Search results for: full reference image quality assessment (FR-IQA)
13169 Roads and Agriculture: Impacts of Connectivity in Peru
Authors: Julio Aguirre, Yohnny Campana, Elmer Guerrero, Daniel De La Torre Ugarte
Abstract:
A well-developed transportation network is a necessary condition for a country to derive full benefits from good trade and macroeconomic policies. Road infrastructure plays a key role in the economic development of rural areas of developing countries; where agriculture is the main economic activity. The ability to move agricultural production from the place of production to the market, and then to the place of consumption, greatly influence the economic value of farming activities, and of the resources involved in the production process, i.e., labor and land. Consequently, investment in transportation networks contributes to enhance or overcome the natural advantages or disadvantages that topography and location have imposed over the agricultural sector. This is of particular importance when dealing with countries, like Peru, with a great topographic diversity. The objective of this research is to estimate the impacts of road infrastructure on the performance of the agricultural sector. Specific variables of interest are changes in travel time, shifts of production for self-consumption to production for the market, changes in farmers income, and impacts on the diversification of the agricultural sector. In the study, a cross-section model with instrumental variables is the central methodological instrument. The data is obtained from agricultural and transport geo-referenced databases, and the instrumental variable specification utilized is based on the Kruskal algorithm. The results show that the expansion of road connectivity reduced farmers' travel time by an average of 3.1 hours and the proportion of output sold in the market increases by up to 40 percentage points. The increase in connectivity has an unexpected increase in the districts index of diversification of agricultural production. The results are robust to the inclusion of year and region fixed-effects, and to control for geography (i.e., slope and altitude), population variables, and mining activity. Other results are also very eloquent. For example, a clear positive impact can be seen in access to local markets, but this does not necessarily correlate with an increase in the production of the sector. This can be explained by the fact that agricultural development not only requires provision of roads but additional complementary infrastructure and investments intended to provide the necessary conditions so that producers can offer quality products (improved management practices, timely maintenance of irrigation infrastructure, transparent management of water rights, among other factors). Therefore, complementary public goods are needed to enhance the effects of roads on the welfare of the population, beyond enabling them to increase their access to markets.Keywords: agriculture devolepment, market access, road connectivity, regional development
Procedia PDF Downloads 21013168 Effect of Perioperative Protocol of Care on Clinical Outcomes among Patients Undergoing Coronary Artery Bypass Graft
Authors: Manal Ahmed, Amal Shehata, Shereen Deeb
Abstract:
The study's purpose was to determine the effect of the perioperative protocol of care on clinical outcomes among patients undergoing coronary artery bypass graft. Subjects: A sample of 100 adult patients who were planned for coronary artery bypass graft, were selected and divided alternatively and randomly into two equal groups (50 study -50 control).The study was carried out at National heart Institute in Cairo and open heart surgical intensive care unit in Shebin El-Kom Teaching Hospital. Instruments: Four instruments were used for data collection: Interviewing questionnaire, dyspnea analogue scale, Biophysiological measurement instrument, and Compliance assessment sheet. Results: There were statistically significant differences between both groups regarding most respiratory system assessment findings at discharge. More than two-thirds of the study group of the current study had a continuous and regular commitment to diet regimen, which ranked first followed by the compliance of daily living activities then quitting smoking. Conclusions: The perioperative protocol of care has a significant improving effect on respiratory findings, dyspnea degree, duration of mechanical ventilation, length of hospital stay, compliance to diet, therapeutic regimen, daily living activities, and quit smoking among study group undergoing CABG. Recommendations: Perioperative protocol of care should be carried out for CABG patients at open-heart surgical units as well as an illustrative colored booklet about CAD, CABG and perioperative care should be available and distributed to all CABG patients.Keywords: perioperative, effect, clinical outcomes, coronary artery, bypass graft, protocol of care
Procedia PDF Downloads 14113167 Urban Block Design's Impact on the Indoor Daylight Quality, Heating and Cooling Loads of Buildings in the Semi-Arid Regions: Duhok City in Kurdistan Region-Iraq as a Case Study
Authors: Kawar Salih
Abstract:
It has been proven that designing sustainable buildings starts from early stages of urban design. The design of urban blocks specifically, is considered as one of the pragmatic strategies of sustainable urbanism. There have been previous studies that focused on the impact of urban block design and regulation on the outdoor thermal comfort in the semi-arid regions. However, no studies have been found that concentrated on that impact on the internal behavior of buildings of those regions specifically the daylight quality and energy performance. Further, most studies on semi-arid regions are focusing only on the cooling load reduction, neglecting the heating load. The study has focused on two parameters of urban block distribution which are the block orientation and the surface-to-volume ratio with the consideration of both heating and cooling loads of buildings. In Duhok (a semi-arid city in Kurdistan region of Iraq), energy consumption and daylight quality of different types of residential blocks have been examined using dynamic simulation. The findings suggest that there is a considerable higher energy load for heating than cooling, contradicting many previous studies about these regions. The results also highlight that the orientation of urban blocks can vary the energy consumption to 8%. Regarding the surface-to-volume ratio (S/V), it was observed that after the twice enlargement of the S/V, the energy consumption increased 15%. Though, the study demonstrates as well that there are opportunities for reducing energy consumption with the increase of the S/V which contradicts many previous research on S/V impacts on energy consumption. These results can help to design urban blocks with the bigger S/V than existing blocks in the city which it can provide better indoor daylight and relatively similar energy consumption.Keywords: blocke orienation, building energy consumption, urban block design, semi-arid regions, surfacet-to-volume ratio
Procedia PDF Downloads 36713166 Measurement of Nasal Septal Cartilage in Adult Filipinos Using Computed Tomography
Authors: Miguel Limbert Ramos, Joseph Amado Galvez
Abstract:
Background: The nasal septal cartilage is an autologous graft that is widely used in different otolaryngologic procedures of the different subspecialties, such as in septorhinoplasty and ear rehabilitation procedures. The cartilage can be easily accessed and harvested to be utilized for such procedures. However, the dimension of the nasal septal cartilage differs, corresponding to race, gender, and age. Measurements can be done via direct measurement of harvested septal cartilage in cadavers or utilizing radiographic imaging studies giving baseline measurement of the nasal septal cartilage distinct to every race. A preliminary baseline measurement of the dimensions of Filipino nasal septal cartilage was previously established by measuring harvested nasal septal cartilage in Filipino Malay cadavers. This study intends to reinforce this baseline measurement by utilizing computed tomography (CT) scans of adult Filipinos in a tertiary government hospital in the City of Manila, Philippines, which will cover a larger sampling population. Methods: The unit of observation and analysis will be the computed tomography (CT) scans of patients ≥ 18years old who underwent cranial, facial, orbital, paranasal sinus, and temporal bone studies for the year 2019. The measurements will be done in a generated best midsagittal image (155 subjects) which is a view through the midline of the cerebrum that is simultaneously viewed with its coronal and axial views for proper orientation. The view should reveal important structures that will be used to plot the anatomic boundaries, which will be measured by a DICOM image viewing software (RadiAnt). The measured area of nasal septal cartilage will be compared by gender and age. Results: The total area of the nasal septal cartilage is larger in males compared to females, with a mean value of 6.52 cm² and 5.71 cm², respectively. The harvestable nasal septal cartilage area is also larger in males with a mean value of 3.57 cm² compared to females with only a measured mean value of 3.13 cm². The total and harvestable area of the nasal septal cartilage is largest in the 18-30 year-old age group with a mean value of 6.47 cm² and 3.60 cm² respectively and tends to decrease with the advancement of age, which can be attributed to continuous ossification changes. Conclusion: The best time to perform septorhinoplasty and other otolaryngologic procedures which utilize the nasal septal cartilage as graft material is during post-pubertal age, hence surgeries should be avoided or delayed to allow growth and maturation of the cartilage. A computed tomography scan is a cost-effective and non-invasive tool that can provide information on septal cartilage areas prior to these procedures.Keywords: autologous graft, computed tomography, nasal septal cartilage, septorhinoplasty
Procedia PDF Downloads 16513165 In vivo Estimation of Mutation Rate of the Aleutian Mink Disease Virus
Authors: P.P. Rupasinghe, A.H. Farid
Abstract:
The Aleutian mink disease virus (AMDV, Carnivore amdoparvovirus 1) causes persistent infection, plasmacytosis, and formation and deposition of immune complexes in various organs in adult mink, leading to glomerulonephritis, arteritis and sometimes death. The disease has no cure nor an effective vaccine, and identification and culling of mink positive for anti-AMDV antibodies have not been successful in controlling the infection in many countries. The failure to eradicate the virus from infected farms may be caused by keeping false-negative individuals on the farm, virus transmission from wild animals, or neighboring farms. The identification of sources of infection, which can be performed by comparing viral sequences, is important in the success of viral eradication programs. High mutation rates could cause inaccuracies when viral sequences are used to trace back an infection to its origin. There is no published information on the mutation rate of AMDV either in vivo or in vitro. The in vivo estimation is the most accurate method, but it is difficult to perform because of the inherent technical complexities, namely infecting live animals, the unknown numbers of viral generations (i.e., infection cycles), the removal of deleterious mutations over time and genetic drift. The objective of this study was to determine the mutation rate of AMDV on which no information was available. A homogenate was prepared from the spleen of one naturally infected American mink (Neovison vison) from Nova Scotia, Canada (parental template). The near full-length genome of this isolate (91.6%, 4,143 bp) was bidirectionally sequenced. A group of black mink was inoculated with this homogenate (descendant mink). Spleen sampled were collected from 10 descendant mink after 16 weeks post-inoculation (wpi) and from anther 10 mink after 176 wpi, and their near-full length genomes were bi-directionally sequenced. Sequences of these mink were compared with each other and with the sequence of the parental template. The number of nucleotide substitutions at 176 wpi was 3.1 times greater than that at 16 wpi (113 vs 36) whereas the estimates of mutation rate at 176 wpi was 3.1 times lower than that at 176 wpi (2.85×10-3 vs 9.13×10-4 substitutions/ site/ year), showing a decreasing trend in the mutation rate per unit of time. Although there is no report on in vivo estimate of the mutation rate of DNA viruses in animals using the same method which was used in the current study, these estimates are at the higher range of reported values for DNA viruses determined by various techniques. These high estimates are logical based on the wide range of diversity and pathogenicity of AMDV isolates. The results suggest that increases in the number of nucleotide substitutions over time and subsequent divergence make it difficult to accurately trace back AMDV isolates to their origin when several years elapsed between the two samplings.Keywords: Aleutian mink disease virus, American mink, mutation rate, nucleotide substitution
Procedia PDF Downloads 12913164 Reinforcement Learning for Quality-Oriented Production Process Parameter Optimization Based on Predictive Models
Authors: Akshay Paranjape, Nils Plettenberg, Robert Schmitt
Abstract:
Producing faulty products can be costly for manufacturing companies and wastes resources. To reduce scrap rates in manufacturing, process parameters can be optimized using machine learning. Thus far, research mainly focused on optimizing specific processes using traditional algorithms. To develop a framework that enables real-time optimization based on a predictive model for an arbitrary production process, this study explores the application of reinforcement learning (RL) in this field. Based on a thorough review of literature about RL and process parameter optimization, a model based on maximum a posteriori policy optimization that can handle both numerical and categorical parameters is proposed. A case study compares the model to state–of–the–art traditional algorithms and shows that RL can find optima of similar quality while requiring significantly less time. These results are confirmed in a large-scale validation study on data sets from both production and other fields. Finally, multiple ways to improve the model are discussed.Keywords: reinforcement learning, production process optimization, evolutionary algorithms, policy optimization, actor critic approach
Procedia PDF Downloads 10313163 Study on Influencing Factors of Walkability of Rail Transit Station Area
Authors: Yang Wenjuan, Xu Yilun
Abstract:
Based on the comparative analysis of the relevant evaluation methods of walking environment, this paper selects the combined evaluation method of macro urban morphology analysis and micro urban design quality survey, then investigates and analyzes the walking environment of three rail transit station area in Nanjing to explore the influence factor and internal relation of walkability of rail transit station area. Analysis shows that micro urban design factors have greater impact on the walkability of rail transit station area compared with macro urban morphology factors, the convenience is the key factor in the four aspects of convenience, security, identity and comfortability of the urban design factors, the convenience is not only affected by the block network form, but also related to the quality of the street space. The overall evaluation of walkability comes from the overlapping and regrouping of the walking environment at different levels, but some environmental factors play a leading role. The social attributes of pedestrians also partly influence their walking perception and evaluation.Keywords: rail transit station area, walkability, evaluation, influence factors
