Search results for: respiration rates
2286 Fiscal Stability Indicators and Public Debt Trajectory in Croatia
Authors: Hrvoje Simovic
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Paper analyses the key problems of fiscal sustainability in Croatia. To point out key challenges of fiscal sustainability, the public debt sustainability is analyzed using standard indicators of fiscal stability, accompanied with the identification of regime changes approach in the public debt trajectory using switching regression approach. The analysis is conducted for the period from 2001 to 2016. Results show huge vulnerability in recession period (2009-14), so key challenges in current fiscal policy and public debt management are recognized in maturity prolongation, interest rates trends, and credit rating expectations.Keywords: fiscal sustainability, public debt, Croatia, budget deficit
Procedia PDF Downloads 2602285 Tension-Free Vaginal Tape Secur (TVT Secur) versus Tension-Free Vaginal Tape-Obturator (TVT-O) from inside to outside in Surgical Management of Genuine Stress Urinary Incontinence
Authors: Ibrahim Mohamed Ibrahim Hassanin, Hany Hassan Mostafa, Mona Mohamed Shaban, Ahlam El Said Kamel
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Background: New so-called minimally invasive devices have been developed to limit groin pain after sling placement for treatment of stress urinary incontinence (SUI) to minimize the risk of postoperative pain and organ perforation. A new generation of suburethral slings was described that avoided skin incision to pull out and tension the sling. Evaluation of this device through prospective short-term series has shown controversial results compared with other tension-free techniques. The aim of this study is to compare success rates and complications for tension-free vaginal tape secur (TVT secur) and trans-obturator sub urethral tape inside-out technique (TVT-O) for treatment of stress urinary incontinence (SUI). Materials and Methods: Fifty patients with genuine SUI were divided into two groups: group S (n=25) were operated upon using (TVT secur) and group O (n=25) were operated upon using trans-obturator suburethral tape inside-out technique (TVT-O). Success rate, quality of life and postoperative complications such as groin pain, urgency, urine retention and vaginal tape erosion were reported in both groups at one, three, and six months after surgery. Results: As regards objective cure rate at one, three, six months intervals; there was a significant difference between group S (56%, 64%, and 60%), and group O (80%, 88%, and 88%) respectively (P <0.05). As regards subjective cure rate at one, three, six months intervals; there was a significant difference between group S (44%, 44%, and 48%), and group O (76%, 80%, and 80%) respectively (P <0.05). Quality of life (QoL) parameters improved significantly in cured patients with no difference between both groups. As regards complications, group O had a higher frequency of complications than group S; groin pain (12% vs 12% p= 0.05), urgency (4% (1 case) vs 0%), urine retention (8% (2 cases) vs 0%), vaginal tape erosion (4% (1 case) vs 0%). No cases were complicated with wound infection. Conclusion: Compared to TVT secur, TVT-O showed higher subjective and objective cure rates after six months but higher rate of complications. Both techniques were comparable as regards improvement of quality of life after surgery.Keywords: stress urinary incontinence, trans-vaginal tape-obturator, TVT Secur, TVT-O
Procedia PDF Downloads 3592284 Novel Low-cost Bubble CPAP as an Alternative Non-invasive Oxygen Therapy for Newborn Infants with Respiratory Distress Syndrome in a Tertiary Level Neonatal Intensive Care Unit in the Philippines: A Single Blind Randomized Controlled Trial
Authors: Navid P Roodaki, Rochelle Abila, Daisy Evangeline Garcia
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Background and Objective: Respiratory Distress Syndrome (RDS) among premature infants is a major causes of neonatal death. The use of Continuous Positive Airway Pressure (CPAP) has become a standard of care for preterm newborns with RDS hence cost-effective innovations are needed. This study compared a novel low-cost Bubble CPAP (bCPAP) device to ventilator driven CPAP in the treatment of RDS. Methods: This is a single-blind, randomized controlled trial done on May 2022 to October 2022 in a Level III Neonatal Intensive Care Unit in the Philippines. Preterm newborns (<36 weeks) with RDS were randomized to receive Vayu bCPAP device or Ventilator-derived CPAP. Arterial Blood Gases, Oxygen Saturation, administration of surfactant, and CPAP failure rates were measured. Results: Seventy preterm newborns were included. No differences were observed between the Ventilator driven CPAP and Vayu bCPAP on the PaO2 (97.51mmHg vs 97.37mmHg), So2 (97.08% vs 95.60%) levels, amount of surfactant administered between groups. There were no observed differences in CPAP failure rates between Vayu bPCAP (x̄ 3.23 days) and ventilator-driven CPAP (x̄ 2.98 days). However, a significant difference was noted on the CO2 level (40.32mmHg vs 50.70mmHg), which was higher among those hooked to Ventilator-driven CPAP (p 0.004). Conclusion: This study has shown that the novel low-cost bubble CPAP (Vayu bCPAP) can be used as an efficacious alternate non invasive oxygen therapy among preterm neonates with RDS, although the CO2 levels were higher among those hooked to ventilator driven CPAP, other outcome parameters measured showed that both devices are comparable. Recommendation: A multi-center or national study to account for geographic region, which may alter the outcomes of patients connected to different ventilatory support. Cost comparison between devices is also suggested. A mixed-method research assessing the experiences of health care professionals in assembling and utilizing the gadget is a second consideration.Keywords: bubble CPAP, ventilator-derived CPAP; infant, premature, respiratory distress syndrome
Procedia PDF Downloads 832283 Mitochondrial DNA Defect and Mitochondrial Dysfunction in Diabetic Nephropathy: The Role of Hyperglycemia-Induced Reactive Oxygen Species
Authors: Ghada Al-Kafaji, Mohamed Sabry
