Search results for: internal iliac artery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2691

Search results for: internal iliac artery

1851 Improving 99mTc-tetrofosmin Myocardial Perfusion Images by Time Subtraction Technique

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

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1850 High Viscous Oil–Water Flow: Experiments and CFD Simulations

Authors: A. Archibong-Eso, J. Shi, Y Baba, S. Alagbe, W. Yan, H. Yeung

Abstract:

This study presents over 100 experiments conducted in a 25.4 mm internal diameter (ID) horizontal pipeline. Oil viscosity ranging from 3.5 Pa.s–5.0 Pa.s are used with superficial velocities of oil and water ranging from 0.06 to 0.55 m/s and 0.01 m/s to 1.0 m/s, respectively. Pressure gradient measurements and flow pattern observations are discussed. Numerical simulation of some flow conditions is performed using the commercial CFD code ANSYS Fluent® and the simulation results are compared with experimental results. Results indicate that CFD numerical simulation performed moderately well in predicting the flow configurations observed in this study while discrepancies were observed in the pressure gradient predictions.

Keywords: flow patterns, plug, pressure gradient, rivulet

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1849 Post 2014 Afghanistan and Its Implications on Pakistan

Authors: Naad-E-Ali Sulehria

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This paper unfolds the facts and findings of Afghan scenario particularly its implications on Pakistan. At present, the Post 2014 withdrawal of US and ISAF combat forces from Afghan land is one of the up-to-the-minute issues among analysts of international relations. Deliberating from the current situation of Afghanistan towards its future prospects and the elements vibrating Afghanistan's internal dynamics, as well as exploitation of its resources by other states and non-state actors, are discussed accordingly. Moreover, the reasons behind such a paradigm shift in US foreign policy are tried to be contemplated with first hand knowledge. It is investigated that 'what is the current image of Afghanistan in today's world?', 'what will be its future aspects?', and 'what sort of Afghanistan does Pakistan foresees' as the concerned area of discussion.

Keywords: Afghanistan, Pakistan, new great game, taliban

Procedia PDF Downloads 281
1848 Study the Behavior of Different Composite Short Columns (DST) with Prismatic Sections under Bending Load

Authors: V. Sadeghi Balkanlou, M. Reza Bagerzadeh Karimi, A. Hasanbakloo, B. Bagheri Azar

Abstract:

In this paper, the behavior of different types of DST columns has been studied under bending load. Briefly, composite columns consist of an internal carbon steel tube and an external stainless steel wall that the between the walls are filled with concrete. Composite columns are expected to combine the advantages of all three materials and have the advantage of high flexural stiffness of CFDST columns. In this research, ABAQUS software is used for finite element analysis then the results of ultimate strength of the composite sections are illustrated.

Keywords: DST, stainless steel, carbon steel, ABAQUS, straigh columns, tapered columns

Procedia PDF Downloads 364
1847 Causes of Nigeria Unrest and Conflict Situation

Authors: Victor Osaghae

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In 2005, the CIA published a report warning that Nigeria, the seventh most populous country in the world, could disintegrate within 15 years. Nigeria experiences civil unrest, violence and strikes. Nigeria has one of the highest rates of internal violence in the world, only unlike others with similar levels of bloodshed such as Colombia or Chechnya, there is not a civil war going on. The types of unrest observed in Nigeria from literatures consulted can be categorized into five namely: religious, social, political, labour, and communal or ethnic unrests. The cuases of the unrests are as follows: injustice, unemployment, religious intolerance, illiteracy and government not filling agreements reached with unions. The cost due to these unrests cannot be quantified because it affects human, material/properties and money.

Keywords: unrest, conflicts, Boko Haram, disturbance

Procedia PDF Downloads 367
1846 Young Female’s Heart Was Bitten by Unknown Ghost (Isolated Cardiac Sarcoidosis): A Case Report

Authors: Heru Al Amin

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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 68
1845 Upside Down Words as Initial Clinical Presentation of an Underlying Acute Ischemic Stroke

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

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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

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1844 Detection of Powdery Mildew Disease in Strawberry Using Image Texture and Supervised Classifiers

Authors: Sultan Mahmud, Qamar Zaman, Travis Esau, Young Chang

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Strawberry powdery mildew (PM) is a serious disease that has a significant impact on strawberry production. Field scouting is still a major way to find PM disease, which is not only labor intensive but also almost impossible to monitor disease severity. To reduce the loss caused by PM disease and achieve faster automatic detection of the disease, this paper proposes an approach for detection of the disease, based on image texture and classified with support vector machines (SVMs) and k-nearest neighbors (kNNs). The methodology of the proposed study is based on image processing which is composed of five main steps including image acquisition, pre-processing, segmentation, features extraction and classification. Two strawberry fields were used in this study. Images of healthy leaves and leaves infected with PM (Sphaerotheca macularis) disease under artificial cloud lighting condition. Colour thresholding was utilized to segment all images before textural analysis. Colour co-occurrence matrix (CCM) was introduced for extraction of textural features. Forty textural features, related to a physiological parameter of leaves were extracted from CCM of National television system committee (NTSC) luminance, hue, saturation and intensity (HSI) images. The normalized feature data were utilized for training and validation, respectively, using developed classifiers. The classifiers have experimented with internal, external and cross-validations. The best classifier was selected based on their performance and accuracy. Experimental results suggested that SVMs classifier showed 98.33%, 85.33%, 87.33%, 93.33% and 95.0% of accuracy on internal, external-I, external-II, 4-fold cross and 5-fold cross-validation, respectively. Whereas, kNNs results represented 90.0%, 72.00%, 74.66%, 89.33% and 90.3% of classification accuracy, respectively. The outcome of this study demonstrated that SVMs classified PM disease with a highest overall accuracy of 91.86% and 1.1211 seconds of processing time. Therefore, overall results concluded that the proposed study can significantly support an accurate and automatic identification and recognition of strawberry PM disease with SVMs classifier.

