Search results for: superficial temporal artery islandized flap

Authors: Nicholas Bayfield, Liam Bibo, Charley Budgeon, Robert Larbalestier, Tom Briffa

Abstract:

Introduction: Stress hyperglycaemia is common following cardiac surgery. Its optimal management is uncertain and may differ by diabetic status. This study assesses the in-hospital glycaemic management of cardiac surgery patients and associated postoperative outcomes. Methods: A retrospective cohort analysis of all patients undergoing cardiac surgery at Fiona Stanley Hospital from February 2015 to May 2019 was undertaken. Management and outcomes of hyperglycaemia following cardiac surgery were assessed. Follow-up was assessed to 1 year postoperatively. Multivariate regression modelling was utilised. Results: 1050 non-diabetic patients and 689 diabetic patients were included. In the non-diabetic cohort, patients with mild (peak blood sugar level [BSL] < 14.3), transient stress hyperglycaemia managed without insulin were not at an increased risk of wound-related morbidity (P=0.899) or mortality at 1 year (P=0.483). Insulin management was associated with wound-related readmission to hospital (P=0.004) and superficial sternal wound infection (P=0.047). Prolonged or severe stress hyperglycaemia was predictive of hospital re-admission (P=0.050) but not morbidity or mortality (P=0.546). Diabetes mellitus was an independent risk factor 1-year mortality (OR; 1.972 [1.041–3.736], P=0.037), graft harvest site wound infection (OR; 1.810 [1.134–2.889], P=0.013) and wound-related readmission (OR; 1.866 [1.076–3.236], P=0.026). In diabetics, postoperative peak BSL > 13.9mmol/L was predictive of graft harvest site infections (OR; 3.528 [1.724-7.217], P=0.001) and wound-related readmission OR; 3.462 [1.540-7.783], P=0.003) regardless of modality of management. A peak BSL of 10.0-13.9 did not increase the risk of morbidity/mortality compared to a peak BSL of < 10.0 (P=0.557). Diabetics with a peak BSL of 13.9 or less did not have significantly increased morbidity/mortality outcomes compared to non-diabetics (P=0.418). Conclusion: In non-diabetic patients, transient mild stress hyperglycaemia following cardiac surgery does not uniformly require treatment. In diabetic patients, postoperative hyperglycaemia with peak BSL exceeding 13.9mmol/L was associated with wound-related morbidity and hospital readmission following cardiac surgery.

Keywords: cardiac surgery, pulmonary embolism, pulmonary embolectomy, cardiopulmonary bypass

Procedia PDF Downloads 160

Authors: G. Venkatesha, Urs Samarth, H. K. Ramaraju, Arun Kumar Sharma

Abstract:

The projection for Groundwater states that the total domestic water demand for greater Bangalore would increase from 1,170 MLD in 2010 to 1,336 MLD in 2016. Dependence on groundwater is ever increasing due to rapid Industrialization & Urbanization. It is estimated that almost 40% of the population of Bangalore is dependent on groundwater. Due to the unscientific disposal of domestic and industrial waste generated, groundwater is getting highly polluted in the city. The scale of this impact will depend mainly upon the water-service infrastructure, the superficial geology and the regional setting. The quality of ground water is equally important as that of quantity. Jointed and fractured granites and gneisses constitute the major aquifer system of BBMP area. Two new observatory Borewells were drilled and lithology report has been prepared. Petrographic Analysis (XRD/XRF) and Water quality Analysis were carried out as per the standard methods. Petrographic samples were analysed by collecting chip of rock from the borewell for every 20ft depth, most of the samples were similar and samples were identified as Biotite-Gneiss, Schistose Amphibolite. Water quality analysis was carried out for individual chemical parameters for two borewells drilled. 1st Borewell struck water at 150ft (Total depth-200ft) & 2nd struck at 740ft (Total depth-960ft). 5 water samples were collected till end of depth in each borewell. Chemical parameter values such as, Total Hardness (360-348, 280-320) mg/ltr, Nitrate (12.24-13.5, 45-48) mg/ltr, Chloride (104-90, 70-70)mg/ltr, Fe (0.75-0.09, 1.288-0.312)mg/ltr etc. are calculated respectively. Water samples were analysed from various parts of BBMP covering 750 sq kms, also thematic maps (IDW method) of water quality is generated for these samples for Post-Monsoon season. The study aims to explore the sub-surface Lithological layers and the thickness of weathered zone, which indirectly helps to know the Groundwater pollution source near surface water bodies, dug wells, etc. The above data are interpreted for future ground water resources planning and management.

Keywords: lithology, petrographic, pollution, urbanization

Procedia PDF Downloads 292

Authors: Benedetta Isella, Aleksander Drinic, Alissa Heim, Phillip Czichowski, Lisa Lauts, Hans Leemhuis

Abstract:

Introduction: Membranes for guided bone regeneration are essential to perform a barrier function between the soft and the regenerating bone tissue. Bioabsorbable membranes are desirable in this field as they do not require a secondary surgery for removal, decreasing patient surgical risk. Collagen was the first bioabsorbable alternative introduced on the market, but its degradation time may be too fast to guarantee bone regeneration, and optimisation is needed. Silk fibroin, being biocompatible, slowly bioabsorbable, and processable into different scaffold types, could be a promising alternative. Objectives: The objective is to compare the general performance of a silk fibroin membrane for guided bone regeneration to current collagen alternatives developing suitable standardized tests for the mechanical and morphological characterization. Methods: Silk fibroin and collagen-based membranes were compared from the morphological and chemical perspective, with techniques such as SEM imaging and from the mechanical point of view with techniques such as tensile and suture retention strength (SRS) tests. Results: Silk fibroin revealed a high degree of reproducibility in surface density. The SRS of silk fibroin (0.76 ± 0.04 N), although lower than collagen, was still comparable to native tissues such as the internal mammary artery (0.56 N), and the same can be extended to general mechanical behaviour in tensile tests. The SRS could be increased by an increase in thickness. Conclusion: Silk fibroin is a promising material in the field of guided bone regeneration, covering the interesting position of not being considered a product containing cells or tissues of animal origin from the regulatory perspective and having longer degradation times with respect to collagen.