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Mitochondria are the site of cellular respiration and produce energy in the form of adenosine triphosphate (ATP) via oxidative phosphorylation. They are the major source of intracellular reactive oxygen species (ROS) and are also direct target to ROS attack. Oxidative stress and ROS-mediated disruptions of mitochondrial function are major components involved in the pathogenicity of diabetic complications. In this work, the changes in mitochondrial DNA (mtDNA) copy number, biogenesis, gene expression of mtDNA-encoded subunits of electron transport chain (ETC) complexes, and mitochondrial function in response to hyperglycemia-induced ROS and the effect of direct inhibition of ROS on mitochondria were investigated in an in vitro model of diabetic nephropathy using human renal mesangial cells. The cells were exposed to normoglycemic and hyperglycemic conditions in the presence and absence of Mn(III)tetrakis(4-benzoic acid) porphyrin chloride (MnTBAP) or catalase for 1, 4 and 7 days. ROS production was assessed by the confocal microscope and flow cytometry. mtDNA copy number and PGC-1a, NRF-1, and TFAM, as well as ND2, CYTB, COI, and ATPase 6 transcripts, were all analyzed by real-time PCR. PGC-1a, NRF-1, and TFAM, as well as ND2, CYTB, COI, and ATPase 6 proteins, were analyzed by Western blotting. Mitochondrial function was determined by assessing mitochondrial membrane potential and adenosine triphosphate (ATP) levels. Hyperglycemia-induced a significant increase in the production of mitochondrial superoxide and hydrogen peroxide at day 1 (P < 0.05), and this increase remained significantly elevated at days 4 and 7 (P < 0.05). The copy number of mtDNA and expression of PGC-1a, NRF-1, and TFAM as well as ND2, CYTB, CO1 and ATPase 6 increased after one day of hyperglycemia (P < 0.05), with a significant reduction in all those parameters at 4 and 7 days (P < 0.05). The mitochondrial membrane potential decreased progressively at 1 to 7 days of hyperglycemia with the parallel progressive reduction in ATP levels over time (P < 0.05). MnTBAP and catalase treatment of cells cultured under hyperglycemic conditions attenuated ROS production reversed renal mitochondrial oxidative stress and improved mtDNA, mitochondrial biogenesis, and function. These results show that hyperglycemia-induced ROS caused an early increase in mtDNA copy number, mitochondrial biogenesis and mtDNA-encoded gene expression of the ETC subunits in human mesangial cells as a compensatory response to the decline in mitochondrial function, which precede the mtDNA defect and mitochondrial dysfunction with a progressive oxidative response. Protection from ROS-mediated damage to renal mitochondria induced by hyperglycemia may be a novel therapeutic approach for the prevention/treatment of DN.Keywords: diabetic nephropathy, hyperglycemia, reactive oxygen species, oxidative stress, mtDNA, mitochondrial dysfunction, manganese superoxide dismutase, catalase
Procedia PDF Downloads 2472282 Analysis of the IEEE 802.15.4 MAC Parameters to Achive Lower Packet Loss Rates
Authors: Imen Bouazzi
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The IEEE-802.15.4 standard utilizes the CSMA-CA mechanism to control nodes access to the shared wireless communication medium. It is becoming the popular choice for various applications of surveillance and control used in wireless sensor network (WSN). The benefit of this standard is evaluated regarding of the packet loss probability who depends on the configuration of IEEE 802.15.4 MAC parameters and the traffic load. Our exigency is to evaluate the effects of various configurable MAC parameters on the performance of beaconless IEEE 802.15.4 networks under different traffic loads, static values of IEEE 802.15.4 MAC parameters (macMinBE, macMaxCSMABackoffs, and macMaxFrame Retries) will be evaluated. To performance analysis, we use ns-2[2] network simulator.Keywords: WSN, packet loss, CSMA/CA, IEEE-802.15.4
Procedia PDF Downloads 3402281 Artificial Intelligence Ethics: What Business Leaders Need to Consider for the Future
Authors: Kylie Leonard
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Investment in artificial intelligence (AI) can be an attractive opportunity for business leaders as there are many easy-to-see benefits. These benefits include task completion rates, overall cost, and better forecasting. Business leaders are often unaware of the challenges that can accompany AI, such as data center costs, access to data, employee acceptance, and privacy concerns. In addition to the benefits and challenges of AI, it is important to practice AI ethics to ensure the safe creation of AI. AI ethics include aspects of algorithm bias, limits in transparency, and surveillance. To be a good business leader, it is critical to address all the considerations involving the challenges of AI and AI ethics.Keywords: artificial intelligence, artificial intelligence ethics, business leaders, business concerns
Procedia PDF Downloads 1472280 Investigation of Knitted Fabric Properties Effect on Evaporation Rate
Authors: N. S. Achour, M. Hamdaoui, S. Ben Nasrallah
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Evaporation kinetics of water from porous knitted fabrics are studied: An experimental study of determining evaporated water mass (g) versus time (s) from different knitted fabrics was gravimetrically investigated in various atmospheric conditions. Then evaporation rates are calculated. The goal is to determine the effect of fabric composition, knit structure and yarns properties on evaporation rate. The results show that fabrics geometrical properties, such as porosity and thickness, have a significant influence on evaporated water quantities.Keywords: evaporation rate, experimental study, geometrical properties, porous knitted fabrics
Procedia PDF Downloads 5032279 Efficient Elimination of Common Allergens through the Application of Dry Microfine Steam on Innate Surfaces
Authors: O. Rachinel, C. Recchia, M. Bourel, B. Recchia
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Dry microfine steam (DMS) technology, developed by Laurastar, was shown to effectively eliminate a range of pathogens such as Sars-CoV-2, E. coli, S. aureus and C. Albicans. The aim of this study was to investigate the effect of DMS technology on allergens. Therefore, the application of the DMS technology was tested on two common allergens (Dermatophagoides pteronyssinus and cat allergen Fel d 1), on different inert surfaces (e.g., cotton), during 2 to 3 seconds. Quantification of the remaining allergens was performed and the reduction rates reached 100% in 3 seconds for D. pteronyssinus and 97,74% in 2 seconds for cat allergens. In conclusion, DMS showed high efficacy in the elimination of common allergens and could be seen as a natural solution to improve domestic hygiene and reduce allergies.Keywords: steam, allergens, dust mites, pollens
