Search results for: patients’ related risks in the current home hemodialysis practices
Commenced in January 2007
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Paper Count: 26602

Search results for: patients’ related risks in the current home hemodialysis practices

19672 A Study of Traditional Mode in the Framework of Sustainable Urban Transportation

Authors: Juanita, B. Kombaitan, Iwan Pratoyo Kusumantoro

Abstract:

The traditional mode is a non-motorized vehicle powered by human or animal power. The objective of the study was to define the strategy of using traditional modes by the framework of sustainable urban transport in support of urban tourism activities. The study of the traditional mode does not include a modified mode using the engine power as motor tricycles are often called ‘bentor ‘in Indonesia. The use of non-motorized traditional mode in Indonesia has begun to shift, and its use began to be eliminated by the change of propulsion using the machine. In an effort to push back the use of traditional mode one of them with tourism activities. Strategies for the use of traditional modes within the framework of sustainable urban transport are seen from three dimensions: social, economic and environmental. The social dimension related to accessibility and livability, an economic dimension related to traditional modes can promote products and tourist attractions, while the environmental dimension related to the needs of the users/groups with respect to safety, comfort. The traditional mode is rarely noticed by the policy makers, and public opinion in its use needs attention. The involvement of policy-making between stakeholders and the community is needed in the development of sustainable traditional mode strategies in support of urban tourism activities.

Keywords: traditional mode, sustainable, urban, transportation

Procedia PDF Downloads 271
19671 Risks and Values in Adult Safeguarding: An Examination of How Social Workers Screen Safeguarding Referrals from Residential Homes

Authors: Jeremy Dixon

Abstract:

Safeguarding adults forms a core part of social work practice. The Government in England and Wales has made efforts to standardise practices through The Care Act 2014. The Act states that local authorities have duties to make inquiries in cases where an adult with care or support needs is experiencing or at risk of abuse and is unable to protect themselves from abuse or neglect. Despite the importance given to safeguarding adults within law there remains little research about how social workers conduct such decisions on the ground. This presentation reports on findings from a pilot research study conducted within two social work teams in a Local Authority in England. The objective of the project was to find out how social workers interpreted safeguarding duties as laid out by The Care Act 2014 with a particular focus on how workers assessed and managed risk. Ethnographic research methods were used throughout the project. This paper focusses specifically on decisions made by workers in the assessment team. The paper reports on qualitative observation and interviews with five workers within this team. Drawing on governmentality theory, this paper analyses the techniques used by workers to manage risk from a distance. A high proportion of safeguarding referrals came from care workers or managers in residential care homes. Social workers conducting safeguarding assessments were aware that they had a duty to work in partnership with these agencies. However, their duty to safeguard adults also meant that they needed to view them as potential abusers. In making judgments about when it was proportionate to refer for a safeguarding assessment workers drew on a number of common beliefs about residential care workers which were then tested in conversations with them. Social workers held the belief that residential homes acted defensively, leading them to report any accident or danger. Social workers therefore encouraged residential workers to consider whether statutory criteria had been met and to use their own procedures to manage risk. In addition social workers carried out an assessment of the workers’ motives; specifically whether they were using safeguarding procedures as a shortcut for avoiding other assessments or as a means of accessing extra resources. Where potential abuse was identified social workers encouraged residential homes to use disciplinary policies as a means of isolating and managing risk. The study has implications for understanding risk within social work practice. It shows that whilst social workers use law to govern individuals, these laws are interpreted against cultural values. Additionally they also draw on assumptions about the culture of others.

Keywords: adult safeguarding, governmentality, risk, risk assessment

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19670 A Good Start for Digital Transformation of the Companies: A Literature and Experience-Based Predefined Roadmap

Authors: Batuhan Kocaoglu

Abstract:

Nowadays digital transformation is a hot topic both in service and production business. For the companies who want to stay alive in the following years, they should change how they do their business. Industry leaders started to improve their ERP (Enterprise Resource Planning) like backbone technologies to digital advances such as analytics, mobility, sensor-embedded smart devices, AI (Artificial Intelligence) and more. Selecting the appropriate technology for the related business problem also is a hot topic. Besides this, to operate in the modern environment and fulfill rapidly changing customer expectations, a digital transformation of the business is required and change the way the business runs, affect how they do their business. Even the digital transformation term is trendy the literature is limited and covers just the philosophy instead of a solid implementation plan. Current studies urge firms to start their digital transformation, but few tell us how to do. The huge investments scare companies with blur definitions and concepts. The aim of this paper to solidify the steps of the digital transformation and offer a roadmap for the companies and academicians. The proposed roadmap is developed based upon insights from the literature review, semi-structured interviews, and expert views to explore and identify crucial steps. We introduced our roadmap in the form of 8 main steps: Awareness; Planning; Operations; Implementation; Go-live; Optimization; Autonomation; Business Transformation; including a total of 11 sub-steps with examples. This study also emphasizes four dimensions of the digital transformation mainly: Readiness assessment; Building organizational infrastructure; Building technical infrastructure; Maturity assessment. Finally, roadmap corresponds the steps with three main terms used in digital transformation literacy as Digitization; Digitalization; and Digital Transformation. The resulted model shows that 'business process' and 'organizational issues' should be resolved before technology decisions and 'digitization'. Companies can start their journey with the solid steps, using the proposed roadmap to increase the success of their project implementation. Our roadmap is also adaptable for relevant Industry 4.0 and enterprise application projects. This roadmap will be useful for companies to persuade their top management for investments. Our results can be used as a baseline for further researches related to readiness assessment and maturity assessment studies.

