Search results for: clinically relevant
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3673

Search results for: clinically relevant

3103 A Framework on the Critical Success Factors of E-Learning Implementation in Higher Education: A Review of the Literature

Authors: Sujit K. Basak, Marguerite Wotto, Paul Bélanger

Abstract:

This paper presents a conceptual framework on the critical success factors of e-learning implementation in higher education, derived from an in-depth survey of literature review. The aim of this study was achieved by identifying critical success factors that affect for the successful implementation of e-learning. The findings help to articulate issues that are related to e-learning implementation in both formal and non-formal higher education and in this way contribute to the development of programs designed to address the relevant issues.

Keywords: critical success factors, e-learning, higher education, life-long learning

Procedia PDF Downloads 338
3102 Allocation of Mobile Units in an Urban Emergency Service System

Authors: Dimitra Alexiou

Abstract:

In an urban area the allocation placement of an emergency service mobile units, such as ambulances, police patrol must be designed so as to achieve a prompt response to demand locations. In this paper, a partition of a given urban network into distinct sub-networks is performed such that; the vertices in each component are close and simultaneously the difference of the sums of the corresponding population in the sub-networks is almost uniform. The objective here is to position appropriately in each sub-network a mobile emergency unit in order to reduce the response time to the demands. A mathematical model in the framework of graph theory is developed. In order to clarify the corresponding method a relevant numerical example is presented on a small network.

Keywords: graph partition, emergency service, distances, location

Procedia PDF Downloads 475
3101 Photoactivated Chromophore for Keratitis-Cross Linking Window Absorption Alone versus Combined Pack-CXL Window Absorption and Standard Anti-microbial Therapy for Treatment of Infectious Keratitis: A Prospective Study

Authors: Mohammed M. Mahdy Tawfeek

Abstract:

Objective: The aim of this work is to compare the outcome of photoactivated chromophore for keratitis-cross linking (PACK-CXL) window absorption (WA) alone with combined PACK-CXL WA and standard anti-microbial therapy (SAT) for the treatment of infectious keratitis. Patients and Methods: This is a randomized prospective comparative clinical trial. Thirty eyes with clinically suspected infectious keratitis were randomly assigned into two equal groups of 15 eyes each: Group (A) was treated by PACK-CXL WA alone and group (B) was treated by PACK-CXL WA combined with SAT. Identification of organisms was made by lab study before treatment. Corneal healing was evaluated by corneal examination and anterior segment OCT (AS-OCT). Written informed consent was obtained from all participants and the study was approved by the research ethics committee of the Faculty of Medicine, Zagazig University. The work has been carried out in accordance with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for studies involving humans. Results: Complete healing and resolution (Successful treatment) were observed in 10 eyes (66.7%) of a group (A) and 14 eyes (93.3%) of group (B) and failure was observed in 5 eyes (33.3%) of a group (A) and one eye (6.67%) of group (B). They were statistically significant (P =0.042 and 0.003) in a comparison between both groups regarding success and failure of treatment, respectively. Complete corneal healing was reported in the third month postoperatively in 10 eyes (66.7%) of group (A) and 14 eyes (93.3%) of group (B). Complications were absent in 12 patients (80%) in group (A) and 14 patients (93.3%) of group (B); however, perforation and impending perforation were found in 3 patients of group (A) and only one patient of group (B). Conclusion: PACK-CXL is a promising, non-invasive treatment option for infectious keratitis, especially when performed with the window absorption (WA) technique, either alone or combined with SAT. It has a synergistic effect with a standard antimicrobial treatment that gives good outcome results in the treatment of infectious keratitis. Also, it avoids the antibiotics resistance that has become rapidly spreading worldwide.

Keywords: corneal cross linking, infectious keratitis, PACK-CXL, window absorption

Procedia PDF Downloads 117
3100 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

Abstract:

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 285
3099 The Effectiveness of Rebranding as a Comparative Study of Ghanaian Business Using the Principles of Corporate Rebranding

Authors: Kennedy Gbenu, Richmond Kweku Frempong

Abstract:

Rebranding has become a very important strategic tool for companies wanting to succeed in the ever competitive business world using the principles of rebranding Moisescu. Two businesses in Ghana (Ghana Commercial Bank and Vodafone Ghana) have been used to ascertain how rebranding of these organizations was done using the principles in their effort to rebrand themselves and to stay relevant. A secondary research mainly on literature surrounding rebranding, official websites of the organizations under study have also been used extensively. After a basic comparative study undertaken two firms (GCB and VODAFONE) seems to be using the first three principles and reaping from it as provided by Moisescu. This goes to show that rebranding should not be done in vacuum but should be guided by such principles so as to achieve the full potential of any kind of investments made.

Keywords: brands, corporate branding, innovation, case studies

Procedia PDF Downloads 374
3098 Treatment of Non-Small Cell Lung Cancer (NSCLC) With Activating Mutations Considering ctDNA Fluctuations

Authors: Moiseenko F. V., Volkov N. M., Zhabina A. S., Stepanova E. O., Kirillov A. V., Myslik A. V., Artemieva E. V., Agranov I. R., Oganesyan A. P., Egorenkov V. V., Abduloeva N. H., Aleksakhina S. Yu., Ivantsov A. O., Kuligina E. S., Imyanitov E. N., Moiseyenko V. M.

