Search results for: length of follow up

Authors: Nina Philipova

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The influence of the geometric parameters of trapezoidal labyrinth channel on the pressure losses along the labyrinth length is investigated in this work. The impact of the dentate height is studied at fixed values of the dentate angle and the dentate spacing. The objective of the work presented in this paper is to derive a mathematical model of the pressure losses along the labyrinth length depending on the dentate height. The numerical simulations of the water flow movement are performed by using Commercial codes ANSYS GAMBIT and FLUENT. Dripper inlet pressure is set up to be 1 bar. As a result, the mathematical model of the pressure losses is determined as a second-order polynomial by means Commercial code STATISTIKA. Bi-objective optimization is performed by using the mean algebraic function of utility. The optimum value of the dentate height is defined at fixed values of the dentate angle and the dentate spacing. The derived model of the pressure losses and the optimum value of the dentate height are used as a basis for a more successful emitter design.

Keywords: drip irrigation, labyrinth channel hydrodynamics, numerical simulations, Reynolds stress model

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Authors: Gheyder Concha Bendezu, Rodrigo Lescano Loli, Aldo Bravo Lizano

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In big urbanized cities of Latin America, motor vehicles have priority over non-motor vehicles and pedestrians. There is an important problem that affects people's health and quality of life; lack of inclusion towards pedestrians makes it difficult for them to move smoothly and safely since the city has been planned for the transit of motor vehicles. Faced with the new trend for sustainable and economical transport, the city is forced to develop infrastructure in order to incorporate pedestrians and users with non-motorized vehicles in the transport system. The present research aims to study the influence of non-motorized vehicles on an avenue, the optimization of a cycle using traffic lights based on simulation in Synchro software, to improve the flow of non-motor vehicles. The evaluation is of the microscopic type; for this reason, field data was collected, such as vehicular, pedestrian, and non-motor vehicle user demand. With the values of speed and travel time, it is represented in the current scenario that contains the existing problem. These data allow to create a microsimulation model in Vissim software, later to be calibrated and validated so that it has a behavior similar to reality. The results of this model are compared with the efficiency parameters of the proposed model; these parameters are the queue length, the travel speed, and mainly the travel times of the users at this intersection. The results reflect a reduction of 27% in travel time, that is, an improvement between the proposed model and the current one for this great avenue. The tail length of motor vehicles is also reduced by 12.5%, a considerable improvement. All this represents an improvement in the level of service and in the quality of life of users.

Keywords: bikeway, microsimulation, pedestrians, queue length, traffic light cycle, travel time

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Authors: Daisy Dutta, Chhanda Chakraborti

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Background and significance of the study: Menstrual Hygiene Management (MHM) is poor in many Lower and Middle-Income Countries (LMIC) such as India. Poor and inadequate menstrual hygiene has an adverse effect on the health and social life of adolescent girls and women. There are many well-known barriers to adequate Menstrual Hygiene Management (MHM); e.g., lack of awareness, lack of WASH (Water, Sanitation and Hygiene) facilities, lack of affordable menstrual absorbents, etc. But, there is a unique barrier which is very much avoidable; i.e., lack of proper guidance and counseling about menstruation. Menstruation is associated with various social and cultural restrictions and taboos and being a taboo topic; often there is no discussion in the society on this topic. Thus, many adolescent girls encounter the menarche with a lot of unnecessary and avoidable trauma, stress and awkwardness. This trauma, stress, and anxiety are even more prevalent among adolescent girls residing in rural areas. This study argues that this unnecessary stress and anxiety of the adolescent girls can be alleviated by reinforcing social support and adequate information and guidance about MHM and eliminating the futile socio-cultural restrictions during menstruation. Methodology: A qualitative study was conducted in a North-eastern State of India where 45 adolescent girls were interviewed both from rural and urban areas. The adolescent girls were asked about their experiences of stress and anxiety on their first menstruation, their preparedness for menarche, their source of information and guidance, their hygiene-practices, and the various restrictions they follow. Findings: Maximum number of girls did not receive any information about menstruation before menarche. Most of them reported that they were terrified about their first menstruation as they were unprepared. Among those who were aware before menarche, reported that they did not receive proper guidance to manage their menstruation in a hygienic manner. Hygiene-related practices are also influenced by their knowledge about MHM. In maximum cases, girls are bound to follow certain cultural and religious restrictions even if they don’t want to follow which created additional stress in managing their menstruation with dignity. Conclusion: Lack of proper guidance and counseling about menstruation and MHM along with an array of socio-cultural restrictions can enhance a negative attitude in adolescent girls towards menstruation due to which they have to go through an extra and unnecessary burden of stress and trauma. This stress and trauma is preventable by improving the provisions of proper guidance and counseling about menstruation in a supportive environment.

