Search results for: AIDS mortality rates

Authors: Heena Akbar, Winnie Niumata, Danielle Gallegos

Abstract:

Type 2 diabetes is a significant public health problem for Māori and Pasifika communities in Queensland, who are experiencing a higher burden of morbidity and mortality from the condition. Despite this higher burden, there are few initiatives that are culturally tailored to improve prevention and management. Modification of personal behaviors through women’s wellness programs aimed at early intervention has been shown to reduce the risk of developing complications in established type 2 diabetes and may reduce hospitalization rates from preventable complications related to this disease. The 24-week Pasifika Women’s Diabetes Wellness Program (PWDWP) was culturally co-designed and co-developed with Māori and Pasifika women with type 2 diabetes through a community-academia partnership in Queensland. Underpinned by Social Cognitive Theory and the Indigenous Pacific Health frameworks to include family culture & spirituality and integrating a collectivist and whānau (family) centered approach to self-care, the program takes into consideration the cultural shame associated with acknowledging the disease and tailors the interventions using talanoa (storytelling or conversation in a relational context) as the key strategy to come to a shared meaning for behavior change. The pilot trial is a 12-week intervention followed by a 12-week follow-up period conducted with 50 women with type 2 diabetes, 25 women who will receive the intervention and 25 women who will receive usual care. The pilot program provides in-person and virtual access to culturally supported prevention and self-management of Māori and Pasifika women with type 2 diabetes with the aim to improve healthy lifestyles and reduce late hospital presentations from diabetes-related complications for better diabetes-related outcomes. This study will test and evaluate the effectiveness of the PWDWP pilot trial in partnership with Māori & Pasifika community organizations and key stakeholders for improved glycated hemoglobin (HbA1c) levels associated with poor management of type 2 diabetes.

Keywords: culturally co-designed intervention, Indigenous methodology, Māori and Pasifika communities, type 2 diabetes self-management

Procedia PDF Downloads 86

Authors: Parimalakrishnan Sundararjan, Madheswaran Murugan, Dhanya Dharman, Yatindra Kumar, Sudhir Singh Gangwar, Guru Prasad Mohanta

Abstract:

Antibiotic resistance AR is a global issue, India started to redress the issues of antibiotic resistance late and it plans to have: active surveillance of microbial resistance and promote appropriate use of antibiotics. The present study attempted to achieve appropriate use of antibiotics through pharmacists’ intervention at practice point. In a quasi-experimental prospective cohort study, the cases with bacteremia from four hospitals were identified during 2015 and 2016 for intervention. The pharmacists centered intervention: active screening of each prescription and comparing with the selection of antibiotics with susceptibility of the bacteria. Wherever irrationality noticed, it was brought to the notice of the treating physician for making changes. There were two groups: intervention group and control group without intervention. The active screening and intervention in 915 patients has reduced therapeutic regimen time in patients with bacteremia. The intervention group showed the decreased duration of hospital stay 3.4 days from 5.1 days. Further, multivariate modeling of patients who were in control group showed that patients in the intervention group had a significant decrease in both duration of hospital stay and infection-related mortality. Unlike developed countries, pharmacists are not active partners in patient care in India. This unique attempt of pharmacist’ invention was planned in consultation with hospital authorities which proved beneficial in terms of reducing the duration of treatment, hospital stay, and infection-related mortality. This establishes the need for a collaborative decision making among the health workforce in patient care at least for promoting rational use of antibiotics, an attempt to combat resistance.

Keywords: antibiotics resistance, intervention, bacteremia, multivariate modeling

Procedia PDF Downloads 180

Authors: Ainura Tursunalieva, Irene Hudson

Abstract:

Continuous improvement of both the quality and safety of health care is an important goal in Australia and internationally. The intensive care unit (ICU) receives patients with a wide variety of and severity of illnesses. Accurately identifying patients at risk of developing complications or dying is crucial to increasing healthcare efficiency. Thus, it is essential for clinicians and researchers to have a robust framework capable of evaluating the risk profile of a patient. ICU scoring systems provide such a framework. The Acute Physiology and Chronic Health Evaluation III and the Simplified Acute Physiology Score II are ICU scoring systems frequently used for assessing the severity of acute illness. These scoring systems collect multiple risk factors for each patient including physiological measurements then render the assessment outcomes of individual risk factors into a single numerical value. A higher score is related to a more severe patient condition. Furthermore, the Mortality Probability Model II uses logistic regression based on independent risk factors to predict a patient’s probability of mortality. An important overlooked limitation of SAPS II and MPM II is that they do not, to date, include interaction terms between a patient’s vital signs. This is a prominent oversight as it is likely there is an interplay among vital signs. The co-existence of certain conditions may pose a greater health risk than when these conditions exist independently. One barrier to including such interaction terms in predictive models is the dimensionality issue as it becomes difficult to use variable selection. We propose an innovative scoring system which takes into account a dependence structure among patient’s vital signs, such as systolic and diastolic blood pressures, heart rate, pulse interval, and peripheral oxygen saturation. Copulas will capture the dependence among normally distributed and skewed variables as some of the vital sign distributions are skewed. The estimated dependence parameter will then be incorporated into the traditional scoring systems to adjust the points allocated for the individual vital sign measurements. The same dependence parameter will also be used to create an alternative copula-based model for predicting a patient’s probability of mortality. The new copula-based approach will accommodate not only a patient’s trajectories of vital signs but also the joint dependence probabilities among the vital signs. We hypothesise that this approach will produce more stable assessments and lead to more time efficient and accurate predictions. We will use two data sets: (1) 250 ICU patients admitted once to the Chui Regional Hospital (Kyrgyzstan) and (2) 37 ICU patients’ agitation-sedation profiles collected by the Hunter Medical Research Institute (Australia). Both the traditional scoring approach and our copula-based approach will be evaluated using the Brier score to indicate overall model performance, the concordance (or c) statistic to indicate the discriminative ability (or area under the receiver operating characteristic (ROC) curve), and goodness-of-fit statistics for calibration. We will also report discrimination and calibration values and establish visualization of the copulas and high dimensional regions of risk interrelating two or three vital signs in so-called higher dimensional ROCs.