Procedia PDF Downloads 29913162 Forward Stable Computation of Roots of Real Polynomials with Only Real Distinct Roots
Authors: Nevena Jakovčević Stor, Ivan Slapničar
Abstract:
Any polynomial can be expressed as a characteristic polynomial of a complex symmetric arrowhead matrix. This expression is not unique. If the polynomial is real with only real distinct roots, the matrix can be chosen as real. By using accurate forward stable algorithm for computing eigen values of real symmetric arrowhead matrices we derive a forward stable algorithm for computation of roots of such polynomials in O(n^2 ) operations. The algorithm computes each root to almost full accuracy. In some cases, the algorithm invokes extended precision routines, but only in the non-iterative part. Our examples include numerically difficult problems, like the well-known Wilkinson’s polynomials. Our algorithm compares favorably to other method for polynomial root-finding, like MPSolve or Newton’s method.Keywords: roots of polynomials, eigenvalue decomposition, arrowhead matrix, high relative accuracy
Procedia PDF Downloads 42013161 Insulin Resistance in Patients with Chronic Hepatitis C Virus Infection: Upper Egypt Experience
Authors: Ali Kassem
Abstract:
Background: In the last few years, factors such as insulin resistance (IR) and hepatic steatosis have been linked to progression of hepatic fibrosis.Patients with chronic liver disease, and cirrhosis in particular, are known to be prone to IR. However, chronic HCV (hepatitis C) infection may induce IR, regardless of the presence of liver cirrhosis. Our aims are to study insulin resistance (IR) assessed by HOMA-IR (Homeostatic Model Assessment Insulin Resistance) as a possible risk factor in disease progression in cirrhotic patients and to evaluate the role of IR in hepatic fibrosis progression. The correlations of HOMA-IR values to laboratory, virological and histopathological parameters of chronic HCV are also examined. Methods: The study included 50 people divided into 30 adult chronic hepatitis C patients diagnosed by PCR (polymerase chain reaction) within previous 6 months and 20 healthy controls. The functional and morphological status of the liver were evaluated by ultrasonography and laboratory investigations including liver function tests and by liver biopsy. Fasting blood glucose and fasting insulin levels were measured and body mass index and insulin resistance were calculated. Patients having HOMA-IR >2.5 were labeled as insulin resistant. Results: Chronic hepatitis C patients with IR showed significantly higher mean values of BMI (body mass index) and fasting insulin than those without IR (P < 0.000). Patients with IR were more likely to have steatosis (p = 0.006), higher necroinflammatory activity (p = 0.05). No significant differences were found between the two groups regarding hepatic fibrosis. Conclusion: HOMA-IR measurement could represent a novel marker to identify the cirrhotic patients at greater risk for the progression of liver disease. As IR is a potentially modifiable risk factor, these findings may have important prognostic and therapeutic implications. Assessment of IR by HOMA-IR and improving insulin sensitivity are recommended in patients with HCV and related chronic liver disease.Keywords: hepatic fibrosis, hepatitis C virus infection, hepatic steatosis, insulin resistance
Procedia PDF Downloads 15613160 Efficacy of CAM Methods for Pain Reduction in Acute Non-specific Lower Back Pain
Authors: John Gaber
Abstract:
Objectives: Complementary and alternative medicine (CAM) is a medicine or health practice that is used alongside conventional practice. Nowadays, CAM is commonly used in North America and other countries, and there is a need for more scientific study to understand its efficacy in different clinical cases. This retrospective study explores the effectiveness and recovery time of CAMs such as cupping, acupuncture, and sotai to treat cases of non-specific low back pain (ANLBP). Methods: We assessed the effectiveness of acupuncture, cupping, and sotai methods on pain and for the treatment of ANLBP. We have compared the magnitude of pain relief using a pain scale assessment method to compare the efficacy of each treatment. The Face Pain Scale assessment was conducted before and 24 hours post-treatment. This retrospective study analyzed 40 patients and categorized them according to the treatment they received. The study included the control group, and the three intervention groups, each with ten patients. Each of the three intervention groups received one of the intervention methods. The first group received the cupping treatment, where cups were placed on the lower back of both sides on points: BL23, BL25, BL26, BL54, BL37, BL40, and BL57. After vacuuming, the cups will stay for 10-15 minutes under infrared light (IR) heating. IR heating is applied by an infrared heat lamp. The second group received the acupuncture treatment, placing needles on points: BL23, BL25, BL26, BL52BL54, GB30, BL37, BL40, BL57, BL59, BL60, and KI3. The needles will be simulated with IR light. The final group received the sotai treatment, a Japanese form of structural realignment that relieves pain, balance, and mobility -moving the body naturally and spontaneously towards a comfortable direction by focusing on the inner feeling and synchronizing with the patient’s breathing. The SPSS statistical software was used to analyze the data using repeated-measures ANOVA. The data collected demonstrates the change in the FPS assessment method value over the course of treatment. p<0.05 was considered statistically significant. Results: In the cupping, acupuncture, and sotai therapy groups, the mean of the FPS value reduced from 8.7±1.2, 8.8±1.2, 9.0±0.8 before the intervention to 3.5±1.4, 4.3±1.4, 3.3±1.3, 24 hours after the intervention, respectively. The data collected shows that the CAM methods included in this study all show improvements in pain relief 24 hours after treatment. Conclusion: Complementary and alternative medicine were developed to treat injuries and illnesses with the whole body in mind, designed to be used in addition to standard treatments. The data above shows that the use of these treatments can have a pain-relieving effect, but more research should be done on the matter, as finding CAM methods that are efficacious is crucial in the landscape of health sciences.Keywords: acupuncture, cupping, alternative medicine, rehabilitation, acute injury
Procedia PDF Downloads 5913159 Uterine Cervical Cancer; Early Treatment Assessment with T2- And Diffusion-Weighted MRI
Authors: Susanne Fridsten, Kristina Hellman, Anders Sundin, Lennart Blomqvist
Abstract:
Background: Patients diagnosed with locally advanced cervical carcinoma are treated with definitive concomitant chemo-radiotherapy. Treatment failure occurs in 30-50% of patients with very poor prognoses. The treatment is standardized with risk for both over-and undertreatment. Consequently, there is a great need for biomarkers able to predict therapy outcomes to allow for individualized treatment. Aim: To explore the role of T2- and diffusion-weighted magnetic resonance imaging (MRI) for early prediction of therapy outcome and the optimal time point for assessment. Methods: A pilot study including 15 patients with cervical carcinoma stage IIB-IIIB (FIGO 2009) undergoing definitive chemoradiotherapy. All patients underwent MRI four times, at baseline, 3 weeks, 5 weeks, and 12 weeks after treatment started. Tumour size, size change (∆size), visibility on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and change of ADC (∆ADC) at the different time points were recorded. Results: 7/15 patients relapsed during the study period, referred to as "poor prognosis", PP, and the remaining eight patients are referred to "good prognosis", GP. The tumor size was larger at all time points for PP than for GP. The ∆size between any of the four-time points was the same for PP and GP patients. The sensitivity and specificity to predict prognostic group depending on a remaining tumor on DWI were highest at 5 weeks and 83% (5/6) and 63% (5/8), respectively. The combination of tumor size at baseline and remaining tumor on DWI at 5 weeks in ROC analysis reached an area under the curve (AUC) of 0.83. After 12 weeks, no remaining tumor was seen on DWI among patients with GP, as opposed to 2/7 PP patients. Adding ADC to the tumor size measurements did not improve the predictive value at any time point. Conclusion: A large tumor at baseline MRI combined with a remaining tumor on DWI at 5 weeks predicted a poor prognosis.Keywords: chemoradiotherapy, diffusion-weighted imaging, magnetic resonance imaging, uterine cervical carcinoma
Procedia PDF Downloads 14813158 Implementation of Performance Management and Development System: The Case of the Eastern Cape Provincial Department of Health, South Africa
Authors: Thanduxolo Elford Fana
Abstract:
Rationale and Purpose: Performance management and development system are central to effective and efficient service delivery, especially in highly labour intensive sectors such as South African public health. Performance management and development systems seek to ensure that good employee performance is rewarded accordingly, while those who underperform are developed so that they can reach their full potential. An effective and efficiently implemented performance management system motivates and improves employee engagement. The purpose of this study is to examine the implementation of the performance management and development system and the challenges that are encountered during its implementation in the Eastern Cape Provincial Department of Health. Methods: A qualitative research approach and a case study design was adopted in this study. The primary data were collected through observations, focus group discussions with employees, a group interview with shop stewards, and in-depth interviews with supervisors and managers, from April 2019 to September 2019. There were 45 study participants. In-depth interviews were held with 10 managers at facility level, which included chief executive officer, chief medical officer, assistant director’s in human resources management, patient admin, operations, finance, and two area manager and two operation managers nursing. A group interview was conducted with five shop stewards and an in-depth interview with one shop steward from the group. Five focus group discussions were conducted with clinical and non-clinical staff. The focus group discussions were supplemented with an in-depth interview with one person from each group in order to counter the group effect. Observations included moderation committee, contracting, and assessment meetings. Findings: The study shows that the performance management and development system was not properly implemented. There was non-compliance to performance management and development system policy guidelines in terms of time lines for contracting, evaluation, payment of incentives to good performers, and management of poor performance. The study revealed that the system is ineffective in raising the performance of employees and unable to assist employees to grow. The performance bonuses were no longer paid to qualifying employees. The study also revealed that lack of capacity and commitment, poor communication, constant policy changes, financial constraints, weak and highly bureaucratic management structures, union interference were challenges that were encountered during the implementation of the performance management and development system. Lastly, employees and supervisors were rating themselves three irrespective of how well or bad they performed. Conclusion: Performance management is regarded as vital to improved performance of the health workforce and healthcare service delivery among populations. Effective implementation of performance management and development system depends on well-capacitated and unbiased management at facility levels. Therefore, there is an urgent need to improve communication, link performance management to rewards, and capacitate staff on performance management and development system, as it is key to improved public health sector outcomes or performance.Keywords: challenges, implementation, performance management and development system, public hospital
Procedia PDF Downloads 14013157 Brain-Computer Interface System for Lower Extremity Rehabilitation of Chronic Stroke Patients
Authors: Marc Sebastián-Romagosa, Woosang Cho, Rupert Ortner, Christy Li, Christoph Guger
Abstract:
Neurorehabilitation based on Brain-Computer Interfaces (BCIs) shows important rehabilitation effects for patients after stroke. Previous studies have shown improvements for patients that are in a chronic stage and/or have severe hemiparesis and are particularly challenging for conventional rehabilitation techniques. For this publication, seven stroke patients in the chronic phase with hemiparesis in the lower extremity were recruited. All of them participated in 25 BCI sessions about 3 times a week. The BCI system was based on the Motor Imagery (MI) of the paretic ankle dorsiflexion and healthy wrist dorsiflexion with Functional Electrical Stimulation (FES) and avatar feedback. Assessments were conducted to assess the changes in motor improvement before, after and during the rehabilitation training. Our primary measures used for the assessment were the 10-meters walking test (10MWT), Range of Motion (ROM) of the ankle dorsiflexion and Timed Up and Go (TUG). Results show a significant increase in the gait speed in the primary measure 10MWT fast velocity of 0.18 m/s IQR = [0.12 to 0.2], P = 0.016. The speed in the TUG was also significantly increased by 0.1 m/s IQR = [0.09 to 0.11], P = 0.031. The active ROM assessment increased 4.65º, and IQR = [ 1.67 - 7.4], after rehabilitation training, P = 0.029. These functional improvements persisted at least one month after the end of the therapy. These outcomes show the feasibility of this BCI approach for chronic stroke patients and further support the growing consensus that these types of tools might develop into a new paradigm for rehabilitation tools for stroke patients. However, the results are from only seven chronic stroke patients, so the authors believe that this approach should be further validated in broader randomized controlled studies involving more patients. MI and FES-based non-invasive BCIs are showing improvement in the gait rehabilitation of patients in the chronic stage after stroke. This could have an impact on the rehabilitation techniques used for these patients, especially when they are severely impaired and their mobility is limited.Keywords: neuroscience, brain computer interfaces, rehabilitat, stroke
Procedia PDF Downloads 9513156 Assessing the Vulnerability Level in Coastal Communities in the Caribbean: A Case Study of San Pedro, Belize
Authors: Sherry Ann Ganase, Sandra Sookram
Abstract:
In this paper, the vulnerability level to climate change is analysed using a comprehensive index, consisting of five pillars: human, social, natural, physical, and financial. A structural equation model is also applied to determine the indicators and relationships that exist between the observed environmental changes and the quality of life. Using survey data to model the results, a value of 0.382 is derived as the vulnerability level for San Pedro, where values closer to zero indicates lower vulnerability and values closer to one indicates higher vulnerability. The results showed the social pillar to be most vulnerable, with the indicator ‘participation’ ranked the highest in its cohort. Although, the environmental pillar is ranked as least vulnerable, the indicators ‘hazard’ and ‘biodiversity’ obtained scores closer to 0.4, suggesting that changes in the environment are occurring from natural and anthropogenic activities. These changes can negatively influence the quality of life as illustrated in the structural equation modelling. The study concludes by reporting on the need for collective action and participation by households in lowering vulnerability to ensure sustainable development and livelihood.Keywords: climate change, participation, San Pedro, structural equation model, vulnerability index
Procedia PDF Downloads 63713155 Attenuation Scale Calibration of an Optical Time Domain Reflectometer
Authors: Osama Terra, Hatem Hussein
Abstract:
Calibration of Optical Time Domain Reflectometer (OTDR) is crucial for the accurate determination of loss budget for long optical fiber links. In this paper, the calibration of the attenuation scale of an OTDR using two different techniques is discussed and implemented. The first technique is the external modulation method (EM). A setup is proposed to calibrate an OTDR over a dynamic range of around 15 dB based on the EM method. Afterwards, the OTDR is calibrated using two standard reference fibers (SRF). Both SRF are calibrated using cut-back technique; one of them is calibrated at our home institute (the National Institute of Standards – NIS) while the other at the National Physical Laboratory (NPL) of the United Kingdom to confirm our results. In addition, the parameters contributing the calibration uncertainty are thoroughly investigated. Although the EM method has several advantages over the SRF method, the uncertainties in the SRF method is found to surpass that of the EM method.Keywords: optical time domain reflectometer, fiber attenuation measurement, OTDR calibration, external source method
Procedia PDF Downloads 46713154 Wastewater Treatment by Floating Macrophytes (Salvinia natans) under Algerian Semi-Arid Climate
Authors: Laabassi Ayache, Boudehane Asma
Abstract:
Macrophyte pond has developed strongly in the field of wastewater treatment for irrigation in rural areas and small communities. Their association allows, in some cases, to increase the hydraulic capacity while maintaining the highest level of quality. The present work is devoted to the treatment of domestic wastewater under climatic conditions of Algeria (semi-arid) through a system using two tanks planted with Salvinia natans. The performance study and treatment efficiency of the system overall shows that the latter provides a significant removal of nitrogen pollution: total Kjeldahl nitrogen NTK (85.2%), Ammonium NH₄⁺-N (79%), Nitrite NO₂⁻-N (40%) also, a major meaningful reduction of biochemical oxygen demand BOD₅ was observed at the output of the system (96.9 %). As BOD₅, the chemical oxygen demand (COD) removal was higher than 95% at the exit of the two tanks. A moderately low yield of phosphate-phosphorus (PO₄³-P) was achieved with values not exceeding 37%. In general, the quality of treated effluent meets the Algerian standard of discharge and which allows us to select a suitable species in constructed wetland treatment systems under semi-arid climate.Keywords: nutrient removal, Salvinia natans, semi-arid climate, wastewater treatment
Procedia PDF Downloads 15713153 Translation of Self-Inject Contraception Training Objectives Into Service Performance Outcomes
Authors: Oluwaseun Adeleke, Samuel O. Ikani, Simeon Christian Chukwu, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu
Abstract:
Background: Health service providers are offered in-service training periodically to strengthen their ability to deliver services that are ethical, quality, timely and safe. Not all capacity-building courses have successfully resulted in intended service delivery outcomes because of poor training content, design, approach, and ambiance. The Delivering Innovations in Selfcare (DISC) project developed a Moment of Truth innovation, which is a proven training model focused on improving consumer/provider interaction that leads to an increase in the voluntary uptake of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) self-injection among women who opt for injectable contraception. Methodology: Six months after training on a moment of truth (MoT) training manual, the project conducted two intensive rounds of qualitative data collection and triangulation that included provider, client, and community mobilizer interviews, facility observations, and routine program data collection. Respondents were sampled according to a convenience sampling approach, and data collected was analyzed using a codebook and Atlas-TI. Providers and clients were interviewed to understand their experience, perspective, attitude, and awareness about the DMPA-SC self-inject. Data were collected from 12 health facilities in three states – eight directly trained and four cascades trained. The research team members came together for a participatory analysis workshop to explore and interpret emergent themes. Findings: Quality-of-service delivery and performance outcomes were observed to be significantly better in facilities whose providers were trained directly trained by the DISC project than in sites that received indirect training through master trainers. Facilities that were directly trained recorded SI proportions that were twice more than in cascade-trained sites. Direct training comprised of full-day and standalone didactic and interactive sessions constructed to evoke commitment, passion and conviction as well as eliminate provider bias and misconceptions in providers by utilizing human interest stories and values clarification exercises. Sessions also created compelling arguments using evidence and national guidelines. The training also prioritized demonstration sessions, utilized job aids, particularly videos, strengthened empathetic counseling – allaying client fears and concerns about SI, trained on positioning self-inject first and side effects management. Role plays and practicum was particularly useful to enable providers to retain and internalize new knowledge. These sessions provided experiential learning and the opportunity to apply one's expertise in a supervised environment where supportive feedback is provided in real-time. Cascade Training was often a shorter and abridged form of MoT training that leveraged existing training already planned by master trainers. This training was held over a four-hour period and was less emotive, focusing more on foundational DMPA-SC knowledge such as a reorientation to DMPA-SC, comparison of DMPA-SC variants, counseling framework and skills, data reporting and commodity tracking/requisition – no facility practicums. Training on self-injection was not as robust, presumably because they were not directed at methods in the contraceptive mix that align with state/organizational sponsored objectives – in this instance, fostering LARC services. Conclusion: To achieve better performance outcomes, consideration should be given to providing training that prioritizes practice-based and emotive content. Furthermore, a firm understanding and conviction about the value training offers improve motivation and commitment to accomplish and surpass service-related performance outcomes.Keywords: training, performance outcomes, innovation, family planning, contraception, DMPA-SC, self-care, self-injection.
