Search results for: warehouse failure risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7917

Search results for: warehouse failure risk

1467 Combination of Diane-35 and Metformin to Treat Early Endometrial Carcinoma in PCOS Women with Insulin Resistance

Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao

Abstract:

Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.

Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma

Procedia PDF Downloads 392
1466 Seismic Inversion for Geothermal Exploration

Authors: E. N. Masri, E. Takács

Abstract:

Amplitude Versus Offset (AVO) and simultaneous model-based impedance inversion techniques have not been utilized for geothermal exploration commonly; however, some recent publications called the attention that they can be very useful in the geothermal investigations. In this study, we present rock physical attributes obtained from 3D pre-stack seismic data and well logs collected in a study area of the NW part of Pannonian Basin where the geothermal reservoir is located in the fractured zones of Triassic basement and it was hit by three productive-injection well pairs. The holes were planned very successfully based on the conventional 3D migrated stack volume prior to this study. Subsequently, the available geophysical-geological datasets provided a great opportunity to test modern inversion procedures in the same area. In this presentation, we provide a summary of the theory and application of the most promising seismic inversion techniques from the viewpoint of geothermal exploration. We demonstrate P- and S-wave impedance, as well as the velocity (Vp and Vs), the density, and the Vp/Vs ratio attribute volumes calculated from the seismic and well-logging data sets. After a detailed discussion, we conclude that P-wave impedance and Vp/Vp ratio are the most helpful parameters for lithology discrimination in the study area. They detect the hot water saturated fracture zone very well thus they can be very useful in mapping the investigated reservoir. Integrated interpretation of all the obtained rock-physical parameters is essential. We are extending the above discussed pre-stack seismic tools by studying the possibilities of Elastic Impedance Inversion (EII) for geothermal exploration. That procedure provides two other useful rock-physical properties, the compressibility and the rigidity (Lamé parameters). Results of those newly created elastic parameters will also be demonstrated in the presentation. Geothermal extraction is of great interest nowadays; and we can adopt several methods have been successfully applied in the hydrocarbon exploration for decades to discover new reservoirs and reduce drilling risk and cost.

Keywords: fractured zone, seismic, well-logging, inversion

Procedia PDF Downloads 113
1465 Giving Right-of-Way to Emergency Ambulances: Attitude and Behavior of Road Users in Developing Countries

Authors: Mahmoud T. Alwidyan, Ahmad Alrawashdeh, Alaa O. Oteir

Abstract:

Background: Emergency medical service (EMS) providers, oftentimes, use the lights and sirens (L&S) of their ambulances to warn road users, navigate through traffic, and expedite transport to save lives of ill and injured patients. Despite the contribution of road users in the effectiveness of reducing transport time of EMS ambulances using L&S, there is a lack of empirical assessments exploring the road user’s attitude and behavior in such situations. This study, therefore, aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use. Methods: This was a cross-sectional survey developed and distributed to adult road users in Northern Jordan. The questionnaire included 20 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants’ responses and assessed the association between demographics and attitude statements using logistic regression. Results: A total of 1302 questionnaires were complete and appropriate for analysis. The mean age was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) in our sample would perform inappropriate action in response to EMS ambulances with L&S in use. The multivariate logistic regression model show that being female (OR, 0.63; 95% CI = 0.48-0.81), more educated (OR, 0.68; 95% CI = 0.53-0.86), or public transport driver (OR, 0.55; 95% CI = 0.34-0.90) is significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as crossing red traffic lights or following the passing by EMS ambulances, which would, in turn, increase the risk on ambulances and other road users. Conclusions: A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances, and many engage in risky driving behaviors due perhaps to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior, which, in turn, improves the efficiency of ambulance services.

Keywords: EMS ambulances, lights and sirens, road users, attitude and behavior

Procedia PDF Downloads 69
1464 Starting the Hospitalization Procedure with a Medicine Combination in the Cardiovascular Department of the Imam Reza (AS) Mashhad Hospital

Authors: Maryamsadat Habibi

Abstract:

Objective: pharmaceutical errors are avoidable occurrences that can result in inappropriate pharmaceutical use, patient harm, treatment failure, increased hospital costs and length of stay, and other outcomes that affect both the individual receiving treatment and the healthcare provider. This study aimed to perform a reconciliation of medications in the cardiovascular ward of Imam Reza Hospital in Mashhad, Iran, and evaluate the prevalence of medication discrepancies between the best medication list created for the patient by the pharmacist and the medication order of the treating physician there. Materials & Methods: The 97 patients in the cardiovascular ward of the Imam Reza Hospital in Mashhad were the subject of a cross-sectional study from June to September of 2021. After giving their informed consent and being admitted to the ward, all patients with at least one underlying condition and at least two medications being taken at home were included in the study. A medical reconciliation form was used to record patient demographics and medical histories during the first 24 hours of admission, and the information was contrasted with the doctors' orders. The doctor then discovered medication inconsistencies between the two lists and double-checked them to separate the intentional from the accidental anomalies. Finally, using SPSS software version 22, it was determined how common medical discrepancies are and how different sorts of discrepancies relate to various variables. Results: The average age of the participants in this study was 57.6915.84 years, with 57.7% of men and 42.3% of women. 95.9% of the patients among these people encountered at least one medication discrepancy, and 58.9% of them suffered at least one unintentional drug cessation. Out of the 659 medications registered in the study, 399 cases (60.54%) had inconsistencies, of which 161 cases (40.35%) involved the intentional stopping of a medication, 123 cases (30.82%) involved the stopping of a medication unintentionally, and 115 cases (28.82%) involved the continued use of a medication by adjusting the dose. Additionally, the category of cardiovascular pharmaceuticals and the category of gastrointestinal medications were found to have the highest medical inconsistencies in the current study. Furthermore, there was no correlation between the frequency of medical discrepancies and the following variables: age, ward, date of visit, type, and number of underlying diseases (P=0.13), P=0.61, P=0.72, P=0.82, P=0.44, and so forth. On the other hand, there was a statistically significant correlation between the number of medications taken at home (P=0.037) and the prevalence of medical discrepancies with gender (P=0.029). The results of this study revealed that 96% of patients admitted to the cardiovascular unit at Imam Reza Hospital had at least one medication error, which was typically an intentional drug discontinuance. According to the study's findings, patients admitted to Imam Reza Hospital's cardiovascular ward have a great potential for identifying and correcting various medication discrepancies as well as for avoiding prescription errors when the medication reconciliation method is used. As a result, it is essential to carry out a precise assessment to achieve the best treatment outcomes and avoid unintended medication discontinuation, unwanted drug-related events, and drug interactions between the patient's home medications and those prescribed in the hospital.

Keywords: drug combination, drug side effects, drug incompatibility, cardiovascular department

Procedia PDF Downloads 70
1463 Standard Protocol Selection for Acquisition of Breast Thermogram in Perspective of Early Breast Cancer Detection

Authors: Mrinal Kanti Bhowmik, Usha Rani Gogoi Jr., Anjan Kumar Ghosh, Debotosh Bhattacharjee

Abstract:

In the last few decades, breast thermography has achieved an average sensitivity and specificity of 90% for breast tumor detection. Breast thermography is a non-invasive, cost-effective, painless and radiation-free breast imaging modality which makes a significant contribution to the evaluation and diagnosis of patients, suspected of having breast cancer. An abnormal breast thermogram may indicate significant biological risk for the existence or the development of breast tumors. Breast thermography can detect a breast tumor, when the tumor is in its early stage or when the tumor is in a dense breast. The infrared breast thermography is very sensitive to environmental changes for which acquisition of breast thermography should be performed under strictly controlled conditions by undergoing some standard protocols. Several factors like air, temperature, humidity, etc. are there to be considered for characterizing thermal images as an imperative tool for detecting breast cancer. A detailed study of various breast thermogram acquisition protocols adopted by different researchers in their research work is provided here in this paper. After going through a rigorous study of different breast thermogram acquisition protocols, a new standard breast thermography acquisition setup is proposed here in this paper for proper and accurate capturing of the breast thermograms. The proposed breast thermogram acquisition setup is being built in the Radiology Department, Agartala Government Medical College (AGMC), Govt. of Tripura, Tripura, India. The breast thermograms are captured using FLIR T650sc thermal camera with the thermal sensitivity of 20 mK at 30 degree C. The paper is an attempt to highlight the importance of different critical parameters of breast thermography like different thermography views, patient preparation protocols, acquisition room requirements, acquisition system requirements, etc. This paper makes an important contribution by providing a detailed survey and a new efficient approach on breast thermogram capturing.

