Search results for: report utility
2426 Comprehensive Literature Review of the Humanistic Burden of Clostridium (Clostridiodes) difficile Infection
Authors: Caroline Seo, Jennifer Stephens, Kirstin H. Heinrich
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Background: Clostridiodes (formerly Clostridium) difficile infection (CDI) is an anaerobic, spore-forming bacterium with manifestations including diarrhea, pseudomembranous colitis and toxic megacolon. Despite general understanding that CDI may be associated with marked burden on patients’ health, there has been limited information available on the humanistic burden of CDI. The objective of this literature review was to summarize the published data on the humanistic burden of CDI globally, in order to better inform future research efforts and increase awareness of the patient perspective in this disease. Methods: A comprehensive literature review of the past 15 years (2002-2017) was conducted using MEDLINE, Embase and Cumulative Index of Nursing and Allied Health Literature. Additional searches were conducted from conference proceedings (2015-2017). Articles selected were studies specifically designed to examine the humanistic burden of illness associated with adult patients with CDI. Results: Of 3,325 articles or abstracts identified, 33 remained after screening and full text review. Sixty percent (60%) were published in 2016 or 2017. Data from the United States or Western Europe were most common. Data from Brazil, Canada, China and Spain also exist. Thirteen (13) studies used validated patient-reported outcomes instruments, mostly EQ-5D utility and SF-36 generic instruments. Three (3) studies used CDI-specific instruments (CDiff32, CDI-DaySyms). The burden of CDI impacts patients in multiple health-related quality of life (HRQOL) domains. SF-36 domains with the largest decrements compared to other GI diarrheal diseases (IBS-D and Crohn’s) were role physical, physical functioning, vitality, social functioning, and role emotional. Reported EQ-5D utilities for CDI ranged from 0.35-0.42 compared to 0.65 in Crohn’s and 0.72 in IBS-D. The majority of papers addressed physical functioning and mental health domains (67% for both). Across various studies patients reported weakness, lack of appetite, sleep disturbance, functional dependence, and decreased activities of daily lives due to the continuous diarrhea. Due to lack of control over this infection, CDI also impacts the psychological and emotional quality of life of the patients. Patients reported feelings of fear, anxiety, frustration, depression, and embarrassment. Additionally, the type of disease (primary vs. recurrent) may impact mental health. One study indicated that there is a decrement in SF-36 mental scores in patients with recurrent CDI, in comparison to patients with primary CDI. Other domains highlighted by these studies include pain (27%), social isolation (27%), vitality and fatigue (24%), self-care (9%), and caregiver burden (0%). Two studies addressed work productivity, with 1 of these studies reporting that CDI patients had the highest work productivity and activity impairment scores among the gastrointestinal diseases. No study specifically included caregiver self-report. However, 3 studies did provide mention of patients’ worry on how their diagnosis of CDI would impact family, caregivers, and/or friends. Conclusions: Despite being a serious public health issue there has been a paucity of research on the HRQOL among those with CDI. While progress is being made, gaps exist in understanding the burden on patients, caregivers, and families. Future research is warranted to aid understanding of the CDI patient perspective.Keywords: burden, Clostridiodes, difficile, humanistic, infection
Procedia PDF Downloads 1362425 The AI Arena: A Framework for Distributed Multi-Agent Reinforcement Learning
Authors: Edward W. Staley, Corban G. Rivera, Ashley J. Llorens
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Advances in reinforcement learning (RL) have resulted in recent breakthroughs in the application of artificial intelligence (AI) across many different domains. An emerging landscape of development environments is making powerful RL techniques more accessible for a growing community of researchers. However, most existing frameworks do not directly address the problem of learning in complex operating environments, such as dense urban settings or defense-related scenarios, that incorporate distributed, heterogeneous teams of agents. To help enable AI research for this important class of applications, we introduce the AI Arena: a scalable framework with flexible abstractions for distributed multi-agent reinforcement learning. The AI Arena extends the OpenAI Gym interface to allow greater flexibility in learning control policies across multiple agents with heterogeneous learning strategies and localized views of the environment. To illustrate the utility of our framework, we present experimental results that demonstrate performance gains due to a distributed multi-agent learning approach over commonly-used RL techniques in several different learning environments.Keywords: reinforcement learning, multi-agent, deep learning, artificial intelligence
Procedia PDF Downloads 1572424 Towards Safety-Oriented System Design: Preventing Operator Errors by Scenario-Based Models
Authors: Avi Harel
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Most accidents are commonly attributed in hindsight to human errors, yet most methodologies for safety focus on technical issues. According to the Black Swan theory, this paradox is due to insufficient data about the ways systems fail. The article presents a study of the sources of errors, and proposes a methodology for utility-oriented design, comprising methods for coping with each of the sources identified. Accident analysis indicates that errors typically result from difficulties of operating in exceptional conditions. Therefore, following STAMP, the focus should be on preventing exceptions. Exception analysis indicates that typically they involve an improper account of the operational scenario, due to deficiencies in the system integration. The methodology proposes a model, which is a formal definition of the system operation, as well as principles and guidelines for safety-oriented system integration. The article calls to develop and integrate tools for recording and analysis of the system activity during the operation, required to implement validate the model.Keywords: accidents, complexity, errors, exceptions, interaction, modeling, resilience, risks
Procedia PDF Downloads 1952423 Emotion Dysregulation as Mediator between Child Abuse and Opiate Use Motives
Authors: Usha Barahmand, Ali Khazaee, Goudarz Sadeghi Hashjin
