Search results for: clinical trial optimization
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7524

Search results for: clinical trial optimization

6954 Optimization of Reinforced Concrete Buildings According to the Algerian Seismic Code

Authors: Nesreddine Djafar Henni, Nassim Djedoui, Rachid Chebili

Abstract:

Recent decades have witnessed significant efforts being made to optimize different types of structures and components. The concept of cost optimization in reinforced concrete structures, which aims at minimizing financial resources while ensuring maximum building safety, comprises multiple materials, and the objective function for their optimal design is derived from the construction cost of the steel as well as concrete that significantly contribute to the overall weight of reinforced concrete (RC) structures. To achieve this objective, this work has been devoted to optimizing the structural design of 3D RC frame buildings which integrates, for the first time, the Algerian regulations. Three different test examples were investigated to assess the efficiency of our work in optimizing RC frame buildings. The hybrid GWOPSO algorithm is used, and 30000 generations are made. The cost of the building is reduced by iteration each time. Concrete and reinforcement bars are used in the building cost. As a result, the cost of a reinforced concrete structure is reduced by 30% compared with the initial design. This result means that the 3D cost-design optimization of the framed structure is successfully achieved.

Keywords: optimization, automation, API, Malab, RC structures

Procedia PDF Downloads 49
6953 A Metaheuristic Approach for the Pollution-Routing Problem

Authors: P. Parthiban, Sonu Rajak, R. Dhanalakshmi

Abstract:

This paper presents an Ant Colony Optimization (ACO) approach, combined with a Speed Optimization Algorithm (SOA) to solve the Vehicle Routing Problem (VRP) with environmental considerations, which is well known as Pollution-Routing Problem (PRP). It consists of routing a number of vehicles to serve a set of customers, and determining fuel consumption, driver wages and their speed on each route segment, while respecting the capacity constraints and time windows. Since VRP is NP-hard problem, so PRP also a NP-hard problem, which requires metaheuristics to solve this type of problems. The proposed solution method consists of two stages. Stage one is to solve a Vehicle Routing Problem with Time Window (VRPTW) using ACO and in the second stage, a SOA is run on the resulting VRPTW solution. Given a vehicle route, the SOA consists of finding the optimal speed on each arc of the route to minimize an objective function comprising fuel consumption costs and driver wages. The proposed algorithm tested on benchmark problem, the preliminary results show that the proposed algorithm can provide good solutions within reasonable computational time.

Keywords: ant colony optimization, CO2 emissions, speed optimization, vehicle routing

Procedia PDF Downloads 360
6952 Creatine Associated with Resistance Training Increases Muscle Mass in the Elderly

Authors: Camila Lemos Pinto, Juliana Alves Carneiro, Patrícia Borges Botelho, João Felipe Mota

Abstract:

Sarcopenia, a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, currently affects over 50 million people and increases the risk of adverse outcomes such as physical disability, poor quality of life and death. The aim of this study was to examine the efficacy of creatine supplementation associated with resistance training on muscle mass in the elderly. A 12-week, double blind, randomized, parallel group, placebo controlled trial was conducted. Participants were randomly allocated into one of the following groups: placebo with resistance training (PL+RT, n=14) and creatine supplementation with resistance training (CR + RT, n=13). The subjects from CR+RT group received 5 g/day of creatine monohydrate and the subjects from the PL+RT group were given the same dose of maltodextrin. Participants were instructed to ingest the supplement on non-training days immediately after lunch and on training days immediately after resistance training sessions dissolved in a beverage comprising 100 g of maltodextrin lemon flavored. Participants of both groups undertook a supervised exercise training program for 12 weeks (3 times per week). The subjects were assessed at baseline and after 12 weeks. The primary outcome was muscle mass, assessed by dual energy X-ray absorptiometry (DXA). The secondary outcome included diagnose participants with one of the three stages of sarcopenia (presarcopenia, sarcopenia and severe sarcopenia) by skeletal muscle mass index (SMI), handgrip strength and gait speed. CR+RT group had a significant increase in SMI and muscle (p<0.0001), a significant decrease in android and gynoid fat (p = 0.028 and p=0.035, respectively) and a tendency of decreasing in body fat (p=0.053) after the intervention. PL+RT only had a significant increase in SMI (p=0.007). The main finding of this clinical trial indicated that creatine supplementation combined with resistance training was capable of increasing muscle mass in our elderly cohort (p=0.02). In addition, the number of subjects diagnosed with one of the three stages of sarcopenia at baseline decreased in the creatine supplemented group in comparison with the placebo group (CR+RT, n=-3; PL+RT, n=0). In summary, 12 weeks of creatine supplementation associated with resistance training resulted in increases in muscle mass. This is the first research with elderly of both sexes that show the same increase in muscle mass with a minor quantity of creatine supplementation in a short period. Future long-term research should investigate the effects of these interventions in sarcopenic elderly.

Keywords: creatine, dietetic supplement, elderly, resistance training

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6951 Groundwater Level Prediction Using hybrid Particle Swarm Optimization-Long-Short Term Memory Model and Performance Evaluation

Authors: Sneha Thakur, Sanjeev Karmakar

Abstract:

This paper proposed hybrid Particle Swarm Optimization (PSO) – Long-Short Term Memory (LSTM) model for groundwater level prediction. The evaluation of the performance is realized using the parameters: root mean square error (RMSE) and mean absolute error (MAE). Ground water level forecasting will be very effective for planning water harvesting. Proper calculation of water level forecasting can overcome the problem of drought and flood to some extent. The objective of this work is to develop a ground water level forecasting model using deep learning technique integrated with optimization technique PSO by applying 29 years data of Chhattisgarh state, In-dia. It is important to find the precise forecasting in case of ground water level so that various water resource planning and water harvesting can be managed effectively.