Keywords: digital transformation, digital business, ERP, roadmap

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19669 A Nanosensor System Based on Disuccinimydyl – CYP2E1 for Amperometric Detection of the Anti-Tuberculosis Drug, Pyrazinamide

Authors: Rachel F. Ajayi, Unathi Sidwaba, Usisipho Feleni, Samantha F. Douman, Ezo Nxusani, Lindsay Wilson, Candice Rassie, Oluwakemi Tovide, Priscilla G.L. Baker, Sibulelo L. Vilakazi, Robert Tshikhudo, Emmanuel I. Iwuoha

Abstract:

Pyrazinamide (PZA) is among the first-line pro-drugs in the tuberculosis (TB) combination chemotherapy used to treat Mycobacterium tuberculosis. Numerous reports have suggested that hepatotoxicity due to pyrazinamide in patients is due to inappropriate dosing. It is therefore necessary to develop sensitive and reliable techniques for determining the PZA metabolic profile of diagnosed patients promptly and at point-of-care. This study reports the determination of PZA based on nanobiosensor systems developed from disuccinimidyl octanedioate modified Cytochrome P450-2E1 (CYP2E1) electrodeposited on gold substrates derivatised with (poly(8-anilino-1-napthalene sulphonic acid) PANSA/PVP-AgNPs nanocomposites. The rapid and sensitive amperometric PZA detection gave a dynamic linear range of 2 µM to 16 µM revealing a limit of detection of 0.044 µM and a sensitivity of 1.38 µA/µM. The Michaelis-Menten parameters; KM, KMapp and IMAX were also calculated and found to be 6.0 µM, 1.41 µM and 1.51 µA respectively indicating a nanobiosensor suitable for use in serum.

Keywords: tuberculosis, cytochrome P450-2E1, disuccinimidyl octanedioate, pyrazinamide

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19668 Populism and the Democratic Crisis: Comparative Study of Four Countries

Authors: Hyein Ko

Abstract:

In 2017, many signs of populism occurred around the world. This paper suggests that populism is not a sudden phenomenon, but a manifestation of common people’s will. By analyzing previous research, this paper proposes three factors related to populism: Inequality, experience of economic crisis, and rapid cultural change. With these three elements, four cases will be investigated in this article; two countries experienced populism, and the other two countries did not experience it. Comparing four cases by using three elements will give a fruitful foundation for further analysis regarding populism. In sum, aforementioned three elements are highly related to the occurrence of populism. However, there is one hidden factor: dissatisfaction with established politics. Thus, populism is not a temporal phenomenon. It is a red alert for democratic crisis.

Keywords: common people, democratic crisis, populism, Trump phenomenon

Procedia PDF Downloads 247
19667 Prevalence and Risk Factors of Low Back Disorder among Waste Collection Workers: A Systematic Review

Authors: Benedicta Asante, Catherine Trask, Brenna Bath

Abstract:

Background: Waste Collection Workers’ (WCWs) activities contribute greatly to the recycling sector and are an important component of the waste management industry. As the recycling sector evolves, there is the increase in reports of injuries, particularly for common and debilitating musculoskeletal disorders such as low back disorder (LBD). WCWs are likely exposed to diverse work-related hazards that could contribute to LBD. However, there is currently no summary of the state of knowledge on the prevalence and risk factors of LBD within this workforce. Method: A comprehensive search was conducted in Ovid Medline, EMBASE, and Global Health e-publications with search term categories ‘low back disorder’ and ‘waste collection workers’. Two reviewers screened articles at title, abstract, and full-text stages. Data were extracted on study design, sampling strategy, socio-demographics, geographical region, and exposure definition, the definition of LBD, response rate, statistical techniques, LBD prevalence and risk factors. The risk of bias was assessed with a standardized tool. Results: The search of three databases generated 79 studies. Thirty-two studies met the study inclusion criteria for both title and abstract; only thirteen full-text articles met the study criteria and underwent data extraction. The majority of articles reported a 12-month prevalence of LBD between 16-74%. Although none of the included studies quantified relationships between risk factors and LBD, the suggested risk factors for LBD among WCWs included: awkward posture; lifting; pulling; pushing; repetitive motions; work duration; and physical loads. Conclusion: LBD is a major occupational health issue among WCWs. In light of these risks and future growth in this industry, further research should focus on the investigation of risk factors, with more focus on ergonomic exposure assessment, and LBD prevention efforts.

Keywords: low back pain, scavenger, waste pickers, waste collection workers

Procedia PDF Downloads 258
19666 Pelvic Floor Electrophysiology Patterns Associated with Obstructed Defecation

Authors: Emmanuel Kamal Aziz Saba, Gihan Abd El-Lateif Younis El-Tantawi, Mohammed Hamdy Zahran, Ibrahim Khalil Ibrahim, Mohammed Abd El-Salam Shehata, Hussein Al-Moghazy Sultan, Medhat

Abstract:

Pelvic floor electrophysiological tests are essential for assessment of patients with obstructed defecation. The present study was conducted to determine the different patterns of pelvic floor electrophysiology that are associated with obstructed defecation. The present cross sectional study included 25 patients with obstructed defecation. A control group of 20 apparently healthy subjects were included. All patients were subjected to history taking, clinical examination, proctosigmoidoscopy, lateral proctography (evacuation proctography), dynamic pelvic magnetic resonance imaging, anal manometry and electrophysiological studies. Electrophysiological studies were including pudendal nerve motor conduction study, pudendo-anal reflex, needle electromyography of external anal sphincter and puborectalis muscles, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The control group was subjected to electrophysiological studies which included pudendal nerve motor conduction study, pudendo-anal reflex, pudendal somatosensory evoked potential and tibial somatosensory evoked potential. The most common pelvic floor electrodiagnostic pattern characteristics of obstructed defecation was pudendal neuropathy, denervation and anismus of external anal sphincter and puborectalis with complete interference pattern of external anal sphincter and puborectalis at squeezing and cough and no localized defect in external anal sphincter. In conclusion, there were characteristic pelvic floor electrodiagnostic patterns associated with obstructed defecation.