Keywords: adolescent girls, menstrual hygiene management, socio-cultural restrictions, stress, trauma

Procedia PDF Downloads 165

Authors: Ozhan Simsek, Dicle Donmez, Burhanettin Imrak, Ahsen Isik Ozguven, Yildiz Aka Kacar

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Pomegranate (Punica granatum L.) is known to be one of the oldest edible fruit tree species, with a wide geographical global distribution. Fruits from the two defined varieties (Hicaznar and 33N26) were taken at intervals after pollination and fertilization at different sizes. Seed samples were used for transcriptome sequencing. Primary sequencing was produced by Illumina Hi-Seq™ 2000. Firstly, we had raw reads, and it was subjected to quality control (QC). Raw reads were filtered into clean reads and aligned to the reference sequences. De novo analysis was performed to detect genes expressed in seeds of pomegranate varieties. We performed downstream analysis to determine differentially expressed genes. We generated about 27.09 gb bases in total after Illumina Hi-Seq sequencing. All samples were assembled together, we got 59,264 Unigenes, the total length, average length, N50, and GC content of Unigenes are 84.547.276 bp, 1.426 bp, 2,137 bp, and 46.20 %, respectively. Unigenes were annotated with 7 functional databases, finally, 42.681(NR: 72.02%), 39.660 (NT: 66.92%), 30.790 (Swissprot: 51.95%), 20.212 (COG: 34.11%), 27.689 (KEGG: 46.72%), 12.328 (GO: 20.80%), and 33,833 (Interpro: 57.09%) Unigenes were annotated. With functional annotation results, we detected 42.376 CDS, and 4.999 SSR distribute on 16.143 Unigenes.

Keywords: next generation sequencing, SSR, RNA-Seq, Illumina

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Authors: Ming-Hwi Yao, Su-Szu Yang

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Typhoons are one of the major types of disasters that affect Taiwan each year and that cause severe damage to agriculture. Indeed, the damage exacted during a typical typhoon season can be up to $1 billion, and is responsible for nearly 75% of yearly agricultural losses. However, there is no consensus on how to reduce the damage caused by the strong winds and heavy precipitation engendered by typhoons. One suggestion is the use of windbreak nets, which are a low-cost and easy-to-use disaster mitigation strategy for crop production. In the present study, we conducted an evaluation to determine the optimal conditions of a windbreak net by using a computational fluid dynamics (CFD) model. This model may be used as a reference for crop protection. The results showed that CFD simulation validated windbreak nets of different mesh sizes and heights in the experimental area; thus, CFD is an efficient tool for evaluating the effectiveness of windbreak nets. Specifically, the effective wind protection length and height were found to be 6 and 1.3 times the length and height of the windbreak net, respectively. During a real typhoon, maximum wind gusts of 18 m s-1 can be reduced to 4 m s-1 by using a windbreak net that has a 70% blocking rate. In short, windbreak nets are significantly effective in protecting typhoon-affected areas.

Keywords: computational fluid dynamics, disaster, typhoon, windbreak net

Procedia PDF Downloads 173

Authors: Mehrak Zargaryaeghoubi, Masood Hajali

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Drilled shafts are the most popular of deep foundations, because they have the capability that one single shaft can easily carry the entire load of a large column from a bridge or tall building. Drilled shaft may be an economical alternative to pile foundations because a pile cap is not needed, which not only reduces that expense, but also provides a rough surface in the border of soil and concrete to carry a more axial load. Due to the larger construction sizes of drilled shafts, they have an excellent axial load carrying capacity. Part of the axial load carrying capacity of the drilled shaft is resisted by the soil below the tip of the shaft which is tip resistance and the other part is resisted by the friction developed around the drilled shaft which is side resistance. The condition at the bottom of the excavation can affect the end bearing capacity of the drilled shaft. Also, type of the soil and size of the drilled shaft can affect the frictional resistance. The main loads applied on the drilled shafts are axial compressive loads. It is important to know how many percent of the maximum applied load will be shed inside friction and how much will be transferred to the base. The axial capacity of the drilled shaft foundation is influenced by the size of the drilled shaft, and soil characteristics. In this study, the effect of the size and soil characteristic will be investigated on the contribution of side resistance and end-bearing capacity. Also, the study presents a three-dimensional finite element modeling of a drilled shaft subjected to axial load using ANSYS. The top displacement and settlement of the drilled shaft are verified with analytical results. The soil profile is considered as Table 1 and for a drilled shaft with 7 ft diameter and 95 ft length the stresses in z-direction are calculated through the length of the shaft. From the stresses in z-direction through the length of the shaft the side resistance can be calculated and with the z-direction stress at the tip, the tip resistance can be calculated. The result of the side and tip resistance for this drilled shaft are compared with the analytical results.

Keywords: Drilled Shaft Foundation, size and soil characteristic, axial load capacity, Finite Element

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Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu

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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).

Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium

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Authors: Adaour Mohamed Amine, Bachene Mohamed Sadek, Fortassi Mosaab, Siouda Wafaa

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Foot infections are responsible for a significant number of hospitalizations and amputations in diabetic patients. The objective of our study is to analyze and evaluate the management of diabetic foot in a surgical setting. A retrospective study was conducted based on a selected case of suspected diabetic foot infections of osteitis treated at the Mohamed Boudiaf hospital in Medea. The case was reiterated as a therapeutic charge, consisting of treating first the infection of the soft tissues, then the osteitis: biopsy after at least 15 days of cessation of antibiotic therapy. Successful treatment of osteitis was defined at the end of a follow-up period of complete wound healing, lack of bone resection/amputation surgery at the initial bone site during follow-up , Instead, biopsies are prescribed in the treatment of soft tissue infection. The mean duration of treatment for soft tissue infection was 2-3 weeks, the duration of the antibiotic-free window of therapy prior to bone biopsy was 2-4 weeks. This patient received medical management without surgical resection. The success rate for treating osteitis at one year was 73% and healing at one year was 88%.It is often limited to a sausage of the foot at the cost of repeated amputations. The best management remains prevention, which necessarily involves setting up a specialized and adapted centre.