Keywords: acquisition protocol, breast cancer, breast thermography, infrared thermography

Procedia PDF Downloads 382
1462 Structural Challenges of Social Integration of Immigrants in Iran: Investigating the Status of Providing Citizenship and Social Services

Authors: Iman Shabanzadeh

Abstract:

In terms of its geopolitical position, Iran has been one of the main centers of migration movements in the world in recent decades. However, the policy makers' lack of preparation in completing the cycle of social integration of these immigrants, especially the second and third generation, has caused these people to always be prone to leave the country and immigrate to developed and industrialized countries. In this research, the issue of integration of immigrants in Iran from the perspective of four indicators, "Identity Documents", "Access to Banking Services", "Access to Health and Treatment Services" and "Obtaining a Driver's License" will be analyzed. The research method is descriptive-analytical. To collect information, library and document sources in the field of laws and regulations related to immigrants' rights in Iran, semi-structured interviews with experts have been used. The investigations of this study show that none of the residence documents of immigrants in Iran guarantee the full enjoyment of basic citizenship rights for them. In fact, the function of many of these identity documents, such as the census card, educational support card, etc., is only to prevent crossing the border, and none of them guarantee the basic rights of citizenship. Therefore, for many immigrants, the difference between legality and illegality is only in the risk of crossing the border, and this has led to the spread of the habit of illegal presence for them. Despite this, it seems that there is no clear and coherent policy framework around the issue of foreign immigrants in the country. This policy incoherence can be clearly seen in the diversity and plurality of identity and legal documents of the citizens present in the country and the policy maker's lack of planning to integrate and organize the identity of this huge group. Examining the differences and socioeconomic inequalities between immigrants and the native Iranian population shows that immigrants have been poorly integrated into the structures of Iranian society from an economic and social point of view.

Keywords: immigrants, social integration, citizen services, structural inequality

Procedia PDF Downloads 32
1461 A Proposed Inclusive Motor Skill Intervention Programme for Pre-schoolers in Low Resources Areas in Preparation of School Readiness

Authors: J. Van der Walt, N. A. Plastow, M. Unger

Abstract:

Gross and fine motor skill difficulties among children affect their ability to learn and progress in school. Research indicates that children in low socio-economic areas are at a higher risk of motor skill difficulties, while therapy resources are limited. The Hopscotch motor skill programme is a well-researched accessible in-school intervention developed by occupational and physiotherapists through complex intervention development. The development stage of the complex intervention development model firstly included a prevalence study in a low-resourced area in the West Coast of South Africa, indicating a high prevalence with significant motor skill difficulties among pre-school children at 14.5% with fine motor skill difficulties at 24.6%. A scoping review identifies motor skill interventions for pre-school children and a proposed a framework of fundamental concepts to consider when developing a motor skill intervention. a Delphi-study considered the framework and encouraged collaboration between therapists and educators to make the programme accessible, resource and cost effective, specifically geared towards a rural, low resourced area. The results from the Delphi study, together with the proposed framework from the scoping review was used to develop the Hopscotch programme, adopting a task-shifting approach. The eight-week small-group programme is facilitated by teachers with the support of therapists. The programme aims to improve the motor skills of pre-school aged children with motor skill difficulties to promote academic readiness through obstacle courses, ball skill games and fine motor games and crafts. A randomised controlled trial is planned as a next stage to determine the preliminary effect of the programme on the motor and early academic skills of pre-school children.

Keywords: accesible learning, motor skill intervention, school readiness, task shifting

Procedia PDF Downloads 176
1460 Identification of Analogues to EGCG for the Inhibition of HPV E7: A Fundamental Insights through Structural Dynamics Study

Authors: Murali Aarthy, Sanjeev Kumar Singh

Abstract:

High risk human papillomaviruses are highly associated with the carcinoma of the cervix and the other genital tumors. Cervical cancer develops through the multistep process in which increasingly severe premalignant dysplastic lesions called cervical intraepithelial neoplastic progress to invasive cancer. The oncoprotein E7 of human papillomavirus expressed in the lower epithelial layers drives the cells into S-phase creating an environment conducive for viral genome replication and cell proliferation. The replication of the virus occurs in the terminally differentiating epithelium and requires the activation of cellular DNA replication proteins. To date, no suitable drug molecule is available to treat HPV infection whereas identification of potential drug targets and development of novel anti-HPV chemotherapies with unique mode of actions are expected. Hence, our present study aimed to identify the potential inhibitors analogous to EGCG, a green tea molecule which is considered to be safe to use for mammalian systems. A 3D similarity search on the natural small molecule library from natural product database using EGCG identified 11 potential hits based on their similarity score. The structure based docking strategies were implemented in the potential hits and the key interacting residues of protein with compounds were identified through simulation studies and binding free energy calculations. The conformational changes between the apoprotein and the complex were analyzed with the simulation and the results demonstrated that the dynamical and structural effects observed in the protein were induced by the compounds and indicated the dominance to the oncoprotein. Overall, our study provides the basis for the structural insights of the identified potential hits and EGCG and hence, the analogous compounds identified can be potent inhibitors against the HPV 16 E7 oncoprotein.

Keywords: EGCG, oncoprotein, molecular dynamics simulation, analogues

Procedia PDF Downloads 111
1459 Size Effects on Structural Performance of Concrete Gravity Dams

Authors: Mehmet Akköse

Abstract:

Concern about seismic safety of concrete dams have been growing around the world, partly because the population at risk in locations downstream of major dams continues to expand and also because it is increasingly evident that the seismic design concepts in use at the time most existing dams were built were inadequate. Most of the investigations in the past have been conducted on large dams, typically above 100m high. A large number of concrete dams in our country and in other parts of the world are less than 50m high. Most of these dams were usually designed using pseudo-static methods, ignoring the dynamic characteristics of the structure as well as the characteristics of the ground motion. Therefore, it is important to carry out investigations on seismic behavior this category of dam in order to assess and evaluate the safety of existing dams and improve the knowledge for different high dams to be constructed in the future. In this study, size effects on structural performance of concrete gravity dams subjected to near and far-fault ground motions are investigated including dam-water-foundation interaction. For this purpose, a benchmark problem proposed by ICOLD (International Committee on Large Dams) is chosen as a numerical application. Structural performance of the dam having five different heights is evaluated according to damage criterions in USACE (U.S. Army Corps of Engineers). It is decided according to their structural performance if non-linear analysis of the dams requires or not. The linear elastic dynamic analyses of the dams to near and far-fault ground motions are performed using the step-by-step integration technique. The integration time step is 0.0025 sec. The Rayleigh damping constants are calculated assuming 5% damping ratio. The program NONSAP modified for fluid-structure systems with the Lagrangian fluid finite element is employed in the response calculations.