Procedia PDF Downloads 1362278 BTEX (Benzene, Toluene, Ethylbenzene and Xylene) Degradation by Cold Plasma
Authors: Anelise Leal Vieira Cubas, Marina de Medeiros Machado, Marília de Medeiros Machado
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The volatile organic compounds - BTEX (Benzene, Toluene, Ethylbenzene, and Xylene) petroleum derivatives, have high rates of toxicity, which may carry consequences for human health, biota and environment. In this direction, this paper proposes a method of treatment of these compounds by using corona discharge plasma technology. The efficiency of the method was tested by analyzing samples of BTEX after going through a plasma reactor by gas chromatography method. The results show that the optimal residence time of the sample in the reactor was 8 minutes.Keywords: BTEX, degradation, cold plasma, ecological sciences
Procedia PDF Downloads 3172277 A Cohort and Empirical Based Multivariate Mortality Model
Authors: Jeffrey Tzu-Hao Tsai, Yi-Shan Wong
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This article proposes a cohort-age-period (CAP) model to characterize multi-population mortality processes using cohort, age, and period variables. Distinct from the factor-based Lee-Carter-type decomposition mortality model, this approach is empirically based and includes the age, period, and cohort variables into the equation system. The model not only provides a fruitful intuition for explaining multivariate mortality change rates but also has a better performance in forecasting future patterns. Using the US and the UK mortality data and performing ten-year out-of-sample tests, our approach shows smaller mean square errors in both countries compared to the models in the literature.Keywords: longevity risk, stochastic mortality model, multivariate mortality rate, risk management
Procedia PDF Downloads 532276 A New Approach to Predicting Physical Biometrics from Behavioural Biometrics
Authors: Raid R. O. Al-Nima, S. S. Dlay, W. L. Woo
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A relationship between face and signature biometrics is established in this paper. A new approach is developed to predict faces from signatures by using artificial intelligence. A multilayer perceptron (MLP) neural network is used to generate face details from features extracted from signatures, here face is the physical biometric and signatures is the behavioural biometric. The new method establishes a relationship between the two biometrics and regenerates a visible face image from the signature features. Furthermore, the performance efficiencies of our new technique are demonstrated in terms of minimum error rates compared to published work.Keywords: behavioural biometric, face biometric, neural network, physical biometric, signature biometric
Procedia PDF Downloads 4742275 Numerical Investigation on the Influence of Incoming Flow Conditions on the Rotating Stall in Centrifugal Pump
Authors: Wanru Huang, Fujun Wang, Chaoyue Wang, Yuan Tang, Zhifeng Yao, Ruofu Xiao, Xin Chen
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Rotating stall in centrifugal pump is an unsteady flow phenomenon that causes instabilities and high hydraulic losses. It typically occurs at low flow rates due to large flow separation in impeller blade passage. In order to reveal the influence of incoming flow conditions on rotating stall in centrifugal pump, a numerical method for investigating rotating stall was established. This method is based on a modified SST k-ω turbulence model and a fine mesh model was adopted. The calculated flow velocity in impeller by this method was in good agreement with PIV results. The effects of flow rate and sealing-ring leakage on stall characteristics of centrifugal pump were studied by using the proposed numerical approach. The flow structures in impeller under typical flow rates and typical sealing-ring leakages were analyzed. It is found that the stall vortex frequency and circumferential propagation velocity increase as flow rate decreases. With the flow rate decreases from 0.40Qd to 0.30Qd, the stall vortex frequency increases from 1.50Hz to 2.34Hz, the circumferential propagation velocity of the stall vortex increases from 3.14rad/s to 4.90rad/s. Under almost all flow rate conditions where rotating stall is present, there is low frequency of pressure pulsation between 0Hz-5Hz. The corresponding pressure pulsation amplitude increases with flow rate decreases. Taking the measuring point at the leading edge of the blade pressure surface as an example, the flow rate decreases from 0.40Qd to 0.30Qd, the pressure fluctuation amplitude increases by 86.9%. With the increase of leakage, the flow structure in the impeller becomes more complex, and the 8-shaped stall vortex is no longer stable. On the basis of the 8-shaped stall vortex, new vortex nuclei are constantly generated and fused with the original vortex nuclei under large leakage. The upstream and downstream vortex structures of the 8-shaped stall vortex have different degrees of swimming in the flow passage, and the downstream vortex swimming is more obvious. The results show that the proposed numerical approach could capture the detail vortex characteristics, and the incoming flow conditions have significant effects on the stall vortex in centrifugal pumps.Keywords: centrifugal pump, rotating stall, numerical simulation, flow condition, vortex frequency
Procedia PDF Downloads 1372274 Hybrid SVM/DBN Model for Arabic Isolated Words Recognition
Authors: Elyes Zarrouk, Yassine Benayed, Faiez Gargouri
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This paper presents a new hybrid model for isolated Arabic words recognition. To do this, we apply Support Vectors Machine (SVM) as an estimator of posterior probabilities within the Dynamic Bayesian networks (DBN). This paper deals a comparative study between DBN and SVM/DBN systems for multi-dialect isolated Arabic words. Performance using SVM/DBN is found to exceed that of DBNs trained on an identical task, giving higher recognition accuracy for four different Arabic dialects. In fact, the average of recognition rates for the four dialects with SVM/DBN was 87.67% while 83.01% with DBN.Keywords: dynamic Bayesian networks, hybrid models, supports vectors machine, Arabic isolated words
Procedia PDF Downloads 5602273 Demarcating Wetting States in Pressure-Driven Flows by Poiseuille Number
Authors: Anvesh Gaddam, Amit Agrawal, Suhas Joshi, Mark Thompson
