Search results for: internal carotid artery; MCA
2038 Wettability Properties of Pineapple Leaf Fibers and Banana Pseudostem Fibers Treated by Cold Plasma
Authors: Tatiana Franco, Hugo A. Estupinan
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Banana pseudostem fiber (BPF) and pineapple leaf fiber (PLF) for their excellent mechanical properties and biodegradability characteristics arouse interest in different areas of research. F In tropical regions, where the banana pseudostem and the pineapple leaf are transformed into hard-to-handle solid waste, they can be low-cost raw material and environmentally sustainable in research for composite materials. In terms of functionality of this type of fiber, an open structure would allow the adsorption and retention of organic, inorganic and metallic species. In general, natural fibers have closed structures on their surface with intricate internal arrangements that can be used for the solution of environmental problems and other technological uses, however it is not possible to access their internal structure and sublayers, exposing the fibers in the natural state. An alternative method to chemical and enzymatic treatment are the processes with the plasma treatments, which are known to be clean, economical and controlled. In this type of treatment, a gas contained in a reactor in the form of plasma acts on the fiber generating changes in its structure, morphology and topography. This work compares the effects on fibers of PLF and BPF treated with cold argon plasma, alternating time and current. These fibers are grown in the regions of Antioquia-Colombia. The morphological, compositional and wettability properties of the fibers were analyzed by Raman microscopy, contact angle measurements, scanning electron microscopy (SEM) and atomic force microscopy analysis (AFM). The treatment with cold plasma on PLF and BPF allowed increasing its wettability, the topography and the microstructural relationship between lignin and cellulose.Keywords: cold plasma, contact angle, natural fibers, Raman, SEM, wettability
Procedia PDF Downloads 1482037 An Exploration of Why Insider Fraud Is the Biggest Threat to Your Business
Authors: Claire Norman-Maillet
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Insider fraud, otherwise known as occupational, employee, or internal fraud, is a financial crime threat. Perpetrated by defrauding (or attempting to defraud) one’s current, prospective, or past employer, an ‘employee’ covers anyone employed by the company, including board members and contractors. The Coronavirus pandemic has forced insider fraud into the spotlight, and it isn’t dimming. As the focus of most academics and practitioners has historically been on that of ‘external fraud’, insider fraud is often overlooked or not considered to be a real threat. However, since COVID-19 changed the working world, pushing most of us into remote or hybrid working, employers cannot easily keep an eye on what their staff are doing, which has led to reliance on trust and transparency. This, therefore, brings about an increased risk of insider fraud perpetration. The objective of this paper is to explore why insider fraud is, therefore, now the biggest threat to a business. To achieve the research objective, participating individuals within the financial crime sector (either as a practitioner or consultants) attended semi-structured interviews with the researcher. The principal recruitment strategy for these individuals was via the researcher’s LinkedIn network. The main findings in the research suggest that insider fraud has been ignored and rejected as a threat to a business, owing to a reluctance to admit that a colleague may perpetrate. A positive of the Coronavirus pandemic is that it has forced insider fraud into a more prominent position and giving it more importance on a business’ agenda and risk register. Despite insider fraud always having been a possibility (and therefore a risk) within any business, it is very rare that a business has given it the attention it requires until now, if at all. The research concludes that insider fraud needs to prioritised by all businesses, and even ahead of external fraud. The research also provides advice on how a business can add new or enhance existing controls to mitigate the risk.Keywords: insider fraud, occupational fraud, COVID-19, COVID, coronavirus, pandemic, internal fraud, financial crime, economic crime
Procedia PDF Downloads 572036 Assessing the Feasibility of Commercial Meat Rabbit Production in the Kumasi Metropolis of Ghana
Authors: Nana Segu Acquaah-Harrison, James Osei Mensah, Richard Aidoo, David Amponsah, Amy Buah, Gilbert Aboagye
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The study aimed at assessing the feasibility of commercial meat rabbit production in the Kumasi Metropolis of Ghana. Structured and unstructured questionnaires were utilized in obtaining information from two hundred meat consumers and 15 meat rabbit farmers. Data were analyzed using Net Present Value (NPV), Internal Rate of Return (IRR), Benefit Cost Ratio (BCR)/Profitability Index (PI) technique, percentages and chi-square contingency test. The study found that the current demand for rabbit meat is low (36%). The desirable nutritional attributes of rabbit meat and other socio economic factors of meat consumers make the potential demand for rabbit meat high (69%). It was estimated that GH¢5,292 (approximately $ 2672) was needed as a start-up capital for a 40-doe unit meat rabbit farm in Kumasi Metropolis. The cost of breeding animals, housing and equipment formed 12.47%, 53.97% and 24.87% respectively of the initial estimated capital. A Net Present Value of GH¢ 5,910.75 (approximately $ 2984) was obtained at the end of the fifth year, with an internal rate return and profitability index of 70% and 1.12 respectively. The major constraints identified in meat rabbit production were low price of rabbit meat, shortage of fodder, pest and diseases, high cost of capital, high cost of operating materials and veterinary care. Based on the analysis, it was concluded that meat rabbit production is feasible in the Kumasi Metropolis of Ghana. The study recommends embarking on mass advertisement; farmer association and adapting to new technologies in the production process will help to enhance productivity.Keywords: feasibility, commercial meat rabbit, production, Kumasi, Ghana
Procedia PDF Downloads 1192035 The Use of Emergency Coronary Angiography in Patients Following Out-Of-Hospital Cardiac Arrest and Subsequent Cardio-Pulmonary Resuscitation
Authors: Scott Ashby, Emily Granger, Mark Connellan
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Objectives: 1) To identify if emergency coronary angiography improves outcomes in studies examining OHCA from assumed cardiac aetiology? 2) If so, is it indicated in all patients resuscitated following OHCA, and if not, who is it indicated for? 3) How effective are investigations for screening for the appropriate patients? Background: Out-of-hospital cardiac arrest is one of the leading mechanisms of death, and the most common causative pathology is coronary artery disease. In-hospital treatment following resuscitation greatly affects outcomes, yet there is debate over the most effective protocol. Methods: A literature search was conducted over multiple databases to identify all relevant articles published from 2005. An inclusion criterion was applied to all publications retrieved, which were then sorted by type. Results: A total of 3 existing reviews and 29 clinical studies were analysed in this review. There were conflicting conclusions, however increased use of angiography has shown to improve outcomes in the majority of studies, which cover a variety of settings and cohorts. Recommendations: Currently, emergency coronary angiography appears to improve outcomes in all/most cases of OHCA of assumed cardiac aetiology, regardless of ECG findings. Until a better tool for screening is available to reduce unnecessary procedures, the benefits appear to outweigh the costs/risks.Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine
Procedia PDF Downloads 2912034 Geochemical Characterization of Geothermal Waters in Albania, Preliminary Results