Abstract:

Analysis of ctDNA in patients with NSCLC is an emerging biomarker. Multiple research efforts of quantitative or at least qualitative analysis before and during the first periods of treatment with TKI showed the prognostic value of ctDNA clearance. Still, these important results are not incorporated in clinical standards. We evaluated the role of ctDNA in EGFR-mutated NSCLC receiving first-line TKI. Firstly, we analyzed sequential plasma samples from 30 patients that were collected before intake of the first tablet (at baseline) and at 6, 12, 24, 36, and 48 hours after the “starting point.” EGFR-M+ allele was measured by ddPCR. Afterward, we included sequential qualitative analysis of ctDNA with cobas® EGFR Mutation Test v2 from 99 NSCLC patients before the first dose, after 2 and 4 months of treatment, and on progression. Early response analysis showed the decline of EGFR-M+ level in plasma within the first 48 hours of treatment in 11 subjects. All these patients showed objective tumor response. 10 patients showed either elevation of EGFR-M+ plasma concentration (n = 5) or stable content of circulating EGFR-M+ after the start of the therapy (n = 5); only 3 of these patients achieved an objective response (p = 0.026) when compared to the former group). The rapid decline of plasma EGFR-M+ DNA concentration also predicted for longer PFS (13.7 vs. 11.4 months, p = 0.030). Long-term ctDNA monitoring showed clinically significant heterogeneity of EGFR-mutated NSCLC treated with 1st line TKIs in terms of progression-free and overall survival. Patients without detectable ctDNA at baseline (N = 32) possess the best prognosis on the duration of treatment (PFS: 24.07 [16.8-31.3] and OS: 56.2 [21.8-90.7] months). Those who achieve clearance after two months of TKI (N = 42) have indistinguishably good PFS (19.0 [13.7 – 24.2]). Individuals who retain ctDNA after 2 months (N = 25) have the worst prognosis (PFS: 10.3 [7.0 – 13.5], p = 0.000). 9/25 patients did not develop ctDNA clearance at 4 months with no statistical difference in PFS from those without clearance at 2 months. Prognostic heterogeneity of EGFR-mutated NSCLC should be taken into consideration in planning further clinical trials and optimizing the outcomes of patients.

Keywords: NSCLC, EGFR, targeted therapy, ctDNA, prognosis

Procedia PDF Downloads 33
3097 Regular Laboratory Based Neonatal Simulation Program Increases Senior Clinicians’ Knowledge, Skills and Confidence Caring for Sick Neonates

Authors: Madeline Tagg, Choihoong Mui, Elizabeth Lek, Jide Menakaya

Abstract:

Introduction: Simulation technology is used by neonatal teams to learn and refresh skills and gain the knowledge and confidence to care for sick neonates. In-situ simulation is considered superior to laboratory-based programmes as it closely mirrors real life situations. This study reports our experience of running regular laboratory-based simulation sessions for senior clinicians and nurses and its impact on their knowledge, skills and confidence. Methods: A before and after questionnaire survey was carried out on senior clinicians and nurses that attended a scheduled laboratory-based simulation session. Participants were asked to document their expectations before a 3-hour monthly laboratory programme started and invited to feedback their reflections at the end of the session. The session included discussion of relevant clinical guidelines, immersion in a scenario and video led debrief. The results of the survey were analysed in three skills based categories - improved, no change or a worsened experience. Results: 45 questionnaires were completed and analysed. Of these 25 (55%) were completed by consultants seven and six by nurses and trainee doctors respectively, and seven respondents were unknown. 40 (88%) rated the session overall and guideline review as good/excellent, 39 respondents (86%) rated the scenario session good/excellent and 40/45 fed back a good/excellent debrief session. 33 (73%) respondents completed the before and after questionnaire. 21/33 (63%) reflected an improved knowledge, skill or confidence in caring for sick new-bon babies, eight respondents reported no change and four fed back a worse experience after the session. Discussion: Most respondents found the laboratory based structured simulation session beneficial for their professional development. They valued equally the whole content of the programme such as guideline review and equipment training as well as the simulation and debrief sessions. Two out three participants stated their knowledge of caring for sick new-born babies had been transformed positively by the session. Sessions where simulation equipment failed or relevant staff were absent contributed to a poor educational experience. Summary: A regular structured laboratory-based simulation programme with a rich content is a credible educational resource for improving the knowledge, skills and confidence of senior clinicians caring for sick new born babies.

Keywords: knowledge, laboratory based, neonates, simulation

Procedia PDF Downloads 103
3096 Determiner Phrase in Persian

Authors: Reza Morad Sahraei, Roghayeh Kazeminahad

Abstract:

Surveying the structure of NP in Persian, this article tries to show that most of NP constituents are either independent of each other or they are dependent to Determiner Phrase (=DP). The writer follows a uniform minimal analysis to illustrate the structural position of relevant constituents of DP, including Possessive Phrase, Ezafat Phrase and Quantifier Phrase, under the tree diagram. The most important point of this article is the claim that NP is mostly one of the dependents of DP. Hence, the final section of the article deals with and analyzes the structure of DP in Persian. The DP analysis undertaken in this article has some advantages. It can explain the internal relevance of all DP constituents and provides them all a uniform analysis. Also, the semantic importance of Persian genitive marker and its role in parsing is borne out.

Keywords: determiner phrase (DP), ezafat phrase (Ezaf P), noun phrase(NP), possessive phrase (PossP), quantifier phrase (QP)

Procedia PDF Downloads 557
3095 The Effect of Integrated Reporting on Corporate Financial Performance: A Bibliometric Analysis

Authors: Adhila Sandra Devy, Evangeline Syalomita Silitonga

Abstract:

The landscape of corporate governance and accountability has led to the emergence of Integrated Reporting (IR) in response to the shortcomings of traditional reporting frameworks. Developed by The International Integrated Reporting Council (IIRC), IR aims to offer stakeholders a comprehensive view of a company’s performance by integrating financial and non-financial disclosures. This study analyzes literature on Integrated Reporting and Corporate Financial Performance from 2013 to 2024, employing a descriptive analysis methodology. 31 relevant articles were gathered from various sources, indicating a positive correlation between integrated reporting and financial performance, albeit without conclusive evidence of long-term impact.

