Search results for: adverse drug effects
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12848

Search results for: adverse drug effects

7538 Utilizing Artificial Intelligence to Predict Post Operative Atrial Fibrillation in Non-Cardiac Transplant

Authors: Alexander Heckman, Rohan Goswami, Zachi Attia, Paul Friedman, Peter Noseworthy, Demilade Adedinsewo, Pablo Moreno-Franco, Rickey Carter, Tathagat Narula

Abstract:

Background: Postoperative atrial fibrillation (POAF) is associated with adverse health consequences, higher costs, and longer hospital stays. Utilizing existing predictive models that rely on clinical variables and circulating biomarkers, multiple societies have published recommendations on the treatment and prevention of POAF. Although reasonably practical, there is room for improvement and automation to help individualize treatment strategies and reduce associated complications. Methods and Results: In this retrospective cohort study of solid organ transplant recipients, we evaluated the diagnostic utility of a previously developed AI-based ECG prediction for silent AF on the development of POAF within 30 days of transplant. A total of 2261 non-cardiac transplant patients without a preexisting diagnosis of AF were found to have a 5.8% (133/2261) incidence of POAF. While there were no apparent sex differences in POAF incidence (5.8% males vs. 6.0% females, p=.80), there were differences by race and ethnicity (p<0.001 and 0.035, respectively). The incidence in white transplanted patients was 7.2% (117/1628), whereas the incidence in black patients was 1.4% (6/430). Lung transplant recipients had the highest incidence of postoperative AF (17.4%, 37/213), followed by liver (5.6%, 56/1002) and kidney (3.6%, 32/895) recipients. The AUROC in the sample was 0.62 (95% CI: 0.58-0.67). The relatively low discrimination may result from undiagnosed AF in the sample. In particular, 1,177 patients had at least 1 AI-ECG screen for AF pre-transplant above .10, a value slightly higher than the published threshold of 0.08. The incidence of POAF in the 1104 patients without an elevated prediction pre-transplant was lower (3.7% vs. 8.0%; p<0.001). While this supported the hypothesis that potentially undiagnosed AF may have contributed to the diagnosis of POAF, the utility of the existing AI-ECG screening algorithm remained modest. When the prediction for POAF was made using the first postoperative ECG in the sample without an elevated screen pre-transplant (n=1084 on account of n=20 missing postoperative ECG), the AUROC was 0.66 (95% CI: 0.57-0.75). While this discrimination is relatively low, at a threshold of 0.08, the AI-ECG algorithm had a 98% (95% CI: 97 – 99%) negative predictive value at a sensitivity of 66% (95% CI: 49-80%). Conclusions: This study's principal finding is that the incidence of POAF is rare, and a considerable fraction of the POAF cases may be latent and undiagnosed. The high negative predictive value of AI-ECG screening suggests utility for prioritizing monitoring and evaluation on transplant patients with a positive AI-ECG screening. Further development and refinement of a post-transplant-specific algorithm may be warranted further to enhance the diagnostic yield of the ECG-based screening.

Keywords: artificial intelligence, atrial fibrillation, cardiology, transplant, medicine, ECG, machine learning

Procedia PDF Downloads 140
7537 Exercise and Geriatric Depression: a Scoping Review of the Research Evidence

Authors: Samira Mehrabi

Abstract:

Geriatric depression is a common late-life mental health disorder that increases morbidity and mortality. It has been shown that exercise is effective in alleviating symptoms of geriatric depression. However, inconsistencies across studies and lack of optimal dose-response of exercise for improving geriatric depression have made it challenging to draw solid conclusions on the effectiveness of exercise in late-life depression. Purpose: To further investigate the moderators of the effectiveness of exercise on geriatric depression across the current body of evidence. Methods: Based on the Arksey and O’Malley framework, an extensive search strategy was performed by exploring PubMed, Scopus, Sport Discus, PsycInfo, ERIC, and IBSS without limitations in the time frame. Eight systematic reviews with empirical results that evaluated the effect of exercise on depression among people aged ≥ 60 years were identified and their individual studies were screened for inclusion. One additional study was found through the hand searching of reference lists. After full-text screening and applying inclusion and exclusion criteria, 21 studies were retained for inclusion. Results: The review revealed high variability in characteristics of the exercise interventions and outcome measures. Sample characteristics, nature of comparators, main outcome assessment, and baseline severity of depression also varied notably. Mind-body and aerobic exercises were found to significantly reduce geriatric depression. However, results on the relationship between resistance training and improvements in geriatric depression were inconsistent, and results of the intensity-related antidepressant effects of exercise interventions were mixed. Extensive use of self-reported questionnaires for the main outcome assessment and lack of evidence on the relationship between depression severity and observed effects were of the other important highlights of the review. Conclusion: Several literature gaps were found regarding the potential effect modifiers of exercise and geriatric depression. While acknowledging the complexity of establishing recommendations on the exercise variables and geriatric depression, future studies are required to understand the interplay and threshold effect of exercise for treating geriatric depression.

Keywords: exercise, geriatric depression, healthy aging, older adults, physical activity intervention, scoping review

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7536 Effects of Additional Pelvic Floor Exercise on Sexual Function, Quality of Life and Pain Intensity in Subjects with Chronic Low Back Pain

Authors: Emel Sonmezer, Hayri Baran Yosmaoglu

Abstract:

The negative impact of chronic pain syndromes on sexual function has been reported in several studies; however, the influences of treatment strategies on sexual dysfunction have not been evaluated widely. The aim of this study was to determine the effects of pelvic floor exercise on sexual dysfunction in female patients with chronic low back pain. Forty-two patient with chronic low back pain were enrolled this study. Subjects were divided into two groups. Group 1 received conventional physiotherapy consist of heat therapy, ergonomic education, William flexion exercise during 6 weeks. Group 2 received pelvic floor exercises in addition to conventional physiotherapy. Female Sexual Function Index (FSFI) was used for the assessment of sexual function. Pain intensity was assessed with Visual Analogue Scale. Quality of life was assessed with World Health Organization Quality of Life Scale. All measurements were taken before and after treatment. In conventional physiotherapy group; there were significant improvement in pain intensity (p= 0,003), physical health (p=0,011), psychological health (p=0,042) subscales of quality of life scale, arousal (p=0,042), lubrication (p=0,028) and pain (p= 0,034) subscales of FSFI. In additional pelvic floor exercise group; there were significant improvement in pain intensity (p= 0,005), physical health (p=0,012) psychological health (p=0,039) subscales of quality of life scale, arousal (p=0,024), lubrication (p=0,011), orgasm (p=0,035) and pain (p= 0,015) subscales and total score (p=0,016) of FSFI. Total FSFI score (p=0,025) and orgasm (p=0,017) subscale of FSFI were significantly higher for the additional pelvic floor exercise group than the conventional physiotherapy group.The outcome of this study suggested that conventional physiotherapy may contribute to improve pain, quality of life and some parameters of the sexual function in patients with low back pain. Although additional pelvic floor exercise did not reveal more treatment effect in terms of quality of life and pain intensity, it caused significant improvement in sexual function. It is recommended that pelvic floor exercise should be added to treatment programs in order to manage sexual dysfunction more effectively in patients with chronic low back pain.