Procedia PDF Downloads 8913152 Management Challenges and Product Quality of Fish Farms in Greece
Authors: S. Anastasiou, C. Nathanailides, S. Logothetis, G. Kanlis
Abstract:
The Greek aquaculture industry is second most important economic sector for the growth of the Greek Economy. The purpose of the present work is to present some data for the management challenges that the Aquaculture industry in Greece is currently facing. Currently the Greek aquaculture industry is going through a series of mergers and restructure. The financial status of the different aquaculture companies, the working conditions and management practices may vary according to lending exposure, market mix, company size, and technological parameters of the different fish farm units and rearing systems. Frequently, the aquaculture personnel are exposed to harsh environmental conditions and to occupational risk. Furthermore, there is pressure on the personnel of fish farms to constantly improve their production efficiency and to enhance their work skills to the new methods and practices which are adopted by the aquaculture industry. There is some data to suggest the existence of gender inequality in the workforce of Greek fish farms. Women are paid less, frequently absent higher managerial positions and most of the male workmates consider the job to harsh for women. Nevertheless, high level of job satisfaction was observed in both men and women. This high level of job satisfaction of the aquaculture personnel can be attributed, at least partially, to the nature of the work which has a very distinct working environment but most of the staff has very positive experiences with the interaction with their workmates and the satisfaction of being in a business which always exceeds its production target. Indeed, there is some evidence to suggest that the Greek aquaculture industry is always exceeding its production targets, while it is rapidly adopting and improving new technology, constantly improving of human resources management practices, which include constant training of the staff, very good communication channels between management and the personnel and reducing the risk of occupational hazard to the aquaculture personnel. All these parameters of management may have a determining role for the volume and quality of the production and future of this sector in Greece.Keywords: aquaculture, fish quality, management, production targets
Procedia PDF Downloads 44613151 Explaining E-Learning Systems Usage in Higher Education Institutions: UTAUT Model
Authors: Muneer Abbad
Abstract:
This research explains the e-learning usage in a university in Jordan. Unified theory of acceptance and use of technology (UTAUT) model has been used as a base model to explain the usage. UTAUT is a model of individual acceptance that is compiled mainly from different models of technology acceptance. This research is the initial part from full explanations of the users' acceptance model that use Structural Equation Modelling (SEM) method to explain the users' acceptance of the e-learning systems based on UTAUT model. In this part data has been collected and prepared for further analysis. The main factors of UTAUT model has been tested as different factors using exploratory factor analysis (EFA). The second phase will be confirmatory factor analysis (CFA) and SEM to explain the users' acceptance of e-learning systems.Keywords: e-learning, moodle, adoption, Unified Theory of Acceptance and Use of Technology (UTAUT)
Procedia PDF Downloads 41313150 Wealth-Based Inequalities in Child Health: A Micro-Level Analysis of Maharashtra State in India
Abstract:
The study examines the degree and magnitude of wealth-based inequalities in child health and its determinants in India. Despite making strides in economic growth, India has failed to secure a better nutritional status for all the children. The country currently faces the double burden of malnutrition as well as the problems of overweight and obesity. Child malnutrition, obesity, unsafe water, sanitation among others are identified as the risk factors for Non-Communicable Diseases (NCDs). Eliminating malnutrition in all its forms will catalyse improved health and economic outcomes. The assessment of the distributive dimension of child health across various segments of the population is essential for effective policy intervention. The study utilises the fourth round of District Level Health Survey for 2012-13 to analyse the inequalities among children in the age group 0-14 years in Maharashtra, a state in the western region of India with a population of 11.24 crores which constitutes 9.3 percent of the total population of India. The study considers the extent of health inequality by state, districts, sector, age-groups, and gender. The z-scores of four child health outcome variables are computed to assess the nutritional status of pre-school and school children using WHO reference. The descriptive statistics, concentration curves, concentration indices, correlation matrix, logistic regression have been used to analyse the data. The results indicate that magnitude of inequality is higher in Maharashtra and child health inequalities manifest primarily among the weaker sections of society. The concentration curves show that there exists a pro-poor inequality in child malnutrition measured by stunting, wasting, underweight, anaemia and a pro-rich overweight inequality. The inequalities in anaemia are observably lower due to the widespread prevalence. Rural areas exhibit a higher incidence of malnutrition, but greater inequality is observed in the urban areas. Overall, the wealth-based inequalities do not vary significantly between age groups. It appears that there is no gender discrimination at the state level. Further, rural-urban differentials in gender show that boys from the rural area and girls living in the urban region experience higher disparities in health. The relative distribution of undernutrition across districts in Maharashtra reveals that malnutrition is rampant and considerable heterogeneity also exists. A negative correlation is established between malnutrition prevalence and human development indicators. The findings of logistic regression analysis reveal that lower economic status of the household is associated with a higher probability of being malnourished. The study recognises household wealth, education of the parent, child gender, and household size as factors significantly related to malnutrition. The results suggest that among the supply-side variables, child-oriented government programmes might be beneficial in tackling nutrition deficit. In order to bridge the health inequality gap, the government needs to target the schemes better and should expand the coverage of services.Keywords: child health, inequality, malnutrition, obesity
Procedia PDF Downloads 14913149 Mechanical Properties of Self-Compacting Concrete with Three-Dimensional Steel Fibres
Authors: Jeffri Ramli, Brabha Nagaratnam, Keerthan Poologanathan, Wai Ming Cheung, Thadshajini Suntharalingham
Abstract:
Fiber-reinforced self-compacting concrete (FRSCC) combines the benefits of SCC of high flowability and randomly dispersed short fibres together in one single concrete. Fibres prevent brittle behaviour and improve several mechanical properties of SCC. In this paper, an experimental investigation of the effect of three-dimensional (3D) fibres on the mechanical properties of SCC has been conducted. Seven SCC mixtures, namely SCC with no fibres as a reference mix, and six 3D steel fibre reinforced SCC mixes were prepared. Two different sizes of 3D steel fibres with perimeters of 115 mm and 220 mm at different fibre contents of 1%, 2%, and 3% (by cement weight) were considered. The mechanical characteristics were obtained through compressive, splitting tensile, and flexural strength tests. The test results revealed that the addition of 3D fibres improves the mechanical properties of SCC.Keywords: self-compacting concrete, three-dimensional steel fibres, mechanical properties, compressive strength, splitting tensile strength, flexural strength