Keywords: obstructed defecation, pudendal nerve terminal motor latency, pudendoanal reflex, sphincter electromyography

Procedia PDF Downloads 443
19665 Information System for Early Diabetic Retinopathy Diagnostics Based on Multiscale Texture Gradient Method

Authors: L. S. Godlevsky, N. V. Kresyun, V. P. Martsenyuk, K. S. Shakun, T. V. Tatarchuk, K. O. Prybolovets, L. F. Kalinichenko, M. Karpinski, T. Gancarczyk

Abstract:

Structures of eye bottom were extracted using multiscale texture gradient method and color characteristics of macular zone and vessels were verified in CIELAB scale. The difference of average values of L*, a* and b* coordinates of CIE (International Commision of Illumination) scale in patients with diabetes and healthy volunteers was compared. The average value of L* in diabetic patients exceeded such one in the group of practically healthy persons by 2.71 times (P < 0.05), while the value of a* index was reduced by 3.8 times when compared with control one (P < 0.05). b* index exceeded such one in the control group by 12.4 times (P < 0.05). The integrated index on color difference (ΔE) exceeded control value by 2.87 times (P < 0.05). More pronounced differences with ΔE were followed by a shorter period of MA appearance with a correlation level at -0.56 (P < 0.05). The specificity of diagnostics raised by 2.17 times (P < 0.05) and negative prognostic index exceeded such one determined with the expert method by 2.26 times (P < 0.05).

Keywords: diabetic retinopathy, multiscale texture gradient, color spectrum analysis, medical diagnostics

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19664 Nutrition Support Practices and Nutritional Status of Adolescents Receiving Antiretroviral Therapy in Selected Hospitals in Ethiopia

Authors: Meless Gebrie Bore, Lin Perry, Xiaoyue Xu, Andargachew Kassa, Marilyn Cruickshank

Abstract:

Background: Adolescents living with HIV (ALHIV) in Ethiopia face significant health challenges, particularly related to nutrition, which is essential for optimizing antiretroviral therapy (ART) outcomes. This population is vulnerable to nutritional deficiencies due to increased energy demands and the adverse effects of HIV, alongside rapid growth and low socio-economic status. Despite advances in ART, research on nutritional care for ALHIV in Ethiopia is limited. Integrated nutritional interventions are critical for improving health outcomes, yet comprehensive guidance is lacking. This study aimed to evaluate healthcare workers' practices in ART clinics, assess the nutritional status of ALHIV, and provide recommendations for enhancing nutritional care. Method: Cross-sectional surveys were conducted, recruiting 44 healthcare professionals and 384 ALHIV across ten public hospitals in Addis Ababa and Oromia regions. Participants were selected using purposive sampling for healthcare workers and proportionate random sampling for ALHIV engaged in ART services. Data was collected using a pre-tested structured questionnaire with quantitative and qualitative components facilitated by trained healthcare workers through the Kobo Toolbox program. Results: Findings revealed that while most healthcare workers conducted basic nutritional assessments, more sensitive methods were rarely used. Only 36.4% assessed dietary intake and 27.3% evaluated food security. Nutrition counseling was limited, with only 38.6% providing such services regularly. Health Care worker participants expressed dissatisfaction with the integration of nutrition services due to a lack of training and resources. Nutritional assessments revealed that 24.2% of ALHIV were classified as thin, 21.7% as stunted, and 34.9% as malnourished based on mid-upper arm circumference, with 19.4% experiencing severe acute malnutrition. These results highlight the urgent need and opportunities to improve nutritional support tailored to ALHIV-specific needs. Conclusion and Recommendations: Study findings identified evidence of substantial nutritional deficits and critical gaps in nutritional care for ALHIV in Ethiopian ART clinics. While basic assessment and counseling were generally practiced, limited use of more sensitive methods and inadequate integration of nutrition services hindered care effectiveness. To improve health outcomes, it is essential to enhance training for healthcare workers, develop standardized nutrition guidelines, and allocate resources effectively. Conducting further research with large, diverse samples and integrating comprehensive nutritional care alongside ART services will enable better matching of the nutritional needs of this vulnerable population.

Keywords: adolescents living with HIV(ALHIV), antiretroviral therapy (ART), HIV, Ethiopia, malnutrition, nutritional support, stunting, thinness

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19663 Use of External Sensory Stimuli in the Treatment of Parkinson Disease: Literature Review

Authors: Hadi O. Tohme

Abstract:

This study is a review on the effectiveness of new physiotherapy techniques with external sensory stimulus compared to standard physiotherapy in the daily activities of patients with Parkinson's disease. Twenty studies from 1996 to 2015 were analyzed and discussed in this review, using the rehabilitation strategy with external sensory stimulus evaluating walking, freezing episodes, balance, transfers, and daily activities of parkinsonian patients. The study highlights the effectiveness of the variety of rehabilitation with cueing strategy used in the treatment of Parkinson's disease. Based on the literature review completed, there is a need for more specific trials with better treatment strategies to support the most appropriate choice of physiotherapy intervention using external sensory stimulus to the type and frequency of this stimulus. In addition, no trials examined the long-term benefits of the physiotherapy intervention with the external sensory stimulus. In order to determine if, or how long the improvements due to the external sensory stimulus physiotherapy intervention can last, long-term follow-up should be performed.

Keywords: cueing strategy, external sensory stimulus, parkinson disease, rehabilitation for parkinson, sensory attention focused exercises, sensory strategy reeducation

Procedia PDF Downloads 253
19662 Engaging Local Communities on Large-Scale Construction Project

Authors: Melissa Teo

Abstract:

It is increasingly important that project managers develop greater capabilities to better manage the social, cultural, political, environmental and economic impacts on proposed construction projects. These challenges are best resolved in consultation with communities rather than in conflict with them. This is particularly important on controversial projects which are projects that have obtained government sanctioned ‘development approval’ but not ‘community approval’. While a rich body of research and intellectual frameworks exist in the fields of urban geography and planning to understand and manage community concerns during the pre-development approval stages of new projects, current theoretical frameworks guiding community engagement in project management are inadequate. A new and innovative research agenda is needed to guide thinking about the role of local communities in the construction process and is an important research gap that needs to be filled. Within this context, this research aims to assess the effectiveness of strategies adopted by project teams to engage with local communities so as to capture lessons learnt to apply to future projects. This paper reports a research methodology which uses Arnstein’s model of participation to better understand how power differentials between the project team and local communities can influence the adoption of community engagement strategies. A case study approach is utilizing interviews and documentary analysis of a large-scale controversial construction project in Queensland, Australia is presented. The findings will result in a number of recommendations to guide community engagement practices on future projects.