Keywords: physiotherapy, chronic pain, sexual dysfunction, pelvic floor

Procedia PDF Downloads 270
7535 On Regional Climate Singularity: On Example of the Territory of Georgia

Authors: T. Davitashvili

Abstract:

In this paper, some results of numerical simulation of the air flow dynamics in the troposphere over the Caucasus Mountains taking place in conditions of nonstationarity of large-scale undisturbed background flow are presented. Main features of the atmospheric currents changeability while air masses are transferred from the Black Sea to the land’s surface had been investigated. In addition, the effects of thermal and advective-dynamic factors of atmosphere on the changes of the West Georgian climate have been studied. It was shown that non-proportional warming of the Black Sea and Colkhi lowland provokes the intensive strengthening of circulation and effect of climate cooling in the western Georgia.

Keywords: regional climate, numerical simulation, local circulation, orographic effect

Procedia PDF Downloads 485
7534 Outlawing Gender: A Comparative Study of Anti-Gender Studies Legislation in the U.S. and Global Contexts

Authors: Tracey Jean Boisseau

Abstract:

Recently, the rise of concerted right-wing and authoritarian movements has put feminists as well as women, queer, trans, and non-binary folk, immigrants, refugees, the global poor, and people of color in their crosshairs. The U.S. is seeing unprecedented attacks on liberal democratic institutions, escalating “culture wars,” and increased anti-intellectual vitriol specifically targeting feminist and anti-racist educators and scholars. Such vitriol has fueled new legislation curtailing or outright banning of “gender studies” for its ideological commitment to theorizing gender identity as a cultural construct and an inherently political project rather than a “natural” binary that can not be contested or interrogated. At the same time, across the globe—in Afghanistan, Argentina, Brazil, France, Haiti, Hungary, Kenya, Nicaragua, Nigeria, Pakistan, the Philippines, Poland, Russia, South Korea, Sweden, Turkey, Uganda, the United Kingdom, and elsewhere—emergent anti-feminist, nativist, and white-supremacist political parties, as well as established autocratic and authoritarian regimes, have instituted blatantly misogynistic, anti-queer, and anti-trans legislation, often accompanied by governmental and extra-governmental policies explicitly intended to marginalize, erase, suppress, or extinguish gender studies as a legitimate academic discipline, topic of research, and teaching field. This paper considers the origins and effects of such legislation -as well as the strategies exhibited by practitioners of gender studies to counter these effects and resist erasure- from a cross-cultural perspective. The research underpinning this paper’s conclusions includes a survey of nearly 2000 gender studies programs in the U.S. and interviews with dozens of gender studies scholars and administrative leaders of gender-studies programs located worldwide. The goal of this paper is to illuminate distinctions, continuities, and global connections between anti-gender studies legislation that emanates from within national borders but arises from rightwing movements that supercede those borders, and that, ultimately, require globalist responses.

Keywords: anti-feminist, anti-LGBTQ, legislation, criminalization, authoritarianism, globalization

Procedia PDF Downloads 83
7533 Magnetic Nanoparticles Coated with Modified Polysaccharides for the Immobilization of Glycoproteins

Authors: Kinga Mylkie, Pawel Nowak, Marta Z. Borowska

Abstract:

The most important proteins in human serum responsible for drug binding are human serum albumin (HSA) and α1-acid glycoprotein (AGP). The AGP molecule is a glycoconjugate containing a single polypeptide chain composed of 183 amino acids (the core of the protein), and five glycan branched chains (sugar part) covalently linked by an N-glycosidic bond with aspartyl residues (Asp(N) -15, -38, -54, -75, - 85) of polypeptide chain. This protein plays an important role in binding alkaline drugs, a large group of drugs used in psychiatry, some acid drugs (e.g., coumarin anticoagulants), and neutral drugs (steroid hormones). The main goal of the research was to obtain magnetic nanoparticles coated with biopolymers in a chemically modified form, which will have highly reactive functional groups able to effectively immobilize the glycoprotein (acid α1-glycoprotein) without losing the ability to bind active substances. The first phase of the project involved the chemical modification of biopolymer starch. Modification of starch was carried out by methods of organic synthesis, leading to the preparation of a polymer enriched on its surface with aldehyde groups, which in the next step was coupled with 3-aminophenylboronic acid. Magnetite nanoparticles coated with starch were prepared by in situ co-precipitation and then oxidized with a 1 M sodium periodate solution to form a dialdehyde starch coating. Afterward, the reaction between the magnetite nanoparticles coated with dialdehyde starch and 3-aminophenylboronic acid was carried out. The obtained materials consist of a magnetite core surrounded by a layer of modified polymer, which contains on its surface dihydroxyboryl groups of boronic acids which are capable of binding glycoproteins. Magnetic nanoparticles obtained as carriers for plasma protein immobilization were fully characterized by ATR-FTIR, TEM, SEM, and DLS. The glycoprotein was immobilized on the obtained nanoparticles. The amount of mobilized protein was determined by the Bradford method.