Authors: Aurela Jahja, Katarzyna Wątor, Arjan Beqiraj, Piotr Rusiniak, Nevton Kodhelaj
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Albanian geological terrains represent an important node of the Alpine – Mediterranean mountain belt and are divided into several predominantly NNW - SSE striking geotectonic units, which, based on the presence or lack of Cretaceous transgression and magmatic rocks, belong to Internal or External Albanides. The internal (Korabi, Mirdita and Gashi) units are characterized by the Lower Cretaceous discordance and the presence of abundant magmatic rocks whereas in the external (Alps, Krasta-Cukali, Kruja, Ionian, Sazani and Peri Adriatic Depression) units an almost continuous sedimentation from Triassic to Paleogene is evidenced. The internal and external units show relevant differences in both geothermal and heat flow density values. The gradient values vary from 15-21.3 to 36 mK/m, while the heat flow density ranges from 42 to 60 mW/m2, in the external (Preadriatic Depression) and internal (ophiolitic belt) units, respectively. The geothermal fluids, which are found in natural springs and deep oil wells of Albania, are located in four thermo-mineral provinces: a) Peshkopi (Korabi) province; b) Kruja province; c) Preadriatic basin province, and d) South Ionian province. Thirteen geothermal waters were sampled from 11 natural springs and 2 deep wells, of which 6 springs and 2 wells from Kruja, 1 spring from Peshkopia, 2 springs from Preadriatic basin and 2 springs South Ionian province. Temperature, pH and Electrical Conductivity were measured in situ, while in laboratory were analyzed by ICP method major anions and cations and several trace elements (B, Li, Sr, Rb, I, Br, etc.). The measured values of temperature, pH and electrical conductivity range within 17-63°C, 6.26-7.92 and 724- 26856µS/cm intervals, respectively. The chemical type of the Albania thermal waters is variable. In the Kruja province prevail the Cl-SO4-NaCa and Cl-Na-Ca water types; while SO4-Ca, HCO3-Ca and Cl-HCO3-Na-Ca, and Cl-Na are found in the provinces of Peshkopi, Ionian and Preadriatic basin, respectively. In the Cl-SO4-HCO3 triangular diagram most of the geothermal waters are close to the chloride corner that belong to “mature waters”, typical of geothermal deep and hot fluids. Only samples from the Ionian province are located within the region of high bicarbonate concentration and they can be classified as peripheral waters that may have mixed with cold groundwater. In the Na-Ca-Mg and Na-K-Mg triangular diagram the majority of waters fall in the corner of sodium, suggesting that their cation ratios are controlled by mineral-solution equilibrium. There is a linear relationship between Cl and B which indicates the mixing of geothermal water with cold water, where the low-chlorine thermal waters from Ionian basin and Preadriatic depression provinces are distinguished by high-chlorine thermal waters from Kruja province. The Cl/Br molar ration of the thermal waters from Kruja province ranges from 1000 to 2660 and separates them from the thermal waters of Ionian basin and Preadriatic depression provinces having Cl/Br molar ratio lower than 650. The apparent increase of Cl/Br molar ratio that correlates with the increasing of the chloride, is probably related with dissolution of the Halite.Keywords: geothermal fluids, geotectonic units, natural springs, deep wells, mature waters, peripheral waters
Procedia PDF Downloads 2112033 Development and Evaluation of a Psychological Adjustment and Adaptation Status Scale for Breast Cancer Survivors
Authors: Jing Chen, Jun-E Liu, Peng Yue
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Objective: The objective of this study was to develop a psychological adjustment and adaptation status scale for breast cancer survivors, and to examine the reliability and validity of the scale. Method: 37 breast cancer survivors were recruited in qualitative research; a five-subject theoretical framework and an item pool of 150 items of the scale were derived from the interview data. In order to evaluate and select items and reach a preliminary validity and reliability for the original scale, the suggestions of study group members, experts and breast cancer survivors were taken, and statistical methods were used step by step in a sample of 457 breast cancer survivors. Results: An original 24-item scale was developed. The five dimensions “domestic affections”, “interpersonal relationship”, “attitude of life”, “health awareness”, “self-control/self-efficacy” explained 58.053% of the total variance. The content validity was assessed by experts, the CVI was 0.92. The construct validity was examined in a sample of 264 breast cancer survivors. The fitting indexes of confirmatory factor analysis (CFA) showed good fitting of the five dimensions model. The criterion-related validity of the total scale with PTGI was satisfactory (r=0.564, p<0.001). The internal consistency reliability and test-retest reliability were tested. Cronbach’s alpha value (0.911) showed a good internal consistency reliability, and the intraclass correlation coefficient (ICC=0.925, p<0.001) showed a satisfactory test-retest reliability. Conclusions: The scale was brief and easy to understand, was suitable for breast cancer patients whose physical strength and energy were limited.Keywords: breast cancer survivors, rehabilitation, psychological adaption and adjustment, development of scale
Procedia PDF Downloads 5062032 Autonomous Flight Control for Multirotor by Alternative Input Output State Linearization with Nested Saturations
Authors: Yong Eun Yoon, Eric N. Johnson, Liling Ren
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Multirotor is one of the most popular types of small unmanned aircraft systems and has already been used in many areas including transport, military, surveillance, and leisure. Together with its popularity, the needs for proper flight control is growing because in most applications it is required to conduct its missions autonomously, which is in many aspects based on autonomous flight control. There have been many studies about the flight control for multirotor, but there is still room for enhancements in terms of performance and efficiency. This paper presents an autonomous flight control method for multirotor based on alternative input output linearization coupled with nested saturations. With alternative choice of the output of the multirotor flight control system, we can reduce computational cost regarding Lie algebra, and the linearized system can be stabilized with the introduction of nested saturations with real poles of our own design. Stabilization of internal dynamics is also based on the nested saturations and accompanies the determination of part of desired states. In particular, outer control loops involving state variables which originally are not included in the output of the flight control system is naturally rendered through this internal dynamics stabilization. We can also observe that desired tilting angles are determined by error dynamics from outer loops. Simulation results show that in any tracking situations multirotor stabilizes itself with small time constants, preceded by tuning process for control parameters with relatively low degree of complexity. Future study includes control of piecewise linear behavior of multirotor with actuator saturations, and the optimal determination of desired states while tracking multiple waypoints.Keywords: automatic flight control, input output linearization, multirotor, nested saturations
Procedia PDF Downloads 2222031 The Influence of the Islamic State (IS) on India: Recent Developments and Challenges
Authors: Alvite Singh Ningthoujam
