Search results for: early stopping
3081 Determination of Circulating Tumor Cells in Breast Cancer Patients by Electrochemical Biosensor
Authors: Gökçe Erdemir, İlhan Yaylım, Serap Erdem-Kuruca, Musa Mutlu Can
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It has been determined that the main reason for the death of cancer disease is caused by metastases rather than the primary tumor. The cells that leave the primary tumor and enter the circulation and cause metastasis in the secondary organs are called "circulating tumor cells" (CTCs). The presence and number of circulating tumor cells has been associated with poor prognosis in many major types of cancer, including breast, prostate, and colorectal cancer. It is thought that knowledge of circulating tumor cells, which are seen as the main cause of cancer-related deaths due to metastasis, plays a key role in the diagnosis and treatment of cancer. The fact that tissue biopsies used in cancer diagnosis and follow-up are an invasive method and are insufficient in understanding the risk of metastasis and the progression of the disease have led to new searches. Liquid biopsy tests performed with a small amount of blood sample taken from the patient for the detection of CTCs are easy and reliable, as well as allowing more than one sample to be taken over time to follow the prognosis. However, since these cells are found in very small amounts in the blood, it is very difficult to capture them and specially designed analytical techniques and devices are required. Methods based on the biological and physical properties of the cells are used to capture these cells in the blood. Early diagnosis is very important in following the prognosis of tumors of epithelial origin such as breast, lung, colon and prostate. Molecules such as EpCAM, vimentin, and cytokeratins are expressed on the surface of cells that pass into the circulation from very few primary tumors and reach secondary organs from the circulation, and are used in the diagnosis of cancer in the early stage. For example, increased EpCAM expression in breast and prostate cancer has been associated with prognosis. These molecules can be determined in some blood or body fluids to be taken from patients. However, more sensitive methods are required to be able to determine when they are at a low level according to the course of the disease. The aim is to detect these molecules found in very few cancer cells with the help of sensitive, fast-sensing biosensors, first in breast cancer cells reproduced in vitro and then in blood samples taken from breast cancer patients. In this way, cancer cells can be diagnosed early and easily and effectively treated.Keywords: electrochemical biosensors, breast cancer, circulating tumor cells, EpCAM, Vimentin, Cytokeratins
Procedia PDF Downloads 2613080 Prevalence and Risk Factors of Economic Toxicity in Gynecologic Malignancies: A Systematic Review
Authors: Dongliu Li
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Objective: This study systematically evaluates the incidence and influencing factors of economic toxicity in patients with gynecological malignant tumors. Methods: Literature on economic toxicity of gynecological malignancies were comprehensively searched in Pubmed, The Cochrane Library, Web of Science, Embase, CINAHL, CNKI, Wanfang Database, Chinese Biomedical Literature database and VIP database. The search period is up to February 2024. Stata 17 software was used to conduct a single-group meta-analysis of the incidence of economic toxicity in gynecological malignant tumors, and descriptive analysis was used to analyze the influencing factors. Results: A total of 11 pieces of literature were included, including 6475 patients with gynecological malignant tumors. The results of the meta-analysis showed that the incidence of economic toxicity in gynecological malignant tumors was 40% (95%CI 31%—48%). The influencing factors of economic toxicity in patients with gynecological malignant tumors include social demographic factors, medical insurance-related factors and disease-related factors. Conclusion: The incidence of economic toxicity in patients with gynecological malignant tumors is high, and medical staff should conduct early screening of patients according to relevant influencing factors, personalized assessment of patients' economic status, early prevention work and personalized intervention measures.Keywords: gynecological malignancy, economic toxicity, the incidence rate, influencing factors, systematic review
Procedia PDF Downloads 303079 Taking Risks to Get Pleasure: Reproductive Health Behaviour of Early Adolescents in Pantura Line, Indonesia
Authors: Juariah Salam Suryadi
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North coast (Pantura) line is known as a high-risk area related to reproductive health. This is because along the line, there are many food stalls and entertainment industries that at night the function changed to be sexual transaction areas. This business line also facilitate circulation and transaction of drug and substance abuse. The environment conditions can influence adolescents who live in this area. It is because of adolescence characteristics that has high curiosity and looking for their identities. Therefore, purposes of this study were to explore reproductive health behaviour of early adolescents who lived in Pantura line and to suggest intervention based on the adolescents reproductive health conditions. This study was conducted in November 2016 among the seventh-grade students of Pusakajaya Junior High School 1 and 2, Subang District. Number of respondents were 269 students (Male=135, Female=134). The students were interviewed using a semi-structured questionnaire. Some teachers also interviewed to complement the data. The quantitative data was analyzed with univariate analysis, while content analysis was used for the qualitative data. Findings of this study showed that 85,2% of male students were smoker. Most of them started smoking at elementary school. Male students who often drunk alcohol were about 25,2% and all of them initiated to drink at elementary school. There were about 21,5% of male students ever used drug and substance abuse. There were 54,6% of the students that confessed having a lover. Most of them were female students. Sexual behaviour that ever done with their lovers were: holding hands (37,4%), kissing (4%) and embracing (6,8%). Although all of the students claimed to have never had sexual intercourse, but 5,9% of them said that they had friends who have had sexual intercourse. Most of the students also had friends with negative characteristics. Their friends were smoker (82,2%), drinker (53,2%) and drug abuse (42%). Most of the students recognized that they took the risks behaviour to get pleasure with their peers. Information from the teachers indicated that most problem of male students were smoking and drug and substance abuse; while sexuality including unwanted pregnancies were reproductive problems of many female students. Therefore, It is recommended to enhance understanding of the adolescents about risks of unhealthy behaviour through continuing reproductive health education, both in school and out of school. Policy support to create positive social environment and adolescents friendly is also suggested.Keywords: reproductive health, behaviour, early adolescents, pantura line
Procedia PDF Downloads 2893078 Effect of On-Road Vehicular Traffic on Noise Pollution in Bhubaneswar City, Eastern India
Authors: Dudam Bharath Kumar, Harsh Kumar, Naveed Ahmed
