Search results for: Mark Daniel De Luna
341 The Improvement in Clinical Outcomes with the Histological Presence of Nidus Following Radiofrequency Ablation (RFA) for Osteoid Osteoma (OO)
Authors: Amirul Adlan, Motaz AlAqeel, Scott Evans, Vaiyapuri sumathi, Mark Davies, Rajesh Botchu
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Background & Objectives: Osteoid osteoma (OO) is a benign tumor of the bone commonly found in childhood and adolescence, causing bone pain, especially during the night. CT-guided radiofrequency ablation (RFA) is currently the mainstay treatment for OO. There is currently no literature reporting the outcomes of OO following RFA based on the histological presence of a nidus seen on a biopsy taken at the time of RFA. The primary aim of this study was to compare the clinical outcomes of OO between the group of patients with the presence of nidus on biopsy samples from RFA with those without nidus. Secondly, we aimed to examine other factors that may affect the outcomes of OO, reflecting our experience as a tertiary orthopedic oncology center. Methods: We retrospectively reviewed 88 consecutive patients diagnosed with osteoid osteoma treated with RFA between November 2005 and March 2015, consisting of 63 males (72%) and 25 females (28%). Sixty-six patients (75%) had nidus present in their biopsy samples. Patients’ mean age was 17.6 years (4-53). The median duration of follow-up was 12.5 months (6-20.8). Lesions were located in the appendicular skeleton in seventy-nine patients (90%), while nine patients (10%) had an OO in the axial skeleton. Outcomes assessed were based on patients’ pain alleviation (partial, complete, or no pain improvement) and the need for further interventions. Results: Pain improvement in the patient group with nidus in the histology sample was significantly better than in the group without nidus (OR 7.4, CI 1.35-41.4, p=0.021). The patient group with nidus on biopsy demonstrated less likelihood of having a repeat procedure compared to the group without nidus(OR 0.092, CI 0.016-0.542, p=0.008). Our study showed significantly better outcomes in pain improvement in appendicular lesions compared to the axially located lesions (p = 0.005). Patients with spinal lesions tend to have relatively poor pain relief than those with appendicular or pelvic lesions (p=0.007). Conclusions: Patients with nidus on histology had better pain alleviation compared to patients without nidus. The histological presence of nidus significantly reduces the chance of repeat interventions. The pain alleviation of osteoid osteoma following RFA is better in patients with appendicular lesions than spinal or axially located lesions.Keywords: osteoid osteoma, benign tumour, radiofrequency ablation, oncology
Procedia PDF Downloads 153340 Features of Technological Innovation Management in Georgia
Authors: Ketevan Goletiani, Parmen Khvedelidze
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discusses the importance of the topic, which is reflected in the advanced and developed countries in the formation of a new innovative stage of the distinctive mark of the modern world development. This phase includes the construction of the economy, which generates stockpiling and use is based. Intensifying the production and use of the results of new scientific and technical innovation has led to a sharp reduction in the cycle and accelerate the pace of product and technology updates. The world's leading countries in the development of innovative management systems for the formation of long-term and stable development of the socio-economic order conditions. The last years of the 20th century, the social and economic relations, modification, accelerating economic reforms, and profound changes in the system of the time. At the same time, the country should own place in the world geopolitical and economic space. Accelerated economic development tasks, the World Trade Organization, the European Union deep and comprehensive trade agreement, the new system of economic management, technical and technological renewal of production potential, and scientific fields in the share of the total volume of GDP growth requires new approaches. XX - XXI centuries Georgia's socio-economic changes is one of the urgent tasks in the form of a rise to the need for change, involving the use of natural resource-based economy to the latest scientific and technical achievements of an innovative and dynamic economy based on an accelerated pace. But Georgia still remains unresolved in many methodological, theoretical, and practical nature of the problem relating to the management of the economy in various fields for the development of innovative systems for optimal implementation. Therefore, the development of an innovative system for the formation of a complex and multi-problem, which is reflected in the following: countries should have higher growth rates than the geopolitical space of the neighboring countries that its competitors are. Formation of such a system is possible only in a deep theoretical research and innovative processes in the multi-level (micro, meso- and macro-levels) management on the basis of creation.Keywords: georgia, innovative, socio-economic, innovative manage
Procedia PDF Downloads 121339 Strategies For Management Of Massive Intraoperative Airway Haemorrhage Complicating Surgical Pulmonary Embolectomy
Authors: Nicholas Bayfield, Liam Bibo, Kaushelandra Rathore, Lucas Sanders, Mark Newman
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INTRODUCTION: Surgical pulmonary embolectomy is an established therapy for acute pulmonary embolism causing right heart dysfunction and haemodynamic instability. Massive intraoperative airway haemorrhage is a rare complication of pulmonary embolectomy. We present our institutional experience with massive airway haemorrhage complicating pulmonary embolectomy and discuss optimal therapeutic strategies. METHODS: A retrospective review of emergent surgical pulmonary embolectomy patients was undertaken. Cases complicated by massive intra-operative airway haemorrhage were identified. Intra- and peri-operative management strategies were analysed and discussed. RESULTS: Of 76 patients undergoing emergent or salvage pulmonary embolectomy, three cases (3.9%) of massive intraoperative airway haemorrhage were identified. Haemorrhage always began on weaning from cardiopulmonary bypass. Successful management strategies involved intraoperative isolation of the side of bleeding, occluding the affected airway with an endobronchial blocker, institution of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) and reversal of anticoagulation. Running the ECMO without heparinisation allows coagulation to occur. Airway haemorrhage was controlled within 24 hours of operation in all patients, allowing re-institution of dual lung ventilation and decannulation from ECMO. One case in which positive end-expiratory airway pressure was trialled initially was complicated by air embolism. Although airway haemorrhage was controlled successfully in all cases, all patients died in-hospital for reasons unrelated to the airway haemorrhage. CONCLUSION: Massive intraoperative airway haemorrhage during pulmonary embolectomy is a rare complication with potentially catastrophic outcomes. Re-perfusion alveolar and capillary injury is the likely aetiology. With a systematic approach to management, airway haemorrhage can be well controlled intra-operatively and often resolves within 24 hours. Stopping blood flow to the pulmonary arteries and support of oxygenation by the institution of VA ECMO is important. This management has been successful in our 3 cases.Keywords: pulmonary embolectomy, cardiopulmonary bypass, cardiac surgery, pulmonary embolism
Procedia PDF Downloads 176338 20th-Century River Course Changes and Their Relation to Sediment Carbon Distribution Patterns in the Yellow River Delta
Authors: Dongxue Li, Zhonghua Ning, Yi’na Li, Baoshan Cui, Wasner Daniel, Sebastian Dötterl
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Most of the world's coastal alluvial plains can be significant carbon (C) eservoirs in which upland sediments are deposited and bury former topsoil, thereby contributing to soil C preservation, especially in river-controlled deltas like the Yellow River Delta, China. These deltas are affected by the continuous large amount of sediment transport and strong river dynamics from the upper reaches, which makes the river course in the deltas change frequently. However, the impact of varying river course changes on C stocks in these estuary wetlands is unclear. To investigate this, we drilled five 2 m cores along a sediment deposition sequence of the Yellow River Delta, which shifted its main course flow in the delta several times throughout the 20th century. Covering 80 years of sediment deposition, we explored both soil C stocks and their potential sources, and identified key soil physicochemical and hydrometeorological variables that correlate to C density and deposition rate. Further, the spatiotemporal C distribution and its relationship with these variables was examined. Our results showed that sediments at a soil depth of 200 cm in the main courses of the Yellow River corresponded to deposition ages ranging from 1942 to 1989. The oldest course has the lowest C stocks and showed C-enriched compared with younger courses. Contributions of soil C stemming from fresh particulate organic carbon from deposited upstream sources were significantly higher than local, in-situ vegetation. In addition, the carbon of the oldest and relatively young courses tends to be affected by interaction effects of hydrometeorological and physiochemical varibales, and that of the middle courses tends to be affected by independent variables. Our findings can help prioritize conservation efforts across different river courses and provide quantitative support for global carbon emission reduction by assessing sediment carbon reservoirs.Keywords: alluvial plains, coastal wetland, core drilling, course diversion, organic carbon, sediment deposition rate, soil deposition