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Coping motives are considered to be indicators of problematic substance use. The present investigation examined a model with emotional abuse as an antecedent and emotional dysregulation as a mediator leading to substance use. The intent of this study was to examine the associations between various types of childhood maltreatment and motives for substance use. The sample consisted of 72 male opiate users recruited from those enrolled for Methadone Maintenance treatment. Participants responded to measures of childhood maltreatment, emotion dysregulation, and motives for opiate use. All data were analyzed using Pearson's correlation coefficients and bootstrap analysis of mediation. Results supported the hypothesis that the experience of emotional abuse in childhood is associated with problems in regulating emotions which in turn correlates with opiate use as a way to cope with negative affect, to enhance positive effect or to obtain social rewards. Bootstrap analysis confirmed the mediating role of emotion dysregulation. Findings support the potential utility of further research into emotion dysregulation and motives as antecedents of problematic opiate use.Keywords: childhood abuse, emotion dysregulation, motives, substance use
Procedia PDF Downloads 4442422 Myocardial Reperfusion Injury during Percutaneous Coronary Intervention in Patient with Triple-Vessel Disease in Limited Resources Hospital: A Case Report
Authors: Fanniyah Anis, Bram Kilapong
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Myocardial reperfusion injury is defined as the cellular damage that results from a period of ischemia, followed by the reestablishment of the blood supply to the infarcted tissue. Ventricular tachycardia is one of the most commonly encountered reperfusion arrhythmia as one of the types of myocardial perfusion injury. Prompt and early treatment can reduce mortality, despite limited resources of the hospital in high risk patients with history of triple vessel disease. Case report, Male 53 years old has been diagnosed with NSTEMI with 3VD and comorbid disease of Hypertension and has undergone revascularization management with Percutaneous coronary intervention. Ventricular tachycardia leading to cardiac arrest occurred right after the stent was inserted. Resuscitation was performed for almost 2 hours until spontaneous circulation returned. Patient admitted in ICU with refractory cardiac shock despite using combination of ionotropic and vasopressor agents under standard non-invasive monitoring due to the limitation of the hospital. Angiography was performed again 5 hours later to exclude other possibilities of blockage of coronary arteries and conclude diagnosis of myocardial reperfusion injury. Patient continually managed with combination of antiplatelet agents and maintenance dose of anti-arrhythmia agents. The handling of the patient was to focus more on supportive and preventive from further deteriorating of the condition. Patient showed clinically improvement and regained consciousness within 24 hours. Patient was successfully discharged from ICU within 3 days without any neurological sequela and was discharge from hospital after 3 days observation in general ward. Limited Resource of hospital did not refrain the physician from attaining a good outcome for this myocardial reperfusion injury case and angiography alone can be used to confirm the diagnosis of myocardial reperfusion injury.Keywords: limited resources hospital, myocardial reperfusion injury, prolonged resuscitation, refractory cardiogenic shock, reperfusion arrhythmia, revascularization, triple-vessel disease
Procedia PDF Downloads 3042421 European Environmental Policy for Road Transport: Analysis of the Perverse Effects Generated and Proposals for a Good Practice Guide
Authors: Pedro Pablo Ramírez Sánchez, Alassane Ballé Ndiaye, Roberto Rendeiro Martín-Cejas
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The aim of this paper is to analyse the different environmental policies adopted in Europe for car emissions, to comment on some of the possible perverse effects generated and point out these policies which are considered more efficient under the environmental perspective. This paper is focused on passenger cars as this category is the most significant in road transport. The utility of this research lies in this being the first step or basis to improve and optimise actual policies. The methodology applied in this paper refers to a comparative analysis from a practical and theoretical point of view of European environmental policies in road transport. This work describes an overview of the road transport industry in Europe pointing out some relevant aspects such as the contribution of road transport to total emissions and the vehicle fleet in Europe. Additionally, we propose a brief practice guide with the combined policies in order to optimise their aim.Keywords: air quality, climate change, emission, environment, perverse effect, road transport, tax policy
Procedia PDF Downloads 1612420 Genistein Suppresses Doxorubicin Associated Genotoxicity in Human Lymphocytes
Authors: Tanveer Beg, Yasir H. Siddique, Gulshan Ara, Asfar S. Azmi, Mohammad Afzal
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Doxorubicin is a well-known DNA intercalating chemotherapy drug that is widely used for treatment of different cancers. Its clinical utility is limited due to the observed genotoxic side effects on healthy cells suggesting that newer combination and genoprotective regimens are urgently needed for the management of doxorubicin chemotherapy. Some dietary phytochemicals are well known for their protective mechanism of action and genistein from soy is recognized as an anti-oxidant with similar properties. Therefore, the present study investigates the effect of genistein against the genotoxic doses of doxorubicin by assessing chromosomal aberrations, sister chromatid exchanges, cell cycle kinetics, cell viability, apoptosis, and DNA damage markers in cultured human lymphocytes. Our results reveal that genistein treatment significantly suppresses genotoxic damage induced by doxorubicin. It is concluded that genistein has the potential to reduce the genotoxicity induced by anti-cancer drugs, thereby reducing the chances of developing secondary tumors during the therapy.Keywords: apoptosis, DNA damage markers, doxorubicin, genistein, genotoxicity, human lymphocyte culture
Procedia PDF Downloads 3592419 SVM-Based Modeling of Mass Transfer Potential of Multiple Plunging Jets
Authors: Surinder Deswal, Mahesh Pal