Keywords: integrated reporting, corporate financial performance, corporate performance, firm performance, bibliometric analysis

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3094 The Sociolinguistics of Prison Slang

Authors: Jonathan M. Watt, Regina L. Sturiale

Abstract:

The linguistic idiosyncrasies of prison populations have been studied with great interest by scholarly and popular writers alike, whose interests range from curiosity to a disciplined understanding of its function. This paper offers a formalized nomenclature for the four relevant terms (slang, jargon, argot, and cant) and brings together key sociolinguistic concepts such as domain and register with research on institutional dynamics as well as culture and identity. It presents a fresh body of data drawn from interviews with prison staff in the American NE and with awareness of selected publications. The paper then draws a correlation between a person’s competence in prison antilanguage and their status as part of the in-group. This is a distinctive marker of identification that is essential to inmate survival and staff effectiveness.

Keywords: slang, jargon, argot, sociolinguistics, antilanguage, identity

Procedia PDF Downloads 36
3093 Evaluation of Complications Observed in Porcelain Fused to Metal Crowns Placed at a Teaching Institution

Authors: Shizrah Jamal, Robia Ghafoor, Farhan Raza

Abstract:

Porcelain fused to metal crown is the most versatile variety of crown that is commonly placed worldwide. Various complications have been reported in the PFM crowns with use over the period of time. These include chipping of the porcelain, recurrent caries, loss of retention, open contacts, and tooth fracture. The objective of the present study was to determine the frequency of these complications in crowns cemented over a period of five years in a tertiary care hospital and also to report the survival of these crowns. A retrospective study was conducted in Dental clinics, Aga Khan University Hospital in which 150 PFM crowns cemented over a period of five years were evaluated. Patient demographics, oral hygiene habits, para-functional habits, crown insertion and follow-up dates were recorded in a specially designed proforma. All PFM crowns fulfilling the inclusion criteria were assessed both clinically and radiographically for the presence of any complication. SPSS version 22.0 was used for statistical analysis. Frequency distribution and proportion of complications were determined. Chi-square test was used to determine the association of complications of PFM crowns with multiple variables including tooth wear, opposing dentition and betel nut chewing. Kaplan- meier survival analysis was used to determine the survival of PFM crowns over the period of five years. Level of significance was kept at 0.05. A total of 107 patients, with a mean age of 43.51 + 12.4 years, having 150 PFM crowns were evaluated. The most common complication observed was open proximal contacts (8.7%) followed by porcelain chipping (6%), decementation (5.3%), and abutment fracture (1.3%). Chi square test showed that there was no statistically significant association of PFM crown complication with tooth wear, betel nut and opposing dentition (p-value <0.05). The overall success and survival rates of PFM crowns turned out to be 78.7 and 84.7% respectively. Within the limitations of the study, it can be concluded that PFM crowns are an effective treatment modality with high success and survival rates. Since it was a single centered study; the results should be generalized with caution.

Keywords: chipping, complication, crown, survival rate

Procedia PDF Downloads 178
3092 Urban Rehabilitation Assessment: Buildings' Integrity and Embodied Energy

Authors: Joana Mourão

Abstract:

Transition to a low carbon economy requires changes in consumption and production patterns, including the improvement of existing buildings’ environmental performance. Urban rehabilitation is a top policy priority in Europe, creating an opportunity to increase this performance. However, urban rehabilitation comprises different typologies of interventions with distinct levels of consideration for cultural urban heritage values and for environmental values, thus with different impacts. Cities rely on both material and non-material forms of heritage that are deep-rooted and resilient. One of the most relevant parts of that urban heritage is the historical pre-industrial housing stock, with an extensive presence in many European cities, as Lisbon. This stock is rehabilitated and transformed at the framework of urban management and local governance traditions, as well as the framework of the global economy, and in that context, faces opportunities and threats that need evaluation and control. The scope of this article is to define methodological bases and research lines for the assessment of impacts that urban rehabilitation initiatives set on the vulnerable and historical pre-industrial urban housing stock, considering it as an environmental and cultural unreplaceable material value and resource. As a framework, this article reviews the concepts of urban regeneration, urban renewal, current buildings conservation and refurbishment, and energy refurbishment of buildings, seeking to define key typologies of urban rehabilitation that represent different approaches to the urban fabric, in terms of scope, actors, and priorities. Moreover, main types of interventions - basing on a case-study in a XVIII century neighborhood in Lisbon - are defined and analyzed in terms of the elements lost in each type of intervention, and relating those to urbanistic, architectonic and constructive values of urban heritage, as well as to environmental and energy efficiency. Further, the article overviews environmental cultural heritage assessment and life-cycle assessment tools, selecting relevant and feasible impact assessment criteria for urban buildings rehabilitation regulation, focusing on multi-level urban heritage integrity. Urbanistic, architectonic, constructive and energetic integrity are studied as criteria for impact assessment and specific indicators are proposed. The role of these criteria in sustainable urban management is discussed. Throughout this article, the key challenges for urban rehabilitation planning and management, concerning urban built heritage as a resource for sustainability, are discussed and clarified.