Keywords: long short-term memory, particle swarm optimization, prediction, deep learning, groundwater level

Procedia PDF Downloads 78
6950 Visual Improvement with Low Vision Aids in Children with Stargardt’s Disease

Authors: Anum Akhter, Sumaira Altaf

Abstract:

Purpose: To study the effect of low vision devices i.e. telescope and magnifying glasses on distance visual acuity and near visual acuity of children with Stargardt’s disease. Setting: Low vision department, Alshifa Trust Eye Hospital, Rawalpindi, Pakistan. Methods: 52 children having Stargardt’s disease were included in the study. All children were diagnosed by pediatrics ophthalmologists. Comprehensive low vision assessment was done by me in Low vision clinic. Visual acuity was measured using ETDRS chart. Refraction and other supplementary tests were performed. Children with Stargardt’s disease were provided with different telescopes and magnifying glasses for improving far vision and near vision. Results: Out of 52 children, 17 children were males and 35 children were females. Distance visual acuity and near visual acuity improved significantly with low vision aid trial. All children showed visual acuity better than 6/19 with a telescope of higher magnification. Improvement in near visual acuity was also significant with magnifying glasses trial. Conclusions: Low vision aids are useful for improvement in visual acuity in children. Children with Stargardt’s disease who are having a problem in education and daily life activities can get help from low vision aids.

Keywords: Stargardt, s disease, low vision aids, telescope, magnifiers

Procedia PDF Downloads 539
6949 Morphology Optimization and Photophysics Study in Air-Processed Perovskite Solar Cells

Authors: Soumitra Satapathi, Anubhav Raghav

Abstract:

Perovskite solar cell technology has passed through a phase of unprecedented growth in the efficiency scale from 3.8% to above 22% within a half decade. This technology has drawn tremendous research interest. It has been observed that performances of perovskite based solar cells are extremely dependent on the morphology and crystallinity of the perovskite layer. It has also been observed that device lifetime depends on the perovskite morphology; devices with larger perovskite grains degrade slowly than those of the smaller ones. Various methods of perovskite growth have been applied to achieve the most appropriate morphology necessary for high efficient solar cells. The recent progress in morphology optimization by various methods emphasizing on grain sizes, stoichiometry, and ambient compatibility as well as photophysics study in air-processed perovskite solar cells will be discussed.

Keywords: perovskite solar cells, morphology optimization, photophysics study, air-processed solar cells

Procedia PDF Downloads 164
6948 Structural Development and Multiscale Design Optimization of Additively Manufactured Unmanned Aerial Vehicle with Blended Wing Body Configuration

Authors: Malcolm Dinovitzer, Calvin Miller, Adam Hacker, Gabriel Wong, Zach Annen, Padmassun Rajakareyar, Jordan Mulvihill, Mostafa S.A. ElSayed

Abstract:

The research work presented in this paper is developed by the Blended Wing Body (BWB) Unmanned Aerial Vehicle (UAV) team, a fourth-year capstone project at Carleton University Department of Mechanical and Aerospace Engineering. Here, a clean sheet UAV with BWB configuration is designed and optimized using Multiscale Design Optimization (MSDO) approach employing lattice materials taking into consideration design for additive manufacturing constraints. The BWB-UAV is being developed with a mission profile designed for surveillance purposes with a minimum payload of 1000 grams. To demonstrate the design methodology, a single design loop of a sample rib from the airframe is shown in details. This includes presentation of the conceptual design, materials selection, experimental characterization and residual thermal stress distribution analysis of additively manufactured materials, manufacturing constraint identification, critical loads computations, stress analysis and design optimization. A dynamic turbulent critical load case was identified composed of a 1-g static maneuver with an incremental Power Spectral Density (PSD) gust which was used as a deterministic design load case for the design optimization. 2D flat plate Doublet Lattice Method (DLM) was used to simulate aerodynamics in the aeroelastic analysis. The aerodynamic results were verified versus a 3D CFD analysis applying Spalart-Allmaras and SST k-omega turbulence to the rigid UAV and vortex lattice method applied in the OpenVSP environment. Design optimization of a single rib was conducted using topology optimization as well as MSDO. Compared to a solid rib, weight savings of 36.44% and 59.65% were obtained for the topology optimization and the MSDO, respectively. These results suggest that MSDO is an acceptable alternative to topology optimization in weight critical applications while preserving the functional requirements.

Keywords: blended wing body, multiscale design optimization, additive manufacturing, unmanned aerial vehicle

Procedia PDF Downloads 375
6947 Reducing the Computational Overhead of Metaheuristics Parameterization with Exploratory Landscape Analysis

Authors: Iannick Gagnon, Alain April

Abstract:

The performance of a metaheuristic on a given problem class depends on the class itself and the choice of parameters. Parameter tuning is the most time-consuming phase of the optimization process after the main calculations and it often nullifies the speed advantage of metaheuristics over traditional optimization algorithms. Several off-the-shelf parameter tuning algorithms are available, but when the objective function is expensive to evaluate, these can be prohibitively expensive to use. This paper presents a surrogate-like method for finding adequate parameters using fitness landscape analysis on simple benchmark functions and real-world objective functions. The result is a simple compound similarity metric based on the empirical correlation coefficient and a measure of convexity. It is then used to find the best benchmark functions to serve as surrogates. The near-optimal parameter set is then found using fractional factorial design. The real-world problem of NACA airfoil lift coefficient maximization is used as a preliminary proof of concept. The overall aim of this research is to reduce the computational overhead of metaheuristics parameterization.