Keywords: guided bone regeneration, mechanical characterization, membrane, silk fibroin

Procedia PDF Downloads 41

Authors: Nicholas Milburn, Yu Liang, Dalei Wu

Abstract:

Athlete performance scoring within the climbing do-main presents interesting challenges as the sport does not have an objective way to assign skill. Assessing skill levels within any sport is valuable as it can be used to mark progress while training, and it can help an athlete choose appropriate climbs to attempt. Machine learning-based methods are popular for complex problems like this. The dataset available was composed of dynamic force data recorded during climbing; however, this dataset came with challenges such as data scarcity, imbalance, and it was temporally heterogeneous. Investigated solutions to these challenges include data augmentation, temporal normalization, conversion of time series to the spectral domain, and cross validation strategies. The investigated solutions to the classification problem included light weight machine classifiers KNN and SVM as well as the deep learning with CNN. The best performing model had an 80% accuracy. In conclusion, there seems to be enough information within climbing force data to accurately categorize climbers by skill.

Keywords: classification, climbing, data imbalance, data scarcity, machine learning, time sequence

Procedia PDF Downloads 140

Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

Abstract:

Background: The risk of sudden cardiac arret/death (SCA/D) in athletes is controversial. There is a lack of meta-analyses assessing the sex differences in the risk of SCA/D in competitive athletes. Purpose: The aim of the present study was to evaluate sex differences in the incidence of SCA/D in competitive athletes using meta-analyses. Methods: The systematic review was registered in the PROSPERO database (registration ID: CRD42023432022) and was conducted according to the PRISMA guidelines. PubMed, Embase, Scopus, SPORT Discus and Cochrane Library were searched up to July 2023. To avoid systematic bias in data pooling, only studies with data for both sexes were included. Results: From the 18 included studies, 2028 cases of SCA/D were observed (males 1821 (89.79%), females 207 (10.21%)). The age ranges from the adolescents (<26 years) to the elderly (>45 years). The incidence in male athletes was 1.32/100,000 AY (95% CI: [0.90, 1.93]) and in females was 0.26/100,000 AY (95% CI: [0.16, 0.43]), the incidence rate ratio (IRR) was 6.43 (95% CI: [4.22, 9.79]). The subgroup synthesis showed a higher incidence in males than in females in both age groups <25 years and ≤35 years, the IRR was 5.86 (95% CI: [4.69, 7.32]) and 5.79 (95% CI: [4.73, 7.09]), respectively. When considering the events, the IRR was 6.73 (95%CI: [3.06, 14.78]) among studies involving both SCA/D events and 7.16 (95% CI: [4.93, 10.40]) among studies including only cases of SCD. The available clinical evidence showed that cardiac events were most frequently seen in long-distance running races (26, 35.1%), marathon (16, 21.6%) and soccer (10, 13.5%). Coronary artery disease (14, 18.9%), hypertrophic cardiomyopathy (8, 10.8%), and arrhythmogenic right ventricular cardiomyopathy (7, 9.5%) are the most common causes of SCA/D in competitive athletes. Conclusion: The meta-analysis provides evidence of sex differences in the incidence of SCA/D in competitive athletes. The incidence of SCA/D in male athletes was 6 to 7 times higher than in females. Identifying the reasons for this difference may have implications for targeted the prevention of fatal evets in athletes.

Keywords: incidence, sudden cardiac arrest, sudden cardiac death, sex difference, athletes

Procedia PDF Downloads 62

Authors: Neil Michael Walsh, Angelique Lombarts

Abstract:

The authors propose that hospitality is ‘made’ (constituted and performed) in the encounters on the Silk-Routes. Inspired with an initial Derridean perspective on hospitality (the conditional/unconditional) and methodologically underpinned with a Delueuzian relational-rhizomatic approach, the authors contend that hospitality is (re)produced in the encounters of self/other, east/west (among others). Thus, in the spirit of performativity and using the temporal-spatial conduit of the Silk Routes (the sites of ethical, cultural, economic, and material interaction of such exchange), the authors concur that hospitality is produced at the moment in which it is performed. Key themes engaged as units of analysis become welcome, reception, hostility, (and so on) which the authors engage and examine –as they unfold- in the narratives and accounts and material legacies of those who travelled the Silk Routes between the 2nd and 18th Centuries. The preliminary results suggest that these earlier performative moments in hospitality-making on the silk routes continue to resonate and ‘form’ the hospitalities of today. Indeed, these acts of hospitality continue to reconstitute and are never a final state of affairs.

Keywords: hospitality-genealogy, interactions, hospitality-making, Silk-Routes, rhizome, relationality

Procedia PDF Downloads 132

Authors: Ben Nwokenkwo, Michael M. Eze, Felix Ike

Abstract:

The need to study trends in land values around institutions of higher learning cannot be overemphasized. Numerous studies in Nigeria have investigated the economic, and social influence of the sitting of institutions of higher learning at the micro, meso and macro levels. However, very few studies have evaluated the temporal extent at which such institution influences local land values. Since institutions greatly influence both the physical and environmental aspects of their immediate vicinity, attention must be taken to understand the influence of such changes on land values. This study examines the trend in land values using the Mann-Kendall analysis in order to determine if, between its beginning and end, a monotonic increase, decrease or stability exist in the land values across six institutions of higher learning for the period between 2004 and 2014. Specifically, The analysis was applied to the time series of the price(or value) of the land .The results of this study revealed that land values has either been increasing or remained stabled across all the institution sampled. The study finally recommends measures that can be put in place as counter magnets for land values estimation across institutions of higher learning.