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Vehicular traffic on the road-side plays a significant role in affecting the noise pollution in most of the cities over the world. To assess the correlation of the road-traffic on noise pollution in the city environment, continuous measurements were carried out in an entire daytime starting from 8:00 AM IST to 6:00 PM IST at a single point for each 5 minutes (8:00-8:05, 9:00-9:05, 10:00-10:05 AM, ...) near the KIIT University campus road. Noise levels were observed using a mobile operated app of android cell phone and a handheld noise meter. Calibration analysis shows high correlation about 0.89 for the study location for the day time period. Results show diurnal variability of atmospheric noise pollution levels go hand-in and with the vehicular number which pass through a point of observation. The range of noise pollution levels in the daytime period is observed as 55 to 75 dB(A). As a day starts, sudden upsurge of noise levels is observed from 65 to 71 dB(A) in the early morning, 64 dB(A) in late morning, regains the same quantity 68-71 dB(A) in the afternoon, and rises 70 dB(A) in the early evening. Vehicular number of the corresponding noise levels exhibits 115-120, 150-160, and 140-160, respectively. However, this preliminary study suggests the importance of vehicular traffic on noise pollution levels in the urban environment and further to study population exposed to noise levels. Innovative approaches help curb the noise pollution through modelling the traffic noise pollution spatially and temporally over the city environments.Keywords: noise pollution, vehicular traffic, urban environment, noise meter
Procedia PDF Downloads 2973077 Optimization of Hate Speech and Abusive Language Detection on Indonesian-language Twitter using Genetic Algorithms
Authors: Rikson Gultom
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Hate Speech and Abusive language on social media is difficult to detect, usually, it is detected after it becomes viral in cyberspace, of course, it is too late for prevention. An early detection system that has a fairly good accuracy is needed so that it can reduce conflicts that occur in society caused by postings on social media that attack individuals, groups, and governments in Indonesia. The purpose of this study is to find an early detection model on Twitter social media using machine learning that has high accuracy from several machine learning methods studied. In this study, the support vector machine (SVM), Naïve Bayes (NB), and Random Forest Decision Tree (RFDT) methods were compared with the Support Vector machine with genetic algorithm (SVM-GA), Nave Bayes with genetic algorithm (NB-GA), and Random Forest Decision Tree with Genetic Algorithm (RFDT-GA). The study produced a comparison table for the accuracy of the hate speech and abusive language detection model, and presented it in the form of a graph of the accuracy of the six algorithms developed based on the Indonesian-language Twitter dataset, and concluded the best model with the highest accuracy.Keywords: abusive language, hate speech, machine learning, optimization, social media
Procedia PDF Downloads 1283076 Application of Deep Learning Algorithms in Agriculture: Early Detection of Crop Diseases
Authors: Manaranjan Pradhan, Shailaja Grover, U. Dinesh Kumar
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Farming community in India, as well as other parts of the world, is one of the highly stressed communities due to reasons such as increasing input costs (cost of seeds, fertilizers, pesticide), droughts, reduced revenue leading to farmer suicides. Lack of integrated farm advisory system in India adds to the farmers problems. Farmers need right information during the early stages of crop’s lifecycle to prevent damage and loss in revenue. In this paper, we use deep learning techniques to develop an early warning system for detection of crop diseases using images taken by farmers using their smart phone. The research work leads to building a smart assistant using analytics and big data which could help the farmers with early diagnosis of the crop diseases and corrective actions. The classical approach for crop disease management has been to identify diseases at crop level. Recently, ImageNet Classification using the convolutional neural network (CNN) has been successfully used to identify diseases at individual plant level. Our model uses convolution filters, max pooling, dense layers and dropouts (to avoid overfitting). The models are built for binary classification (healthy or not healthy) and multi class classification (identifying which disease). Transfer learning is used to modify the weights of parameters learnt through ImageNet dataset and apply them on crop diseases, which reduces number of epochs to learn. One shot learning is used to learn from very few images, while data augmentation techniques are used to improve accuracy with images taken from farms by using techniques such as rotation, zoom, shift and blurred images. Models built using combination of these techniques are more robust for deploying in the real world. Our model is validated using tomato crop. In India, tomato is affected by 10 different diseases. Our model achieves an accuracy of more than 95% in correctly classifying the diseases. The main contribution of our research is to create a personal assistant for farmers for managing plant disease, although the model was validated using tomato crop, it can be easily extended to other crops. The advancement of technology in computing and availability of large data has made possible the success of deep learning applications in computer vision, natural language processing, image recognition, etc. With these robust models and huge smartphone penetration, feasibility of implementation of these models is high resulting in timely advise to the farmers and thus increasing the farmers' income and reducing the input costs.Keywords: analytics in agriculture, CNN, crop disease detection, data augmentation, image recognition, one shot learning, transfer learning
Procedia PDF Downloads 1193075 Health Psychology Intervention: Identifying Early Symptoms in Neurological Disorders
Authors: Simon B. N. Thompson
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Early indicator of neurological disease has been proposed by the expanded Thompson Cortisol Hypothesis which suggests that yawning is linked to rises in cortisol levels. Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/Keywords: cortisol, electromyography, neurology, yawning
Procedia PDF Downloads 5903074 Assessment of the Economic Factors and Motivations towards De-Dollarization since the Early 2000s and Their Implications
Authors: Laila Algalal, Chen Xi
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The US dollar has long served as the world's primary reserve currency. However, this dominance faces growing challenges from internal US economic pressures and the rise of alternative currencies. Internally, issues like high debt, inflation, reduced competitiveness, and economic instability due to inequality in economic policies threaten the dollar's position. Externally, more countries are establishing alternative currencies, payment systems, and regional financial institutions to reduce dollar dependence. These drivers have contributed to a decline in the dollar's share of global foreign exchange reserves from 71% in 2001 to an estimated 58% in 2022. While this 13-percentage point drop took two decades, recent initiatives suggest de-dollarization could accelerate in the coming few decades. Efforts to establish non-dollar trade deals and alternative financial systems show more substantial progress compared to initiatives in the early 2000s. As the nature of the world system is anarchic, states make either individual or group efforts to guarantee their economic security and achieve their interests. Based on neoclassical realism, this paper analyzes both internal and external US economic factors driving current and future de-dollarization and the implications on the international monetary system, in addition to examining the motivation for such moves.Keywords: de-dollarization, US dollar, monetary system, economic security, economic policies.