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The most recent terror phenomenon, which is also known as the Islamic State of Iraq and Syria (ISIS), or Islamic State (IS), has its influence felt in South Asia. This dreaded Sunni militant group, today, has become a concern in India as well. Already affected by various terror activities in the country, the influence of the IS on the radicalised Muslim youths in India has been watched closely by the security agencies. There had already been a few IS-related incidents in India due to which this issue has emerged as a threat or challenge to India’s internal security. The rapid radicalisation of youths in a few states where there are sizeable Muslim populations has gone, to some extent, in favour of the IS, particularly in the terror outfit’s recruitment process. What has added to the worry of the Indian security agencies is the announcement of the Al-Qaeda leader, Ayman al-Zawahari, of the creation of the Al-Qaeda in the Indian Subcontinent. In fact, this is a worrisome factor as both the militant groups, that is, al-Qaeda and ISIS, have a similar objective to target India and to turn this South Asian country as one of the recruiting grounds for extremists. There is also a possibility that an Indian Mujahedeen (IM) man was believed to be instrumental in recruiting for the ISIS poor Muslims in a few Indian states. If this nexus between ISIS and India’s home-grown terror groups manages to establish a robust link, then the headache of combating such amalgamated force will be a hard task for Indian security agencies. In the wake of the above developments, this paper would seek to analyse the developing trend in India in regard to IS. It would also bring out the reasons as to why further penetration of the IS influence on India would be a grave concern in the internal security of the country. The last section of the paper would highlight the steps that have been taken by the Indian government to tackle this menace effectively.Keywords: India, Islamic State, Muslim, Security
Procedia PDF Downloads 3622030 The Effect of Reverse Trendelenburg Position on the Back Pain after Cardiovascular Angiography and Interventions
Authors: Pramote Thangkratok
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The aims of this experimental study were to investigate the effect of Reverse Trendelenburg Position on the Back Pain after Cardiovascular Angiography and Interventions. In addition, to compare bleeding and hematoma occurrences at the Access site between experimental and control groups. The randomized controlled trial (RCT) was conducted in 70 patients who underwent Cardiovascular Angiography and Interventions via the femoral artery and received post procedural care at the intermediate cardiac care unit, Bangkok Heart Hospital. From December 2015 to February 2016. The control group (35 patients) was to get standard care after the intervention, whereas the experimental group (35 patients) was Reverse Trendelenburg Position 30-45 degrees. The groups were not significantly different in terms of demographic characteristics, Age, Gender, BMI, blood pressure, heart rate. While not significantly different from each other, the intensity of back pain control group had a significantly higher pain score than experimental group. Vascular complications in terms of bleeding and hematoma were not significantly different between the control and experimental groups. The findings show that Reverse Trendelenburg Position after Cardiovascular Angiography and Interventions would reduce or prevent the back pain without increasing the chance of bleeding and hematoma.Keywords: reverse trendelenburg position, back pain, cardiovascular angiography, cardiovascular interventions
Procedia PDF Downloads 2692029 Modeling Loads Applied to Main and Crank Bearings in the Compression-Ignition Two-Stroke Engine
Authors: Marcin Szlachetka, Mateusz Paszko, Grzegorz Baranski
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This paper discusses the AVL EXCITE Designer simulation research into loads applied to main and crank bearings in the compression-ignition two-stroke engine. There was created a model of engine lubrication system which covers the part of this system related to particular nodes of a bearing system, i.e. a connection of main bearings in an engine block with a crankshaft, a connection of crank pins with a connecting rod. The analysis focused on the load given as a distribution of hydrodynamic oil film pressure corresponding different values of radial internal clearance. There was also studied the impact of gas force on minimal oil film thickness in main and crank bearings versus crankshaft rotational speed. Our model calculates oil film parameters, an oil film pressure distribution, an oil temperature change and dimensions of bearings as well as an oil temperature distribution on surfaces of bearing seats. Accordingly, it was possible to select, for example, a correct clearance for each of the node bearings. The research was performed for several values of engine crankshaft speed ranging from 800 RPM to 4000 RPM. Bearing oil pressure was changed according to engine speed ranging between 1 bar and 5 bar and an oil temperature of 90°C. The main bearing clearances made initially for the calculation and research were: 0.015 mm, 0.025 mm, 0.035 mm, 0.05 mm, 0.1 mm. The oil used for the research corresponded the SAE 5W-40 classification. The paper presents the selected research results referring to certain specific operating points and bearing radial internal clearances. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK ‘PZL-KALISZ’ S.A. and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.Keywords: crank bearings, diesel engine, oil film, two-stroke engine
Procedia PDF Downloads 2002028 Internal Evaluation of Architecture University Department in Architecture Engineering Bachelor's Level: A Case from Iran
Authors: Faranak Omidian
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This study has been carried out to examine the status of architecture department at bachelor's level of engineering architecture in Islamic Azad University of Dezful in 2012-13 academic year. The present research is a descriptive cross sectional study and in terms of measurement, it is descriptive and analytical, which was done based on 7 steps and in 7 areas with 32 criteria and 169 indicators. The sample includes 201 students, 14 faculty members, 72 graduates and 39 employers. Simple random sampling method, complete enumeration method, network sampling (snowball sampling) were used for students, faculty members and graduates respectively. All sample responded to the questions. After data collection, the findings were ranked on Likert scale from desirable to undesirable with the scores ranging from 1 to 3.The results showed that the department with a score of 1.88 in regard to objectives, organizational status, management and organizations, with a score of 2 in relation to students, with a score of 1.8 in regard to faculty members was in a relatively desirable status. Regarding training courses and curriculum, it gained a score of 2.33 which indicates the desirable status of the department in this regard. It gained scores of 1.75, 2, and 1.8 with respect to educational and research facilities and equipment, teaching and learning strategies, and graduates respectively, all of which shows the relatively desirable status of the department. The results showed that the department of architecture, with an average score of 2.14 in all evaluated areas, was in a desirable situation. Therefore, although the department generally has a desirable status, it needs to put in more effort to tackle its weaknesses and shortages and corrects its defects in order to promote educational quality, taking to the desirable level.Keywords: internal evaluation, architecture department in Islamic, Azad University, Dezful
Procedia PDF Downloads 4342027 Payload Bay Berthing of an Underwater Vehicle With Vertically Actuated Thrusters
Authors: Zachary Cooper-Baldock, Paulo E. Santos, Russell S. A. Brinkworth, Karl Sammut