Keywords: powdery mildew, image processing, textural analysis, color co-occurrence matrix, support vector machines, k-nearest neighbors

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1843 Thermal Analysis of a Composite of Coco Fiber and Látex

Authors: Elmo Thiago Lins Cöuras Ford, Valentina Alessandra Carvalho do Vale

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Given the unquestionable need of environmental preservation, the natural fibers have been seen as a salutary alternative for production of composites in substitution to the synthetic fibers, vitreous and metallic. In this work, the behavior of a composite was analyzed done with fiber of the peel of the coconut as reinforcement and latex as head office, when submitted the source of heat. The temperature profiles were verified in the internal surfaces and it expresses of the composite as well as the temperature gradient in the same. It was also analyzed the behavior of this composite when submitted to a cold source. As consequence, in function of the answers of the system, conclusions were reached.

Keywords: natural fiber, composite, temperature, latex, gradient

Procedia PDF Downloads 787
1842 Development of Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Guideline Adherence in Emergency Department: Modified Delphi Study

Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor

Abstract:

Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.

Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan

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1841 Unsteady Reactive Hydromagnetic Fluid Flow of a Two-Step Exothermic Chemical Reaction through a Channel

Authors: J. A. Gbadeyan, R. A. Kareem

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In this paper, we investigated the effects of unsteady internal heat generation of a two-step exothermic reactive hydromagnetic fluid flow under different chemical kinetics namely: Sensitized, Arrhenius and Bimolecular kinetics through an isothermal wall temperature channel. The resultant modeled nonlinear partial differential equations were simplified and solved using a combined Laplace-Differential Transform Method (LDTM). The solutions obtained were discussed and presented graphically to show the salient features of the fluid flow and heat transfer characteristics.

Keywords: unsteady, reactive, hydromagnetic, couette ow, exothermi creactio

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1840 Rare Internal Organ Trauma in Adolescent Athletes: Insights from a Pancreatic Injury Case Study

Authors: Muhandiram Rallage Ruvini Nisansala Yatigammana, Anuruddhika Kumudu Kumari Rajakaruna Jayathilaka

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Sports injuries are common among teenagers and children engaged in organized sports. While most sports injuries are typical, some rare occurrences involve conditions such as eye, dental, cervical, and rare internal organ injuries, such as pancreatic injuries. These injuries, especially traumatic pancreatitis, require prompt attention due to their potential for severe and sometimes fatal complications. This case revolves around a real accident involving a 12-year-old girl, Piyumi, who suffered a face-to-face collision during netball practice, resulting in severe abdominal pain. After a medical examination, she was diagnosed with a rare pancreatic injury, uncommon in children compared to adults. In Piyumi’s case, she had a grade 3 pancreatic injury and underwent non-surgical management, successfully healing her wound without surgery. The study attempts to fill empirical and population gaps, addressing a rarely discussed injury experienced by a 12-year-old female netball player. The paper will also provide an in-depth understanding of pancreatic injury, which is a rare sports injury. The study’s main objective was to investigate the incidence and characteristics of pancreatic injury, particularly focusing on pancreatic trauma, among children and adolescents engaged in high-impact sports, such as netball. This research adopted a case study strategy, employing interviews as the primary data collection method. Interviews were conducted with Piyumi, her parents, and the two specialist doctors directly involved in her treatment, providing firsthand accounts and insights. By examining the case, the paper arrives at three main conclusions. Firstly, pancreatic damage is uncommon, especially in the sports world, and proper diagnosis is essential to avoiding health concerns, particularly for minors. Secondly, CT (Computed Tomography) was useful in locating the injury, as injuries can be diagnosed very well with Computed Tomography (CT) images. Finally, and most importantly, pancreatic injuries are infrequent, but trauma can still occur, particularly in high-impact sports or accidents involving extreme force or falls. These injuries should be accurately diagnosed and treated promptly.