Keywords: influence, land, trend, value

Procedia PDF Downloads 362

Authors: Ruoyu Mao

Abstract:

Exploring the relationship between urban green development and regional integration level is of great significance for realising regional high quality and sustainable development. Based on the Tapio decoupling model and the theoretical framework of urban green development and regional integration, this paper builds an analysis system, makes a quantitative analysis of urban green development and regional integration level in a certain period, and discusses the relationship between the two. It also takes China's Yangtze River Delta urban agglomeration as an example to study the degree of decoupling, the type of decoupling, and the trend of the evolution of the spatio-temporal pattern of decoupling between the level of urban green development and the level of regional integration in the period of 2014-2021, with the aim of providing a useful reference for the future development of the region.

Keywords: regional integration, urban green development, Tapio decoupling model, Yangtze River Delta urban agglomeration

Procedia PDF Downloads 42

Authors: Steven R. Lawyer, Tereza Prihodova, Katerina Prihodova

Abstract:

Delay discounting (DD) is one of the most frequently used behavioral-economic measures of impulsive choice, but there are few cross-cultural comparisons of discounting, and to the best of our knowledge, none compare patterns of DD across different commodities or compare real and hypothetical rewards across cultures. The purpose of this study was to compare patterns of DD for both real and hypothetical money and cigarettes among participants in the USA and the Czech Republic. Adult smokers from the United States and the Czech Republic completed standard measures of DD for hypothetical and real money (~$10USD) and cigarettes (1 pack, or 20 cigarettes). Contrary to data from the USA sample, Czech Republic participants discounted the value of real money steeper than hypothetical money, though this could be related to the relatively poor fit of the hyperbolic decay function to DD for hypothetical money in the Czech sample. These findings suggest that there might be cultural differences in delay discounting that warrant further attention.

Keywords: delay discounting, temporal discounting, cigarette smoking, real rewards, hypothetical rewards

Procedia PDF Downloads 185

Authors: Matan Cohen, Maxim Shoshany

Abstract:

Climatic, topographic and geological diversity, together with frequent disturbance and recovery cycles, produce highly complex spatial patterns of trees, shrubs, dwarf shrubs and bare ground patches. Assessment of spatial and temporal variations of these life-forms patterns under climate change is of high ecological priority. Here we report on one of the first attempts to discriminate between images of three Mediterranean life-forms patterns at three densities. The development of an extensive database of orthophoto images representing these 9 pattern categories was instrumental for training and testing pre-trained and newly-trained DL models utilizing DenseNet architecture. Both models demonstrated the advantages of using Deep Learning approaches over existing spectral and spatial (pattern or texture) algorithmic methods in differentiation 9 life-form spatial mixtures categories.

Keywords: texture classification, deep learning, desert fringe ecosystems, climate change

Procedia PDF Downloads 88

Authors: Mansur Hamma-Adama, Tahar Kouider

Abstract:

Construction Industry has been evolving since the development of Building Information Modelling (BIM). This technological process is unstoppable; it is out to the market with remarkable case studies of solving the long industry’s history of fragmentation. This industry has been changing over time; United States has recorded the most significant development in construction digitalization, Australia, United Kingdom and some other developed nations are also amongst promoters of BIM process and its development. Recently, a developing country like China and Malaysia are keying into the industry’s digital shift, while very little move is seen in South Africa whose development is considered higher and perhaps leader in the digital transition amongst the African countries. To authors’ best knowledge, Nigerian construction industry has never engaged in BIM discussions hence has no attention at national level. Consequently, Nigeria has no “Noteworthy BIM publications.” Decision makers and key stakeholders need to be informed on the current trend of the industry’s development (BIM in specific) and the opportunities of adopting this digitalization trend in relation to the identified challenges. BIM concept can be traced mostly in Architectural practices than engineering practices in Nigeria. A superficial BIM practice is found to be at organisational level only and operating a model based - “BIM stage 1.” Research to adopting this innovation has received very little attention. This piece of work is literature review based, aimed at exploring BIM in Nigeria and its prospects. The exploration reveals limitations in the literature availability as to extensive research in the development of BIM in the country. Numerous challenges were noticed including building collapse, inefficiencies, cost overrun and late project delivery. BIM has potentials to overcome the above challenges and even beyond. Low level of BIM adoption with reasonable level of awareness is noticed. However, lack of policy and guideline as well as serious lack of experts in the field are amongst the major barriers to BIM adoption. The industry needs to embrace BIM to possibly compete with its global counterpart.

Keywords: adoption, BIM, CAD, construction industry, Nigeria, opportunities

Procedia PDF Downloads 151

Authors: Laura Roe

Abstract:

This study draws on twelve months of ethnographic fieldwork conducted in 2017 with heroin and poly-substance users in Scotland and explores experiences of time and temporality as factors in continuing drug use. The research largely took place over the year in which drug-related deaths in Scotland reached a record high, and were statistically recorded as the highest in Europe. This qualitative research is therefore significant in understanding both evolving patterns of drug use and the experiential lifeworlds of those who use heroin and other substances in high doses. Methodologies included participant observation, structured and semi-structured interviews, and unstructured conversations with twenty-two regular participants. The fieldwork was conducted in two needle exchanges, a community recovery group and in the community. The initial aim of the study was to assess evolving patterns of drug preferences in order to explore a clinical and user-reported rise in the use of novel psychoactive substances (NPS), which are typically considered to be highly potent, synthetic substances, often available at a low cost. It was found, however, that while most research participants had experimented with NPS with varying intensity, those who used every day regularly consumed heroin, methadone, and alcohol with benzodiazepines such as diazepam or anticonvulsants such as gabapentin. The research found that many participants deliberately pursued the non-fatal effects of overdose, aiming to induce states of dissociation, detachment and uneven consciousness, and did so by both mixing substances and experimenting with novel modes of consumption. Temporality was significant in the decision to consume cocktails of substances, as users described wishing to sever themselves from time; entering into states of ‘non-time’ and insensibility through specific modes of intoxication. Time and temporality similarly impacted other aspects of addicted life. Periods of attempted abstinence witnessed a slowing of time’s passage that was tied to affective states of boredom and melancholy, in addition to a disruptive return of distressing and difficult memories. Abject past memories frequently dominated and disrupted the present, which otherwise could be highly immersive due to the time and energy-consuming nature of seeking drugs while in financial difficulty. There was furthermore a discordance between individual user temporalities and the strict time-based regimes of recovery services and institutional bodies, and the study aims to highlight the impact of such a disjuncture on the efficacy of treatment programs. Many participants had difficulty in adhering to set appointments or temporal frameworks due to their specific temporal situatedness. Overall, exploring increasing tendencies of heroin users in Scotland towards poly-substance use, this study draws on experiences and perceptions of time, analysing how temporality comes to bear on the ways drugs are sought and consumed, and how recovery is imagined and enacted. The study attempts to outline the experiential, intimate and subjective worlds of heroin and poly-substance users while explicating the structural and historical factors that shape them.

Keywords: addiction, poly-substance use, temporality, timelessness

Procedia PDF Downloads 118

Authors: Seyedeh Belin Tavakoly Sany, H. Rosli, R. Majid, S. Aishah

Abstract:

In this study, water monitoring was performed from Nov. 2012 to Oct. 2013 to assess water quality and evaluate the spatial and temporal distribution of physicochemical and biological variables in water. Water samples were collected from 10 coastal water stations of West Port. In the case of water-quality assessment, multi-metric indices and operational indicators have been proposed to classify the trophic status at different stations. The trophic level of West Port coastal water ranges from eutrophic to hypertrophic. Chl-a concentration was used to estimate the biological response of phytoplankton biomass and indicated eutrophic conditions in West Port and mesotrophic conditions at the control site. During the study period, no eutrophication events or secondary symptoms occurred, which may be related to hydrodynamic turbulence and water exchange, which prevent the development of eutrophic conditions in the West Port.

Keywords: water quality, multi-metric indices, operational indicator, Malaysia, West Port

Procedia PDF Downloads 294

Authors: T. N. Goh, M. Hashmi, O. Hussain

Abstract:

Temporomandibular joint (TMJ) dysfunction (TMD) is a condition that may affect patients via restricted mouth opening, significant pain during normal functioning, and/or reproducible joint noise. TMD includes myofascial pain, TMJ functional derangements (internal derangement, dislocation), and TMJ degenerative/inflammatory joint disease. Internal derangement (ID) is the most common cause of TMD-related clicking and locking. These patients are managed in a stepwise approach, from patient education (homecare advice and analgesia), splint therapy, physiotherapy, botulinum toxin treatment, to arthrocentesis. Arthrotomy is offered when the aforementioned treatment options fail to alleviate symptoms and improve quality of life. The aim of this prospective study was to review the outcomes of jaw joint open surgery in TMD patients. Patients who presented from 2015-2022 at the Oral and Maxillofacial Surgery Department in the Doncaster NHS Foundation Trust, UK, with a Wilkes classification of III -V were included. These patients underwent either i) discopexy with bone-anchoring suture (9); ii) intrapositional temporalis flap (ITF) with bone-anchoring suture (3); iii) eminoplasty and discopexy with suturing to the capsule (3); iii) discectomy + ITF with bone-anchoring suture (1); iv) discoplasty + bone-anchoring suture (1); v) ITF (1). Maximum incisal opening (MIO) was assessed pre-operatively and at each follow-up. Pain score, determined via the visual analogue scale (VAS, with 0 being no pain and 10 being the worst pain), was also recorded. A total of 18 eligible patients were identified with a mean age of 45 (range 22 - 79), of which 16 were female. The patients were scored by Wilkes Classification as III (14), IV (1), or V (4). Twelve patients had anterior disc displacement without reduction (66%) and six had degenerative/arthritic changes (33%) to the TMJ. The open joint procedure resulted in an increase in MIO and reduction in pain VAS and for the majority of patients, across all Wilkes Classifications. Pre-procedural MIO was 22.9 ± 7.4 mm and VAS was 7.8 ± 1.5. At three months post-procedure there was an increase in MIO to 34.4 ± 10.4 mm (p < 0.01) and a decrease in the VAS to 1.5 ± 2.9 (p < 0.01). Three patients were lost to follow-up prior to six months. Six were discharged at six month review and five patients were discharged at 12 months review as they were asymptomatic with good mouth opening. Four patients are still attending for annual botulinum toxin treatment. Two patients (Wilkes III and V) subsequently underwent TMJ replacement (11%). One of these patients (Wilkes III) had improvement initially to MIO of 40 mm, but subsequently relapsed to less than 20 mm due to lack of compliance with jaw rehabilitation device post-operatively. Clinical improvements in 89% of patients within the study group were found, with a return to near normal MIO range and reduced pain score. Intraoperatively, the operator found bone-anchoring suture used for discopexy/discoplasty more secure than the soft tissue anchoring suturing technique.