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An increase in surface area to volume ratio with a decrease in characteristic length scale, leads to a rapid increase in pressure drop across the microchannel. Texturing the microchannel surfaces reduce the effective surface area, thereby decreasing the pressured drop. Surface texturing introduces two wetting states: a metastable Cassie-Baxter state and stable Wenzel state. Predicting wetting transition in textured microchannels is essential for identifying optimal parameters leading to maximum drag reduction. Optical methods allow visualization only in confined areas, therefore, obtaining whole-field information on wetting transition is challenging. In this work, we propose a non-invasive method to capture wetting transitions in textured microchannels under flow conditions. To this end, we tracked the behavior of the Poiseuille number Po = f.Re, (with f the friction factor and Re the Reynolds number), for a range of flow rates (5 < Re < 50), and different wetting states were qualitatively demarcated by observing the inflection points in the f.Re curve. Microchannels with both longitudinal and transverse ribs with a fixed gas fraction (δ, a ratio of shear-free area to total area) and at a different confinement ratios (ε, a ratio of rib height to channel height) were fabricated. The measured pressure drop values for all the flow rates across the textured microchannels were converted into Poiseuille number. Transient behavior of the pressure drop across the textured microchannels revealed the collapse of liquid-gas interface into the gas cavities. Three wetting states were observed at ε = 0.65 for both longitudinal and transverse ribs, whereas, an early transition occurred at Re ~ 35 for longitudinal ribs at ε = 0.5, due to spontaneous flooding of the gas cavities as the liquid-gas interface ruptured at the inlet. In addition, the pressure drop in the Wenzel state was found to be less than the Cassie-Baxter state. Three-dimensional numerical simulations confirmed the initiation of the completely wetted Wenzel state in the textured microchannels. Furthermore, laser confocal microscopy was employed to identify the location of the liquid-gas interface in the Cassie-Baxter state. In conclusion, the present method can overcome the limitations posed by existing techniques, to conveniently capture wetting transition in textured microchannels.Keywords: drag reduction, Poiseuille number, textured surfaces, wetting transition
Procedia PDF Downloads 1612272 Development and Range Testing of a LoRaWAN System in an Urban Environment
Authors: N. R. Harris, J. Curry
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This paper describes the construction and operation of an experimental LoRaWAN network surrounding the University of Southampton in the United Kingdom. Following successful installation, an experimental node design is built and characterised, with particular emphasis on radio range. Several configurations are investigated, including different data rates, and varying heights of node. It is concluded that although range can be great (over 8 km in this case), environmental topology is critical. However, shorter range implementations, up to about 2 km in an urban environment, are relatively insensitive although care is still needed. The example node and the relatively simple base station reported demonstrate that LoraWan can be a very low cost and practical solution to Internet of Things type applications for distributed monitoring systems with sensors spread over distances of several km.Keywords: long-range, wireless, sensor, network
Procedia PDF Downloads 1372271 Homelessness and Disaster Mitigation: An Exploratory Study into How Casualties Can Be Reduced with the Homeless
Authors: Blythe Maltby
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Homeless populations are one of the sections of society most vulnerable to the effects of natural disasters. Channels of communication to these populations are limited as they lack access to mainstream modes of emergency notification, often being the last to know about state emergencies. This study aims to answer if there is a way that cities and policies be designed to help reduce casualty rates to the homeless during state emergencies, such as earthquake and tsunami preparations. The study used a qualitative research approach, namely by speaking to levels of government, homelessness charities and workers and others about preparations and their experiences with the response of state emergencies. The proposed paper may help countries identify the gaps in their preparations to help facilitate better resources to look after these vulnerable populations.Keywords: accessibility, disaster mitigation, homeless, Vancouver
Procedia PDF Downloads 2232270 The Implementation of a Nurse-Driven Palliative Care Trigger Tool
Authors: Sawyer Spurry
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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).Keywords: palliative care, nursing, quality improvement, trigger tool
Procedia PDF Downloads 1942269 Recovery of Cd (II) and Pb (II) under the Effect of Temperature with the Synthetic Zeolite NaA
Authors: Karima Menad, Ahmed Feddag
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In this study, large crystals of the zeolite NaA were synthesized by hydrothermal way. By following this zeolite was used to recover two heavy metals that are allowing the most dangerous toxic, lead and cadmium. The synthesized zeolite was analyzed by XRD and SEM aims to verify its purity and its good morphology; after it was undergoing ion exchange operations by aqueous solution with lead and cadmium in two salts Pb(CH3COOH)2 and CdCl2 at different concentrations. The exchange was carried out under the effect of two temperatures (25 °C and 60 °C). The contents of Pb++, Cd++ and Na+ were analyzed by atomic absorption and the results are given in the form of exchange rates. At the end the samples are analyzed by XRD exchanged to confirm their conservation of their zeolite framework. It is found that the exchange rate increases with the increase of initial concentration and the best results are found for the temperature of 60 °C.Keywords: exchange rate, ion exchange, LTA zeolite, zeolite NaA
Procedia PDF Downloads 4142268 A Service Evaluation Exploring the Effectiveness of a Tier 3 Weight Management Programme Offering Face-To-Face and Remote Dietetic Support
Authors: Rosemary E. Huntriss, Lucy Jones