Keywords: concrete gravity dams, Lagrangian approach, near and far-fault ground motion, USACE damage criterions

Procedia PDF Downloads 259
1458 Marginalisation of an Age Old Culture. The Case of Female Cultural Initiation in Some South African Cultural Groups

Authors: Lesibana Rafapa

Abstract:

Accounts exist of circumcision-anchored cultural initiation in central Africa, East Africa, Southern Africa, North Africa, and West Africa -straddling states like Botswana, Kenya, Lesotho, Malawi, Senegal, South Africa, Zambia, and Zimbabwe. This attests to the continent-wide spread of this cultural practice. In this paper, the writer relates the cultural aspect of circumcision-subsuming initiation among black African cultural groups across the continent to the notion that African cultures are varied yet subscribe to a common central concept. The premise of the paper is that the common practice of initiation for both male and female children that have to be initiated by adults to the tradition and customs of a people coincides with such a central concept. The practice of traditional initiation is as broad as to encompass aspects of spirituality, morality, and social organisation, in the nature of the central concept of which it is a trans-sectional part. Cultural initiation, sometimes referred to as traditional circumcision, constitutes culture-determined rites of passage for the initiates. The study’s aim, the findings of which are presented in this paper, was to probe gender equality in the development and promotion of the cultural practice of initiation. The researcher intended to demonstrate how in South Africa, female circumcision is treated equally or marginalised in efforts of the democratic government to regulate and strengthen the practice of circumcision as part of its broader liberation programme meant to reverse politico-cultural bondage experienced during apartheid rule that the present black regime helped bring to an end. It is argued that the failure to regard female circumcision as equal to its male counterpart is a travesty of the black government’s legislation and policies espousing equality and the protection and empowerment of vulnerable and previously marginalised population groups that include black women. The writer did a desk-top study of the history and characteristics of female circumcision among the black Northern Sotho, VaTsonga, and VhaVenda cultural groups of the Limpopo Province, stretching north to the border of South Africa with Zimbabwe, as well as literature on how political and other authorities exert efforts to preserve and empower the practice. The findings were that male initiation is foregrounded and totalised to represent the practice of initiation as a whole, at the expense of its female counterpart facing marginalisation and unequal regard. It is outlined in this paper how such impoverishment of an otherwise woman-empowering cultural practice deprives hitherto black cultures that suffered brutal repression during apartheid of a fuller recovery much needed in the democratic era. The writer applies some aspects of postcolonial theory and some tropes of feminism in the discussion of an uneven status of cultural circumcision at the hands of present day powers that be.

Keywords: African cultures, female circumcision, gender equality, women empowerment

Procedia PDF Downloads 140
1457 Construction Innovation: Support for 3D Printing House

Authors: Andrea Palazzo, Daniel Macek, Veronika Malinova

Abstract:

Contour processing is the new technology challenge for architects and construction companies. The many advantages it promises make it one of the most interesting solutions for construction in terms of automation of building processes. The technology for 3D printing houses offers many application possibilities, from low-cost construction, to being considered by NASA for visionary projects as a good solution for building settlements on other planets. Another very important point is that clients, as architects, will no longer have many limits in design concerning ideas and creativity. The prices for real estate are constantly increasing and the lack of availability of construction materials as well as the speculation that has been created around it in 2021 is bringing prices to such a level that in the future real estate developers risk not being able to find customers for these ultra-expensive homes. Hence, this paper starts with the introduction of 3D printing, which now has the potential to gain an important position in the market, becoming a valid alternative to the classic construction process. This technology is not only beneficial from an economic point of view but it is also a great opportunity to have an impact on the environment by reducing CO2 emissions. Further on in the article we will also understand if, after the COP 26 (2021 United Nations Climate Change Conference), world governments could also push towards building technologies that reduce the waste materials that are needed to be disposed of and at the same time reduce emissions with the contribution of governmental funds. This paper will give us insight on the multiple benefits of 3D printing and emphasise the importance of finding new solutions for materials that can be used by the printer. Therefore, based on the type of material, it will be possible to understand the compatibility with current regulations and how the authorities will be inclined to support this technology. This will help to enable the rise and development of this technology in Europe and in the rest of the world on actual housing projects and not only on prototypes.

Keywords: additive manufacturing, contour crafting, development, new regulation, printing material

Procedia PDF Downloads 180
1456 Unveiling the Truth of Female Reproductive Health: The Tied Shackles of Authoritative Knowledge and Domestic Violence: An Ethnographic Study on an Urban Slum of Dhaka City

Authors: Saba Nuzhat

Abstract:

The present ethnographic study examines how domestic violence and authoritative knowledge affect the reproductive health of females; in terms of contraceptive behavior and induced abortion. This qualitative study has been conducted by collecting in depth informal interviews and case studies of 12 female respondents living in an urban slum of Keraniganj, located Dhaka city. The study depicts how multivariable factors are linked to a woman’s ability to contracept and make abortion decisions in a cultural context where being a wife infers to submission, limited mobility, sexual availability, and restricted autonomy on her own reproduction health. This study shows how violence is being normalized and socially acceptable, every time women do not adhere to go through expected gender roles. The study primarily explores the subjective experiences and perceptions of the females about contraceptive behavior as well as abortions from a medical anthropological perspective. A number of salient examples are highlighted into this paper where women who go through abortion or adopt various measures of contraceptives get highly influenced by authoritative knowledge or under the pressure of male dominance. The lack of female autonomy or prevalence of domestic violence challenges the gender equality of Bangladeshi society and female sovereignty in accessing sexual or reproductive rights. This paper remarks the significance of medical anthropological research that helps to understand the intricate interrelationship between authoritative knowledge and male dominance with female reproductive health in order to reduce women’s risk of experiencing domestic violence and to promote reproductive health autonomy for themselves for espousing contraceptive behaviors and abortion decisions.

Keywords: abortion, authoritative knowledge, contraception, domestic violence, reproductive health

Procedia PDF Downloads 122
1455 Analysis of Cross-Sectional and Retrograde Data on the Prevalence of Marginal Gingivitis

Authors: Ilma Robo, Saimir Heta, Nedja Hysi, Vera Ostreni

Abstract:

Introduction: Marginal gingivitis is a disease with considerable frequency among patients who present routinely for periodontal control and treatment. In fact, this disease may not have alarming symptoms in patients and may go unnoticed by themselves when personal hygiene conditions are optimal. The aim of this study was to collect retrograde data on the prevalence of marginal gingiva in the respective group of patients, evaluated according to specific periodontal diagnostic tools. Materials and methods: The study was conducted in two patient groups. The first group was with 34 patients, during December 2019-January 2020, and the second group was with 64 patients during 2010-2018 (each year in the mentioned monthly period). Bacterial plaque index, hemorrhage index, amount of gingival fluid, presence of xerostomia and candidiasis were recorded in patients. Results: Analysis of the collected data showed that susceptibility to marginal gingivitis shows higher values according to retrograde data, compared to cross-sectional ones. Susceptibility to candidiasis and the occurrence of xerostomia, even in the combination of both pathologies, as risk factors for the occurrence of marginal gingivitis, show higher values ​​according to retrograde data. The female are presented with a reduced bacterial plaque index than the males, but more importantly, this index in the females is also associated with a reduced index of gingival hemorrhage, in contrast to the males. Conclusions: Cross-sectional data show that the prevalence of marginal gingivitis is more reduced, compared to retrograde data, based on the hemorrhage index and the bacterial plaque index together. Changes in production in the amount of gingival fluid show a higher prevalence of marginal gingivitis in cross-sectional data than in retrograde data; this is based on the sophistication of the way data are recorded, which evolves over time and also based on professional sensitivity to this phenomenon.