Procedia PDF Downloads 27337 Mapping the Digital Landscape: An Analysis of Party Differences between Conventional and Digital Policy Positions
Authors: Daniel Schwarz, Jan Fivaz, Alessia Neuroni
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Although digitization is a buzzword in almost every election campaign, the political parties leave voters largely in the dark about their specific positions on digital issues. In the run-up to the 2019 elections in Switzerland, the ‘Digitization Monitor’ project (DMP) was launched in order to change this situation. Within the framework of the DMP, all 4,736 candidates were surveyed about their digital policy positions and values. The DMP is designed as a digital policy supplement to the existing ‘smartvote’ voting advice application. This enabled a direct comparison of the digital policy attitudes according to the DMP with the topics of the ‘smartvote’ questionnaire which are comprehensive in content but mainly related to conventional policy areas. This paper’s main research goal is to analyze and visualize possible differences between conventional and digital policy areas in terms of response patterns between and within political parties. The analysis is based on dimensionality reduction methods (multidimensional scaling and principal component analysis) for the visualization of inter-party differences, and on standard deviation as a measure of variation for the evaluation of intra-party unity. The results reveal that digital issues show a lower degree of inter-party polarization compared to conventional policy areas. Thus, the parties have more common ground in issues on digitization than in conventional policy areas. In contrast, the study reveals a mixed picture regarding intra-party unity. Homogeneous parties show a lower degree of unity in digitization issues whereas parties with heterogeneous positions in conventional areas have more united positions in digital areas. All things considered, the findings are encouraging as less polarized conditions apply to the debate on digital development compared to conventional politics. For the future, it would be desirable if in further countries similar projects to the DMP could emerge to broaden the basis for conclusions.Keywords: comparison of political issue dimensions, digital awareness of candidates, digital policy space, party positions on digital issues
Procedia PDF Downloads 186336 Studies on Organic and Inorganic Micro/Nano Particle Reinforced Epoxy Composites
Authors: Daniel Karthik, Vijay Baheti, Jiri Militky, Sundaramurthy Palanisamy
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Fibre based nano particles are presently considered as one of the potential filler materials for the improvement of mechanical and physical properties of polymer composites. Due to high matrix-filler interfacial area there will be uniform and homogeneous dispersion of nanoparticles. In micro/nano filler reinforced composites, resin material is usually tailored by organic or inorganic nanoparticles to have improved matrix properties. The objective of this study was to compare the potential of reinforcement of different organic and inorganic micro/nano fillers in epoxy composites. Industrial and agricultural waste of fibres like Agave Americana, cornhusk, jute, basalt, carbon, glass and fly ash was utilized to prepare micro/nano particles. Micro/nano particles were obtained using high energy planetary ball milling process in dry condition. Milling time and ball size were kept constant throughout the ball milling process. Composites were fabricated by hand lay method. Particle loading was kept constant to 3% wt. for all composites. In present study, loading of fillers was selected as 3 wt. % for all composites. Dynamic mechanical properties of the nanocomposite films were performed in three-point bending mode with gauge length and sample width of 50 mm and 10 mm respectively. The samples were subjected to an oscillating frequency of 1 Hz, 5 Hz and 10 Hz and 100 % oscillating amplitude in the temperature ranges of 30°C to 150°C at the heating rate of 3°C/min. Damping was found to be higher with the jute composites. Amongst organic fillers lowest damping factor was observed with Agave Americana particles, this means that Agave americana fibre particles have betters interface adhesion with epoxy resin. Basalt, fly ash and glass particles have almost similar damping factors confirming better interface adhesion with epoxy.Keywords: ball milling, damping factor, matrix-filler interface, particle reinforcements
Procedia PDF Downloads 264335 Tattooing: Personal Markings with Meaning: Themes Uncovered While Making a Video Documentary
Authors: Byrad Yyelland, Robert Bianchi
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No longer the secret mark of outlaw bikers, criminals, and sailors, tattooing has become mainstream in much of the world. The current study showcases data gathered for a video documentary on the triangulated relationship connecting tattoos as a form of body modification, cultural norms, and personal meanings. This research has revealed that some religious belief systems, Buddhism in Thailand, is one example, connect tattooing with spirituality in an intimate manner. Buddhist monks provide tattoos using traditional bamboo implements and processes, and they pray over the tattoo, infusing magic into the tattoo and consequently, into the body of the receiver. In contrast, although there is no direct mention of tattooing in the Qur’an, many Islamic scholars argue that permanent tattooing is considered haram—forbidden for Muslims. Only the temporary henna is acceptable. In fact, tattooing is illegal in Qatar. Some Indigenous belief systems in Canada adopt a similar stance on the basis that we were all created by the Creator and as such, we do not have the right to alter what the Creator has made. Still other belief systems such as Spiritism in Brazil and mainstream Christianity in the West are more inclined to regard tattooing as a matter of personal choice. It is practically impossible for any culture to resist the dual impacts of time and globalization. Long term cultural change has resulted in mainstream acceptance of tattooing in the west and increased acceptance in Japan. Short-term cultural change is seen in Qatar where tattoos are on on public display amongst expats and migrant laborers. This tolerance of tattooed individuals was clearly evident with the choice of David Beckham as ambassador for the FIFA World Cup and during the corresponding tourist celebrations. Themes uncovered in this multicultural research also include individual meanings attributed to tattoo imagery and processes, experiences of personal empowerment, devotion to family, personal philosophy, gender identity, and aesthetics.Keywords: culture, norms, tattooing, spirituality, personal motivations and personal meanings
Procedia PDF Downloads 73334 Optical Flow Technique for Supersonic Jet Measurements
Authors: Haoxiang Desmond Lim, Jie Wu, Tze How Daniel New, Shengxian Shi
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This paper outlines the development of a novel experimental technique in quantifying supersonic jet flows, in an attempt to avoid seeding particle problems frequently associated with particle-image velocimetry (PIV) techniques at high Mach numbers. Based on optical flow algorithms, the idea behind the technique involves using high speed cameras to capture Schlieren images of the supersonic jet shear layers, before they are subjected to an adapted optical flow algorithm based on the Horn-Schnuck method to determine the associated flow fields. The proposed method is capable of offering full-field unsteady flow information with potentially higher accuracy and resolution than existing point-measurements or PIV techniques. Preliminary study via numerical simulations of a circular de Laval jet nozzle successfully reveals flow and shock structures typically associated with supersonic jet flows, which serve as useful data for subsequent validation of the optical flow based experimental results. For experimental technique, a Z-type Schlieren setup is proposed with supersonic jet operated in cold mode, stagnation pressure of 8.2 bar and exit velocity of Mach 1.5. High-speed single-frame or double-frame cameras are used to capture successive Schlieren images. As implementation of optical flow technique to supersonic flows remains rare, the current focus revolves around methodology validation through synthetic images. The results of validation test offers valuable insight into how the optical flow algorithm can be further improved to improve robustness and accuracy. Details of the methodology employed and challenges faced will be further elaborated in the final conference paper should the abstract be accepted. Despite these challenges however, this novel supersonic flow measurement technique may potentially offer a simpler way to identify and quantify the fine spatial structures within the shock shear layer.Keywords: Schlieren, optical flow, supersonic jets, shock shear layer