Keywords: metaheuristics, stochastic optimization, particle swarm optimization, exploratory landscape analysis

Procedia PDF Downloads 153
6946 Electrochemical Bioassay for Haptoglobin Quantification: Application in Bovine Mastitis Diagnosis

Authors: Soledad Carinelli, Iñigo Fernández, José Luis González-Mora, Pedro A. Salazar-Carballo

Abstract:

Mastitis is the most relevant inflammatory disease in cattle, affecting the animal health and causing important economic losses on dairy farms. This disease takes place in the mammary gland or udder when some opportunistic microorganisms, such as Staphylococcus aureus, Streptococcus agalactiae, Corynebacterium bovis, etc., invade the teat canal. According to the severity of the inflammation, mastitis can be classified as sub-clinical, clinical and chronic. Standard methods for mastitis detection include counts of somatic cells, cell culture, electrical conductivity of the milk, and California test (evaluation of “gel-like” matrix consistency after cell lysed with detergents). However, these assays present some limitations for accurate detection of subclinical mastitis. Currently, haptoglobin, an acute phase protein, has been proposed as novel and effective biomarker for mastitis detection. In this work, an electrochemical biosensor based on polydopamine-modified magnetic nanoparticles (MNPs@pDA) for haptoglobin detection is reported. Thus, MNPs@pDA has been synthesized by our group and functionalized with hemoglobin due to its high affinity to haptoglobin protein. The protein was labeled with specific antibodies modified with alkaline phosphatase enzyme for its electrochemical detection using an electroactive substrate (1-naphthyl phosphate) by differential pulse voltammetry. After the optimization of assay parameters, the haptoglobin determination was evaluated in milk. The strategy presented in this work shows a wide range of detection, achieving a limit of detection of 43 ng/mL. The accuracy of the strategy was determined by recovery assays, being of 84 and 94.5% for two Hp levels around the cut off value. Milk real samples were tested and the prediction capacity of the electrochemical biosensor was compared with a Haptoglobin commercial ELISA kit. The performance of the assay has demonstrated this strategy is an excellent and real alternative as screen method for sub-clinical bovine mastitis detection.

Keywords: bovine mastitis, haptoglobin, electrochemistry, magnetic nanoparticles, polydopamine

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6945 Embolization of Spinal Dural Arteriovenous Fistulae: Clinical Outcomes and Long-Term Follow-Up: A Multicenter Study

Authors: Walid Abouzeid, Mohamed Shadad, Mostafa Farid, Magdy El Hawary

Abstract:

The most frequent treatable vascular abnormality of the spinal canal is spinal dural arteriovenous fistulae (SDAVFs), which cause progressive para- or quadriplegia mostly affecting elderly males. SDAVFs are present in the thoracolumbar region. The main goal of treatment must be to obliterate the shunting zone via superselective embolization with the usage of a liquid embolic agent. This study aims to evaluate endovascular technique as a safe and efficient approach for the treatment SDAVFs, especially with long-term follow-up clinical outcomes. Study Design: A retrospective clinical case study. From May 2010 to May 2017, 15 patients who had symptoms attributed to SDAVFs underwent the operation in the Departments of Neurosurgery in Suhag, Tanta, and Al-Azhar Universities and Interventional Radiology, Ain Shams University. All the patients had varying degrees of progressive spastic paraparesis with and without sphincteric disturbances. Endovascular embolization was used in all cases. Fourteen were males, with ages ranging from 45 to 74 years old. After the treatment, good outcome was found in five patients (33.3%), a moderate outcome was delineated in six patients (40 %), and four patients revealed a poor outcome (26.7%). Spinal AVF could be treated safely and effectively by the endovascular approach. Generally, there is no correlation between the disappearance of MRI abnormalities and significant clinical improvement. The preclinical state of the patient is directly proportional to the clinical outcome. Due to unexpected responses, embolization should be attempted even the patient is in a bad clinical condition.

Keywords: spine, arteriovenous, fistula, endovascular, embolization

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6944 A Biomimetic Approach for the Multi-Objective Optimization of Kinetic Façade Design

Authors: Do-Jin Jang, Sung-Ah Kim

Abstract:

A kinetic façade responds to user requirements and environmental conditions.  In designing a kinetic façade, kinetic patterns play a key role in determining its performance. This paper proposes a biomimetic method for the multi-objective optimization for kinetic façade design. The autonomous decentralized control system is combined with flocking algorithm. The flocking agents are autonomously reacting to sensor values and bring about kinetic patterns changing over time. A series of experiments were conducted to verify the potential and limitations of the flocking based decentralized control. As a result, it could show the highest performance balancing multiple objectives such as solar radiation and openness among the comparison group.

Keywords: biomimicry, flocking algorithm, autonomous decentralized control, multi-objective optimization

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6943 Optimal Allocation of Distributed Generation Sources for Loss Reduction and Voltage Profile Improvement by Using Particle Swarm Optimization

Authors: Muhammad Zaheer Babar, Amer Kashif, Muhammad Rizwan Javed

Abstract:

Nowadays distributed generation integration is best way to overcome the increasing load demand. Optimal allocation of distributed generation plays a vital role in reducing system losses and improves voltage profile. In this paper, a Meta heuristic technique is proposed for allocation of DG in order to reduce power losses and improve voltage profile. The proposed technique is based on Multi Objective Particle Swarm optimization. Fewer control parameters are needed in this algorithm. Modification is made in search space of PSO. The effectiveness of proposed technique is tested on IEEE 33 bus test system. Single DG as well as multiple DG scenario is adopted for proposed method. Proposed method is more effective as compared to other Meta heuristic techniques and gives better results regarding system losses and voltage profile.

