Search results for: knowledge translation
2486 Mammographic Multi-View Cancer Identification Using Siamese Neural Networks
Authors: Alisher Ibragimov, Sofya Senotrusova, Aleksandra Beliaeva, Egor Ushakov, Yuri Markin
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Mammography plays a critical role in screening for breast cancer in women, and artificial intelligence has enabled the automatic detection of diseases in medical images. Many of the current techniques used for mammogram analysis focus on a single view (mediolateral or craniocaudal view), while in clinical practice, radiologists consider multiple views of mammograms from both breasts to make a correct decision. Consequently, computer-aided diagnosis (CAD) systems could benefit from incorporating information gathered from multiple views. In this study, the introduce a method based on a Siamese neural network (SNN) model that simultaneously analyzes mammographic images from tri-view: bilateral and ipsilateral. In this way, when a decision is made on a single image of one breast, attention is also paid to two other images – a view of the same breast in a different projection and an image of the other breast as well. Consequently, the algorithm closely mimics the radiologist's practice of paying attention to the entire examination of a patient rather than to a single image. Additionally, to the best of our knowledge, this research represents the first experiments conducted using the recently released Vietnamese dataset of digital mammography (VinDr-Mammo). On an independent test set of images from this dataset, the best model achieved an AUC of 0.87 per image. Therefore, this suggests that there is a valuable automated second opinion in the interpretation of mammograms and breast cancer diagnosis, which in the future may help to alleviate the burden on radiologists and serve as an additional layer of verification.Keywords: breast cancer, computer-aided diagnosis, deep learning, multi-view mammogram, siamese neural network
Procedia PDF Downloads 1262485 The Effect of the Organization of Mental Health Care on General Practitioners’ Prescription Behavior of Psychotropics for Adolescents in Belgium
Authors: Ellen Lagast, Melissa Ceuterick, Mark Leys
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Although adolescence is a stressful period with an increased risk for mental illnesses such as anxiety and depression, little in-depth knowledge is available on the determinants of the use of psychotropic drugs (BZD/SSRIs) and the effects. A qualitative research with adolescents in Flanders was performed. Based on indepth interviews, the interviewees indicate feelings of ambiguity towards their medication use because on the one hand the medication helps to manage their mental vulnerability and disrupted lives, but on the other hand they experience a loss of control of their self and their environment. Undesired side-effects and stigma led to a negative pharmaceutical self. The interviewed youngsters also express dissatisfaction about the prescription behavior with regard to psychotropic drugs of their general practitioner (GP). They wished to have received more information about alternative non-pharmaceutical treatment options. Notwithstanding these comments, the majority of the interviewees maintained trust in their GP to act in their best interest. This paper will relate the prescription behavior in primary care to the organization of mental health care to better understand the “phamaceuticalization” and medicalization of mental health problems in Belgium. Belgium implemented fundamental mental health care reforms to collaborate, to integrate care and to optimize continuity of care. Children and adolescents still are confronted with long waiting lists to access (non-medicalized) mental health services. This access to mental health care partly explains general practitioners’ prescription behavior of psychotropics. Moreover, multidisciplinary practices have not pervaded primary health care yet. Medicalization and pharmaceuticalization of mental health vulnerabilities of youth are both a structural and cultural problem.Keywords: adolescents, antidepressants, benzodiazepines, mental health system, psychotropic drugs
Procedia PDF Downloads 982484 Pharmacogenetics Study of Dapsone-Induced Severe Cutaneous Adverse Reactions and HLA Class I Alleles in Thai Patients
Authors: Patompong Satapornpong, Therdpong Tempark, Pawinee Rerknimitr, Jettanong Klaewsongkram, Chonlaphat Sukasem
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Dapsone (4, 4’-diaminodiphenyl sulfone, DDS) is broadly used for the treatment of inflammatory diseases and infections such as; leprosy, Pneumocystis jiroveci pneumonia in patients with HIV infection, neutrophilic dermatoses, dermatitis herpetiformis and autoimmune bullous disease. The severe cutaneous adverse drug reactions (SCARs) including, Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) are rare but severe life-threatening adverse drug reactions. Dapsone is one of many culprit drugs induced SJS, TEN and DRESS. Notwithstanding, to our knowledge, there are no studies of the association of HLA class I alleles and dapsone-induced SCARs in non-leprosy Thai patients. This investigation was a prospective cohort study, which performed in a total of 45 non-leprosy patients. Fifteen patients of dapsone-induced SCARs were classified as following the RegiSCAR criteria, and 30 dapsone-tolerant controls were exposed to dapsone more than 6 months without any evidence of cutaneous reactions. The genotyping of HLA-A, -B and –C were performed using sequence-specific oligonucleotides (PCR-SSOs). The Ethics Committee of Ramathibodi hospital, Mahidol University, approved this study. Among all HLA class I alleles, HLA-A*24:07, HLA-B*13:01, HLA-B*15:02, HLA-C*03:04 and HLA-C*03:09 were significantly associated with dapsone-induced SCARs (OR = 10.55, 95% CI = 1.06 – 105.04, p = 0.0360; OR = 56.00, 95% CI = 8.27 – 379.22, p = 0.0001; OR = 7.00, 95% CI = 1.17 – 42.00, p = 0.0322; OR = 6.00, 95% CI = 1.24 – 29.07, p = 0.0425 and OR = 17.08, 95% CI = 0.82 – 355.45, p = 0.0321, respectively). Furthermore, HLA-B*13:01 allele had strong association with dapsone-induced SJS-TEN and DRESS when compared with dapsone-tolerant controls (OR = 42.00, 95% CI = 2.88 – 612.31, p = 0.0064 and OR = 63.00, 95% CI = 7.72 – 513.94 and p = 0.0001, respectively). Consequently, HLA-B*13:01 might serve as a pharmacogenetic marker for screening before initiating the therapy with dapsone for prevention of dapsone-induced SCARs.Keywords: dapsone-induced SCARs, HLA-B*13:01, HLA class I alleles, severe cutaneous adverse reactions, Thai
Procedia PDF Downloads 2262483 Challenges to Reaching Higher Education in Developing Countries
Authors: Suhail Shersad
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Introduction In developing countries, the access to higher education for the lower socioeconomic strata is very poor at less than 0.05%. The challenges faced by prospective students in these circumstances to pursue higher education have been explored through direct interaction with them and their families in urban slums of New Delhi. This study included evaluation of the demographics, social indices, expectations and perceptions of selected communities. Results The results show that the poor life expectancy, low exposure to technology, lack of social infrastructure and poor sanitary conditions have reduced their drive for academic achievements. This is despite a good level of intelligence and critical thinking skills among these students. The perception of the community including parents shows that despite their desire to excel, there are too may roadblocks to achieving a fruitful professional life for the next generation. Discussion The prerequisites of higher education may have to be revisited to be more inclusive of socially handicapped students. The knowledge, skills and attributes required for higher education system should form the baseline for creating a roadmap for higher secondary education suited for local needs. Conventional parameters like marks and grading have to be re-looked so that life skills and vocational training form part of the core curriculum. Essential skills should be incorporated at an earlier age, providing an alternative pathway for such students to join higher education. Conclusion: There is a need to bridge the disconnect that exists between higher education planning, the needs of the concerned cohorts and the existing higher secondary education. The variables that contribute to making such a decision have to be examined further. Keywords: prerequisites of higher education, social mobility, society expectations, access to higher educationKeywords: access to higher education, prerequisites of higher education, society expectations, social mobility