Procedia PDF Downloads 312333 The Influence of Mycelium Species and Incubation Protocols on Heat and Moisture Transfer Properties of Mycelium-Based Composites
Authors: Daniel Monsalve, Takafumi Noguchi
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Mycelium-based composites (MBC) are made by growing living mycelium on lignocellulosic fibres to create a porous composite material which can be lightweight, and biodegradable, making them suitable as a sustainable thermal insulation. Thus, they can help to reduce material extraction while improving the energy efficiency of buildings, especially when agricultural by-products are used. However, as MBC are hygroscopic materials, moisture can reduce their thermal insulation efficiency. It is known that surface growth, or “mycelium skin”, can form a natural coating due to the hydrophobic properties in the mycelium cell wall. Therefore, this research aims to biofabricate a homogeneous mycelium skin and measure its influence on the final composite material by testing material properties such as thermal conductivity, vapour permeability and water absorption by partial immersion over 24 hours. In addition, porosity, surface morphology and chemical composition were also analyzed. The white-rot fungi species Pleurotus ostreatus, Ganoderma lucidum, and Trametes versicolor were grown on 10 mm hemp fibres (Cannabis sativa), and three different biofabrication protocols were used during incubation, varying the time and surface treatment, including the addition of pre-colonised sawdust. The results indicate that density can be reduced by colonisation time, which will favourably impact thermal conductivity but will negatively affect vapour and liquid water control. Additionally, different fungi can exhibit different resistance to prolonged water absorption, and due to osmotic sensitivity, mycelium skin may also diminish moisture control. Finally, a collapse in the mycelium network after water immersion was observed through SEM, indicating how the microstructure is affected, which is also dependent on fungi species and the type of skin achieved. These results help to comprehend the differences and limitations of three of the most common species used for MBC fabrication and how precise engineering is needed to effectively control the material output.Keywords: mycelium, thermal conductivity, vapor permeability, water absorption
Procedia PDF Downloads 41332 Managing Sunflower Price Risk from a South African Oil Crushing Company’s Perspective
Authors: Daniel Mokatsanyane, Johnny Jansen Van Rensburg
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The integral role oil-crushing companies play in sunflower oil production is often overlooked to offer high-quality oil to refineries and end consumers. Sunflower oil crushing companies in South Africa are exposed to price fluctuations resulting from the local and international markets. Hedging instruments enable these companies to hedge themselves against unexpected prices spikes and to ensure sustained profitability. A crushing company is a necessary middleman, and as such, these companies have exposure to the purchasing and selling sides of sunflower. Sunflower oil crushing companies purchase sunflower seeds from farmers or agricultural companies that provide storage facilities. The purchasing price is determined by the supply and demand of sunflower seed, both national and international. When the price of sunflower seeds in South Africa is high but still below import parity, then the crush margins realised by these companies are reduced or even negative at times. There are three main products made by sunflower oil crushing companies, oil, meal, and shells. Profits are realised from selling three products, namely, sunflower oil, meal and shells. However, when selling sunflower oil to refineries, sunflower oil crushing companies needs to hedge themselves against a reduction in vegetable oil prices. Hedging oil prices is often done via futures and is subject to specific volume commitments before a hedge position can be taken in. Furthermore, South African oil-crushing companies hedge sunflower oil with international, Over-the-counter contracts as South Africa is a price taker of sunflower oil and not a price maker. As such, South Africa provides a fraction of the world’s sunflower oil supply and, therefore, has minimal influence on price changes. The advantage of hedging using futures ensures that the sunflower crushing company will know the profits they will realise, but the downside is that they can no longer benefit from a price increase. Alternative hedging instruments like options might pose a solution to the opportunity cost does not go missing and that profit margins are locked in at the best possible prices for the oil crushing company. This paper aims to investigate the possibility of employing options alongside futures to simulate different scenarios to determine if options can bridge the opportunity cost gap.Keywords: derivatives, hedging, price risk, sunflower, sunflower oil, South Africa
Procedia PDF Downloads 165331 India’s Developmental Assistance in Africa: Analyzing India’s Aid and Developmental Projects
Authors: Daniel Gidey, Kunwar Siddarth Dadhwal
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By evaluating India's aid systems and ongoing development initiatives, this conference paper offers light on India's role as a source of developmental assistance in Africa. This research attempts to provide insights into the developing landscape of foreign aid and development cooperation by focusing on understanding India's motivations and strategy. In recent years, India's connection with Africa has grown significantly, driven by economic, political, and strategic reasons. This conference paper covers India's many forms of aid, including financial, capacity building efforts, technical assistance, and infrastructure development projects, via a thorough investigation. The article seeks to establish India's priorities and highlight the possible impacts of its development assistance in Africa by examining the industries and locations of concentration. Using secondary data sources, the investigation delves into the underlying goals of India's aid policy in Africa. It investigates whether India's development assistance is consistent with its broader geopolitical aims, such as access to resources, competing with regional rivals, or strengthening diplomatic ties. Furthermore, the article investigates how India's aid policy combines the ideals of South-South cooperation and mutual development, as well as the ramifications for recipient countries. Furthermore, the paper assesses the efficacy and sustainability of India's aid operations in Africa. It takes into account the elements that influence their success, the problems they face, and the amount to which they contribute to local development goals, community empowerment, and poverty alleviation. The study also focuses on the accountability systems, transparency, and knowledge transfer aspects of India's development assistance. By providing a detailed examination of India's aid endeavors in Africa, the paper adds to the current literature on international development cooperation. By offering fresh insights into the motives, strategies, and impacts of India's assistance programs, it seeks to enhance understanding of the emerging patterns in South-South cooperation and the complex dynamics of contemporary international aid architecture.Keywords: India, Africa, developmental assistance, aid projects and South-South cooperation
Procedia PDF Downloads 64330 Structure and Mechanics Patterns in the Assembly of Type V Intermediate-Filament Protein-Based Fibers
Authors: Mark Bezner, Shani Deri, Tom Trigano, Kfir Ben-Harush