Keywords: osteitis, antibiotic therapy, bone biopsy, diabetic foot

Procedia PDF Downloads 91

Authors: M. B. Mshelia, J. K Balogun, J. Auta, N. O. Bankole

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The current status and abundance of the genus Citharinus was carried out in Jebba Lake, Niger State, Nigeria from January to December, 2011. The aim was to determine the extent of exploitation of the genus Citharinus in Jebba Lake so as to advice the government of Nigeria on how to overcome difficulties in terms of the sustainability of the said fish in the Lake. Descriptive statistics were used to analyze the data obtained. A total of 2,389 of the genus Citharinus were caught during the sampling period. Only two species of the genus Citharinus were caught with 1,220 in number and 430.68kg total weight of Citharinus citharus and 1,169 in number and 418.56kg total weight of Citharinus latus). The current total yield estimated for the genus Citharinus in Jebba Lake in the six (6) sampling sites was calculated and pooled together to be 849.24kg. A day’s catch was calculated to be 35.38kg. The monthly and annual yields of the genus Citharinus were calculated to 1061.55 equivalents to 1 ton and 12 metric tonnes respectively. For the fecundity, June, July and August were discovered as the spawning period for the genus Citharinus and out of total experimental gillnet catch of 2, 389, only 244 (10.21%)of Citharinus citharus and 231 (9.67%) of Citharinus latus were in sexually mature stage. Out of these numbers, 113 (46.31%) were males and 121 (53.69%) were females of Citharinus citharus and 112 (48.48) were males and 119 (51.52) were females of Citharinus latus. The youngest mature males in either of the two had a standard length of 31.5 with a weight of 800.5gWhilethe youngest spawning females were having the standard length of 29.5 cm with a weight of 1,3oo.5g.It was also discovered that females started maturing earlier than the males at the standard length for females and males to be 18.0cm and 19.5cm respectively. Their fecundity ranged from 15,000 to 16, 500 eggs. The sex ratio of 1172 that were males and 1217 that were females was 1 male to 1.0383 females which was equivalent to 1:1 sex ratio of male to female. It was concluded that Jebba Lake had suffered seriously over exploitation of the genus Citharinus and proper management have to be enforced on the lake otherwise the threat of fish being extent may arise.

Keywords: Jebba Lake, Niger State, Nigeria, Citharinus citharus, Citharinus latus, fecundity, sex ratio

Procedia PDF Downloads 240

Authors: S. Zenia, A. Menasseria, A. E. Kheidous, F. Larinouna, A. Smai, H. Saadi, F. Haddadj, A. Milla, F. Marniche

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Pheasant, is a bird of great ornamental value through the beauty of its form and colors, it is among the most popular birds. The present study was conducted in an experimental breeding. The objective of this work is to know the quality of the eggs of this bird. A total of 938 eggs were collected. To deepen the knowledge about the characteristics of external shell quality, biometric parameters were studied, among them we find the weight with a mean value of 29.2± 2, 24 g. Egg length (mm) and egg width (mm) mean value are respectively 43.01 ± 1,84 cm and 34.05 ± 1,44cm. The volume and shape index of eggs obtained are respectively 25,63±2,88cm3 and 79.00 ± 3%, shell index which recorded an average of 68%. Water loss recorded is 13%. Note that all these parameters and others may influence hatching. The analysis of variance applied for the comparison of egg weight shows that there is no significant difference in the same form factor (P> 0.05). Otherwise, the comparison test used shows a significant difference with P <0.05 for length, width, volume, density, indices of shell and water loss of eggs between the different. Indeed, several factors may explain the difference as the absence of sorting eggs during incubation and other factors that will be exposing later.

Keywords: analysis of variance, egg, hatching, morphometry of eggs Phaisan (Phasianus colchicus.L.)

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Authors: Néné Gallé Kide, Mamadou Dia, Lemhaba Ould Yarba, Youssouf Kone, Fatimetou Mint Khalil, Hajar Bouksir, Ghislane Salhi, Younès Saoud

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The diet of Sarotherodon melanotheron and Tilapia guineensis were investigated in the National Park of Banc d'Arguin (PNBA) from September 2012 to October 2013. A total of 499 individuals ranging in size between 219 and 400 mm total length of S. melanotheron (253 males and 246 females), and 280 individuals of T.guineensis (229 males and 51 females) ranged between 180 and 424mm total length. We used for studying the feeding habits of both two species the frequency of occurrence method. The coefficient of emptiness was 40.88% for S. melanotheron and 38.57% for T. guineensis. Both two species were herbivorous and very close feedings. Their diet consists of Seagrass, green, red, blue, and brown algae, diatoms, gastropods, bivalves, Crustaceans, and mud. The Seagrass and green algae were prey preference of these two species. The diet feeding showed that the composition varies slightly depending on the season and size of individuals.