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In recent years, large unmanned underwater vehicles such as the Boeing Voyager and Anduril Ghost Shark have been developed. These vessels can be structured to contain onboard internal payload bays. These payload bays can serve a variety of purposes – including the launch and recovery (LAR) of smaller underwater vehicles. The LAR of smaller vessels is extremely important, as it enables transportation over greater distances, increased time on station, data transmission and operational safety. The larger vessel and its payload bay structure complicate the LAR of UUVs in contrast to static docks that are affixed to the seafloor, as they actively impact the local flow field. These flow field impacts require analysis to determine if UUV vessels can be safely launched and recovered inside the motherships. This research seeks to determine the hydrodynamic forces exerted on a vertically over-actuated, small, unmanned underwater vehicle (OUUV) during an internal LAR manoeuvre and compare this to an under-actuated vessel (UUUV). In this manoeuvre, the OUUV is navigated through the stern wake region of the larger vessel to a set point within the internal payload bay. The manoeuvre is simulated using ANSYS Fluent computational fluid dynamics models, covering the entire recovery of the OUUV and UUUV. The analysis of the OUUV is compared against the UUUV to determine the differences in the exerted forces. Of particular interest are the drag, pressure, turbulence and flow field effects exerted as the OUUV is driven inside the payload bay of the larger vessel. The hydrodynamic forces and flow field disturbances are used to determine the feasibility of making such an approach. From the simulations, it was determined that there was no significant detrimental physical forces, particularly with regard to turbulence. The flow field effects exerted by the OUUV are significant. The vertical thrusters exert significant wake structures, but their orientation ensures the wake effects are exerted below the UUV, minimising the impact. It was also seen that OUUV experiences higher drag forces compared to the UUUV, which will correlate to an increased energy expenditure. This investigation found no key indicators that recovery via a mothership payload bay was not feasible. The turbulence, drag and pressure phenomenon were of a similar magnitude to existing static and towed dock structures.Keywords: underwater vehicles, submarine, autonomous underwater vehicles, AUV, computational fluid dynamics, flow fields, pressure, turbulence, drag
Procedia PDF Downloads 692026 Synthesis of Human Factors Theories and Industry 4.0
Authors: Andrew Couch, Nicholas Loyd, Nathan Tenhundfeld
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The rapid emergence of technology observably induces disruptive effects that carry implications for internal organizational dynamics as well as external market opportunities, strategic pressures, and threats. An examination of the historical tendencies of technology innovation shows that the body of managerial knowledge for addressing such disruption is underdeveloped. Fundamentally speaking, the impacts of innovation are unique and situationally oriented. Hence, the appropriate managerial response becomes a complex function that depends on the nature of the emerging technology, the posturing of internal organizational dynamics, the rate of technological growth, and much more. This research considers a particular case of mismanagement, the BP Texas City Refinery explosion of 2005, that carries notable discrepancies on the basis of human factors principles. Moreover, this research considers the modern technological climate (shaped by Industry 4.0 technologies) and seeks to arrive at an appropriate conceptual lens by which human factors principles and Industry 4.0 may be favorably integrated. In this manner, the careful examination of these phenomena helps to better support the sustainment of human factors principles despite the disruptive impacts that are imparted by technological innovation. In essence, human factors considerations are assessed through the application of principles that stem from usability engineering, the Swiss Cheese Model of accident causation, human-automation interaction, signal detection theory, alarm design, and other factors. Notably, this stream of research supports a broader framework in seeking to guide organizations amid the uncertainties of Industry 4.0 to capture higher levels of adoption, implementation, and transparency.Keywords: Industry 4.0, human factors engineering, management, case study
Procedia PDF Downloads 582025 An Exploration of Cross-culture Consumer Behaviour - The Characteristics of Chinese Consumers’ Decision Making in Europe
Authors: Yongsheng Guo, Xiaoxian Zhu, Mandella Osei-Assibey Bonsu
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This study explores the effects of national culture on consumer behaviour by identifying the characteristics of Chinese consumers’ decision making in Europe. It offers a better understanding of how cultural factors affect consumers’ behaviour, and how consumers make decisions in other nations with different culture. It adopted a grounded theory approach and conducted twenty-four in-depth interviews. Grounded theory models are developed to link the causal conditions, process and consequences. Results reveal that some cultural factors including conservatism, emotionality, acquaintance community, long-term orientation and principles affect Chinese consumers when making purchase decisions in Europe. Most Chinese consumers plan and prepare their expenditure and stay in Europe as cultural learners, and purchase durable products or assets as investment, and share their experiences within a community. This study identified potential problems such as political and social environment, complex procedures, and restrictions. This study found that external factors influence on internal factors and then internal characters determine consumer behaviour. This study proposes that cultural traits developed in convergence evolution through social selection and Chinese consumers persist most characters but adapt some perceptions and actions overtime in other countries. This study suggests that cultural marketing could be adopted by companies to reflect consumers’ preferences. Agencies, shops, and the authorities could take actions to reduce the complexity and restrictions.Keywords: national culture, consumer behaviour, decision making, cultural marketing
Procedia PDF Downloads 852024 Analysis of Cardiovascular Diseases Using Artificial Neural Network
Authors: Jyotismita Talukdar
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In this paper, a study has been made on the possibility and accuracy of early prediction of several Heart Disease using Artificial Neural Network. (ANN). The study has been made in both noise free environment and noisy environment. The data collected for this analysis are from five Hospitals. Around 1500 heart patient’s data has been collected and studied. The data is analysed and the results have been compared with the Doctor’s diagnosis. It is found that, in noise free environment, the accuracy varies from 74% to 92%and in noisy environment (2dB), the results of accuracy varies from 62% to 82%. In the present study, four basic attributes considered are Blood Pressure (BP), Fasting Blood Sugar (FBS), Thalach (THAL) and Cholesterol (CHOL.). It has been found that highest accuracy(93%), has been achieved in case of PPI( Post-Permanent-Pacemaker Implementation ), around 79% in case of CAD(Coronary Artery disease), 87% in DCM (Dilated Cardiomyopathy), 89% in case of RHD&MS(Rheumatic heart disease with Mitral Stenosis), 75 % in case of RBBB +LAFB (Right Bundle Branch Block + Left Anterior Fascicular Block), 72% for CHB(Complete Heart Block) etc. The lowest accuracy has been obtained in case of ICMP (Ischemic Cardiomyopathy), about 38% and AF( Atrial Fibrillation), about 60 to 62%.Keywords: coronary heart disease, chronic stable angina, sick sinus syndrome, cardiovascular disease, cholesterol, Thalach
Procedia PDF Downloads 1652023 Left Ventricular Adaptations of Elite Volleyball Players Based on the Playing Position
Authors: Shihab Aldin Al Riyami, Khosrow Ebrahim, Sajad Ahmadizad