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The paper investigates the potential of support vector machines based regression approach to model the mass transfer capacity of multiple plunging jets, both vertical (θ = 90°) and inclined (θ = 60°). The data set used in this study consists of four input parameters with a total of eighty eight cases. For testing, tenfold cross validation was used. Correlation coefficient values of 0.971 and 0.981 (root mean square error values of 0.0025 and 0.0020) were achieved by using polynomial and radial basis kernel functions based support vector regression respectively. Results suggest an improved performance by radial basis function in comparison to polynomial kernel based support vector machines. The estimated overall mass transfer coefficient, by both the kernel functions, is in good agreement with actual experimental values (within a scatter of ±15 %); thereby suggesting the utility of support vector machines based regression approach.Keywords: mass transfer, multiple plunging jets, support vector machines, ecological sciences
Procedia PDF Downloads 4642418 A Case Report on Cognitive-Communication Intervention in Traumatic Brain Injury
Authors: Nikitha Francis, Anjana Hoode, Vinitha George, Jayashree S. Bhat
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The interaction between cognition and language, referred as cognitive-communication, is very intricate, involving several mental processes such as perception, memory, attention, lexical retrieval, decision making, motor planning, self-monitoring and knowledge. Cognitive-communication disorders are difficulties in communicative competencies that result from underlying cognitive impairments of attention, memory, organization, information processing, problem solving, and executive functions. Traumatic brain injury (TBI) is an acquired, non - progressive condition, resulting in distinct deficits of cognitive communication abilities such as naming, word-finding, self-monitoring, auditory recognition, attention, perception and memory. Cognitive-communication intervention in TBI is individualized, in order to enhance the person’s ability to process and interpret information for better functioning in their family and community life. The present case report illustrates the cognitive-communicative behaviors and the intervention outcomes of an adult with TBI, who was brought to the Department of Audiology and Speech Language Pathology, with cognitive and communicative disturbances, consequent to road traffic accident. On a detailed assessment, she showed naming deficits along with perseverations and had severe difficulty in recalling the details of the accident, her house address, places she had visited earlier, names of people known to her, as well as the activities she did each day, leading to severe breakdowns in her communicative abilities. She had difficulty in initiating, maintaining and following a conversation. She also lacked orientation to time and place. On administration of the Manipal Manual of Cognitive Linguistic Abilities (MMCLA), she exhibited poor performance on tasks related to visual and auditory perception, short term memory, working memory and executive functions. She attended 20 sessions of cognitive-communication intervention which followed a domain-general, adaptive training paradigm, with tasks relevant to everyday cognitive-communication skills. Compensatory strategies such as maintaining a dairy with reminders of her daily routine, names of people, date, time and place was also recommended. MMCLA was re-administered and her performance in the tasks showed significant improvements. Occurrence of perseverations and word retrieval difficulties reduced. She developed interests to initiate her day-to-day activities at home independently, as well as involve herself in conversations with her family members. Though she lacked awareness about her deficits, she actively involved herself in all the therapy activities. Rehabilitation of moderate to severe head injury patients can be done effectively through a holistic cognitive retraining with a focus on different cognitive-linguistic domains. Selection of goals and activities should have relevance to the functional needs of each individual with TBI, as highlighted in the present case report.Keywords: cognitive-communication, executive functions, memory, traumatic brain injury
Procedia PDF Downloads 3472417 Pre-Treatment of Anodic Inoculum with Nitroethane to Improve Performance of a Microbial Fuel Cell
Authors: Rajesh P.P., Md. Tabish Noori, Makarand M. Ghangrekar
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Methanogenic substrate loss is reported to be a major bottleneck in microbial fuel cell which significantly reduces the power production capacity and coulombic efficiency (CE) of microbial fuel cell (MFC). Nitroethane is found to be a potent inhibitor of hydrogenotrophic methanogens in rumen fermentation process. Influence of nitroethane pre-treated sewage sludge inoculum on suppressing the methanogenic activity and enhancing the electrogenesis in MFC was evaluated. MFC inoculated with nitroethane pre-treated anodic inoculum demonstrated a maximum operating voltage of 541 mV, with coulombic efficiency and sustainable volumetric power density of 39.85 % and 14.63 W/m3 respectively. Linear sweep voltammetry indicated a higher electron discharge on the anode surface due to enhancement of electrogenic activity while suppressing methanogenic activity. A 63 % reduction in specific methanogenic activity was observed in anaerobic sludge pre-treated with nitroethane; emphasizing significance of this pretreatment for suppressing methanogenesis and its utility for enhancing electricity generation in MFC.Keywords: coulombic efficiency, methanogenesis inhibition, microbial fuel cell, nitroethane
Procedia PDF Downloads 3182416 Primary Fallopian Tube Carcinoma: A Case Report
Authors: Mary Abigail T. Ty, Mary Jocelyn Yu-Laygo, Jocelyn Z. Mariano
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This is a case of L.S.T., a 61 year old, G6P4 (3124) who presented with a one month history of intermittent, brownish, watery, non foul smelling vaginal discharge. There were no other accompanying symptoms. On rectovaginal examination, a palpable adnexal mass on the left was appreciated, with the lower border measuring 3 cm. The mass was non-tender, had irregular borders and solid areas. On transvaginal sonography, it revealed a left pelvic mass measuring 3 x 4 x 2 cm, with a Sassone score of 9. It had vascularization. The primary consideration was Ovarian Newgrowth, probably malignant in nature. CA-125 results were slightly elevated at 43.2 u/ml (NV: 0-35 u/ml). After intraoperative evaluation, the left fallopian tube was converted into a 9 x 4.5 x 3 cm bulbous cystic mass with solid areas. On cut section, the ampullary portion of the fallopian tube contained necrotic and friable looking tissues. Specimen was sent for frozen section and results revealed adenocarcinoma of the left fallopian tube. Patient subsequently underwent complete surgical staging with unremarkable post-operative course. The Surg Ico pathologic diagnosis was G6P4 (3124) Fallopian tube serous cystadenocarcinoma stage 1. The mean incidence of PFTC is 3.6 per million women yearly. This is associated with a generally low survival rate. The primary diagnosis is very difficult to establish because only 0–10% of patients suffering from PFTC are diagnosed pre-operatively. Symptoms play a very important role in the discovery of this disease, because there will be no presentation to the hospital without symptoms. The most common of which may be vaginal bleeding, abdominal pain, a palpable mass and ascites. A conglomerate of manifestations may be encountered, but not at all times. This is termed hydrops tubae profluens where there is presence of colicky pain with relief from intermittent passage of serosanguinous vaginal discharge. The significance of this report is to emphasize the rarity of the case and how the dilemma in the diagnosis is almost always present despite ancillary procedures.Keywords: fallopian tube carcinoma, prognosis, rare, risk factors