Keywords: glycoproteins, immobilization, magnetic nanoparticles, polysaccharides

Procedia PDF Downloads 135
7532 A Review of Benefit-Risk Assessment over the Product Lifecycle

Authors: M. Miljkovic, A. Urakpo, M. Simic-Koumoutsaris

Abstract:

Benefit-risk assessment (BRA) is a valuable tool that takes place in multiple stages during a medicine's lifecycle, and this assessment can be conducted in a variety of ways. The aim was to summarize current BRA methods used during approval decisions and in post-approval settings and to see possible future directions. Relevant reviews, recommendations, and guidelines published in medical literature and through regulatory agencies over the past five years have been examined. BRA implies the review of two dimensions: the dimension of benefits (determined mainly by the therapeutic efficacy) and the dimension of risks (comprises the safety profile of a drug). Regulators, industry, and academia have developed various approaches, ranging from descriptive textual (qualitative) to decision-analytic (quantitative) models, to facilitate the BRA of medicines during the product lifecycle (from Phase I trials, to authorization procedure, post-marketing surveillance and health technology assessment for inclusion in public formularies). These approaches can be classified into the following categories: stepwise structured approaches (frameworks); measures for benefits and risks that are usually endpoint specific (metrics), simulation techniques and meta-analysis (estimation techniques), and utility survey techniques to elicit stakeholders’ preferences (utilities). All these approaches share the following two common goals: to assist this analysis and to improve the communication of decisions, but each is subject to its own specific strengths and limitations. Before using any method, its utility, complexity, the extent to which it is established, and the ease of results interpretation should be considered. Despite widespread and long-time use, BRA is subject to debate, suffers from a number of limitations, and currently is still under development. The use of formal, systematic structured approaches to BRA for regulatory decision-making and quantitative methods to support BRA during the product lifecycle is a standard practice in medicine that is subject to continuous improvement and modernization, not only in methodology but also in cooperation between organizations.

Keywords: benefit-risk assessment, benefit-risk profile, product lifecycle, quantitative methods, structured approaches

Procedia PDF Downloads 161
7531 Rounded-off Measurements and Their Implication on Control Charts

Authors: Ran Etgar

Abstract:

The process of rounding off measurements in continuous variables is commonly encountered. Although it usually has minor effects, sometimes it can lead to poor outcomes in statistical process control using X ̅-chart. The traditional control limits can cause incorrect conclusions if applied carelessly. This study looks into the limitations of classical control limits, particularly the impact of asymmetry. An approach to determining the distribution function of the measured parameter (Y ̅) is presented, resulting in a more precise method to establish the upper and lower control limits. The proposed method, while slightly more complex than Shewhart's original idea, is still user-friendly and accurate and only requires the use of two straightforward tables.

Keywords: inaccurate measurement, SPC, statistical process control, rounded-off, control chart

Procedia PDF Downloads 46
7530 Effects of Compensation on Distribution System Technical Losses

Authors: B. Kekezoglu, C. Kocatepe, O. Arikan, Y. Hacialiefendioglu, G. Ucar

Abstract:

One of the significant problems of energy systems is to supply economic and efficient energy to consumers. Therefore studies has been continued to reduce technical losses in the network. In this paper, the technical losses analyzed for a portion of European side of Istanbul MV distribution network for different compensation scenarios by considering real system and load data and results are presented. Investigated system is modeled with CYME Power Engineering Software and optimal capacity placement has been proposed to minimize losses.

Keywords: distribution system, optimal capacitor placement, reactive power compensation, technical losses

Procedia PDF Downloads 679
7529 Low NOx Combustion Technology for Minimizing NOx

Authors: Sewon Kim, Changyeop Lee

Abstract:

A noble low NOx combustion technology, based on partial oxidation combustion concept in a fuel rich combustion zone, is successfully applied in this research. The burner is designed such that a portion of fuel is heated and pre-vaporized in the furnace then injected into a fuel rich combustion zone so that a partial oxidation reaction occurs. The effects of equivalence ratio, thermal load, and fuel distribution ratio on the emissions of NOx and CO are experimentally investigated. This newly developed combustion technology is successfully applied to industrial furnace, and showed extremely low NOx emission levels.

Keywords: low NOx, combustion, burner, fuel rich

Procedia PDF Downloads 413
7528 Distribution System Modelling: A Holistic Approach for Harmonic Studies

Authors: Stanislav Babaev, Vladimir Cuk, Sjef Cobben, Jan Desmet

Abstract:

The procedures for performing harmonic studies for medium-voltage distribution feeders have become relatively mature topics since the early 1980s. The efforts of various electric power engineers and researchers were mainly focused on handling large harmonic non-linear loads connected scarcely at several buses of medium-voltage feeders. In order to assess the impact of these loads on the voltage quality of the distribution system, specific modeling and simulation strategies were proposed. These methodologies could deliver a reasonable estimation accuracy given the requirements of least computational efforts and reduced complexity. To uphold these requirements, certain analysis assumptions have been made, which became de facto standards for establishing guidelines for harmonic analysis. Among others, typical assumptions include balanced conditions of the study and the negligible impact of impedance frequency characteristics of various power system components. In latter, skin and proximity effects are usually omitted, and resistance and reactance values are modeled based on the theoretical equations. Further, the simplifications of the modelling routine have led to the commonly accepted practice of neglecting phase angle diversity effects. This is mainly associated with developed load models, which only in a handful of cases are representing the complete harmonic behavior of a certain device as well as accounting on the harmonic interaction between grid harmonic voltages and harmonic currents. While these modelling practices were proven to be reasonably effective for medium-voltage levels, similar approaches have been adopted for low-voltage distribution systems. Given modern conditions and massive increase in usage of residential electronic devices, recent and ongoing boom of electric vehicles, and large-scale installing of distributed solar power, the harmonics in current low-voltage grids are characterized by high degree of variability and demonstrate sufficient diversity leading to a certain level of cancellation effects. It is obvious, that new modelling algorithms overcoming previously made assumptions have to be accepted. In this work, a simulation approach aimed to deal with some of the typical assumptions is proposed. A practical low-voltage feeder is modeled in PowerFactory. In order to demonstrate the importance of diversity effect and harmonic interaction, previously developed measurement-based models of photovoltaic inverter and battery charger are used as loads. The Python-based script aiming to supply varying voltage background distortion profile and the associated current harmonic response of loads is used as the core of unbalanced simulation. Furthermore, the impact of uncertainty of feeder frequency-impedance characteristics on total harmonic distortion levels is shown along with scenarios involving linear resistive loads, which further alter the impedance of the system. The comparative analysis demonstrates sufficient differences with cases when all the assumptions are in place, and results indicate that new modelling and simulation procedures need to be adopted for low-voltage distribution systems with high penetration of non-linear loads and renewable generation.