Procedia PDF Downloads 923073 Concerns for Extreme Climate Conditions and Their Implications in Southwest Nigeria
Authors: Oyenike Eludoyin
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Extreme climate conditions are deviation from the norms and are capable of causing upsets in many important environmental parameter including disruption of water balance and air temperature balance. Studies have shown that extreme climate conditions can foretell disaster in regions with inadequate early warning systems. In this paper, we combined geographical information systems, statistics and social surveys to evaluate the physiologic indices [(Dewpoint Temperature (Td), Effective Temperature Index (ETI) and Relative Strain Index (RSI)] and extreme climate conditions in different parts of southwest Nigeria. This was with the view to assessing the nature and the impact of the conditions on the people and their coping strategies. The results indicate that minimum, mean and maximum temperatures were higher in 1960-1990 than 1991-2013 periods at most areas, and more than 80% of the people adapt to thermal stress by changing wear type or cloth, installing air conditioner and fan at home and/or work place and sleeping outside at certain period of the night and day. With respect to livelihoods, about 52% of the interviewed farmers indicated that too early rainfall, late rainfall, prolonged dryness after an initial rainfall, excessive rainfall and windstorms caused low crop yields. Main (76%) coping strategies were changing of planting dates, diversification of crops, and practices of mulching and intercropping. Government or institutional support was less than 20%.Keywords: coping strategies, extreme climate, livelihoods, physiologic comfort
Procedia PDF Downloads 2803072 Changes in Plasma Prolactin in the Algerian Saharan Goat During Kidding and Early Lactation
Authors: K. Henna, F. Toumi, Z. Amirat, F. Khammar, S. Charallah
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Saharan goat is a traditional goat breed widely distributed in the South West of Algeria. This breed is famous for its fertility, prolificacy, meat, and fibers and is well adapted to the harsh environmental conditions of its biotope. In fact, it is characterized by resistance to long photoperiods, a low water turnover and reduced metabolic needs allowing the survival of its offspring by maintaining the lactation. Several studies have claimed that parturition and lactation are critical periods that require the involvement of galactopoietic's hormones. Among them, Prolactin (PRL). The purpose of this study was to determine the changes in plasma PRL levels of healthy female Saharan goats on the day of parturition and post-partum (PP). The study was conducted on 14 females kept at the research station of Béni-Abbès: 30°07' N, 2°10' W; 495m elevation). Blood samples were taken from the jugular vein on the day of parturition (D0) and then weekly of PP (W1 to W12). Results were statistically analyzed using Kruskal Wallis and Dunn's tests in GraphPad Prism. Plasma PRL increases gradually (P>0.05) with slight fluctuations from D0 to W2 and reaches two peaks at W3 and W9 (258.2 ± 36.4 and 229.4 ± 35.1 ng/mL, respectively); this increase remains stable until W12 of lactation. The results show important modifications in plasma PRL levels in the Saharan goats on the day of parturition and in early lactation, which is needed for milk synthesis to ensure the maintenance of lactation and the growth of kids. Moreover, this study deserves to be supplemented by the dosage of thyroid hormones and estrogens to better clarify the endogenous determinism of these variations.Keywords: prolactin, parturition, lactation, Saharan goat
Procedia PDF Downloads 913071 Potential Serological Biomarker for Early Detection of Pregnancy in Cows
Authors: Shveta Bathla, Preeti Rawat, Sudarshan Kumar, Rubina Baithalu, Jogender Singh Rana, Tushar Kumar Mohanty, Ashok Kumar Mohanty
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Pregnancy is a complex process which includes series of events such as fertilization, formation of blastocyst, implantation of embryo, placental formation and development of fetus. The success of these events depends on various interactions which are synchronized by endocrine interaction between a receptive dam and competent embryo. These interactions lead to change in expression of hormones and proteins. But till date no protein biomarker is available which can be used to detect successful completion of these events. We employed quantitative proteomics approach to develop putative serological biomarker which has diagnostic applicability for early detection of pregnancy in cows. For this study, sera were collected from control (non-pregnant, n=6) and pregnant animals on successive days of pregnancy (7, 19, 45, n=6). The sera were subjected to depletion for removal of albumin using Norgen depletion kit. The tryptic peptides were labeled with iTRAQ. The peptides were pooled and fractionated using bRPLC over 80 min gradient. Then 12 fractions were injected to nLC for identification and quantitation in DDA mode using ESI. Identification using Mascot search revealed 2056 proteins out of which 352 proteins were differentially expressed. Twenty proteins were upregulated and twelve proteins were down-regulated with fold change > 1.5 and < 0.6 respectively (p < 0.05). The gene ontology studies of DEPs using Panther software revealed that majority of proteins are actively involved in catalytic activities, binding and enzyme regulatory activities. The DEP'S such as NF2, MAPK, GRIPI, UGT1A1, PARP, CD68 were further subjected to pathway analysis using KEGG and Cytoscape plugin Cluego that showed involvement of proteins in successful implantation, maintenance of pluripotency, regulation of luteal function, differentiation of endometrial macrophages, protection from oxidative stress and developmental pathways such as Hippo. Further efforts are continuing for targeted proteomics, western blot to validate potential biomarkers and development of diagnostic kit for early pregnancy diagnosis in cows.Keywords: bRPLC, Cluego, ESI, iTRAQ, KEGG, Panther
Procedia PDF Downloads 4613070 Attention Deficit Hyperactivity Disorder and Criminality: A Psychological Profile of Convicts Serving Prison Sentences
Authors: Agnieszka Nowogrodzka