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Hemodynamic changes and ventricular loading during exercise lead to left ventricular (LV) hypertrophy. In athletes, volume load induces enlargement of the LV internal diameter and a proportional increase of wall thickness; while, pressure load would induce thickening of the ventricular wall. These adaptations are not similar in all athletes and are related to the types of sport. Volleyball players have different types of activity and roles based on their playing. Therefore, their physiological adaptations and requirements are different. The aim of the current study was to investigate the LV adaptationsinelite volleyball players based on their playing position. Sixty male elite volleyball players (age, 30.55±3.64 years)from Brazil, Serbia, Poland, Iran, Colombia, Cameroon, Japan, Egypt, Qatar, and Tunisia were investigated (from all five volleyball play positions). All participants had the experience of at least 3 years of participation at a professional level and international tournaments. LV characteristics were evaluated and measured using the echocardiography technique. Statistical analyses revealed significant differences (P<0.05)among the five groups of players forLV internal dimension (LVID), posterior wall thickness (PWT), and intact ventricular septum (IVS). Post-hoc analysis showed that opposite position players had significant higher value of LVID, PWT, and IVS when compared with other players, including outside hitter, middle blocker, setter, and libero (p<0.05). Additionally, in libero players, PWT was significantly lower when compared with other players (p<0.05). Based on the findings of the present study, it is concluded that LV adaptations in volleyball players are related to their playing position and that the opposite players had the highest LV adaptations when compared to other positions.Keywords: athletes, cardiac adaptations, echocardio graphy, heart, sport
Procedia PDF Downloads 2532022 A Study of Influence of Freezing on Mechanical Properties of Tendon Fascicles
Authors: Martyna Ekiert, Andrzej Mlyniec
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Tendons are the biological structures, which primary function is to transfer force generated by muscles to the bones. Unfortunately, damages of tendons are also one of the most common injuries of the human musculoskeletal system. For the most severe cases of tendon rupture, such as the tear of calcaneus tendon or anterior cruciate ligament of the knee, a surgical procedure is the only possible way of full recovery. Tendons used as biological grafts are usually subjected to the process of deep freezing and subsequent thawing. This, in particular for multiple freezing/thawing cycles, may result in changes of tendon internal structure causing deterioration of mechanical properties of the tissue. Therefore, studies on the influence of freezing on tendons biomechanics, including internal water content in soft tissue, seems to be greatly needed. An experimental study of the influence of freezing on mechanical properties of the tendon was performed on fascicles samples dissected form bovine flexor tendons. The preparation procedure was performed with the presence of 0.9% saline solution in order to prevent an excessive tissue drying. All prepared samples were subjected to the different number of freezing/thawing cycles. For freezing part of the protocol we used -80°C temperature while for slow thawing we used fridge temperature (4°C) combined with equalizing temperatures in the standard state (25°C). After final thawing, the mechanical properties of each sample was examined using cyclic loading test. Our results may contribute for better understanding of negative effects of soft tissues freezing, resulting from abnormal thermal expansion of water. This also may help to determine the limit of freezing/thawing cycles disqualifying tissue for surgical purposes and thus help optimize tissues storage conditions.Keywords: freezing, soft tissue, tendon, bovine fascicles
Procedia PDF Downloads 2052021 Basic Properties of a Fundamental Particle: Behavioral-Physical and Visual Methods for the Study of Fundamental Particle
Authors: Shukran M. Dadayev
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To author's best knowledge, in this paper, the Basic Properties and Research methods of a Fundamental Particle is studied for the first time. That's to say, Fundamental Particle has not been discovered in the Nature yet. Because Fundamental Particle consists of specific Physical, Geometrical and Internal bases. Geometrical and Internal characteristics that are considered significant for the elementary and fundamental particles aren’t basic properties, characteristics or criteria of a Fundamental Particle. Of course, completely new Physical and Visual experimental methods of Quantum mechanics and Behavioral-Physical investigations of Particles are needed to study and discover the Fundamental Particle. These are new Physical, Visual and Behavioral-Physical experimental methods for describing and discovering the Fundamental Particle in the Nature and Microworld. Fundamental Particle consists of the same Energy-Mass-Motion system and a symmetry of Energy-Mass-Motion. Fundamental Particle supplies each of the elementary particles with the same Energy-Mass-Motion system at the same time and regulates each of the particles. Fundamental Particle gives Energy, Mass and Motion to each particles at the same time, each of the Particles consists of acquired Energy-Mass-Motion system and symmetry. Energy, Mass, Motion given by the Fundamental Particle to the particles are Symmetrical Equivalent and they remain in their primary shapes in all cases. Fundamental Particle gives Energy-Mass-Motion system and symmetry consisting of different measures and functions to each of the particles. The Motion given by the Fundamental Particle to the particles is Gravitation, Gravitational Interaction not only gives Motion, but also cause Motion by attracting. All Substances, Fields and Cosmic objects consist of Energy-Mass-Motion. The Field also includes specific Mass. They are always Energetic, Massive and Active. Fundamental Particle establishes the bases of the Nature. Supplement and Regulating of all the particles existing in the Nature belongs to Fundamental Particle.Keywords: basic properties of a fundamental particle, behavioral-physical and visual methods, energy-mass-motion system and symmetrical equivalence, fundamental particle
Procedia PDF Downloads 35752020 Driving Forces of Bank Liquidity: Evidence from Selected Ethiopian Private Commercial Banks
Authors: Tadele Tesfay Teame, Tsegaye Abrehame, Hágen István Zsombor
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Liquidity is one of the main concerns for banks, and thus achieving the optimum level of liquidity is critical. The main objective of this study is to discover the driving force of selected private commercial banks’ liquidity. In order to achieve the objective explanatory research design and quantitative research approach were used. Data has been collected from a secondary source of the sampled Ethiopian private commercial banks’ financial statements, the National Bank of Ethiopia, and the Minister of Finance, the sample covering the period from 2011 to 2022. Bank-specific and macroeconomic variables were analyzed by using the balanced panel fixed effect regression model. Bank’s liquidity ratio is measured by the total liquid asset to total deposits. The findings of the study revealed that bank size, capital adequacy, loan growth rate, and non-performing loan had a statistically significant impact on private commercial banks’ liquidity, and annual inflation rate and interest rate margin had a statistically significant impact on the liquidity of Ethiopian private commercial banks measured by L1 (bank liquidity). Thus, banks in Ethiopia should not only be concerned about internal structures and policies/procedures, but they must consider both the internal environment and the macroeconomic environment together in developing their strategies to efficiently manage their liquidity position and private commercial banks to maintain their financial proficiency shall have bank liquidity management policy by assimilating both bank-specific and macro-economic variables.Keywords: liquidity, Ethiopian private commercial banks, liquidity ratio, panel data regression analysis
Procedia PDF Downloads 842019 Hydrodynamic Analysis of Payload Bay Berthing of an Underwater Vehicle With Vertically Actuated Thrusters
Authors: Zachary Cooper-Baldock, Paulo E. Santos, Russell S. A. Brinkworth, Karl Sammut