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Intermediate filament (IF) proteins-based fibers are among the toughest fibers in nature, as was shown by native hagfish slime threads and by synthetic fibers that are based on type V IF-proteins, the nuclear lamins. It is assumed that their mechanical performance stems from two major factors: (1) the transition from elastic -helices to stiff-sheets during tensile load; and (2) the specific organization of the coiled-coil proteins into a hierarchical network of nano-filaments. Here, we investigated the interrelationship between these two factors by using wet-spun fibers based on C. elegans (Ce) lamin. We found that Ce-lamin fibers, whether assembled in aqueous or alcoholic solutions, had the same nonlinear mechanical behavior, with the elastic region ending at ~5%. The pattern of the transition was, however, different: the ratio between -helices and -sheets/random coils was relatively constant until a 20% strain for fibers assembled in an aqueous solution, whereas for fibers assembled in 70% ethanol, the transition ended at a 6% strain. This structural phenomenon in alcoholic solution probably occurred through the transition between compacted and extended conformation of the random coil, and not between -helix and -sheets, as cycle analyses had suggested. The different transition pattern can also be explained by the different higher order organization of Ce-lamins in aqueous or alcoholic solutions, as demonstrated by introducing a point mutation in conserved residue in Ce-lamin gene that alter the structure of the Ce-lamins’ nano-fibrils. In addition, biomimicking the layered structure of silk and hair fibers by coating the Ce-lamin fiber with a hydrophobic layer enhanced fiber toughness and lead to a reversible transition between -helix and the extended conformation. This work suggests that different hierarchical structures, which are formed by specific assembly conditions, lead to diverse secondary structure transitions patterns, which in turn affect the fibers’ mechanical properties.Keywords: protein-based fibers, intermediate filaments (IF) assembly, toughness, structure-property relationships
Procedia PDF Downloads 110329 The Concept of Birthday: A Theoretical, Historical, and Social Overview, in Judaism and Other Cultures
Authors: Orly Redlich
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In the age of social distance, which has been added to an individual and competitive worldview, it has become important to find a way to promote closeness and personal touch. The sense of social belonging and the existence of positive interaction with others have recently become a considerable necessity. Therefore, this theoretical paper will review one of the familiar and common concepts among different cultures around the world – birthday. This paper has a theoretical contribution that deepens the understanding of the birthday concept. Birthday rituals are historical and universal events, which noted since the prehistoric eras. In ancient history, birthday rituals were solely reserved for kings and nobility members, but over the years, birthday celebrations have evolved into a worldwide tradition. Some of the familiar birthday customs and symbols are currently common among most cultures, while some cultures have adopted for themselves unique birthday customs, which characterized their values and traditions. The birthday concept has a unique significance in Judaism as well, historically, religiously, and socially: It is considered as a lucky day and a private holiday for the celebrant. Therefore, the present paper reviews diverse birthday customs around the world in different cultures, including Judaism, and marks important birthdays throughout history. The paper also describes how the concept of birthday appears over the years in songs, novels, and art, and presents quotes from distinguished sages. The theoretical review suggests that birthday has a special meaning as a time-mark in the cycle of life, and as a socialization means in human development. Moreover, the birthday serves as a symbol of belonging and group cohesiveness, a day in which the celebrant's sense of belonging and sense of importance are strengthened and nurtured. Thus, the reappearance of these elements in a family or group interaction during the birthday ceremony allows the celebrant to absorb positive impressions about himself. In view of the extensive theoretical review, it seems that the unique importance of birthdays can serve as the foundation for intervention programs that may affect the participants’ sense of belonging and empowerment. In the group aspect, perhaps it can also yield therapeutic factors within a group. Concrete recommendations are presented at the end of the paper.Keywords: birthday, universal events, positive interaction, group cohesiveness, rituals
Procedia PDF Downloads 141328 Spirituality, Sense of Community and Economic Welfare: A Case of Mawlynnong Village, India
Authors: Ricky A. J. Syngkon, Santi Gopal Maji
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Decent work and inclusive economic growth, social development, environmental protection, eradication of poverty and hunger as well as clean water and sanitation are the rudiments of 2030 agenda of sustainable development goals of the United Nations. On the other hand, spirituality is deeply entwined in the fabric of daily lives that helps in shaping attitudes, opinions, and behaviors of common people and ensuring quality of lives and overall sustainable development through protection of environment and natural resources. Mawlynnong, a small village in North-Eastern part of India, is a vivid example of how spirituality influences the development of sense of community leading to upliftment of the economic conditions of the people. Mawlynnong as a small hamlet has been in existence for a couple of centuries and it was acknowledged as the cleanest village of Asia in 2004 by BBC and National Geographic and subsequently endorsed by UNESCO in 2006. Consequently, it has attracted large number of tourists over the years from India and other parts of the world. This paper tries to explore how spirituality leads to a sense of community and the economic benefits for the people. Further, this paper also tries to find out the answer whether such an informal collective effort is sustainable or not for achieving solidarity economy. The study is based on both primary and secondary data collected from the local people and the State Government records. The findings of the study indicate that over the last one and a half decade the tourist footfall has increased to a great extent in Mawlynnong and this has brought about a paradigm shift in the occupational structure of its inhabitants from plantation to service sector particularly tourism and tourism related activities. As a result, from the economic standpoint, it is observed that life is much better off now as compared to before. But from the socio-cultural standpoint, the study finds a drift in terms of the cohesiveness and community bonding which was the hallmark of this village. This drift puts a question mark about the sustainability of such practices and consequently the development of solidarity economy.Keywords: spirituality, sense of community, economic welfare, solidarity economy, Mawlynnong village
Procedia PDF Downloads 140327 Rethinking Entrepreneurship Education as a Remedy for Graduates Unemployment in Nigeria
Authors: Chinwe Susan Oguejiofor, Daniel Osamwonyi Iyioha
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Over the last two decades, Nigeria has witnessed an upsurge in graduate unemployment occasioned by the lack of industries and proliferation of tertiary institutions churning out thousands of graduates every year to compete for the few available job space. The astronomical rise in the unemployment rate amongst Nigerian graduates however, is principally assumed to be the defective curricula of the universities and other tertiary institutions whose focus is on training for white-collar jobs. Although graduate unemployment has become a global scourge, its adverse economic impact is believed to be more in developing economies like Nigeria with a huge young population within the working age who cannot seem to find gainful employment to make out a respectable livelihood. Thus, higher institutions especially Universities found itself under pressure and intense competition to produce graduates who can think outside the box and create jobs; hence there was the need to focus on instilling hands-on practical job skills into their students that will make them job creators rather than job seekers on graduation. In the same vein stakeholders in education have continued to lend their voices to the philosophy that the undergraduate curricula should be completely overhauled to accomodate the development of hand-on practical skills and innovative capacity relevant to creating solutions to societal problems. In a bid to correct this anomaly, the Federal Government of Nigeria in conjunction with the Ministry of Commerce, Industry and Investment inaugurated a programme tagged “University Entrepreneurship Development Programme” (UNEDEP) whose objective was basically to promote self-employment among the youth right from the institutions of higher learning. But the question is whether the objectives of the programme have actually been achieved. Despite the inclusion in Nigerian educational curriculum close to two decades now,, one wonder if the essence has been aborted. Thus, the paper focused on the concept of entrepreneurship education, objectives of entrepreneurship education, Graduates unemployment, rethinking entrepreneurship education programme in tertiary institution for employment generation , role of entrepreneurship in job creation, challenges of entrepreneurship education in tertiary institution in Nigeria, conclusion and recommendations were drawn accordingly.Keywords: rethinking, entrepreneurship education, remedy, unemployment, job creation