Keywords: marginal gingivitis, cross-sectional, retrograde, prevalence

Procedia PDF Downloads 147
1454 Time to Pancreatic Surgery after Preoperative Biliary Drainage in Periampullary Cancers: A Systematic Review and Meta‑Analysis

Authors: Maatouk Mohamed, Nouira Mariem, Hamdi Kbir Gh, Mahjoubi M. F., Ben Moussa M.

Abstract:

Background and aim: Preoperative biliary drainage (PBD) has been introduced to lower bilirubin levels and to control the negative effects of obstructive jaundice in patients with malignant obstructive jaundice undergoing pancreaticoduodenectomy (PD). The optimal time interval between PBD and PD is still not clear. Delaying surgery by 4 to 6 weeks is the commonly accepted practice. However, delayed PD has been shown to decrease the rate of resection and adversely affect the tumor grading and prognosis. Thus, the purpose of our systematic review and meta-analysis was to evaluate the optimal period for PBD prior to PD: short or prolonged in terms of postoperative morbidity and survival outcomes. Methods: Trials were searched in PubMed, Science Direct, Google Scholar, and Cochrane Library until November 2022. Studies using PBD in patients with malignant obstructive jaundice that compared short duration group (SDG) (surgery performed within 3-4 weeks) with prolonged duration group (PDG) (at least 3-4 weeks after PBD) were included in this study. The risk of bias was assessed using the Rob v2 and Robins-I tools. The priori protocol was published in PROSPERO (ID: CRD42022381405). Results: Seven studies comprising 1625 patients (SDG 870, PDG 882) were included. All studies were non-randomized, and only one was prospective. No significant differences were observed between the SDG and PDG in mortality (OR= 0.59; 95% CI [0.30, 1.17], p=0.13), major morbidity (Chi² = 30.28, p <0.00001; I² = 87%), pancreatic fistula (Chi² = 6.61, p = 0.25); I² = 24%), post pancreatectomy haemorrhage (OR= 1.16; 95% CI [0.67, 2.01], p=0.59), positive drainage culture (OR= 0.36; 95% CI [0.10, 1.32], p=0.12), septic complications (OR= 0.78; 95% CI [0.23, 2.72], p=0.70), wound infection (OR= 0.08, p=0.07), operative time (MD= 0.21; p=0.21). Conclusion: Early surgery within 3 or 4 weeks after biliary drainage is both safe and effective. Thus, it is reasonable to suggest early surgery following PBD for patients having resectable periampullary cancers.

Keywords: preoperative biliary drainage, pancreatic cancer, pancreatic surgery, complication

Procedia PDF Downloads 55
1453 Adoption of Risk and Insurance among Aquaculture Producers in Khuzestan Province, Iran

Authors: Kiyanoush Ghalavand

Abstract:

Aquaculture production is inherently a risky business, and farmers face a variety of weather, pest, disease, inptut supply, and market related risks. There are many factors out farmers control and unpredictable. Insurance has an important role in aquaculture production and is a tool to support farmers against threats. Investigation of factors affecting aquaculture farmers' adoption of aquaculture insurance strategy was the objective of this study. The purpose of this study was determining the related factors to adoption of insurance by aquaculture farmers in Khuzestan province, Iran. The research design was a descriptive and correlation surveying method. Aquaculture farmers in Khuzestan province were the target population for this study. A random sample of aquaculture selected (N=1830, n =139). The main result of the study reveled that exist correlation between the level of education, knowledge about purpose of insurance, participation in extension course, visit with insurance organization, and contact with extension agents to the adoption of insurance by aquaculture farmers were significantly positive. By using Bartlett's test and KMO test, determine whether research variables are appropriate for factor analysis (Sig = 0.000, Bartlett test = 0.9724, KMO = 0.74). The number of factors was determined using a split plot, eigenvalue, and percent of variance. An examination of the items and their factors loadings was used to understand the nature of the nine factors. To reduce subjectivity, items with factor loading equal to or greater than 0.5 were considered most important when factors were labeled. The nine factors were labeled (1) Extension and education activities, (2) Economical characteristics, (3) Governmental support, (4) communicational channel, (5) local leaders, (6) Facilitate in given damage (7) Motivation establishing, (8) Given damage in appropriate methods and (9) Appropriate activities by insurance organization. The results obtained from the factors analysis reveal that the nine factors explain percentage75 of the variation of the adoption of insurance of the adoption of insurance by aquaculture farmers in Khuzestan province.

Keywords: aquaculture farmers, insurance, factorial analysis, Khuzestan province, risks

Procedia PDF Downloads 138
1452 The Impact Evaluation of the Innovation Implementation within the EU Funds on the SMEs Performance Results

Authors: Beata Ślusarczyk, Sebastian Kot

Abstract:

In subjective terms, Polish SME sector occupies a prominent position in the national economic development, in which planning of the management strategies should be primarily based on identifying and meeting the innovation needs. As a research sample, there is chosen a printing sector of industry. SMEs share in printing sector in Poland is estimated at the level of 81% of all enterprises. In recent years, the printing industry achieved one of the highest levels of EU support in Poland. There is a relatively high increase in the development of technological innovations in equipment and the associated significant increase in production capacity. It can be also noticed that on average, every third enterprise belonging to the printing industry has implemented innovations, but not all of them effected in better economic results. Therefore, the aim of this article is to evaluate the impact of the implementation of innovation projects financed from the EU funds for performance of SMEs in the printing industry. As the results of research of EU funds co-financing effects on the development of innovation in the printing industry, it was specified that examined SMEs prefer to implement product innovation to receive a grant to the project at a level between 40% to 60%, the remaining part of the investment is usually covered with equity. The most common type of innovation had indicated a single implementation, related only to the change in process, technology, or organization. The relationship between variables of the EU funds and management of innovative activities was verified. It has been observed that the identified variables arising from the support in a form of the EU funds had a positive effect on the level of earned revenue, the increase in margin and in increase in employment as well. It was confirmed that the implemented innovations supported by the European funds have a positive impact on the performance of the printing companies. Although there is a risk that due to the decreasing demand for printing services such a high level of funding the companies in this sector will significantly increase competition in the long term, that may also contribute to the economic problems of the enterprises belonging to the analyzed branch.

Keywords: innovations, SMEs, performance, results

Procedia PDF Downloads 292
1451 The Impact of Intelligent Control Systems on Biomedical Engineering and Research

Authors: Melkamu Tadesse Getachew

Abstract:

Intelligent control systems have revolutionized biomedical engineering, advancing research and enhancing medical practice. This review paper examines the impact of intelligent control on various aspects of biomedical engineering. It analyzes how these systems enhance precision and accuracy in biomedical instrumentation, improving diagnostics, monitoring, and treatment. Integration challenges are addressed, and potential solutions are proposed. The paper also investigates the optimization of drug delivery systems through intelligent control. It explores how intelligent systems contribute to precise dosing, targeted drug release, and personalized medicine. Challenges related to controlled drug release and patient variability are discussed, along with potential avenues for overcoming them. The comparison of algorithms used in intelligent control systems in biomedical control is also reviewed. The implications of intelligent control in computational and systems biology are explored, showcasing how these systems enable enhanced analysis and prediction of complex biological processes. Challenges such as interpretability, human-machine interaction, and machine reliability are examined, along with potential solutions. Intelligent control in biomedical engineering also plays a crucial role in risk management during surgical operations. This section demonstrates how intelligent systems improve patient safety and surgical outcomes when integrated into surgical robots, augmented reality, and preoperative planning. The challenges associated with these implementations and potential solutions are discussed in detail. In summary, this review paper comprehensively explores the widespread impact of intelligent control on biomedical engineering, showing the future of human health issues promising. It discusses application areas, challenges, and potential solutions, highlighting the transformative potential of these systems in advancing research and improving medical practice.