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Objectives: ADHD is a neurodevelopmental disorder in which symptoms are most prominent throughout childhood. In the longer term, these symptoms, as well as the behaviour of the child, the experiences arising from the response of the community to the child's symptoms, as well as the functioning of the community itself, all contribute to the onset of secondary symptoms and subsequent outcomes of the disorder, such as crime or mental disorders. The purpose of this study is to estimate the prevalence of ADHD among Polish convicts serving a prison sentence. To that end, the study will focus on the relationship between the severity of ADHD and early childhood trauma, family relations, maladaptive cognitive schemas, as well as mental disorders. It is an attempt to assess the interdependence between ADHD, childhood experiences, and secondary outcomes. Methods: The study enrolled two groups of first-time convicts and repeat offenders aged between 21 and 65 –each of the study groups comprised 120 participants; 240 participants in total took part in the study. Participants were recruited in semi-open penal institutions in Poland (Poznań Custody Suite, Wronki Penal Institution, Iława Penal Institution). The control group comprised 110 men without criminal records aged 21 to 65. The DIVA 5.0 questionnaire was employed to identify the severity of ADHD symptoms. Other questionnaires employed in the course of the study included the Childhood Trauma Questionnaire (CTQ), The Family Adaptability and Cohesion Scale IV (FACES-IV), Young Schema Questionnaire (YSQ), and the General Health Questionnaire (GHQ-30). Results: The findings of the study in question are currently still being compiled and will be shared during the conference. The findings of a pilot study involving two cohorts of convicts (each numbering 20 men) and a control group (20 men with no criminal records) indicate a significant correlation between ADHD and the experience of early childhood trauma. The severity of ADHD also shows a correlation with the assessment of the functioning of the family, with the subjects assessing the relationships in their families more negatively than the control group. Furthermore, the severity of ADHD is also correlated with maladaptive emotional schemas manifesting in the participants. The findings also show a correlation between selected dimensions and the severity of offenses.Keywords: ADHD, social impairments, mental disorders, early childhood traumas, criminality
Procedia PDF Downloads 923069 Severity Index Level in Effectively Managing Medium Voltage Underground Power Cable
Authors: Mohd Azraei Pangah Pa'at, Mohd Ruzlin Mohd Mokhtar, Norhidayu Rameli, Tashia Marie Anthony, Huzainie Shafi Abd Halim
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Partial Discharge (PD) diagnostic mapping testing is one of the main diagnostic testing techniques that are widely used in the field or onsite testing for underground power cable in medium voltage level. The existence of PD activities is an early indication of insulation weakness hence early detection of PD activities can be determined and provides an initial prediction on the condition of the cable. To effectively manage the results of PD Mapping test, it is important to have acceptable criteria to facilitate prioritization of mitigation action. Tenaga Nasional Berhad (TNB) through Distribution Network (DN) division have developed PD severity model name Severity Index (SI) for offline PD mapping test since 2007 based on onsite test experience. However, this severity index recommendation action had never been revised since its establishment. At presence, PD measurements data have been extensively increased, hence the severity level indication and the effectiveness of the recommendation actions can be analyzed and verified again. Based on the new revision, the recommended action to be taken will be able to reflect the actual defect condition. Hence, will be accurately prioritizing preventive action plan and minimizing maintenance expenditure.Keywords: partial discharge, severity index, diagnostic testing, medium voltage, power cable
Procedia PDF Downloads 1863068 Encouraging the Development of Scientific Literacy in Early Childhood Institutions: Croatian Experience
Authors: L. Vujičić, Ž. Ivković, Ž. Boneta
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There is a widespread belief in everyday discourse that science subjects (physics, chemistry and biology) are, along with math, the most difficult school subjects in the education of an individual. This assumption is usually justified by the following facts: low GPA in these subjects, the number of pupils who fail these subjects is high in comparison to other subjects, and the number of pupils interested in continuing their studies in the fields with a focus on science subjects is lower compared to non-science-oriented fields. From that perspective, the project: “Could it be different? How do children explore it?” becomes extremely interesting because it is focused on young children and on the introduction of new methods, with aim of arousing interest in scientific literacy development in 10 kindergartens by applying the methodology of an action research, with an ethnographic approach. We define scientific literacy as a process of encouraging and nurturing the research and explorative spirit in children, as well as their natural potential and abilities that represent an object of scientific research: to learn about exploration by conducting exploration. Upon project completion, an evaluation questionnaire was created for the parents of the children who had participated in the project, as well as for those whose children had not been involved in the project. The purpose of the first questionnaire was to examine the level of satisfaction with the project implementation and its outcomes among those parents whose children had been involved in the project (N=142), while the aim of the second questionnaire was to find out how much the parents of the children not involved (N=154) in this activity were interested in this topic.Keywords: documenting, early childhood education, evaluation questionnaire for parents, scientific literacy development
Procedia PDF Downloads 2533067 The Great Mimicker: A Case of Disseminated Tuberculosis
Authors: W. Ling, Mohamed Saufi Bin Awang
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Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis
Procedia PDF Downloads 1893066 Electrical Cardiac Remodeling in Elite Athletes: A Comparative Study between Triathletes and Cyclists
Authors: Lingxia Li, Frédéric Schnell, Thibault Lachard, Anne-Charlotte Dupont, Shuzhe Ding, Solène Le Douairon Lahaye
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Background: Repetitive participation in triathlon training results in significant myocardial changes. However, whether the cardiac remodeling in triathletes is related to the specificities of the sport (consisting of three sports) raises questions. Methods: Elite triathletes and cyclists registered on the French ministerial lists of high-level athletes were involved. The basic information and routine electrocardiogram records were obtained. Electrocardiograms were evaluated according to clinical criteria. Results: Of the 105 athletes included in the study, 42 were from the short-distance triathlon (40%), and 63 were from the road cycling (60%). The average age was 22.1±4.2 years. The P wave amplitude was significantly lower in triathletes than in cyclists (p=0.005), and no significant statistical difference was found in heart rate, RR interval, PR or PQ interval, QRS complex, QRS axe, QT interval, and QTc (p>0.05). All the measured parameters were within normal ranges. The most common electrical manifestations were early repolarization (60.95%) and incomplete right bundle branch block (43.81%); there was no statistical difference between the groups (p>0.05). Conclusions: Prolonged intensive endurance exercise training induces physiological cardiac remodeling in both triathletes and cyclists. The most common electrocardiogram manifestations were early repolarization and incomplete right bundle branch block.Keywords: cardiac screening, electrocardiogram, triathlon, cycling, elite athletes