Procedia PDF Downloads 3202415 Type–2 Fuzzy Programming for Optimizing the Heat Rate of an Industrial Gas Turbine via Absorption Chiller Technology
Authors: T. Ganesan, M. S. Aris, I. Elamvazuthi, Momen Kamal Tageldeen
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Terms set in power purchase agreements (PPA) challenge power utility companies in balancing between the returns (from maximizing power production) and securing long term supply contracts at capped production. The production limitation set in the PPA has driven efforts to maximize profits through efficient and economic power production. In this paper, a combined industrial-scale gas turbine (GT) - absorption chiller (AC) system is considered to cool the GT air intake for reducing the plant’s heat rate (HR). This GT-AC system is optimized while considering power output limitations imposed by the PPA. In addition, the proposed formulation accounts for uncertainties in the ambient temperature using Type-2 fuzzy programming. Using the enhanced chaotic differential evolution (CEDE), the Pareto frontier was constructed and the optimization results are analyzed in detail.Keywords: absorption chillers (AC), turbine inlet air cooling (TIC), power purchase agreement (PPA), multiobjective optimization, type-2 fuzzy programming, chaotic differential evolution (CDDE)
Procedia PDF Downloads 3102414 Spontaneous Pneumothorax in Mixed Poisoning Presented as Daisley Barton Syndrome
Authors: A. A. Md. Ryhan Uddin, Swarup Das, Rajesh Barua, Joheb Hasan, Rashedul Islam
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Background: The herbicide has toxicological importance because some of them are associated with high mortality rates due to respiratory failure. Organophosphate poisoning (OPC) & Paraquat self-poisoning is a major clinical and public health problems in low and middle-income countries across much of South Asia. Paraquat was not used as a common suicidal agent previously in Bangladesh. We report a case of 15 years old female admitted to the ER with a history of nausea & vomiting after ingestion of an unknown substance in a suicidal attempt, later identified as mixed poisoning- OPC & Paraquat. She was initially asymptomatic but later developed renal shutdown & lung injuries as well as pneumothorax, referred to as Daisley Barton Syndrome. Objective: This case report aims to alert spontaneous pneumothorax in mixed poisoning on uncommon forms of presentation. Pneumothorax in a patient with paraquat poisoning is a less unusual but underdiagnosed finding. It has a high index of early mortality. Case history: The patient's attendant complained about nausea followed by vomiting, which was nonprojectile & contains undigested food materials first, then gastric juice later. After a few hours, she also complains of urinary retention. Her family members treated her with some home remedies for her initial symptoms, but all attempts failed. After admission, the patient was initially asymptomatic. Through repeated history taking, her attendant showed a bottle of OPC in liquid form, which they suspected that she may have ingested some of the liquid from that bottle accidentally or attempted Suicide. So, management started for OPC poisoning. She responded well initially, but on 4th day of admission, the patient's condition became deteriorating. After the workout with the family member, 2nd bottle of Pesticide was discovered, which was Paraquat. Conclusion: Physicians should be aware of the symptoms of mixed poisoning and the timely use of urine dithionate testing for early detection and treatment. Pneumothorax is an early predictor of mortality in patients with paraquat poisoning.Keywords: pneumothorax, suicide, dithionate, OPC, herbicide
Procedia PDF Downloads 992413 Evaluation of P16, Human Papillomavirus Capsid Protein L1 and Ki67 in Cervical Intraepithelial Lesions: Potential Utility in Diagnosis and Prognosis
Authors: Hanan Alsaeid Alshenawy
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Background: Cervical dysplasia, which is potentially precancerous, has increased in young women. Detection of cervical is important for reducing morbidity and mortality in cervical cancer. This study analyzes the immunohistochemical expression of p16, HPV L1 capsid protein and Ki67 in cervical intraepithelial lesions and correlates them with lesion grade to develop a set of markers for diagnosis and detect the prognosis of cervical cancer precursors. Methods: 75 specimens were analyzed including 15 cases CIN 1, 28 CIN 2, 20 CIN 3, and 12 cervical squamous carcinoma, besides 10 normal cervical tissues. They were stained for p16, HPV L1 and Ki-67. Sensitivity, specificity, predictive values and accuracy were evaluated for each marker. Results: p16 expression increased during the progression from CIN 1 to carcinoma. HPV L1 positivity was detected in CIN 2 and decreased gradually as the CIN grade increased but disappear in carcinoma. Strong Ki-67 expression was observed with high grades CIN and carcinoma. p16, HPV L1 and Ki67 were sensitive but with variable specificity in detecting CIN lesions. Conclusions: p16, HPV L1 and Ki67 are useful set of markers in establishing the risk of high-grade CIN. They complete each other to reach accurate diagnosis and prognosis.Keywords: p16, HPV L1, Ki67, CIN, cervical carcinoma
Procedia PDF Downloads 3412412 The Use of X-Ray Computed Microtomography in Petroleum Geology: A Case Study of Unconventional Reservoir Rocks in Poland
Authors: Tomasz Wejrzanowski, Łukasz Kaczmarek, Michał Maksimczuk