Keywords: Intelligent control systems, biomedical instrumentation, drug delivery systems, robotic surgical instruments, Computational monitoring and modeling

Procedia PDF Downloads 23
1450 Classification of ECG Signal Based on Mixture of Linear and Non-Linear Features

Authors: Mohammad Karimi Moridani, Mohammad Abdi Zadeh, Zahra Shahiazar Mazraeh

Abstract:

In recent years, the use of intelligent systems in biomedical engineering has increased dramatically, especially in the diagnosis of various diseases. Also, due to the relatively simple recording of the electrocardiogram signal (ECG), this signal is a good tool to show the function of the heart and diseases associated with it. The aim of this paper is to design an intelligent system for automatically detecting a normal electrocardiogram signal from abnormal one. Using this diagnostic system, it is possible to identify a person's heart condition in a very short time and with high accuracy. The data used in this article are from the Physionet database, available in 2016 for use by researchers to provide the best method for detecting normal signals from abnormalities. Data is of both genders and the data recording time varies between several seconds to several minutes. All data is also labeled normal or abnormal. Due to the low positional accuracy and ECG signal time limit and the similarity of the signal in some diseases with the normal signal, the heart rate variability (HRV) signal was used. Measuring and analyzing the heart rate variability with time to evaluate the activity of the heart and differentiating different types of heart failure from one another is of interest to the experts. In the preprocessing stage, after noise cancelation by the adaptive Kalman filter and extracting the R wave by the Pan and Tampkinz algorithm, R-R intervals were extracted and the HRV signal was generated. In the process of processing this paper, a new idea was presented that, in addition to using the statistical characteristics of the signal to create a return map and extraction of nonlinear characteristics of the HRV signal due to the nonlinear nature of the signal. Finally, the artificial neural networks widely used in the field of ECG signal processing as well as distinctive features were used to classify the normal signals from abnormal ones. To evaluate the efficiency of proposed classifiers in this paper, the area under curve ROC was used. The results of the simulation in the MATLAB environment showed that the AUC of the MLP and SVM neural network was 0.893 and 0.947, respectively. As well as, the results of the proposed algorithm in this paper indicated that the more use of nonlinear characteristics in normal signal classification of the patient showed better performance. Today, research is aimed at quantitatively analyzing the linear and non-linear or descriptive and random nature of the heart rate variability signal, because it has been shown that the amount of these properties can be used to indicate the health status of the individual's heart. The study of nonlinear behavior and dynamics of the heart's neural control system in the short and long-term provides new information on how the cardiovascular system functions, and has led to the development of research in this field. Given that the ECG signal contains important information and is one of the common tools used by physicians to diagnose heart disease, but due to the limited accuracy of time and the fact that some information about this signal is hidden from the viewpoint of physicians, the design of the intelligent system proposed in this paper can help physicians with greater speed and accuracy in the diagnosis of normal and patient individuals and can be used as a complementary system in the treatment centers.

Keywords: neart rate variability, signal processing, linear and non-linear features, classification methods, ROC Curve

Procedia PDF Downloads 244
1449 A Systematic Review of Patient-Reported Outcomes and Return to Work after Surgical vs. Non-surgical Midshaft Humerus Fracture

Authors: Jamal Alasiri, Naif Hakeem, Saoud Almaslmani

Abstract:

Background: Patients with humeral shaft fractures have two different treatment options. Surgical therapy has lesser risks of non-union, mal-union, and re-intervention than non-surgical therapy. These positive clinical outcomes of the surgical approach make it a preferable treatment option despite the risks of radial nerve palsy and additional surgery-related risk. We aimed to evaluate patients’ outcomes and return to work after surgical vs. non-surgical management of shaft humeral fracture. Methods: We used databases, including PubMed, Medline, and Cochrane Register of Controlled Trials, from 2010 to January 2022 to search for potential randomised controlled trials (RCTs) and cohort studies comparing the patients’ related outcome measures and return to work between surgical and non-surgical management of humerus fracture. Results: After carefully evaluating 1352 articles, we included three RCTs (232 patients) and one cohort study (39 patients). The surgical intervention used plate/nail fixation, while the non-surgical intervention used a splint or brace procedure to manage shaft humeral fracture. The pooled DASH effects of all three RCTs at six (M.D: -7.5 [-13.20, -1.89], P: 0.009) I2:44%) and 12 months (M.D: -1.32 [-3.82, 1.17], p:0.29, I2: 0%) were higher in patients treated surgically than in non-surgical procedures. The pooled constant Murley score at six (M.D: 7.945[2.77,13.10], P: 0.003) I2: 0%) and 12 months (M.D: 1.78 [-1.52, 5.09], P: 0.29, I2: 0%) were higher in patients who received non-surgical than surgical therapy. However, pooled analysis for patients returning to work for both groups remained inconclusive. Conclusion: Altogether, we found no significant evidence supporting the clinical benefits of surgical over non-surgical therapy. Thus, the non-surgical approach remains the preferred therapeutic choice for managing shaft humeral fractures due to its lesser side effects.

Keywords: shaft humeral fracture, surgical treatment, Patient-related outcomes, return to work, DASH

Procedia PDF Downloads 87
1448 First-Year Growth and Development of 445 Preterm Infants: A Clinical Study

Authors: Ying Deng, Fan Yang

Abstract:

Aim: To study the growth pattern of preterm infants during the first year of life and explore the association between head circumference (HC) and neurodevelopment sequences and to get a general knowledge of the incidence of anemia in preterm babies in Chengdu, Southwest China. Method: We conducted a prospective longitudinal study, neonates with gestational age < 37 weeks were enrolled this study from 2012.1.1 to 2014.7.9. Anthropometry (weight, height, HC) was obtained at birth, every month before 6 months-old and every 2 months in the next half year. All the infants’ age were corrected to 40 weeks. Growth data presented as Z-scores which was calculated by WHO Anthro software. Z-score defined as (the actual value minus the average value)/standard deviation. Neurodevelopment was assessed at 12 months-old [9-11 months corrected age (CA)] by using “Denver Development Screen Test (DDST)". The hemoglobin (Hb) was examined at 6 months for CA. Result: 445 preterm infants were followed-up 1 year, including 64 very low birth weight infants (VLBW), 246 low birth weight infants (LBW) and 135 normal birth weight infants(NBW). From full-term to 12 months after birth, catch-up growth was observed in most preterm infants. From VLBW to NBW, HCZ was -1.17 (95 % CI: -1.53,-0.80; P value < 0.0001) lower during the first12 months. WAZ was-1.12(95 % CI: -1.47,-0.76; p < 0.0001) lower. WHZ and HAZ were -1.04 (95%CI:-1.38, -0.69; P<0.0001) and -0.69 (95%CI:-1.06,-0.33; P < 0.0001) lower respectively. The peak of WAZ appeared during 0-3 months CA among preterm infants. For VLBW infants, the peak of HAZ and HCZ emerged at 8-11 months CA. However, the trend of HAZ and HCZ is the same as WAZ in LBW and NBW infants. Growth in the small for gestational age (SGA) infants was poorer than appropriate for gestational age (AGA) infants. The rate of DQ < 70 in VLBW and LBW were 29.6%, 7.7%, respectively (P < 0.0001). HCZ < -1SD at 3 months emerged as an independent predictor of DQ scores below 85 at 12 months after birth. The incidence of anemia in preterm infants was 11% at 6 months for CA. Moreover, 7 children (1.7%) diagnosed with Cerebral palsy (CP). Conclusions: The catch-up growth was observed in most preterm infants. VLBW and SGA showed poor growth. There was imbalance between WAZ and HAZ in VLBW infants. The VLBW babies had higher severe abnormal scores than LBW and NBW, especially in boys. Z score for HC at 3 months < -1SDwas a significant risk factor for abnormal DQ scores at the first year. The iron supplement reduced the morbidity of anemia in preterm infants.