Procedia PDF Downloads 63065 Prevalent Affective-Cognitive Functioning of Intimate Partner Offenders: A study with Inmates
Authors: Alexandra Serra, Nair Torrão, Rui G. Serôdio, José A. Lima
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The present study aimed to evaluate the incidence and the prevalence of domestic violence legitimatory beliefs, emotional regulation difficulties and, early maladaptive schemas regarding intimidate partner violence in a sample of 50 Portuguese inmates. As expected, results show high levels of legitimatory beliefs, significant difficulties of emotional regulation and a set of high levels of early maladaptive schemas that clearly compromise the inmates affective-cognitive functioning. The most prevalent set of maladaptive schemas are associated with depression, anxiety, hostility, reduced ability to empathize and, dependence on the approval of others, which, combined, may trigger aggressive responses towards the intimate’s partner. Being victimized in their childhood and having committing murder are not differentiating factors on the measures we analyzed, but alcohol consumption may be associated with an intensification of domestic violence legitimatory beliefs. In the discussion of our findings, we compare the pattern of the psychosocial measures we used with the equivalent results obtained with convicted individuals that attend a community compulsory program, specifically designed for domestic violence perpetrators. We also highlight the importance of implementing specialized interventions in prison settings focusing on an evidence-based-practice.Keywords: domestic violence, intimate partner offenders, incidence and prevalence of legitimatory beliefs, Portuguese inmates
Procedia PDF Downloads 5313064 Expression of Hypoxia-Inducible Transmembrane Carbonic Anhydrases IX, Ca XII and Glut 1 in Ovarian Cancer
Authors: M. Sunitha, B. Nithyavani, Mathew Yohannan, S. Thiruvieni Balajji, M. A. Rathi, C. Arul Raj, P. Ragavendran, V. K. Gopalkrishnan
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Establishment of an early and reliable biomarker for ovarian carcinogenesis whose expression can be monitored through noninvasive techniques will enable early diagnosis of cancer. Carbonic anhydrases (CA) isozymes IX and XII have been suggested to play a role in oncogenic processes. In von Hippel-Lindau (VHL)-defective tumors, the cell surface transmembrane carbonic anhydrase (CA) CA XI and CA XII genes are overexpressed because of the absence of pVHL. These enzymes are involved in causing a hypoxia condition, thereby providing an environment for metastasis. Aberrant expression of the facilitative glucose transporter GLUT I is found in a wide spectrum of epithelial malignancies. Studying the mRNA expression of CA IX, CA XII and Glut I isozymes in ovarian cancer cell lines (OAW-42 and PA-1) revealed the expression of these hypoxia genes. Immunohistochemical staining of carbonic anhydrases was also performed in 40 ovarian cancer tissues. CA IX and CA XII were expressed at 540 bp and 520 bp in OAW42, PA1 in ovarian cancer cell lines. GLUT-1 was expressed at 325bp in OAW 42, PA1 genes in ovarian cancer cell lines. Immunohistochemistry revealed high to moderate levels of expression of these enzymes. The immuostaining was seen predominantly on the cell surface membrane. The study concluded that these genes CA IX, CA XII and Glut I are expressed under hypoxic condition in tumor cells. From the present results expression of CA IX, XII and Glut I may represent potential targets in ovarian cancer therapy.Keywords: ovarian cancer, carbonic anhydrase IX, XII, Glut I, tumor markers
Procedia PDF Downloads 3693063 An Analysis of a Relational Frame Skills Training Intervention to Increase General Intelligence in Early Childhood
Authors: Ian M. Grey, Bryan Roche, Anna Dillon, Justin Thomas, Sarah Cassidy, Dylan Colbert, Ian Stewart
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This paper presents findings from a study conducted in two schools in Abu Dhabi. The hypothesis is that teaching young children to derive various relations between stimuli leads to increases in full-scale IQ scores of typically developing children. In the experimental group, sixteen 6-7-year-old children were exposed over six weeks to an intensive training intervention designed specifically for their age group. This training intervention, presented on a tablet, aimed to improve their understanding of the relations Same, Opposite, Different, contextual control over the concept of Sameness and Difference, and purely arbitrary derived relational responding for Sameness and Difference. In the control group, sixteen 6-7-year-old children interacted with KIBO robotics over six weeks. KIBO purports to improve cognitive skills through engagement with STEAM activities. Increases in full-scale IQ were recorded for most children in the experimental group, while no increases in full-scale IQ were recorded for the control group. These findings support the hypothesis that relational skills underlie many aspects of general cognitive ability.Keywords: early childhood, derived relational responding, intelligence, relational frame theory, relational skills
Procedia PDF Downloads 1853062 Ideological and Poetological Tensions: Wu Mi’s Enterprise of Imitating and Translating George Gordon Byron
Authors: Hanjin Yan
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The English Romantic George Gordon Byron (1788-1824) was widely celebrated by men of letters in early republican China as a Satanic freedom fighter challenging classical poetics and traditional values. However, Wu Mi (1894-1978), the most persistent critic of contemporary iconoclasm, perceived Byron as a paragon of self-righteous poet-exiles who maintained moral integrity and achieved poetic excellence during times of frustration, just like canonized classical Chinese poets. Wu Mi not only composed lengthy imitations of the third canto of Byron’s Childe Harold’s Pilgrimage (1816) but also patronized a rendering of the canto. Taking André Lefevere’s rewriting theory as a framework, this paper explores the interplay of ideology and poetics by examining Wu Mi’s imitations against Byron’s original and its Chinese translation patronized by Wu Mi. Textual analysis shows that Wu Mi’s approach to Byron’s poetry was informed not only by his endeavor to invigorate classical Chinese poetics, but also by his program to preserve China’s cultural traditions and integrate Western new humanism, a theory proposed by his Harvard mentor Irving Babbitt (1865-1933). This study reveals how Byron was appropriated to serve conflicting poetic and ideological purposes in early republican China and suggests that imitation as a type of rewriting merits further attention.Keywords: George Gordon Byron, ideology, imitation, poetics, translation
Procedia PDF Downloads 2303061 The Implementation of Inclusive Education in Collaboration between Teachers of Special Education Classes and Regular Classes in a Preschool
Authors: Chiou-Shiue Ko