Keywords: community engagement, construction, case study, project management

Procedia PDF Downloads 259
19661 Evaluation of Cardiac Rhythm Patterns after Open Surgical Maze-Procedures from Three Years' Experiences in a Single Heart Center

Authors: J. Yan, B. Pieper, B. Bucsky, H. H. Sievers, B. Nasseri, S. A. Mohamed

Abstract:

In order to optimize the efficacy of medications, the regular follow-up with long-term continuous monitoring of heart rhythmic patterns has been facilitated since clinical introduction of cardiac implantable electronic monitoring devices (CIMD). Extensive analysis of rhythmic circadian properties is capable to disclose the distributions of arrhythmic events, which may support appropriate medication according rate-/rhythm-control strategy and minimize consequent afflictions. 348 patients (69 ± 0.5ys, male 61.8%) with predisposed atrial fibrillation (AF), undergoing primary ablating therapies combined to coronary or valve operations and secondary implantation of CIMDs, were involved and divided into 3 groups such as PAAF (paroxysmal AF) (n=99, male 68.7%), PEAF (persistent AF) (n=94, male 62.8%), and LSPEAF (long-standing persistent AF) (n=155, male 56.8%). All patients participated in three-year ambulant follow-up (3, 6, 9, 12, 18, 24, 30 and 36 months). Burdens of atrial fibrillation recurrence were assessed using cardiac monitor devices, whereby attacks frequencies and their circadian patterns were systemically analyzed. Anticoagulants and regular anti-arrhythmic medications were evaluated and the last were listed in terms of anti-rate and anti-rhythm regimens. Patients in the PEAF-group showed the least AF-burden after surgical ablating procedures compared to both of the other subtypes (p < 0.05). The AF-recurrences predominantly performed such attacks’ property as shorter than one hour, namely within 10 minutes (p < 0.05), regardless of AF-subtypes. Concerning circadian distribution of the recurrence attacks, frequent AF-attacks were mostly recorded in the morning in the PAAF-group (p < 0.05), while the patients with predisposed PEAF complained less attack-induced discomforts in the latter half of the night and the ones with LSPEAF only if they were not physically active after primary surgical ablations. Different AF-subtypes presented distinct therapeutic efficacies after appropriate surgical ablating procedures and recurrence properties in sense of circadian distribution. An optimization of medical regimen and drug dosages to maintain the therapeutic success needs more attention to detailed assessment of the long-term follow-up. Rate-control strategy plays a much more important role than rhythm-control in the ongoing follow-up examinations.

Keywords: atrial fibrillation, CIMD, MAZE, rate-control, rhythm-control, rhythm patterns

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19660 Achieving Design-Stage Elemental Cost Planning Accuracy: Case Study of New Zealand

Authors: Johnson Adafin, James O. B. Rotimi, Suzanne Wilkinson, Abimbola O. Windapo

Abstract:

An aspect of client expenditure management that requires attention is the level of accuracy achievable in design-stage elemental cost planning. This has been a major concern for construction clients and practitioners in New Zealand (NZ). Pre-tender estimating inaccuracies are significantly influenced by the level of risk information available to estimators. Proper cost planning activities should ensure the production of a project’s likely construction costs (initial and final), and subsequent cost control activities should prevent unpleasant consequences of cost overruns, disputes and project abandonment. If risks were properly identified and priced at the design stage, observed variance between design-stage elemental cost plans (ECPs) and final tender sums (FTS) (initial contract sums) could be reduced. This study investigates the variations between design-stage ECPs and FTS of construction projects, with a view to identifying risk factors that are responsible for the observed variance. Data were sourced through interviews, and risk factors were identified by using thematic analysis. Access was obtained to project files from the records of study participants (consultant quantity surveyors), and document analysis was employed in complementing the responses from the interviews. Study findings revealed the discrepancies between ECPs and FTS in the region of -14% and +16%. It is opined in this study that the identified risk factors were responsible for the variability observed. The values obtained from the analysis would enable greater accuracy in the forecast of FTS by Quantity Surveyors. Further, whilst inherent risks in construction project developments are observed globally, these findings have important ramifications for construction projects by expanding existing knowledge on what is needed for reasonable budgetary performance and successful delivery of construction projects. The findings contribute significantly to the study by providing quantitative confirmation to justify the theoretical conclusions generated in the literature from around the world. This therefore adds to and consolidates existing knowledge.

Keywords: accuracy, design-stage, elemental cost plan, final tender sum

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19659 Psoriasis Diagnostic Test Development: Exploratory Study

Authors: Salam N. Abdo, Orien L. Tulp, George P. Einstein

Abstract:

The purpose of this exploratory study was to gather the insights into psoriasis etiology, treatment, and patient experience, for developing psoriasis and psoriatic arthritis diagnostic test. Data collection methods consisted of a comprehensive meta-analysis of relevant studies and psoriasis patient survey. Established meta-analysis guidelines were used for the selection and qualitative comparative analysis of psoriasis and psoriatic arthritis research studies. Only studies that clearly discussed psoriasis etiology, treatment, and patient experience were reviewed and analyzed, to establish a qualitative data base for the study. Using the insights gained from meta-analysis, an existing psoriasis patient survey was modified and administered to collect additional data as well as triangulate the results. The hypothesis is that specific types of psoriatic disease have specific etiology and pathophysiologic pattern. The following etiology categories were identified: bacterial, environmental/microbial, genetic, immune, infectious, trauma/stress, and viral. Additional results, obtained from meta-analysis and confirmed by patient survey, were the common age of onset (early to mid-20s) and type of psoriasis (plaque; mild; symmetrical; scalp, chest, and extremities, specifically elbows and knees). Almost 70% of patients reported no prescription drug use due to severe side effects and prohibitive cost. These results will guide the development of psoriasis and psoriatic arthritis diagnostic test. The significant number of medical publications classified psoriatic arthritis disease as inflammatory of an unknown etiology. Thus numerous meta-analyses struggle to report any meaningful conclusions since no definitive results have been reported to date. Therefore, return to the basics is an essential step to any future meaningful results. To date, medical literature supports the fact that psoriatic disease in its current classification could be misidentifying subcategories, which in turn hinders the success of studies conducted to date. Moreover, there has been an enormous commercial support to pursue various immune-modulation therapies, thus following a narrow hypothesis/mechanism of action that is yet to yield resolution of disease state. Recurrence and complications may be considered unacceptable in a significant number of these studies. The aim of the ongoing study is to focus on a narrow subgroup of patient population, as identified by this exploratory study via meta-analysis and patient survey, and conduct an exhaustive work up, aiming at mechanism of action and causality before proposing a cure or therapeutic modality. Remission in psoriasis has been achieved and documented in medical literature, such as immune-modulation, phototherapy, various over-the-counter agents, including salts and tar. However, there is no psoriasis and psoriatic arthritis diagnostic test to date, to guide the diagnosis and treatment of this debilitating and, thus far, incurable disease. Because psoriasis affects approximately 2% of population, the results of this study may affect the treatment and improve the quality of life of a significant number of psoriasis patients, potentially millions of patients in the United States alone and many more millions worldwide.