Keywords: Distributed generation (DG), Multi Objective Particle Swarm Optimization (MOPSO), particle swarm optimization (PSO), IEEE standard Test System

Procedia PDF Downloads 454
6942 Collaborative Energy Optimization for Multi-Microgrid Distribution System Based on Two-Stage Game Approach

Authors: Hanmei Peng, Yiqun Wang, Mao Tan, Zhuocen Dai, Yongxin Su

Abstract:

Efficient energy management in multi-microgrid distribution systems holds significant importance for enhancing the economic benefits of regional power grids. To better balance conflicts among various stakeholders, a two-stage game-based collaborative optimization approach is proposed in this paper, effectively addressing the realistic scenario involving both competition and collaboration among stakeholders. The first stage, aimed at maximizing individual benefits, involves constructing a non-cooperative tariff game model for the distribution network and surplus microgrid. In the second stage, considering power flow and physical line capacity constraints we establish a cooperative P2P game model for the multi-microgrid distribution system, and the optimization involves employing the Lagrange method of multipliers to handle complex constraints. Simulation results demonstrate that the proposed approach can effectively improve the system economics while harmonizing individual and collective rationality.

Keywords: cooperative game, collaborative optimization, multi-microgrid distribution system, non-cooperative game

Procedia PDF Downloads 70
6941 A New Conjugate Gradient Method with Guaranteed Descent

Authors: B. Sellami, M. Belloufi

Abstract:

Conjugate gradient methods are an important class of methods for unconstrained optimization, especially for large-scale problems. Recently, they have been much studied. In this paper, we propose a new two-parameter family of conjugate gradient methods for unconstrained optimization. The two-parameter family of methods not only includes the already existing three practical nonlinear conjugate gradient methods, but also has other family of conjugate gradient methods as subfamily. The two-parameter family of methods with the Wolfe line search is shown to ensure the descent property of each search direction. Some general convergence results are also established for the two-parameter family of methods. The numerical results show that this method is efficient for the given test problems. In addition, the methods related to this family are uniformly discussed.

Keywords: unconstrained optimization, conjugate gradient method, line search, global convergence

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6940 Grey Wolf Optimization Technique for Predictive Analysis of Products in E-Commerce: An Adaptive Approach

Authors: Shital Suresh Borse, Vijayalaxmi Kadroli

Abstract:

E-commerce industries nowadays implement the latest AI, ML Techniques to improve their own performance and prediction accuracy. This helps to gain a huge profit from the online market. Ant Colony Optimization, Genetic algorithm, Particle Swarm Optimization, Neural Network & GWO help many e-commerce industries for up-gradation of their predictive performance. These algorithms are providing optimum results in various applications, such as stock price prediction, prediction of drug-target interaction & user ratings of similar products in e-commerce sites, etc. In this study, customer reviews will play an important role in prediction analysis. People showing much interest in buying a lot of services& products suggested by other customers. This ultimately increases net profit. In this work, a convolution neural network (CNN) is proposed which further is useful to optimize the prediction accuracy of an e-commerce website. This method shows that CNN is used to optimize hyperparameters of GWO algorithm using an appropriate coding scheme. Accurate model results are verified by comparing them to PSO results whose hyperparameters have been optimized by CNN in Amazon's customer review dataset. Here, experimental outcome proves that this proposed system using the GWO algorithm achieves superior execution in terms of accuracy, precision, recovery, etc. in prediction analysis compared to the existing systems.

Keywords: prediction analysis, e-commerce, machine learning, grey wolf optimization, particle swarm optimization, CNN

Procedia PDF Downloads 113
6939 Evidence Based Medicine: Going beyond Improving Physicians Viewpoints, Usage and Challenges Upcoming

Authors: Peyman Rezaei Hachesu, Vahideh Zareh Gavgani, Zahra Salahzadeh

Abstract:

To survey the attitudes, awareness, and practice of Evidence Based Medicine (EBM), and to determine the barriers that influence apply’ EBM in therapeutic process among clinical residents in Iran.We conducted a cross sectional survey during September to December 2012 at the teaching hospitals of Tehran University of Medical Sciences among 79 clinical residents from different medical specialties. A valid and reliable questionnaire consisted of five sections and 27 statements were used in this research. We applied Spearman and Mann Whitney test for correlation between variables. Findings showed that the knowledge of residents about EBM is low. Their attitude towards EBM was positive but their knowledge and skills in regard with the evidence based medical information resources were mostly limited to PubMed and Google scholar. The main barrier was the lack of enough time to practicing EBM. There was no significant correlation between residency grade and familiarity and use of electronic EBM resources (Spearman, P = 0.138). Integration of training approaches like journal clubs or workshops with clinical practice is suggested.