Procedia PDF Downloads 3762482 Persuasive Communication on Social Egg Freezing in California from a Framing Theory Perspective
Authors: Leila Mohammadi
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This paper presents the impact of persuasive communication implemented by fertility clinics websites, and how this information influences women at their decision-making for undertaking this procedure. The influential factors for women decisions to do social egg freezing (SEF) are analyzed from a framing theory perspective, with a specific focus on the impact of persuasive information on women’s decision making. This study follows a quantitative approach. A two-phase survey has been conducted to examine the interest rate to undertake SEF. In the first phase, a questionnaire was available during a month (May 2015) to women to answer whether or not they knew enough information of this process, with a total of 230 answers. The second phase took place in the two last weeks of July 2015. All the respondents were invited to a seminars called ‘All about egg freezing’ and afretwards they were requested to answer the second questionnaire. After the seminar, in which they were given an extensive amount of information about egg freezing, a total of 115 women replied the questionnaire. The collected data during this process were analyzed using descriptive statistics. Most of the respondents changed their opinion in the second questionaire which was after receiving information. Although in the first questionnaire their self-evaluation of having knowledge about this process and the implemented technologies was very high, they realized that they still need to access more information from different sources in order to be able to make a decision. The study reached the conclusion that persuasive and framed information by clinics would affect the decisions of these women. Despite the reasons women have to do egg freezing and their motivations behind it, providing people necessary information and unprejudiced data about this process (such as its positive and negative aspects, requirements, suppositions, possibilities and consequences) would help them to make a more precise and reasonable decision about what they are buying.Keywords: decision making, fertility clinics, framing theory, persuasive information, social egg freezing
Procedia PDF Downloads 2402481 Association of Calcium Intake Adequacy with Wealth Indices among Selected Female Adults Living in Depressed and Non-Depressed Area in Metro Manila, Philippines
Authors: Maria Viktoria Melgo
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This study aimed to determine the possible association between calcium intake and wealth indices of selected female adults. Specifically, it aimed to: a) determine the calcium intake adequacy of the respondents. b) determine the relationship, if any, between calcium intake adequacy, area and wealth indices. The study used the survey design and employed convenience sampling in selecting participants. Two hundred females aged 20 – 64 years old were covered in the study from depressed and non-depressed areas. Data collected were calcium intake taken from two 24-hour food recall and Food Frequency Questionnaire (FFQ) and wealth indices using housing characteristics, household assets and access to utilities and infrastructure. Descriptive statistics and Chi-square test were used to determine the frequency distribution and association between the given variables, respectively, using Statistical Package for Social Sciences (SPSS) and OpenEpi software. The results showed that there were 86% of respondents in the depressed area with an inadequate calcium intake while there were 78% of respondents in the non-depressed area with an adequate calcium intake. No significant relationship was obtained in most wealth indices with calcium intake adequacy and area but appliance and ownership of main material of the house showed a significant relationship to calcium intake adequacy by area. The study recommends that the Local Government Unit (LGU) should provide seminars or nutrition education that will further enhance the knowledge of the people in the community. The study also recommends to conduct a similar study but with different, larger sample size, different location nonetheless if it is in urban or rural and include the anthropometry measurement of the respondents.Keywords: association, calcium intake adequacy, metro Manila, Philippines, wealth indices
Procedia PDF Downloads 1892480 Treating On-Demand Bonds as Cash-In-Hand: Analyzing the Use of “Unconscionability” as a Ground for Challenging Claims for Payment under On-Demand Bonds
Authors: Asanga Gunawansa, Shenella Fonseka
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On-demand bonds, also known as unconditional bonds, are commonplace in the construction industry as a means of safeguarding the employer from any potential non-performance by a contractor. On-demand bonds may be obtained from commercial banks, and they serve as an undertaking by the issuing bank to honour payment on demand without questioning and/or considering any dispute between the employer and the contractor in relation to the underlying contract. Thus, whether or not a breach had occurred under the underlying contract, which triggers the demand for encashment by the employer, is not a question the bank needs to be concerned with. As a result, an unconditional bond allows the beneficiary to claim the money almost without any condition. Thus, an unconditional bond is as good as cash-in-hand. In the past, establishing fraud on the part of the employer, of which the bank had knowledge, was the only ground on which a bank could dishonour a claim made under an on-demand bond. However, recent jurisprudence in common law countries shows that courts are beginning to consider unconscionable conduct on the part of the employer in claiming under an on-demand bond as a ground that contractors could rely on the prevent the banks from honouring such claims. This has created uncertainty in connection with on-demand bonds and their liquidity. This paper analyzes recent judicial decisions in four common law jurisdictions, namely, England, Singapore, Hong Kong, and Sri Lanka, to identify the scope of using the concept of “unconscionability” as a ground for preventing unreasonable claims for encashment of on-demand bonds. The objective of this paper is to argue that on-demand bonds have lost their effectiveness as “cash-in-hand” and that this is, in fact, an advantage and not an impediment to international commerce, as the purpose of such bonds should not be to provide for illegal and unconscionable conduct by the beneficiaries.Keywords: fraud, performance guarantees, on-demand bonds, unconscionability
Procedia PDF Downloads 982479 Factors Affecting the Formation of Architectural Space and Construction Systems in the Jordanian Vernacular Architecture
Authors: Mohannad Tarrad