Keywords: electric power system, harmonic distortion, power quality, public low-voltage network, harmonic modelling

Procedia PDF Downloads 164
7527 Exploring Sexual Behavior among Unmarried Male Youth in Bangladesh: A Cross-Sectional Study

Authors: Subas Chandra Biswas, Kazi Sameen Naser, Farzana Misha

Abstract:

Little is known about the sexual behavior of male youth, particularly unmarried young men in Bangladesh as most of the sexual and reproductive health and rights-related research and intervention are mainly focused on females and married couples. To understand the unmarried youth’s sexual behavior, data from a nationwide survey conducted in all 64 districts of Bangladesh were analyzed. Using multistage systematic random sampling, a survey was conducted among 11,113 male youth aged 15-24 years from May-August, 2019. This article analyzed and presented findings of the sexual behavior of unmarried respondents based on the data collected from 10,026 unmarried male youth. Findings showed that 18% had ever experience of sexual relationship, and the reported mean age of first sexual intercourse was 16.5years. For unmarried male youth, those who had a sexual experience, their first sexual partners were female friends/classmate (57%), female neighbors (16%), and female sex workers (12%), relatives (6%) and girlfriends with whom they had love relationship (4%). However, about 36% reported that they had a love relationship with girlfriends, and among them, 23% reported that they had sexual intercourse with their girlfriend. Those who had sexual relations with their girlfriend, 47% reported that they did not use the condom in their last sex with their girlfriend. Furthermore, 29% reported that they had sexual relationships with others besides their girlfriends. Other reported partners were female sex workers (32%), neighbors (29%), female friends (19%), relatives (12%), and cousins (5%). Also, 46% reported that they did not even use the condom during sex with other partners. About 9% used some sort of sexual stimulant to increase their libido. Among the respondents, 376 reported that they bought sex in the last six months, and the mean expenditure of buying sex for the respondent was 1,140 Taka (13.46 US Dollar). Though premarital sexual relations are not socially accepted, findings showed a large portion of male youth are engaged in these relationships and risky sexual behavior. Lack of awareness of sexual and reproductive health, unprotected sexual intercourse, use of the drug during sexual intercourse also increase the threats to health. Thus these findings are important to understand the sexual behavior of male youth in policy and programmatic implications. Therefore, to ensure a healthy sexual life and wellbeing, an immediate and culturally sensitive sexual health promotion intervention is needed for male youth in Bangladesh.

Keywords: Bangladesh, male youth, sexual and reproductive health, sexual behavior

Procedia PDF Downloads 143
7526 Association of Daily Physical Activity with Diabetes Control in Patients with Type II Diabetes

Authors: Chia-Hsun Chang

Abstract:

Background: Combination of drug treatment, dietary management, and regular exercise can effectively control type II diabetes mellitus (T2DM). Performing daily physical activities other than structured exercise is much easier and whether daily physical activities including work, walking, housework, gardening, leisure exercise, or transportation have a similar effect on diabetes control is not well studied.Aims and Objectives: This study aims to determine whether daily physical activity undertaken by patients with T2DM is associated with their diabetes control. Design: A correlation study with prospective design. Methods: Purposive sampling of 206 patients with T2DM was recruited from a medical center in Central Taiwan. The International Physical Activity Questionnaire was used to assess daily levels of physical activities, and the Diabetes Compliance Questionnaire was used to assess medication and dietary compliance. Data of diabetes control (hemoglobin A1c, HbA1c)were followed up every three months for one year after recruitment. Results: In this study, the average age of the participants was 62.5 years (±10.4 years), and the average duration of diabetes since diagnosis was 13.2 years (±7.8), 112 of the participants were women (54.4%) and 94 of the participants were men (45.6%). The mean HbA1c level was 7.8% (±1.4), and 78.2% of the participants presented with unsatisfactory diabetes control. Because the participants were distributed across a wide age range, and their physical health, activity levels, and comorbidities might have varied with age, the participants were divided into two groups: 121 participants who were younger than 65 years (58.7%) and 85 participants who were older than 65 years (41.3%). Both younger (< 65 years) and older (> 65 years) patients with diabetes engaged in more moderate and low levels of physical activity (89.3% and 87%, respectively). Results showed that the levels of daily physical activity were not significantly associated with diabetes control after adjustment for medication and dietary compliance in both groups. Conclusion: Performing daily physical activity is not significantly correlated with diabetes control. Daily physical activity cannot completely replace exercise. Relevance to Clinical Practice: Health personnel must encourage patients to engage in exercise that is planned, structured, and repetitive for improving diabetes control.

Keywords: daily physical activity, diabetes control, international physical activity questionnaire (IPAQ), type II diabetes mellitus (T2DM)

Procedia PDF Downloads 172
7525 Flexural Toughness of Fiber Reinforced Reactive Powder Concrete (RPC)

Authors: S. Yousefi Oderji, B. Chen

Abstract:

According to the ASTM C1018 toughness index method, the single and combined toughness effects of copper coated steel fiber and polypropylene (pp) fiber on reactive powder concrete (RPC) were investigated. Through flexural toughness test of RPC with different fiber volume dosages, the corresponding load-deflection curves were also drawn. Test results indicate that the binary combination of fibers provide the best flexural toughness, and improve the post-peak load-deflection characteristics of RPC. However, the single effect of pp fibers was not pronounced on improving the flexural toughness of RPC.

Keywords: RPC, PP, flexural toughness, toughness index

Procedia PDF Downloads 339
7524 Influence of Smoking on Fine And Ultrafine Air Pollution Pm in Their Pulmonary Genetic and Epigenetic Toxicity

Authors: Y. Landkocz, C. Lepers, P.J. Martin, B. Fougère, F. Roy Saint-Georges. A. Verdin, F. Cazier, F. Ledoux, D. Courcot, F. Sichel, P. Gosset, P. Shirali, S. Billet

Abstract:

In 2013, the International Agency for Research on Cancer (IARC) classified air pollution and fine particles as carcinogenic to humans. Causal relationships exist between elevated ambient levels of airborne particles and increase of mortality and morbidity including pulmonary diseases, like lung cancer. However, due to a double complexity of both physicochemical Particulate Matter (PM) properties and tumor mechanistic processes, mechanisms of action remain not fully elucidated. Furthermore, because of several common properties between air pollution PM and tobacco smoke, like the same route of exposure and chemical composition, potential mechanisms of synergy could exist. Therefore, smoking could be an aggravating factor of the particles toxicity. In order to identify some mechanisms of action of particles according to their size, two samples of PM were collected: PM0.03 2.5 and PM0.33 2.5 in the urban-industrial area of Dunkerque. The overall cytotoxicity of the fine particles was determined on human bronchial cells (BEAS-2B). Toxicological study focused then on the metabolic activation of the organic compounds coated onto PM and some genetic and epigenetic changes induced on a co-culture model of BEAS-2B and alveolar macrophages isolated from bronchoalveolar lavages performed in smokers and non-smokers. The results showed (i) the contribution of the ultrafine fraction of atmospheric particles to genotoxic (eg. DNA double-strand breaks) and epigenetic mechanisms (eg. promoter methylation) involved in tumor processes, and (ii) the influence of smoking on the cellular response. Three main conclusions can be discussed. First, our results showed the ability of the particles to induce deleterious effects potentially involved in the stages of initiation and promotion of carcinogenesis. The second conclusion is that smoking affects the nature of the induced genotoxic effects. Finally, the in vitro developed cell model, using bronchial epithelial cells and alveolar macrophages can take into account quite realistically, some of the existing cell interactions existing in the lung.