Keywords: child athlete, pancreatic injury, rare sports injuries, sportswoman

Procedia PDF Downloads 53
1839 Towards Sustainable Concrete: Maturity Method to Evaluate the Effect of Curing Conditions on the Strength Development in Concrete Structures under Kuwait Environmental Conditions

Authors: F. Al-Fahad, J. Chakkamalayath, A. Al-Aibani

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Conventional methods of determination of concrete strength under controlled laboratory conditions will not accurately represent the actual strength of concrete developed under site curing conditions. This difference in strength measurement will be more in the extreme environment in Kuwait as it is characterized by hot marine environment with normal temperature in summer exceeding 50°C accompanied by dry wind in desert areas and salt laden wind on marine and on shore areas. Therefore, it is required to have test methods to measure the in-place properties of concrete for quality assurance and for the development of durable concrete structures. The maturity method, which defines the strength of a given concrete mix as a function of its age and temperature history, is an approach for quality control for the production of sustainable and durable concrete structures. The unique harsh environmental conditions in Kuwait make it impractical to adopt experiences and empirical equations developed from the maturity methods in other countries. Concrete curing, especially in the early age plays an important role in developing and improving the strength of the structure. This paper investigates the use of maturity method to assess the effectiveness of three different types of curing methods on the compressive and flexural strength development of one high strength concrete mix of 60 MPa produced with silica fume. This maturity approach was used to predict accurately, the concrete compressive and flexural strength at later ages under different curing conditions. Maturity curves were developed for compressive and flexure strengths for a commonly used concrete mix in Kuwait, which was cured using three different curing conditions, including water curing, external spray coating and the use of internal curing compound during concrete mixing. It was observed that the maturity curve developed for the same mix depends on the type of curing conditions. It can be used to predict the concrete strength under different exposure and curing conditions. This study showed that concrete curing with external spray curing method cannot be recommended to use as it failed to aid concrete in reaching accepted values of strength, especially for flexural strength. Using internal curing compound lead to accepted levels of strength when compared with water cuing. Utilization of the developed maturity curves will help contactors and engineers to determine the in-place concrete strength at any time, and under different curing conditions. This will help in deciding the appropriate time to remove the formwork. The reduction in construction time and cost has positive impacts towards sustainable construction.

Keywords: curing, durability, maturity, strength

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1838 Antimicrobial, Antioxidant and Enzyme Activities of Geosmithia pallida (KU693285): A Fungal Endophyte Associated with Brucea mollis Wall Ex. Kurz, an Endangered and Medicinal Plant of N. E. India

Authors: Deepanwita Deka, Dhruva Kumar Jha

Abstract:

Endophytes are the microbes that colonize living, internal tissues of plants without causing any immediate, overt negative effects. Endophytes are rich source of therapeutic substances like antimicrobial, anticancerous, herbicidal, insecticidal, immunomodulatory compounds. Brucea mollis, commonly known as Quinine in Assam, belonging to the family Simaroubaceae, is a shrub or small tree, recorded as endangered species in North East India by CAMP survey in 2003. It is traditionally being used as antimalarial and antimicrobial agent and has antiplasmodial, cytotoxic, anticancer, diuretic, cardiovascular effect etc. Being endangered and medicinal; this plant may host certain noble endophytes which need to be studied in depth. The aim of the present study was isolation and identification of potent endophytic fungi from Brucea mollis, an endangered medicinal plant, to protect it from extinction due to over use for medicinal purposes. Aseptically collected leaves, barks and roots samples of healthy plants were washed and cut into a total of 648 segments of about 2 cm long and 0.5 cm broad with sterile knife, comprising 216 segments each from leaves, barks and roots. These segments were surface sterilized using ethanol, mercuric chloride (HgCl2) and aqueous solution of sodium hypochlorite (NaClO). Different media viz., Czapeck-Dox-Agar (CDA, Himedia), Potato-Dextrose-Agar (PDA, Himedia), Malt Extract Agar (MEA, Himedia), Sabourad Dextrose Agar (SDA, Himedia), V8 juice agar, nutrient agar and water agar media and media amended with plant extracts were used separately for the isolation of the endophytic fungi. A total of 11 fungal species were recovered from leaf, bark and root tissues of B. mollis. The isolates were screened for antimicrobial, antioxidant and enzymatic activities using certain protocols. Cochliobolus geniculatus was identified as the most dominant species. The mycelia sterilia (creamy white) showing highest inhibitory activity against Candida albicans (MTCC 183) was induced to sporulate using modified PDA media. The isolate was identified as Geosmithia pallida. The internal transcribed spacer of rDNA was sequenced for confirmation of the taxonomic identity of the sterile mycelia (creamy white). The internal transcribed spacer r-DNA sequence was submitted to the NCBI (KU693285) for the first time from India. G. pallida and Penicillium showed highest antioxidant activity among all the isolates. The antioxidant activity of G. pallida and Penicillium didn’t show statistically significant difference (P˃0.05). G. pallida, Cochliobolus geniculatus and P. purpurogenum respectively showed highest cellulase, amylase and protease activities. Thus, endopytic fungal isolates may be used as potential natural resource of pharmaceutical importance. The endophytic fungi, Geosmithia pallida, may be used for synthesis of pharmaceutically important natural products and consequently can replace plants hitherto used for the same purpose. This study suggests that endophytes should be investigated more aggressively to better understand the endophyte biology of B. mollis.