Keywords: evidence-based medicine, clinical residents, decision-making, attitude, questionnaire

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6938 Hybrid Artificial Bee Colony and Least Squares Method for Rule-Based Systems Learning

Authors: Ahcene Habbi, Yassine Boudouaoui

Abstract:

This paper deals with the problem of automatic rule generation for fuzzy systems design. The proposed approach is based on hybrid artificial bee colony (ABC) optimization and weighted least squares (LS) method and aims to find the structure and parameters of fuzzy systems simultaneously. More precisely, two ABC based fuzzy modeling strategies are presented and compared. The first strategy uses global optimization to learn fuzzy models, the second one hybridizes ABC and weighted least squares estimate method. The performances of the proposed ABC and ABC-LS fuzzy modeling strategies are evaluated on complex modeling problems and compared to other advanced modeling methods.

Keywords: automatic design, learning, fuzzy rules, hybrid, swarm optimization

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6937 Improvement of the Robust Proportional–Integral–Derivative (PID) Controller Parameters for Controlling the Frequency in the Intelligent Multi-Zone System at the Present of Wind Generation Using the Seeker Optimization Algorithm

Authors: Roya Ahmadi Ahangar, Hamid Madadyari

Abstract:

The seeker optimization algorithm (SOA) is increasingly gaining popularity among the researchers society due to its effectiveness in solving some real-world optimization problems. This paper provides the load-frequency control method based on the SOA for removing oscillations in the power system. A three-zone power system includes a thermal zone, a hydraulic zone and a wind zone equipped with robust proportional-integral-differential (PID) controllers. The result of simulation indicates that load-frequency changes in the wind zone for the multi-zone system are damped in a short period of time. Meanwhile, in the oscillation period, the oscillations amplitude is not significant. The result of simulation emphasizes that the PID controller designed using the seeker optimization algorithm has a robust function and a better performance for oscillations damping compared to the traditional PID controller. The proposed controller’s performance has been compared to the performance of PID controller regulated with Particle Swarm Optimization (PSO) and. Genetic Algorithm (GA) and Artificial Bee Colony (ABC) algorithms in order to show the superior capability of the proposed SOA in regulating the PID controller. The simulation results emphasize the better performance of the optimized PID controller based on SOA compared to the PID controller optimized with PSO, GA and ABC algorithms.

Keywords: load-frequency control, multi zone, robust PID controller, wind generation

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6936 Acute Kidney Injury in Severe Trauma Patients: Clinical Presentation and Risk Factor Analysis

Authors: Inkyong Yi

Abstract:

Acute kidney injury (AKI) in trauma patients is known to be associated with multiple factors, especially shock and consequent inadequate renal perfusion, yet its clinical presentation is little known in severe trauma patients. Our aim was to investigate the clinical presentation of acute kidney injury and its outcome in severe trauma patients at a level I trauma center. A total of 93 consecutive adult trauma patients with an injury severity score (ISS) of more than 15 were analyzed retrospectively from our Level I trauma center data base. Patients with direct renal injury were excluded. Patients were dichotomized into two groups, according to the presence of AKI. Various clinical parameters were compared between two groups, with Student’s T test and Mann-Whitney’s U test. The AKI group was further dichotomized into patients who recovered within seven days, and those who required more than 7days for recovery or those who did not recover at all. Various clinical parameters associated with outcome were further analyzed. Patients with AKI (n=33, 35%) presented with significantly higher age (61.4±17.3 vs. 45.4±17.3, p < 0.0001), incidence of comorbidities (hypertension; 51.5% vs. 13.3%, OR 6.906 95%CI 2.515-18.967, diabetes; 27.3% vs. 6.7%, OR 5.250, 95%CI 1.472-18.722), odds of head and neck trauma (69.7% vs. 41.7%, OR 3.220, 95%CI 1.306-7.942) and presence of shock during emergency room care (66.7% vs 21.7% OR 7.231, 95%CI, 2.798-18.687). Among AKI patients, patients who recovered within 1 week showed lower peak lactate (4.7mmol/L, 95%CI 2.9-6.5 vs 7.3mmol/L, 95%CI 5.0-9.6, p < 0.0287), lesser units of transfusion during first 24 hours (pRBC; 20.4unit, 95%CI 12.5-28.3 vs. 58.9unit, 95%CI 39.4-78.5, p=0.0003, FFP; 16.6unit, 95%CI 6.8-26.4 vs. 56.1unit, 95%CI 26.9-85.2, p=0.0027). In severe trauma patients, patients with AKI showed different clinical presentations and worse outcomes. Initial presence of shock and higher DIC profiles may be important risk factors for AKI in severe trauma patients. In patients with AKI, peak lactate level and amounts of transfusion are related to recovery.

Keywords: acute kidney injury, lactate, transfusion, trauma

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6935 Topology Optimization of the Interior Structures of Beams under Various Load and Support Conditions with Solid Isotropic Material with Penalization Method

Authors: Omer Oral, Y. Emre Yilmaz

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Topology optimization is an approach that optimizes material distribution within a given design space for a certain load and boundary conditions by providing performance goals. It uses various restrictions such as boundary conditions, set of loads, and constraints to maximize the performance of the system. It is different than size and shape optimization methods, but it reserves some features of both methods. In this study, interior structures of the parts were optimized by using SIMP (Solid Isotropic Material with Penalization) method. The volume of the part was preassigned parameter and minimum deflection was the objective function. The basic idea behind the theory was considered, and different methods were discussed. Rhinoceros 3D design tool was used with Grasshopper and TopOpt plugins to create and optimize parts. A Grasshopper algorithm was designed and tested for different beams, set of arbitrary located forces and support types such as pinned, fixed, etc. Finally, 2.5D shapes were obtained and verified by observing the changes in density function.