Procedia PDF Downloads 15513148 To Investigate a Discharge Planning Connect with Long Term Care 2.0 Program in a Medical Center in Taiwan
Authors: Chan Hui-Ya, Ding Shin-Tan
Abstract:
Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.Keywords: discharge planning, long-term care, case manager, patient care
Procedia PDF Downloads 28813147 Practice of Social Innovation in School Education: A Study of Third Sector Organisations in India
Authors: Prakash Chittoor
Abstract:
In the recent past, it is realised especially in third sector that employing social innovation is crucial for achieving viable and long lasting social transformation. In this context, education is one among many sectors that have opened up itself for such move where employing social innovation emerges as key for reaching out to the excluded sections who are often failed to get support from either policy or market interventions. In fact, education is being as a crucial factor for social development is well understood at both academic and policy level. In order to move forward to achieve better results, interventions from multiple sectors may be required as its reach cultivates capabilities and skill of the deprived in order to ensure both market and social participation in the long run. Despite state’s intervention, it is found that still millions of children are out of school due to lack of political will, lapses in policy implementation and neoliberal intervention of marketization. As a result, universalisation of elementary education became as an elusive goal to poor and marginalised sections where state obtain constant pressure by corporate sector to withdraw from education sector that led convince in providing quality education. At this juncture, the role of third sector organizations plays is quite remarkable. Especially, it has evolved as a key player in education sector to reach out to the poor and marginalised in the far-flung areas. These organisations work in resources constrain environment, yet, in order to achieve larger social impact they adopt various social innovations from time to time to reach out to the unreached. Their attempts not only limited to just approaching the unreached children but to retain them for long-time in the schooling system in order to ripe the results for their families and communities. There is a need to highlight various innovative ways adopted and practiced by the third sector organisations in India to achieve the elusive goal of universal access of primary education with quality. With this background, the paper primarily attempts to present an in-depth understanding about innovative practices employed by third sectors organisations like Isha Vidya through government schools adoption programme in India where it engages itself with government and build capabilities among the government teachers to promote state run schooling with quality and better infrastructure. Further, this paper assess whether such innovative attempts succeeded in to achieving universal quality education in the areas where it operates and draws implications for State policy.Keywords: school education, third sector organisations, social innovation, market domination
Procedia PDF Downloads 26413146 The Use of Foreign Law by the Constitutional Court of Taiwan: A Case-By-Case Analysis from 1990 to 2017
Authors: Mingsiang Chen
Abstract:
The increasing transactions among countries worldwide have brought about a trend of comparative law research in the legal community. An important branch of legal research, i.e., constitutional law, is no exception to the trend. The comparative study of constitutional law takes various forms, and one of these is to study the use of foreign law by constitutional courts. There are, in essence, three sources of foreign law usually used by constitutional courts: foreign constitutions, decisions by foreign constitutional courts, and legal theories developed by foreign scholars. There are two types of using foreign law by constitutional courts: citing any of the forenamed sources for reference purpose, ruling based on the contents or logic of any of the forenamed sources. This paper examines all the decisions handed down by the Constitutional Court of Taiwan from 1990 to 2017. Its purpose is to seek out the occasions, the extent, the significance, and the approach of such usage.Keywords: comparative constitutional law, constitutional court, judicial review, Taiwan judiciary
Procedia PDF Downloads 22513145 Angular Correlation and Independent Particle Model in Two-Electron Atomic Systems
Authors: Tokuei Sako
Abstract:
The ground and low-lying singly-excited states of He and He-like atomic ions have been studied by the Full Configuration Interaction (FCI) method focusing on the angular correlation between two electrons in the studied systems. The two-electron angle density distribution obtained by integrating the square-modulus of the FCI wave function over the coordinates other than the interelectronic angle shows a distinct trend between the singlet-triplet pair of states for different values of the nuclear charge Zn. Further, both of these singlet and triplet distributions tend to show an increasingly stronger dependence on the interelectronic angle as Zn increases, in contrast to the well-known fact that the correlation energy approaches towards zero for increasing Zn. This controversial observation has been rationalized on the basis of the recently introduced concept of so-called conjugate Fermi holes.Keywords: He-like systems, angular correlation, configuration interaction wave function, conjugate Fermi hole
Procedia PDF Downloads 41813144 Quantitative Analysis of Contract Variations Impact on Infrastructure Project Performance
Authors: Soheila Sadeghi
Abstract:
Infrastructure projects often encounter contract variations that can significantly deviate from the original tender estimates, leading to cost overruns, schedule delays, and financial implications. This research aims to quantitatively assess the impact of changes in contract variations on project performance by conducting an in-depth analysis of a comprehensive dataset from the Regional Airport Car Park project. The dataset includes tender budget, contract quantities, rates, claims, and revenue data, providing a unique opportunity to investigate the effects of variations on project outcomes. The study focuses on 21 specific variations identified in the dataset, which represent changes or additions to the project scope. The research methodology involves establishing a baseline for the project's planned cost and scope by examining the tender budget and contract quantities. Each variation is then analyzed in detail, comparing the actual quantities and rates against the tender estimates to determine their impact on project cost and schedule. The claims data is utilized to track the progress of work and identify deviations from the planned schedule. The study employs statistical analysis using R to examine the dataset, including tender budget, contract quantities, rates, claims, and revenue data. Time series analysis is applied to the claims data to track progress and detect variations from the planned schedule. Regression analysis is utilized to investigate the relationship between variations and project performance indicators, such as cost overruns and schedule delays. The research findings highlight the significance of effective variation management in construction projects. The analysis reveals that variations can have a substantial impact on project cost, schedule, and financial outcomes. The study identifies specific variations that had the most significant influence on the Regional Airport Car Park project's performance, such as PV03 (additional fill, road base gravel, spray seal, and asphalt), PV06 (extension to the commercial car park), and PV07 (additional box out and general fill). These variations contributed to increased costs, schedule delays, and changes in the project's revenue profile. The study also examines the effectiveness of project management practices in managing variations and mitigating their impact. The research suggests that proactive risk management, thorough scope definition, and effective communication among project stakeholders can help minimize the negative consequences of variations. The findings emphasize the importance of establishing clear procedures for identifying, assessing, and managing variations throughout the project lifecycle. The outcomes of this research contribute to the body of knowledge in construction project management by demonstrating the value of analyzing tender, contract, claims, and revenue data in variation impact assessment. However, the research acknowledges the limitations imposed by the dataset, particularly the absence of detailed contract and tender documents. This constraint restricts the depth of analysis possible in investigating the root causes and full extent of variations' impact on the project. Future research could build upon this study by incorporating more comprehensive data sources to further explore the dynamics of variations in construction projects.Keywords: contract variation impact, quantitative analysis, project performance, claims analysis