Keywords: Antimicrobial activity, antioxidant activity, Brucea mollis, endophytic fungi, enzyme activity, Geosmithia pallida

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1837 Sediment Wave and Cyclic Steps as Mechanism for Sediment Transport in Submarine Canyons Thalweg

Authors: Taiwo Olusoji Lawrence, Peace Mawo Aaron

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Seismic analysis of bedforms has proven to be one of the best ways to study deepwater sedimentary features. Canyons are known to be sediment transportation conduit. Sediment wave are large-scale depositional bedforms in various parts of the world's oceans formed predominantly by suspended load transport. These undulating objects usually have tens of meters to a few kilometers in wavelength and a height of several meters. Cyclic steps have long long-wave upstream-migrating bedforms confined by internal hydraulic jumps. They usually occur in regions with high gradients and slope breaks. Cyclic steps and migrating sediment waves are the most common bedform on the seafloor. Cyclic steps and related sediment wave bedforms are significant to the morpho-dynamic evolution of deep-water depositional systems architectural elements, especially those located along tectonically active margins with high gradients and slope breaks that can promote internal hydraulic jumps in turbidity currents. This report examined sedimentary activities and sediment transportation in submarine canyons and provided distinctive insight into factors that created a complex seabed canyon system in the Ceara Fortaleza basin Brazilian Equatorial Margin (BEM). The growing importance of cyclic steps made it imperative to understand the parameters leading to their formation, migration, and architecture as well as their controls on sediment transport in canyon thalweg. We extracted the parameters of the observed bedforms and evaluated the aspect ratio and asymmetricity. We developed a relationship between the hydraulic jump magnitude, depth of the hydraulic fall and the length of the cyclic step therein. It was understood that an increase in the height of the cyclic step increases the magnitude of the hydraulic jump and thereby increases the rate of deposition on the preceding stoss side. An increase in the length of the cyclic steps reduces the magnitude of the hydraulic jump and reduces the rate of deposition at the stoss side. Therefore, flat stoss side was noticed at most preceding cyclic step and sediment wave.

Keywords: Ceara Fortaleza, submarine canyons, cyclic steps, sediment wave

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1836 Monitoring Land Cover/Land Use Change in Rupandehi District by Optimising Remotely Sensed Image

Authors: Hritik Bhattarai

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Land use and land cover play a crucial role in preserving and managing Earth's natural resources. Various factors, such as economic, demographic, social, cultural, technological, and environmental processes, contribute to changes in land use and land cover (LULC). Rupandehi District is significantly influenced by a combination of driving forces, including its geographical location, rapid population growth, economic opportunities, globalization, tourism activities, and political events. Urbanization and urban growth in the region have been occurring in an unplanned manner, with internal migration and natural population growth being the primary contributors. Internal migration, particularly from neighboring districts in the higher and lower Himalayan regions, has been high, leading to increased population growth and density. This study utilizes geospatial technology, specifically geographic information system (GIS), to analyze and illustrate the land cover and land use changes in the Rupandehi district for the years 2009 and 2019, using freely available Landsat images. The identified land cover categories include built-up area, cropland, Das-Gaja, forest, grassland, other woodland, riverbed, and water. The statistical analysis of the data over the 10-year period (2009-2019) reveals significant percentage changes in LULC. Notably, Das-Gaja shows a minimal change of 99.9%, while water and forest exhibit increases of 34.5% and 98.6%, respectively. Riverbed and built-up areas experience changes of 95.3% and 39.6%, respectively. Cropland and grassland, however, show concerning decreases of 102.6% and 140.0%, respectively. Other woodland also indicates a change of 50.6%. The most noteworthy trends are the substantial increase in water areas and built-up areas, leading to the degradation of agricultural and open spaces. This emphasizes the urgent need for effective urban planning activities to ensure the development of a sustainable city. While Das-Gaja seems unaffected, the decreasing trends in cropland and grassland, accompanied by the increasing built-up areas, are unsatisfactory. It is imperative for relevant authorities to be aware of these trends and implement proactive measures for sustainable urban development.

Keywords: land use and land cover, geospatial, urbanization, geographic information system, sustainable urban development

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1835 The Importance of Supply Chain Management in Prosperity of Organizations

Authors: Seyedeza Baharisaravi

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As we know, we are living in the hyper competitive environment and all of companies strive hard to engross more and more customers. Thus, in this milieu, we should produce and deliver diverse commodities, regarding with the consumers' interests. So, all companies elicit that they should pay attention on the external resources besides the internal ones. Hence, the meaning of supply chain management has been introduced as a fundamental issue for global e-business, e-commerce and e-government. The present paper explains prominences, challenges, keys, various descriptions, advantages and disadvantages, globalization and the future of one of the vital issues in the business realm which is supply chain management (SCM). This issue is one of the newest concepts of business science that has transformed the essence of every business and attitude of marketers.

Keywords: SCM concepts, supply chain management, the importance of SCM, SCM in organization

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1834 Developing the Collaboration Model of Physical Education and Sport Sciences Faculties with Service Section of Sport Industrial