Keywords: Grasshopper, lattice structure, microstructures, Rhinoceros, solid isotropic material with penalization method, TopOpt, topology optimization

Procedia PDF Downloads 136
6934 Validation of a Placebo Method with Potential for Blinding in Ultrasound-Guided Dry Needling

Authors: Johnson C. Y. Pang, Bo Pengb, Kara K. L. Reevesc, Allan C. L. Fud

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Objective: Dry needling (DN) has long been used as a treatment method for various musculoskeletal pain conditions. However, the evidence level of the studies was low due to the limitations of the methodology. Lack of randomization and inappropriate blinding are potentially the main sources of bias. A method that can differentiate clinical results due to the targeted experimental procedure from its placebo effect is needed to enhance the validity of the trial. Therefore, this study aimed to validate the method as a placebo ultrasound(US)-guided DN for patients with knee osteoarthritis (KOA). Design: This is a randomized controlled trial (RCT). Ninety subjects (25 males and 65 females) aged between 51 and 80 (61.26±5.57) with radiological KOA were recruited and randomly assigned into three groups with a computer program. Group 1 (G1) received real US-guided DN, Group 2 (G2) received placebo US-guided DN, and Group 3 (G3) was the control group. Both G1 and G2 subjects received the same procedure of US-guided DN, except the US monitor was turned off in G2, blinding the G2 subjects to the incorporation of faux US guidance. This arrangement created the placebo effect intended to permit comparison of their results to those who received actual US-guided DN. Outcome measures, including the visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of pain, symptoms and quality of life (QOL), were analyzed by repeated-measures analysis of covariance (ANCOVA) for time effects and group effects. The data regarding the perception of receiving real US-guided DN or placebo US-guided DN were analyzed by the chi-squared test. The missing data were analyzed with the intention-to-treat (ITT) approach if more than 5% of the data were missing. Results: The placebo US-guided DN (G2) subjects had the same perceptions as the use of real US guidance in the advancement of DN (p<0.128). G1 had significantly higher pain reduction (VAS and KOOS-pain) than G2 and G3 at 8 weeks (both p<0.05) only. There was no significant difference between G2 and G3 at 8 weeks (both p>0.05). Conclusion: The method with the US monitor turned off during the application of DN is credible for blinding the participants and allowing researchers to incorporate faux US guidance. The validated placebo US-guided DN technique can aid in investigations of the effects of US-guided DN with short-term effects of pain reduction for patients with KOA. Acknowledgment: This work was supported by the Caritas Institute of Higher Education [grant number IDG200101].

Keywords: reliability, jumping, 3D motion analysis, anterior crucial ligament reconstruction

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6933 Disease Characteristics of Neurofibromatosis Type II and Cochlear Implantation

Authors: Boxiang Zhuang

Abstract:

This study analyzes the clinical manifestations, hearing rehabilitation methods and outcomes of a complex case of neurofibromatosis type II (NF2). Methods: The clinical manifestations, medical history, clinical data, surgical methods and postoperative hearing rehabilitation outcomes of an NF2 patient were analyzed to determine the hearing reconstruction method and postoperative effect for a special type of NF2 acoustic neuroma. Results: The patient had bilateral acoustic neuromas with profound sensorineural hearing loss in both ears. Peripheral blood genetic testing did not reveal pathogenic gene mutations, suggesting mosaicism. The patient had an intracochlear schwannoma in the right ear and severely impaired vision in both eyes. Cochlear implantation with tumor retention was performed in the right ear. After 2 months of family-based auditory and speech rehabilitation, the Categories of Auditory Performance (CAP) score improved from 0 to 5. Conclusion: NF2 has complex clinical manifestations and poor prognosis. For NF2 patients with intracochlear tumors, cochlear implantation with tumor retention can be used to reconstruct hearing.

Keywords: NF2, intracochlear schwannoma, hearing reconstruction, cochlear implantation

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6932 Defense Mechanism Maturity and the Severity of Mood Disorder Symptoms

Authors: Maja Pandža, Sanjin Lovrić, Iva Čolak, Josipa Mandarić, Miro Klarić

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This study explores the role of symptoms related to mood disorders salience on different types of defense mechanisms (mature, neurotic, immature) predominance. Total of 177 both clinical and non-clinical participants in Mostar, Bosnia & Herzegovina, completed a battery of questionnaires associated with defense mechanisms and self-reported depression and anxiety symptoms. The sample was additionally divided into four groups, given the level of symptoms experienced: 1. minimal, 2. mild, 3. moderate, 4. severe depression/anxiety. Participants with minimal anxiety and depression symptoms use mature defense mechanisms more often than other three groups. Immature mechanisms are most commonly used by the group with severe depression/anxiety levels in comparison with other groups. These differences are discussed on the dynamic level of analysis to have a better understanding of the relationship between defense mechanisms' maturity and degree of mood disorders' symptom severity. Also, results given could serve as an implication for the psychotherapeutic treatment plans.

Keywords: anxiety/depression symptoms, clinical/non-clinical sample, defense mechanism maturity, dynamic approach

Procedia PDF Downloads 457
6931 A Robust Optimization for Multi-Period Lost-Sales Inventory Control Problem

Authors: Shunichi Ohmori, Sirawadee Arunyanart, Kazuho Yoshimoto

Abstract:

We consider a periodic review inventory control problem of minimizing production cost, inventory cost, and lost-sales under demand uncertainty, in which product demands are not specified exactly and it is only known to belong to a given uncertainty set, yet the constraints must hold for possible values of the data from the uncertainty set. We propose a robust optimization formulation for obtaining lowest cost possible and guaranteeing the feasibility with respect to range of order quantity and inventory level under demand uncertainty. Our formulation is based on the adaptive robust counterpart, which suppose order quantity is affine function of past demands. We derive certainty equivalent problem via second-order cone programming, which gives 'not too pessimistic' worst-case.