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The research deals with the beginnings of the vernacular Jordanian architecture since the establishment of the Jordanian state in the early nineteenth century until now, where the Jordanian architecture was based on the interactions of the Jordanian society with the surrounding environment, where the local materials available in the construction area were used, and the construction systems inherited from previous civilizations were used. The builders in Jordan relied on exchanging knowledge and transferring it from one generation to another, where they were able to formulate a construction style capable of responding to the requirement of architectural spaces, and each region of Jordan has its own way of building, as there are various geographical areas in Jordan, including agricultural, mountainous and desert areas. Then the research touched on a historical study of the architectural space and identifying the value of the architectural space in the Jordanian social life, which is related to the customs and traditions of a society influenced by the Arab Islamic civilization, and then the construction, the structural structure, its characteristics and the constituent elements of the building were defined in the vernacular l Jordanian architecture. From the structural point of view, and then to identify the structural materials used in the structural structure and the impact of the structural structure on the design from several aspects, leading to the interior space and the factors affecting it. The research aims to explain and clarify the interconnected design and construction solutions in the vernacular Jordanian architecture in a manner that respects the environmental context, taking into account the material cost of the building, where the financial situation of the home owner plays an important role in choosing the building material and construction method. Case studies from heritage buildings from several Jordanian regions will be analyzed to illustrate the idea of the research.Keywords: construction systems, architectural space, environmental context, Jordanian architecture
Procedia PDF Downloads 1942478 Examining the Predicting Effect of Mindfulness on Psychological Well-Being among Undergraduate Students
Authors: Piyanee Klainin-Yobas, Debbie Ramirez, Zenaida Fernandez, Jenneth Sarmiento, Wareerat Thanoi, Jeanette Ignacio, Ying Lau
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In many countries, university students experience various stressors that may negatively affect their psychological well-being (PWB). Hence, they are at risk for physical and mental problems. This research aimed to examine the predicting effects of mindfulness, self-efficacy, and social support on psychological well-being among undergraduate students. A non-experimental research was conducted at a university in the Philippines. All students enrolled in undergraduate programs were eligible for this study unless they had chronic medical or mental health problems. Power analysis was used to calculate an adequate sample size and a convenience sampling of 630 was recruited. Data were collected through online self-reported questionnaires from year 2013 to 2015. All self-reported scales used in this study had sound psychometric properties. Descriptive statistics, correlational analyses, and structural equation modeling were performed to analyze the research data. Results showed that the participants were mostly Filipino, female, Christian, and in Schools of Nursing. Mindfulness, self-efficacy, support from family, support from friends, and support from significant others were significant predictors of psychological well-being. Mindfulness was the strongest predictor of positive psychological well-being whereas self-efficacy was the strongest predictor of negative psychological well-being. In conclusion, findings from this study add knowledge to the existing literature regarding the predictors of psychological well-being. Psychosocial interventions, with the focus on strengthening mindfulness and self-efficacy, could be delivered to undergraduate students to help them enhance psychological well-being. More studies can be undertaken to test the interventions and multi-centered research can be conducted to enhance generalizability of research findings.Keywords: mindfulness, self-efficacy, social support, psychological wellbeing
Procedia PDF Downloads 4142477 Fatigue Life Prediction under Variable Loading Based a Non-Linear Energy Model
Authors: Aid Abdelkrim
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A method of fatigue damage accumulation based upon application of energy parameters of the fatigue process is proposed in the paper. Using this model is simple, it has no parameter to be determined, it requires only the knowledge of the curve W–N (W: strain energy density N: number of cycles at failure) determined from the experimental Wöhler curve. To examine the performance of nonlinear models proposed in the estimation of fatigue damage and fatigue life of components under random loading, a batch of specimens made of 6082 T 6 aluminium alloy has been studied and some of the results are reported in the present paper. The paper describes an algorithm and suggests a fatigue cumulative damage model, especially when random loading is considered. This work contains the results of uni-axial random load fatigue tests with different mean and amplitude values performed on 6082T6 aluminium alloy specimens. The proposed model has been formulated to take into account the damage evolution at different load levels and it allows the effect of the loading sequence to be included by means of a recurrence formula derived for multilevel loading, considering complex load sequences. It is concluded that a ‘damaged stress interaction damage rule’ proposed here allows a better fatigue damage prediction than the widely used Palmgren–Miner rule, and a formula derived in random fatigue could be used to predict the fatigue damage and fatigue lifetime very easily. The results obtained by the model are compared with the experimental results and those calculated by the most fatigue damage model used in fatigue (Miner’s model). The comparison shows that the proposed model, presents a good estimation of the experimental results. Moreover, the error is minimized in comparison to the Miner’s model.Keywords: damage accumulation, energy model, damage indicator, variable loading, random loading
Procedia PDF Downloads 3862476 Modernizer'ness as Madness: A Comparative Historical Study of Emperor Tewodros II of Ethiopia and Sultan Selim III of Ottoman Turkey's Modernization Reforms
Authors: Seid Ahmed Mohammed, Nedim Yalansiz
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Many historians hardly gave due attention for historical comparison as their methods of study. They were still stunt supporter of the use of their own historical research method in their studies. But this method lacks the way to analyze some worldwide dynamics of events in comparative perspectives. Some dynamics like revolution, modernization, societal change and transformation needs broader analysis for broadening our historical knowledge’s by comparing and contrasting of the causes, courses and consequences of such dynamics historical developments in the world at large. In this paper, our study focuses up on ‘the dynamics of modernization’ and the challenge of modernity of the old regimes. For instance, countries like Turkey, Ethiopia, China, Russia, Iran, Afghanistan and Thailand have almost the same dynamics in facing the challenge of modernity. In such countries, the old regimes tried to introduce modernization and ‘reform from the above’ in order to tackle the gradual decline of the empire that faced strong challenge from the outside world. The other similarity of them was that as the rulers attempted to introduce the modernization reforms the old traditional and the religious institutions strongly opposed the reforms as the reforms alienated the power and prestige of the traditional classes. Similarly, the rules introduced modernization for maintaining their own unique socio-cultural and religious dynamics not as borrowing and acculturation of the west by complete destruction of their own. Therefore, this paper attempted to give a comparative analysis of two modernizers Tewodros II (1855-1868) of Ethiopia and Sultan Selim III (1739-1808) of Ottoman Turkey who tried to modernize their empire unfortunately they paid their precious life as a result of modernization.Keywords: comparative history, Ethiopia, modernization, Ottoman Turkey
Procedia PDF Downloads 1942475 Analogy to Continental Divisions: An Attention-Grabbing Approach to Teach Taxonomic Hierarchy to Students
Authors: Sagheer Ahmad