Procedia PDF Downloads 79326 Femoropatellar Groove: An Anatomical Study
Authors: Mamatha Hosapatna, Anne D. Souza, Vrinda Hari Ankolekar, Antony Sylvan D. Souza
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Introduction: The lower extremity of the femur is characterized by an anterior groove in which patella is held during motion. This groove separates the two lips of the trochlea (medial and lateral), prolongation of the two condyles. In humans, the lateral trochlear lip is more developed than the medial one, creating an asymmetric groove that is also specific to the human body. Because of femoral obliquity, contraction of quadriceps leads to a lateral dislocation stress on the patella, and the more elevated lateral side of the patellar groove helps the patella stays in its correct place, acting as a wall against lateral dislocation. This specific shape fits an oblique femur. It is known that femoral obliquity is not genetically determined but comes with orthostatism and biped walking. Material and Methodology: To measure the various dimensions of the Femoropatellar groove (FPG) and femoral condyle using digital image analyser. 37 dried adult femora (22 right,15 left) were used for the study. End on images of the lower end of the femur was taken. Various dimensions of the Femoropatellar groove and FP angle were measured using image J software. Results were analyzed statistically. Results: Maximum of the altitude of medial condyle of the right femur is 4.98± 0.35 cm and of the left femur is 5.20±.16 cm. Maximum altitude of lateral condyle is 5.44±0.4 and 5.50±0.14 on the right and left side respectively. Medial length of the groove is 1.30±0.38 cm on the right side and on the left side is 1.88±0.16 cm. The lateral length of the groove on the right side is 1.900±.16 cm and left side is 1.88±0.16 cm. Femoropatellar angle is 136.38◦±2.59 on the right side and on the left side it is 142.38◦±7.0 Angle and dimensions of the femoropatellar groove on the medial and lateral sides were measured. Asymmetry in the patellar groove was observed. The lateral lip was found to be wider and bigger which correlated with the previous studies. An asymmetrical patellar groove with a protruding lateral side associated with an oblique femur is a specific mark of bipedal locomotion. Conclusion: Dimensions of FPG are important in maintaining the stability of patella and also in knee replacement surgeries. The implants used in to replace the patellofemoral compartment consist of a metal groove to fit on the femoral end and a plastic disc that attaches to the undersurface of the patella. The location and configuration of the patellofemoral groove of the distal femur are clinically significant in the mechanics and pathomechanics of the patellofemoral articulation.Keywords: femoral patellar groove, femoro patellar angle, lateral condyle, medial condyle
Procedia PDF Downloads 402325 The Application of Collision Damage Analysis in Reconstruction of Sedan-Scooter Accidents
Authors: Chun-Liang Wu, Kai-Ping Shaw, Cheng-Ping Yu, Wu-Chien Chien, Hsiao-Ting Chen, Shao-Huang Wu
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Objective: This study analyzed three criminal judicial cases. We applied the damage analysis of the two vehicles to verify other evidence, such as dashboard camera records of each accident, reconstruct the scenes, and pursue the truth. Methods: Evidence analysis, the method is to collect evidence and the reason for the results in judicial procedures, then analyze the involved damage evidence to verify other evidence. The collision damage analysis method is to inspect the damage to the vehicles and utilize the principles of tool mark analysis, Newtonian physics, and vehicle structure to understand the relevant factors when the vehicles collide. Results: Case 1: Sedan A turned right at the T junction and collided with Scooter B, which was going straight on the left road. The dashboard camera records showed that the left side of Sedan A’s front bumper collided with the body of Scooter B and rider B. After the analysis of the study, the truth was that the front of the left side of Sedan A impacted the right pedal of Scooter B and the right lower limb of rider B. Case 2: Sedan C collided with Scooter D on the left road at the crossroads. The dashboard camera record showed that the left side of the Sedan C’s front bumper collided with the body of Scooter D and rider D. After the analysis of the study, the truth was that the left side of the Sedan C impacted the left side of the car body and the front wheel of Scooter D and rider D. Case 3: Sedan E collided with Scooter F on the right road at the crossroads. The dashboard camera record showed that the right side of the Sedan E’s front bumper collided with the body of Scooter F and rider F. After the analysis of the study, the truth was that the right side of the front bumper and the right side of the Sedan F impacted the Scooter. Conclusion: The application of collision damage analysis in the reconstruction of a sedan-scooter collision could discover the truth and provide the basis for judicial justice. The cases and methods could be the reference for the road safety policy.Keywords: evidence analysis, collision damage analysis, accident reconstruction, sedan-scooter collision, dashboard camera records
Procedia PDF Downloads 78324 Social Protection Reforms in Indonesia: Towards a Life Cycle Based Social Protection System
Authors: Dyah Larasati, Karishma Alize Huda, Sri Kusumastuti Rahayu, Martin Daniel Siyaranamual
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Indonesia continues to reform its social protection system to provide the needed protection for its citizen. Indonesia Social Protection consisted of social assistance programs (non-contributory/tax-financed) specifically targeted for the poor and at-risk and social security/insurance program (contributory system). The social assistance programs have mostly been implemented since 1998. The national health insurance has been implemented since 2014 and the employment social insurance since 2015. One major reform implemented has been improving the targeting performance of its major social assistance portfolios including (1) Food Assistance for the poor families (Rastra and BPNT/noncash foods assistance); (2) Education Assistance for poor children; (3) Conditional Cash Transfer for poor families (PKH); and (4) Subsidized beneficiaries of National Health Insurance (JKN-PBI) for the poor and at-risk individuals. For the Social Insurance (through BPJS Employment program), several initiatives have been implemented to expand the program contributing members, although it mostly benefits the formal sector workers. However, major gaps still exist especially for the emerging middle-income groups who typically work at the informal sectors. They have yet to get the protection needed to sustain their social and economic growth. Since 2017, TNP2K (the National Team for Poverty Reduction) under the Vice President office has led the social protection discourse as the government understands the need to address vulnerabilities across the lifecycle and prioritize support to the most at-risk population particularly the elderly, young children and people with disabilities. Discussion and advocacy to recommend for more investment is continuing in order for the government to establish a comprehensive social protection system in the near future (2020-2024) that protects children through an inclusive child benefit program; build a system to benefit more working-age adults (including individuals with disabilities) and a three-tier elderly protection as they reach 65 years.Keywords: poverty reduction, social assistance, social insurance, social protection
Procedia PDF Downloads 179323 Bridging Healthcare Information Systems and Customer Relationship Management for Effective Pandemic Response
Authors: Sharda Kumari