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- In recent years, large unmanned underwater vehicles such as the Boeing Voyager and Anduril Ghost Shark have been developed. These vessels can be structured to contain onboard internal payload bays. These payload bays can serve a variety of purposes – including the launch and recovery (LAR) of smaller underwater vehicles. The LAR of smaller vessels is extremely important, as it enables transportation over greater distances, increased time on station, data transmission and operational safety. The larger vessel and its payload bay structure complicate the LAR of UUVs in contrast to static docks that are affixed to the seafloor, as they actively impact the local flow field. These flow field impacts require analysis to determine if UUV vessels can be safely launched and recovered inside the motherships. This research seeks to determine the hydrodynamic forces exerted on a vertically over-actuated, small, unmanned underwater vehicle (OUUV) during an internal LAR manoeuvre and compare this to an under-actuated vessel (UUUV). In this manoeuvre, the OUUV is navigated through the stern wake region of the larger vessel to a set point within the internal payload bay. The manoeuvre is simulated using ANSYS Fluent computational fluid dynamics models, covering the entire recovery of the OUUV and UUUV. The analysis of the OUUV is compared against the UUUV to determine the differences in the exerted forces. Of particular interest are the drag, pressure, turbulence and flow field effects exerted as the OUUV is driven inside the payload bay of the larger vessel. The hydrodynamic forces and flow field disturbances are used to determine the feasibility of making such an approach. From the simulations, it was determined that there was no significant detrimental physical forces, particularly with regard to turbulence. The flow field effects exerted by the OUUV are significant. The vertical thrusters exert significant wake structures, but their orientation ensures the wake effects are exerted below the UUV, minimising the impact. It was also seen that OUUV experiences higher drag forces compared to the UUUV, which will correlate to an increased energy expenditure. This investigation found no key indicators that recovery via a mothership payload bay was not feasible. The turbulence, drag and pressure phenomenon were of a similar magnitude to existing static and towed dock structures.Keywords: underwater vehicles, submarine, autonomous underwater vehicles, auv, computational fluid dynamics, flow fields, pressure, turbulence, drag
Procedia PDF Downloads 632018 Environmental Impacts of Point and Non-Point Source Pollution in Krishnagiri Reservoir: A Case Study in South India
Authors: N. K. Ambujam, V. Sudha
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Reservoirs are being contaminated all around the world with point source and Non-Point Source (NPS) pollution. The most common NPS pollutants are sediments and nutrients. Krishnagiri Reservoir (KR) has been chosen for the present case study, which is located in the tropical semi-arid climatic zone of Tamil Nadu, South India. It is the main source of surface water in Krishnagiri district to meet the freshwater demands. The reservoir has lost about 40% of its water holding capacity due to sedimentation over the period of 50 years. Hence, from the research and management perspective, there is a need for a sound knowledge on the spatial and seasonal variations of KR water quality. The present study encompasses the specific objectives as (i) to investigate the longitudinal heterogeneity and seasonal variations of physicochemical parameters, nutrients and biological characteristics of KR water and (ii) to examine the extent of degradation of water quality in KR. 15 sampling points were identified by uniform stratified method and a systematic monthly sampling strategy was selected due to high dynamic nature in its hydrological characteristics. The physicochemical parameters, major ions, nutrients and Chlorophyll a (Chl a) were analysed. Trophic status of KR was classified by using Carlson's Trophic State Index (TSI). All statistical analyses were performed by using Statistical Package for Social Sciences programme, version-16.0. Spatial maps were prepared for Chl a using Arc GIS. Observations in KR pointed out that electrical conductivity and major ions are highly variable factors as it receives inflow from the catchment with different land use activities. The study of major ions in KR exhibited different trends in their values and it could be concluded that as the monsoon progresses the major ions in the water decreases or water quality stabilizes. The inflow point of KR showed comparatively higher concentration of nutrients including nitrate, soluble reactive phosphorus (SRP), total phosphors (TP), total suspended phosphorus (TSP) and total dissolved phosphorus (TDP) during monsoon seasons. This evidently showed the input of significant amount of nutrients from the catchment side through agricultural runoff. High concentration of TDP and TSP at the lacustrine zone of the reservoir during summer season evidently revealed that there was a significant release of phosphorus from the bottom sediments. Carlson’s TSI of KR ranged between 81 and 92 during northeast monsoon and summer seasons. High and permanent Cyanobacterial bloom in KR could be mainly due to the internal loading of phosphorus from the bottom sediments. According to Carlson’s TSI classification Krishnagiri reservoir was ranked in the hyper-eutrophic category. This study provides necessary basic data on the spatio-temporal variations of water quality in KR and also proves the impact of point and NPS pollution from the catchment area. High TSI warrants a greater threat for the recovery of internal P loading and hyper-eutrophic condition of KR. Several expensive internal measures for the reduction of internal loading of P were introduced by many scientists. However, the outcome of the present research suggests for the innovative algae harvesting technique for the removal of sediment nutrients.Keywords: NPS pollution, nutrients, hyper-eutrophication, krishnagiri reservoir
Procedia PDF Downloads 3182017 Software Architecture Implications on Development Productivity: A Case of Malawi Point of Care Electronic Medical Records
Authors: Emmanuel Mkambankhani, Tiwonge Manda
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Software platform architecture includes system components, their relationships, and design, as well as evolution principles. Software architecture and documentation affect a platform's customizability and openness to external innovators, thus affecting developer productivity. Malawi Point of Care (POC) Electronic Medical Records System (EMRS) follows some architectural design standards, but it lacks third-party innovators and is difficult to customize as compared to CommCare and District Health Information System 2 (DHIS2). Improving software architecture and documentation for the Malawi POC will increase productivity and third-party contributions. A conceptual framework based on Generativity and Boundary Resource Model (BRM) was used to compare the three platforms. Interviews, observations, and document analysis were used to collect primary and secondary data. Themes were found by analyzing qualitative and quantitative data, which led to the following results. Configurable, flexible, and cross-platform software platforms and the availability of interfaces (Boundary Resources) that let internal and external developers interact with the platform's core functionality, hence boosting developer productivity. Furthermore, documentation increases developer productivity, while its absence inhibits the use of resources. The study suggests that the architecture and openness of the Malawi POC EMR software platform will be improved by standardizing web application program interfaces (APIs) and making interfaces that can be changed by the user. In addition, increasing the availability of documentation and training will improve the use of boundary resources, thus improving internal and third-party development productivity.Keywords: health systems, configurable platforms, software architecture, software documentation, software development productivity
Procedia PDF Downloads 792016 Zhou Enlai’s Impact to the Foreign Folicy of China
Authors: Nazira B. Boldurukova