Keywords: urban rehabilitation, impact assessment criteria, buildings integrity, embodied energy

Procedia PDF Downloads 175
3091 Competitive Advantage on the Road Again: Exploring Nuances through a Conceptual Review and Future Research Avenues

Authors: Seyedabdolali Mortazavi Kamalabadi, Faegheh Taheran

Abstract:

By giving an overview of previous arguments and findings concerned with the concept of competitive advantage, first, we define the overall concept of competitive advantage and discuss nuances of understanding such an important and strategic idea. Finally, by considering the major concerns of marketing academia, including globalization, AI-based technologies, consumer well-being, and internal coopetition between a firm’s units, fruitful avenues to be explored by future studies are presented in the form of research propositions. In the end, relevant gaps mentioned by numerous studies that are worth investigating are demonstrated.

Keywords: artificial intelligence, competitive advantage, consumer well-being, coopetition, globalization, literature review, temporary competitive advantage

Procedia PDF Downloads 99
3090 Application of Signature Verification Models for Document Recognition

Authors: Boris M. Fedorov, Liudmila P. Goncharenko, Sergey A. Sybachin, Natalia A. Mamedova, Ekaterina V. Makarenkova, Saule Rakhimova

Abstract:

In modern economic conditions, the question of the possibility of correct recognition of a signature on digital documents in order to verify the expression of will or confirm a certain operation is relevant. The additional complexity of processing lies in the dynamic variability of the signature for each individual, as well as in the way information is processed because the signature refers to biometric data. The article discusses the issues of using artificial intelligence models in order to improve the quality of signature confirmation in document recognition. The analysis of several possible options for using the model is carried out. The results of the study are given, in which it is possible to correctly determine the authenticity of the signature on small samples.

Keywords: signature recognition, biometric data, artificial intelligence, neural networks

Procedia PDF Downloads 123
3089 Indigenous Companies in Nigeria's Oil Sector: Stages, Opportunities, and Obstacles regarding Corporate Social Responsibility

Authors: L. U. Dumuje, R. Leite

Abstract:

There is an ongoing debate in terms of corporate social responsibility (CSR) initiative in Niger Delta, Nigeria, that originates from existing gap between stated objective of organizations in the Nigerian oil sector and their main activities that threaten the society. CSR in developing countries is becoming popular, and to contribute to scientific knowledge, we need to research on CSR practices and discourse in indigenous Nigeria that is scarce. Despite governments mandate in terms of unofficial blazing, methane gas is released into the air around refinery area which contributes to global warming. There is a need to understand if this practice applies to indigenous oil companies in Nigeria. To get a better understanding of CSR among indigenous oil companies in Nigeria, our study focuses on discourse and rhetoric regarding CSR. This current paper contributions is twofold: on the one hand, it aims to better understand practitioner’s rationale and fundamentals of CSR in Nigerian oil companies. On the other hand, it intends to identify the stages of CSR initiatives, advantages and difficulties of CSR implementation in indigenous Nigeria oil sector. This current paper uses the qualitative research as a methodological strategy. Instrument for data collection is semi-structured interview. Besides 28 interviews, we conduct five focus group discussions with stakeholders. Participant for this study consist of: employees, managers and executives of indigenous oil companies in Nigeria. It is relevant to mention, key informants as government institution, environmental organization and community leader/member are part of our sample. It is important that despite significant findings in some studies, there are still some gaps. To help filling this existing gaps, we have formulated some research questions, as follows: ‘What are the stages, opportunities and obstacles of having corporate social responsibility practice in indigenous oil companies in Nigeria’. This ongoing research sub-questions as follows: What are the CSR discourses and practices among indigenous companies in the Nigerian oil sector; what is the actual status regarding CSR development; what are the main perceptions of opportunities and obstacles with regard to CSR in indigenous Nigerian oil companies; who are the main stakeholders of indigenous Nigerian oil companies and their different meanings and understandings of CSR practices. Regarding the above questions, the following objectives have been determined: first, we conduct a literature review with the aim of understanding and identifying importance of CSR practises in western and developing countries. Second, this current paper identify specific characteristics of the national context in terms of CSR engagement in Nigeria, so we perform empirical research with relevant stakeholder in indigenous Nigerian, as well as key informants, in order to identify development of CSR and different perception of this praised initiative, CSR.

Keywords: corporate social responsibility, indigenous, oil organizations, Nigeria, practice

Procedia PDF Downloads 114
3088 Farm Diversification and the Corresponding Policy for Its Implementation in Georgia

Authors: E. Kharaishvili

Abstract:

The paper shows the necessity of farm diversification in accordance with the current trends in agricultural sector of Georgia. The possibilities for the diversification and the corresponding economic policy are suggested. The causes that hinder diversification of farms are revealed, possibilities of diversification are suggested and the ability of increasing employment through diversification is proved. Index of harvest diversification is calculated based on the areas used for cereals and legumes, potatoes and vegetables and other food crops. Crop and livestock production indexes are analyzed, correlation between crop capacity index and value-added per one worker and one ha is studied. Based on the research farm diversification strategies and priorities of corresponding economic policy are presented. Based on the conclusions relevant recommendations are suggested.

Keywords: farm diversification, diversification index, agricultural development policy

Procedia PDF Downloads 446
3087 A Study of Environmental Test Sequences for Electrical Units

Authors: Jung Ho Yang, Yong Soo Kim

Abstract:

Electrical units are operated by electrical and electronic components. An environmental test sequence is useful for testing electrical units to reduce reliability issues. This study introduces test sequence guidelines based on relevant principles and considerations for electronic testing according to international standard IEC-60068-1 and the United States military standard MIL-STD-810G. Then, test sequences were proposed based on the descriptions for each test. Finally, General Motors (GM) specification GMW3172 was interpreted and compared to IEC-60068-1 and MIL-STD-810G.