Keywords: Cichlidae, trophic ecology, National park, Banc d'Arguin, Mauritania

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Authors: Sang-Wook Han, Zhenlan Jin, In-Hui Hwang, Chang-In Park

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We examined structural and electrical properties of uniformly-oriented VO₂/ZnO nanostructures. VO₂ was deposited on ZnO templates by using a direct current-sputtering deposition. Scanning electron microscope and transmission electron microscope measurements indicated that b-oriented VO₂ were uniformly crystallized on ZnO templates with different lengths. VO₂/ZnO formed nanorods on ZnO nanorods with length longer than 250 nm. X-ray absorption fine structure at V K edge of VO₂/ZnO showed M1 and R phases of VO₂ at 30 and 100 ℃, respectively, suggesting structural phase transition between temperatures. Temperature-dependent resistance measurements of VO₂/ZnO nanostructures revealed metal-to-insulator transition at 65 ℃ and 55 ℃ during heating and cooling, respectively, regardless of ZnO length. The bond lengths of V-O and V-V pairs in VO₂/ZnO nanorods were somewhat distorted, and a substantial amount of structural disorder existed in the atomic pairs, compared to those of VO₂ films without ZnO. Resistance from VO₂/ZnO nanorods revealed a sharp MIT near 65 ℃ during heating and a hysteresis behavior. The resistance results suggest that microchannel for charge carriers exist nearly room temperature during cooling. VO₂/ZnO nanorods are quite stable and reproducible so that they can be widely used for practical applications to electronic devices, gas sensors, and ultra-fast switches, as examples.

Keywords: metal-to-insulator transition, VO₂, ZnO, XAFS, structural-phase transition

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Authors: Emmanuel Abayomi Rotimi

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Context: Rabbits production plays important role in increasing animal protein supply in Nigeria. Rabbit production provides a cheap, affordable, and healthy source of meat. The growth of animals involves an increase in body weight, which can change the conformation of various parts of the body. Live weight and linear measurements are indicators of growth rate in rabbits and other farm animals. Aims: This study aimed to define the body dimensions of New Zealand rabbits and also to investigate the morphometric traits variables that contribute to body conformation by the use of principal component analysis (PCA). Methods: Data were obtained from 80 New Zealand rabbits (40 bucks and 40 does) raised in Livestock Teaching and Research Farm, Federal University Dutsinma. Data were taken on body weight (BWT), body length (BL), ear length (EL), tail length (TL), heart girth (HG) and abdominal circumference (AC). Data collected were subjected to multivariate analysis using SPSS 20.0 statistical package. Key results: The descriptive statistics showed that the mean BWT, BL, EL, TL, HG, and AC were 0.91kg, 27.34cm, 10.24cm, 8.35cm, 19.55cm and 21.30cm respectively. Sex showed significant (P<0.05) effect on all the variables examined, with higher values recorded for does. The phenotypic correlation coefficient values (r) between the morphometric traits were all positive and ranged from r = 0.406 (between EL and BL) to r = 0.909 (between AC and HG). HG is the most correlated with BWT (r = 0.786). The principal component analysis with variance maximizing orthogonal rotation was used to extract the components. Two principal components (PCs) from the factor analysis of morphometric traits explained about 80.42% of the total variance. PC1 accounted for 64.46% while PC2 accounted for 15.97% of the total variances. Three variables, representing body conformation, loaded highest in PC1. PC1 had the highest contribution (64.46%) to the total variance, and it is regarded as body conformation traits. Conclusions: This component could be used as selection criteria for improving body weight of rabbits.

Keywords: conformation, multicollinearity, multivariate, rabbits and principal component analysis

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Authors: Tayab D. Memon, Shahji Farooque, Marvi Deshi, Imtiaz Hussain Kalwar, B. S. Chowdhry

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Recently single-bit ternary FIR-like filter (SBTFF) hardware synthesize in FPGA is reported and compared with multi-bit FIR filter on similar spectral characteristics. Results shows that SBTFF dominates upon multi-bit filter overall. In this paper, an optimized adder module for ternary quantized sigma-delta modulated signal is presented. The adder is simulated using ModelSim for functional verification the area-performance of the proposed adder were obtained through synthesis in Xilinx and compared to conventional adder trees. The synthesis results show that the proposed adder tree achieves higher clock rates and lower chip area at higher inputs to the adder block; whereas conventional adder tree achieves better performance and lower chip area at lower number of inputs to the same adder block. These results enhance the usefulness of existing short word length DSP algorithms for fast and efficient mobile communication.