Keywords: copula, intensive unit scoring system, ROC curves, vital sign dependence

Procedia PDF Downloads 148

Authors: Elvis Enowbeyang Tarkang

Abstract:

Background: Since students in high schools in Cameroon fall within the age group hardest hit by HIV/AIDS, it is assumed that these students might be exposed to sexual risk behaviours. Sexual risk behaviours include engaging in unprotected sexual intercourse, early sexual debut, multiple sexual partners and coerced or forced sex, and these behaviours might predispose youth to HIV transmission. However, little has been explored on the sexual risk behaviours of high school learners in Cameroon. This study aimed at examining the sexual risk behaviours of high school students in an urban town of Cameroon. Method: A quantitative cross sectional design was adopted, using a self-administered questionnaire to collect data from a disproportional stratified simple random sample of 480 (240 male and 240 female) grade 10 to grade 12 students from two participating secondary school in Limbe in the Southwest region of Cameroon August 2014. Descriptive and Chi square statistics were calculated using statistical Package for Social Sciences (SPSS) version 20 software program at the level 0.05. Results: Majority of the respondents, 63.4% reported being sexually active, of whom only 33.2% used condoms consistently. Up to 37% of the sexually active respondents had multiple sexual partners in the past one year before the study, while 23% had multiple sexual partners during the study period. The mean age of first sex was 15.4 years. Among Christians, Pentecostals, 17 (58.6%) were more likely to have experienced sexual coercion than non-Pentecostals, 111 (42.2%) (p= 0.000). Christians, 41 (10.3%) were more likely to have been forced into first sex than Muslims, 0 (0.0%); while among the Christians, Pentecostals, 6 (15.0%) were more likely to have been forced into first sex than non-Pentecostals, 35 (10.9%) (p=0.004). Among the Christians, Pentecostals, 16 (66.7%) were more likely to have experienced sex by age 16 years than non-Pentecostals, 125 (64.1%) (p= 0.000). Students who lived in rented places, 32 (22.7%) were more likely to have had multiple sexual partners than those who lived in their parents’ houses, 35 (18.1%) (p= 0.000). Males, 36 (16.0%) were likely to have had multiple concurrent sexual partners than females, 14 (6.0%) (p=0.002). Students who used condoms consistently, 25 (33.3%) were more likely to have a higher perception of risk of contracting HIV than those who did not use condoms consistently, 38 (29.9%) (p=0.002). Students who lived in their parents’ houses, 35 (35.4%) were more likely to use condoms consistently during sex, than those who lived in rented places, 31 (29.8%) (p=0.021). Students who passed their examinations, 57 (30.9%) were more likely to have used condoms consistently than those with low academic profiles, 24 (27.9%) (p= 0.034). Conclusions and Recommendations: Gender, lack of parental control, religion, academic profile, poverty, place of residence and perception of risk of HIV infection were the main factors associated with sexual risk behaviours among students in urban Cameroon. The findings indicate that sexual risk behaviours exist among high school students in Limbe urban town of Cameroon. There is need for campaigns and interventions to bring about sexual behaviour change.

Keywords: Cameroon, high school students, HIV/AIDS, Limbe urban town, sexual risk behaviours

Procedia PDF Downloads 326

Authors: A. Bello-Olusoji, M. O. Sodamola, Y. A. Adejola, D. D Akinbola

Abstract:

An eight (8) weeks study was carried out on Four hundred and five (405) African catfish (Clarias gariepinus) juveniles to examine the effect of graded levels of egg shell on their growth performance and survival rates. They were acclimatized for two (2) weeks after which they were weighed and allotted into five dietary treatments of three (3) replicates each and 27 fishes per replicate making a total number of eighty-one (81) fishes per treatment. The dietary treatments contained 0, 25, 50, 75 and 100(%) egg shell inclusion from treatment one to treatment five respectively. Parameter on daily feed intake, weekly weight gain, and daily mortalities were recorded. The result of the experiment indicated that treatment four (4) with 75% inclusion of egg shell was the best in terms of weight gain and survival rates and was significantly different (P<0.05) when compared with the other treatments. For Catfish farming to remain viable in the nearest future, lower feed cost and increased profit are required; it is therefore recommended that diets of African catfish (Clarias gariepinus) be supplemented with well processed egg shell at 75% level of inclusion to achieve this.