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As the Covid-19 pandemic continues to leave its mark on the global business landscape, companies have had to adapt to new realities and find ways to sustain their operations amid social distancing measures, government restrictions, and heightened public health concerns. This unprecedented situation has placed considerable stress on both employees and employers, underscoring the need for innovative approaches to manage the risks associated with Covid-19 transmission in the workplace. In response to these challenges, the pandemic has accelerated the adoption of digital technologies, with an increasing preference for remote interactions and virtual collaboration. Customer relationship management (CRM) systems have risen to prominence as a vital resource for organizations navigating the post-pandemic world, providing a range of benefits that include acquiring new customers, generating insightful consumer data, enhancing customer relationships, and growing market share. In the context of pandemic management, CRM systems offer three primary advantages: (1) integration features that streamline operations and reduce the need for multiple, costly software systems; (2) worldwide accessibility from any internet-enabled device, facilitating efficient remote workforce management during a pandemic; and (3) the capacity for rapid adaptation to changing business conditions, given that most CRM platforms boast a wide array of remotely deployable business growth solutions, a critical attribute when dealing with a dispersed workforce in a pandemic-impacted environment. These advantages highlight the pivotal role of CRM systems in helping organizations remain resilient and adaptive in the face of ongoing global challenges.Keywords: healthcare, CRM, customer relationship management, customer experience, digital transformation, pandemic response, patient monitoring, patient management, healthcare automation, electronic health record, patient billing, healthcare information systems, remote workforce, virtual collaboration, resilience, adaptable business models, integration features, CRM in healthcare, telehealth, pandemic management
Procedia PDF Downloads 101322 Exploratory Analysis and Development of Sustainable Lean Six Sigma Methodologies Integration for Effective Operation and Risk Mitigation in Manufacturing Sectors
Authors: Chukwumeka Daniel Ezeliora
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The Nigerian manufacturing sector plays a pivotal role in the country's economic growth and development. However, it faces numerous challenges, including operational inefficiencies and inherent risks that hinder its sustainable growth. This research aims to address these challenges by exploring the integration of Lean and Six Sigma methodologies into the manufacturing processes, ultimately enhancing operational effectiveness and risk mitigation. The core of this research involves the development of a sustainable Lean Six Sigma framework tailored to the specific needs and challenges of Nigeria's manufacturing environment. This framework aims to streamline processes, reduce waste, improve product quality, and enhance overall operational efficiency. It incorporates principles of sustainability to ensure that the proposed methodologies align with environmental and social responsibility goals. To validate the effectiveness of the integrated Lean Six Sigma approach, case studies and real-world applications within select manufacturing companies in Nigeria will be conducted. Data were collected to measure the impact of the integration on key performance indicators, such as production efficiency, defect reduction, and risk mitigation. The findings from this research provide valuable insights and practical recommendations for selected manufacturing companies in South East Nigeria. By adopting sustainable Lean Six Sigma methodologies, these organizations can optimize their operations, reduce operational risks, improve product quality, and enhance their competitiveness in the global market. In conclusion, this research aims to bridge the gap between theory and practice by developing a comprehensive framework for the integration of Lean and Six Sigma methodologies in Nigeria's manufacturing sector. This integration is envisioned to contribute significantly to the sector's sustainable growth, improved operational efficiency, and effective risk mitigation strategies, ultimately benefiting the Nigerian economy as a whole.Keywords: lean six sigma, manufacturing, risk mitigation, sustainability, operational efficiency
Procedia PDF Downloads 207321 An Integrated Approach to Solid Waste Management of Karachi, Pakistan (Waste-to-Energy Options)
Authors: Engineer Dilnawaz Shah
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Solid Waste Management (SWM) is perhaps one of the most important elements constituting the environmental health and sanitation of the urban developing sector. The management system has several components that are integrated as well as interdependent; thus, the efficiency and effectiveness of the entire system are affected when any of its functional components fails or does not perform up to the level mark of operation. Sindh Solid Waste Management Board (SSWMB) is responsible for the management of solid waste in the entire city. There is a need to adopt the engineered approach in the redesigning of the existing system. In most towns, street sweeping operations have been mechanized and done by machinery operated by vehicles. Construction of Garbage Transfer Stations (GTS) at a number of locations within the city will cut the cost of transportation of waste to disposal sites. Material processing, recovery of recyclables, compaction, volume reduction, and increase in density will enable transportation of waste to disposal sites/landfills via long vehicles (bulk transport), minimizing transport/traffic and environmental pollution-related issues. Development of disposal sites into proper sanitary landfill sites is mandatory. The transportation mechanism is through garbage vehicles using either hauled or fixed container systems employing crew for mechanical or manual loading. The number of garbage vehicles is inadequate, and due to comparatively long haulage to disposal sites, there are certain problems of frequent vehicular maintenance and high fuel costs. Foreign investors have shown interest in enterprising improvement schemes and proposed operating a solid waste management system in Karachi. The waste to Energy option is being considered to provide a practical answer to be adopted to generate power and reduce waste load – a two-pronged solution for the increasing environmental problem. The paper presents results and analysis of a recent study into waste generation and characterization probing into waste-to-energy options for Karachi City.Keywords: waste to energy option, integrated approach, solid waste management, physical and chemical composition of waste in Karachi
Procedia PDF Downloads 45320 Liposome Sterile Filtration Fouling: The Impact of Transmembrane Pressure on Performance
Authors: Hercules Argyropoulos, Thomas F. Johnson, Nigel B Jackson, Kalliopi Zourna, Daniel G. Bracewell
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Lipid encapsulation has become essential in drug delivery, notably for mRNA vaccines during the COVID-19 pandemic. However, their sterile filtration poses challenges due to the risk of deformation, filter fouling and product loss from adsorption onto the membrane. Choosing the right filtration membrane is crucial to maintain sterility and integrity while minimizing product loss. The objective of this study is to develop a rigorous analytical framework utilizing confocal microscopy and filtration blocking models to elucidate the fouling mechanisms of liposomes as a model system for this class of delivery vehicle during sterile filtration, particularly in response to variations in transmembrane pressure (TMP) during the filtration process. Experiments were conducted using fluorescent Lipoid S100 PC liposomes formulated by micro fluidization and characterized by Multi-Angle Dynamic Light Scattering. Dual-layer PES/PES and PES/PVDF membranes with 0.2 μm pores were used for filtration under constant pressure, cycling from 30 psi to 5 psi and back to 30 psi, with 5, 6, and 5-minute intervals. Cross-sectional membrane samples were prepared by microtome slicing and analyzed with confocal microscopy. Liposome characterization revealed a particle size range of 100-140 nm and an average concentration of 2.93x10¹¹ particles/mL. Goodness-of-fit analysis of flux decline data at varying TMPs identified the intermediate blocking model as most accurate at 30 psi and the cake filtration model at 5 psi. Membrane resistance analysis showed atypical behavior compared to therapeutic proteins, with resistance remaining below 1.38×10¹¹ m⁻¹ at 30 psi, increasing over fourfold at 5 psi, and then decreasing to 1-1.3-fold when pressure was returned to 30 psi. This suggests that increased flow/shear deforms liposomes enabling them to more effectively navigate membrane pores. Confocal microscopy indicated that liposome fouling mainly occurred in the upper parts of the dual-layer membrane.Keywords: sterile filtration, membrane resistance, microfluidization, confocal microscopy, liposomes, filtration blocking models
Procedia PDF Downloads 19319 Tracking the Mind's Mouth: Use of Smart Technology for Effective Teaching of Speaking to Pupils with Developmental Co-ordination Disorder
Authors: Sadeq Al Yaari, Muhammad Alkhunayn, Ayah Al Yaari, Ayman Al Yaari, Montaha Al Yaari, Adham Al Yaari, Sajedah Al Yaari, Fatehi Eissa