Keywords: preterm infant, growth and development, DDST, Z-scores

Procedia PDF Downloads 210
1447 Evaluation of the Impact of Telematics Use on Young Drivers’ Driving Behaviour: A Naturalistic Driving Study

Authors: WonSun Chen, James Boylan, Erwin Muharemovic, Denny Meyer

Abstract:

In Australia, drivers aged between 18 and 24 remained at high risk of road fatality over the last decade. Despite the successful implementation of the Graduated Licensing System (GLS) that supports young drivers in their early phases of driving, the road fatality statistics for these drivers remains high. In response to these statistics, studies conducted in Australia prior to the start of the COVID-19 pandemic have demonstrated the benefits of using telematics devices for improving driving behaviour, However, the impact of COVID-19 lockdown on young drivers’ driving behaviour has emerged as a global concern. Therefore, this naturalistic study aimed to evaluate and compare the driving behaviour(such as acceleration, braking, speeding, etc.) of young drivers with the adoption of in-vehicle telematics devices. Forty-two drivers aged between 18 and 30 and residing in the Australian state of Victoria participated in this study during the period of May to October 2022. All participants drove with the telematics devices during the first 30-day. At the start of the second 30-day, twenty-one participants were randomised to an intervention group where they were provided with an additional telematics ray device that provided visual feedback to the drivers, especially when they committed to aggressive driving behaviour. The remaining twenty-one participants remined their driving journeys without the extra telematics ray device (control group). Such trustworthy data enabled the assessment of changes in the driving behaviour of these young drivers using a machine learning approach in Python. Results are expected to show participants from the intervention group will show improvements in their driving behaviour compared to those from the control group.Furthermore, the telematics data enable the assessment and quantification of such improvements in driving behaviour. The findings from this study are anticipated to shed some light in guiding the development of customised campaigns and interventions to further address the high road fatality among young drivers in Australia.

Keywords: driving behaviour, naturalistic study, telematics data, young drivers

Procedia PDF Downloads 107
1446 Stability of a Natural Weak Rock Slope under Rapid Water Drawdowns: Interaction between Guadalfeo Viaduct and Rules Reservoir, Granada, Spain

Authors: Sonia Bautista Carrascosa, Carlos Renedo Sanchez

Abstract:

The effect of a rapid drawdown is a classical scenario to be considered in slope stability under submerged conditions. This situation arises when totally or partially submerged slopes experience a descent of the external water level and is a typical verification to be done in a dam engineering discipline, as reservoir water levels commonly fluctuate noticeably during seasons and due to operational reasons. Although the scenario is well known and predictable in general, site conditions can increase the complexity of its assessment and external factors are not always expected, can cause a reduction in the stability or even a failure in a slope under a rapid drawdown situation. The present paper describes and discusses the interaction between two different infrastructures, a dam and a highway, and the impact on the stability of a natural rock slope overlaid by the north abutment of a viaduct of the A-44 Highway due to the rapid drawdown of the Rules Dam, in the province of Granada (south of Spain). In the year 2011, with both infrastructures, the A-44 Highway and the Rules Dam already constructed, delivered and under operation, some movements start to be recorded in the approximation embankment and north abutment of the Guadalfeo Viaduct, included in the highway and developed to solve the crossing above the tail of the reservoir. The embankment and abutment were founded in a low-angle natural rock slope formed by grey graphic phyllites, distinctly weathered and intensely fractured, with pre-existing fault and weak planes. After the first filling of the reservoir, to a relative level of 243m, three consecutive drawdowns were recorded in the autumns 2010, 2011 and 2012, to relative levels of 234m, 232m and 225m. To understand the effect of these drawdowns in the weak rock mass strength and in its stability, a new geological model was developed, after reviewing all the available ground investigations, updating the geological mapping of the area and supplemented with an additional geotechnical and geophysical investigations survey. Together with all this information, rainfall and reservoir level evolution data have been reviewed in detail to incorporate into the monitoring interpretation. The analysis of the monitoring data and the new geological and geotechnical interpretation, supported by the use of limit equilibrium software Slide2, concludes that the movement follows the same direction as the schistosity of the phyllitic rock mass, coincident as well with the direction of the natural slope, indicating a deep-seated movement of the whole slope towards the reservoir. As part of these conclusions, the solutions considered to reinstate the highway infrastructure to the required FoS will be described, and the geomechanical characterization of these weak rocks discussed, together with the influence of water level variations, not only in the water pressure regime but in its geotechnical behavior, by the modification of the strength parameters and deformability.

Keywords: monitoring, rock slope stability, water drawdown, weak rock

Procedia PDF Downloads 150
1445 Detection of Bcl2 Polymorphism in Patient with Hepatocellular carcinoma

Authors: Mohamed Abdel-Hamid, Olfat Gamil Shaker, Doha El-Sayed Ellakwa, Eman Fathy Abdel-Maksoud

Abstract:

Introduction: Despite advances in the knowledge of the molecular virology of hepatitis C virus (HCV), the mechanisms of hepatocellular injury in HCV infection are not completely understood. Hepatitis C viral infection (HCV) influences the susceptibility to apoptosis. This could lead to insufficient antiviral immune response and persistent viral infection. Aim of this study: was to examine whether BCL-2 gene polymorphism at codon 43 (+127G/A or Ala43Thr) has an impact on development of hepatocellular carcinoma caused by chronic hepatitis C Egyptian patients. Subjects and Methods: The study included three groups; group 1: composing of 30 patients with hepatocellular carcinoma (HCC), group 2 composing of 30 patients with HCV, group 3 composing of 30 healthy subjects matching the same age and socioeconomic status were taken as a control group. Gene polymorphism of BCL2 (Ala43Thr) were evaluated by PCR-RFLP technique and measured for all patients and controls. Results: The summed 43Thr genotype was more frequent and statistically significant in HCC patients as compared to control group. This genotype of BCL2 gene may inhibit the programmed cell death which leads to disturbance in tissue and cells homeostasis and reduction in immune regulation. This result leads to viral replication and HCV persistence. Moreover, virus produces variety of mechanisms to block genes participated in apoptosis. This mechanism proves that HCV patients who have 43Thr genotype are more susceptible to HCC. Conclusion: The data suggest for the first time that the BCL2 polymorphism is associated with the susceptibility to HCC in Egyptian populations and might be used as molecular markers for evaluating HCC risk. This study clearly demonstrated that Chronic HCV exhibit a deregulation of apoptosis with the disease progression. This provides an insight into the pathogenesis of chronic HCV infection, and may contribute to the therapy.