Keywords: biologics, early diagnosis, etiology, immune disease, immune modulation therapy, inflammation skin disorder, phototherapy, plaque psoriasis, psoriasis, psoriasis classification, psoriasis disease marker, psoriasis diagnostic test, psoriasis marker, psoriasis mechanism of action, psoriasis treatment, psoriatic arthritis, psoriatic disease, psoriatic disease marker, psoriatic patient experience, psoriatic patient quality of life, remission, salt therapy, targeted immune therapy

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19658 Simulation of Surge Protection for a Direct Current Circuit

Authors: Pedro Luis Ferrer Penalver, Edmundo da Silva Braga

Abstract:

In this paper, the performance of a simple surge protection for a direct current circuit was simulated. The protection circuit was developed from modified electric macro models of a gas discharge tube and a transient voltage suppressor diode. Moreover, a combination wave generator circuit was used as source of energy surges. The simulations showed that the circuit presented ensures immunity corresponding with test level IV of the IEC 61000-4-5:2014 international standard. The developed circuit can be modified to meet the requirements of any other equipment to be protected. Similarly, the parameters of the combination wave generator can be changed to provide different surge amplitudes.

Keywords: combination wave generator, IEC 61000-4-5, Pspice simulation, surge protection

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19657 Product Quality and Profitability of Sea Bream Fish Farms in Greece

Authors: C. Nathanailides, S. Anastasiou, P. Logothetis, G. Kanlis

Abstract:

Production parameters of gilt head sea bream fish farm such as feeding regimes, mortalities, fish densities were used to calculate the economic efficiency of six different aquaculture sites from West Greece. Samples of farmed sea bream were collected and lipid content, microbial load and filleting yield of the samples were used as quality criteria. The results indicate that Lipid content, filleting yield and microbial load of fish originating from different fish farms varied significantly with improved quality exhibited in fish farms which exhibited improved Feed conversion rates and lower mortalities. Changes in feeding management practices such as feed quality and feeding regimes have a significant impact on the financial performance of sea bass farms. Fish farms which exhibited improved feeding conversion rates also exhibited increased profitability. Improvements in the FCR explained about 13.4 % of the difference in profitability of the different aquaculture sites. Lower mortality and higher growth rates were also exhibited by the fish farms which exhibited improved FCR. It is concluded that best feeding management practices resulted in improved product quality and profitability.

Keywords: aquaculture economics, gilt head sea, production fish, feeding management

Procedia PDF Downloads 508
19656 Utilization of Standard Paediatric Observation Chart to Evaluate Infants under Six Months Presenting with Non-Specific Complaints

Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes

Abstract:

Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.

Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart

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19655 Harnessing Earth's Electric Field and Transmission of Electricity

Authors: Vaishakh Medikeri

Abstract:

Energy in this Universe is the most basic characteristic of every particle. Since the birth of life on this planet, there has been a quest undertaken by the living beings to analyze, understand and harness the precious natural facts of the nature. In this quest, one of the greatest undertaken is the process of harnessing the naturally available energy. Scientists around the globe have discovered many ways to harness the freely available energy. But even today we speak of “Power Crisis”. Nikola Tesla once said “Nature has stored up in this universe infinite energy”. Energy is everywhere around us in unlimited quantities; all of it waiting to be harnessed by us. Here in this paper a method has been proposed to harness earth's electric field and transmit the stored electric energy using strong magnetic fields and electric fields. In this paper a new technique has been proposed to harness earth's electric field which is everywhere around the world in infinite quantities. Near the surface of the earth there is an electric field of about 120V/m. This electric field is used to charge a capacitor with high capacitance. Later the energy stored is allowed to pass through a device which converts the DC stored into AC. The AC so produced is then passed through a step down transformer to magnify the incoming current. Later the current passes through the RLC circuit. Later the current can be transmitted wirelessly using the principle of resonant inductive coupling. The proposed apparatus can be placed in most of the required places and any circuit tuned to the frequency of the transmitted current can receive the energy. The new source of renewable energy is of great importance if implemented since the apparatus is not costly and can be situated in most of the required places. And also the receiver which receives the transmitted energy is just an RLC circuit tuned to the resonant frequency of the transmitted energy. By using the proposed apparatus the energy losses can be reduced to a very large extent.

Keywords: capacitor, inductive resonant coupling, RLC circuit, transmission of electricity

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19654 Effect of Social Network Ties on Virtual Organization Success: Mediate Role of Knowledge Sharing Behaviors: An Empirical Study in Tourism Sector Firms in Jordan

Authors: Raed Hanandeh

Abstract:

This empirical study examines how knowledge sharing behaviors mediate the effect Technology-driven strategy on virtual organization success in Jordanian tourism sector firms. The results reveal that Social network ties are positively related to web knowledge seeking, web knowledge contributing and interactive system, but negatively related to accidental knowledge leakage. Furthermore, all types of knowledge sharing behavior are positively related to virtual organization success. Data collected from 23 firms. The total number of questionnaires mailed, 250 questionnaires were delivered. 214 were considered valid out of 241 Responses were received. The findings provide evidence that knowledge sharing behavior play a mediating role between Social network ties and virtual organization success and show that, web knowledge seeking, web knowledge contributing and interactive system playing an important impact on virtual organization success through knowledge sharing behaviors.