Keywords: air pollution, fine and ultrafine particles, genotoxic and epigenetic alterations, smoking

Procedia PDF Downloads 349
7523 BER Estimate of WCDMA Systems with MATLAB Simulation Model

Authors: Suyeb Ahmed Khan, Mahmood Mian

Abstract:

Simulation plays an important role during all phases of the design and engineering of communications systems, from early stages of conceptual design through the various stages of implementation, testing, and fielding of the system. In the present paper, a simulation model has been constructed for the WCDMA system in order to evaluate the performance. This model describes multiusers effects and calculation of BER (Bit Error Rate) in 3G mobile systems using Simulink MATLAB 7.1. Gaussian Approximation defines the multi-user effect on system performance. BER has been analyzed with comparison between transmitting data and receiving data.

Keywords: WCDMA, simulations, BER, MATLAB

Procedia PDF Downloads 595
7522 Transcriptional Response of Honey Bee to Differential Nutritional Status and Nosema Infection

Authors: Farida Azzouz-Olden, Arthur G. Hunt, Gloria Degrandi-Hoffman

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Bees are confronting several environmental challenges, including the intermingled effects of malnutrition and disease. Intuitively, pollen is the healthiest nutritional choice; however, commercial substitutes, such as BeePro and MegaBee, are widely used. Herein we examined how feeding natural and artificial diets shapes transcription in the abdomen of the honey bee, and how transcription shifts in combination with Nosema parasitism. Gene ontology enrichment revealed that, compared with poor diet (carbohydrates (C)), bees fed pollen (P > C), BeePro (B > C), and MegaBee (M > C) showed a broad upregulation of metabolic processes, especially lipids; however, pollen feeding promoted more functions and superior proteolysis. The superiority of the pollen diet was also evident through the remarkable overexpression of vitellogenin in bees fed pollen instead of MegaBee or BeePro. Upregulation of bioprocesses under carbohydrates feeding compared to pollen (C > P) provided a clear poor nutritional status, uncovering stark expression changes that were slight or absent relatively to BeePro (C > B) or MegaBee (C > M). Poor diet feeding (C > P) induced starvation response genes and hippo signaling pathway, while it repressed growth through different mechanisms. Carbohydrate feeding (C > P) also elicited ‘adult behavior’, and developmental processes suggesting transition to foraging. Finally, it altered the ‘circadian rhythm’, reflecting the role of this mechanism in the adaptation to nutritional stress in mammals. Nosema-infected bees fed pollen compared to carbohydrates (PN > CN) upheld certain bioprocesses of uninfected bees (P > C). Poor nutritional status was more apparent against pollen (CN > PN) than BeePro (CN > BN) or MegaBee (CN > MN). Nosema accentuated the effects of malnutrition since more starvation-response genes and stress response mechanisms were upregulated in CN > PN compared to C > P. The bioprocess ‘Macromolecular complex assembly’ was also enriched in CN > PN, and involved genes associated with human HIV and/or influenza, thus providing potential candidates for bee-Nosema interactions. Finally, the enzyme Duox emerged as essential for guts defense in bees, similarly to Drosophila. These results provide evidence of the superior nutritional status of bees fed pollen instead of artificial substitutes in terms of overall health, even in the presence of a pathogen.

Keywords: honeybee, immunity, Nosema, nutrition, RNA-seq

Procedia PDF Downloads 159
7521 Consumer Over-Indebtedness in Germany: An Investigation of Key Determinants

Authors: Xiaojing Wang, Ann-Marie Ward, Tony Wall

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The problem of over-indebtedness has increased since deregulation of the banking industry in the 1980s, and now it has become a major problem for most countries in Europe, including Germany. Consumer debt issues have attracted not only the attention of academics but also government and debt counselling institutions. Overall, this research aims to contribute to the knowledge gap regarding the causes of consumer over-indebtedness in Germany and to develop predictive models for assessing consumer over-indebtedness risk at consumer level. The situation of consumer over-indebtedness is serious in Germany. The relatively high level of social welfare support in Germany suggests that consumer debt problems are caused by other factors, other than just over-spending and income volatility. Prior literature suggests that the overall stability of the economy and level of welfare support for individuals from the structural environment contributes to consumers’ debt problems. In terms of cultural influence, the conspicuous consumption theory in consumer behaviour suggests that consumers would spend more than their means to be seen as similar profiles to consumers in a higher socio-economic class. This results in consumers taking on more debt than they can afford, and eventually becoming over-indebted. Studies have also shown that financial literacy is negatively related to consumer over-indebtedness risk. Whilst prior literature has examined structural and cultural influences respectively, no study has taken a collective approach. To address this gap, a model is developed to investigate the association between consumer over-indebtedness and proxies for influences from the structural and cultural environment based on the above theories. The model also controls for consumer demographic characteristics identified as being of influence in prior literature, such as gender and age, and adverse shocks, such as divorce or bereavement in the household. Benefiting from SOEP regional data, this study is able to conduct quantitative empirical analysis to test both structural and cultural influences at a localised level. Using German Socio-Economic Panel (SOEP) study data from 2006 to 2016, this study finds that social benefits, financial literacy and the existence of conspicuous consumption all contribute to being over-indebted. Generally speaking, the risk of becoming over-indebted is high when consumers are in a low-welfare community, have little awareness of their own financial situation and always over-spend. In order to tackle the problem of over-indebtedness, countermeasures can be taken, for example, increasing consumers’ financial awareness, and the level of welfare support. By analysing causes of consumer over-indebtedness in Germany, this study also provides new insights on the nature and underlying causes of consumer debt issues in Europe.