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Teaching is a sacred profession whereby students are developed in their mental abilities to cope with the challenges of the remote world. Thinkers have developed plenty of interesting ways to make the learning process quick and absorbing for the students. However, third world countries are still lacking these remote facilities in the institutions, and therefore, teaching is totally dependent upon the skills of the teachers. Skillful teachers use self-devised and stimulating ideas to grab the attention of their students. Most of the time their ideas are based on local grounds with which the students are already familiar. This self-explanatory characteristic is the base of several local ideologies to disseminate scientific knowledge to new generations. Biology is such a subject which largely bases upon hypotheses, and teaching it in an interesting way is needful to create a friendly relationship between teacher and student, and to make a fantastic learning environment. Taxonomic classification if presented as it is, may not be attractive for the secondary school students who just start learning about biology at elementary levels. Presenting this hierarchy by exemplifying Kingdom, Phylum, Class, Order, family, genus and Species as comparatives of our division into continents, countries, cities, towns, villages, homes and finally individuals could be an attention-grabbing approach to make this concept get into bones of students. Similarly, many other interesting approaches have also been adopted to teach students in a fascinating way so that learning science subjects may not be boring for them. Discussing these appealing ways of teaching students can be a valuable stimulus to refine teaching methodologies about science, thereby promoting the concept of friendly learning.Keywords: biology, innovative approaches, taxonomic classification, teaching
Procedia PDF Downloads 2422474 Entrepreneurship in Pakistan: Opportunities and Challenges
Authors: Bushra Jamil, Nudrat Baqri, Muhammad Hassan Saeed
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Entrepreneurship is creating or setting up a business not only for the purpose of generating profit but also for providing job opportunities. Entrepreneurs are problem solvers and product developers. They use their financial asset for hiring a professional team and combine the innovation, knowledge, and leadership leads to a successful startup or a business. To be a successful entrepreneur, one should be people-oriented and have perseverance. One must have the ability to take risk, believe in his/her potential, and have the courage to move forward in all circumstances. Most importantly, have the ability to take risk and can assess the risk. For STEM students, entrepreneurship is of specific importance and relevance as it helps them not just to be able to solve real life existing complications but to be able to recognize and identify emerging needs and glitches. It is becoming increasingly apparent that in today’s world, there is a need as well as a desire for STEM and entrepreneurship to work together. In Pakistan, entrepreneurship is slowly emerging, yet we are far behind. It is high time that we should introduce modern teaching methods and inculcate entrepreneurial initiative in students. A course on entrepreneurship can be included in the syllabus, and we must invite businessmen and policy makers to motivate young minds for entrepreneurship. This must be pitching competitions, opportunities to win seed funding, and facilities of incubation centers. In Pakistan, there are many good public sector research institutes, yet there is a void gap in the private sector. Only few research institute are meant for research and development. BJ Micro Lab is one of them. It is SECP registered company and is working in academia to promote and facilitate research in STEM. BJ Micro Lab is a women led initiative, and we are trying to promote research as a passion, not as an arduous burden. For this, we are continuously arranging training workshops and sessions. More than 100 students have been trained in ten different workshops arranged at BJ Micro Lab.Keywords: entrepreneurship, STEM, challenges, oppurtunties
Procedia PDF Downloads 1192473 Aeronautical Noise Management inside an Aerodrome: Analysis of Sound Exposure on Aviation Professional’s Health
Authors: Rafael Felipe Guatura da Silva, José Luis Gomes da Silva, Luiz Antonio, Ferreira Perrone de Brito
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Noise can cause serious damage to human health, such as hearing loss, stress, irritability, fatigue, and others. Aviation is a place where your entire process should be work out with the utmost attention and commitment of human resources, thus the need to study the effects of noise in this sector, as aeronautical noise levels are high. This study aimed to evaluate the impact of noise pollution on the performance of professionals regarding the fatigue generated by aeronautical noise and time to noise exposure. The methodology used consists of measurements of sound pressure levels at 42 points of the aerodrome. The selected points are located inside the hangars and outside the airfield hangars. All points chosen are close to the professionals' work areas, seeking to identify the sound pressure levels to which they submitted. The other part of the research used the principle on the application of a self-report questionnaire to a sample of 207 people working inside the aerodrome. The 207 professionals surveyed consist of aircraft mechanics, pilots, maintenance managers, and administrative professionals. The questionnaire was intended to evaluate the knowledge that professionals have about health risks caused by sound exposure as well as to identify diseases that professionals have, and that may be associated with exposure to high levels of sound pressure. Preliminary results identify points with sound pressure levels of up to 91.7 dB, thus highlighting the need for the use of personal protective equipment that reduces noise exposure. It was also identified a large number of professionals who are bothered by the sound exposure and approximately 25% of professionals interviewed reported having a hearing disorder.Keywords: aeronautical noise, fatigue, noise and health, noise management
Procedia PDF Downloads 1342472 Implementation of Social Network Analysis to Analyze the Dependency between Construction Bid Packages
Authors: Kawalpreet Kaur, Panagiotis Mitropoulos
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The division of the project scope into work packages is the most important step in the preconstruction phase of construction projects. The work division determines the scope and complexity of each bid package, resulting in dependencies between project participants performing these work packages. The coordination between project participants is necessary because of these dependencies. Excessive dependencies between the bid packages create coordination difficulties, leading to delays, added costs, and contractual friction among project participants. However, the literature on construction provides limited knowledge regarding work structuring approaches, issues, and challenges. Manufacturing industry literature provides a systematic approach to defining the project scope into work packages, and the implementation of social network analysis (SNA) in manufacturing is an effective approach to defining and analyzing the divided scope of work at the dependencies level. This paper presents a case study of implementing a similar approach using SNA in construction bid packages. The study uses SNA to analyze the scope of bid packages and determine the dependency between scope elements. The method successfully identifies the bid package with the maximum interaction with other trade contractors and the scope elements that are crucial for project performance. The analysis provided graphical and quantitative information on bid package dependencies. The study can be helpful in performing an analysis to determine the dependencies between bid packages and their scope elements and how these scope elements are critical for project performance. The study illustrates the potential use of SNA as a systematic approach to analyzing bid package dependencies in construction projects, which can guide the division of crucial scope elements to minimize negative impacts on project performance.Keywords: work structuring, bid packages, work breakdown, project participants