Keywords: bone anchoring suture, open temporomandibular joint surgery, temporomandibular joint, temporomandibular joint dysfunction

Procedia PDF Downloads 104

Authors: Fuming Yang, Telma Sousa Almeida, Xinyu Li, Yunxi Deng, Heying Zhang, Michael E. Lamb

Abstract:

Twenty-seven children aged 6-15 years with autism spectrum disorder (ASD) and 32 typically developing children were questioned about their participation in a set of activities after a two-week delay and again after a two-month delay, using a best-practice interview protocol. This paper assessed the narrative coherence of children’s reports based on key story grammar elements and temporal features included in their accounts of the event. Results indicated that, over time, both children with ASD and typically developing (TD) children decreased their narrative coherence. Children with ASD were no different from TD peers with regards to story length and syntactic complexity. However, they showed significantly less coherence than TD children. They were less likely to use the gist of the story to organize their narrative coherence. Interviewer prompts influenced children’s narrative coherence. The findings indicated that children with ASD could provide meaningful and reliable testimony about an event they personally experienced, but the narrative coherence of their reports deteriorates over time and is affected by interviewer prompts.

Keywords: autism spectrum disorders, delay, eyewitness testimony, narrative coherence

Procedia PDF Downloads 286

Authors: Seungmin Chee

Abstract:

This paper investigates which of the two arguments, conservatism or liquidation option, is a true underlying driver of the asymmetric slope coefficient result regarding the association between earnings and returns. The analysis of the relation between earnings and returns in four mutually exclusive settings segmented by ‘profits vs. losses’ and ‘positive returns vs. negative returns’ suggests that liquidation option rather than conservatism is likely to cause the asymmetric slope coefficient result. Furthermore, this paper documents the temporal changes between Basu period (1963-1990) and post-Basu period (1990-2005). Although no significant change in degree of conservatism or value relevance of losses is reported, stronger negative relation between losses and positive returns is observed in the post-Basu period. Separate regression analysis of each quintile based on the rankings of price to sales ratio and book to market ratio suggests that the strong negative relation is driven by growth firms.

Keywords: conservatism, earnings, liquidation option, returns

Procedia PDF Downloads 370

Authors: Ragy Raafat Gaber Attaalla

Abstract:

For cardiovascular illness, oral P2Y12 inhibitors including clopidogrel, prasugrel, and ticagrelor are frequently recommended. Each of these medications has advantages and disadvantages. In the absence of genotyping, it has been demonstrated that the stronger platelet aggregation inhibitors prasugrel and ticagrelor are superior than clopidogrel at preventing significant adverse cardiovascular events following an acute coronary syndrome and percutaneous coronary intervention (PCI). Both, nevertheless, come with a higher risk of bleeding unrelated to a coronary artery bypass. As a prodrug, clopidogrel needs to be bioactivated, principally by the CYP2C19 enzyme. A CYP2C19 no function allele and diminished or absent CYP2C19 enzyme activity are present in about 30% of people. The reduced exposure to the active metabolite of clopidogrel and reduced inhibition of platelet aggregation among clopidogrel-treated carriers of a CYP2C19 no function allele likely contributed to the reduced efficacy of clopidogrel in clinical trials. Clopidogrel's pharmacogenetic results are strongest when used in conjunction with PCI, but evidence for other indications is growing. One of the most typical examples of clinical pharmacogenetic application is CYP2C19 genotype-guided antiplatelet medication following PCI. Guidance is available from expert consensus groups and regulatory bodies to assist with incorporating genetic information into P2Y12 inhibitor prescribing decisions. Here, we examine the data supporting genotype-guided P2Y12 inhibitor selection's effects on clopidogrel response and outcomes and discuss tips for pharmacogenetic implementation. We also discuss procedures for using genotype data to choose P2Y12 inhibitor therapies as well as any unmet research needs. Finally, choosing a P2Y12 inhibitor medication that optimally balances the atherothrombotic and bleeding risks may be influenced by both clinical and genetic factors.

Keywords: inhibitors, cardiovascular events, coronary intervention, pharmacogenetic implementation

Procedia PDF Downloads 111

Authors: Elham Sharif, Nasser Rizk, Sirin Abu Aqel, Ofelia Masoud

Abstract:

Background: Previous studies have investigated the association of rs1544410, rs7975232 and rs731236 polymorphisms in vitamin D receptor gene and its impact on diseases such as cancer, diabetes and hypertension in different ethnic backgrounds. Aim: The aim of this study is to investigate the association between VDR polymorphisms using three SNP’s (rs1544410, rs7975232 and rs731236) and the severity of the significant lesion in coronary arteries among angiographically diagnosed CAD. Methods: A prospective-retrospective study was conducted on 192 CAD patients enrolled from the cardiology department-Heart Hospital HMC, grouped in 96 subjects with significant stenosis and 96 with non-significant stenosis with a mean age between 30 and 75 years old. Genotyping was performed for the following SNPs rs1544410, rs7975232 and rs731236 using TaqMan assay by the Real Time PCR, ABI 7500 in Health Sciences Labs at Qatar University Biomedical Research Center. Results: The results showed that both groups have matched age and gender distribution but patients with the significant stenosis have significantly higher; BMI (p=0.047); smoking status (p=0.039); FBS (p= 0.031); CK-MB (p=0.025) and Troponin (p=0.002) than the patients with non–significant lesion. Among the traditional risk factors, smoking increases the odds of the severe stenotic lesion in CAD patients by 1.984, with 95% CI between 1.024 – 7.063, with p= 0.042.HWE showed deviations of the rs1544410 and rs731236 among the study subjects. The most frequent genotype in distribution of rs7975232 is the AA among the significant stenosis patients, while the heterozygous AC was the frequent genotype in distribution among the non-significant stenosis group. The carriers of CC genotype in rs7975232 increased the risk of having significant coronary arteries stenotic lesion by 1.83 with 95% CI (1.020 – 3.280), p=0.043. No association was found between the rs7975232 with vitamin D and VDBP. Conclusion: There is a significant association between rs7975232 and the severity of CAD lesion. The carrier of CC genotype in rs7975232 increased the risk of having significant coronary arteries atherosclerotic lesion especially in patients with smoking history independent of vitamin D.