Authors: Vahid Saatchian, Seyyed Farideh Hadavi

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The main aim of this study was developing the collaboration model of physical education and sport sciences faculties with service section of sport industrial.The research methods of this study was a qualitative. So researcher with of identifying the priority list of collaboration between colleges and service section of sport industry and according to sampling based of subjective and snowball approach, conducted deep interviews with 22 elites that study around the field of research topic. indeed interviews were analyzed through qualitative coding (open, axial and selective) with 5 category such as causal condition, basic condition, intervening conditions, action/ interaction and strategy. Findings exposed that in causal condition 10 labels appeared. So because of heterogeneity of labes, researcher categorized in total subject. In basic condition 59 labels in open coding identified this categorized in 14 general concepts. Furthermore with composition of the declared category and relationship between them, 5 final and internal categories (culture, intelligence, marketing, environment and ultra-powers) were appeared. Also an intervening condition in the study includes 5 overall scopes of social factors, economic, cultural factors, and the management of the legal and political factors that totally named macro environment. Indeed for identifying strategies, 8 areas that covered with internal and external challenges relationship management were appeared. These are including, understanding, outside awareness, manpower, culture, integrated management, the rules and regulations and marketing. Findings exposed 8 labels in open coding which covered the internal and external of challenges of relation management of two sides and these concepts were knowledge and awareness, external view, human source, madding organizational culture, parties’ thoughts, unit responsible for/integrated management, laws and regulations and marketing. Eventually the consequences categorized in line of strategies and were at scope of the cultural development, general development, educational development, scientific development, under development, international development, social development, economic development, technology development and political development that consistent with strategies. The research findings could help the sport managers witch use to scientific collaboration management and the consequences of this in those sport institutions. Finally, the consequences that identified as a result of the devopmental strategies include: cultural, governmental, educational, scientific, infrastructure, international, social, economic, technological and political that is largely consistent with strategies. With regard to the above results, enduring and systematic relation with long term cooperation between the two sides requires strategic planning were based on cooperation of all stakeholders. Through this, in the turbulent constantly changing current sustainable environment, competitive advantage for university and industry obtained. No doubt that lack of vision and strategic thinking for cooperation in the planning of the university and industry from its capability and instead of using the opportunity, lead the opportunities to problems.

Keywords: university and industry collaboration, sport industry, physical education and sport science college, service section of sport industry

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1833 Multiscale Modelling of Citrus Black Spot Transmission Dynamics along the Pre-Harvest Supply Chain

Authors: Muleya Nqobile, Winston Garira

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We presented a compartmental deterministic multi-scale model which encompass internal plant defensive mechanism and pathogen interaction, then we consider nesting the model into the epidemiological model. The objective was to improve our understanding of the transmission dynamics of within host and between host of Guignardia citricapa Kiely. The inflow of infected class was scaled down to individual level while the outflow was scaled up to average population level. Conceptual model and mathematical model were constructed to display a theoretical framework which can be used for predicting or identify disease pattern.

Keywords: epidemiological model, mathematical modelling, multi-scale modelling, immunological model

Procedia PDF Downloads 436
1832 Assessment of the State of Hygiene in a Tunisian Hospital Kitchen: Interest of Mycological and Parasitological Samples from Food Handlers and Environment

Authors: Bouchekoua Myriam, Aloui Dorsaf, Trabelsi Sonia

Abstract:

Introduction Food hygiene in hospitals is important, particularly among patients who could be more vulnerable than healthy subjects to microbiological and nutritional risks. The consumption of contaminated food may be responsible for foodborne diseases, which can be severe among hospitalized patients, especially those immunocompromised. The aim of our study was to assess the state of hygiene in the internal catering department of a Tunisian hospital. Methodology and major results: A prospective study was conducted for one year in the Parasitology-Mycology laboratory of Charles Nicolle Hospital. Samples were taken from the kitchen staff, worktops, and cooking utensils used in the internal catering department. Thirty one employees have benefited from stool exams and scotch tape in order to evaluate the degree of infestation of parasites. 35% of stool exams were positive. Protozoa were the only parasites detected. Blastocystis sp was the species mostly found in nine food handlers. Its role as a human pathogen is still controversial. Pathogenic protozoa were detected in two food handlers (Giardia intestinalis in one person and Dientamoeba fragilis in the other one. Non-pathogenic protozoa were found in two cases; among them, only one had digestive symptoms without a statistically significant association with the carriage of intestinal parasites. Moreover, samples were performed from the hands of the staff in order to search for a fungal carriage. Thus, 25 employees (81%) were colonized by fungi, including molds. Besides, mycological examination among food handlers with a suspected dermatomycosis for diagnostic confirmation concluded foot onychomycosis in 32% of cases and interdigital intertrigo in 26%. Only one person had hand onychomycosis. Among the 17 samples taken from worktops and kitchen utensils, fungal contamination was detected in 13 sites. Hot and cold equipment were the most contaminated. Molds were mainly identified as belonging to five different genera. Cladosporium sp was predominant. Conclusion: In the view of the importance of intestinal parasites among food handlers, the intensity of fungi hand carriage among these employees, and the high level of fungal contamination in worktops and kitchen utensils, a reinforcement of hygiene measures is more than essential in order to minimize the alimentary contamination-risk.