Procedia PDF Downloads 742471 Improving Healthcare Readiness to Respond to Human Trafficking: A Case Study
Authors: Traci A. Hefner
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Limited research exists on the readiness of emergency departments to respond to human trafficking (HT). The purpose of this qualitative case study was to improve the readiness of a Department of Emergency Medicine (ED), located in the southeast region of the United States, in identifying, assessing, and responding to trafficked individuals. The research objectives were to 1) provide an organizing framework to understand the ED’s readiness to respond to HT, using the Transtheoretical Model’s stages of change construct, 2) explain the readiness of the ED through a three-pronged contextual approach that included policies and procedures, patient data collection processes, and clinical practice methods, and 3) develop recommendations to respond to HT. Content analysis was used for document reviews and on-site observations, while thematic analysis identified themes of staff perceptions of the ED’s readiness in interviews of over 30 clinical and non-clinical healthcare professionals. Results demonstrated low levels of readiness to identify HT through the ED’s policies and procedures, data collection processes, and clinical practice methods. Clinical practice-related factors consisted of limited awareness of HT warning signs and low-levels of knowledge about community resources for possible HT referrals. Policy and practice recommendations to increase the ED’s readiness to respond to HT included: developing staff trainings across the ED system to enhance awareness of HT warning signs, incorporating HT into current policies and procedures for vulnerable patient populations as well as creating a HT protocol that addresses policies and procedures, screening tools, and community referrals.Keywords: emergency medicine, human trafficking, organizational assessment, stages of change
Procedia PDF Downloads 1422470 Nutritional Wellness at the Workplace
Authors: Siveshnee Devar
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Background: The rate of absenteeism and prevalence of NCDs in South Africa is extremely high. This is consistent with other educational institutions and workplaces around the globe. In most cases the absence of health and the presence of one or more non communicable diseases coupled with the lack of physical exercise is a major factor in absenteeism. Absenteeism at the workplace comes at a huge cost to the employer and the country as a whole. Aim: Findings from this study was to develop a suitable nutritional wellness program for the workplace. Methodology: A needs analysis in the form of 24-hour recall, food frequency, health and socio demographic questionnaires was undertaken to determine the need for a wellness program for the institution. Anthropometric indices such as BMI, waist circumference and blood pressure were also undertaken to determine the state of health of the staff. Results: This study has found that obesity, central obesity, hypertension as well as deficiencies in nutrients and minerals were prevalent in this group. Fruit and vegetable consumption was also below the WHO recommendation. This study showed a link between diet, physical activity and diseases of lifestyle. There were positive correlations between age and systolic blood pressure, waist circumference and systolic blood pressure, waist circumference and diastolic blood pressure and waist-to-height ratio and BMI. Conclusion: The results indicated the need for immediate intervention in the form of a wellness program. Nutrition education is important for both the workplace and out. Education and knowledge are important factors for lifestyle changes. The proposed intervention is aimed at improving presenteeism and decreasing the incidence of non- communicable diseases. Presenteeism and good health are important factors for quality education at all educational institutions.Keywords: absenteeism, non-communicable diseases, nutrition, wellness
Procedia PDF Downloads 5722469 Predictors of Non-Adherence to Pharmacological Therapy in Patients with Type 2 Diabetes
Authors: Anan Jarab, Riham Almrayat, Salam Alqudah, Maher Khdour, Tareq Mukattash, Sharell Pinto
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Background: The prevalence of diabetes in Jordan is among the highest in the world, making it a particularly alarming health problem there. It has been indicated that poor adherence to the prescribed therapy lead to poor glycemic control and enhance the development of diabetes complications and unnecessary hospitalization. Purpose: To explore factors associated with medication non-adherence in patients with type 2 diabetes in Jordan. Materials and Methods: Variables including socio-demographics, disease and therapy factors, diabetes knowledge, and health-related quality of life in addition to adherence assessment were collected for 171 patients with type 2 diabetes using custom-designed and validated questionnaires. Logistic regression was performed to develop a model with variables that best predicted medication non-adherence in patients with type 2 diabetes in Jordan. Results: The majority of the patients (72.5%) were non-adherent. Patients were found four times less likely to adhere to their medications with each unit increase in the number of prescribed medications (OR = 0.244, CI = 0.08-0.63) and nine times less likely to adhere to their medications with each unit increase in the frequency of administration of diabetic medication (OR = 0.111, CI = 0.04-2.01). Patients in the present study were also approximately three times less likely (OR = 0.362, CI = 0.24-0.87) to adhere to their medications if they reported having concerns about side effects and twice more likely to adhere to medications (OR = 0.493, CI = 0.08-1.16) if they had one or more micro-vascular complication. Conclusion: The current study revealed low adherence rate to the prescribed therapy among Jordanians with type 2 diabetes. Simplifying dosage regimen, selecting treatments with lower side effects along with an emphasis on diabetes complications should be taken into account when developing care plans for patients with type 2 diabetes.Keywords: type 2 diabetes, adherence, glycemic control, clinical pharmacist, Jordan
Procedia PDF Downloads 4332468 Comparing the Embodied Carbon Impacts of a Passive House with the BC Energy Step Code Using Life Cycle Assessment
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
Procedia PDF Downloads 1392467 Prioritizing the Most Important Information from Contractors’ BIM Handover for Firefighters’ Responsibilities
Authors: Akram Mahdaviparsa, Tamera McCuen, Vahideh Karimimansoob
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Fire service is responsible for protecting life, assets, and natural resources from fire and other hazardous incidents. Search and rescue in unfamiliar buildings is a vital part of firefighters’ responsibilities. Providing firefighters with precise building information in an easy-to-understand format is a potential solution for mitigating the negative consequences of fire hazards. The negative effect of insufficient knowledge about a building’s indoor environment impedes firefighters’ capabilities and leads to lost property. A data rich building information modeling (BIM) is a potentially useful source in three-dimensional (3D) visualization and data/information storage for fire emergency response. Therefore, this research’s purpose is prioritizing the required information for firefighters from the most important information to the least important. A survey was carried out with firefighters working in the Norman Fire Department to obtain the importance of each building information item. The results show that “the location of exit doors, windows, corridors, elevators, and stairs”, “material of building elements”, and “building data” are the three most important information specified by firefighters. The results also implied that the 2D model of architectural, structural and way finding is more understandable in comparison with the 3D model, while the 3D model of MEP system could convey more information than the 2D model. Furthermore, color in visualization can help firefighters to understand the building information easier and quicker. Sufficient internal consistency of all responses was proven through developing the Pearson Correlation Matrix and obtaining Cronbach’s alpha of 0.916. Therefore, the results of this study are reliable and could be applied to the population.Keywords: BIM, building fire response, ranking, visualization