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Developmental co-ordination disorder (DCD) (also known as dyspraxia) causes a child to speak less well than expected in social conversations. We propose that the smart speaking technology could help improve sound production mechanism at both phonetic and phonological levels, which leads to better articulation of an utterance. The participants are twelve privately beginner pupils aged between 6-12 years old and diagnosed with DCD (apraxia) divided into two groups: Experimental group (n=6) and control group (called apraxic control group) (n=6). A total of fifty typically developing and achieving (TD) pupils participated as control group 2 in both groups and were preassigned into two groups (27 pupils with the treatment group and 23 with the apraxic control group). Weekly quizzes were given to all participants each week for four continuous months and results were analyzed by psychoneurolinguists and a statistician. Although being taught by the same speech-language therapist (SLT), treatment group along with TD groups were taught a full-time speaking course with sociolinguistic themes covering both phonetic and phonological properties. The course lasted for a whole semester whereby smart speaking aids have become dominant while apraxic control group and its TD group were not. Compared with apraxic control group and its TD subgroup, results show obvious changes in speaking behavioral mechanism of the DCD experimental group and its TD subgroup. Improvement could be taken from the scores where the zero marks disappeared in the fourth week (end of the first month of treatment). Good marks (5 +/10) were seen starting from the eighth week and culminating with full marks in the week number 15 of treatment where some participants scored full mark. This study concludes to support the primacy of the smart educational technology for speaking purposes and also shows that such aids can expand the range of academic performance differential categories. Further research is required to evaluate the current demonizing of smart educational aids and weighting more reasonably the relationship specificity that speaking aids can offer to other language skills, as well as their limitations.Keywords: smart educational technology, speaking aids, pupils with SCD, apraxia
Procedia PDF Downloads 50318 The Impact of Artificial Intelligence on Journalism and Mass Communication
Authors: Saad Zagloul Shokri Melika
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The London College of Communication is one of the only universities in the world to offer a lifestyle journalism master’s degree. A hybrid originally constructed largely out of a generic journalism program crossed with numerous cultural studies approaches, the degree has developed into a leading lifestyle journalism education attracting students worldwide. This research project seeks to present a framework for structuring the degree as well as to understand how students in this emerging field of study value the program. While some researchers have addressed questions about journalism and higher education, none have looked specifically at the increasingly important genre of lifestyle journalism, which Folker Hanusch defines as including notions of consumerism and critique among other identifying traits. Lifestyle journalism, itself poorly researched by scholars, can relate to topics including travel, fitness, and entertainment, and as such, arguably a lifestyle journalism degree should prepare students to engage with these topics. This research uses the existing Masters of Arts and Lifestyle Journalism at the London College of Communications as a case study to examine the school’s approach. Furthering Hanusch’s original definition, this master’s program attempts to characterizes lifestyle journalism by a specific voice or approach, as reflected in the diversity of student’s final projects. This framework echoes the ethos and ideas of the university, which focuses on creativity, design, and experimentation. By analyzing the current degree as well as student feedback, this research aims to assist future educators in pursuing the often neglected field of lifestyle journalism. Through a discovery of the unique mix of practical coursework, theoretical lessons, and broad scope of student work presented in this degree program, researchers strive to develop a framework for lifestyle journalism education, referring to Mark Deuze’s ten questions for journalism education development. While Hanusch began the discussion to legitimize the study of lifestyle journalism, this project strives to go one step further and open up a discussion about teaching of lifestyle journalism at the university level.Keywords: Journalism, accountability, education, television, publicdearth, investigative, journalism, Nigeria, journalismeducation, lifestyle, university
Procedia PDF Downloads 44317 How Natural Environments Are Being Used by Teachers to Improve Student Learning and Wellbeing in Australia
Authors: Jade Fersterer, Tristan Snell, Mark Rickinson
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This paper is designed to provide a review of the literature concerning the impact of natural environments on student learning and wellbeing in Australia. Specific areas of interest include how child-led and teacher-led pedagogies differ in outdoor learning settings, and the impact of each approach on children’s well-being, behavior, relationships with others as well as educational outcomes. The review will include links to possibilities for future research, including a Ph.D. currently being undertaken in Australia, which aims to fulfill a considerable gap in psychological, educational and outdoor learning research, regarding how natural environments are being used by teachers to improve learning and wellbeing among primary school students. The proposed study aims to understand if children’s experience of learning, 1. in a natural environment, and 2. in a child-led way, can support and strengthen their skills across several areas of development, including those required for positive educational outcomes. Data will be collected from a sample of primary school students and teachers via both quantitative and qualitative methods, including a pre- and post-questionnaire, direct observation, and semi-structured interviews. The study will have valuable implications for the provision of quality education as well as the promotion of good health and wellbeing. The implications of the research will be useful not only for teachers and parents but also for Psychologists working with children and young people in both a school and clinical setting. Understanding the impacts and implications of child-led learning and exposure to natural environments provides the opportunity to build on the current school curriculum. The inclusion of child-led experiences in nature may provide a simple way to build enthusiasm for school and learning, cultivating skills for life and relationships as well as meeting current curriculum requirements and building capacity for ongoing academic pursuits. In addition, understanding the impact of learning in a natural environment on wellbeing will assist in the development and dissemination of an educational model that could help mitigate the negative health outcomes associated with reduced physical activity and decreasing contact with nature among children.Keywords: child-led learning, educational outcomes, natural environments, wellbeing
Procedia PDF Downloads 125316 Comparative Efficacy of Angiotensin Converting Enzymes Inhibitors and Angiotensin Receptor Blockers in Patients with Heart Failure in Tanzania: A Prospective Cohort Study
Authors: Mark P. Mayala, Henry Mayala, Khuzeima Khanbhai
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Background: Heart failure has been a rising concern in Tanzania. New drugs have been introduced, including the group of drugs called Angiotensin receptor Neprilysin Inhibitor (ARNI), but due to their high cost, angiotensin-converting enzymes inhibitors (ACEIs) and Angiotensin receptor blockers (ARBs) have been mostly used in Tanzania. However, according to our knowledge, the efficacy comparison of the two groups is yet to be studied in Tanzania. The aim of this study was to compare the efficacy of ACEIs and ARBs among patients with heart failure. Methodology: This was a hospital-based prospective cohort study done at Jakaya Kikwete Cardiac Institution (JKCI), Tanzania, from June to December 2020. Consecutive enrollment was done until fulfilling the inclusion criteria. Clinical details were measured at baseline. We assessed the relationship between ARBs and ACEIs users with N-terminal pro-brain natriuretic peptide (NT pro-BNP) levels at admission and at 1-month follow-up using a chi-square test. A Kaplan-Meier curve was used to estimate the survival time of the two groups. Results: 155 HF patients were enrolled, with a mean age of 48 years, whereby 52.3% were male, and their mean left ventricular ejection fraction (LVEF) was 37.3%. 52 (33.5%) heart failure patients were on ACEIs, 57 (36.8%) on ARBs, and 46 (29.7%) were neither using ACEIs nor ARBs. At least half of the patients did not receive a guideline-directed medical therapy (GDMT), with only 82 (52.9%) receiving a GDMT. A drop in NT pro-BNP levels was observed during admission and at 1-month follow-up on both groups, from 6389.2 pg/ml to 4000.1 pg/ml for ARB users and 5877.7 pg/ml to 1328.2 pg/ml for the ACEIs users. There was no statistical difference between the two groups when estimated by the Kaplan-Meier curve, though more deaths were observed in those who were neither on ACEIs nor ARBs, with a calculated P value of 0.01. Conclusion: This study demonstrates that ACEIs have more efficacy and overall better clinical outcome than ARBs, but this should be taken under the patient-based case, considering the side effects of ACEIs and patients’ adherence.Keywords: angiotensin converting enzymes inhibitors, angiotensin receptor blockers, guideline direct medical therapy, N-terminal pro-brain natriuretic peptide