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Obesity and excess weight continue to be significant health problems in England. Traditional weight management programmes offer face-to-face support or group education. Remote care is recognised as a viable means of support; however, its effectiveness has not previously been evaluated in a tier 3 weight management setting. This service evaluation explored the effectiveness of online coaching, telephone support, and face-to-face support as optional management strategies within a tier 3 weight management programme. Outcome data were collected for adults with a BMI ≥ 45 or ≥ 40 with complex comorbidity who were referred to a Tier 3 weight management programme from January 2018 and had been discharged before October 2018. Following an initial 45-minute consultation with a specialist weight management dietitian, patients were offered a choice of follow-up support in the form of online coaching supported by an app (8 x 15 minutes coaching), face-to-face or telephone appointments (4 x 30 minutes). All patients were invited to a final 30-minute face-to-face assessment. The planned intervention time was between 12 and 24 weeks. Patients were offered access to adjunct face-to-face or telephone psychological support. One hundred and thirty-nine patients were referred into the programme from January 2018 and discharged before October 2018. One hundred and twenty-four patients (89%) attended their initial assessment. Out of those who attended their initial assessment, 110 patients (88.0%) completed more than half of the programme and 77 patients (61.6%) completed all sessions. The average length of the completed programme (all sessions) was 17.2 (SD 4.2) weeks. Eighty-five (68.5%) patients were coached online, 28 (22.6%) patients were supported face-to-face support, and 11 (8.9%) chose telephone support. Two patients changed from online coaching to face-to-face support due to personal preference and were included in the face-to-face group for analysis. For those with data available (n=106), average weight loss across the programme was 4.85 (SD 3.49)%; average weight loss was 4.70 (SD 3.19)% for online coaching, 4.83 (SD 4.13)% for face-to-face support, and 6.28 (SD 4.15)% for telephone support. There was no significant difference between weight loss achieved with face-to-face vs. online coaching (4.83 (SD 4.13)% vs 4.70 (SD 3.19) (p=0.87) or face-to-face vs. remote support (online coaching and telephone support combined) (4.83 (SD 4.13)% vs 4.85 (SD 3.30)%) (p=0.98). Remote support has been shown to be as effective as face-to-face support provided by a dietitian in the short-term within a tier 3 weight management setting. The completion rates were high compared with another tier 3 weight management services suggesting that offering remote support as an option may improve completion rates within a weight management service.Keywords: dietitian, digital health, obesity, weight management
Procedia PDF Downloads 1412267 Culturally Relevant Pedagogy: A Cross-Cultural Comparison
Authors: Medha Talpade, Salil Talpade
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The intent of this quantitative project was to compare the values and perceptions of students from a predominantly white college (PWI) to those from a historically black college (HBCU) about culturally relevant teaching and learning practices in the academic realm. The reason for interrelating student culture with teaching practices is to enable a pedagogical response to the low retention rates of African American students and first generation Caucasian students in high schools, colleges, and their low rates of social mobility and educational achievement. Culturally relevant pedagogy, according to related research, is deemed rewarding to students, teachers, the local and national community. Critical race theory (CRT) is the main framework used in this project to explain the ubiquity of a culturally relevant pedagogy. The purpose of this quantitative study was to test the critical race theory that relates the presence of the factors associated with culturally relevant teaching strategies with perceived relevance. The culturally relevant teaching strategies were identified based on the recommendations and findings of past research. Participants in this study included approximately 145 students from a HBCU and 55 students from the PWI. A survey consisting of 37 items related to culturally relevant pedagogy was administered. The themes used to construct the items were: Use of culturally-specific examples in class whenever possible; use of culturally-specific presentational models, use of relational reinforcers, and active engagement. All the items had a likert-type response scale. Participants reported their degree of agreement (5-point scale ranging from strongly disagree to strongly agree) and importance (3-point scale ranging from not at all important to very important) with each survey item. A new variable, Relevance was formed based on the multiplicative function of importance and presence of a teaching and learning strategy. A set of six demographic questions were included in the survey. A consent form based on NIH and APA ethical standards was distributed prior to survey administration to the volunteers. Results of a Factor Analyses on the data from the PWI and the HBCU, and a ANOVA indicated significant differences on ‘Relevance’ related to specific themes. Results of this study are expected to inform educational practices and improve teaching and learning outcomes.Keywords: culturally relevant pedagogy, college students, cross-cultural, applied psychology
Procedia PDF Downloads 4322266 Impacts of Commercial Honeybees on Native Butterflies in High-Elevation Meadows in Utah, USA
Authors: Jacqueline Kunzelman, Val Anderson, Robert Johnson, Nicholas Anderson, Rebecca Bates