Keywords: social network ties, virtual organization success, knowledge sharing behaviors, web knowledge

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19653 Intrastromal Donor Limbal Segments Implantation as a Surgical Treatment of Progressive Keratoconus: Clinical and Functional Results

Authors: Mikhail Panes, Sergei Pozniak, Nikolai Pozniak

Abstract:

Purpose: To evaluate the effectiveness of intrastromal donor limbal segments implantation for treatment of progressive keratoconus considering on main characteristics of corneal endothelial cells. Setting: Outpatient ophthalmic clinic. Methods: Twenty patients (20 eyes) with progressive keratoconus II-III of Amsler classification were recruited. The worst eye was treated with the transplantation of donor limbal segments in the recipient corneal stroma, while the fellow eye was left untreated as a control of functional and morphological changes. Furthermore, twenty patients (20 eyes) without progressive keratoconus was used as a control of corneal endothelial cells changes. All patients underwent a complete ocular examination including uncorrected and corrected distance visual acuity (UDVA, CDVA), slit lamp examination fundus examination, corneal topography and pachymetry, auto-keratometry, Anterior Segment Optical Coherence Tomography and Corneal Endothelial Specular Microscopy. Results: After two years, statistically significant improvement in the UDVA and CDVA (on the average on two lines for UDVA and three-four lines for CDVA) were noted. Besides corneal astigmatism decreased from 5.82 ± 2.64 to 1.92 ± 1.4 D. Moreover there were no statistically significant differences in the changes of mean spherical equivalent, keratometry and pachymetry indicators. It should be noted that after two years there were no significant differences in the changes of the number and form of corneal endothelial cells. It can be regarded as a process stabilization. In untreated control eyes, there was a general trend towards worsening of UDVA, CDVA and corneal thickness, while corneal astigmatism was increased. Conclusion: Intrastromal donor segments implantation is a safe technique for keratoconus treatment. Intrastromal donor segments implantation is an efficient procedure to stabilize and improve progressive keratoconus.

Keywords: corneal endothelial cells, intrastromal donor limbal segments, progressive keratoconus, surgical treatment of keratoconus

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19652 Prevalence of Lower Third Molar Impactions and Angulations Among Yemeni Population

Authors: Khawlah Al-Khalidi

Abstract:

Prevalence of lower third molar impactions and angulations among Yemeni population The purpose of this study was to look into the prevalence of lower third molars in a sample of patients from Ibb University Affiliated Hospital, as well as to study and categorise their position by using Pell and Gregory classification, and to look into a possible correlation between their position and the indication for extraction. Materials and methods: This is a retrospective, observational study in which a sample of 200 patients from Ibb University Affiliated Hospital were studied, including patient record validation and orthopantomography performed in screening appointments in people aged 16 to 21. Results and discussion: Males make up 63% of the sample, while people aged 19 to 20 make up 41.2%. Lower third molars were found in 365 of the 365 instances examined, accounting for 91% of the sample under study. According to Pell and Gregory's categorisation, the most common position is IIB, with 37%, followed by IIA with 21%; less common classes are IIIA, IC, and IIIC, with 1%, 3%, and 3%, respectively. It was feasible to determine that 56% of the lower third molars in the sample were recommended for extraction during the screening consultation. Finally, there are differences in third molar location and angulation. There was, however, a link between the available space for third molar eruption and the need for tooth extraction.

Keywords: lower third molar, extraction, Pell and Gregory classification, lower third molar impaction

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19651 Development of Peaceful Wellbeing in Executive Practitioners through Mindfulness-Based Practices

Authors: Narumon Jiwattanasuk, Phrakrupalad Pannavoravat, Pataraporn Sirikanchana

Abstract:

Mindfulness has become a perspective addressing positive wellbeing these days. The aims of this paper are to analyze the problems of executive meditation practitioners at the Buddhamahametta Foundation in Thailand and to provide recommendations on the process to develop peaceful wellbeing in executive meditation practitioners by applying the principles of the four foundations of mindfulness. This study is particularly focused on executives because there is not much research focusing on the well-being development of executives, and the researcher recognizes that executives can be an example within their organizations. This would be a significant influence on their employees and their families to be interested in practicing mindfulness. This improvement will then grow from an individual to the surrounding community such as family, workplace, society, and the nation. This would lead to happiness at the national level, which is the expectation of this research. The paper highlights mindfulness practices that can be performed on a daily basis. This study is qualitative research, and there are 10 key participants who are executives from various sectors such as hospitality, healthcare, retail, power energy, and so on. Three mindfulness-based courses were conducted over a period of 8 months, and in-depth interviews were done before the first course as well as at the end of every course. In total, four in-depth interviews were conducted. The information collected from the interviews was analyzed in order to create the process to develop peaceful well-being. Focus group discussions with the mindfulness specialists were conducted to help develop the mindfulness program as well. As a result of this research, it is found that the executives faced the following problems: stress, negative thinking loops, losing temper, seeking acceptance, worry about uncontrollable external factors, unable to control their words, and weight gain. The cultivation of the four foundations of mindfulness can develop peaceful wellbeing. The results showed that after the key informant executives attended the mindfulness courses and practiced mindfulness regularly, they have developed peaceful well-being in all aspects such as physical, psychological, behavioral, and intellectual by applying 12 mindfulness-based activities. The development of wellbeing, in the conclusion of this study, also includes various tools to support the continuing practice, including the handout of guided mindfulness practice, VDO clips about mindfulness practice, the online dhamma channel, and mobile applications to support regular mindfulness-based practices.

Keywords: executive, mindfulness activities, stress, wellbeing

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19650 An Elegant Technique to Achieve ZCS in a Boost Converter Incorporating Complete Energy Transfer

Authors: Nagesh Vangala, Rayudu Mannam

Abstract:

Soft switching has attracted the interest of various researchers constantly. Many techniques are in vogue to achieve soft switching (ZVS and/or ZCS) in Boost converters. These techniques utilize an auxiliary switch to incorporate the ZCS/ZVS. Such schemes require additional control circuit and induce complexity in design. This paper proposes an elegant fly back approach which guarantees zero current switching of the main Switch without the need for any additional active device. A simple flyback transformer scheme is implemented which absorbs the initial turn ON energy (or the Reverse recovery energy of Boost diode) and delivers to the output.