Procedia PDF Downloads 1252466 The Impact of the Macro-Level: Organizational Communication in Undergraduate Medical Education
Authors: Julie M. Novak, Simone K. Brennan, Lacey Brim
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Undergraduate medical education (UME) curriculum notably addresses micro-level communications (e.g., patient-provider, intercultural, inter-professional), yet frequently under-examines the role and impact of organizational communication, a more macro-level. Organizational communication, however, functions as foundation and through systemic structures of an organization and thereby serves as hidden curriculum and influences learning experiences and outcomes. Yet, little available research exists fully examining how students experience organizational communication while in medical school. Extant literature and best practices provide insufficient guidance for UME programs, in particular. The purpose of this study was to map and examine current organizational communication systems and processes in a UME program. Employing a phenomenology-grounded and participatory approach, this study sought to understand the organizational communication system from medical students' perspective. The research team consisted of a core team and 13 medical student co-investigators. This research employed multiple methods, including focus groups, individual interviews, and two surveys (one reflective of focus group questions, the other requesting students to submit ‘examples’ of communications). To provide context for student responses, nonstudent participants (faculty, administrators, and staff) were sampled, as they too express concerns about communication. Over 400 students across all cohorts and 17 nonstudents participated. Data were iteratively analyzed and checked for triangulation. Findings reveal the complex nature of organizational communication and student-oriented communications. They reveal program-impactful strengths, weaknesses, gaps, and tensions and speak to the role of organizational communication practices influencing both climate and culture. With regard to communications, students receive multiple, simultaneous communications from multiple sources/channels, both formal (e.g., official email) and informal (e.g., social media). Students identified organizational strengths including the desire to improve student voice, and message frequency. They also identified weaknesses related to over-reliance on emails, numerous platforms with inconsistent utilization, incorrect information, insufficient transparency, assessment/input fatigue, tacit expectations, scheduling/deadlines, responsiveness, and mental health confidentiality concerns. Moreover, they noted gaps related to lack of coordination/organization, ambiguous point-persons, student ‘voice-only’, open communication loops, lack of core centralization and consistency, and mental health bridges. Findings also revealed organizational identity and cultural characteristics as impactful on the medical school experience. Cultural characteristics included program size, diversity, urban setting, student organizations, community-engagement, crisis framing, learning for exams, inefficient bureaucracy, and professionalism. Moreover, they identified system structures that do not always leverage cultural strengths or reduce cultural problematics. Based on the results, opportunities for productive change are identified. These include leadership visibly supporting and enacting overall organizational narratives, making greater efforts in consistently ‘closing the loop’, regularly sharing how student input effects change, employing strategies of crisis communication more often, strengthening communication infrastructure, ensuring structures facilitate effective operations and change efforts, and highlighting change efforts in informational communication. Organizational communication and communications are not soft-skills, or of secondary concern within organizations, rather they are foundational in nature and serve to educate/inform all stakeholders. As primary stakeholders, students and their success directly affect the accomplishment of organizational goals. This study demonstrates how inquiries about how students navigate their educational experience extends research-based knowledge and provides actionable knowledge for the improvement of organizational operations in UME.Keywords: medical education programs, organizational communication, participatory research, qualitative mixed methods
Procedia PDF Downloads 1062465 Attribution Theory and Perceived Reliability of Cellphones for Teaching and Learning
Authors: Mayowa A. Sofowora, Seraphin D. Eyono Obono
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The use of information and communication technologies such as computers, mobile phones and the internet is becoming prevalent in today’s world; and it is facilitating access to a vast amount of data, services, and applications for the improvement of people’s lives. However, this prevalence of ICTs is hampered by the problem of low income levels in developing countries to the point where people cannot timeously replace or repair their ICT devices when damaged or lost; and this problem serves as a motivation for this study whose aim is to examine the perceptions of teachers on the reliability of cellphones when used for teaching and learning purposes. The research objectives unfolding this aim are of two types: objectives on the selection and design of theories and models, and objectives on the empirical testing of these theories and models. The first type of objectives is achieved using content analysis in an extensive literature survey, and the second type of objectives is achieved through a survey of high school teachers from the ILembe and Umgungudlovu districts in the KwaZuluNatal province of South Africa. Data collected from this questionnaire based survey is analysed in SPSS using descriptive statistics and Pearson correlations after checking the reliability and validity of the questionnaire. The main hypothesis driving this study is that there is a relationship between the demographics and the attribution identity of teachers on one hand, and their perceptions on the reliability of cellphones on the other hand, as suggested by existing literature; except that attribution identities are considered in this study under three angles: intention, knowledge and ability, and action. The results of this study confirm that the perceptions of teachers on the reliability of cellphones for teaching and learning are affected by the school location of these teachers, and by their perceptions on learners’ cellphones usage intentions and actual use.Keywords: attribution, cellphones, e-learning, reliability
Procedia PDF Downloads 3932464 Ata-Manobo Tribe as Stakeholders in the Making of School Improvement Plan: Basis for Policy Recommendation
Authors: Diobein C. Flores