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In an effort to protect honeybees from colony collapse disorder, beekeepers are filing for government permits to use natural lands as summer pasture for honeybees under the multiple-use management regime in the United States. Utilizing natural landscapes in high mountain ranges may help strengthen honeybee colonies, as this natural setting is generally void of chemical pollutants and pesticides that are found in agricultural and urban settings. However, the introduction of a competitive species could greatly impact the native species occupying these natural landscapes. While honeybees and butterflies have different life histories, behavior, and foraging strategies, they compete for the same nectar resources. Few, if any, studies have focused on the potential population effects of commercial honeybees on native butterfly abundance and diversity. This study attempts to observe this impact using a paired before-after control-impact (BACI) design. Over the course of two years, malaise trap samples were collected every week during the months of the flowering season in two similar areas separated by 11 kilometers. Each area contained nine malaise trap sites for replication. In the first year, samples were taken to analyze and establish trends within the pollinating communities. In the second year, honeybees were introduced to only one of the two areas, and a change in trends between the two areas was assessed. Contrary to the original hypothesis, the resulting observation was an overall significant increase in the mean butterfly abundance in the impact areas after honeybees were introduced, while control areas remained relatively stable. This overall increase in abundance over the season can be attributed to an increase in butterflies during the first and second periods of the data collection when populations were near their peak. Several potential theories are 1) Honeybees are deterring a natural predator/competitor of butterflies that previously limited population growth. 2) Honeybees are consuming resources regularly used by butterflies, which may extend the foraging time and consequent capture rates of butterflies. 3) Environmental factors such as number of rainy days were inconsistent between control and impact areas, biasing capture rates. This ongoing research will help determine the suitability of high mountain ranges for the summer pasturing of honeybees and the population impacts on many different pollinators.Keywords: butterfly, competition, honeybee, pollinator
Procedia PDF Downloads 1462265 Modelling Sudden Deaths from Myocardial Infarction and Stroke
Authors: Y. S. Yusoff, G. Streftaris, H. R Waters
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Death within 30 days is an important factor to be looked into, as there is a significant risk of deaths immediately following or soon after, Myocardial Infarction (MI) or stroke. In this paper, we will model the deaths within 30 days following a Myocardial Infarction (MI) or stroke in the UK. We will see how the probabilities of sudden deaths from MI or stroke have changed over the period 1981-2000. We will model the sudden deaths using a Generalized Linear Model (GLM), fitted using the R statistical package, under a Binomial distribution for the number of sudden deaths. We parameterize our model using the extensive and detailed data from the Framingham Heart Study, adjusted to match UK rates. The results show that there is a reduction for the sudden deaths following a MI over time but no significant improvement for sudden deaths following a stroke.Keywords: sudden deaths, myocardial infarction, stroke, ischemic heart disease
Procedia PDF Downloads 2862264 Risk of Mortality and Spectrum of Second Primary Malignancies in Mantle Cell Lymphoma before and after Ibrutinib Approval: A Population-Based Study
Authors: Karthik Chamari, Vasudha Rudraraju, Gaurav Chaudhari
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Background: Mantle cell lymphoma (MCL) is one of the mature B cell non-Hodgkin lymphomas (NHL). The course of MCL is moderately aggressive and variable, and it has median overall survival of 8 to 10 years. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, was approved by the United States (US) Food and Drug Administration in November of 2013 for the treatment of MCL patients who have received at least one prior therapy. In this study, we aimed to evaluate whether there has been a change in survival and patterns of second primary malignancies (SPMs) among the MCL population in the US after ibrutinib approval. Methods: Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER)-18, we conducted a retrospective study with patients diagnosed with MCL (ICD-0-3 code 9673/3) between 2007 and 2018. We divided patients into two six-year cohorts, pre-ibrutinib approval (2007-2012) and post-ibrutinib approval (2013-2018), and compared relative survival rates (RSRs) and standardized incidence ratios (SIRs) of SPMs between cohorts. Results: We included 9,257 patients diagnosed with MCL between 2007 and 2018 in the SEER-18 survival and SIR registries. Of these, 4,205 (45%) patients were included in the pre-ibrutinib cohort, and 5052 (55%) patients were included in the post-ibrutinib cohort. The median follow-up duration for the pre-ibrutinib cohort was 54 months (range 0 to 143 months), and the post-ibrutinib cohort was 20 months (range 0 to 71 months). There was a significant difference in the five-year RSRs between pre-ibrutinib and post-ibrutinib cohorts (57.5% vs. 62.6%, p < 0.005). Out of the 9,257 patients diagnosed with MCL, 920 developed SPMs. A higher proportion of SPMs occurred in the post-ibrutinib cohort (63%) when compared with the pre-ibrutinib cohort (37%). Non-hematological malignancies comprised most of all SPMs. A higher incidence of non-hematological malignancies occurred in the post-ibrutinib cohort (SIR 1.42, 95% CI 1.29 to 1.56) when compared with the pre-ibrutinib cohort (SIR 1.14, 95% CI 1 to 1.3). There was a statistically significant increase in the incidence of cancers of the respiratory tract (SIR 1.77, 95% CI 1.43 to 2.18), urinary tract (SIR 1.61, 95% CI 1.23 to 2.06) when compared with other non-hematological malignancies in post-ibrutinib cohort. Conclusions: Our study results suggest the relative survival rates have increased since the approval of ibrutinib for mantle cell lymphoma patients. Additionally, for some unclear reasons, the incidence of SPM’s (non-hematological malignancies), mainly cancers of the respiratory tract, urinary tract, have increased in the six years following the approval of ibrutinib. Further studies should be conducted to determine the cause of these findings.Keywords: mantle cell lymphoma, Ibrutinib, relative survival analysis, secondary primary cancers
Procedia PDF Downloads 1852263 Enhancing Tower Crane Safety: A UAV-based Intelligent Inspection Approach
Authors: Xin Jiao, Xin Zhang, Jian Fan, Zhenwei Cai, Yiming Xu