Keywords: BCL2 gene, Hepatitis C Virus, Hepatocellular carcinoma, sensitivity, specificity, apoptosis

Procedia PDF Downloads 493
1444 Impact of Ethiopia's Productive Safety Net Program on Household Dietary Diversity and Child Nutrition in Rural Ethiopia

Authors: Tagel Gebrehiwot, Carolina Castilla

Abstract:

Food insecurity and child malnutrition are among the most critical issues in Ethiopia. Accordingly, different reform programs have been carried to improve household food security. The Food Security Program (FSP) (among others) was introduced to combat the persistent food insecurity problem in the country. The FSP combines a safety net component called the Productive Safety Net Program (PSNP) started in 2005. The goal of PSNP is to offer multi-annual transfers, such as food, cash or a combination of both to chronically food insecure households to break the cycle of food aid. Food or cash transfers are the main elements of PSNP. The case for cash transfers builds on the Sen’s analysis of ‘entitlement to food’, where he argues that restoring access to food by improving demand is a more effective and sustainable response to food insecurity than food aid. Cash-based schemes offer a greater choice of use of the transfer and can allow a greater diversity of food choice. It has been proven that dietary diversity is positively associated with the key pillars of food security. Thus, dietary diversity is considered as a measure of household’s capacity to access a variety of food groups. Studies of dietary diversity among Ethiopian rural households are somewhat rare and there is still a dearth of evidence on the impact of PSNP on household dietary diversity. In this paper, we examine the impact of the Ethiopia’s PSNP on household dietary diversity and child nutrition using panel household surveys. We employed different methodologies for identification. We exploit the exogenous increase in kebeles’ PSNP budget to identify the effect of the change in the amount of money households received in transfers between 2012 and 2014 on the change in dietary diversity. We use three different approaches to identify this effect: two-stage least squares, reduced form IV, and generalized propensity score matching using a continuous treatment. The results indicate the increase in PSNP transfers between 2012 and 2014 had no effect on household dietary diversity. Estimates for different household dietary indicators reveal that the effect of the change in the cash transfer received by the household is statistically and economically insignificant. This finding is robust to different identification strategies and the inclusion of control variables that determine eligibility to become a PSNP beneficiary. To identify the effect of PSNP participation on children height-for-age and stunting we use a difference-in-difference approach. We use children between 2 and 5 in 2012 as a baseline because by then they have achieved long-term failure to grow. The treatment group comprises children ages 2 to 5 in 2014 in PSNP participant households. While changes in height-for-age take time, two years of additional transfers among children who were not born or under the age of 2-3 in 2012 have the potential to make a considerable impact on reducing the prevalence of stunting. The results indicate that participation in PSNP had no effect on child nutrition measured as height-for-age or probability of beings stunted, suggesting that PSNP should be designed in a more nutrition-sensitive way.

Keywords: continuous treatment, dietary diversity, impact, nutrition security

Procedia PDF Downloads 314
1443 Hormone Replacement Therapy (HRT) and Its Impact on the All-Cause Mortality of UK Women: A Matched Cohort Study 1984-2017

Authors: Nurunnahar Akter, Elena Kulinskaya, Nicholas Steel, Ilyas Bakbergenuly

Abstract:

Although Hormone Replacement Therapy (HRT) is an effective treatment in ameliorating menopausal symptoms, it has mixed effects on different health outcomes, increasing, for instance, the risk of breast cancer. Because of this, many symptomatic women are left untreated. Untreated menopausal symptoms may result in other health issues, which eventually put an extra burden and costs to the health care system. All-cause mortality analysis may explain the net benefits and risks of the HRT therapy. However, it received far less attention in HRT studies. This study investigated the impact of HRT on all-cause mortality using electronically recorded primary care data from The Health Improvement Network (THIN) that broadly represents the female population in the United Kingdom (UK). The study entry date for this study was the record of the first HRT prescription from 1984, and patients were followed up until death or transfer to another GP practice or study end date, which was January 2017. 112,354 HRT users (cases) were matched with 245,320 non-users by age at HRT initiation and general practice (GP). The hazards of all-cause mortality associated with HRT were estimated by a parametric Weibull-Cox model adjusting for a wide range of important medical, lifestyle, and socio-demographic factors. The multilevel multiple imputation techniques were used to deal with missing data. This study found that during 32 years of follow-up, combined HRT reduced the hazard ratio (HR) of all-cause mortality by 9% (HR: 0.91; 95% Confidence Interval, 0.88-0.94) in women of age between 46 to 65 at first treatment compared to the non-users of the same age. Age-specific mortality analyses found that combined HRT decreased mortality by 13% (HR: 0.87; 95% CI, 0.82-0.92), 12% (HR: 0.88; 95% CI, 0.82-0.93), and 8% (HR: 0.92; 95% CI, 0.85-0.98), in 51 to 55, 56 to 60, and 61 to 65 age group at first treatment, respectively. There was no association between estrogen-only HRT and women’s all-cause mortality. The findings from this study may help to inform the choices of women at menopause and to further educate the clinicians and resource planners.

Keywords: hormone replacement therapy, multiple imputations, primary care data, the health improvement network (THIN)

Procedia PDF Downloads 152
1442 Harmful Algal Blooming Micro-Algae in Kenya’s Coastal Waters

Authors: Nancy Awuor Oduor, Nils Moosdorf

Abstract:

Harmful Algal Blooms (HABs) are a threat to coastal water quality, marine biodiversity, and human health. The attention on HABs and associated phycotoxins is still very low in tropical coastal developing countries despite the high dependence of local communities on coastal and marine resources for food and livelihoods and the growing evidence of the global increase in HABs frequency, toxicity, and geographical expansion. Lack of HABs monitoring thus creates a high risk of exposure due to uncertainty. This study assessed the spatial and temporal variability and effects of potential HAB-forming species in Kenya’s coastal waters. The preliminary results from 463 sampled collected over a series of 10 coastal surveys conducted over 267 Km of Kenya’s coastline between August 2021 and July 2022 revealed the presence of 87 potential algal blooming species belonging to 47 genera dominated by species capable of producing toxins, causing physical harm and high biomass at 41, 31 and 21 % respectively. The taxonomic composition was also dominated by dinoflagellates at 47%, followed by diatoms, cyanobacteria, and silicoflagellates at 39, 12, and 2%, respectively. About 92 % of the toxin-producing species were established in the creek waters. However, there were no significant variations established in species richness between the dry and wet seasons. Paralytic Shellfish Poisoning (PSP) toxin-producing dinoflagellates Alexandrium spp., Aphanizomenon spp., Gonyaulax spp., Gymnodinium spp., and Brachydinium capitatum, and Amnesic Shellfish Poisoning (ASP) Toxin producing diatoms Amphora spp., Nitzschia spp. and Pseudo-nitzschia spp. Frequented the area in low cell densities ranging between 5 and 1500 cells/L. However, no domoic acid (DA) and saxitoxins (SXTs) were detected during the July surveys. This does not mean that the toxins are absent in the area, and longer studies are recommended.

Keywords: harmful algal blooms, phycotoxins, saxitoxin, domoic acid, Kenya

Procedia PDF Downloads 45
1441 Effect of Different Contaminants on Mineral Insulating Oil Characteristics

Authors: H. M. Wilhelm, P. O. Fernandes, L. P. Dill, C. Steffens, K. G. Moscon, S. M. Peres, V. Bender, T. Marchesan, J. B. Ferreira Neto

Abstract:

Deterioration of insulating oil is a natural process that occurs during transformers operation. However, this process can be accelerated by some factors, such as oxygen, high temperatures, metals and, moisture, which rapidly reduce oil insulating capacity and favor transformer faults. Parts of building materials of a transformer can be degraded and yield soluble compounds and insoluble particles that shorten the equipment life. Physicochemical tests, dissolved gas analysis (including propane, propylene and, butane), volatile and furanic compounds determination, besides quantitative and morphological analyses of particulate are proposed in this study in order to correlate transformers building materials degradation with insulating oil characteristics. The present investigation involves tests of medium temperature overheating simulation by means of an electric resistance wrapped with the following materials immersed in mineral insulating oil: test I) copper, tin, lead and, paper (heated at 350-400 °C for 8 h); test II) only copper (at 250 °C for 11 h); and test III) only paper (at 250 °C for 8 h and at 350 °C for 8 h). A different experiment is the simulation of electric arc involving copper, using an electric welding machine at two distinct energy sets (low and high). Analysis results showed that dielectric loss was higher in the sample of test I, higher neutralization index and higher values of hydrogen and hydrocarbons, including propane and butane, were also observed. Test III oil presented higher particle count, in addition, ferrographic analysis revealed contamination with fibers and carbonized paper. However, these particles had little influence on the oil physicochemical parameters (dielectric loss and neutralization index) and on the gas production, which was very low. Test II oil showed high levels of methane, ethane, and propylene, indicating the effect of metal on oil degradation. CO2 and CO gases were formed in the highest concentration in test III, as expected. Regarding volatile compounds, in test I acetone, benzene and toluene were detected, which are oil oxidation products. Regarding test III, methanol was identified due to cellulose degradation, as expected. Electric arc simulation test showed the highest oil oxidation in presence of copper and at high temperature, since these samples had huge concentration of hydrogen, ethylene, and acetylene. Particle count was also very high, showing the highest release of copper in such conditions. When comparing high and low energy, the first presented more hydrogen, ethylene, and acetylene. This sample had more similar results to test I, pointing out that the generation of different particles can be the cause for faults such as electric arc. Ferrography showed more evident copper and exfoliation particles than in other samples. Therefore, in this study, by using different combined analytical techniques, it was possible to correlate insulating oil characteristics with possible contaminants, which can lead to transformers failure.

Keywords: Ferrography, gas analysis, insulating mineral oil, particle contamination, transformer failures

Procedia PDF Downloads 206
1440 Experimental and Numerical Analysis of Wood Pellet Breakage during Pneumatic Transport

Authors: Julian Jaegers, Siegmar Wirtz, Viktor Scherer

Abstract:

Wood pellets belong to the most established trade formats of wood-based fuels. Especially, because of the transportability and the storage properties, but also due to low moisture content, high energy density, and the homogeneous particle size and shape, wood pellets are well suited for power generation in power plants and for the use in automated domestic firing systems. Before they are thermally converted, wood pellets pass various transport and storage procedures. There they undergo different mechanical impacts, which leads to pellet breakage and abrasion and to an increase in fines. The fines lead to operational problems during storage, charging, and discharging of pellets, they can increase the risk of dust explosions and can lead to pollutant emissions during combustion. In the current work, the dependence of the formation of fines caused by breakage during pneumatic transport is analyzed experimentally and numerically. The focus lies on the influence of conveying velocity, pellet loading, pipe diameter, and the shape of pipe components like bends or couplings. A test rig has been built, which allows the experimental evaluation of the pneumatic transport varying the above-mentioned parameters. Two high-speed cameras are installed for the quantitative optical access to the particle-particle and particle-wall contacts. The particle size distribution of the bulk before and after a transport process is measured as well as the amount of fines produced. The experiments will be compared with results of corresponding DEM/CFD simulations to provide information on contact frequencies and forces. The contribution proposed will present experimental results and report on the status of the DEM/CFD simulations. The final goal of the project is to provide a better insight into pellet breakage during pneumatic transport and to develop guidelines ensuring a more gentle transport.

Keywords: DEM/CFD-simulation of pneumatic conveying, mechanical impact on wood pellets during transportation, pellet breakage, pneumatic transport of wood pellets

Procedia PDF Downloads 133
1439 A Study of the Implications for the Health and Wellbeing of Energy-Efficient House Occupants: A UK-Based Investigation of Indoor Climate and Indoor Air Quality

Authors: Patricia Kermeci

Abstract:

Policies related to the reduction of both carbon dioxide and energy consumption within the residential sector have contributed towards a growing number of energy-efficient houses being built in several countries. Many of these energy-efficient houses rely on the construction of very well insulated and highly airtight structures, ventilated mechanically. Although energy-efficient houses are indeed more energy efficient than conventional houses, concerns have been raised over the quality of their indoor air and, consequently, the possible adverse health and wellbeing effects for their occupants. Using a longitudinal study design over three different weather seasons (winter, spring and summer), this study has investigated the indoor climate and indoor air quality of different rooms (bedroom, living room and kitchen) in five energy-efficient houses and four conventional houses in the UK. Occupants have kept diaries of their activities during the studied periods and interviews have been conducted to investigate possible behavioural explanations for the findings. Data has been compared with reviews of epidemiological, toxicological and other health related published literature to reveals three main findings. First, it shows that the indoor environment quality of energy-efficient houses cannot be treated as a holistic entity as different rooms presented dissimilar indoor climate and indoor air quality. Thus, such differences might contribute to the health and wellbeing of occupants in different ways. Second, the results show that the indoor environment quality of energy-efficient houses can vary following changes in weather season, leaving occupants at a lower or higher risk of adverse health and wellbeing effects during different weather seasons. Third, one cannot assume that even identical energy-efficient houses provide a similar indoor environment quality. Fourth, the findings reveal that the practices and behaviours of the occupants of energy-efficient houses likely determine whether they enjoy a healthier indoor environment when compared with their control houses. In conclusion, it has been considered vital to understand occupants’ practices and behaviours in order to explain the ways they might contribute to the indoor climate and indoor air quality in energy-efficient houses.

Keywords: energy-efficient house, health and wellbeing, indoor environment, indoor air quality

Procedia PDF Downloads 210
1438 Land Rights, Policy and Cultural Identity in Uganda: Case of the Basongora Community

Authors: Edith Kamakune

Abstract:

As much as Indigenous rights are presumed to be part of the broad human rights regime, members of the indigenous communities have continually suffered violations, exclusions, and threat. There are a number of steps taken from the international community in trying to bridge the gap, and this has been through the inclusion of provisions as well as the passing of conventions and declarations with specific reference to the rights of indigenous peoples. Some examples of indigenous people include theSiberian Yupik of St Lawrence Island; the Ute of Utah; the Cree of Alberta, and the Xosa andKhoiKhoi of Southern Africa. Uganda’s wide cultural heritage has played a key role in the failure to pay special attention to the needs of the rights of indigenous peoples. The 1995 Constitution and the Land Act of 1998 provide for abstract land rights without necessarily paying attention to indigenous communities’ special needs. Basongora are a pastoralist community in Western Uganda whose ancestral land is the present Queen Elizabeth National Park of Western Uganda, Virunga National Park of Eastern Democratic Republic of Congo, and the small percentage of the low lands under the Rwenzori Mountains. Their values and livelihood are embedded in their strong attachment to the land, and this has been at stake for the last about 90 Years. This research was aimed atinvestigating the relationship between land rights and the right to cultural identity among indigenous communities, looking at the policy available on land and culture, and whether the policies are sensitive of the specific issues of vulnerable ethnic groups; and largely the effect of land on the right to cultural identity. The research was guided by three objectives: to examine and contextualize the concept of land rights among the Basongora community; to assess the policy frame work available for the protection of the Basongora community; to investigate the forms of vulnerability of the Basongora community. Quantitative and qualitative methods were used. a case of Kaseseand Kampala Districts were purposefully selected .138 people were recruited through random and nonrandom techniques to participate in the study, and these were 70 questionnaire respondents; 20 face to face interviews respondents; 5 key informants, and 43 participants in focus group discussions; The study established that Land is communally held and used and thatit continues to be a central source of livelihood for the Basongora; land rights are important in multiplication of herds; preservation, development, and promotion of culture and language. Research found gaps in the policy framework since the policies are concerned with tenure issues and the general provisions areambiguous. Oftenly, the Basongora are not called upon to participate in decision making processes, even on issues that affect them. The research findings call forauthorities to allow Basongora to access Queen Elizabeth National Park land for pasture during particular seasons of the year, especially during the dry seasons; land use policy; need for a clear alignment of the description of indigenous communitiesunder the constitution (Uganda, 1995) to the international definition.

Keywords: cultural identity, land rights, protection, uganda

Procedia PDF Downloads 136