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The main aim of this article is to give the information about life and social and diplomatic work of Zhou Enlai, to prove his identity in his impact to the history of the world; to show his place in the organization of internal and foreign policy and in the peaceful international relationships of China with other countries.Keywords: China, foreign policy of China, identity, politician, diplomacy, Zhou Enlai
Procedia PDF Downloads 5432015 Evaluation of Egg Quality Parameters in the Isa Brown Line in Intensive Production Systems in the Ocaña Region, Norte de Santander
Authors: Meza-Quintero Myriam, Lobo Torrado Katty Andrea, Sanchez Picon Yesenia, Hurtado-Lugo Naudin
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The objective of the study was to evaluate the internal and external quality of the egg in the three production housing systems: floor, cage, and grazing of laying birds of the Isa Brown line, in the laying period between weeks 35 to 41; 135 hens distributed in 3 treatments of 45 birds per repetition were used (the replicas were the seven weeks of the trial). The feeding treatment supplied in the floor and cage systems contained 114 g/bird/day; for the grazing system, 14 grams less concentrate was provided. Nine eggs were collected to be studied and analyzed in the animal nutrition laboratory (3 eggs per housing system). The random statistical model was implemented: for the statistical analysis of the data, the statistical software of IBM® Statistical Products and Services Solution (SPSS) version 2.3 was used. The evaluation and follow-up instruments were the vernier caliper for the measurement in millimeters, a YolkFan™16 from Roche DSM for the evaluation of the egg yolk pigmentation, a digital scale for the measurement in grams, a micrometer for the measurement in millimeters and evaluation in the laboratory using dry matter, ashes, and ethereal extract. The results suggested that equivalent to the size of the egg (0.04 ± 3.55) and the thickness of the shell (0.46 ± 3.55), where P-Value> 0.05 was obtained, weight albumen (0.18 ± 3.55), albumen height (0.38 ± 3.55), yolk weight (0.64 ± 3.55), yolk height (0.54 ± 3.55) and for yolk pigmentation (1.23 ± 3.55). It was concluded that the hens in the three production systems, floor, cage, and grazing, did not show significant statistical differences in the internal and external quality of the chicken in the parameters studied egg for the production system.Keywords: biological, territories, genetic resource, egg
Procedia PDF Downloads 732014 In vivo Antiplatelet Activity Test of Wet Extract of Mimusops elengi L.'s Leaves on DDY Strain Mice as an Effort to Treat Atherosclerosis
Authors: Dewi Tristantini, Jason Jonathan
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Coronary Artery Disease (CAD) is one of the deathliest diseases which is caused by atherosclerosis. Atherosclerosis is a disease that plaque builds up inside the arteries. Plaque is made up of fat, cholesterol, calcium, platelet, and other substances found in blood. The current treatment of atherosclerosis is to provide antiplatelet therapy treatment, but such treatments often cause gastrointestinal irritation, muscle pain and hormonal imbalance. Mimusops elengi L.’s leaves can be utilized as a natural and cheap antiplatelet’s source because it contains flavonoids such as quertecin. Antiplatelet aggregation effect of Mimusops elengi L.’s leaves’ wet extract was measured by bleeding time on DDY strain mice with the test substances were given orally during the period of 8 days. The bleeding time was measured on first day and 9th day. Empirically, the dose which is used for humans is 8.5 g of leaves in 600 ml of water. This dose is equivalent to 2.1 g of leaves in 350 ml of water for mice. The extract was divided into 3 doses for mice: 0.05 ml/day; 0.1 ml/day; 0.2 ml/day. After getting the percentage of the increase in bleeding time, data were analyzed by analysis of variance test (Anova), followed by individual comparison within the groups by LSD test. The test substances above respectively increased bleeding time 21%, 62%, and 128%. As the conclusion, the 0.02 ml/day dose of Mimusops elengi L.’s leaves’ wet extract could increase bleeding time better than clopidogrel as positive controls with 110% increase in bleeding time.Keywords: antiplatelets, atheroschlerosis, bleeding time, Mimusops elengi
Procedia PDF Downloads 2522013 A Reminder of a Rare Anatomical Variant of the Spinal Accessory Nerve Encountered During Routine Neck Dissection: A Case Report and Updated Review of the Literature
Authors: Sophie Mills, Constantinos Aristotelous, Leila L. Touil, Richard C. W. James
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Objectives: Historical studies of the anatomy of the spinal accessory nerve (SAN) have reported conflicting results regarding its relationship with the internal jugular vein (IJV). A literature review was undertaken to establish the prevalence of anatomical variations of the SAN encountered during routine neck dissection surgery in order to increase awareness and reduce morbidity associated with iatrogenic SAN injury. Materials and Methods: The largest systematic review to date was performed using PRISMA-ScR guidelines, which yielded nine articles following the application of inclusion and exclusion criteria. A case report is also included, which demonstrates the rare anatomical relationship of the SAN traversing a fenestrated IJV, seen for the first time in the senior author’s career. Results: The mean number of dissections per study was 119, of which 55.6% (n=5) studies were performed on cadaver subjects, and 44.4% (n=4) were surgical dissections. Incidences of the SAN lateral to the IJV and medial to the IJV ranged from 38.9%-95.7% and 2.8%-57.4%, respectively. Over half of the studies reported incidences of the SAN traversing the IJV in 0.9%-2.8% of dissections. One study reported an isolated variant of the SAN dividing around the IJV with a prevalence of 0.5%. Conclusion: At the level of the posterior belly of the digastric muscle, the surgeon can anticipate the identification of the SAN lateral to the IJV in approximately three-quarters of cases, whilst around one-quarter are estimated to be medial. A mean of 1.6% of SANs traverses a fenestration of the vein. It is essential for surgeons to be aware of these anatomical variations and their prevalence to prevent injury to vital structures during surgery.Keywords: anatomical variant, internal jugular vein, neck dissection, spinal accessory nerve
Procedia PDF Downloads 1282012 The Role of Physical Activity on Some Factors Affecting Cardiovascular Disease
Authors: M. J. Pourvaghar, M. E. Bahram, Sh. Khoshemehry
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Hyperlipidemia or an increase in blood lipids is a condition that has been rising, especially during the last decade, with the advancement of the life-span of the car, as an important disease. In fact, it is one of the complications of industrial life and semi-industrial. Hyperlipidemia alone is not a disease, but it is recognized as an important risk factor for coronary artery disease. The methodology of this review article is the use of research to provide the best solution for physical activity and exercise in relation to lowering blood lipids and lowering blood pressure. Also, factors that contribute to improving the health status of humans should be introduced. Research findings in this article show that physical activity with a specific duration and severity can keep a person away from the cardiovascular disease. The result shows that regular physical activity with low intensity and long periods of time is essential for human health. Physical mobility reduces blood pressure, reduces the harmful fats and does not cause cardiovascular disease. More than half of the patients suffering from cardiovascular problems are afflicted with blood lipids. On the other hand, high blood pressure is one of the serious health hazards in the world today, which causes a large number of cardiovascular problems and mortality in the world. Undoubtedly, the second most common risk factor for heart disease is high blood pressure after cigarette smoking.Keywords: blood pressure, cardiovascular, hyperlipidemia, risk factor