Keywords: reliability, environmental test sequence, electrical units, IEC 60068-1, MIL-STD-810G

Procedia PDF Downloads 478
3086 Determination of Optimum Torque of an Internal Combustion Engine by Exergy Analysis

Authors: Veena Chaudhary, Rakesh P. Gakkhar

Abstract:

In this study, energy and exergy analysis are applied to the experimental data of an internal combustion engine operating on conventional diesel cycle. The experimental data are collected using an engine unit which enables accurate measurements of fuel flow rate, combustion air flow rate, engine load, engine speed and all relevant temperatures. First and second law efficiencies are calculated for different engine speed and compared. Results indicate that the first law (energy) efficiency is maximum at 1700 rpm whereas exergy efficiency is maximum and exergy destruction is minimum at 1900 rpm.

Keywords: diesel engine, exergy destruction, exergy efficiency, second law of thermodynamics

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3085 Targeting Mre11 Nuclease Overcomes Platinum Resistance and Induces Synthetic Lethality in Platinum Sensitive XRCC1 Deficient Epithelial Ovarian Cancers

Authors: Adel Alblihy, Reem Ali, Mashael Algethami, Ahmed Shoqafi, Michael S. Toss, Juliette Brownlie, Natalie J. Tatum, Ian Hickson, Paloma Ordonez Moran, Anna Grabowska, Jennie N. Jeyapalan, Nigel P. Mongan, Emad A. Rakha, Srinivasan Madhusudan

Abstract:

Platinum resistance is a clinical challenge in ovarian cancer. Platinating agents induce DNA damage which activate Mre11 nuclease directed DNA damage signalling and response (DDR). Upregulation of DDR may promote chemotherapy resistance. Here we have comprehensively evaluated Mre11 in epithelial ovarian cancers. In clinical cohort that received platinum- based chemotherapy (n=331), Mre11 protein overexpression was associated with aggressive phenotype and poor progression free survival (PFS) (p=0.002). In the ovarian cancer genome atlas (TCGA) cohort (n=498), Mre11 gene amplification was observed in a subset of serous tumours (5%) which correlated highly with Mre11 mRNA levels (p<0.0001). Altered Mre11 levels was linked with genome wide alterations that can influence platinum sensitivity. At the transcriptomic level (n=1259), Mre11 overexpression was associated with poor PFS (p=0.003). ROC analysis showed an area under the curve (AUC) of 0.642 for response to platinum-based chemotherapy. Pre-clinically, Mre11 depletion by gene knock down or blockade by small molecule inhibitor (Mirin) reversed platinum resistance in ovarian cancer cells and in 3D spheroid models. Importantly, Mre11 inhibition was synthetically lethal in platinum sensitive XRCC1 deficient ovarian cancer cells and 3D-spheroids. Selective cytotoxicity was associated with DNA double strand break (DSB) accumulation, S-phase cell cycle arrest and increased apoptosis. We conclude that pharmaceutical development of Mre11 inhibitors is a viable clinical strategy for platinum sensitization and synthetic lethality in ovarian cancer.

Keywords: MRE11; XRCC1, ovarian cancer, platinum sensitization, synthetic lethality

Procedia PDF Downloads 104
3084 Executive Functions Directly Associated with Severity of Perceived Pain above and beyond Depression in the Context of Medical Rehabilitation

Authors: O. Elkana, O Heyman, S. Hamdan, M. Franko, J. Vatine

Abstract:

Objective: To investigate whether a direct link exists between perceived pain (PP) and executive functions (EF), above and beyond the influence of depression symptoms, in the context of medical rehabilitation. Design: Cross-sectional study. Setting: Rehabilitation Hospital. Participants: 125 medical records of hospitalized patients were screened for matching to our inclusion criteria. Only 60 patients were found fit and were asked to participate. 19 decline to participate on personal basis. The 41 neurologically intact patients (mean age 46, SD 14.96) that participated in this study were in their sub-acute stage of recovery, with fluent Hebrew, with intact upper limb (to neutralize influence on psychomotor performances) and without an organic brain damage. Main Outcome Measures: EF were assessed using the Wisconsin Card Sorting Test (WCST) and the Stop-Signal Test (SST). PP was measured using 3 well-known pain questionnaires: Pain Disability Index (PDI), The Short-Form McGill Questionnaire (SF-MPQ) and the Pain Catastrophizing Scale (PCS). Perceived pain index (PPI) was calculated by the mean score composite from the 3 pain questionnaires. Depression symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Results: The results indicate that irrespective of the presence of depression symptoms, PP is directly correlated with response inhibition (SST partial correlation: r=0.5; p=0.001) and mental flexibility (WSCT partial correlation: r=-0.37; p=0.021), suggesting decreased performance in EF as PP severity increases. High correlations were found between the 3 pain measurements: SF-MPQ with PDI (r=0.62, p<0.001), SF-MPQ with PCS (r=0.58, p<0.001) and PDI with PCS (r=0.38, p=0.016) and each questionnaire alone was also significantly associated with EF; thus, no specific questionnaires ‘pulled’ the results obtained by the general index (PPI). Conclusion: Examining the direct association between PP and EF, beyond the contribution of depression symptoms, provides further clinical evidence suggesting that EF and PP share underlying mediating neuronal mechanisms. Clinically, the importance of assessing patients' EF abilities as well as PP severity during rehabilitation is underscored.