Keywords: African catfish, egg shell, performance, performance, survival rate, weight gain

Procedia PDF Downloads 383

Authors: Sharein El-Tourky, Sharon Smith, Gary Hitchcock

Abstract:

Effective fisheries management is necessarily dependent on the accuracy of fisheries models, which can be limited if they omit critical elements. One critical element in the formulation of these models is the trophic interactions at the larval stage of fish development. At this stage, fish mortality rates are at their peak and survival is often determined by resource limitation. Thus it is crucial to identify and quantify essential prey resources and determine how they vary in abundance and availability. The main resources larval fish consume are mesozooplankton. In the Straits of Florida, little is known about temporal and spatial variability of the mesozooplankton community despite its importance as a spawning ground for fish such as the Blue Marlin. To investigate mesozooplankton distribution patterns in the Straits of Florida, a transect of 16 stations from Miami to the Bahamas was sampled once a month in 2003 and 2004 at four depths. We found marked temporal and spatial variability in mesozooplankton biomass, diversity, and depth distribution. Mesozooplankton biomass peaked on the western boundary of the SOF and decreased gradually across the straits to a minimum at eastern stations. Midcurrent stations appeared to be a region of enhanced year-round variability, but limited seasonality. Examination of dominant zooplankton groups revealed groups could be parsed into 6 clusters based on abundance. Of these zooplankton groups, copepods were the most abundant zooplankton group, with the 20 most abundant species making up 86% of the copepod community. Copepod diversity was lowest at midcurrent stations and highest in the Eastern SOF. Interestingly, one copepods species, previously identified to compose up to 90% of larval blue marlin and sailfish diets in the SOF, had a mean abundance of less than 7%. However, the unique spatial and vertical distribution patterns of this copepod coincide with peak larval fish spawning periods and larval distribution, suggesting an important relationship requiring further investigation.

Keywords: mesozooplankton biodiversity, larval fish diet, food web, Straits of Florida, vertical distribution, spatiotemporal variability, cross-current comparisons, Gulf Stream

Procedia PDF Downloads 550

Authors: Robin Singh, Jing-Chiou Liou

Abstract:

The Internet of Things (IoT) devices are being used heavily as part of our everyday routines. Through improved communication and automated procedures, its popularity has assisted users in raising the quality of work. These devices are used in healthcare in order to better collect the patient’s data for their treatment. They are generally considered safe and secure. However, there is some possibility that some loopholes do exist which manufacturers do need to identify before some hacker takes advantage of them. For this study, we focused on two medical IoT devices which are pacemakers and hearing aids. The aim of this paper is to identify if there is any likelihood of these medical devices being hijacked and used as a botnet in Distributed Denial-Of Service attacks. Moreover, some mitigation strategies are being proposed to better secure

Keywords: cybersecurity, DDoS, IoT, medical devices

Procedia PDF Downloads 80

Authors: Po-Ching Chou, Wen-Chen Liang, I. Chen Chen, Jong-Hau Hsu, Yuh-Jyh Jong

Abstract:

Background：Cardiopulmonary complications seem to cause high morbidity and mortality in patients with neuromuscular diseases (NMD) but so far there is no domestic data reported in Taiwan. We, therefore attempted to analyze the factors to cause the death in NMD patients from our cohort. Methods：From 1998 to 2013, we retrospectively collected the information of the NMD patients treated and followed up in Kaohsiung Medical University Hospital. Forty-two patients with NMD who expired during these fifteen years were enrolled. The medical records of these patients were reviewed and the causes of death and the associated affecting factors were analyzed. Results：Eighteen patients with NMD (mean age=13.3, SD=12.4) with complete medical record and detailed information were finally included in this study, including spinal muscular atrophy (SMA) (n=9, 7/9: type 1), Duchenne muscular dystrophy (n=6), congenital muscular dystrophy (n=1), carnitine acyl-carnitine translocase (CACT) deficiency (n=1) and spinal muscular atrophy with respiratory distress (SMARD)(n=1). The place of death was in ICU (n=11, 61%), emergency room (n=3, 16.6%) or home (n=4, 22.2%). For SMA type 1 patients, most of them (71.4%, 5/7) died in emergency room or home and the other two expired during an ICU admission. The causes of death included acute respiratory failure due to pneumonia (n=13, 72.2 %), ventilator failure or dislocation (n=2, 11.1%), suffocation/choking (n=2, 11.1%), and heart failure with hypertrophic cardiomyopathy (n=1, 5.55%). Among the 15 patients died of respiratory failure or choking, 73.3% of the patients (n=11) received no ventilator care at home. 80% of the patients (n=12) received no cough assist at home. The patient died of cardiomyopathy received no medications for heart failure until the last admission. Conclusion: Respiratory failure and choking are the leading causes of death in NMD patients. Appropriate respiratory support and airway clearance play the critical role to reduce the mortality.

Keywords: neuromuscular disease, cause of death, tertiary care hospital, medical sciences

Procedia PDF Downloads 527

Authors: Hussaini Garba Mohammed

Abstract:

Background/Significance: The lack of data gathering is affecting NGOs world-wide in general to have good data information about educational and health related issues among communities in any country and around the world. For example, HIV/AIDS smoking (Tuberculosis diseases) and COVID-19 virus carriers is becoming a serious public health problem, especially among old men and women. But there is no full details data survey assessment from communities, villages, and rural area in some countries to show the percentage of victims and patients, especial with this world COVID-19 virus among the people. These data are essential to inform programming targets, strategies, and priorities in getting good information about data gathering in any society.

Keywords: reliable information, data assessment, data mining, data communication

Procedia PDF Downloads 176

Authors: A. S. Lourens, B. Du Plooy

Abstract:

Across the world, initiatives have been introduced to encourage women to enter into and remain in engineering fields. However, research has shown that many women leave engineering or suffer a loss of self-esteem and self-confidence compared to their male counterparts. To address this problem, a South African comprehensive university developed a self-leadership intervention pilot study in 2013, aimed at improving the self-efficacy of its female engineering students and increasing retention rates. This paper is a qualitative, descriptive, and interpretive study of the rationale and operational aspects of the Women in Engineering Leadership Association’s (WELA) self-leadership workshop. The objectives of this paper are to provide a framework for the design of a self-leadership workshop and to provide insight into the process of developing such a workshop specifically for women engineering students at a South African university. Finally, the paper proposes an evaluation process for the pilot workshop, which also provides a framework to improve future workshops. It is anticipated that the self-leadership development framework will be applicable to other higher education institutions wishing to improve women engineering student’s feelings of self-efficacy and therefore retention rates of women in engineering.