Keywords: consumer, debt, financial literacy, socio-economic

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7520 Using Daily Light Integral Concept to Construct the Ecological Plant Design Strategy of Urban Landscape

Authors: Chuang-Hung Lin, Cheng-Yuan Hsu, Jia-Yan Lin

Abstract:

It is an indispensible strategy to adopt greenery approach on architectural bases so as to improve ecological habitats, decrease heat-island effect, purify air quality, and relieve surface runoff as well as noise pollution, all of which are done in an attempt to achieve sustainable environment. How we can do with plant design to attain the best visual quality and ideal carbon dioxide fixation depends on whether or not we can appropriately make use of greenery according to the nature of architectural bases. To achieve the goal, it is a need that architects and landscape architects should be provided with sufficient local references. Current greenery studies focus mainly on the heat-island effect of urban with large scale. Most of the architects still rely on people with years of expertise regarding the adoption and disposition of plantation in connection with microclimate scale. Therefore, environmental design, which integrates science and aesthetics, requires fundamental research on landscape environment technology divided from building environment technology. By doing so, we can create mutual benefits between green building and the environment. This issue is extremely important for the greening design of the bases of green buildings in cities and various open spaces. The purpose of this study is to establish plant selection and allocation strategies under different building sunshade levels. Initially, with the shading of sunshine on the greening bases as the starting point, the effects of the shades produced by different building types on the greening strategies were analyzed. Then, by measuring the PAR( photosynthetic active radiation), the relative DLI( daily light integral) was calculated, while the DLI Map was established in order to evaluate the effects of the building shading on the established environmental greening, thereby serving as a reference for plant selection and allocation. The discussion results were to be applied in the evaluation of environment greening of greening buildings and establish the “right plant, right place” design strategy of multi-level ecological greening for application in urban design and landscape design development, as well as the greening criteria to feedback to the eco-city greening buildings.

Keywords: daily light integral, plant design, urban open space

Procedia PDF Downloads 514
7519 Applications of AFM in 4D to Optimize the Design of Genetic Nanoparticles

Authors: Hosam Abdelhady

Abstract:

Filming the behaviors of individual DNA molecules in their environment when they interact with individual medicinal nano-polymers in a molecular scale has opened the door to understand the effect of the molecular shape, size, and incubation time with nanocarriers on optimizing the design of robust genetic Nano molecules able to resist the enzymatic degradation, enter the cell, reach to the nucleus and kill individual cancer cells in their environment. To this end, we will show how we applied the 4D AFM as a guide to finetune the design of genetic nanoparticles and to film the effects of these nanoparticles on the nanomechanical and morphological profiles of individual cancer cells.

Keywords: AFM, dendrimers, nanoparticles, DNA, gene therapy, imaging

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7518 Justice and the Juvenile: Changing Trends and Developments

Authors: Shikhar Shrivastava, Varun Khare

Abstract:

Background: We are confronted by a society that is becoming more complex, more mobile, and more dysfunctional. Teen pregnancy, suicide, elopement, and the perusal of dangerous drugs have become commonplace. In addition, children do not settle their disputes as they once did. Guns and knives are quotidian. Therefore, it has been an exigent to have a "Juvenile Code" that would provide specific substantive and procedural rules for juveniles in the justice system. However, until the twentieth century, there was little difference between how the justice system treated adults and children. Age was considered only in terms of appropriate punishment and juveniles were eligible for the same punishment as adults. Findings: The increased prevalence and legislative support for specialized courts, Juvenile Justice Boards, including juvenile drug, mental health and truancy court programs, as well as diversion programs and evidence-based approaches into the fabric of juvenile justice are just a few examples of recent advances. In India, various measures were taken to prosecute young offenders who committed violent crimes as adults. But it was argued that equating juveniles with adult criminals was neither scientifically correct nor normatively defensible. It would defeat the very purpose of the justice system. Methodology and Conclusion: This paper attempts to bring forth the results of analytical and descriptive research that examined changing trends in juvenile justice legislation. It covers the investigative and inspective practices of police, the various administrative agencies who have roles in implementing the legislation, the courts, and the detention centers. In this paper we shall discuss about how the juvenile justice system is the dumping ground for many of a youths’ problem. The changing notions of justice, from retributive to restorative and rehabilitative shall be discussed. A comparative study of the Juvenile act in India and that of the U.S has been discussed. Specific social institutions and forces that explain juvenile delinquency are identified. In addition, various influences on juvenile delinquency are noted, such as families, schools, peer groups and communities. The text concludes by addressing socialization, deterrence, imprisonments, alternatives, restitution and preventions.

Keywords: juvenile, justice system, retributive, rehabilitative, delinquency

Procedia PDF Downloads 461
7517 Characterization of Antibiotic Resistance in Cultivable Enterobacteriaceae Isolates from Different Ecological Niches in the Eastern Cape, South Africa

Authors: Martins A. Adefisoye, Mpaka Lindelwa, Fadare Folake, Anthony I. Okoh

Abstract:

Evolution and rapid dissemination of antibiotic resistance from one ecosystem to another has been responsible for wide-scale epidemic and endemic spreads of multi-drug resistance pathogens. This study assessed the prevalence of Enterobacteriaceae in different environmental samples, including river water, hospital effluents, abattoir wastewater, animal rectal swabs and faecal droppings, soil, and vegetables, using standard microbiological procedure. The identity of the isolates were confirmed using matrix-assisted laser desorption ionization-time of flight mass spectrophotometry (MALDI-TOF) while the isolates were profiled for resistance against a panel of 16 antibiotics using disc diffusion (DD) test, and the occurrence of resistance genes (ARG) was determined by polymerase chain reactions (PCR). Enterobacteriaceae counts in the samples range as follows: river water 4.0 × 101 – 2.0 × 104 cfu/100 ml, hospital effluents 1.5 × 103 – 3.0 × 107 cfu/100 ml, municipal wastewater 2.3 × 103 – 9.2 × 104 cfu/100 ml, faecal droppings 3.0 × 105 – 9.5 × 106 cfu/g, animal rectal swabs 3.0 × 102 – 2.9 × 107 cfu/ml, soil 0 – 1.2 × 105 cfu/g and vegetables 0 – 2.2 × 107 cfu/g. Of the 700 randomly selected presumptive isolates subjected to MALDI-TOF analysis, 129 (18.4%), 68 (9.7%), 67 (9.5%), 41 (5.9%) were E. coli, Klebsiella spp., Enterobacter spp., and Citrobacter spp. respectively while the remaining isolates belong to other genera not targeted in the study. The DD test shows resistance ranging between 91.6% (175/191) for cefuroxime and (15.2%, 29/191) for imipenem The predominant multiple antibiotic resistance phenotypes (MARP), (GM-AUG-AP-CTX-CXM-CIP-NOR-NI-C-NA-TS-T-DXT) occurred in 9 Klebsiella isolates. The multiple antibiotic resistance indices (MARI) the isolates (range 0.17–1.0) generally showed >95% had MARI above the 0.2 thresholds, suggesting that most of the isolates originate from high-risk environments with high antibiotic use and high selective pressure for the emergence of resistance. The associated ARG in the isolates include: bla TEM 61.9 (65), bla SHV 1.9 (2), bla OXA 8.6 (9), CTX-M-2 8.6 (9), CTX-M-9 6.7 (7), sul 2 26.7 (28), tet A 16.2 (17), tet M 17.1 (18), aadA 59.1 (62), strA 34.3 (36), aac(3)A 19.1 (20), (aa2)A 7.6 (8), and aph(3)-1A 10.5 (11). The results underscore the need for preventative measures to curb the proliferation of antibiotic-resistant bacteria including Enterobacteriaceae to protect public health.