Keywords: depression, executive functions, mental-flexibility, neuropsychology, pain perception, perceived pain, response inhibition

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3083 Clinical and Radiographic Evaluation of Split-Crest Technique by Ultrasonic Bone Surgery Combined with Platelet Concentrates Prior to Dental Implant Placement

Authors: Ahmed Mohamed El-Shamy, Akram Abbas El-Awady, Mahmoud Taha Eldestawy

Abstract:

Background: The present study was to evaluate clinically and radiographically the combined effect of split crest technique by ultrasonic bone surgery and platelet concentrates in implant site development. Methods: Forty patients with narrow ridge were participated in this study. Patients were assigned randomly into one of the following four groups according to treatment: Group 1: Patients received split-crest technique by ultrasonic bone surgery with implant placement. Group 2: Patients received split-crest technique by ultrasonic bone surgery with implant placement and PRF. Group 3: Patients received split-crest technique by ultrasonic bone surgery with implant placement and PRP. Group 4: Patients received split-crest technique by ultrasonic bone surgery with implant placement and collagen membrane. Modified plaque index, modified sulcus bleeding index, and implant stability were recorded as a baseline and measured again at 3 and 6 months. CBCT scans were taken immediately after surgery completion and at 9 months to evaluate bone density at the bone-implant interface. Results after 6 months; collagen group showed statistically significantly lower mean modified bleeding index than the other groups. After 3 months, the PRF group showed statistically significantly higher mean implant stability with ostell ISQ units' than the other groups. After 6 months, the PRF group showed statistically significantly higher mean implant stability with ostell ISQ units' than the other groups. After 6 months, the PRF group showed statistically significantly higher mean bone density than the collagen group. Conclusion: Ultrasonic bone surgery in split-crest technique can be a successful option for increasing implant stability values throughout the healing period. The use of a combined technique of ultrasonic bone surgery with PRF and simultaneous implant placement potentially improves osseointegration (bone density). PRF membranes represent advanced technology for the stimulation and acceleration of bone regeneration.

Keywords: dental implants, split-crest, PRF, PRP

Procedia PDF Downloads 142
3082 Psychological Interventions as an Effective Treatment of Depression: A Critical Appraisal of the Literature

Authors: Brid Joy

Abstract:

This paper discusses some major psychological interventions and critiques their effectiveness in relation to the treatment of depression. Links are made between this evidence and the social work profession. This paper reviewed the relevant literature and evidence to ascertain the effectiveness of psychological interventions in the treatment of depression. Evidence suggests that psychological interventions are effective in the treatment of depression. However, a gulf between theory and practice remains and the difficulties in implementing evidence-based practice have been documented within this paper.

Keywords: psychological interventions, social work, depression, evidence based practice

Procedia PDF Downloads 245
3081 The Unspoken Truth of Female Domestic Violence: An Integrative Review

Authors: Glenn Guira

Abstract:

Domestic violence is an international pandemic that has affected women from all walks of life. The World Health Organization (2016), announced that recent global prevalence of violence against women indicates that 1 in 3 (35 %) women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner violence in their lifetime. It further said that violence against women is a major public health problem and violations of women’s human rights. Furthermore, the agency said that the factors associated in an increased risk of experiencing intimate partner and sexual violence include low education, child maltreatment or exposure to violence between parents, abuse during childhood, attitudes accepting violence and gender inequality. This is an integrative review of domestic violence focusing on four themes namely types of domestic violence against women, predictors of domestic violence against women, effects of domestic violence against women and strategies in addressing domestic violence against women. This integrative research study was conducted to identify relevant themes on domestic violence that was conducted and published. This study is geared toward understanding further domestic violence as a public health concern. Using the keywords domestic violence, Google Scholar, MEDLINE PLUS, and Ingenta Connect were searched to identify relevant studies. This resulted in 3,467 studies that fall within the copyright year 2006 – 2016. The studies were delimited to domestic violence against women because there are other types of violence that can be committed such as senior citizens abuse, child abuse, violence against males and gay/lesbian abuse. The significant findings of the research study are the following: the forms of domestic violence against women include physical, sexual, psychological, emotional, economic, spiritual and conflict-related violence against, the predictors of domestic violence against women include demographic, health-related, psychological, behavioral, partner-related and social-stress factors, the effects of domestic violence against women include victim-related factors and child-related factors and the strategies addressing domestic violence against women include personal-related strategies, education-related strategies, health-related strategies, legal-related strategies and judicial-related strategies. Consequent to the foregoing findings, the following conclusions are drawn by the researcher that there are published researches that presented different forms, predictors, effects and strategies addressing domestic violence committed by perpetrators against women. The researcher recommended that the summarized comprehensive data should be use to educate people who are potential victims of domestic violence and that future researchers should continue to conduct research for the development of pragmatic programs aimed at reducing domestic violence.

Keywords: domestic violence, physical abuse, intimate partner violence, sexual violence

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3080 Development of Ketorolac Tromethamine Encapsulated Stealth Liposomes: Pharmacokinetics and Bio Distribution

Authors: Yasmin Begum Mohammed

Abstract:

Ketorolac tromethamine (KTM) is a non-steroidal anti-inflammatory drug with a potent analgesic and anti-inflammatory activity due to prostaglandin related inhibitory effect of drug. It is a non-selective cyclo-oxygenase inhibitor. The drug is currently used orally and intramuscularly in multiple divided doses, clinically for the management arthritis, cancer pain, post-surgical pain, and in the treatment of migraine pain. KTM has short biological half-life of 4 to 6 hours, which necessitates frequent dosing to retain the action. The frequent occurrence of gastrointestinal bleeding, perforation, peptic ulceration, and renal failure lead to the development of other drug delivery strategies for the appropriate delivery of KTM. The ideal solution would be to target the drug only to the cells or tissues affected by the disease. Drug targeting could be achieved effectively by liposomes that are biocompatible and biodegradable. The aim of the study was to develop a parenteral liposome formulation of KTM with improved efficacy while reducing side effects by targeting the inflammation due to arthritis. PEG-anchored (stealth) and non-PEG-anchored liposomes were prepared by thin film hydration technique followed by extrusion cycle and characterized for in vitro and in vivo. Stealth liposomes (SLs) exhibited increase in percent encapsulation efficiency (94%) and 52% percent of drug retention during release studies in 24 h with good stability for a period of 1 month at -20°C and 4°C. SLs showed about maximum 55% of edema inhibition with significant analgesic effect. SLs produced marked differences over those of non-SL formulations with an increase in area under plasma concentration time curve, t₁/₂, mean residence time, and reduced clearance. 0.3% of the drug was detected in arthritic induced paw with significantly reduced drug localization in liver, spleen, and kidney for SLs when compared to other conventional liposomes. Thus SLs help to increase the therapeutic efficacy of KTM by increasing the targeting potential at the inflammatory region.