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Tower cranes play a crucial role in the construction industry, facilitating the vertical and horizontal movement of materials and aiding in building construction, especially for high-rise structures. However, tower crane accidents can lead to severe consequences, highlighting the importance of effective safety management and inspection. This paper presents an innovative approach to tower crane inspection utilizing Unmanned Aerial Vehicles (UAVs) and an Intelligent Inspection APP System. The system leverages UAVs equipped with high-definition cameras to conduct efficient and comprehensive inspections, reducing manual labor, inspection time, and risk. By integrating advanced technologies such as Real-Time Kinematic (RTK) positioning and digital image processing, the system enables precise route planning and collection of safety hazards images. A case study conducted on a construction site demonstrates the practicality and effectiveness of the proposed method, showcasing its potential to enhance tower crane safety. On-site testing of UAV intelligent inspections reveals key findings: efficient tower crane hazard inspection within 30 minutes, with a full-identification capability coverage rates of 76.3%, 64.8%, and 76.2% for major, significant, and general hazards respectively and a preliminary-identification capability coverage rates of 18.5%, 27.2%, and 19%, respectively. Notably, UAVs effectively identify various tower crane hazards, except for those requiring auditory detection. The limitations of this study primarily involve two aspects: Firstly, during the initial inspection, manual drone piloting is required for marking tower crane points, followed by automated flight inspections and reuse based on the marked route. Secondly, images captured by the drone necessitate manual identification and review, which can be time-consuming for equipment management personnel, particularly when dealing with a large volume of images. Subsequent research efforts will focus on AI training and recognition of safety hazard images, as well as the automatic generation of inspection reports and corrective management based on recognition results. The ongoing development in this area is currently in progress, and outcomes will be released at an appropriate time.Keywords: tower crane, inspection, unmanned aerial vehicle (UAV), intelligent inspection app system, safety management
Procedia PDF Downloads 422262 Overview of Adaptive Spline interpolation
Authors: Rongli Gai, Zhiyuan Chang
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At this stage, in view of various situations in the interpolation process, most researchers use self-adaptation to adjust the interpolation process, which is also one of the current and future research hotspots in the field of CNC machining. In the interpolation process, according to the overview of the spline curve interpolation algorithm, the adaptive analysis is carried out from the factors affecting the interpolation process. The adaptive operation is reflected in various aspects, such as speed, parameters, errors, nodes, feed rates, random Period, sensitive point, step size, curvature, adaptive segmentation, adaptive optimization, etc. This paper will analyze and summarize the research of adaptive imputation in the direction of the above factors affecting imputation.Keywords: adaptive algorithm, CNC machining, interpolation constraints, spline curve interpolation
Procedia PDF Downloads 2052261 Significant Factor of Magnetic Resonance for Survival Outcome in Rectal Cancer Patients Following Neoadjuvant Combined Chemotherapy and Radiation Therapy: Stratification of Lateral Pelvic Lymph Node
Authors: Min Ju Kim, Beom Jin Park, Deuk Jae Sung, Na Yeon Han, Kichoon Sim
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Purpose: The purpose of this study is to determine the significant magnetic resonance (MR) imaging factors of lateral pelvic lymph node (LPLN) on the assessment of survival outcomes of neoadjuvant combined chemotherapy and radiation therapy (CRT) in patients with mid/low rectal cancer. Materials and Methods: The institutional review board approved this retrospective study of 63 patients with mid/low rectal cancer who underwent MR before and after CRT and patient consent was not required. Surgery performed within 4 weeks after CRT. The location of LPLNs was divided into following four groups; 1) common iliac, 2) external iliac, 3) obturator, and 4) internal iliac lymph nodes. The short and long axis diameters, numbers, shape (ovoid vs round), signal intensity (homogenous vs heterogenous), margin (smooth vs irregular), and diffusion-weighted restriction of LPLN were analyzed on pre- and post-CRT images. For treatment response using size, lymph node groups were defined as group 1) short axis diameter ≤ 5mm on both MR, group 2) > 5mm change into ≤ 5mm after CRT, and group 3) persistent size > 5mm before and after CRT. Clinical findings were also evaluated. The disease-free survival and overall survival rate were evaluated and the risk factors for survival outcomes were analyzed using cox regression analysis. Results: Patients in the group 3 (persistent size >5mm) showed significantly lower survival rates than the group 1 and 2 (Disease-free survival rates of 36.1% and 78.8, 88.8%, p < 0.001). The size response (group 1-3), multiplicity of LPLN, the level of carcinoembryonic antigen (CEA), patient’s age, T and N stage, vessel invasion, perineural invasion were significant factors affecting disease-free survival rate or overall survival rate using univariate analysis (p < 0.05). The persistent size (group 3) and multiplicity of LPLN were independent risk factors among MR imaging features influencing disease-free survival rate (HR = 10.087, p < 0.05; HR = 4.808, p < 0.05). Perineural invasion and T stage were shown as independent histologic risk factors (HR = 16.594, p < 0.05; HR = 15.891, p < 0.05). Conclusion: The persistent size greater than 5mm and multiplicity of LPLN on both pre- and post-MR after CRT were significant MR factors affecting survival outcomes in the patients with mid/low rectal cancer.Keywords: rectal cancer, MRI, lymph node, combined chemoradiotherapy
Procedia PDF Downloads 1502260 Hematological Changes in the Hydatidosed Male Sheep after Experimental Inoculation of Echinococcus granulosus Eggs
Authors: M. Younus, Muhammad Shafique, M. Athar Khan, Tanveer Akhtar , M. Moeen Athar