Keywords: hospital kitchen, environment, intestinal parasitosis, fungal carriage, fungal contamination

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1831 The Impact of External Technology Acquisition and Exploitation on Firms' Process Innovation Performance

Authors: Thammanoon Charmjuree, Yuosre F. Badir, Umar Safdar

Abstract:

There is a consensus among innovation scholars that knowledge is a vital antecedent for firm’s innovation; e.g., process innovation. Recently, there has been an increasing amount of attention to more open approaches to innovation. This open model emphasizes the use of purposive flows of knowledge across the organization boundaries. Firms adopt open innovation strategy to improve their innovation performance by bringing knowledge into the organization (inbound open innovation) to accelerate internal innovation or transferring knowledge outside (outbound open innovation) to expand the markets for external use of innovation. Reviewing open innovation research reveals the following. First, the majority of existing studies have focused on inbound open innovation and less on outbound open innovation. Second, limited research has considered the possible interaction between both and how this interaction may impact the firm’s innovation performance. Third, scholars have focused mainly on the impact of open innovation strategy on product innovation and less on process innovation. Therefore, our knowledge of the relationship between firms’ inbound and outbound open innovation and how these two impact process innovation is still limited. This study focuses on the firm’s external technology acquisition (ETA) and external technology exploitation (ETE) and the firm’s process innovation performance. The ETA represents inbound openness in which firms rely on the acquisition and absorption of external technologies to complement their technology portfolios. The ETE, on the other hand, refers to commercializing technology assets exclusively or in addition to their internal application. This study hypothesized that both ETA and ETE have a positive relationship with process innovation performance and that ETE fully mediates the relationship between ETA and process innovation performance, i.e., ETA has a positive impact on ETE, and turn, ETE has a positive impact on process innovation performance. This study empirically explored these hypotheses in software development firms in Thailand. These firms were randomly selected from a list of Software firms registered with the Department of Business Development, Ministry of Commerce of Thailand. The questionnaires were sent to 1689 firms. After follow-ups and periodic reminders, we obtained 329 (19.48%) completed usable questionnaires. The structure question modeling (SEM) has been used to analyze the data. An analysis of the outcome of 329 firms provides support for our three hypotheses: First, the firm’s ETA has a positive impact on its process innovation performance. Second, the firm’s ETA has a positive impact its ETE. Third, the firm’s ETE fully mediates the relationship between the firm’s ETA and its process innovation performance. This study fills up the gap in open innovation literature by examining the relationship between inbound (ETA) and outbound (ETE) open innovation and suggest that in order to benefits from the promises of openness, firms must engage in both. The study went one step further by explaining the mechanism through which ETA influence process innovation performance.

Keywords: process innovation performance, external technology acquisition, external technology exploitation, open innovation

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1830 Locus of Control and Self-Esteem as Predictors of Maternal and Child Healthcare Services Utilization in Nigeria

Authors: Josephine Aikpitanyi, Friday Okonofua, Lorrettantoimo, Sandy Tubeuf

Abstract:

Every day, 800 women die from conditions related to pregnancy and childbirth, resulting in an estimated 300,000 maternal deaths worldwide per year. Over 99 percent of all maternal deaths occur in developing countries, with more than half of them occurring in sub-Saharan Africa. Nigeria being the most populous nation in sub-Saharan Africa bears a significant burden of worsening maternal and child health outcomes with a maternal mortality rate of 917 per 100,000 live births and child mortality rate of 117 per 1,000 live births. While several studies have documented that financial barriers disproportionately discourage poor women from seeking needed maternal and child healthcare, other studies have indicated otherwise. Evidence shows that there are instances where health facilities with skilled healthcare providers exist, and yet maternal, and child health outcomes remain abysmally low, indicating the presence of non-cognitive and behavioural factors that may affect the utilization of healthcare services. This study investigated the influence of locus of control and self-esteem on utilization of maternal and child healthcare services in Nigeria. Specifically, it explored the differences in utilization of antenatal care, skilled birth care, postnatal care, and child vaccination by women having an internal and external locus of control and women having high and low self-esteem. We collected information on non-cognitive traits of 1411 randomly selected women, along with information on utilization of the various indicators of maternal and child healthcare. Estimating logistic regression models for various components of healthcare services utilization, we found that women’s internal locus of control was a significant predictor of utilization of antenatal care, skilled birth care, and completion of child vaccination. We also found that having high self-esteem was a significant predictor of utilization of antenatal care, postnatal care, and completion of child vaccination after adjusting for other control variables. By improving our understanding of non-cognitive traits as possible barriers to maternal and child healthcare utilization, our findings offer important insights for enhancing participant engagement in intervention programs that are initiated to improve maternal and child health outcomes in low-and-middle-income countries.

Keywords: behavioural economics, health-seeking behaviour, locus of control and self-esteem, maternal and child healthcare, non-cognitive traits, and healthcare utilization

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1829 Influence of Glenohumeral Joint Approximation Technique on the Cardiovascular System in the Acute Phase after Stroke

Authors: Iva Hereitova, Miroslav Svatek, Vit Novacek

Abstract:

Background and Aim: Autonomic imbalance is one of the complications for immobilized patients in the acute stage after a stroke. The predominance of sympathetic activity significantly increases cardiac activity. The technique of glenohumeral joint approximation may contribute in a non-pharmacological way to the regulation of blood pressure and heart rate in patients in this risk group. The aim of the study was to evaluate the effect of glenohumeral joint approximation on the change in heart rate and blood pressure in immobilized patients in the acute phase after a stroke. Methods: The experimental study bilaterally evaluated heart rate, systolic and diastolic pressure values before and after glenohumeral joint approximation in 40 immobilized participants (72.6 ± 10.2 years) in the acute phase after stroke. The experimental group was compared with 40 healthy participants in the control group (68.6 ± 14.2 years). An SpO2 vital signs monitor and a validated Microlife WatchBP Office blood pressure monitor were used for evaluation. Statistical processing and evaluation were performed in MATLAB R2019 (The Math Works®, Inc., Natick, MA, USA). Results: Approximation of the glenohumeral joint resulted in a statistically significant decrease in systolic and diastolic pressure. An average decrease in systolic pressure for individual groups ranged from 8.2 to 11.3 mmHg (p <0.001). For diastolic pressure, the average decrease ranged from 5.0 - 14.2 mmHg (p <0.001). There was a statistically significant reduction in heart rate (p <0.01) only in patients after ischemic stroke in the inferior cerebral artery. There was the average decrease in heart rate of 3.9 beats per minute (median 4 beats per minute). Conclusion: Approximation of the glenohumeral joint leads to a statistically significant decrease in systolic and diastolic pressure in immobilized patients in the acute phase after stroke.

Keywords: Aproximation technique, Cardiovaskular system, Glenohumeral joint, Stroke

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1828 Numerical Study of a 6080HP Open Drip Proof (ODP) Motor

Authors: Feng-Hisang Lai

Abstract:

CFD(Computational Fluid Dynamics) is conducted to numerically study the flow and heat transfer features of a two-pole, 6,080HP, 60Hz, 3,150V open drip-proof (ODP) motor. The stator and rotor cores in this high voltage induction motor are segmented with the use of spacers for cooling purposes, which leads to difficulties in meshing when the entire system is to be simulated. The system is divided into 4 parts, meshed separately and then combined using interfaces. The deviation between the CFD and experimental results in temperature and flow rate is less than 10%. The internal flow is further examined and a final design is proposed to reduce the winding temperature by 10 degrees.

Keywords: CFD, open drip proof, induction motor, cooling

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1827 Using a Phenomenological Approach to Explore the Experiences of Nursing Students in Coping with Their Emotional Responses in Caring for End-Of-Life Patients

Authors: Yun Chan Lee

Abstract:

Background: End-of-life care is a large area of all nursing practice and student nurses are likely to meet dying patients in many placement areas. It is therefore important to understand the emotional responses and coping strategies of student nurses in order for nursing education systems to have some appreciation of how nursing students might be supported in the future. Methodology: This research used a qualitative phenomenological approach. Six student nurses understanding a degree-level adult nursing course were interviewed. Their responses to questions were analyzed using interpretative phenomenological analysis. Finding: The findings identified 3 main themes. First, the common experience of ‘unpreparedness’. A very small number of participants felt that this was unavoidable and that ‘no preparation is possible’, the majority felt that they were unprepared because of ‘insufficient input’ from the university and as a result of wider ‘social taboos’ around death and dying. The second theme showed that emotions were affected by ‘the personal connection to the patient’ and the important sub-themes of ‘the evoking of memories’, ‘involvement in care’ and ‘sense of responsibility’. The third theme, the coping strategies used by students, seemed to fall into two broad areas those ‘internal’ with the student and those ‘external’. In terms of the internal coping strategies, ‘detachment’, ‘faith’, ‘rationalization’ and ‘reflective skills’ are the important components of this part. Regarding the external coping strategies, ‘clinical staff’ and ‘the importance of family and friends’ are the importance of accessing external forms of support. Implication: It is clear that student nurses are affected emotionally by caring for dying patients and many of them have apprehension even before they begin on their placements but very often this is unspoken. Those anxieties before the placement become more pronounced during and continue after the placements. This has implications for when support is offered and possibly its duration. Another significant point of the study is that participants often highlighted their wish to speak to qualified nurses after their experiences of being involved in end-of-life care and especially when they had been present at the time of death. Many of the students spoke that qualified nurses were not available to them. This seemed to be due to a number of reasons. Because the qualified nurses were not available, students had to make use of family members and friends to talk to. Consequently, the implication of this study is not only to educate student nurses but also to educate the qualified mentors on the importance of providing emotional support to students.

Keywords: nursing students, coping strategies, end-of-life care, emotional responses

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1826 Towards a Computational Model of Consciousness: Global Abstraction Workspace

Authors: Halim Djerroud, Arab Ali Cherif

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We assume that conscious functions are implemented automatically. In other words that consciousness as well as the non-consciousness aspect of human thought, planning, and perception, are produced by biologically adaptive algorithms. We propose that the mechanisms of consciousness can be produced using similar adaptive algorithms to those executed by the mechanism. In this paper, we propose a computational model of consciousness, the ”Global Abstraction Workspace” which is an internal environmental modelling perceived as a multi-agent system. This system is able to evolve and generate new data and processes as well as actions in the environment.