Keywords: robust optimization, inventory control, supply chain managment, second-order programming

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6930 Alternating Electric fields-Induced Senescence in Glioblastoma

Authors: Eun Ho Kim

Abstract:

Innovations have conjured up a mode of treating GBM cancer cells in the newly diagnosed patients in a period of 4.9 months at an improved median OS, which brings along only a few minor side effects in the phase III of the clinical trial. This mode has been termed the Alternating Electric Fields (AEF). The study at hand is aimed at determining whether the AEF treatment is beneficial in sensitizing the GBM cancer cells through the process of increasing the AEF –induced senescence. The methodology to obtain the findings for this research ranged across various components, such as obtaining and testing SA-β-gal staining, flow cytometry, Western blotting, morphology, and Positron Emission Tomography (PET) / Computed Tomography (CT), immunohistochemical staining and microarray. The number of cells that displayed a senescence-specific morphology and positive SA-ß-Gal activity gradually increased up to 5 days. These results suggest that p16, p21 and p27 are essential regulators of AEF -induced senescence via NF-κB activation. The results showed that the AEF treatment is functional in enhancing the AEF –induced senescence in the GBM cells via an apoptosis- independent mechanism. This research concludes that this mode of treatment is a trustworthy protocol that can be effectively employed to overcome the limitations of the conventional mode of treatment on GBM.

Keywords: alternating electric fields, senescence, glioblastoma, cell death

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6929 The Effectiveness of Multiple versus Once-Only Membrane Sweeping in Uncomplicated Primi Gravida at 40 Weeks of Gestational Age in a Tertiary Care Hospital, Sri Lanka: A Randomized Controlled Trial

Authors: Jeewantha Ranawaka, Gunawardane Kapila, Wijethunaga Mudiyanselage B. G. Jayathilake

Abstract:

Introduction: Sweeping of the membranes is a fairly simple technique that may positively influence the shift from maintenance of pregnancy to the beginning of labor. Objective: To assess the effectiveness and acceptability of twice versus once-only membrane sweeping in uncomplicated primi gravid at 40 weeks of gestational age in a tertiary care hospital in Sri Lanka. Methods: A randomized controlled clinical trial was done in Ward 05 of Teaching Hospital, Kandy. The participants were primi-gravida with a singleton live fetus who was at 40 weeks of gestation with intact fetal membranes and with a Modified Bishop’s score <5. After randomization both groups received membrane sweeping at 40 weeks of gestation and the experimental group received membrane sweeping after 48 hours (40+2 days). The modified Bishop Score was assessed at 40+5 days. In two groups who did not go into natural labor at 40+5 days were managed according to the ward policy of cervical ripening and with labor induction at 40+5 days. Two different methods were used to assess discomfort and pain. Patient acceptability was assessed using recommendation to another patient and acceptance during next pregnancy. Perinatal, maternal and labour outcomes were assessed. Results: A change of the Bishops score was 67.3% (n= 31 of 46) in experimental group whereas in control group it was 57.5% (n= 38 of 66). (p = 0.21, OR-1.52, CI = 0.6 -3.34). Mean (SD) of Modified Bishop score was 6.36 (1.94) in experimental group and 6.03 (.84) in control group (p = 0.354). The probability of having the spontaneous onset of labour in experimental group was 61.6% (n=74 of 120) whereas in control group it was 45% (n= 54 of 120) (p=0.01, OR-1.966, CI = 1.17 – 3.28 NNT = 5.99). Recommending the method to another among experimental group was 75% (n= 90 of 120) whereas in control group it was 79.2% (n= 95 of 120) (p= 0.443). Accepting membrane Sweeping for subsequent pregnancy among experimental was 72.5% (n=87 of 120) whereas in control group was 72.5% (n=87 of 120) (p= 1.00) Need of formal induction of labour at 40+ 5 days in experimental group was 38.4% (n=46 of 120) whereas in control group was 61.6% (n=66 of 120) (p=0.01, OR=0.5, CI= 0.3 – 0.8, NNT=6). Neonatal outcome, labour outcome such as Cesarean -section rate, need for augmentation and maternal complications such as fever, Premature rupture of membrane, bleeding were comparable in two groups. Conclusions and Recommendations: It can be concluded that twice sweeping of membrane was effective to reduce the need of formal induction of labour and increase the chances of having spontaneous onset of labour (SOL) at 40+5 days without increasing maternal or fetal morbidity. Acceptability of twice sweeping is not different from sweeping once. Hence we recommend consideration of multiple membranes sweeping as first line for women at 40 weeks of gestation.

Keywords: acceptability, induction, labour, membrane sweeping

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6928 Microarrays: Wide Clinical Utilities and Advances in Healthcare

Authors: Salma M. Wakil

Abstract:

Advances in the field of genetics overwhelmed detecting large number of inherited disorders at the molecular level and directed to the development of innovative technologies. These innovations have led to gene sequencing, prenatal mutation detection, pre-implantation genetic diagnosis; population based carrier screening and genome wide analyses using microarrays. Microarrays are widely used in establishing clinical and diagnostic setup for genetic anomalies at a massive level, with the advent of cytoscan molecular karyotyping as a clinical utility card for detecting chromosomal aberrations with high coverage across the entire human genome. Unlike a regular karyotype that relies on the microscopic inspection of chromosomes, molecular karyotyping with cytoscan constructs virtual chromosomes based on the copy number analysis of DNA which improves its resolution by 100-fold. We have been investigating a large number of patients with Developmental Delay and Intellectual disability with this platform for establishing micro syndrome deletions and have detected number of novel CNV’s in the Arabian population with the clinical relevance.