Keywords: short word length (SWL), DSP algorithms, FPGA, SBTFF, VHDL

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Authors: Mimoza Canga, Vito Malagnino, Giulia Malagnino, Irene Malagnino

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Objective: The objective of this study was to compare the effectiveness of Mtwo and RaCe rotary instruments, in cleaning and shaping root canals curvature. Material and Method: The present study was conducted on 160 simulated canals in resin blocks, with an angle curvature 15°-30°. These 160 simulated canals were divided into two groups, where each group consisted of 80 blocks. Each group was divided into two subgroups (n=40 canals each). The simulated canals subgroups were prepared with Mtwo and RaCe rotary nickel-titanium instruments. The root canals were measured at four different points of reference, starting at 13 mm from the orifice. In the first group, the canals were prepared using Mtwo rotary system (VDW, Munich, Germany). The Mtwo files used were: 10/0.04, 15/0.05, 20/0.06, and 25/0.06. These instruments entered in the full length of the canal. Each file was rotated in the canal until it reached the apical point. In the second group, the canals were prepared using RaCe instruments (La Chaux-De-Fonds, Switzerland), performing the crown down technique, using the torque electric control motor (VDWCO, Munich, Germany), with 600 RPM and 2n/cm as follow: ≠40/0.10, ≠35/0.08, ≠30/0.06, ≠25/0.04, ≠25/0.02. The data were recorded using SPSS version 23 software (Microsoft, IL, USA). Data analysis was done using ANOVA test. Results: The results obtained by using the Mtwo rotary instruments, showed that these instruments were able to clean and shape in the right-to-left motion curved canals, at different levels, without any deviation, and in perfect symmetry, with a P-value=0.000. The data showed that the greater the depth of the root canal, the greater the deviations of the RaCe rotary instruments. These deviations occurred in three levels, which are: S2(P=0.004), S3( P=0.007), S4(P=0.009). The Mtwo files can go deeper and create a greater angle in S4 level (21°-28°), compared to RaCe instruments with an angle equal to 19°-24°. Conclusion: The present study noted a clinically significant difference between Mtwo rotary instruments and RaCe rotary files used for the canal preparation and indicated that Mtwo instruments are a better choice for the curved canals.

Keywords: canal curvature, canal preparation, Mtwo, RaCe, resin blocks

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Authors: Dmitry Dikarev, Ajit Nimbalker, Alexei Davydov

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Polar coding is a novel example of error correcting codes, which can achieve Shannon limit at block length N→∞ with log-linear complexity. Active research is being carried to adopt this theoretical concept for using in practical applications such as 5th generation wireless communication systems. Cyclic redundancy check (CRC) error detection code is broadly used in conjunction with successive cancellation list (SCL) decoding algorithm to improve finite-length polar code performance. However, there are two issues: increase of code block payload overhead by CRC bits and decrease of CRC error-detection capability. This paper proposes a method to control CRC overhead and false alarm rate of polar decoding. As shown in the computer simulations results, the proposed method provides the ability to use any set of CRC polynomials with any list size while maintaining the desired level of false alarm rate. This level of flexibility allows using polar codes in 5G New Radio standard.

Keywords: 5G New Radio, channel coding, cyclic redundancy check, list decoding, polar codes

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Authors: Shreya Saxena

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Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

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Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

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Authors: Sheng-Yu Lee

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Aim: Opioid use disorder is often characterized by repetitive drug-seeking and drug-taking behaviors with severe public health consequences. Animal model showed that opioid-induced perturbations in the gut microbiota causally relate to neuroinflammation, deficits in reward responding, and opioid tolerance, possibly due to changes in gut microbiota. Therefore, we propose that the dysbiosis of gut microbiota can be associated with pathogenesis of opioid dependence. In this current study, we explored the differences in gut microbiota between patients and normal controls and in patients before and after initiation of methadone treatment program for 12 weeks. Methods: Patients with opioid use disorder between 20 and 65 years were recruited from the methadone maintenance outpatient clinic in 2 medical centers in the Southern Taiwan. Healthy controls without any family history of major psychiatric disorders (schizophrenia, bipolar disorder and major depressive disorder) were recruited from the community. After initial screening, 15 patients with opioid use disorder joined the study for initial evaluation (Week 0), 12 of them completed the 12-week follow-up while receiving methadone treatment and ceased heroin use (Week 12). Fecal samples were collected from the patients at baseline and the end of 12th week. A one-time fecal sample was collected from the healthy controls. The microbiota of fecal samples were investigated using 16S rRNA V3V4 amplicon sequencing, followed by bioinformatics and statistical analyses. Results: We found no significant differences in species diversity in opioid dependent patients between Week 0 and Week 12, nor compared between patients at both points and controls. For beta diversity, using principal component analysis, we found no significant differences between patients at Week 0 and Week 12, however, both patient groups showed significant differences compared to control (P=0.011). Furthermore, the linear discriminant analysis effect size (LEfSe) analysis was used to identify differentially enriched bacteria between opioid use patients and healthy controls. Compared to controls, the relative abundance of Lactobacillaceae Lactobacillus (L. Lactobacillus), Megasphaera Megasphaerahexanoica (M. Megasphaerahexanoica) and Caecibacter Caecibactermassiliensis (C Caecibactermassiliensis) were increased in patients at Week 0, while Coriobacteriales Atopobiaceae (C. Atopobiaceae), Acidaminococcus Acidaminococcusintestini (A. Acidaminococcusintestini) and Tractidigestivibacter Tractidigestivibacterscatoligenes (T. Tractidigestivibacterscatoligenes) were increased in patients at Week 12. Conclusion: In conclusion, we suggest that the gut microbiome community maybe linked to opioid use disorder, such differences may not be altered even after 12-week of cessation of opioid use.