Keywords: biodistribution, ketorolac tromethamine, stealth liposomes, thin film hydration technique

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3079 Lean Models Classification: Towards a Holistic View

Authors: Y. Tiamaz, N. Souissi

Abstract:

The purpose of this paper is to present a classification of Lean models which aims to capture all the concepts related to this approach and thus facilitate its implementation. This classification allows the identification of the most relevant models according to several dimensions. From this perspective, we present a review and an analysis of Lean models literature and we propose dimensions for the classification of the current proposals while respecting among others the axes of the Lean approach, the maturity of the models as well as their application domains. This classification allowed us to conclude that researchers essentially consider the Lean approach as a toolbox also they design their models to solve problems related to a specific environment. Since Lean approach is no longer intended only for the automotive sector where it was invented, but to all fields (IT, Hospital, ...), we consider that this approach requires a generic model that is capable of being implemented in all areas.

Keywords: lean approach, lean models, classification, dimensions, holistic view

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3078 A Method to Predict the Thermo-Elastic Behavior of Laser-Integrated Machine Tools

Authors: C. Brecher, M. Fey, F. Du Bois-Reymond, S. Neus

Abstract:

Additive manufacturing has emerged into a fast-growing section within the manufacturing technologies. Established machine tool manufacturers, such as DMG MORI, recently presented machine tools combining milling and laser welding. By this, machine tools can realize a higher degree of flexibility and a shorter production time. Still there are challenges that have to be accounted for in terms of maintaining the necessary machining accuracy - especially due to thermal effects arising through the use of high power laser processing units. To study the thermal behavior of laser-integrated machine tools, it is essential to analyze and simulate the thermal behavior of machine components, individual and assembled. This information will help to design a geometrically stable machine tool under the influence of high power laser processes. This paper presents an approach to decrease the loss of machining precision due to thermal impacts. Real effects of laser machining processes are considered and thus enable an optimized design of the machine tool, respective its components, in the early design phase. Core element of this approach is a matched FEM model considering all relevant variables arising, e.g. laser power, angle of laser beam, reflective coefficients and heat transfer coefficient. Hence, a systematic approach to obtain this matched FEM model is essential. Indicating the thermal behavior of structural components as well as predicting the laser beam path, to determine the relevant beam intensity on the structural components, there are the two constituent aspects of the method. To match the model both aspects of the method have to be combined and verified empirically. In this context, an essential machine component of a five axis machine tool, the turn-swivel table, serves as the demonstration object for the verification process. Therefore, a turn-swivel table test bench as well as an experimental set-up to measure the beam propagation were developed and are described in the paper. In addition to the empirical investigation, a simulative approach of the described types of experimental examination is presented. Concluding, it is shown that the method and a good understanding of the two core aspects, the thermo-elastic machine behavior and the laser beam path, as well as their combination helps designers to minimize the loss of precision in the early stages of the design phase.

Keywords: additive manufacturing, laser beam machining, machine tool, thermal effects

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3077 Pediatric Health Nursing Research in Jordan: Evaluating the State of Knowledge and Determining Future Research Direction

Authors: Inaam Khalaf, Nadin M. Abdel Razeq, Hamza Alduraidi, Suhaila Halasa, Omayyah S. Nassar, Eman Al-Horani, Jumana Shehadeh, Anna Talal

Abstract:

Background: Nursing researchers are responsible for generating knowledge that corresponds to national and global research priorities in order to promote, restore, and maintain the health of individuals and societies. The objectives of this scoping review of Jordanian literature are to assess the existing research on pediatric nursing in terms of evolution, authorship and collaborations, funding sources, methodologies, topics of research, and pediatric subjects' age groups so as to identify gaps in research. Methodology: A search was conducted using related keywords obtained from national and international databases. The reviewed literature included pediatric health articles published through December 2019 in English and Arabic, authored by nursing researchers. The investigators assessed the retrieved studies and extracted data using a data-mining checklist. Results: The review included 265 articles authored by Jordanian nursing researchers concerning children's health, published between 1987 and 2019; 95% were published between 2009 and 2019. The most commonly applied research methodology was the descriptive non-experimental method (76%). The main generic topics were health promotion and disease prevention (23%), chronic physical conditions (19%), mental health, behavioral disorders, and forensic issues (16%). Conclusion: The review findings identified a grave shortage of evidence concerning nursing care issues for children below five years of age, especially those between ages two and five years. The research priorities identified in this review resonate with those identified in international reports. Implications: Nursing researchers are encouraged to conduct more research targeting topics of national-level importance in collaboration with clinically involved nurses and international scholars.