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High-resolution X-ray computed microtomography (µCT) is a non-destructive technique commonly used to determine the internal structure of reservoir rock sample. This study concerns µCT analysis of Silurian and Ordovician shales and mudstones from a borehole in the Baltic Basin, north of Poland. The spatial resolution of the µCT images obtained was 27 µm, which enabled the authors to create accurate 3-D visualizations and to calculate the ratio of pores and fractures volume to the total sample volume. A total of 1024 µCT slices were used to create a 3-D volume of sample structure geometry. These µCT slices were processed to obtain a clearly visible image and the volume ratio. A copper X-ray source filter was used to reduce image artifacts. Due to accurate technical settings of µCT it was possible to obtain high-resolution 3-D µCT images of low X-ray transparency samples. The presented results confirm the utility of µCT implementations in geoscience and show that µCT has still promising applications for reservoir exploration and characterization.Keywords: fractures, material density, pores, structure
Procedia PDF Downloads 2572411 Investigating a Crack in Care: Assessing Long-Term Impacts of Child Abuse and Neglect
Authors: Remya Radhakrishnan, Hema Perinbanathan, Anukriti Rath, Reshmi Ramachandran, Rohith Thazhathuvetil Sasindrababu, Maria Karizhenskaia
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Childhood adversities have lasting effects on health and well-being. This abstract explores the connection between adverse childhood experiences (ACEs) and health consequences, including substance abuse and obesity. Understanding the impact of childhood trauma and emphasizing the importance of culturally sensitive treatments and focused interventions help to mitigate these effects. Research consistently shows a strong link between ACEs and poor health outcomes. Our team conducted a comprehensive literature review of depression and anxiety in Canadian children and youth, exploring diverse treatment methods, including medical, psychotherapy, and alternative therapies like art and music therapy. We searched Medline, Google Scholar, and St. Lawrence College Library. Only original research papers, published between 2012 and 2023, peer-reviewed, and reporting on childhood adversities on health and its treatment methods in children and youth in Canada were considered. We focused on their significance in treating depression and anxiety. According to the study's findings, the prevalence of adverse childhood experiences (ACEs) is still a significant concern. In Canada, 40% of people report having had multiple ACEs, and 78% report having had at least one ACE, highlighting the persistence of childhood adversity and indicating that the issue is unlikely to fade off in the near future. Likewise, findings revealed that individuals who experienced abuse, neglect, or violence during childhood are likelier to engage in harmful behaviors like polydrug use, suicidal ideation, and victimization and suffer from mental health problems such as depression and post-traumatic stress disorder (PTSD).Keywords: adverse childhood experiences (ACEs), obesity, post-traumatic stress disorder (PTSD), resilience, substance abuse, trauma-informed care
Procedia PDF Downloads 1202410 Catamenial Pneumothorax: Report of Two Cases and Review of the Local Literature
Authors: Angeli Marie P. Lagman, Nephtali M. Gorgonio
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Catamenial pneumothorax is defined as a recurrent accumulation of air in the pleural cavity, which occurs in the period of 72 hours before or after menses. In a menstruating woman presenting with the difficulty of breathing and chest pain with concomitant radiographic evidence of pneumothorax, a diagnosis of catamenial pneumothorax should be entertained. Two cases of catamenial pneumothorax were reported in our local literature. This report added two more cases. The first case is 45 years old G1P1, while the second case is 46 years old G2P2. These two patients had a history of pelvic endometriosis in the past. All other signs and symptoms were similar to the previously reported cases. All patients presented with difficulty of breathing associated with chest pain. Imaging studies showed right-sided pneumothorax in all patients. Intraoperatively, subpleural bleb, diaphragmatic fenestrations, and endometriotic implants were found. Three patients underwent video-assisted thoracosurgery (VATS), while one patient underwent open thoracotomy with pleurodesis. Histopathology revealed endometriosis in only two patients. All patients received postoperative hormonal therapy, and there were no recurrences noted in all patients. Endometriosis-related catamenial pneumothorax is a rare condition that needs early recognition of the symptoms. Several theories may be involved to explain the pathogenesis of catamenial pneumothorax. Two cases show a strong significant association between a history of pelvic endometriosis and the development of catamenial pneumothorax, while one case can be explained by the hormonal theory. The difficulty of breathing and chest pain in relation to menses may prompt early diagnosis. One case has shown that pneumothorax may occur even after menstruation. A biopsy of the endometrial implants may not always show endometrial glands and stroma, nor will immunostaining, which will not always show estrogen and progesterone receptors. Video-assisted thoracoscopic surgery is the gold standard in the diagnosis and treatment of catamenial pneumothorax. Postoperative hormonal suppression will further reduce the disease recurrence and facilitate the effectiveness of the surgical treatment.Keywords: catamenial pneumothorax, endometriosis, menstruation, video assisted thoracosurgery
Procedia PDF Downloads 1052409 Utility of Routine Colonoscopy in Acute Diverticulitis
Authors: Naya Masood, Russell Hodgson, Mark Tacey
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Purpose: Patients with acute diverticulitis (AD) have an increased risk of underlying colorectal cancer (CRC); however, those with uncomplicated AD may have the same underlying population risk. This study informs on an Australian AD population who were not routinely offered colonoscopic follow-up. Methods: A 2-year (July 2016 – June 2018) retrospective study of patients admitted with CT-confirmed acute diverticulitis was conducted. CT findings were categorised as ‘complicated’ and ‘uncomplicated’ and were correlated with the detection of cancer in subsequent colonoscopy or follow-up. Results: 67.7% (n=292) of 431 patients were seen to have had complicated AD on an abdominopelvic CT scan. Patients were complicated most commonly due to bowel wall thickening reported on CT (90.4%), perforation (20.2%), or an abscess (12%). Follow-up colonoscopic evaluation was conducted in 52.9% (n=228) of total cases of AD, out of which 156 suffered complicated AD and the rest uncomplicated. None of the uncomplicated AD patients in our cohort were found to have CRC. Of those with complicated AD, six were found to have CRC. Conclusion: The only CRC diagnoses were made in patients with complicated AD. Despite available evidence, a significant proportion of uncomplicated AD patients were still undergoing colonoscopy. There is scope to further safely decrease the number of colonoscopies performed in AD patients.Keywords: acute diverticulitis, colonoscopy, colorectal cancer, advanced adenoma, complicated diverticulitis