Keywords: boost converter, complete energy transfer, flyback, zero current switching

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19649 Dose Saving and Image Quality Evaluation for Computed Tomography Head Scanning with Eye Protection

Authors: Yuan-Hao Lee, Chia-Wei Lee, Ming-Fang Lin, Tzu-Huei Wu, Chih-Hsiang Ko, Wing P. Chan

Abstract:

Computed tomography (CT) scan of the head is a good method for investigating cranial lesions. However, radiation-induced oxidative stress can be accumulated in the eyes and promote carcinogenesis and cataract. In this regard, we aimed to protect the eyes with barium sulfate shield(s) during CT scans and investigate the resultant image quality and radiation dose to the eye. Patients who underwent health examinations were selectively enrolled in this study in compliance with the protocol approved by the Ethics Committee of the Joint Institutional Review Board at Taipei Medical University. Participants’ brains were scanned with a water-based marker simultaneously by a multislice CT scanner (SOMATON Definition Flash) under a fixed tube current-time setting or automatic tube current modulation (TCM). The lens dose was measured by Gafchromic films, whose dose response curve was previously fitted using thermoluminescent dosimeters, with or without barium sulfate or bismuth-antimony shield laid above. For the assessment of image quality CT images at slice planes that exhibit the interested regions on the zygomatic, orbital and nasal bones of the head phantom as well as the water-based marker were used for calculating the signal-to-noise and contrast-to-noise ratios. The application of barium sulfate and bismuth-antimony shields decreased 24% and 47% of the lens dose on average, respectively. Under topogram-based TCM, the dose saving power of bismuth-antimony shield was mitigated whereas that of barium sulfate shield was enhanced. On the other hand, the signal-to-noise and contrast-to-noise ratios of DSCT images were decreased separately by barium sulfate and bismuth-antimony shield, resulting in an overall reduction of the CNR. In contrast, the integration of topogram-based TCM elevated signal difference between the ROIs on the zygomatic bones and eyeballs while preferentially decreasing the signal-to-noise ratios upon the use of barium sulfate shield. The results of this study indicate that the balance between eye exposure and image quality can be optimized by combining eye shields with topogram-based TCM on the multislice scanner. Eye shielding could change the photon attenuation characteristics of tissues that are close to the shield. The application of both shields on eye protection hence is not recommended for seeking intraorbital lesions.

Keywords: computed tomography, barium sulfate shield, dose saving, image quality

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19648 Association of Selected Polymorphisms of BER Pathway with the Risk of Colorectal Cancer in the Polish Population

Authors: Jacek Kabzinski, Karolina Przybylowska, Lukasz Dziki, Adam Dziki, Ireneusz Majsterek

Abstract:

The incidence of colorectal cancer (CRC) is increasing from year to year. Despite intensive research CRC etiology remains unknown. Studies suggest that at the basis of the process of carcinogenesis can lie reduced efficiency of DNA repair mechanisms, often caused by polymorphisms in DNA repair genes. The aim of the study was to determine the relationship between gene polymorphisms Pro242Arg of PolB gene and Arg780His of Lig3 gene and modulation of the risk of colorectal cancer in the Polish population. Determination of the molecular basis of carcinogenesis process and predicting increased risk will allow qualifying patients to increased risk group and including them in preventive program. We used blood collected from 110 patients diagnosed with colorectal cancer. The control group consisted of equal number of healthy people. Genotyping was performed by TaqMan method. The obtained results indicate that the genotype 780Arg/His of Lig3 gene is associated with an increased risk of colorectal cancer. On the basis of these results, we conclude that Lig3 gene polymorphism Arg780His may be associated with an increased risk of colorectal cancer.

Keywords: BER, colorectal cancer, PolB, Lig3, polymorphisms

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19647 Classification of Potential Biomarkers in Breast Cancer Using Artificial Intelligence Algorithms and Anthropometric Datasets

Authors: Aref Aasi, Sahar Ebrahimi Bajgani, Erfan Aasi

Abstract:

Breast cancer (BC) continues to be the most frequent cancer in females and causes the highest number of cancer-related deaths in women worldwide. Inspired by recent advances in studying the relationship between different patient attributes and features and the disease, in this paper, we have tried to investigate the different classification methods for better diagnosis of BC in the early stages. In this regard, datasets from the University Hospital Centre of Coimbra were chosen, and different machine learning (ML)-based and neural network (NN) classifiers have been studied. For this purpose, we have selected favorable features among the nine provided attributes from the clinical dataset by using a random forest algorithm. This dataset consists of both healthy controls and BC patients, and it was noted that glucose, BMI, resistin, and age have the most importance, respectively. Moreover, we have analyzed these features with various ML-based classifier methods, including Decision Tree (DT), K-Nearest Neighbors (KNN), eXtreme Gradient Boosting (XGBoost), Logistic Regression (LR), Naive Bayes (NB), and Support Vector Machine (SVM) along with NN-based Multi-Layer Perceptron (MLP) classifier. The results revealed that among different techniques, the SVM and MLP classifiers have the most accuracy, with amounts of 96% and 92%, respectively. These results divulged that the adopted procedure could be used effectively for the classification of cancer cells, and also it encourages further experimental investigations with more collected data for other types of cancers.