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As is explicitly stipulated in Article 7 of the Enforcement Rules of the Special Education Act as amended in 1998, "in principle, children with disabilities should be integrated with normal children for preschool education". Since then, all cities and counties have been committed to promoting preschool inclusive education. The Education Department, New Taipei City Government, has been actively recruiting advisory groups of professors to assist in the implementation of inclusive education in preschools since 2001. Since 2011, the author of this study has been guiding Preschool Rainbow to implement inclusive education. Through field observations, meetings, and teaching demonstration seminars, this study explored the process of how inclusive education has been successfully implemented in collaboration with teachers of special education classes and regular classes in Preschool Rainbow. The implementation phases for inclusive education in a single academic year include the following: 1) Preparatory stage. Prior to implementation, teachers in special education and regular classes discuss ways of conducting inclusive education and organize reading clubs to read books related to curriculum modifications that integrate the eight education strategies, early treatment and education, and early childhood education programs to enhance their capacity to implement and compose teaching plans for inclusive education. In addition to the general objectives of inclusive education, the objective of inclusive education for special children is also embedded into the Individualized Education Program (IEP). 2) Implementation stage. Initially, a promotional program for special education is implemented for the children to allow all the children in the preschool to understand their own special qualities and those of special children. After the implementation of three weeks of reverse inclusion, the children in the special education classes are put into groups and enter the regular classes twice a week to implement adjustments to their inclusion in the learning area and the curriculum. In 2013, further cooperation was carried out with adjacent hospitals to perform development screening activities for the early detection of children with developmental delays. 3) Review and reflection stage. After the implementation of inclusive education, all teachers in the preschool are divided into two groups to record their teaching plans and the lessons learned during implementation. The effectiveness of implementing the objective of inclusive education is also reviewed. With the collaboration of all teachers, in 2015, Preschool Rainbow won New Taipei City’s “Preschool Light” award as an exceptional model for inclusive education. Its model of implementing inclusive education can be used as a reference for other preschools.Keywords: collaboration, inclusive education, preschool, teachers, special education classes, regular classes
Procedia PDF Downloads 4293060 Identifying Autism Spectrum Disorder Using Optimization-Based Clustering
Authors: Sharifah Mousli, Sona Taheri, Jiayuan He
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Autism spectrum disorder (ASD) is a complex developmental condition involving persistent difficulties with social communication, restricted interests, and repetitive behavior. The challenges associated with ASD can interfere with an affected individual’s ability to function in social, academic, and employment settings. Although there is no effective medication known to treat ASD, to our best knowledge, early intervention can significantly improve an affected individual’s overall development. Hence, an accurate diagnosis of ASD at an early phase is essential. The use of machine learning approaches improves and speeds up the diagnosis of ASD. In this paper, we focus on the application of unsupervised clustering methods in ASD as a large volume of ASD data generated through hospitals, therapy centers, and mobile applications has no pre-existing labels. We conduct a comparative analysis using seven clustering approaches such as K-means, agglomerative hierarchical, model-based, fuzzy-C-means, affinity propagation, self organizing maps, linear vector quantisation – as well as the recently developed optimization-based clustering (COMSEP-Clust) approach. We evaluate the performances of the clustering methods extensively on real-world ASD datasets encompassing different age groups: toddlers, children, adolescents, and adults. Our experimental results suggest that the COMSEP-Clust approach outperforms the other seven methods in recognizing ASD with well-separated clusters.Keywords: autism spectrum disorder, clustering, optimization, unsupervised machine learning
Procedia PDF Downloads 1163059 A Comparative Study on Vowel Articulation in Malayalam Speaking Children Using Cochlear Implant
Authors: Deepthy Ann Joy, N. Sreedevi
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Hearing impairment (HI) at an early age, identified before the onset of language development can reduce the negative effect on speech and language development of children. Early rehabilitation is very important in the improvement of speech production in children with HI. Other than conventional hearing aids, Cochlear Implants are being used in the rehabilitation of children with HI. However, delay in acquisition of speech and language milestones persist in children with Cochlear Implant (CI). Delay in speech milestones are reflected through speech sound errors. These errors reflect the temporal and spectral characteristics of speech. Hence, acoustical analysis of the speech sounds will provide a better representation of speech production skills in children with CI. The present study aimed at investigating the acoustic characteristics of vowels in Malayalam speaking children with a cochlear implant. The participants of the study consisted of 20 Malayalam speaking children in the age range of four and seven years. The experimental group consisted of 10 children with CI, and the control group consisted of 10 typically developing children. Acoustic analysis was carried out for 5 short (/a/, /i/, /u/, /e/, /o/) and 5 long vowels (/a:/, /i:/, /u:/, /e:/, /o:/) in word-initial position. The responses were recorded and analyzed for acoustic parameters such as Vowel duration, Ratio of the duration of a short and long vowel, Formant frequencies (F₁ and F₂) and Formant Centralization Ratio (FCR) computed using the formula (F₂u+F₂a+F₁i+F₁u)/(F₂i+F₁a). Findings of the present study indicated that the values for vowel duration were higher in experimental group compared to the control group for all the vowels except for /u/. Ratio of duration of short and long vowel was also found to be higher in experimental group compared to control group except for /i/. Further F₁ for all vowels was found to be higher in experimental group with variability noticed in F₂ values. FCR was found be higher in experimental group, indicating vowel centralization. Further, the results of independent t-test revealed no significant difference across the parameters in both the groups. It was found that the spectral and temporal measures in children with CI moved towards normal range. The result emphasizes the significance of early rehabilitation in children with hearing impairment. The role of rehabilitation related aspects are also discussed in detail which can be clinically incorporated for the betterment of speech therapeutic services in children with CI.Keywords: acoustics, cochlear implant, Malayalam, vowels
Procedia PDF Downloads 1443058 Petroleum Generative Potential of Eocene-Paleocene Sequences of Potwar Basin, Pakistan
Authors: Syed Bilawal Ali Shah
