pulse width modulation, reduction ratio, road load, testbench

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Authors: Mohammad R. Kavian Nezhad, Carlos F. Lange, Brian A. Fleck

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This research presents the validation study of a computational fluid dynamics (CFD) model developed to simulate the scalar dispersion emitted from rooftop sources around the buildings at the University of Alberta North Campus. The ANSYS CFX code was used to perform the numerical simulation of the wind regime and pollutant dispersion by solving the 3D steady Reynolds-averaged Navier-Stokes (RANS) equations on a building-scale high-resolution grid. The validation study was performed in two steps. First, the CFD model performance in 24 cases (eight wind directions and three wind speeds) was evaluated by comparing the predicted flow fields with the available data from the previous measurement campaign designed at the North Campus, using the standard deviation method (SDM), while the estimated results of the numerical model showed maximum average percent errors of approximately 53% and 37% for wind incidents from the North and Northwest, respectively. Good agreement with the measurements was observed for the other six directions, with an average error of less than 30%. In the second step, the reliability of the implemented turbulence model, numerical algorithm, modeling techniques, and the grid generation scheme was further evaluated using the Mock Urban Setting Test (MUST) dispersion dataset. Different statistical measures, including the fractional bias (FB), the geometric mean bias (MG), and the normalized mean square error (NMSE), were used to assess the accuracy of the predicted dispersion field. Our CFD results are in very good agreement with the field measurements.

Keywords: CFD, plume dispersion, complex urban geometry, validation study, wind flow

Procedia PDF Downloads 126

Authors: H. Heidari-Bafroui, B. Ribeiro, A. Charbaji, C. Anagnostopoulos, M. Faghri

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In this paper, we report the development of a portable and inexpensive infrared lightbox for improving the detection limits of paper-based phosphate devices. Commercial paper-based devices utilize the molybdenum blue protocol to detect phosphate in the environment. Although these devices are easy to use and have a long shelf life, their main deficiency is their low sensitivity based on the qualitative results obtained via a color chart. To improve the results, we constructed a compact infrared lightbox that communicates wirelessly with a smartphone. The system measures the absorbance of radiation for the molybdenum blue reaction in the infrared region of the spectrum. It consists of a lightbox illuminated by four infrared light-emitting diodes, an infrared digital camera, a Raspberry Pi microcontroller, a mini-router, and an iPhone to control the microcontroller. An iPhone application was also developed to analyze images captured by the infrared camera in order to quantify phosphate concentrations. Additionally, the app connects to an online data center to present a highly scalable worldwide system for tracking and analyzing field measurements. In this study, the detection limits for two popular commercial devices were improved by a factor of 4 for the Quantofix devices (from 1.3 ppm using visible light to 300 ppb using infrared illumination) and a factor of 6 for the Indigo units (from 9.2 ppm to 1.4 ppm) with repeatability of less than or equal to 1.2% relative standard deviation (RSD). The system also provides more granular concentration information compared to the discrete color chart used by commercial devices and it can be easily adapted for use in other applications.

Keywords: infrared lightbox, paper-based device, phosphate detection, smartphone colorimetric analyzer

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Authors: Amit Kumar, Bhupendra Pratap Singh, Manoj Singh, Monika Punia, Krishan Kumar, V. K. Jain

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Ambient concentrations of volatile organic compounds (VOCs) were investigated in order to find out temporal variations and their ozone forming potentials (OFP) at rural site in Delhi National Capital Region during summer 2013. Sampling was performed for continuous five days, to identify the differences in working days and weekend VOCs concentration levels. Sampling and analytical procedure for VOCs were done using National Institute for Occupational Safety and Health (NIOSH) standard method. On each sampling day, VOCs samples were collected for 3-hours in the morning, afternoon and evening. There has been observed a noticeable contrast in the concentration of VOCs levels between working days and weekend. However, most of the VOCs showed diurnal fluctuations with higher concentrations in the morning and evening as compared to afternoon which might be due to change in meteorology. The results showed that mean toluene/benzene and m-/p-xylene/benzene ratios were higher in the afternoon while it was lower during morning and evening. The relative contribution of the VOCs to ozone formation, total propylene equivalent concentrations and OFP were calculated. Toluene was the most contributing organic contaminant to ozone formation as well as ambient VOCs concentrations. Results obtained in current study demonstrate that ozone formation at rural site in Delhi is probably limited by the emissions of VOCs.