Procedia PDF Downloads 942408 Improvement of the 3D Finite Element Analysis of High Voltage Power Transformer Defects in Time Domain
Authors: M. Rashid Hussain, Shady S. Refaat
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The high voltage power transformer is the most essential part of the electrical power utilities. Reliability on the transformers is the utmost concern, and any failure of the transformers can lead to catastrophic losses in electric power utility. The causes of transformer failure include insulation failure by partial discharge, core and tank failure, cooling unit failure, current transformer failure, etc. For the study of power transformer defects, finite element analysis (FEA) can provide valuable information on the severity of defects. FEA provides a more accurate representation of complex geometries because they consider thermal, electrical, and environmental influences on the insulation models to obtain basic characteristics of the insulation system during normal and partial discharge conditions. The purpose of this paper is the time domain analysis of defects 3D model of high voltage power transformer using FEA to study the electric field distribution at different points on the defects.Keywords: power transformer, finite element analysis, dielectric response, partial discharge, insulation
Procedia PDF Downloads 1572407 Research on Contract's Explicit Incentive and Reputation's Implicit Incentive Mechanism towards Construction Contractors
Authors: Li Ma, Meishuang Ma, Mengying Huang
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The quality of construction projects reflects the credit and responsibilities of construction contractors for the owners and the whole society. Because the construction contractors master more relevant information about the entrusted engineering project under construction while the owners are in unfavorable position of gaining information, asymmetric information may lead the contractors act against the owners in order to pursue their own interests. Building a powerful motivation mechanism is the key to guarantee investor economic interests and the life and property of users in construction projects. Based on principal-agent theory and game theory, the authors develop relevant mathematical models to analyze and compare the contractor’s utility functions under different combinations of contracts’ explicit incentive mechanism and reputation’s implicit incentive mechanism aiming at finding out the conditions for incentive validity. The research concludes that the most rational motivation way is to combine the explicit and implicit incentive effects of both contracts and reputation mechanism, and puts forth some measures for problems on account of China’s current situation.Keywords: construction contractors, contract, reputation, incentive mechanism
Procedia PDF Downloads 5092406 Pet Care Monitoring with Arduino
Authors: Sathapath Kilaso
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Nowadays people who live in the city tend to have a pet in order to relief the loneliness more than usual. It can be observed by the growth of the local pet industry. But the essentials of lifestyle of the urban people which is restricted by time and work might not allow the owner to take care of the pet properly. So this article will be about how to develop the prototype of pet care monitoring with Arduino Microcontroller. This prototype can be used to monitor the pet and its environment around the pet such as temperature (both pet’s temperature and outside temperature), humidity, food’s quantity, air’s quality and also be able to reduce the stress of the pet. This prototype can report the result back to the owner via online-channel such as website etc.Keywords: pet care, Arduino Microcontroller, monitoring, prototype
Procedia PDF Downloads 3582405 The Effect of Smart-Nano Materials in Thermal Retrofit of Healthcare Envelope Layout in Desert Climate: A Case Study on Semnan
Authors: Foroozan Sadri, Mohammadmehdi Moulaii, Farkhondeh Vahdati
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Smart materials can create a great revolution in our built environment, as living systems do. In this research, the optimal structure of healthcare building envelopes is analyzed in terms of thickness according to the utility of the smart-nano materials as nontoxic substances in the region. The research method in this paper is based on library studies and simulation. Grasshopper program is employed to simulate thermal characteristics to achieve the optimum U-value in Semnan desert climate, according to Iranian national standards. The potential of healthcare envelope layouts in thermal properties development (primarily U-value) of these buildings is discussed due to the high thermal loads of healthcare buildings and also toxicity effects of conventional materials. As a result, envelope thicknesses are calculated, and the performance of the nano-PCM and gypsum wallboards are compared. A solution with comparable performance using smart-nano materials instead of conventional materials would determine a decrease in wall thickness.Keywords: energy saving, exterior envelope, smart-nano materials, thermal performance, U-value
Procedia PDF Downloads 1702404 Non-Standard Forms of Reporting Domestic Violence: Analysis of the Phenomenon in the Perception of Operators of the Polish Emergency Number 112 and Polish Society
Authors: Joanna Kufel-Orlowska
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Domestic violence is a social threat to public safety and order. It poses a threat not only to the family members of the perpetrator but also disturbs the functioning of society and even the state. In a situation of danger, an individual either defends himself or/and calls for help by contacting an appropriate institution whose aim is to ensure civil security. Most often, such contact takes place through a telephone conversation, which is aimed at diagnosing the problem and prompt intervention. People in different situations and in different ways, despite the general reporting standards, try to inform about the need for help. The article aims to present the results of research on non-standard forms of reporting domestic violence in the opinion of the Polish society and operators of the Polish emergency number 112 (911). The research was conducted in the form of a survey technique on a sample of 160 operators (purposeful selection) and 300 people living in Poland (random selection). The research was conducted in the form of online surveys. The study found that in Poland: 1. emergency number operators often receive reports of domestic violence although they are not always able to diagnose whether the case is strictly about violence; 2. non-standard reports of domestic violence are received by about 30% of emergency number operators. Non-standard should be understood as reports of violence that deviate from the norm, are unusual, or are reported by a non-victim. 