Procedia PDF Downloads 2282011 Apolipoprotein E Gene Polymorphism and Its Association with Cardiovascular Heart Disease Risk Factors in Type 2 Diabetes Mellitus
Authors: Amani Ashari, Julia Omar, Arif Hashim, Shahrul Hamid
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Apolipoprotein E (APOE) gene polymorphism has influence on serum lipids which relates to cardiovascular risk. The purpose of this study was to determine the frequency distribution of APOE alleles among Malaysian Type 2 Diabetes Mellitus (DM) patients with and without coronary artery disease (CAD) and their association with serum lipid profiles. A total of 115 patients were recruited in which 78 patients had Type 2 DM without CAD and 37 patients had Type 2 DM with CAD. The APOE polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The APOE ɛ3 allele was the most common one in both groups. There was no significant association between the APOE genotypes and the CAD status in Type 2 DM using Pearson χ2 test. Further analysis indicated there were no significant differences in all lipid parameters between E2, E3 and E4 subgroups in both groups. The study showed that the E4 allele carriers of Type 2 DM with CAD patients had higher LDL-C level and lower HDL-C level compared to the other allele carriers. However, analyses showed these levels were not statistically different. The study also showed that the Type 2 DM with CAD group with E2 allele had higher triglyceride (TG). In conclusion, further study with larger sample size is needed to confirm role of E4 as a marker of CAD among Type 2 DM patients in Malaysian population.Keywords: Apolipoprotein E, diabetes mellitus, cardiovascular disease, lipids
Procedia PDF Downloads 2842010 Open Joint Surgery for Temporomandibular Joint Internal Derangement: Wilkes Stages III-V
Authors: T. N. Goh, M. Hashmi, O. Hussain
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Temporomandibular joint (TMJ) dysfunction (TMD) is a condition that may affect patients via restricted mouth opening, significant pain during normal functioning, and/or reproducible joint noise. TMD includes myofascial pain, TMJ functional derangements (internal derangement, dislocation), and TMJ degenerative/inflammatory joint disease. Internal derangement (ID) is the most common cause of TMD-related clicking and locking. These patients are managed in a stepwise approach, from patient education (homecare advice and analgesia), splint therapy, physiotherapy, botulinum toxin treatment, to arthrocentesis. Arthrotomy is offered when the aforementioned treatment options fail to alleviate symptoms and improve quality of life. The aim of this prospective study was to review the outcomes of jaw joint open surgery in TMD patients. Patients who presented from 2015-2022 at the Oral and Maxillofacial Surgery Department in the Doncaster NHS Foundation Trust, UK, with a Wilkes classification of III -V were included. These patients underwent either i) discopexy with bone-anchoring suture (9); ii) intrapositional temporalis flap (ITF) with bone-anchoring suture (3); iii) eminoplasty and discopexy with suturing to the capsule (3); iii) discectomy + ITF with bone-anchoring suture (1); iv) discoplasty + bone-anchoring suture (1); v) ITF (1). Maximum incisal opening (MIO) was assessed pre-operatively and at each follow-up. Pain score, determined via the visual analogue scale (VAS, with 0 being no pain and 10 being the worst pain), was also recorded. A total of 18 eligible patients were identified with a mean age of 45 (range 22 - 79), of which 16 were female. The patients were scored by Wilkes Classification as III (14), IV (1), or V (4). Twelve patients had anterior disc displacement without reduction (66%) and six had degenerative/arthritic changes (33%) to the TMJ. The open joint procedure resulted in an increase in MIO and reduction in pain VAS and for the majority of patients, across all Wilkes Classifications. Pre-procedural MIO was 22.9 ± 7.4 mm and VAS was 7.8 ± 1.5. At three months post-procedure there was an increase in MIO to 34.4 ± 10.4 mm (p < 0.01) and a decrease in the VAS to 1.5 ± 2.9 (p < 0.01). Three patients were lost to follow-up prior to six months. Six were discharged at six month review and five patients were discharged at 12 months review as they were asymptomatic with good mouth opening. Four patients are still attending for annual botulinum toxin treatment. Two patients (Wilkes III and V) subsequently underwent TMJ replacement (11%). One of these patients (Wilkes III) had improvement initially to MIO of 40 mm, but subsequently relapsed to less than 20 mm due to lack of compliance with jaw rehabilitation device post-operatively. Clinical improvements in 89% of patients within the study group were found, with a return to near normal MIO range and reduced pain score. Intraoperatively, the operator found bone-anchoring suture used for discopexy/discoplasty more secure than the soft tissue anchoring suturing technique.Keywords: bone anchoring suture, open temporomandibular joint surgery, temporomandibular joint, temporomandibular joint dysfunction
Procedia PDF Downloads 1012009 Validating the Cerebral Palsy Quality of Life for Children (CPQOL-Child) Questionnaire for Use in Sri Lanka
Authors: Shyamani Hettiarachchi, Gopi Kitnasamy
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Background: The potentially high level of physical need and dependency experienced by children with cerebral palsy could affect the quality of life (QOL) of the child, the caregiver and his/her family. Poor QOL in children with cerebral palsy is associated with the parent-child relationship, limited opportunities for social participation, limited access to healthcare services, psychological well-being and the child's physical functioning. Given that children experiencing disabilities have little access to remedial support with an inequitable service across districts in Sri Lanka, and given the impact of culture and societal stigma, there may be differing viewpoints across respondents. Objectives: The aim of this study was to evaluate the psychometric properties of the Tamil version of the Cerebral Palsy Quality of Life for Children (CPQOL-Child) Questionnaire. Design: An instrument development and validation study. Methods: Forward and backward translations of the CPQOL-Child were undertaken by a team comprised of a physiotherapist, speech and language therapist and two linguists for the primary caregiver form and the child self-report form. As part of a pilot phase, the Tamil version of the CPQOL was completed by 45 primary caregivers with children with cerebral palsy and 15 children with cerebral palsy (GMFCS level 3-4). In addition, the primary caregivers commented on the process of filling in the questionnaire. The psychometric properties of test-retest reliability, internal consistency and construct validity were undertaken. Results: The test-retest reliability and internal consistency were high. A significant association (p < 0.001) was found between limited motor skills and poor QOL. The Cronbach's alpha for the whole questionnaire was at 0.95.Similarities and divergences were found between the two groups of respondents. The child respondents identified limited motor skills as associated with physical well-being and autonomy. Akin to this, the primary caregivers associated the severity of motor function with limitations of physical well-being and autonomy. The trend observed was that QOL was not related to the level of impairment but connected to environmental factors by the child respondents. In addition to this, the main concern among primary caregivers about the child's future and on the child's lack of independence was not fully captured by the QOL questionnaire employed. Conclusions: Although the initial results of the CPQOL questionnaire show high test-retest reliability and internal consistency of the instrument, it does not fully reflect the socio-cultural realities and primary concerns of the caregivers. The current findings highlight the need to take child and caregiver perceptions of QOL into account in clinical practice and research. It strongly indicates the need for culture-specific measures of QOL.Keywords: cerebral palsy, CPQOL, culture, quality of life
Procedia PDF Downloads 338