Keywords: VOCs, rural, NIOSH, ozone forming potential, propylene equivalent concentration

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Authors: Lorena Polovina, Maddy Kennedy-Parrott, Mohammad Fakoor

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The construction industry accounts for approximately 40% of total GHG emissions worldwide. In order to limit global warming to 1.5 degrees Celsius, ambitious reductions in the carbon intensity of our buildings are crucial. Passive House presents an opportunity to reduce operational carbon by as much as 90% compared to a traditional building through improving thermal insulation, limiting thermal bridging, increasing airtightness and heat recovery. Up until recently, Passive House design was mainly concerned with meeting the energy demands without considering embodied carbon. As buildings become more energy-efficient, embodied carbon becomes more significant. The main objective of this research is to calculate the embodied carbon impact of a Passive House and compare it with the BC Energy Step Code (ESC). British Columbia is committed to increasing the energy efficiency of buildings through the ESC, which is targeting net-zero energy-ready buildings by 2032. However, there is a knowledge gap in the embodied carbon impacts of more energy-efficient buildings, in particular Part 3 construction. In this case study, life cycle assessments (LCA) are performed on Part 3, a multi-unit residential building in Victoria, BC. The actual building is not constructed to the Passive House standard; however, the building envelope and mechanical systems are designed to comply with the Passive house criteria, as well as Steps 1 and 4 of the BC Energy Step Code (ESC) for comparison. OneClick LCA is used to perform the LCA of the case studies. Several strategies are also proposed to minimize the total carbon emissions of the building. The assumption is that there will not be significant differences in embodied carbon between a Passive House and a Step 4 building due to the building envelope.

Keywords: embodied carbon, energy modeling, energy step code, life cycle assessment

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Authors: Pushpa Debnath

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Buddhism implies the ultimate methodology to obtain the acknowledgment to get out from cycling existence applied by the sutras. The Buddha’s natural methodology is the highest way of cessation from suffering existence. To be out of it, one must know the suffering before having tentativeness. According to the Buddha’s methodology, one can observe every being suffer from chronologically grasping craving. It is because lack of knowledge that the Buddha finds the four noble truths which are the basic states. These are suffering, the origin of suffering, cessation of suffering, and the path leading to the cessation of suffering. The Buddha describes that birth is suffering, aging is suffering, sickness is suffering, death is suffering, association with the unexpected is suffering, separation from the pleasant is suffering, and not receiving what one desires is suffering, In brief, the five aggregates of clinging are suffering. As the five aggregates are form, feeling, perception, mental formation, and consciousness. These are known as the matter that we identify with “You, Me” or “He.” The second truth cause of suffering is craving which has three types: craving for sense pleasures, craving for existence, and craving for non-existence. The third truth is the obliteration of craving, suffering can be eliminated to attain the Nibbana. The fourth truth is the path of liberation is the noble eight-fold path consisting of the right view, right intention, right speech, right action, right livelihood, right effort, right mindfulness, and right concentration. The six senses are the media of the eye, ear, nose, tongue, body, and mind sense faculties relating with the five aggregates and the six senses objects visual objects, sounds, smells, tastes, touch, and mind-objects that are contained by every visible being. The first five internal sense bases are material while the mind is a non-material phenomenon. Contact with the external world maintains by receiving through the six senses; visual objects through the eye, sounds through the ear, smells through the nose, tastes through the tongue, touch through the body, and mind-objects through sense faculties. These are the six senses a living being experiences by craving. Everything is conglomerated with all senses faculties through the natural phenomenon which are earth, water, fire, and air element. In this analysis, it is believed that beings are well adapted to the natural phenomenon. Everybody has fear of life because we have hatred, delusion, and anger which are the primary resources of falling into (Samsara) continuously that is the continuity of the natural way. These are the reasons for the suffering that chronically self-diluting through the threefold way. These are the roots of the entire beings suffering so the Buddha finds the enlightenment to uproot from cycling existence and the understanding of the natural consequence. When one could uproot ignorance, one could able to realize the ultimate happiness of Nirvana. From the craving of ignorance, everything starts to be present to the future which gives us mental agonies in existence.