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A total of 48 apparently healthy weaned sheep lambs (Ovis aries) of 8-10 weeks old weighing 7-10 Kg were purchased from the contractors, maintained in the experimental station of University of the Punjab, Quaid-e-Azam Campus at Lahore, Pakistan. They were dewormed against nematodes with levamisole (ICI) at recommended dose rates. The feces were tested against the parasitic eggs, no helminths ova were seen. All the 48 sheep lambs were divided into two groups i.e. group A & group B. Group 'A' comprising of 40 sheep, kept as infected groups whereas group 'B' comprising of 08 sheep & kept as a new infected control group. Each sheep lamb of group A was given 3-4 fresh gravid segments contains 2-3 thousand eggs of Echinococcus granulosus. These were collected from experimentally infected dogs by feeding fresh hydrated cysts collected from liver & lungs of sheep after slaughtering. Each lamb was fed with fresh gravid segments for a total period of 5 days or each alternate day. Coagulated blood was collected before the start of infected diet and after every month by jugular phlebotomy of each sheep lamb from the infected & new infected control group. One lamb each from group A & group B was slaughtered at the end of each month for the presence of macroscopic hydatid cyst in viscera & abdominal cavity. After 180 days of the experiment, hydatid cysts were confirmed in the abdominal cavity. Hematological parameters of zero days & then at the end of every month revealed that there was a gradual increase (PL 0.05) in the White Blood Cell (WBC), Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin Concentration (MCHC) and Erythrocyte Sedimentation Rates (ESR). The increasing trend was probably due to inflammatory response and lytic effect of the newly developing E. granulosus hydatid cysts. The red blood cell (RBC), Hemoglobin (HB), Packed Cell Volume (PCV) and Mean Corpuscular Hemoglobin (MCH) infected groups were decreased significantly as compared to the control group (PL 0.05). The experiment was terminated at the end of the 7th month. It can be concluded that Echinococcus granulosus can damage livestock and other intermediate hosts such as horses, the development of hydatid cysts affect the organs due to the growing cysts pressuring the organ tissues. Parts of the tissue die, which impairs the functioning of the affected organ. The clinical signs depend on the affected organ. The major damage for livestock is organ condemnation at slaughter.Keywords: echinococcus granulosus, hydatidosis, sheep, hematology
Procedia PDF Downloads 4172259 A Look into Surgical Site Infections: Impact of Collective Interventions
Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff
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Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement
Procedia PDF Downloads 4822258 Comparing Implications of Manual and ROSA-assisted Total Knee Replacements on Patients and Physicians: A Scoping Review
Authors: Bassem M. Darwish, Robert H. Ablove
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Introduction: Total knee arthroscopy (TKA) is a commonly performed procedure in patients with end-stage osteoarthritis and inaccuracy of component alignment in TKA has been shown to have many adverse post-operative outcomes such as accelerated implant wear, reduced functional outcomes, and shorter overall implant survival. Robotic surgical systems have been introduced to try and improve joint alignment and functional outcomes in knee arthroscopy, one recent iteration is the ROSA knee system, released to the market in 2019. The objective of this scoping review is to map the available evidence, identify the current types of evidence, and identify knowledge gaps to guide future studies on patient outcomes following ROSA-assisted total knee arthroplasties. Methods: An electronic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Search terms included ROSA, knee arthroscopy, osteoarthritis, robotic, and malalignment. Types of study participants included patients with osteoarthritis, ages 18 and older, male or female, who received manual TKA (mTKA) or ROSA-assisted TKA (rTKA), and human patients or cadavers. Published, peer-reviewed controlled trials, observational studies, and case series were included. Case reports were not included in article review. Resulting articles were first screened based on title and abstract. Articles meeting inclusion criteria based on title and abstract review then underwent full-text review by the same reviewer. Results: This scoping review identified 11 total studies, 3 prospective observational studies, and 8 retrospective observational studies - a total of 970 rTKA patients and 1745 mTKA patients. There were no case series or randomized controlled trials comparing rTKA and mTKA. Patient-centered outcomes showed promise for rTKA, where it frequently showed significantly favorable functional outcomes, measured via KOOS-JR, VAS, KSS, OKS, FJS, and PROMIS scores, at various times postoperatively. However, there was much discrepancy about which score yielded significance at which postoperative follow-up. Complication rates, reoperation rates, and LOS were very similar between mTKA and rTKA groups. Studies also showed rTKA had more accurate joint alignment within the 0 ± 3o corridor and had significantly higher rates of achieving postoperative joint angles similar to the preoperative plan. Finally, there was major agreement that rTKA cases take significantly longer time at the start, however, there is a rapid learning curve. Once past the learning curve, rTKA cases are performed in a similar time to mTKA and reduced physician stress and strain. Conclusion: The ROSA knee system represents a promising option for the management of osteoarthritis via total knee arthroscopy. The studies reviewed in this paper favor the patient-centered function outcomes, joint alignments, and physician health implications of the ROSA knee system to conventional total knee arthroscopy. Further study is warranted, however, to better understand recovery periods, longer-term functional outcomes, operative fatigue, and reduction in radiation exposure.Keywords: arthroplasty, knee, robotics, malalignment
Procedia PDF Downloads 292257 The Creep Analysis of a Varying Thickness on a Rotating Composite Disk with Different Particle Size by Using Sherby’s Law
Authors: Rupinder Kaur, Harjot Kaur
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The objective of this paper is to present the study of the effect of varying thickness on rotating composite disks made from Al-SiC_P having different particle sizes. Mathematical modeling is used to calculate the effect of varying thickness with different particle sizes on rotating composite disks in radial as well as tangential directions with thermal gradients. In comparison to various particle sizes with varied thicknesses, long-term deformation occurs. The results are displayed visually, demonstrating how creep deformation decreases with changing particle size and thickness.Keywords: creep, varying thickness, particle size, stresses and strain rates
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