3. The most common forms of reporting violence not directly are: pretending to talk to a friend, calling a cab, making an appointment with a dentist/doctor, calling a store and helping with the selection of goods, asking about the bank's hotline, not speaking (in order for the emergency number operator to hear what is going on). 4. Emergency number operators in Poland are properly trained and are able to recognize the threatening situation of the reporting party and conduct the conversation in a safe manner for the reporting party. On the other hand, Polish people support the ability to report violence in a non-standard way and would do so themselves in the event of a threat to their own life, health, or property, thus expecting the emergency number operator to recognize a report and help us.Keywords: domestic violence, operator of the emergency number 112 (911), emergency call center, reporting domestic violence
Procedia PDF Downloads 1052403 Grid-Connected Inverter Experimental Simulation and Droop Control Implementation
Authors: Nur Aisyah Jalalludin, Arwindra Rizqiawan, Goro Fujita
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In this study, we aim to demonstrate a microgrid system experimental simulation for an easy understanding of a large-scale microgrid system. This model is required for industrial training and learning environments. However, in order to create an exact representation of a microgrid system, the laboratory-scale system must fulfill the requirements of a grid-connected inverter, in which power values are assigned to the system to cope with the intermittent output from renewable energy sources. Aside from that, during changes in load capacity, the grid-connected system must be able to supply power from the utility grid side and microgrid side in a balanced manner. Therefore, droop control is installed in the inverter’s control board to maintain equal power sharing in both sides. This power control in a stand-alone condition and droop control in a grid-connected condition must be implemented in order to maintain a stabilized system. Based on the experimental results, power control and droop control can both be applied in the system by comparing the experimental and reference values.Keywords: droop control, droop characteristic, grid-connected inverter, microgrid, power control
Procedia PDF Downloads 8862402 Corporate Sustainability Practices in Asian Countries: Pattern of Disclosure and Impact on Financial Performance
Authors: Santi Gopal Maji, R. A. J. Syngkon
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The changing attitude of the corporate enterprises from maximizing economic benefit to corporate sustainability after the publication of Brundtland Report has attracted the interest of researchers to investigate the sustainability practices of firms and its impact on financial performance. To enrich the empirical literature in Asian context, this study examines the disclosure pattern of corporate sustainability and the influence of sustainability reporting on financial performance of firms from four Asian countries (Japan, South Korea, India and Indonesia) that are publishing sustainability report continuously from 2009 to 2016. The study has used content analysis technique based on Global Reporting Framework (3 and 3.1) reporting framework to compute the disclosure score of corporate sustainability and its components. While dichotomous coding system has been employed to compute overall quantitative disclosure score, a four-point scale has been used to access the quality of the disclosure. For analysing the disclosure pattern of corporate sustainability, box plot has been used. Further, Pearson chi-square test has been used to examine whether there is any difference in the proportion of disclosure between the countries. Finally, quantile regression model has been employed to examine the influence of corporate sustainability reporting on the difference locations of the conditional distribution of firm performance. The findings of the study indicate that Japan has occupied first position in terms of disclosure of sustainability information followed by South Korea and India. In case of Indonesia, the quality of disclosure score is considerably less as compared to other three countries. Further, the gap between the quality and quantity of disclosure score is comparatively less in Japan and South Korea as compared to India and Indonesia. The same is evident in respect of the components of sustainability. The results of quantile regression indicate that a positive impact of corporate sustainability becomes stronger at upper quantiles in case of Japan and South Korea. But the study fails to extricate any definite pattern on the impact of corporate sustainability disclosure on the financial performance of firms from Indonesia and India.Keywords: corporate sustainability, quality and quantity of disclosure, content analysis, quantile regression, Asian countries
Procedia PDF Downloads 1942401 Performance Evaluation of Grid Connected Photovoltaic System
Authors: Abdulkadir Magaji
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This study analyzes and compares the actual measured and simulated performance of a 3.2 kwP grid-connected photovoltaic system. The system is located at the Outdoor Facility of Government Day secondary School Katsina State, which lies approximately between coordinate of 12°15′N 7°30′E. The system consists of 14 Mono crystalline silicon modules connected in two strings of 7 series-connected modules, each facing north at a fixed tilt of 340. The data presented in this study were measured in the year 2015, where the system supplied a total of 4628 kWh to the local electric utility grid. The performance of the system was simulated using PVsyst software using measured and Meteonorm derived climate data sets (solar radiation, ambient temperature and wind speed). The comparison between measured and simulated energy yield are discussed. Although, both simulation results were similar, better comparison between measured and predicted monthly energy yield is observed with simulation performed using measured weather data at the site. The measured performance ratio in the present study shows 58.4% is higher than those reported elsewhere as compared in the study.Keywords: performance, evaluation, grid connection, photovoltaic system
Procedia PDF Downloads 1812400 Conceptual Design of Suction Cup Lifting System
Authors: Mohammed Aijaz