Keywords: vitamin D, vitamin D receptor, polymorphism, coronary harat disease

Procedia PDF Downloads 311

Authors: Mostafa ‘Neo’ Mohsenvand, Mohammad Rasool Izadi, Pattie Maes

Abstract:

EEG-based biometrics (user identification) has been explored on small datasets of no more than 157 subjects. Here we show that the accuracy of modern supervised methods falls rapidly as the number of users increases to a few thousand. Moreover, supervised methods require a large amount of labeled data for training which limits their applications in real-world scenarios where acquiring data for training should not take more than a few minutes. We show that using contrastive learning for pre-training, it is possible to maintain high accuracy on a dataset of 2130 subjects while only using a fraction of labels. We compare 5 different self-supervised tasks for pre-training of the encoder where our proposed method achieves the accuracy of 96.4%, improving the baseline supervised models by 22.75% and the competing self-supervised model by 3.93%. We also study the effects of the length of the signal and the number of channels on the accuracy of the user-identification models. Our results reveal that signals from temporal and frontal channels contain more identifying features compared to other channels.

Keywords: brainprint, contrastive learning, electroencephalo-gram, self-supervised learning, user identification

Procedia PDF Downloads 155

Authors: Tutku Ak, A. Esra Cengiz, Çiğdem Ayhan Kaptan

Abstract:

The conservation community has been increasingly promoting the concept of ecological connectivity towards the prevention and mitigation of landscape fragmentation. Many tools have been proposed for this purpose in not only Europe, but also around the world. Spatial planning for building connectivity, however, has many problems associated with the complexity of ecological processes at spatial and temporal scales. Furthermore, on the ground implementation could be very difficult potentially leading to ecologically disastrous results and waste of resources. These problems, on the other hand, can be avoided or rectified as more experience is gained with implementation. Therefore, it is the objective of this study to document the experiences gained with connectivity planning in Turkish landscapes. This paper is a preliminary review of the conservation initiatives and projects aimed at protecting and building ecological connectivity in and around Turkey. The objective is to scope existing conservation plans, tools and implementation approaches in Turkey and the ultimate goal is to understand to what degree they have been implemented and what are the constraints and opportunities that are being faced.

Keywords: ecological connectivity, large-scale landscapes, planning and implementation, Turkey

Procedia PDF Downloads 500

Authors: Yasuyuki Takahashi, Hayato Ishimura, Masao Miyagawa, Teruhito Mochizuki

Abstract:

Quantitative measurement of myocardium perfusion is possible with single photon emission computed tomography (SPECT) using a semiconductor detector. However, accumulation of ^99mTc-tetrofosmin in the liver may make it difficult to assess that accurately in the inferior myocardium. Our idea is to reduce the high accumulation in the liver by using dynamic SPECT imaging and a technique called time subtraction. We evaluated the performance of a new SPECT system with a cadmium-zinc-telluride solid-state semi- conductor detector (Discovery NM 530c; GE Healthcare). Our system acquired list-mode raw data over 10 minutes for a typical patient. From the data, ten SPECT images were reconstructed, one for every minute of acquired data. Reconstruction with the semiconductor detector was based on an implementation of a 3-D iterative Bayesian reconstruction algorithm. We studied 20 patients with coronary artery disease (mean age 75.4 ± 12.1 years; range 42-86; 16 males and 4 females). In each subject, 259 MBq of ^99mTc-tetrofosmin was injected intravenously. We performed both a phantom and a clinical study using dynamic SPECT. An approximation to a liver-only image is obtained by reconstructing an image from the early projections during which time the liver accumulation dominates (0.5~2.5 minutes SPECT image-5~10 minutes SPECT image). The extracted liver-only image is then subtracted from a later SPECT image that shows both the liver and the myocardial uptake (5~10 minutes SPECT image-liver-only image). The time subtraction of liver was possible in both a phantom and the clinical study. The visualization of the inferior myocardium was improved. In past reports, higher accumulation in the myocardium due to the overlap of the liver is un-diagnosable. Using our time subtraction method, the image quality of the ^99mTc-tetorofosmin myocardial SPECT image is considerably improved.

Keywords: 99mTc-tetrofosmin, dynamic SPECT, time subtraction, semiconductor detector

Procedia PDF Downloads 334

Authors: Imad Eddine Rezouani, Khalil Draidi, Badis bakhouche, Selman Anes Chabani

Abstract:

The Algerian coast is an important site for wintering and migratory birds. Four species of shorebirds were surveyed, including Kentish plover Charadrius alexandrinus, Little ringed plover Charadrius dubius, Common ringed plover Charadrius hiaticula, and black-winged stilt Himantopus hilarious in three different sites, two important wetlands: Reghaia lake and Macta and a small area Sublette promenade to provide a new data about time activity budget. The study found a higher frequency of abundance in April during the study period (February to May), with a mean of 49. Estimating the temporal activity budget of these coastal birds, it was found that there were three main activities in different proportions between males and females: Pecking (29.51 ％) for males, (26.59％) for females, Looking above (28.01％) for males, (19.54 ％) for females And Away (9.95％) for males, (11.75％), contrarily the two previous one. Differences between study areas revealed differences in species behavior and distribution.