Keywords: opioid use disorder, gut microbiota, methadone treatment, follow up study

Procedia PDF Downloads 89

Authors: J. Yan, B. Pieper, B. Bucsky, B. Nasseri, S. Klotz, H. H. Sievers, S. Mohamed

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Cryoablation is evermore applied for interventional treatment of paroxysmal (PAAF) or persistent atrial fibrillation (PEAF). In the cardiac surgery, this procedure is often combined with coronary arterial bypass graft (CABG) and valve operations. Three different methods are feasible in this sense in respect to practicing extents and mechanisms such as lone left atrial cryoablation, Cox-Maze IV and III in our heart center. 415 patients (68 ± 0.8ys, male 68.2%) with predisposed atrial fibrillation who initially required either coronary or valve operations were enrolled and divided into 3 matched groups according to deployed procedures: CryoLA-group (cryoablation of lone left atrium, n=94); Cox-Maze-IV-group (n=93) and Cox-Maze-III-group (n=8). All patients additionally received closure of the left atrial appendage (LAA) and regularly underwent three-year ambulant follow-up assessments (3, 6, 9, 12, 18, 24, 30 and 36 months). Burdens of atrial fibrillation were assessed directly by means of cardiac monitor (Reveal XT, Medtronic) or of 3-day Holter electrocardiogram. Herewith, attacks frequencies of AF and their circadian patterns were systemically analyzed. Furthermore, anticoagulants and regular rate-/rhythm-controlling medications were evaluated and listed in terms of anti-rate and anti-rhythm regimens. Concerning PAAF treatment, Cox Maze IV procedure provided therapeutically acceptable effect as lone left atrium (LA) cryoablation did (5.25 ± 5.25% vs. 10.39 ± 9.96% AF-burden, p > 0.05). Interestingly, Cox Maze III method presented a better short-term effect in the PEAF therapy in comparison to lone cryoablation of LA and Cox Maze IV (0.25 ± 0.23% vs. 15.31 ± 5.99% and 9.10 ± 3.73% AF-burden within the first year, p < 0.05). But this therapeutic advantage went lost during ongoing follow-ups (26.65 ± 24.50% vs. 8.33 ± 8.06% and 15.73 ± 5.88% in 3rd follow-up year). In this way, lone LA-cryoablation established its antiarrhythmic efficacy and 69.5% patients were released from the Vit-K-antagonists, while Cox Maze IV liberated 67.2% patients from continuous anticoagulant medication. The AF-recurrences mostly performed such attacks property as less than 60min duration for all 3 procedures (p > 0.05). In the sense of the circadian distribution of the recurrence attacks, weighted by ongoing follow-ups, lone LA cryoablation achieved and stabilized the antiarrhythmic effects over time, which was especially observed in the treatment of PEAF, while Cox Maze IV and III had their antiarrhythmic effects weakened progressively. This phenomenon was likewise evaluable in the therapy of circadian rhythm of reverting AF-attacks. Furthermore, the strategy of rate control was much more often applied to support and maintain therapeutic successes obtained than the one of rhythm control. Derived from experiences in our heart center, lone LA cryoablation presented equivalent effects in the treatment of AF in comparison to Cox Maze IV and III procedures. These therapeutic successes were especially investigable in the patients suffering from persistent AF (PEAF). Additional supportive strategies such as rate control regime should be initialized and implemented to improve the therapeutic effects of the cryoablations according to appropriate criteria.

Keywords: AF-burden, atrial fibrillation, cardiac monitor, COX MAZE, cryoablation, Holter, LAA

Procedia PDF Downloads 183

Authors: Skezeer John B. Paz, Ederlina G. Nocon

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Finding an optimal binary linear code is a central problem in coding theory. A binary linear code C = [n, k, d] is called optimal if there is no linear code with higher minimum distance d given the length n and the dimension k. There are bounds giving limits for the minimum distance d of a linear code of fixed length n and dimension k. The lower bound which can be taken by construction process tells that there is a known linear code having this minimum distance. The upper bound is given by theoretic results such as Griesmer bound. One way to find an optimal binary linear code is to make the lower bound of d equal to its higher bound. That is, to construct a binary linear code which achieves the highest possible value of its minimum distance d, given n and k. Some optimal binary linear codes were presented by Andries Brouwer in his published table on bounds of the minimum distance d of binary linear codes for 1 ≤ n ≤ 256 and k ≤ n. This was further improved by Markus Grassl by giving a detailed construction process for each code exhibiting the lower bound. In this paper, we construct new optimal binary linear codes by using some construction processes on existing binary linear codes. Particularly, we developed an algorithm applied to the codes already constructed to extend the list of optimal binary linear codes up to 257 ≤ n ≤ 300 for k ≤ 7.