Procedia PDF Downloads 4613143 Ground Track Assessment Using Electrical Resistivity Tomography Application
Authors: Noryani Natasha Yahaya, Anas Ibrahim, Juraidah Ahmad, Azura Ahmad, Mohd Ikmal Fazlan Rosli, Zailan Ramli, Muhd Sidek Muhd Norhasri
Abstract:
The subgrade formation is an important element of the railway structure which holds overall track stability. Conventional track maintenance involves many substructure component replacements, as well as track re-ballasting on a regular basis is partially contributed to the embankment's long-term settlement problem. For subgrade long-term stability analysis, the geophysical method is commonly being used to diagnose those hidden sources/mechanisms of track deterioration problems that the normal visual method is unable to detect. Electrical resistivity tomography (ERT) is one of the applicable geophysical tools that are helpful in railway subgrade inspection/track monitoring due to its flexibility and reliability of the analysis. The ERT was conducted at KM 23.0 of Pinang Tunggal track to investigate the subgrade of railway track through the characterization/mapping on track formation profiling which was directly generated using 2D analysis of Res2dinv software. The profiles will allow examination of the presence and spatial extent of a significant subgrade layer and screening of any poor contact of soil boundary. Based on the finding, there is a mix/interpretation/intermixing of an interlayer between the sub-ballast and the sand. Although the embankment track considered here is at no immediate risk of settlement effect or any failure, the regular monitoring of track’s location will allow early correction maintenance if necessary. The developed data of track formation clearly shows the similarity of the side view with the assessed track. The data visualization in the 2D section of the track embankment agreed well with the initial assumption based on the main element structure general side view.Keywords: ground track, assessment, resistivity, geophysical railway, method
Procedia PDF Downloads 16413142 Effects of Milling Process Parameters on Cutting Forces and Surface Roughness When Finishing Ti6al4v Produced by Electron Beam Melting
Authors: Abdulmajeed Dabwan, Saqib Anwar, Ali Al-Samhan
Abstract:
Electron Beam Melting (EBM) is a metal powder bed-based Additive Manufacturing (AM) technology, which uses computer-controlled electron beams to create fully dense three-dimensional near-net-shaped parts from metal powder. It gives the ability to produce any complex parts directly from a computer-aided design (CAD) model without tools and dies, and with a variety of materials. However, the quality of the surface finish in EBM process has limitations to meeting the performance requirements of additively manufactured components. The aim of this study is to investigate the cutting forces induced during milling Ti6Al4V produced by EBM as well as the surface quality of the milled surfaces. The effects of cutting speed and radial depth of cut on the cutting forces, surface roughness, and surface morphology were investigated. The results indicated that the cutting speed was found to be proportional to the resultant cutting force at any cutting conditions while the surface roughness improved significantly with the increase in cutting speed and radial depth of cut.Keywords: electron beam melting, additive manufacturing, Ti6Al4V, surface morphology
Procedia PDF Downloads 11813141 Trauma Scores and Outcome Prediction After Chest Trauma
Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag
Abstract:
Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries
Procedia PDF Downloads 42313140 Computer Aide Discrimination of Benign and Malignant Thyroid Nodules by Ultrasound Imaging
Authors: Akbar Gharbali, Ali Abbasian Ardekani, Afshin Mohammadi
Abstract:
Introduction: Thyroid nodules have an incidence of 33-68% in the general population. More than 5-15% of these nodules are malignant. Early detection and treatment of thyroid nodules increase the cure rate and provide optimal treatment. Between the medical imaging methods, Ultrasound is the chosen imaging technique for assessment of thyroid nodules. The confirming of the diagnosis usually demands repeated fine-needle aspiration biopsy (FNAB). So, current management has morbidity and non-zero mortality. Objective: To explore diagnostic potential of automatic texture analysis (TA) methods in differentiation benign and malignant thyroid nodules by ultrasound imaging in order to help for reliable diagnosis and monitoring of the thyroid nodules in their early stages with no need biopsy. Material and Methods: The thyroid US image database consists of 70 patients (26 benign and 44 malignant) which were reported by Radiologist and proven by the biopsy. Two slices per patient were loaded in Mazda Software version 4.6 for automatic texture analysis. Regions of interests (ROIs) were defined within the abnormal part of the thyroid nodules ultrasound images. Gray levels within an ROI normalized according to three normalization schemes: N1: default or original gray levels, N2: +/- 3 Sigma or dynamic intensity limited to µ+/- 3σ, and N3: present intensity limited to 1% - 99%. Up to 270 multiscale texture features parameters per ROIs per each normalization schemes were computed from well-known statistical methods employed in Mazda software. From the statistical point of view, all calculated texture features parameters are not useful for texture analysis. So, the features based on maximum Fisher coefficient and the minimum probability of classification error and average correlation coefficients (POE+ACC) eliminated to 10 best and most effective features per normalization schemes. We analyze this feature under two standardization states (standard (S) and non-standard (NS)) with Principle Component Analysis (PCA), Linear Discriminant Analysis (LDA) and Non-Linear Discriminant Analysis (NDA). The 1NN classifier was performed to distinguish between benign and malignant tumors. The confusion matrix and Receiver operating characteristic (ROC) curve analysis were used for the formulation of more reliable criteria of the performance of employed texture analysis methods. Results: The results demonstrated the influence of the normalization schemes and reduction methods on the effectiveness of the obtained features as a descriptor on discrimination power and classification results. The selected subset features under 1%-99% normalization, POE+ACC reduction and NDA texture analysis yielded a high discrimination performance with the area under the ROC curve (Az) of 0.9722, in distinguishing Benign from Malignant Thyroid Nodules which correspond to sensitivity of 94.45%, specificity of 100%, and accuracy of 97.14%. Conclusions: Our results indicate computer-aided diagnosis is a reliable method, and can provide useful information to help radiologists in the detection and classification of benign and malignant thyroid nodules.Keywords: ultrasound imaging, thyroid nodules, computer aided diagnosis, texture analysis, PCA, LDA, NDA
Procedia PDF Downloads 281