Keywords: wetland, behavioral, algerian coast, shorebirds, time budget activity

Procedia PDF Downloads 59

Authors: Haowei Chen, Kaiqi Xiong

Abstract:

This paper aims to answer how malware will propagate in Wireless Mesh Networks (WMNs) and how communication radius and distributed density of nodes affects the process of spreading. The above analysis is essential for devising network-wide strategies to counter malware. We answer these questions by developing an improved dynamical system that models malware propagation in the area where nodes were uniformly distributed. The proposed model captures both the spatial and temporal dynamics regarding the malware spreading process. Equilibrium and stability are also discussed based on the threshold of the system. If the threshold is less than one, the infected nodes disappear, and if the threshold is greater than one, the infected nodes asymptotically stabilize at the endemic equilibrium. Numerical simulations are investigated about communication radius and distributed density of nodes in WMNs, which allows us to draw various insights that can be used to guide security defense.

Keywords: Bluetooth security, malware propagation, wireless mesh networks, stability analysis

Procedia PDF Downloads 98

Authors: Youcef Lakhdar Hamina

Abstract:

In order to tame the ecological damage specificity, it is imperative to assert the procedural and objective liability aspect, which leads us to analyse current trends based on the development of preventive civil liability based on the precautionary principle. Our research focuses on the instruments of the environment protection in urban areas based on two complementary aspects appearing contradictory and refer directly to the institutional dimensions: - The preventive aspect: considered as a main objective of the environmental policy which highlights the different legal mechanisms for the environment protection by highlighting the role of administration in its implementation (environmental planning, tax incentives, modes of participation of all actors, etc.). - The healing-repressive aspect: considered as an approach for the identification of ecological damage and the forms of reparation (spatial and temporal-responsibility) to the impossibility of predicting with rigor and precision, the appearance of ecological damage, which cannot be avoided.

Keywords: environmental law, environmental taxes, environmental damage, eco responsibility, precautionary principle, environmental management

Procedia PDF Downloads 412

Authors: Chia-Wen Kuo

Abstract:

Jesse Curran states that there is a "breath awareness" that "facilitates a present-minded capability" to catalyse an "epistemological rupture" in Emily Dickinson's poetry, particularly in the age of Anthropocene. In Dickinson's "Nature", non-humans are subjectified as nature ceases to be subordinated to human interests, and Dickinson's Eco-humility has driven us, readers, into mimicking nature for the making of a better world. In terms of sustainable architecture, Norman Foster is among the representatives who utilise BIM to reduce architectural waste while satiating the users' aesthetic craving for a spectacular skyline. Notably, the Gherkin - 30 St. Mary Axe in east-end London. In 2019, Foster and his team aspired to savour the London skyline with his new design - the Tulip, which has been certified by the LEED as a legitimate green building as well as a complementary extension of the Gherkin. However, Foster's proposition had been denied for numerous times by the mayor Sadiq Khan and the city council as the Tulip cannot blend in the public space around while its observatory functions like a surveillance platform. The Tulip, except for its aesthetic idiosyncrasy, fails to serve for the public good other than another ostentatious tourist attraction in London. The architectural team for Mode Gakuen Cocoon tower, completed in 2008, intended to honour Nature with the symbolism in the building's aesthetic design. It serves as an architectural cocoon that nurtures the students of "Special Technology and Design College" inside. The building itself turns into a Dickinsonian anthropomorphism, where humans are made humble to learn from the entomological beings for self-betterment in the age of Anthropocene. Despite bearing resemblance to a tulip as well as its LEED credential, Norman Foster’s Tulip merely pays tribute to the Nature in a relatively superficial manner without constructing an apparatus that substantially benefit the Londoners as all green cities should embrace Emily Dickinson’s “breath awareness” and be built and treated as an extensive as well as expansive form of biomimicry.

Keywords: green city, sustianable architecture, London, Tokyo

Procedia PDF Downloads 153

Authors: Walid Fantazi

Abstract:

The development of sensor technology (such as microelectromechanical systems (MEMS), wireless communications, embedded systems, distributed processing and wireless sensor applications) has contributed to a broad range of WSN applications which are capable of collecting a large amount of spatiotemporal data in real time. These systems require real-time data processing to manage storage in real time and query the data they process. In order to cover these needs, we propose in this paper a Snapshot spatiotemporal data model based on object-oriented concepts. This model allows saving storing and reducing data redundancy which makes it easier to execute spatiotemporal queries and save analyzes time. Further, to ensure the robustness of the system as well as the elimination of congestion from the main access memory we propose a spatiotemporal indexing technique in RAM called Captree *. As a result, we offer an RIA (Rich Internet Application) -based SOA application architecture which allows the remote monitoring and control.

Keywords: WSN, indexing data, SOA, RIA, geographic information system

Procedia PDF Downloads 252

Authors: Heru Al Amin

Abstract:

Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is a very rare condition that causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity. Case summary: In this report, we discuss a case of a 50-year-old woman who presented with recurrent palpitation, dizziness, vertigo and presyncope. Electrocardiogram revealed variable heart blocks, including first-degree AV block, second-degree AV block, high-degree AV block, complete AV block, trifascicular block and sometimes supraventricular arrhythmia. Twenty-four hours of Holter monitoring show atrial bigeminy, first-degree AV block and trifascicular block. Transthoracic echocardiography showed Thinning of basal anteroseptal and inferred septum with LV dilatation with reduction of Global Longitudinal Strain. A dual-chamber pacemaker was implanted. CT Coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance revealed basal anteroseptal and inferior septum thinning with focal edema with LGE suggestive of sarcoidosis. Computed tomography of the chest showed no lymphadenopathy or pulmonary infiltration. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the whole body showed. We started steroids and followed up with the patient. Conclusion: This case serves to highlight the challenges in identifying and managing isolated CS in a young patient with recurrent syncope with variable heart block. Early, even late initiation of steroids can improve arrhythmia as well as left ventricular function.