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The investigation of the hydrocarbon source rock potential of Eocene-Paleocene formations of Potwar Basin, part of Upper Indus Basin Pakistan, was done using geochemical and petrological techniques. Analysis was performed on forty-five core-cutting samples from two wells. The sequences analysed are Sakesar, Lockhart and Patala formations of Potwar Basin. Patala Formation is one of Potwar Basin's major petroleum-bearing source rocks. The Lockhart Formation samples VR (%Ro) and Tmax data indicate that the formation is early mature to immature for petroleum generation for hydrocarbon generation; samples from the Patala and Sakesar formations, however, have a peak oil generation window and an early maturity (oil window). With 3.37 weight percent mean TOC and HI levels up to 498 mg HC/g TOC, the source rock characteristics of the Sakesar and Patala formations generally exhibit good to very strong petroleum generative potential. The majority of sediments representing Lockhart Formation have 1.5 wt.% mean TOC having fair to good potential with HI values ranging between 203-498 mg HC/g TOC. 1. The analysed sediments of all formations possess primarily mixed Type II/III and Type III kerogen. Analysed sediments indicate that both the Sakesar and Patala formations can possess good oil-generation potential and may act as an oil source rock in the Potwar Basin.Keywords: Potwar Basin, Patala Shale, Rock-Eval pyrolysis, Indus Basin, VR %Ro
Procedia PDF Downloads 883057 Reduce the Impact of Wildfires by Identifying Them Early from Space and Sending Location Directly to Closest First Responders
Authors: Gregory Sullivan
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The evolution of global warming has escalated the number and complexity of forest fires around the world. As an example, the United States and Brazil combined generated more than 30,000 forest fires last year. The impact to our environment, structures and individuals is incalculable. The world has learned to try to take this in stride, trying multiple ways to contain fires. Some countries are trying to use cameras in limited areas. There are discussions of using hundreds of low earth orbit satellites and linking them together, and, interfacing them through ground networks. These are all truly noble attempts to defeat the forest fire phenomenon. But there is a better, simpler answer. A bigger piece of the solutions puzzle is to see the fires while they are small, soon after initiation. The approach is to see the fires while they are very small and report their location (latitude and longitude) to local first responders. This is done by placing a sensor at geostationary orbit (GEO: 26,000 miles above the earth). By placing this small satellite in GEO, we can “stare” at the earth, and sense temperature changes. We do not “see” fires, but “measure” temperature changes. This has already been demonstrated on an experimental scale. Fires were seen at close to initiation, and info forwarded to first responders. it were the first to identify the fires 7 out of 8 times. The goal is to have a small independent satellite at GEO orbit focused only on forest fire initiation. Thus, with one small satellite, focused only on forest fire initiation, we hope to greatly decrease the impact to persons, property and the environment.Keywords: space detection, wildfire early warning, demonstration wildfire detection and action from space, space detection to first responders
Procedia PDF Downloads 703056 Automated Digital Mammogram Segmentation Using Dispersed Region Growing and Pectoral Muscle Sliding Window Algorithm
Authors: Ayush Shrivastava, Arpit Chaudhary, Devang Kulshreshtha, Vibhav Prakash Singh, Rajeev Srivastava
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Early diagnosis of breast cancer can improve the survival rate by detecting cancer at an early stage. Breast region segmentation is an essential step in the analysis of digital mammograms. Accurate image segmentation leads to better detection of cancer. It aims at separating out Region of Interest (ROI) from rest of the image. The procedure begins with removal of labels, annotations and tags from the mammographic image using morphological opening method. Pectoral Muscle Sliding Window Algorithm (PMSWA) is used for removal of pectoral muscle from mammograms which is necessary as the intensity values of pectoral muscles are similar to that of ROI which makes it difficult to separate out. After removing the pectoral muscle, Dispersed Region Growing Algorithm (DRGA) is used for segmentation of mammogram which disperses seeds in different regions instead of a single bright region. To demonstrate the validity of our segmentation method, 322 mammographic images from Mammographic Image Analysis Society (MIAS) database are used. The dataset contains medio-lateral oblique (MLO) view of mammograms. Experimental results on MIAS dataset show the effectiveness of our proposed method.Keywords: CAD, dispersed region growing algorithm (DRGA), image segmentation, mammography, pectoral muscle sliding window algorithm (PMSWA)
Procedia PDF Downloads 3123055 Effect of Total Body Irradiation for Metastatic Lymph Node and Lung Metastasis in Early Stage
Authors: Shouta Sora, Shizuki Kuriu, Radhika Mishra, Ariunbuyan Sukhbaatar, Maya Sakamoto, Shiro Mori, Tetsuya Kodama
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Lymph node (LN) metastasis accounts for 20 - 30 % of all deaths in patients with head and neck cancer. Therefore, the control of metastatic lymph nodes (MLNs) is necessary to improve the life prognosis of patients with cancer. In a classical metastatic theory, tumor cells are thought to metastasize hematogenously through a bead-like network of lymph nodes. Recently, a lymph node-mediated hematogenous metastasis theory has been proposed, in which sentinel LNs are regarded as a source of distant metastasis. Therefore, the treatment of MLNs at the early stage is essential to prevent distant metastasis. Radiation therapy is one of the primary therapeutic modalities in cancer treatment. In addition, total body irradiation (TBI) has been reported to act as activation of natural killer cells and increase of infiltration of CD4+ T-cells to tumor tissues. However, the treatment effect of TBI for MLNs remains unclear. This study evaluated the possibilities of low-dose total body irradiation (L-TBI) and middle-dose total body irradiation (M-TBI) for the treatment of MLNs. Mouse breast cancer FM3A-Luc cells were injected into subiliac lymph node (SiLN) of MXH10/Mo/LPR mice to induce the metastasis to the proper axillary lymph node (PALN) and lung. Mice were irradiated for the whole body on 4 days after tumor injection. The L-TBI and M-TBI were defined as irradiations to the whole body at 0.2 Gy and 1.0 Gy, respectively. Tumor growth was evaluated by in vivo bioluminescence imaging system. In the non-irradiated group, tumor activities on SiLN and PALN significantly increased over time, and the metastasis to the lung from LNs was confirmed 28 days after tumor injection. The L-TBI led to a tumor growth delay in PALN but did not control tumor growth in SiLN and metastasis to the lung. In contrast, it was found that the M-TBI significantly delayed the tumor growth of both SiLN and PALN and controlled the distant metastasis to the lung compared with non-irradiated and L-TBI groups. These results suggest that the M-TBI is an effective treatment method for MLNs in the early stage and distant metastasis from lymph nodes via blood vessels connected with LNs.Keywords: metastatic lymph node, lung metastasis, radiation therapy, total body irradiation, lymphatic system