Procedia PDF Downloads 85315 Management of Acute Biliary Pathology at Gozo General Hospital
Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti
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Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management
Procedia PDF Downloads 161314 Algorithm for Predicting Cognitive Exertion and Cognitive Fatigue Using a Portable EEG Headset for Concussion Rehabilitation
Authors: Lou J. Pino, Mark Campbell, Matthew J. Kennedy, Ashleigh C. Kennedy
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A concussion is complex and nuanced, with cognitive rest being a key component of recovery. Cognitive overexertion during rehabilitation from a concussion is associated with delayed recovery. However, daily living imposes cognitive demands that may be unavoidable and difficult to quantify. Therefore, a portable tool capable of alerting patients before cognitive overexertion occurs could allow patients to maintain their quality of life while preventing symptoms and recovery setbacks. EEG allows for a sensitive measure of cognitive exertion. Clinical 32-lead EEG headsets are not practical for day-to-day concussion rehabilitation management. However, there are now commercially available and affordable portable EEG headsets. Thus, these headsets can potentially be used to continuously monitor cognitive exertion during mental tasks to alert the wearer of overexertion, with the aim of preventing the occurrence of symptoms to speed recovery times. The objective of this study was to test an algorithm for predicting cognitive exertion from EEG data collected from a portable headset. EEG data were acquired from 10 participants (5 males, 5 females). Each participant wore a portable 4 channel EEG headband while completing 10 tasks: rest (eyes closed), rest (eyes open), three levels of the increasing difficulty of logic puzzles, three levels of increasing difficulty in multiplication questions, rest (eyes open), and rest (eyes closed). After each task, the participant was asked to report their perceived level of cognitive exertion using the NASA Task Load Index (TLX). Each participant then completed a second session on a different day. A customized machine learning model was created using data from the first session. The performance of each model was then tested using data from the second session. The mean correlation coefficient between TLX scores and predicted cognitive exertion was 0.75 ± 0.16. The results support the efficacy of the algorithm for predicting cognitive exertion. This demonstrates that the algorithms developed in this study used with portable EEG devices have the potential to aid in the concussion recovery process by monitoring and warning patients of cognitive overexertion. Preventing cognitive overexertion during recovery may reduce the number of symptoms a patient experiences and may help speed the recovery process.Keywords: cognitive activity, EEG, machine learning, personalized recovery
Procedia PDF Downloads 220313 Explaining the Relationship between Religiosity and Resilience
Authors: Rita Phillips, Mark Burgess, Maga Berlinski
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Although the positive impact of religiosity on well-being, health, and life-coping abilities is well known, up to date research has failed to provide scientific evidence for the relationship reasons. Therefore the present study took a qualitative approach by examining how religiosity interacts in coping with emotionally distressful situations, for which wedding preparations are an example. Wedding preparations, related to the experience of ambiguous emotions, can be the reason for phases of high distress. Although being per-se religious ceremonies, they are also socially-scripted and characterized by people’s striving for personally meaningful celebrations. The negotiation of these many influences can evoke conflicts. To reveal components of religiosity which contribute to stress-resolution, eight biographic-narrative interviews with recently married spouses were conducted. Participants were from different nationalities and Catholic deep-belief communities in order to determine factors independent from national-culture and social-subgroup. The audio-tape recorded, transcribed and translated interviews were analyzed by Interpretative Phenomenological Analysis. Opposing previous research on wedding-related conflicts but in-line with the quantitative account on the relation between stress-resilience and religiosity, the present study found participants reporting very low levels of distress and ambiguity. Although similar areas of potential conflicts were revealed, deep-belief Christians seemed to handle them in a different way. Participants freed themselves from own and others’ rigor mundane expectations by their spiritual preparation and the focus on a divine instance. This evoked a feeling of perceived closeness to God and of unconditional love, resulting in acceptance of oneself and others. Through relativizing mundane goods, participants perceived absolute freedom. Thus belief did not supplement coping strategies, previously defined in the literature, but substituted them. The paper implies that in explaining the connection between stress-resilience and religiosity, one’s perception and experience of unconditional love might outweigh other social or personal factors. However, further qualitative investigations are needed to fully explain the phenomenon.Keywords: deep-belief, religiosity, resilience, wedding
Procedia PDF Downloads 244312 Projected Uncertainties in Herbaceous Production Result from Unpredictable Rainfall Pattern and Livestock Grazing in a Humid Tropical Savanna Ecosystem
Authors: Daniel Osieko Okach, Joseph Otieno Ondier, Gerhard Rambold, John Tenhunen, Bernd Huwe, Dennis Otieno
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Increased human activities such as grazing, logging, and agriculture alongside unpredictable rainfall patterns have been detrimental to the ecosystem service delivery, therefore compromising its productivity potential. This study aimed at simulating the impact of drought (50%) and enhanced rainfall (150%) on the future herbaceous CO2 uptake, biomass production and soil C:N dynamics in a humid savanna ecosystem influenced by livestock grazing. Rainfall pattern was predicted using manipulation experiments set up to reduce (50%) and increase (150%) ambient (100%) rainfall amounts in grazed and non-grazed plots. The impact of manipulated rainfall regime on herbaceous CO2 fluxes, biomass production and soil C:N dynamics was measured against volumetric soil water content (VWC) logged every 30 minutes using the 5TE (Decagon Devices Inc., Washington, USA) soil moisture sensors installed (at 20 cm soil depth) in every plots. Herbaceous biomass was estimated using destructive method augmented by standardized photographic imaging. CO2 fluxes were measured using the ecosystem chamber method and the gas analysed using LI-820 gas analyzer (USA). C:N ratio was calculated from the soil carbon and Nitrogen contents (analyzed using EA2400CHNS/O and EA2410 N elemental analyzers respectively) of different plots under study. The patterning of VWC was directly influenced by the rainfall amount with lower VWC observed in the grazed compared to the non-grazed plots. Rainfall variability, grazing and their interaction significantly affected changes in VWC (p < 0.05) and subsequently total biomass and CO2 fluxes. VWC had a strong influence on CO2 fluxes under 50% rainfall reduction in the grazed (r2 = 0.91; p < 0.05) and ambient rainfall in the ungrazed (r2 = 0.77; p < 0.05). The dependence of biomass on VWC across plots was enhanced under grazed (r2 = 0.78 - 0.87; p < 0.05) condition as compared to ungrazed (r2 = 0.44 - 0.85; p < 0.05). The C:N ratio was however not correlated to VWC across plots. This study provides insight on how the predicted trends in humid savanna will respond to changes influenced by rainfall variability and livestock grazing and consequently the sustainable management of such ecosystems.Keywords: CO2 fluxes, rainfall manipulation, soil properties, sustainability
Procedia PDF Downloads 133