Keywords: co-curricular interventions, self-efficacy, self-leadership, women in engineering

Procedia PDF Downloads 441

Authors: Tonga Agadi Danladi, Ajao Wasiu Bamidele, Terdue Dyeko

Abstract:

Recent advancement in microwave communications technologies especially in telecommunications and broadcasting have resulted in congestion on the frequencies below 10GHz. This has forced microwave designers to look for high frequencies. Unfortunately for frequencies greater than 10GHz rain becomes one of the main factors of attenuation in signal strength. At frequencies from 10GHz upwards, rain drop sizes leads to outages that compromises the availability and quality of service this making it a critical factor in satellite link budget design. Rain rate and rain attenuation predictions are vital steps to be considered when designing microwave satellite communication link operating at Ku-band frequencies (112-18GHz). Unreliable rain rates data in the tropical regions of the world like Nigeria from radio communication group of the international Telecommunication Union (ITU-R) makes it difficult for microwave engineers to determine a realistic rain margin that needs to be accommodated in satellite link budget design in such region. This work presents an empirical tool for predicting the amount of signal due to rain on DBS signal operating at the Ku-band.

Keywords: attenuation, Ku-Band, microwave communication, rain rates

Procedia PDF Downloads 477

Authors: S. Studente, S. Ellis, S. F. Garivaldis

Abstract:

We report upon a study introducing a chatbot to develop learning communities at a London University, with a largely international student base. The focus of the chatbot was twofold; to ease the transition for students into their first year of university study, and to increase study engagement. Four learning communities were created using the chatbot; level 3 foundation, level 4 undergraduate, level 6 undergraduate and level 7 post-graduate. Students and programme leaders were provided with access to the chat bot via mobile app prior to their study induction and throughout the autumn term of 2019. At the end of the term, data were collected via questionnaires and focus groups with students and teaching staff to allow for identification of benefits and challenges. Findings indicated a positive correlation between study engagement and engagement with peers. Students reported that the chatbot enabled them to obtain support and connect to their programme leader. Both staff and students also made recommendation on how engagement could be further enhanced using the bot in terms of; clearly specified purpose, integration with existing university systems, leading by example and connectivity. Extending upon these recommendations, a second pilot study is planned for September 2020, for which the focus will be upon improving attendance rates, student satisfaction and module pass rates.

Keywords: chatbot, e-learning, learning communities, student engagement

Procedia PDF Downloads 118

Authors: Gimhani Madhushika Hewayalage, Thilini Ariyadasa, Sanja Gunawardena

Abstract:

In Sri Lanka, the largest contribution for the industrial export earnings is governed by textile and apparel industry. However, this industry generates huge quantities of effluent consists of unfixed dyes which enhance the effluent colour and toxicity thereby leading towards environmental pollution. Therefore, the effluent should properly be treated prior to the release into the environment. The biological technique has now captured much attention as an environmental-friendly and cost-competitive effluent decolourization method due to the drawbacks of physical and chemical treatment techniques. The present study has focused on identifying dye decolourizing potential of several bacterial isolates obtained from the effluent of the local textile industry. Yellow EXF, Red EXF, Blue EXF, Nova Black WNN and Nylosan-Rhodamine-EB dyes have been selected for the study to represent different chromophore groups such as Azo and Xanthene. The rates of decolorization of each dye have been investigated by employing distinct bacterial isolates. Bacterial isolate which exhibited effective dye decolorizing potential was identified as Proteus mirabilis using 16S rRNA gene sequencing analysis. The high decolorizing rates of identified bacterial strain indicate its potential applicability in the treatment of dye-containing wastewaters.

Keywords: azo, bacterial, biological, decolourization, xanthene

Procedia PDF Downloads 249

Authors: Yibeltal T. Bayou, Yohana S. Mashalla, Gloria Thupayagale-Tshweneagae

Abstract:

Background: Maternal mortality has been shown to be lower in urban areas than in rural areas. However, disparities for the fast-growing population of urban poor who struggle as much their rural counterparts to access quality healthcare are masked by the urban averages. The aim of this paper is to report on the findings of antenatal adequacy among slum residents in Addis Ababa, Ethiopia. Methods and Materials: A quantitative and cross-sectional community-based study design was employed. A stratified two-stage cluster sampling technique was used to determine the sample and data was collected using structured questionnaire administered to 837 women aged 15-49 years. Binary logistic regression models were employed to identify predictors of adequacy of antenatal care. Results: The majority of slum residents did not have adequate antenatal care services i.e., only 50.7%, 19.3% and 10.2% of the slum resident women initiated early antenatal care, received adequate antenatal care service contents and had overall adequate antenatal care services. Pregnancy intention, educational status and place of ANC visits were important determinant factors for adequacy of ANC in the study area. Women with secondary and above educational status were 2.9 times more likely to have overall adequate care compared to those with no formal education. Similarly, women whose last pregnancy was intended and clients of private healthcare facilities were 1.8 and 2.8 times more likely to have overall adequate antenatal care compared to those whose last pregnancy was unintended and clients of public healthcare facilities respectively. Conclusion: In order to improve ANC adequacy in the study area, the policymaking, planning, and implementation processes should focus on the poor adequacy of ANC among the disadvantaged groups in particular and the slum residents in general.