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The populace in Municipality of Talaingod is composed of Ata-Manobo. The said lumads enrich their culture, orientation and self because the place is a hive of their tribe. In lieu, the study would analyze the participation of the Ata-Manobo in the making of school improvement plan (SIP). Thus, it recommends alternative policy options that would help strengthen their involvement. The school stakeholders-Ata Manobo representatives from students, parent-teacher association, alumni, basic sector, municipal/barangay government unit, civic/social organizations and other government various agencies are the key participants in this study. The research used descriptive design. The responses of the representatives were analyzed through the criteria involved in employing Rational Model. The technical dimension, administrative, political acceptability and economic are the criteria in revealing decision. The policy alternative option 3- recommends to formulate policy for the purpose of capacitating stakeholders or governing council members in the making of SIP was pointed out as the most preferred option. This could strengthen the participation among Ata-Manobo as stakeholders in planning. Hence, the formulation alternative policy- capacitating stakeholders in the crafting of school improvement plan is recommended. The suggested initiative would assist the Department of Education in forging consensus across neighborhoods during the making of SIP. The appropriation of the definite budget to be used during the conduct of capability building activities is also suggested. Training-workshops are identified as possible intervention to ensure that the stakeholders are equipped with necessary knowledge and skills needed in the making of SIP. Indeed, the equal opportunities for all stakeholders regardless of their life circumstances must be noted. With the belief, people must be empowered to take advantage and spearhead progress in the making of SIP.Keywords: Ata-Manobo Tribe, stakeholders, school improvement plan, Municipality of Talaingod, Philippines
Procedia PDF Downloads 3162463 Chemical Study of Volatile Organic Compounds (VOCS) from Xylopia aromatica (LAM.) Mart (Annonaceae)
Authors: Vanessa G. P. Severino, JOÃO Gabriel M. Junqueira, Michelle N. G. do Nascimento, Francisco W. B. Aquino, João B. Fernandes, Ana P. Terezan
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The scientific interest in analyzing VOCs represents a significant modern research field as a result of importance in most branches of the present life and industry. Therefore it is extremely important to investigate, identify and isolate volatile substances, since they can be used in different areas, such as food, medicine, cosmetics, perfumery, aromatherapy, pesticides, repellents and other household products through methods for extracting volatile constituents, such as solid phase microextraction (SPME), hydrodistillation (HD), solvent extraction (SE), Soxhlet extraction, supercritical fluid extraction (SFE), stream distillation (SD) and vacuum distillation (VD). The Chemometrics is an area of chemistry that uses statistical and mathematical tools for the planning and optimization of the experimental conditions, and to extract relevant chemical information multivariate chemical data. In this context, the focus of this work was the study of the chemical VOCs by SPME of the specie X. aromatica, in search of constituents that can be used in the industrial sector as well as in food, cosmetics and perfumery, since these areas industrial has a considerable role. In addition, by chemometric analysis, we sought to maximize the answers of this research, in order to search for the largest number of compounds. The investigation of flowers from X. aromatica in vitro and in alive mode proved consistent, but certain factors supposed influence the composition of metabolites, and the chemometric analysis strengthened the analysis. Thus, the study of the chemical composition of X. aromatica contributed to the VOCs knowledge of the species and a possible application.Keywords: chemometrics, flowers, HS-SPME, Xylopia aromatica
Procedia PDF Downloads 3522462 Learning Disability or Learning Differences: Understanding Differences Between Cultural and Linguistic Diversity, Learning Differences, and Learning Disabilities
Authors: Jolanta Jonak, Sylvia Tolczyk
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Students demonstrate various learning preferences and learning styles that range from visual, auditory to kinesthetic preferences. These learning preferences are further impacted by individual cognitive make up that characterizes itself in linguistic strengths, logical- special, inter-or intra- personal, just to name a few. Students from culturally and linguistically diverse backgrounds (CLD) have an increased risk of being misunderstood by many school systems and even medical personnel. CLD students are influenced by many factors (like acculturation and experience) that may impact their achievements and functioning levels. CLD students who develop initial or basic interpersonal communication proficiency skills in the target language are even at a higher risk for being suspected of learning disability when they are underachieving academically. Research indicates that large numbers of students arenot provided the type of education and types of supports they need in order to be successful in an academicenvironment. Multiple research findings indicate that significant numbers of school staff self-reports that they do not feel adequately prepared to work with CLD students. It is extremely important for the school staff, especially school psychologists, who often are the first experts that are consulted, to be educated about overlapping symptoms and settle differences between learning difference and disability. It is equally important for medical personnel, mainly pediatricians, psychologists, and psychiatrists, to understand the subtle differences to avoid inaccurate opinions. Having the knowledge, school staff can avoid unnecessary referrals for special education evaluations and avoid inaccurate decisions about the presence of a disability. This presentation will illustrate distinctions based on research between learning differences and disabilities, how to recognize them, and how to assess for them.Keywords: special education, learning disability, differentiation, differences
Procedia PDF Downloads 1452461 The Use of Metformin in Treatment of Polycystic Ovary Syndrome (PCOS) and Glucose Control in Pregnant Women with Gestational Diabetes Mellitus (GDM) at Tripoli Medical Center
Authors: Ebtisam A. Benomran, Abdurrauf M. Gusbi, Malak S. Elazarg, M. Sultan, Layla M. Kafu, Arwa M. Matoug, Esra E. Benamara
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Normal pregnancy is associated with metabolic changes leading to decreased insulin sensitivity and reduced glucose tolerance, however, 3-5% of pregnant women proceed to develop gestational diabetes mellitus (GDM). Researcher studied the use of metformin in many fields and the benefit to risk balance of using metformin during pregnancy and the risk of fetotoxic. In this study we examined the use of Metformin to control Glucose in pregnant Women with gestational diabetes mellitus (GDM) and evaluate its safety use during the first trimester of pregnancy.A group of pregnant patients with gestational diabetes mellitus from the first trimester of pregnancy, non smoking with no family history of congenital malformation disease, aged between (20-45 years) and have no liver diseases and who had indicating good compliance at more than one visit over several month until delivery put on Metformin were participated in this trial. Our study shown that all the studied group of pregnant women using metformin 500 mg daily delivered a healthy babies. Meta-analysis by mother risk program showed no increase in incidence of malformations by use Metformin during the first trimester of pregnancy. A hundred outpatients were participated in the survey on the general knowledge and awareness of diabetic patients to their illness and medication used their aged between 20-40 years old. In this survey we realize that 90% of the doctors are not giving the patient full information about their illness and the use of metformin during pregnancy, also about 65% of the patients did not know about the nutritionist in the hospital and the right control diet for diabetes. Courses on first aid, rapid diagnosis of poisoning and follow the written procedures to dealing with such cases.Keywords: gestational diabetes, malformations, metformin, pregnancy
Procedia PDF Downloads 4862460 Quality of Life and Renal Biomarkers in Feline Chronic Kidney Disease
Authors: Bárbara Durão, Pedro Almeida, David Ramilo, André Meneses, Rute Canejo-Teixeira