Keywords: enterobacteriaceae, antibiotic-resistance, MALDI-TOF, resistance genes, MARP, MARI, public health

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7516 Forensic Detection of Errors Permitted by the Witnesses in Their Testimony

Authors: Lev Bertovsky

Abstract:

The purpose of this study was to determine the reasons for the formation of false testimony from witnesses and make recommendations on the recognition of such cases. During the studies, which were based on the achievements of professionals in the field of psychology, as well as personal investigative practice, the stages of perception of the information were studied, as well as the process of its reclaim from the memory and transmission to the communicator upon request. Based on the principles of the human brain, kinds of conscientious witness mistakes were systematized. Proposals were formulated for the optimization of investigative actions in cases where the witnesses make an honest mistake with respect to the effects previously observed by them.

Keywords: criminology, eyewitness testimony, honest mistake, information, investigator, investigation, questioning

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7515 Critical Assessment of Herbal Medicine Usage and Efficacy by Pharmacy Students

Authors: Anton V. Dolzhenko, Tahir Mehmood Khan

Abstract:

An ability to make an evidence-based decision is a critically important skill required for practicing pharmacists. The development of this skill is incorporated into the pharmacy curriculum. We aimed in our study to estimate perception of pharmacy students regarding herbal medicines and their ability to assess information on herbal medicines professionally. The current Monash University curriculum in Pharmacy does not provide comprehensive study material on herbal medicines and students should find their way to find information, assess its quality and make a professional decision. In the Pharmacy course, students are trained how to apply this process to conventional medicines. In our survey of 93 undergraduate students from year 1-4 of Pharmacy course at Monash University Malaysia, we found that students’ view on herbal medicines is sometimes associated with common beliefs, which affect students’ ability to make evidence-based conclusions regarding the therapeutic potential of herbal medicines. The use of herbal medicines is widespread and 95.7% of the participated students have prior experience of using them. In the scale 1 to 10, students rated the importance of acquiring herbal medicine knowledge for them as 8.1±1.6. More than half (54.9%) agreed that herbal medicines have the same clinical significance as conventional medicines in treating diseases. Even more, students agreed that healthcare settings should give equal importance to both conventional and herbal medicine use (80.6%) and that herbal medicines should comply with strict quality control procedures as conventional medicines (84.9%). The latter statement also indicates that students consider safety issues associated with the use of herbal medicines seriously. It was further confirmed by 94.6% of students saying that the safety and toxicity information on herbs and spices are important to pharmacists and 95.7% of students admitting that drug-herb interactions may affect therapeutic outcome. Only 36.5% of students consider herbal medicines as s safer alternative to conventional medicines. The students use information on herbal medicines from various sources and media. Most of the students (81.7%) obtain information on herbal medicines from the Internet and only 20.4% mentioned lectures/workshop/seminars as a source of such information. Therefore, we can conclude that students attained the skills on the critical assessment of therapeutic properties of conventional medicines have a potential to use their skills for evidence-based decisions regarding herbal medicines.

Keywords: evidence-based decision, pharmacy education, student perception, traditional medicines

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7514 Investigation of the Flow in Impeller Sidewall Gap of a Centrifugal Pump Using CFD

Authors: Mohammadreza DaqiqShirazi, Rouhollah Torabi, Alireza Riasi, Ahmad Nourbakhsh

Abstract:

In this paper, the flow in a sidewall gap of an impeller which belongs to a centrifugal pump is studied using numerical method. The flow in sidewall gap forms internal leakage and is the source of “disk friction loss” which is the most important cause of reduced efficiency in low specific speed centrifugal pumps. Simulation is done using CFX software and a high quality mesh, therefore the modeling error has been reduced. Navier-Stokes equations have been solved for this domain. In order to predict the turbulence effects the SST model has been employed.

Keywords: numerical study, centrifugal pumps, disk friction loss, sidewall gap

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7513 Constraint-Based Computational Modelling of Bioenergetic Pathway Switching in Synaptic Mitochondria from Parkinson's Disease Patients

Authors: Diana C. El Assal, Fatima Monteiro, Caroline May, Peter Barbuti, Silvia Bolognin, Averina Nicolae, Hulda Haraldsdottir, Lemmer R. P. El Assal, Swagatika Sahoo, Longfei Mao, Jens Schwamborn, Rejko Kruger, Ines Thiele, Kathrin Marcus, Ronan M. T. Fleming

Abstract:

Degeneration of substantia nigra pars compacta dopaminergic neurons is one of the hallmarks of Parkinson's disease. These neurons have a highly complex axonal arborisation and a high energy demand, so any reduction in ATP synthesis could lead to an imbalance between supply and demand, thereby impeding normal neuronal bioenergetic requirements. Synaptic mitochondria exhibit increased vulnerability to dysfunction in Parkinson's disease. After biogenesis in and transport from the cell body, synaptic mitochondria become highly dependent upon oxidative phosphorylation. We applied a systems biochemistry approach to identify the metabolic pathways used by neuronal mitochondria for energy generation. The mitochondrial component of an existing manual reconstruction of human metabolism was extended with manual curation of the biochemical literature and specialised using omics data from Parkinson's disease patients and controls, to generate reconstructions of synaptic and somal mitochondrial metabolism. These reconstructions were converted into stoichiometrically- and fluxconsistent constraint-based computational models. These models predict that Parkinson's disease is accompanied by an increase in the rate of glycolysis and a decrease in the rate of oxidative phosphorylation within synaptic mitochondria. This is consistent with independent experimental reports of a compensatory switching of bioenergetic pathways in the putamen of post-mortem Parkinson's disease patients. Ongoing work, in the context of the SysMedPD project is aimed at computational prediction of mitochondrial drug targets to slow the progression of neurodegeneration in the subset of Parkinson's disease patients with overt mitochondrial dysfunction.