Keywords: Addis Ababa, adequacy of antenatal care, slum residents, maternal mortality

Procedia PDF Downloads 418

Authors: Erica Cochran Hameen, Bobuchi Ken-Opurum, Shalini Priyadarshini, Berangere Lartigue, Sadhana Anath-Pisipati

Abstract:

School districts throughout the United States are constantly seeking measures to improve test scores, reduce school absenteeism and improve indoor environmental quality. It is imperative to identify key building investments which will provide the largest benefits to schools in terms of improving the aforementioned factors. This study uses Analysis of Variance (ANOVA) tests to statistically evaluate the impact of a school building’s mechanical and plumbing characteristics on a child’s educational performance. The educational performance is measured via three indicators, i.e. test scores, suspensions, and absenteeism. The study investigated 125 New York City school facilities to determine the potential correlations between 50 mechanical and plumbing variables and the performance indicators. Key findings from the tests revealed that elementary schools with pneumatic systems in “good” condition have 48.8% lower percentages of students scoring at the minimum English Language Arts (ELA) competency level compared with those with no pneumatic system. Additionally, elementary schools with “unit heaters/cabinet heaters” in “good to fair” conditions have 1.1% higher attendance rates compared to schools with no “unit heaters/cabinet heaters” or those in inferior condition. Furthermore, elementary schools with air conditioning have 0.6% higher attendance rates compared to schools with no air conditioning, and those with interior floor drains in “good” condition have 1.8% higher attendance rates compared to schools with interior drains in inferior condition.

Keywords: academic attendance and performance, mechanical and plumbing systems, schools, student health

Procedia PDF Downloads 114

Authors: Nikoo Soleimani

Abstract:

Background: Reducing torque during bone drilling is one of the effective factors in reaching to an optimal drilling process. Methods: 15 bovine femurs were drilled in vitro with a drill bit with a diameter of 4 mm using two methods of torsional ultrasonic assisted drilling (T-UAD) and convent conventional drilling (CD) and the effects of changing the feed rate and rotational speed on the torque were compared in both methods. Results: There was no significant difference in the thrust force measured in both methods due to the direction of vibrations. Results showed that using T-UAD method for bone drilling at feed rates of 0.16, 0.24 and 0.32 mm/rev led for all rotational speeds to a decrease of at least 16.3% in torque compared to the CD method. Further, using T-UAD at rotational speeds of 355~1000 rpm with various feed rates resulted in a torque reduction of 16.3~50.5% compared to CD method. Conclusions: Reducing the feed rate and increasing the rotational speed, except for the rotational speed of 500 rpm and a feed rate of 0.32 mm/rev, resulted generally in torque reduction in both methods. However, T-UAD is a more effective and desirable option for bone drilling considering its significant torque reduction.

Keywords: torsional ultrasonic assisted drilling, torque, bone drilling, rotational speed, feed rate

Procedia PDF Downloads 154

Authors: Jin-Ming Wu, Te-Wei Ho, Yu-Wen Tien

Abstract:

Background: The aim of this population-based study was to determine the occurrence of diabetes and exocrine pancreatic insufficiencies (EPI) on non-diabetes subjects receiving distal pancreatectomy (DP). Method: A nationwide cohort study between 2000 and 2010 was collected from the Taiwan National Health Insurance Research Database. Among 3264 DP patients, we identified 1410 non-diabetes and 966 non-diabetes non-EPI. Results. Of 1410 non-diabetes DP subjects, 312 patients (22.1%) developed newly-diagnosed diabetes after PD. On a multiple logistic regression model, co-morbid hyperlipidemia (odds ratio, 1.640; 95% CI, 1.362–2.763; P < 0.001) and pancreatitis (odds ratio, 2.428; 95% CI, 1.889–3.121; P < 0.001) significantly contributed to higher incidences of diabetes after DP. Moreover, 380 subjects (39.3%) developed EPI, and pancreatic cancer is the statistically significant risk factor (odds ratio, 4.663; 95% CI, 2.108–6.085; P < 0.001). Conclusion: The patients with co-morbid hyperlipidemia and chronic pancreatitis had higher rates of newly-diagnosed diabetes after DP, moreover, pancreatic cancer subjects had higher rates of pancreatic exocrine insufficiency after DP. The clinicians should be alert to follow up glucose metabolism and clinical symptoms of fat intolerance for DP patients.

Keywords: distal pancreatectomy, National database, diabetes, exocrine insufficiency

Procedia PDF Downloads 194

Authors: Nikhil Padhye

Abstract:

Recently a new phenomenon for bonding of polymeric films in solid-state, at ambient temperatures well below the glass transition temperature of the polymer, has been reported. This is achieved by bulk plastic compression of polymeric films held in contact. Here we analyze the process of cold-rolling of polymeric films via finite element simulations and illustrate a flexible and modular experimental rolling-apparatus that can achieve bonding of polymeric films through cold-rolling. Firstly, the classical theory of rolling a rigid-plastic thin-strip is utilized to estimate various deformation fields such as strain-rates, velocities, loads etc. in rolling the polymeric films at the specified feed-rates and desired levels of thickness-reduction(s). Predicted magnitudes of slow strain-rates, particularly at ambient temperatures during rolling, and moderate levels of plastic deformation (at which Bauschinger effect can be neglected for the particular class of polymeric materials studied here), greatly simplifies the task of material modeling and allows us to deploy a computationally efficient, yet accurate, finite deformation rate-independent elastic-plastic material behavior model (with inclusion of isotropic-hardening) for analyzing the rolling of these polymeric films. The interfacial behavior between the roller and polymer surfaces is modeled using Coulombic friction; consistent with the rate-independent behavior. The finite deformation elastic-plastic material behavior based on (i) the additive decomposition of stretching tensor (D = De + Dp, i.e. a hypoelastic formulation) with incrementally objective time integration and, (ii) multiplicative decomposition of deformation gradient (F = FeFp) into elastic and plastic parts, are programmed and carried out for cold-rolling within ABAQUS Explicit. Predictions from both the formulations, i.e., hypoelastic and multiplicative decomposition, exhibit a close match. We find that no specialized hyperlastic/visco-plastic model is required to describe the behavior of the blend of polymeric films, under the conditions described here, thereby speeding up the computation process .