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The importance of quality of life (QoL) assessment in veterinary medicine is an integral part of patient care. This is especially true in cases of chronic diseases, such as chronic kidney disease (CKD), where the ever more advanced treatment options prolong the patient’s life. Whether this prolongment of life comes with an acceptable quality of life remains has been called into question. The aim of this study was to evaluate the relationship between CKD disease biomarkers and QoL in cats. Thirty-seven cats diagnosed with CKD and with no known concurrent illness were enrolled in an observational study. Through the course of several evaluations, renal biomarkers were assessed in blood and urine samples, and owners retrospectively described their cat’s quality of life using a validated instrument for this disease. Correlations between QoL scores (AWIS) and the biomarkers were assessed using Spearman’s rank test. Statistical significance was set at p-value < 0.05, and every serial sample was considered independent. Thirty-seven cats met the inclusion criteria, and all owners completed the questionnaire every time their pet was evaluated, giving a total of eighty-four questionnaires, and the average-weighted-impact-score was –0.5. Results showed there was a statistically significant correlation between the quality of life and most of 17 the studied biomarkers and confirmed that CKD has a negative impact on QoL in cats especially due to the management of the disease and secondary appetite disorders. To our knowledge, this is the attempt to assess the correlation between renal biomarkers and QoL in cats. Our results reveal a strong potential of this type of approach in clinical management, mainly in situations where it is not possible to measure biomarkers. Whilst health-related QoL is a reliable predictor of mortality and morbidity in humans; our findings can help improve the clinical practice in cats with CKD.Keywords: chronic kidney disease, biomarkers, quality of life, feline
Procedia PDF Downloads 1692459 Marketing Parameters on Consumer's Perceptions of Farmed Sea Bass in Greece
Authors: Sophia Anastasiou, Cosmas Nathanailides, Fotini Kakali, Kostas Karipoglou
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Wild fish are considered as testier and in fish restaurants are offered at twice the price of farmed fish. Several chemical and structural differences can affect the consumer's attitudes for farmed fish. The structure and chemical composition of fish muscle is also important for the performance of farmed fish during handling, storage and processing. In the present work we present the chemical and sensory parameters which are used as indicators of fish flesh quality and we investigated the perceptions of consumers for farmed sea bass and the organoleptic differences between samples of wild and farmed sea bass. A questionnaire was distributed to a group of various ages that were regular consumers of sea bass. The questionnaire included a survey on the perceptions on taste and appearance differences between wild and farmed sea bass. A significant percentage (>40%) of the participants stated their perception of superior taste of wild sea bass versus the farmed fish. The participants took part in an organoleptic assessment of wild and farmed sea bass prepared and cooked by a local fish restaurant. Portions were evaluated for intensity of sensorial attributes from 1 (low intensity) to 5 (high intensity). The results indicate that contrary to the assessor's perception, farmed sea bass scored better in al organoleptic parameters assessed with marked superiority in texture and taste over the wild sea bass. This research has been co-financed by the European Union (European Social Fund – ESF) and Greek national funds through the Operational Program "Education and Lifelong Learning" of the National Strategic Reference Framework (NSRF) - Research Funding Program: ARCHIMEDES III. Investing in knowledge society through the European Social Fund.Keywords: fish marketing, farmed fish, seafood quality, wild fish
Procedia PDF Downloads 3942458 Impact of Human Resources Accounting on Employees' Performance in Organization
Authors: Hamid Saremi, Shida Hanafi
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In an age of technology and economics, human capital has important and axial role in the organization and human resource accounting has a wide perception to key resources of organization i.e. human resources. Human resources accounting is new branch of accounting that has Short-lived and generally deals to a range of policies and measures that are related to various aspects of human resources and It gives importance to an organization's most important asset is its human resources and human resource management is the key to success in an organization and to achieve this important matter must review and evaluation of human resources data be with knowledge of accounting based on empirical studies and methods of measurement and reporting of human resources accounting information. Undoubtedly human resource management without information cannot be done and take decision and human resources accounting is practical way to inform the decision makers who are committed to harnessing human resources,, human resources accounting with applying accounting principles in the organization and is with conducting basic research on the extent of the of human resources accounting information" effect of employees' personal performance. In human resource accounting analysis and criteria and valuation of cost and manpower valuating is as the main resource in each Institute. Protection of human resources is a process that according to human resources accounting is for organization profitability. In fact, this type of accounting can be called as a major source in measurement and trends of costs and human resources valuation in each institution. What is the economic value of such assets? What is the amount of expenditures for education and training of professional individuals to value in asset account? What amount of funds spent should be considered as lost opportunity cost? In this paper, according to the literature of human resource accounting we have studied the human resources matter and its objectives and topic of the importance of human resource valuation on employee performance review and method of reporting of human resources according to different models.Keywords: human resources, human resources, accounting, human capital, human resource management, valuation and cost of human resources, employees, performance, organization
Procedia PDF Downloads 5372457 Genetic Characterization of Acanthamoeba Isolates from Amoebic Keratitis Patients
Authors: Sumeeta Khurana, Kirti Megha, Amit Gupta, Rakesh Sehgal
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Background: Amoebic keratitis is a painful vision threatening infection caused by a free living pathogenic amoeba Acanthamoeba. It can be misdiagnosed and very difficult to treat if not suspected early. The epidemiology of Acanthamoeba genotypes causing infection in our geographical area is not yet known to the best of our knowledge. Objective: To characterize Acanthamoeba isolates from amoebic keratitis patients. Methods: A total of 19 isolates obtained from patients with amoebic keratitis presenting to the Advanced Eye Centre at Postgraduate Institute of Medical Education and Research, a tertiary care centre of North India over a period of last 10 years were included. Their corneal scrapings, lens solution and lens case (in case of lens wearer) were collected for microscopic examination, culture and molecular diagnosis. All the isolates were maintained in the Non Nutrient agar culture medium overlaid with E.coli and 13 strains were axenised and maintained in modified Peptone Yeast Dextrose Agar. Identification of Acanthamoeba genotypes was based on amplification of diagnostic fragment 3 (DF3) region of the 18srRNA gene followed by sequencing. Nucleotide similarity search was performed by BLAST search of sequenced amplicons in GenBank database (http//www.ncbi.nlm.nih.gov/blast). Multiple Sequence alignments were determined by using CLUSTAL X. Results: Nine out of 19 Acanthamoeba isolates were found to belong to Genotype T4 followed by 6 isolates of genotype T11, 3 T5 and 1 T3 genotype. Conclusion: T4 is the predominant Acanthamoeba genotype in our geographical area. Further studies should focus on differences in pathogenicity of these genotypes and their clinical significance.Keywords: Acanthamoeba, free living amoeba, keratitis, genotype, ocular
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