Keywords: cardiac sarcoidosis, conduction abnormality, syncope, cardiac MRI

Procedia PDF Downloads 88

Authors: Ramuel Spirituel Mattathiah A. San Juan, Neil Ambasing

Abstract:

Background: Reversal of vision metamorphopsia is a transient form of metamorphopsia described as an upside-down alteration of the visual field in the coronal plane. Patients would describe objects, such as cups, upside down, but the tea would not spill, and people would walk on their heads. It is extremely rare as a stable finding, lasting days or weeks. We report a case wherein this type of metamorphopsia occurred only in written words and lasted for six months. Objective: To the best of our knowledge, we report the first rare occurrence of reversal of vision metamorphopsia described as inverted words as the sole initial presentation of an underlying stroke. Case Presentation: We report a 59-year-old male with poorly controlled hypertension and diabetes mellitus who presented with a 3-day history of difficulty reading, described as the words were turned upside down as if the words were inverted horizontally then with the progression of deficits such as right homonymous hemianopia and achromatopsia, prosopagnosia. Cranial magnetic resonance imaging (MRI) revealed an acute infarct on the left posterior cerebral artery territory. Follow-up after six months revealed improvement of the visual field cut but with the persistence of the higher cortical function deficits. Conclusion: We report the first rare occurrence of metamorphopsia described as purely inverted words as the sole initial presentation of an underlying stroke. The differential diagnoses of a patient presenting with text reversal metamorphopsia should include stroke in the occipitotemporal areas. It further expands the landscape of metamorphopsias due to its exclusivity to written words and prolonged duration. Knowing these clinical features will help identify the lesion locus and improve subsequent stroke care, especially in time-bound management like intravenous thrombolysis.

Keywords: rare presentation, text reversal metamorphopsia, ischemic stroke, stroke

Procedia PDF Downloads 57

Authors: Matteo Calabrese, Martin Cimmino, Dimos Kapetis, Martina Manfrin, Donato Concilio, Giuseppe Toscano, Giovanni Ciandrini, Giancarlo Paccapeli, Gianluca Giarratana, Marco Siciliano, Andrea Forlani, Alberto Carrotta

Abstract:

In this paper we describe a machine learning methodology for Predictive Maintenance (PdM) applied on woodworking industrial machines. PdM is a prominent strategy consisting of all the operational techniques and actions required to ensure machine availability and to prevent a machine-down failure. One of the challenges with PdM approach is to design and develop of an embedded smart system to enable the health status of the machine. The proposed approach allows screening simultaneously multiple connected machines, thus providing real-time monitoring that can be adopted with maintenance management. This is achieved by applying temporal feature engineering techniques and training an ensemble of classification algorithms to predict Remaining Useful Lifetime of woodworking machines. The effectiveness of the methodology is demonstrated by testing an independent sample of additional woodworking machines without presenting machine down event.

Keywords: predictive maintenance, machine learning, connected machines, artificial intelligence

Procedia PDF Downloads 222

Authors: Daniel Rowe, Christopher R. Vogel, Richard H. J. Willden

Abstract:

The University of Oxford’s recirculating water flume is a combined wave and current test tank with a 1 m depth, 1.1 m width, and 10 m long working section, and is capable of flow speeds up to 1 ms−1 . This study documents the hydrodynamic characteristics of the facility in preparation for experimental testing of horizontal axis tidal stream turbine models. The turbine to be tested has a rotor diameter of 0.6 m and is a modified version of one of two model-scale turbines tested in previous experimental campaigns. An Acoustic Doppler Velocimeter (ADV) was used to measure the flow at high temporal resolution at various locations throughout the flume, enabling the spatial uniformity and turbulence flow parameters to be investigated. The mean velocity profiles exhibited high levels of spatial uniformity at the design speed of the flume, 0.6 ms−1 , with variations in the three-dimensional velocity components on the order of ±1% at the 95% confidence level, along with a modest streamwise acceleration through the measurement domain, a target 5 m working section of the flume. A high degree of uniformity was also apparent for the turbulence intensity, with values ranging between 1-2% across the intended swept area of the turbine rotor. The integral scales of turbulence exhibited a far higher degree of variation throughout the water column, particularly in the streamwise and vertical scales. This behaviour is believed to be due to the high signal noise content leading to decorrelation in the sampling records. To achieve more realistic levels of vertical velocity shear in the flume, a simple procedure to practically generate target vertical shear profiles in open-channel flows is described. Here, the authors arranged a series of non-uniformly spaced parallel bars placed across the width of the flume and normal to the onset flow. By adjusting the resistance grading across the height of the working section, the downstream profiles could be modified accordingly, characterised by changes in the velocity profile power law exponent, 1/n. Considering the significant temporal variation in a tidal channel, the choice of the exponent denominator, n = 6 and n = 9, effectively provides an achievable range around the much-cited value of n = 7 observed at many tidal sites. The resulting flow profiles, which we intend to use in future turbine tests, have been characterised in detail. The results indicate non-uniform vertical shear across the survey area and reveal substantial corner flows, arising from the differential shear between the target vertical and cross-stream shear profiles throughout the measurement domain. In vertically sheared flow, the rotor-equivalent turbulence intensity ranges between 3.0-3.8% throughout the measurement domain for both bar arrangements, while the streamwise integral length scale grows from a characteristic dimension on the order of the bar width, similar to the flow downstream of a turbulence-generating grid. The experimental tests are well-defined and repeatable and serve as a reference for other researchers who wish to undertake similar investigations.

Keywords: acoustic doppler Velocimeter, experimental hydrodynamics, open-channel flow, shear profiles, tidal stream turbines

Procedia PDF Downloads 86