Keywords: bounds of linear codes, Griesmer bound, construction of linear codes, optimal binary linear codes

Procedia PDF Downloads 737

Authors: Gholam Hossein Javanmard, Roghayeh Mohammadi Garegozlo

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The present study was a randomized three-group double-blind clinical trial with repeated measures designs which aimed to determine the pure effect and combined effect of mindfulness based-relaxation (MBR) technique and Transcranial Electrical Simulation (tCES) on psychological distress decreasing of patients with type-2 diabetes. The sample of the study consisted of 30 patients with type-2 diabetes who were selected from the Diabetes Association of Bonab city in Iran. The participants were matched and then randomly assigned to the three groups of 10 subjects (MBR, CES, MBR+CES). The subjects received interventions related to their group in 10 individual sessions. Pre-test, post-test, and one-month follow-up were conducted using DASS-42. Analysis of variance with repeated measures showed a significant change in psychological distress. Multivariate covariance analysis and the paired interpersonal comparative test of Ben Foruni indicated that both interventions of MBR and CES have a similar effect on psychological distress decreasing in the post-test and follow-up phase. But, the combined therapy of MBR+CES was more efficient, and it had a more stable effect. However, all three interventions, especially combined intervention of MBR+CES, as efficient and stable treatment, are suggested for improving the psychological status of diabetic patients.

Keywords: mindfulness based-relaxation, transcranial electrical simulation, type 2 diabetes, psychological distress

Procedia PDF Downloads 120

Authors: Amine Mezni, Merfat Algethami, Ali Aldalbahi, Arwa Alrooqi, Abel Santos, Dusan Losic, Sarah Alharthi, Tariq Altalhi

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In situ synthesis of carbon nanotubes featuring different diameters (10-200 nm), lengths (1 to 100 µm) and periodically nanostructured shape was performed in a custom designed chemical vapor deposition (CVD) system using nanoporous anodic alumina (NAA) under different conditions. The morphology of the resulting CNTs/NAA composites and free-standing CNTs were analyzed by transmission electron microscopy (TEM) and scanning electron microscopy (SEM). The results confirm that highly ordered arrays of CNTs with precise control of nanotube dimensions in the range 20-200 nm with tube length in the range < 1 µm to > 100 μm and with periodically shaped morphology can be fabricated using nanostructured NAA templates prepared by anodization. This technique allows us to obtain tubes open at one / both ends with a uniform diameter along the pore length without using any metal catalyst. Our finding suggests that this fabrication strategy for designing new CNTs membranes and structures can be significant for emerging applications as molecular separation/transport, optical biosensing, and drug delivery.

Keywords: carbon nanotubes, CVD approach, composites membrane, nanoporous anodic alumina

Procedia PDF Downloads 262

Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

Procedia PDF Downloads 163

Authors: T. S. Bubuche, L. Abubakar, N.D. Ibrahim, A. A. Aliero, H. M. Sama, B. S. Haliru

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A two-year study was conducted at the Fadama farm of Usmanu Danfodiyo University Sokoto, Nigeria. Correlations and path coefficients analysis were used to determine the interrelationship and importance of various characters as components of yield in sugarcane during 20011-012 and 2012-013 growing seasons. Fourteen sugarcane hybrids and a local check were evaluated. The experiment was laid out in a randomized complete block design (RCBD) and replicated three times. Significant and positive correlation were recorded between total cane weight/ha and single stalk weight, between single stalk weight and final brix and between stalk girth and stalk length while final brix and number of milliable cane/ha recorded no significant correlation. Traits that had high direct contribution to the final yield were number of stalk/stool, number of milliable cane/ha, single stalk weight and brix content while high indirect positive contributions were observed in growth habit, number of internode per stalk and stalk length..

Keywords: correlation, path analysis, sugarcane, yield components

Procedia PDF Downloads 236

Authors: Peng Hao Wang, Ronald Sterkenburg, Garam Kim, Yuwei He

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As composite materials continue to gain popularity in the aerospace industry; large airframe sections made out of composite materials are becoming the standard for aerospace manufacturers. However, the heavy utilization of these composite materials also increases the importance of the recycling of these composite materials. A team of Purdue University School of Aviation and Transportation Technology (SATT) faculty and students have partnered to investigate the characteristics of 3D printed recycled carbon fiber. A prototype of a 3D printed recycled carbon fiber part was provided by an industry partner and different sections of the prototype were used to create specimens. A furnace was utilized in order to remove the polymer from the specimens and the specimen’s fiber content and fiber length was calculated from the remaining fibers. A differential scanning calorimetry (DSC) and dynamic mechanical analysis (DMA) test was also conducted on the 3D printed recycled carbon fiber prototype in order to determine the prototype’s degree of cure at different locations. The data collected from this study provided valuable information in the process improvement and understanding of 3D printed recycled carbon fiber.

Keywords: 3D printed, carbon fiber, fiber content, recycling

Procedia PDF Downloads 170

Authors: Quang M. Dinh

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Stigmatogobius pleurostigma is a commercial fish being caught increasingly in the Mekong Delta. Although it plays an important role for food supply, little is known about this species including morphology, distribution and growth pattern. Meanwhile, its population and age structure is unknown. The present study was conducted in the Mekong Delta to provide new data on population parameters of this goby species. The von Bertalanffy growth parameters were L∞= 8.6 cm, K = 0.83 yr⁻¹, and t0 = -0.07 yr⁻¹ basing on length frequency data analysis of 601 individuals. The fish total length at first capture was 3.8 cm; and fishing, natural and total mortalities of the fish population were 2.31 yr⁻¹, 1.17 yr⁻¹, and 3.48 yr⁻¹ respectively. The maximum fish yield (Eₘₐₓ), economic yield (E₀.₁) and yield of 50% reduction of exploitation (E₅₀) rates were 0.704, 0.555 and 0.335 based on the relative yield-per-recruit and biomass-per-recruit analyses. The fish longevity was 3.61 yr, and growth performance was 1.79. Three fish age groups were recorded in this study (0+, 1+ and 2+). The species is a potential aquaculture candidate because of its high growth parameter. This goby stock was overexploited in the Mekong Delta as its exploitation rate (E=0.34) was higher than E₅₀ (0.335). The mesh size of gillnets should be increased and avoid catching fish in June, recruitment time, for future sustainable fishery management.