Keywords: Jordan, scoping review, children health nursing, pediatric, adolescents

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3076 Emissions and Total Cost of Ownership Assessment of Hybrid Propulsion Concepts for Bus Transport with Compressed Natural Gases or Diesel Engine

Authors: Volker Landersheim, Daria Manushyna, Thinh Pham, Dai-Duong Tran, Thomas Geury, Omar Hegazy, Steven Wilkins

Abstract:

Air pollution is one of the emerging problems in our society. Targets of reduction of CO₂ emissions address low-carbon and resource-efficient transport. (Plug-in) hybrid electric propulsion concepts offer the possibility to reduce total cost of ownership (TCO) and emissions for public transport vehicles (e.g., bus application). In this context, typically, diesel engines are used to form the hybrid propulsion system of the vehicle. Though the technological development of diesel engines experience major advantages, some challenges such as the high amount of particle emissions remain relevant. Gaseous fuels (i.e., compressed natural gases (CNGs) or liquefied petroleum gases (LPGs) represent an attractive alternative to diesel because of their composition. In the framework of the research project 'Optimised Real-world Cost-Competitive Modular Hybrid Architecture' (ORCA), which was funded by the EU, two different hybrid-electric propulsion concepts have been investigated: one using a diesel engine as internal combustion engine and one using CNG as fuel. The aim of the current study is to analyze specific benefits for the aforementioned hybrid propulsion systems for predefined driving scenarios with regard to emissions and total cost of ownership in bus application. Engine models based on experimental data for diesel and CNG were developed. For the purpose of designing optimal energy management strategies for each propulsion system, maps-driven or quasi-static models for specific engine types are used in the simulation framework. An analogous modelling approach has been chosen to represent emissions. This paper compares the two concepts regarding their CO₂ and NOx emissions. This comparison is performed for relevant bus missions (urban, suburban, with and without zero-emission zone) and with different energy management strategies. In addition to the emissions, also the downsizing potential of the combustion engine has been analysed to minimize the powertrain TCO (pTCO) for plug-in hybrid electric buses. The results of the performed analyses show that the hybrid vehicle concept using the CNG engine shows advantages both with respect to emissions as well as to pTCO. The pTCO is 10% lower, CO₂ emissions are 13% lower, and the NOx emissions are more than 50% lower than with the diesel combustion engine. These results are consistent across all usage profiles under investigation.

Keywords: bus transport, emissions, hybrid propulsion, pTCO, CNG

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3075 Quality of Work Life of Alien Workers in Thailand

Authors: Chetsada Noknoi

Abstract:

This research aims to study the quality of life of alien workers in Thailand and to compare the quality of work life of alien workers based on personal factors and work factors. Data analysis is performed using frequencies, percentage, mean standard deviation, t-test and ANOVA. Findings will benefit to the relevant authorities to be aware of the quality of life of alien workers in Thailand. This will help to find ways to enhance the quality of life of alien workers. It also brings awareness to the problems and obstacles that alien workers face in their work and life. It is a strategic approach to improve the management of the country's alien workers to be more efficient and effective. Moreover, the knowledge can be the basis of service to the society in different ways.

Keywords: quality of work life, alien worker, contemporary marketing, management

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3074 A (Morpho) Phonological Typology of Demonstratives: A Case Study in Sound Symbolism

Authors: Seppo Kittilä, Sonja Dahlgren

Abstract:

In this paper, a (morpho)phonological typology of proximal and distal demonstratives is proposed. Only the most basic proximal (‘this’) and distal (‘that’) forms have been considered, potential more fine-grained distinctions based on proximity are not relevant to our discussion, nor are the other functions the discussed demonstratives may have. The sample comprises 82 languages that represent the linguistic diversity of the world’s languages, although the study is not based on a systematic sample. Four different major types are distinguished; (1) Vowel type: front vs. back; high vs. low vowel (2) Consonant type: front-back consonants (3) Additional element –type (4) Varia. The proposed types can further be subdivided according to whether the attested difference concern only, e.g., vowels, or whether there are also other changes. For example, the first type comprises both languages such as Betta Kurumba, where only the vowel changes (i ‘this’, a ‘that’) and languages like Alyawarra (nhinha vs. nhaka), where there are also other changes. In the second type, demonstratives are distinguished based on whether the consonants are front or back; typically front consonants (e.g., labial and dental) appear on proximal demonstratives and back consonants on distal demonstratives (such as velar or uvular consonants). An example is provided by Bunaq, where bari marks ‘this’ and baqi ‘that’. In the third type, distal demonstratives typically have an additional element, making it longer in form than the proximal one (e.g., Òko òne ‘this’, ònébé ‘that’), but the type also comprises languages where the distal demonstrative is simply phonologically longer (e.g., Ngalakan nu-gaʔye vs. nu-gunʔbiri). Finally, the last type comprises cases that do not fit into the three other types, but a number of strategies are used by the languages of this group. The two first types can be explained by iconicity; front or high phonemes appear on the proximal demonstratives, while back/low phonemes are related to distal demonstratives. This means that proximal demonstratives are pronounced at the front and/or high part of the oral cavity, while distal demonstratives are pronounced lower and more back, which reflects the proximal/distal nature of their referents in the physical world. The first type is clearly the most common in our data (40/82 languages), which suggests a clear association with iconicity. Our findings support earlier findings that proximal and distal demonstratives have an iconic phonemic manifestation. For example, it has been argued that /i/ is related to smallness (small distance). Consonants, however, have not been considered before, or no systematic correspondences have been discovered. The third type, in turn, can be explained by markedness; the distal element is more marked than the proximal demonstrative. Moreover, iconicity is relevant also here: some languages clearly use less linguistic substance for referring to entities close to the speaker, which is manifested in the longer (morpho)phonological form of the distal demonstratives. The fourth type contains different kinds of cases, and systematic generalizations are hard to make.

Keywords: demonstratives, iconicity, language typology, phonology

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