Keywords: purification, morality, natural phenomenon, analysis, development of mind, observatory, Nirvana

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Authors: Shaine Mehta, Neelam Parmar, Patrick White, Mark Ashworth

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Patients with a history of substance have a high prevalence of comorbidities, including asthma and chronic obstructive pulmonary disease (COPD). Mortality rates are higher than that of the general population and the link to respiratory disease is reported. Randomised controlled trials (RCTs) support opioid substitution therapy as an effective means for harm reduction. However, whilst a high proportion of patients receiving opioid substitution therapy are smokers, to the author’s best knowledge there have been no studies of respiratory disease and smoking intensity in these patients. A cross sectional prevalence study was conducted using an anonymised patient-level database in primary care, Lambeth DataNet (LDN). We included patients aged 18 years and over who had records of ever having been prescribed methadone in primary care. Patients under 18 years old or prescribed buprenorphine (because of uncertainty about the prescribing indication) were excluded. Demographic, smoking, alcohol and asthma and COPD coding data were extracted. Differences between methadone and non-methadone users were explored with multivariable analysis. LDN contained data on 321, 395 patients ≥ 18 years; 676 (0.16%) had a record of methadone prescription. Patients prescribed methadone were more likely to be male (70.7% vs. 50.4%), older (48.9yrs vs. 41.5yrs) and less likely to be from an ethnic minority group (South Asian 2.1% vs. 7.8%; Black African 8.9% vs. 21.4%). Almost all those prescribed methadone were smokers or ex-smokers (97.3% vs. 40.9%); more were non-alcohol drinkers (41.3% vs. 24.3%). We found a high prevalence of COPD (12.4% vs 1.4%) and asthma (14.2% vs 4.4%). Smoking intensity data shows a high prevalence of ≥ 20 cigarettes per day (21.5% vs. 13.1%). Risk of COPD, adjusted for age, gender, ethnicity and deprivation, was raised in smokers: odds ratio 14.81 (95%CI 11.26, 19.47), and in the methadone group: OR 7.51 (95%CI: 5.78, 9.77). Furthermore, after adjustment for smoking intensity (number of cigarettes/day), the risk was raised in methadone group: OR 4.77 (95%CI: 3.13, 7.28). High burden of respiratory disease compounded by the high rates of smoking is a public health concern. This supports an integrated approach to health in patients treated for opiate dependence, with access to smoking cessation support. Further work may evaluate the current structure and commissioning of substance misuse services, including smoking cessation. Regression modelling highlights that methadone as a ‘risk factor’ was independently associated with COPD prevalence, even after adjustment for smoking intensity. This merits further exploration, as the association may be related to unexplored aspects of smoking (such as the number of years smoked) or may be related to other related exposures, such as smoking heroin or crack cocaine.

Keywords: methadone, respiratory disease, smoking cessation, substance misuse

Procedia PDF Downloads 136

Authors: Mohd Said Nurumal, Sarah Sheikh Abdul Karim

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Information regarding out of hospital cardiac arrest incidence include outcome in Malaysia is limited and fragmented. This study aims to identify incidence and adherence to protocol of out of hospital cardiac arrest and also to explore the issues faced by the pre-hospital personnel in regards managing cardiac arrest victim in Kuala Lumpur, Malaysia. A mixed method approach combining the qualitative and quantitative study design was used. The 285 pre-hospital care data sheet of out of hospital cardiac arrest during the year of 2011 were examined by using checklists for identify the incidence and adherence to protocol. Nine semi-structured interviews and two focus group discussions were performed. For the incidence based on the overall out of hospital cardiac arrest cases that occurred in 2011 (n=285), the survival rates were 16.8%. For adherence to protocol, only 89 (41.8%) of the cases adhered to the given protocol and 124 did not adhere to such protocol. The qualitative information provided insight about the issues related to out of hospital cardiac arrest in every aspect. All the relevant qualitative data were merged into few categories relating issues that could affect the management of out of hospital cardiac arrest performed by pre-hospital care team. One of the essential elements in the out of hospital cardiac arrest handling by pre-hospital care is to ensure increase of survival rates and excellent outcomes by adhering to given protocols based on international standard benchmarks. Measures are needed to strengthen the quick activation of the pre-hospital care service, prompt bystander cardiopulmonary resuscitation, early defibrillation and timely advanced cardiac life support and also to tackle all the issues highlighted in qualitative results.

Keywords: pre-hospital care, out of hospital cardiac arrest, incidence, protocol, mixed method research

Procedia PDF Downloads 407