Keywords: microarrays, molecular karyotyping, developmental delay, genetics

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6927 Prevalence of Bovine Mastitis and Associated Risk Factors in Selected Dairy Farms in Zoba Anseba, Eritrea

Authors: Redie Kidane Ghebrehawariat, Betiel Habte Hadgu, Filmon Berhane Kahsay, Rim Berhane Fisehaye, Samuel Haile Kahsay, Saron Yemane Yosief, Selemawit Mosazghi Gilazghi

Abstract:

A cross-sectional study was conducted from 22 February to 9 April 2022 on small, medium, and large holder dairy farms to determine the bovine mastitis prevalence and associated risk factors in the Anseba region, Eritrea. A total of 34 dairy farms and 193 dairy cows were randomly selected. Dairy cows were physically examined for any change on the udder and milk; a California mastitis test was performed to check sub-clinical mastitis; a closed-ended semi-structured questionnaire composed of 28 variables/risk factors (21 management risk factors and 7 animal-level risk factors) was used to determine the risk factors responsible for clinical and sub-clinical mastitis in the dairy cows. The overall cow-level prevalence of mastitis was 147 (76.2%). The animal level prevalence rate of clinical and sub-clinical mastitis was found to be 22 (11.4%) and 125 (64.8%), respectively, while herd level prevalence both for clinical and subclinical mastitis was found to be 14 (41.2%) and 26 (76.5%) respectively. Based on the already set P-value, which is <0.05, a number of risk factors were found to have a significant relationship with the occurrence of clinical and sub-clinical mastitis. Generally, animal risk factors such as animal age, parity, injury on the udder or teat, and previous history of mastitis presence of injury on the udder and lactation stage were risk factors with a significant relationship with the occurrence of clinical and sub-clinical mastitis. On the other hand, management risk factors with a significant relationship to the occurrence of clinical and sub-clinical mastitis were herd size, failure to milk mastitic cow, at last, educational level, floor type, failure to use a towel, using one towel for more than one cow and failure to practice mastitis test. From a total of 772 quarters, 280 (36.3%) were found positive for sub-clinical mastitis using the California mastitis test; of these, 70 (9%) were weakly positive, 90 (11.7%) were distinct positive, and 120 (15.5%) were strongly positive. Furthermore, 13 (1.7%) quarters were blocked. Quarter level prevalence was right front 80 (41.5%), left front 64 (33.3%), right hind 69 (35.8%) and left hind 67 (34.7%). The study has shown that mastitis is a major problem for dairy farms and the findings suggested that mastitis is one of the limiting factors in increasing milk production. Subclinical mastitis was found to be a devastating problem, and it occurred in all three breeds of lactating dairy cattle. Therefore, farmers should work hard to avoid the above-mentioned risk factors to minimize the infection of their dairy cattle by mastitis and thereby increase their profit. On the other hand, the Ministry of Agriculture, through the extension unit, should work in close contact with the farmers to increase awareness of the economic importance of the disease and associated risk factors.

Keywords: mastitis, prevalence, dairy cattle, Anseba, Eritrea

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6926 Screening of Different Exotic Varieties of Potato through Adaptability Trial for Local Cultivation

Authors: Arslan Shehroz, Muhammad Amjad Ali, Amjad Abbas, Imran Ramzan, Muhammad Zunair Latif

Abstract:

Potato (Solanum tuberosum L.) is the 4th most important food crop of the world after wheat, rice and maize. It is the staple food in many European countries. Being rich in starch (one of the main three food ingredients) and having the highest productivity per unit area, has great potential to address the challenge of the food security. Processed potato is also used as chips and crisps etc as ‘fast food’. There are many biotic and abiotic factors which check the production of potato and become hurdle in achievement production potential of potato. 20 new varieties along with two checks were evaluated. Plant to plant and row to row distances were maintained as 20 cm and 75 cm, respectively. The trial was conducted according to the randomized complete block design with three replications. Normal agronomic and plant protection measures were carried out in the crop. It is revealed from the experiment that exotic variety 171 gave the highest yield of 35.5 t/ha followed by Masai with 31.0 t/ha tuber yield. The check variety Simply Red 24.2 t/ha yield, while the lowest tuber yield (1.5 t/ha) was produced by the exotic variety KWS-06-125. The maximum emergence was shown by the Variety Red Sun (89.7 %). The lowest emergence was shown by the variety Camel (71.7%). Regarding tuber grades, it was noted that the maximum Ration size tubers were produced by the exotic variety Compass (3.7%), whereas 11 varieties did not produce ration size tubers at all. The variety Red Sun produced lowest percentage of small size tubers (12.7%) whereas maximum small size tubers (93.0%) were produced by the variety Jitka. Regarding disease infestation, it was noted that the maximum scab incidence (4.0%) was recorded on the variety Masai, maximum rhizoctonia attack (60.0%) was recorded on the variety Camel and maximum tuber cracking (0.7%) was noted on the variety Vendulla.

Keywords: check variety, potato, potential and yield, trial

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6925 The Development of the Psychosomatic Nursing Model from an Evidence-Based Action Research on Proactive Mental Health Care for Medical Inpatients

Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee

Abstract:

In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.

Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing

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