Keywords: bioenergetics, mitochondria, Parkinson's disease, systems biochemistry

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7512 A Study on Inference from Distance Variables in Hedonic Regression

Authors: Yan Wang, Yasushi Asami, Yukio Sadahiro

Abstract:

In urban area, several landmarks may affect housing price and rents, hedonic analysis should employ distance variables corresponding to each landmarks. Unfortunately, the effects of distances to landmarks on housing prices are generally not consistent with the true price. These distance variables may cause magnitude error in regression, pointing a problem of spatial multicollinearity. In this paper, we provided some approaches for getting the samples with less bias and method on locating the specific sampling area to avoid the multicollinerity problem in two specific landmarks case.

Keywords: landmarks, hedonic regression, distance variables, collinearity, multicollinerity

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7511 Effects of Wind Load on the Tank Structures with Various Shapes and Aspect Ratios

Authors: Doo Byong Bae, Jae Jun Yoo, Il Gyu Park, Choi Seowon, Oh Chang Kook

Abstract:

There are several wind load provisions to evaluate the wind response on tank structures such as API, Euro-code, etc. the assessment of wind action applying these provisions is made by performing the finite element analysis using both linear bifurcation analysis and geometrically nonlinear analysis. By comparing the pressure patterns obtained from the analysis with the results of wind tunnel test, most appropriate wind load criteria will be recommended.

Keywords: wind load, finite element analysis, linear bifurcation analysis, geometrically nonlinear analysis

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7510 Appraisal of Conservation Strategies of Veligonda Forest Range of Eastern Ghats, Andhra Pradesh, India

Authors: Khasim Munir Bhasha Shaik

Abstract:

Veligonda and adjoining hill range spread along about 170 Km North to South in Kadapa and Nellore Districts stretching a little further into Prakasam District. The latitude in general ranges up to 1000m. The forests are generally dry deciduous type. Veligonda and adjoining hill ranges comprise of Palakonda, Seshachalam, Lankamala and the terminal part of Nallamalais from mid-region of Southern Eastern Ghats. The Veligonda range which separates the Nellore district from Kadapa and Kurnool is the backbone of the Eastern Ghats, starting from Nagari promontory in Chittoor district. It runs in a northerly direction along the western border of the Nellore district, with a raising elevation of 3,626 ft at Penchalakona in Raipur thaluk. Veligonda hill ranges are high in altitude and have deep valleys. Among the Veligondas range of hills the Durgam in Venkatagiri range and Penchalakona are the most prominent and are situated 914 meters above mean sea level. It has more than 3000 species of plants along with 500 animal species. The unique specialty of this region is the presence of Pterocarpus santalinus(endangered) and Santalum album (vulnerable). In the present study, an attempt is made to assess the efforts that are going on to conserve the biodiversity of flora and fauna of this region. Various conservation strategies were suggested to protect the biodiversity and richness of Veligonda forest, hill region of Eastern Ghats of Andhra Pradesh. The major threats and the reasons for the dwindling species richness are poor rainfall, adverse climatic conditions, robbery of Red sanders and poaching of animals by the local tribals. Efforts are to be made to conserve some of the animals by both in situ and ex-situ methods. More awareness is to be developed among the local communities who are dwelling in the vicinity and importance of conservation is to be emphasized to them. Anthropogenic attachments are to be made by introducing more numbers of sacred groves. Gross enforcement of law is to be made to protect the various forest resources in this area. The important species with the medicinal values are to be identified. It was found that two important wildlife sanctuaries named Sri Lankamalleswarawildlife sanctuary and Sripenusila Narasimha wildlife sanctuary are working for the comprehensive conservation of the environment in this area. Apart from this more than 38 important sacred grooves are there where the plants and animals are protected by local Yanadi and other communities.

Keywords: biodiversity, wild life sanctuary, habitat destruction, eastern Ghats

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7509 Making a Difference in a Crisis: How the 24-Hour Surgical Ambulatory Assessment Unit Transformed Emergency Care during COVID-19

Authors: Bindhiya Thomas, Rehana Hafeez

Abstract:

Background: The Surgical Ambulatory Unit (SAU) also known as the Same Day Emergency Care (SDEC) is an established part of many hospitals providing same day emergency care service to surgical patients who would have otherwise required admission through the A&E. Prior to Covid, the SAU was functioning as a 12-hour service, but during the Covid crisis this service was transformed to a 24 hour functioning Surgical Ambulatory Assessment unit (SAAU). We studied the effects that this change brought about in-patient care in our hospital. Objective: The objective of the study was to assess the impact of a 24-hour Surgical Ambulatory Assessment unit on patient care during the time of Covid, in particular its role in freeing A&E capacity and delivering effective patient care. Methods: We collected two sets of data retrospectively. The first set was collected over a 6-week period when the SAU was functioning at the Princess Royal University Hospital. On March 23rd, 2020, the SAU was transformed into a 24-hour SAAU. Following this transformation, a second set of patient data was collected over a period of 6 weeks. A comparison was made between data collected from when the hospital had a 12-hour Surgical Ambulatory unit and later when it was transformed into a 24-hour facility. Its effects on the change in the number of patients breaching the four hour waiting period and the number of emergency surgical admissions. Results: The 24-hour Surgical Ambulatory Assessment unit brought significant reductions in the number of patients breaching the waiting period of 4 hours in A&E from 44% during the period of the 12-hour Surgical Ambulatory care facility to 0% from when the 24-hour Surgical Ambulatory Assessment Unit was established. A 28% reduction was also seen in the number of surgical patients' admissions from A&E. Conclusions: The 24-hour SAAU was found to have a profound positive impact on emergency care of surgical patients. Especially during the Covid crisis, it played a crucial role in providing not only effective and accessible patient care but also in reducing the A&E workload and admissions. It thus proved to be a strategic tool that helped to deal with the immense workload in emergency care during the Covid crisis and helped free much needed headspace at a time of uncertainty for the A&E to better configure their services. If sustained, the 24-hour SAAU could be relied on to augment the NHS emergency services in the future, especially in the event of another crisis.

Keywords: Princess Royal University Hospital, surgical ambulatory assessment unit, surgical ambulatory unit, same day emergency care

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