Keywords: Polymer Plasticity, Bonding, Deformation Induced Mobility, Rolling

Procedia PDF Downloads 186

Authors: Shyam Shukla

Abstract:

A brand is the identity of a specific product, service or business. A brand can take many forms, including a name, sign, symbol, color, combination or slogan. The word brand began simply as a way to tell one person's identity from another by means of a hot iron stamp. A legally protected brand name is called a trademark. The word brand has continued to evolve to encompass identity - it affects the personality of a product, company or service. A concept brand is a brand that is associated with an abstract concept, like AIDS awareness or environmentalism, rather than a specific product, service, or business. A commodity brand is a brand associated with a commodity1. In this paper, it is tried to explore the significance of an intellectual capital for the branding of an Institution.

Keywords: brand, commodity, consumer, cultural values, intellectual capital, zonal cluster

Procedia PDF Downloads 461

Authors: Yong-Heng Shi, Peng Hao, Bai-Chen Xie

Abstract:

Solar prosumers are playing increasingly prominent roles in the power system. However, its uncertainty affects the outcomes and functions of the power market, especially in the asymmetric information environment. Therefore, an important issue is how to take effective measures to reduce the impact of uncertainty on market equilibrium. We propose a two-level stochastic differential game model to explore the Cournot decision problem of prosumers. In particular, we study the impact of punishment and cooperation mechanisms on the efficiency of the Cournot game in which prosumers face uncertainty. The results show that under the penalty mechanism of fixed and variable rates, producers and consumers tend to take conservative actions to hedge risks, and the variable rates mechanism is more reasonable. Compared with non-cooperative situations, prosumers can improve the efficiency of the game through cooperation, which we attribute to the superposition of market power and uncertainty reduction. In addition, the market environment of asymmetric information intensifies the role of uncertainty. It reduces social welfare but increases the income of prosumers. For regulators, promoting alliances is an effective measure to realize the integration, optimization, and stable grid connection of producers and consumers.

Keywords: Cournot games, power market, uncertainty, prosumer cooperation

Procedia PDF Downloads 104

Authors: Y. P. Raghavendra Babu

Abstract:

Electrocution is a common cause of morbidity and mortality as electricity is an indispensible part of today’s World. Deaths due to electrocution which are witnessed do not pose a problem at the manner and cause of death. However un-witnessed deaths can raise suspicion of manner of death. A case of fatal electrocution is reported here which was diagnosed to be accidental in manner with the help of reconstruction of events by proper investigation.

Keywords: electrocution, manner of death, reconstruction of events, health information

Procedia PDF Downloads 258

Authors: Shirley Lamptey, Lingling Li, Junhong Xie

Abstract:

Agriculture in the semi-arid is often challenged by overuse of N, inadequate soil water, and heavy carbon emissions thereby threatening sustainability. Field experiments were conducted to investigate the effect of nitrogen fertilization levels (0-N₀, 100-N₁₀₀, 200-N₂₀₀, and 300 kg ha⁻¹-N₃₀₀) on soil water dynamics, soil respiration (Rs), net ecosystem production (NEP), and biomass yield. Zero nitrogen soils decreased Rs by 23% and 16% compared to N₃₀₀ and N₂₀₀ soils, respectively. However, biomass yield was greatest under N₃₀₀ compared with N₀, which therefore translated into increased net primary production (NPP) by 89% and NEP by 101% compared to N₀. To a lesser extent, N₂₀₀ increased net primary production by 69% and net ecosystem production by 79% compared to N₀. Grain yields were greatest under N₃₀₀ compared with N₁₀₀ and N₀, which therefore translated into increased carbon emission efficiency (CEE) by 53%, 39% and 3% under N₃₀₀ compared to N₀, N₁₀₀, and N₂₀₀ treatments respectively. Under the conditions of this study, crop yield and CEE may be optimized at nitrogen application rates in the range of 200-300 kg ha⁻¹. Based on these results, there appears potential for 200 kg N ha⁻¹ to be used to improve yield and increase CEE in the context of the rainfall-limiting environment.

Keywords: carbon emission, carbon emission efficiency, C sequestration, N rates, semi-arid

Procedia PDF Downloads 234

Authors: Nighat Bakhtiar, Ali Raza Khan, Shahid Khan Khattak, Aamir Ali Syed

Abstract:

Introduction: Chemoradiation followed by resection has been the standard therapy for resectable (cT1-4aN0-3M0) esophageal carcinoma. The optimal surgical approach remains a matter of debate. Therefore, the purpose of this study was to share our experiences of minimal invasive esophagectomies concerning morbidity, mortality and oncological quality. This study aims to enlighten the world about the surgical outcomes after minimally invasive esophagectomy at Shaukat Khanum Hospital Lahore. Objective: The purpose of this study is to review an institutional experience of Surgical outcomes of Minimal Invasive esophagectomies for esophageal cancer. Methodology: This retrospective study was performed after ethical approval at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) Pakistan. Patients who underwent Minimal Invasive esophagectomies for esophageal cancer from March 2018 to March 2023 were selected. Data was collected through the human information system (HIS) electronic database of SKMCH&RC. Data was described using mean and median with minimum and maximum values for quantitative variables. For categorical variables, a number of observations and percentages were reported. Results: A total of 621 patients were included in the study, with the mean age of the patient was 39 years, ranging between 18-58 years. Mean Body Mass Index of patients was 21.2.1±4.1. Neo-adjuvant chemoradiotherapy was given to all patients. The mean operative time was 210.36 ± 64.51 minutes, and the mean blood loss was 121 milliliters. There was one mortality in 90 days, while the mean postoperative hospital stay was 6.58 days with a 4.64 standard deviation. The anastomotic leak rate was 4.2%. Chyle leak was observed in 12 patients. Conclusion: The minimal invasive technique is a safe approach for esophageal cancers, with minimal complications and fast recovery.