Keywords: Stigmatogobius pleurostigma, age, population structure, Vietnam

Procedia PDF Downloads 181

Authors: Alasdair Warwick, Luna Dhir

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Aim: To ascertain the efficacy of overcorrecting minus lens therapy in intermittent distance exotropia. Methods: Retrospective audit of all intermittent distance exotropia patients seen in the Chelsea and Westminster Hospital pediatric eye clinic between 1st January 2014 and 1st March 2016. Change in LogMAR visual acuity, stereopsis, near and distance angles of deviation, as well as the proportions of patients converting to exophoria or undergoing strabismus surgery, were recorded. Results: 22 patients were identified, 45% male, mean age 5 years (range 0.6 to 18.5 years). The median overminus prescription was -1.0 dioptres (range -0.5 to -1.75 dioptres) and mean follow-up was 15 months (range 3 to 54 months). Visual acuity, near and distance angles of deviation improved but were not statistically significant: -0.15 LogMAR, -0.2 prism dioptres and -1.2 prism dioptres respectively (p>0.05). However, a significant change in stereopsis was observed: -74'' (p<0.01). 27% underwent strabismus surgery and 36% converted to exophoria whilst wearing their overminus prescription. Conclusions: Overcorrecting minus lens therapy is an effective therapy for intermittent distance exotropia. There was no deterioration in visual acuity and a significant improvement in stereopsis was seen in our cohort, with many patients converting to an exophoria. The proportion of patients requiring strabismus surgery was comparable to other studies. Further, follow-up is needed to ascertain long-term outcomes.

Keywords: exotropia, overcorrecting minus lens, refraction, strabismus

Procedia PDF Downloads 230

Authors: Nikolai Bertelsen, Robert A. Alphinas, Klaus B. Orskov

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The shortest possible tool stickout has been the traditional go-to approach with expectations of increased stability and productivity. However, experimental studies at Danish Advanced Manufacturing Research Center (DAMRC) have proven that for some tool stickout lengths, there exist local productivity optimums when utilizing the Stability Lobe Diagrams for chatter avoidance. This contradicts with traditional logic and the best practices taught to machinists. This paper explores the vibrational characteristics and behaviour of a milling system over the tool stickout length. The experimental investigation has been conducted by tap testing multiple endmills where the tool stickout length has been varied. For each length, the modal parameters have been recorded and mapped to visualize behavioural tendencies. Furthermore, the paper explores the correlation between the modal parameters and the Stability Lobe Diagram to outline the influence and importance of each parameter in a multi-mode system. The insights are conceptualized into a tool tuning approximation solution. It builds on an almost linear change in the natural frequencies when amending tool stickout, which results in changed positions of the Chatter-free Stability Lobes. Furthermore, if the natural frequency of two modes become too close, it will onset of the dynamic absorber effect phenomenon. This phenomenon increases the critical stable depth of cut, allowing for a more stable milling process. Validation tests on the tool tuning approximation solution have shown varying success of the solution. This outlines the need for further research on the boundary conditions of the solution to understand at which conditions the tool tuning approximation solution is applicable. If the conditions get defined, the conceptualized tool tuning approximation solution outlines an approach for quick and roughly approximating tool stickouts with the potential for increased stiffness and optimized productivity.

Keywords: milling, modal parameters, stability lobes, tap testing, tool tuning

Procedia PDF Downloads 134

Authors: Cecilia Fagerstrom, Solve Elmstahl, Lena S. Wranker

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The conditions of increased morbidity in an aging population cause the need for family care to become more common at an advanced age. The role of family caregivers may well last for a long time but may also change over time, from being caregivers to being non-caregivers or vice versa. Although demands associated with family caring change as individuals enter into, engage with, and exit from this role, the evidence regarding the impact of family caregiving transitions on the health of older carers is still limited. This study comprised individuals (n=2294, 60+years) from the southern part of Sweden included in the project Swedish National study of Aging and Care. Caregiving transitions are discussed in the categories: enter, exit, and continuing during a six-year period. Individuals who exited caregiving during the time were older than those who continued or entered into the role of caregiving. At the six-year follow-up, caregivers who were continuing or had exited caregiving were more often worried about their own health compared to baseline. Resembling findings were not found in those who entered caregiving. Family caregiving transitions of exiting, entering or continuing had no effect on the individuals’ functional, physical and mental health expect for participants who entered in caregiving. For them, entering the role of family caregiving was associated with an improvement in physical health during the six years follow up period. Conclusion: Although the health impact of different caregiving transitions in late life does not differ, individual conditions and health at baseline are important parameters to take into consideration to improve long-term health in family caregivers.

Keywords: family caregiving, health, old age, transition

Procedia PDF Downloads 206