Keywords: breast cancer, diagnosis, machine learning, biomarker classification, neural network

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19646 The Effect of Dementia on Family Members

Authors: Shakeela Ahmed, Nabanita Hazarika

Abstract:

The study aims to understand the effects of dementia on family members. The primary objectives of this research are to identify the main reasons for dementia among the elderly, understand the struggles and stigmas faced by the family members, and understand the effects of dementia on family members. The research employs a qualitative method and utilizes unstructured interviews with family members, counselors and caregivers. A descriptive research design is employed, and thematic analysis is used to analyze the data. A total of 17 family members in the age group of 54-69 years were interviewed, along with 2 counselors and 2 caretakers. In understanding dementia, the researcher has reviewed articles, and the studies revealed diverse meanings, symptoms, stages attached to dementia, and the complex interplay of protective and risk factors for dementia. However, in understanding dementia and its effects on families, there is a lack of studies in relation to the significant effects of dementia on family members and their role as primary caregivers. Therefore, an attempt has been made to understand the effects of dementia on family members, along with ways to improve dementia care for family members. The purpose of the study was to understand the effects and challenges of dementia on family members, the psychosocial reasons for dementia among the elderly, and the various struggles and stigmas faced by the family members of dementia patients. The major findings of the study indicate that people with dementia are cared for by family members at home. Dementia has a significant impact on family members. Family member's quality of life is affected; they experience feelings of anxiety, stress, irritation, frustration, and fear as they watch their loved ones struggle with dementia. They also experience financial strain, as dementia care, medication, and therapy are expensive. Another common impact is the role reversal of family members for their loved ones with dementia. There is a lack of awareness and social understanding about dementia, which leads to family members experiencing stigma and struggles. Caregivers are unable to take care of themselves, and many times, the primary caregiver, a spouse who is elderly, experiences acute stress and a physical inability to meet the demands of being a caregiver. Strategies to improve dementia care are understanding dementia, being patient with the person, showing love and care for the person, avoiding provoking the person, distracting them, offering reassurance, playing their favorite music, talking about things they love, going through old memories, following a structured routine, and remaining calm. The study has made an attempt to provide strategies to manage dementia care, understanding the struggles family members go through, and raising awareness about dementia that will enable further research and investigations.

Keywords: elderly, dementia, stigma, family members

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19645 Knowledge Sharing Model Based on Individual and Organizational Factors Related to Faculty Members of University

Authors: Mitra Sadoughi

Abstract:

This study presents the knowledge-sharing model based on individual and organizational factors related to faculty members. To achieve this goal, individual and organizational factors were presented through qualitative research in the form of open codes, axial, and selective observations; then, the final model was obtained using structural equation model. Participants included 1,719 faculty members of the Azad Universities, Mazandaran Province, Region 3. The samples related to the qualitative survey included 25 faculty members experienced at teaching and the samples related to the quantitative survey included 326 faculty members selected by multistage cluster sampling. A 72-item questionnaire was used to measure the quantitative variables. The reliability of the questionnaire was 0.93. Its content and face validity was determined with the help of faculty members, consultants, and other experts. For the analysis of quantitative data obtained from structural model and regression, SPSS and LISREL were used. The results showed that the status of knowledge sharing is moderate in the universities. Individual factors influencing knowledge sharing included the sharing of educational materials, perception, confidence and knowledge self-efficiency, and organizational factors influencing knowledge sharing included structural social capital, cognitive social capital, social capital relations, organizational communication, organizational structure, organizational culture, IT infrastructure and systems of rewards. Finally, it was found that the contribution of individual factors on knowledge sharing was more than organizational factors; therefore, a model was presented in which contribution of individual and organizational factors were determined.

Keywords: knowledge sharing, social capital, organizational communication, knowledge self-efficiency, perception, trust, organizational culture

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19644 Toward Green Infrastructure Development: Dispute Prevention Mechanisms along the Belt and Road and Beyond

Authors: Shahla Ali

Abstract:

In the context of promoting green infrastructure development, new opportunities are emerging to re-examine sustainable development practices. This paper presents an initial exploration of the development of community-investor dispute prevention and facilitation mechanisms in the context of the Belt and Road Initiative (BRI) spanning Asia, Africa, and Europe. Given the widescale impact of China’s multi-jurisdictional development initiative, learning how to coordinate with local communities is vital to realizing inclusive and sustainable growth. In the 20 years since the development of the first multilateral community-investor dispute resolution mechanism developed by the International Finance Centre/World Bank, much has been learned about public facilitation, community engagement, and dispute prevention during the early stages of major infrastructure development programs. This paper will explore initial findings as they relate to initiatives underway along the BRI within the Asian Infrastructure Investment Bank and the Asian Development Bank. Given the borderless nature of sustainability concerns, insights from diverse regions are critical to deepening insights into best practices. Drawing on a case-based methodology, this paper will explore the achievements, challenges, and lessons learned in community-investor dispute prevention and resolution for major infrastructure projects in the greater China region.

Keywords: law and development, dispute prevention, sustainable development, mitigation

Procedia PDF Downloads 111
19643 Outcomes of Live Renal Donors with a History of Nephrolithiasis

Authors: Bin Mohamed Ebrahim, Aminesh Singla, Henry Pleass

Abstract:

Aim: There is an ongoing gap in renal transplantation between organs available for donation and recipients on the waiting list. Live donors with pre-existing or a history of renal calculi were thought to be a relative contraindication due to safety concerns for donors. We aim to review current literature assessing outcomes of donors who were found to have a history of renal calculi. Methods: Ovid and Embase were searched between 1960 to 2021 using key terms and Medical Subject Headings (MeSH) – nephrolithiasis, renal stones, renal transplantation and renal graft. Articles included conference proceedings and journal articles and were not excluded based on patient numbers. Studies were excluded if the specific organ was not identified, duplicated reports found or if post-transplant outcomes were not recorded. Outcomes were donor’s renal function or renal calculi recurrence postoperatively. Results: Upon reviewing 344 articles, 14 manuscripts met inclusion criteria. A total of 152 live donors were identified as having pre-existing or with a history of renal calculi at pre-operative workup. The mean stone size was 2.6 4mm (1 – 16) with a mean follow-up duration of 31.8 months (1 – 96). Seven studies had both outcomes. None showed renal complications or stone recurrence. The remaining studies contained 2 out of 84 patients having recurrent nephrolithiasis. Conclusion: Data suggests minimal morbidity involved for live renal donors with a history of nephrolithiasis. This should encourage surgeons to continue recruiting such donors for kidney transplantation.

Keywords: renal transplantation, renal graft, nephrolithiasis, renal calculi, live donor

Procedia PDF Downloads 185