Keywords: minimal invasive, esophagectomy, laparscopic, cancer

Procedia PDF Downloads 69

Authors: Sevda Engin, Ugur Buyuk, Necmettin Marasli

Abstract:

Directional solidification of eutectic alloys attracts considerable attention because of microhardness, tensile strength, and electrical resistivity influenced by eutectic structures. In this research, we examined processing of Al–Si–Fe (Al–11.7wt.%Si–1wt.%Fe) eutectic by directional solidification. The alloy was prepared by vacuum furnace and directionally solidified in Bridgman-type equipment. During the directional solidification process, the growth rates utilized varied from 8.25 m/s to 164.80 m/s. The Al–Si–Fe system showed an eutectic transformation, which resulted in the matrix Al, Si and Al5SiFe plate phases. The eutectic spacing between (λ_Si-λ_Si, λ_(Al_5 SiFe)-λ_(Al_5 SiFe)) was measured. Additionally, the microhardness, tensile strength, and electrical resistivity of the alloy were determined using directionally solidified samples. The effects of growth rates on microhardness, tensile strength, and electrical resistivity for directionally solidified Al–Si–Fe eutectic alloy were investigated, and the relationships between them were experimentally obtained. It was found that the microhardness, tensile strength, and electrical resistivity were affected by both eutectic spacing and the solidification parameter.

Keywords: directional solidification, aluminum alloy, microstructure, electrical properties, tensile test, hardness test

Procedia PDF Downloads 292

Authors: Yasir Naseem

Abstract:

In this fast-growing and evolving world, usage and adoption of technology have displayed an essential component of the learning process, both in and out of the class, which converges and incorporates every domain of the learning aspects. It aids in learning distinct entities irrespective of their levels of challenge. It also incorporates both viewpoints of learning, i.e., competence as well as the performances of the learner. In today's learning scenario, nearly every language class ordinarily uses some form of technology. It integrates with various teaching methodologies and transforms in a way that now it grew as an integral part of the language learning courses. It has been employed to facilitate, promote, and enhances language learning. It facilitates educators in numerous ways and enhances their methodologies by equipping them to modify classroom activities, which covers every aspect of language learning.

Keywords: communication, methodology, technology, skills

Procedia PDF Downloads 169

Authors: Liong-Rung Liu, Yu-Hui Chiu, Wen-Han Chang

Abstract:

Firearm injuries are high-energy injuries. The ballistic pathways could cause severe burns or chemical damages to vessels, musculoskeletal or other major organs. The high mortality rate is accompanied by complications such as sepsis. As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at the center of Taipei city is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in Taiwan. To author’s best knowledge, there are few published research articles regarding this unique situation. We hereby analyze the distinct characteristics and length of stay (LOS) of GSW patients in the emergency room (ER) at Mackay Memorial Hospital. A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for the following analyses, 1) wound position and the correlated clinical presentations; 2) the LOS in ED of patients receiving emergency surgery for major organ or vascular injuries. We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities. With regards to the ER LOS, the average time were 72.2 ± 34.5 minutes for patients with triage I and 207.4 ± 143.9 minutes for patients with triage II. The ED LOS of patients whose ISS score were more than 15 was 59.9 ± 25.6 minutes, and 179.4 ± 119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 10 patients had emergency surgery and their average ED stay time was 104.5 ± 33.3 minutes. Even more, the average ED stay time could be shortened to 88.8 ± 32.3 minutes in the 5 patients with trauma team activation. In conclusion, trauma team activation in severe GSW patients indeed shortens the ED LOS and might initially improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and acute care surgical management.

Keywords: gunshot, length of stay, trauma, mortality

Procedia PDF Downloads 130

Authors: Stella O. Olubodun, George E. Eriyamremu

Abstract:

The study assessed the effect of crude oil applied at rates, 0, 2, 5, and 10% on the fractional chemical forms and availability of some metals in soils from Usen, Edo State, with no known crude oil contamination and soil from a crude oil spill site in Ubeji, Delta State, Nigeria. Three methods were used to determine the bioavailability of metals in the soils: maize (Zea mays) plant, EDTA and BCR sequential extraction. The sequential extract acid soluble fraction of the BCR extraction (most labile fraction of the soils, normally associated with bioavailability) were compared with total metal concentration in maize seedlings as a means to compare the chemical and biological measures of bioavailability. Total Fe was higher in comparison to other metals for the crude oil contaminated soils. The metal concentrations were below the limits of 4.7% Fe, 190mg/kg Cu and 720mg/kg Zn intervention values and 36mg/kg Cu and 140mg/kg Zn target values for soils provided by the Department of Petroleum Resources (DPR) guidelines. The concentration of the metals in maize seedlings increased with increasing rates of crude oil contamination. Comparison of the metal concentrations in maize seedlings with EDTA extractable concentrations showed that EDTA extracted more metals than maize plant.