Procedia PDF Downloads 1813054 Queuing Analysis and Optimization of Public Vehicle Transport Stations: A Case of South West Ethiopia Region Vehicle Stations
Authors: Mequanint Birhan
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Modern urban environments present a dynamically growing field where, notwithstanding shared goals, several mutually conflicting interests frequently collide. However, it has a big impact on the city's socioeconomic standing, waiting lines and queues are common occurrences. This results in extremely long lines for both vehicles and people on incongruous routes, service coagulation, customer murmuring, unhappiness, complaints, and looking for other options sometimes illegally. The root cause of this is corruption, which leads to traffic jams, stopping, and packing vehicles beyond their safe carrying capacity, and violating the human rights and freedoms of passengers. This study focused on the optimizing time of passengers had to wait in public vehicle stations. This applied research employed both data gathering sources and mixed approaches, then 166 samples of key informants of transport station were taken by using the Slovin sampling formula. The length of time vehicles, including the drivers and auxiliary drivers ‘Weyala', had to wait was also studied. To maximize the service level at vehicle stations, a queuing model was subsequently devised ‘Menaharya’. Time, cost, and quality encompass performance, scope, and suitability for the intended purposes. The minimal response time for passengers and vehicles queuing to reach their final destination at the stations of the Tepi, Mizan, and Bonga towns was determined. A new bus station system was modeled and simulated by Arena simulation software in the chosen study area. 84% improvement on cost reduced by 56.25%, time 4hr to 1.5hr, quality, safety and designed load performance calculations employed. Stakeholders are asked to put the model into practice and monitor the results obtained.Keywords: Arena 14 automatic rockwell, queue, transport services, vehicle stations
Procedia PDF Downloads 783053 Multiracial Society and Oral Tradition: A Study through Secondary Data
Authors: Jesvin Puay-Hwa Yeo, Laavanya Kathiravelu, Sa’Eda Binte Buang
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In the early days, myths and taboos were used by our ancestors to give explanations to the existence of nature and man, as well as to propitiate fortunes and to avoid unluckiness and harm. Myths and taboos are deeply rooted in our cultures and environment, and they form certain characteristics of any society, even in modern societies. With decades of the three main ethnic communities in Singapore – Malay, Indian and Chinese – living together, there has been intermingling and intermixing of traditions and practices. This may mean that what we think is a ‘Malay’ practice is actually one that is a hybrid of the Chinese and Malay. A good example would be the practice of covering all mirrors in a house of mourning. Therefore, the proposed seeks to explore and understand the underlying social influences of Singapore’s oral tradition. As part of a bigger cultural research project: Designing Cultures, the proposed paper focused on using secondary data to contribute to the overall cultural understanding of the integral connections between oral traditions, people and landscapes. The proposed paper will discuss in details the initials findings of the research project, including the two manners that contributed to the intermixing of myths and taboos. The first is the presence of social institutions such as religions, and the second is the presence of cross-cultural minorities such as the Straits Chinese. As well as other observations included the use and influence of Chinese oral traditions such as folklore among the early Chinese immigrants through social institutions.Keywords: cultural belief, multiracial society, myths, oral tradition
Procedia PDF Downloads 2633052 Utility of Thromboelastography Derived Maximum Amplitude and R-Time (MA-R) Ratio as a Predictor of Mortality in Trauma Patients
Authors: Arulselvi Subramanian, Albert Venencia, Sanjeev Bhoi
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Coagulopathy of trauma is an early endogenous coagulation abnormality that occurs shortly resulting in high mortality. In emergency trauma situations, viscoelastic tests may be better in identifying the various phenotypes of coagulopathy and demonstrate the contribution of platelet function to coagulation. We aimed to determine thrombin generation and clot strength, by estimating a ratio of Maximum amplitude and R-time (MA-R ratio) for identifying trauma coagulopathy and predicting subsequent mortality. Methods: We conducted a prospective cohort analysis of acutely injured trauma patients of the adult age groups (18- 50 years), admitted within 24hrs of injury, for one year at a Level I trauma center and followed up on 3rd day and 5th day of injury. Patients with h/o coagulation abnormalities, liver disease, renal impairment, with h/o intake of drugs were excluded. Thromboelastography was done and a ratio was calculated by dividing the MA by the R-time (MA-R). Patients were further stratified into sub groups based on the calculated MA-R quartiles. First sampling was done within 24 hours of injury; follow up on 3rd and 5thday of injury. Mortality was the primary outcome. Results: 100 acutely injured patients [average, 36.6±14.3 years; 94% male; injury severity score 12.2(9-32)] were included in the study. Median (min-max) on admission MA-R ratio was 15.01(0.4-88.4) which declined 11.7(2.2-61.8) on day three and slightly rose on day 5 13.1(0.06-68). There were no significant differences between sub groups in regard to age, or gender. In the lowest MA-R ratios subgroup; MA-R1 (<8.90; n = 27), injury severity score was significantly elevated. MA-R2 (8.91-15.0; n = 23), MA-R3 (15.01-19.30; n = 24) and MA-R4 (>19.3; n = 26) had no difference between their admission laboratory investigations, however slight decline was observed in hemoglobin, red blood cell count and platelet counts compared to the other subgroups. Also significantly prolonged R time, shortened alpha angle and MA were seen in MA-R1. Elevated incidence of mortality also significantly correlated with on admission low MA-R ratios (p 0.003). Temporal changes in the MA-R ratio did not correlated with mortality. Conclusion: The MA-R ratio provides a snapshot of early clot function, focusing specifically on thrombin burst and clot strength. In our observation, patients with the lowest MA-R time ratio (MA-R1) had significantly increased mortality compared with all other groups (45.5% MA-R1 compared with <25% in MA-R2 to MA-R3, and 9.1% in MA-R4; p < 0.003). Maximum amplitude and R-time may prove highly useful to predict at-risk patients early, when other physiologic indicators are absent.Keywords: coagulopathy, trauma, thromboelastography, mortality
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