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In industries, to transfer fragile materials like glasses, a holding, lifting, and manipulation system are required. In this report, we designed and analysed a suction cup holding, lifting, and manipulation system that is attached to a head plate and must be able to grip/hold securely, the largest glass panel with 3m x 2.5m x 20mm thick with a mass of 115 kg. The system is able to rotate the panel through 180 degrees in the X, Y, and Z axis in any direction from the outer reach of the robotic arm. The structural analysis is performed to verify the structural strength of the suction cup’s head plate system.Keywords: designing, mechanical, engineering, suction
Procedia PDF Downloads 962399 A Study on the Small Biped Soft Robot with Two Insect-Like Nails
Authors: Mami Nishida
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This paper presented a study on the development and control of a small biped soft robot using shape memory alloys (SMAs). Author proposed a flexible flat plate (FFP) actuators consisting of a thin polyethylene plate and SMAs. This actuator has a nail like an insect. This robot moves from the front to back and from left to right using two nails. The walking robot has two degrees of freedom and is controlled by switching the ON-OFF current signals to the SMA based FFPs. The resulting small biped soft robot weighs a mere 4.7 g (with a height of 67 mm). The small robot realizes biped walking by transferring the elastic potential energy (generated by deflections of the SMA based FFPs) to kinematic energy. Experimental results demonstrated the viability and utility of the small biped soft robot with the proposed SMA-based FFPs and the control strategy to achieve walking behavior.Keywords: biped soft robot with nails, flexible flat plate (FFP) actuators, ON-OFF control strategy, shape memory alloys (SMA)
Procedia PDF Downloads 5022398 Lessons from Seven Years of Teaching Mindfulness to Children Living in a Context of Vulnerability
Authors: Annie Devault
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Mindfulness-based interventions (MBI) can be beneficial for the well-being of children. MBIs offered for children in contexts of vulnerability (poverty, neglect) report positive results in terms of emotion regulation and cognitive flexibility. Anxiety is a common issue for children living in a vulnerable context. It has a negative impact on children’s attention span, emotional regulation and self-esteem. The MBI (12 weeks) associated with this research has been developed for a total of 30 children suffering from anxiety (7 to 9 years old) and receiving services from a community center over the last seven years. The first objective is to describe in details the content of the mindfulness-based intervention. The second purpose is to document what helps and what hinders the practice of mindfulness for children living in a context of vulnerability. A special attention will be given to the importance of the way that the intervention is offered and the principles that are followed by the practitioners. Perceived effects of the intervention on children were collected through an individual semi-structured interview with each child at the end of the program. Parents were also interviewed to have their point of view on the effect of their children’s participation in the group. Anxiety was measure with the Beck youth pre-post and at follow up (2 months). Qualitative analysis of the interviews with children showed that most of them mentioned that the program helped them become calmer, more confident, less scared and more able to deal with difficult emotions. Almost all of them reported having used the material provided to them to practice at home. This result has been confirmed by parents. They reported that their child had gained confidence and were better at verbalizing emotions. Children also grew calmer, even though all anxiety was not gone. They would have liked more material to practice at home. The quantitative instrument used to measure anxiety did not corroborate the qualitative interviews about anxiety. Discussion will question the use of this questionnaire for children who have important cognitive limitations. Discussion will also report the importance of the personalized contact with children, along with other consideration, to enhance the adherence of children and parents. The MBI seems to have benefited children in different ways, which is corroborated by most parents. Since the sample was limited, we will need to continue documenting its effects with more children and parents. The major strength of this research is to have reported the subjective perspectives of children on their experience of mindfulness.Keywords: anxiety, mindfulness, children, best practices
Procedia PDF Downloads 1132397 LYRM7-Associated Mitochondrial Complex III Deficiency with Non-Cavitating Leukoencephalopathy and Stroke-Like Episodes
Authors: Rita Alfattal, Maryam Alfarhan, Adeeb M. Algaith, Buthaina Albash, Reem M. Elshafie, Asma Alshammari, Ahmad Alahmad, Fatima Dashti, Rasha Alsafi, Hind Alsharhan
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Defects of respiratory chain complex III (CIII) result in characteristic but rare mitochondrial disorders associated with distinct neuroradiological findings. The underlying molecular defects affecting mitochondrial CIII assembly factors are few and yet to be identified. LYRM7 assembly factor is required for proper CIII assembly where it acts as a chaperone for the Rieske iron‐sulfur (UQCRFS1) protein in the mitochondrial matrix and stabilizing it. We present here the seventeenth individual with LYRM7-associated mitochondrial leukoencephalopathy harboring a previously reported rare pathogenic homozygous LYRM 7 variant, c.2T>C, (p.Met1?). Like previously reported individuals, our 4-year-old male proband presented with recurrent metabolic and lactic acidosis, encephalopathy, and myopathy. Further, he has additional, previously unreported features, including an acute stroke like episode with bilateral central blindness and optic neuropathy, recurrent hyperglycemia and hypertension associated with metabolic crisis. However, he has no signs of psychomotor regression. He has been stable clinically with residual left-sided reduced visual acuity and amblyopia, and no more metabolic crises for 2-year-period while on the mitochondrial cocktail. Although the reported brain MRI findings in other affected individuals are homogenous, it is slightly different in our index, revealing evidence of bilateral almost symmetric multifocal periventricular T2 hyperintensities with hyperintensities of the optic nerves, optic chiasm, and corona radiata but with no cavitation or cystic changes. This report describes new clinical and radiological findings of LYRM7-associated disease. The report also summarizes the clinical and molecular data of previously reported individuals describing the full phenotypic spectrum.Keywords: LYRM7 gene defect, mitochondrial disease, , lactic acidosis, , genetic disorder
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