Keywords: availability, crude oil contamination, EDTA, maize, metals

Procedia PDF Downloads 222

Authors: J. Waita, S. Wamuhu, J. Makoyo, M. Rachel, T. Ngangari, W. Christine, M. Zipporah

Abstract:

Contraceptive use is one of the key global strategies to alleviate maternal mortality. Global efforts through advocating for contraceptive uptake and service provision has led improved contraceptive prevalence. In Kenya maternal mortality rate has remained a challenged despites efforts by government and non-governmental organizations. Objective: To describe the uptake of contraceptives among women in Tunza Clinics, Kenya. Design and Methods: Ps Kenya through health care marketing fund is implementing a family planning program among its 350 Tunza fractional franchise facilities. Through private partnership, private owned facilities in low socio-economic areas are recruited and trained on contraceptive technology update. The providers are supported through facilitative supervision through a mobile based application Health Network Quality Improvement System (HNQIS) and interpersonal communication through 150 community based volunteers. The data analyzed in this paper was collected between January to July 2017 to show the uptake of modern Contraceptives among women in the Tunza franchise, method mix, age and distribution among the age bracket. Further analysis compares two different service delivery strategies; outreach and walk ins. Supportive supervision HNQIS scores was analyzed. Results: During the time period, a total of 132121 family planning clients were attended in 350 facilities. The average age of clients was 29.6 years. The average number of clients attended in the facilities per month was 18874. 73.7 %( n=132121) of the clients attended in the Tunza facilities were aged above 25 years while 22.1% 20-24 years and 4.2% 15-19 years. On contraceptive method mix, intra uterine device insertions clients contributed to 7.5%, implant insertions 15.3%, pills 11.2%, injections 62.7% while condoms and emergency pills had 2.7% and 0.6% respectively. Analysis of service delivery strategy indicated more than 79% of the clients were walk ins while 21% were attended to during outreaches. Uptake of long term contraceptive methods during outreaches was 73% of the clients while short term modern methods were 27%. Health Network Quality Improvement system assessment scores indicated 51% of the facilities scored over 90%, 25% scoring 80-89% while 21% scored below 80%. Conclusion: Preference for short term methods by women is possibly associated to cost as they are cheaper and easy to administer. When the cost of intra uterine device Implants is meant affordable during outreaches, the uptake is observed to increase. Making intra uterine device and implants affordable to women is a key strategy in increasing contraceptive prevalence hence averting maternal mortality.

Keywords: contraceptives, contraceptive uptake, low socio economic, supportive supervision

Procedia PDF Downloads 165

Authors: A. M. El-Aziz, M. Elsehamy, H. Hussein

Abstract:

Steel or stainless steel have reasonable corrosion behavior in water, their corrosion resistance is significantly dependent on the water purity. It was not expected that demineralized water has an aggressive effect on steel alloys, in this study, the effect of water with different purity on steel X52 and stainless steel 316L was investigated. Weight loss and electrochemical measurements were employed to measure the corrosion behavior. Samples were microscopically investigated after test. It was observed that the higher the water purity the more reactive it is. Comparative analysis of the potentiodynamic curves for different water purity showed the aggressiveness of the demineralised water (conductivity of 0.05 microSiemens per cm) over the distilled water. Whereas, the corrosion rates of stainless steel 858 and 623 nm/y for demi and distilled water respectively. On the other hand, the corrosion rates of carbon steel x52 were estimated about 4.8 and 3.6 µm/y for demi and distilled water, respectively. Open circuit potential (OCP) recorded more positive potentials in case of stainless steel than carbon steel in different water purities. Generally, stainless steel illustrated high pitting resistance than carbon steel alloy, the surface film was investigated by scanning electron microscopy (SEM) and analyzed by energy dispersive X-ray spectroscopy (EDX). This behavior was explained based on that demi and distilled water might be considered as ‘hungry water’ in which it wants to be in equilibrium and will pull ions out of the surrounding metals trying to satisfy its ‘hunger’.

Keywords: corrosion, demineralized water, distilled water, steel alloys

Procedia PDF Downloads 801

Authors: Monalisha Ghosh, Asit Mohanty

Abstract:

The lack of sanitation increases living costs, decreases spend on education and nutrition, lowers income earning potential, and threatens safety and welfare. This is especially true for rural India. Only 32% of rural households have their own toilets and that less than half of Indian households have a toilet at home. Of the estimated billion people in the world who defecate in the open, more than half reside in rural India. It is empirically established that poor sanitation leads to high infant mortality rate and low income generation in rural India. In India, 1,600 children die every day before reaching their fifth birthday and 24% of girls drop out of school as the lack of basic sanitation. Above all, lack of sanitation is not a symptom of poverty but a major contributing factor. According to census 2011, 67.3% of the rural households in the country still did not have access to sanitation facilities. India’s sanitation deficit leads to losses worth roughly 6% of its gross domestic product (GDP) according to World Bank estimates by raising the disease burden in the country. The dropout rate for girl child is thirty percent in schools in rural areas because of lack of sanitation facilities for girl students. The productivity loss per skilled labors during a year is calculated at Rs.44, 160 in Odisha. The performance of the state of Odisha has not been satisfactory in improving sanitation facilities. The biggest challenge is triggering behavior change in vast section of rural population regarding need to use toilets. Another major challenge is funding and implementation for improvement of sanitation facility. In an environment of constrained economic resources, Public Private Partnership in form of performance based management or maintenance contract will be all the more relevant to improve the sanitation status in rural sector.

Keywords: rural sanitation, infant mortality rate, income, granger causality, pooled OLS method test public private partnership

Procedia PDF Downloads 416