Keywords: artificial consciousness, cognitive architecture, global abstraction workspace, multi-agent system

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1825 Extending Theory of Planned Behavior to Modelling Chronic Patients’ Acceptance of Health Information: An Information Overload Perspective

Authors: Shu-Lien Chou, Chung-Feng Liu

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Self-health management of chronic illnesses plays an important part in chronic illness treatments. However, various kinds of health information (health education materials) which government or healthcare institutions provide for patients may not achieve the expected outcome. One of the critical reasons affecting patients’ use intention could be patients’ perceived Information overload regarding the health information. This study proposed an extended model of Theory of Planned Behavior, which integrating perceived information overload as another construct to explore patients’ use intention of the health information for self-health management. The independent variables are attitude, subject norm, perceived behavior control and perceived information overload while the dependent variable is behavior intention to use the health information. The cross-sectional study used a structured questionnaire for data collection, focusing on the chronic patients with coronary artery disease (CAD), who are the potential users of the health information, in a medical center in Taiwan. Data were analyzed using descriptive statistics of the basic information distribution of the questionnaire respondents, and the Partial Least Squares (PLS) structural equation model to study the reliability and construct validity for testing our hypotheses. A total of 110 patients were enrolled in this study and 106 valid questionnaires were collected. The PLS analysis result indicates that the patients’ perceived information overload of health information contributes the most critical factor influencing the behavioral intention. Subjective norm and perceived behavioral control of TPB constructs had significant effects on patients’ intentions to use health information also, whereas the attitude construct did not. This study demonstrated a comprehensive framework, which extending perceived information overload into TPB model to predict patients’ behavioral intention of using heath information. We expect that the results of this study will provide useful insights for studying health information from the perspectives of academia, governments, and healthcare providers.

Keywords: chronic patients, health information, information overload, theory of planned behavior

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1824 An Exploration Survival Risk Factors of Stroke Patients at a General Hospital in Northern Taiwan

Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

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Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

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1823 Self-Esteem on University Students by Gender and Branch of Study

Authors: Antonio Casero Martínez, María de Lluch Rayo Llinas

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This work is part of an investigation into the relationship between romantic love and self-esteem in college students, performed by the students of matter "methods and techniques of social research", of the Master Gender at the University of Balearic Islands, during 2014-2015. In particular, we have investigated the relationships that may exist between self-esteem, gender and field of study. They are known as gender differences in self-esteem, and the relationship between gender and branch of study observed annually by the distribution of enrolment in universities. Therefore, in this part of the study, we focused the spotlight on the differences in self-esteem between the sexes through the various branches of study. The study sample consists of 726 individuals (304 men and 422 women) from 30 undergraduate degrees that the University of the Balearic Islands offers on its campus in 2014-2015, academic year. The average age of men was 21.9 years and 21.7 years for women. The sampling procedure used was random sampling stratified by degree, simple affixation, giving a sampling error of 3.6% for the whole sample, with a confidence level of 95% under the most unfavorable situation (p = q). The Spanish translation of the Rosenberg Self-Esteen Scale (RSE), by Atienza, Moreno and Balaguer was applied. The psychometric properties of translation reach a test-retest reliability of 0.80 and an internal consistency between 0.76 and 0.87. In this paper we have obtained an internal consistency of 0.82. The results confirm the expected differences in self-esteem by gender, although not in all branches of study. Mean levels of self-esteem in women are lower in all branches of study, reaching statistical significance in the field of Science, Social Sciences and Law, and Engineering and Architecture. However, analysed the variability of self-esteem by the branch of study within each gender, the results show independence in the case of men, whereas in the case of women find statistically significant differences, arising from lower self-esteem of Arts and Humanities students vs. the Social and legal Sciences students. These findings confirm the results of numerous investigations in which the levels of female self-esteem appears always below the male, suggesting that perhaps we should consider separately the two populations rather than continually emphasize the difference. The branch of study, for its part has not appeared as an explanatory factor of relevance, beyond detected the largest absolute difference between gender in the technical branch, one in which women are historically a minority, ergo, are no disciplinary or academic characteristics which would explain the differences, but the differentiated social context that occurs within it.

Keywords: study branch, gender, self-esteem, applied psychology

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1822 Outcomes of Using Guidelines for Caring and Referring ST Elevation Myocardial Infarction (STEMI) Patients at the Accident and Emergency Department of Songkhla Hospital, Thailand

Authors: Thanom Kaeniam

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ST-Elevation Myocardial Infarction (STEMI) is a state of sudden death of the heart muscle due to sudden blockage of the artery. STEMI patients are usually in critical condition and with a potential opportunity for sudden death. Therefore, management guidelines for safety in caring and referring STEMI patients are needed. The objective of this developmental research was to assess the effectiveness of using the guidelines for caring and referring STEMI patients at the Accident and Emergency Department of Songkhla Hospital. The subjects of the study were 22 nurses in the emergency room, and doctors on duty in the accident and emergency room selected using purposive sampling with inclusion criteria. The research instruments were the guidelines for caring and referring STEMI patients, and record forms for the effectiveness of using the guidelines for caring and referring STEMI patients (a general record form for STEMI patients, a record form for SK administering, a referring record form for PCI, and a record form for dead patient in the accident and emergency room and during referring). The instruments were tested for content validity by three experts, and the reliability was tested using Kuder-Richardson 20 (KR20). The descriptive statistic employed was the percentage. The outcomes of using the guidelines for caring and referring ST Elevation Myocardial Infarction (STEMI) Patients at the Accident and Emergency Department revealed that before using the guidelines in 2009, 2010, and 2011, there were 84, 73, and 138 STEMI patients receiving services at the accident and emergency room, of which, only 9, 32, and 48 patients were referred for PCI/SK medications, or 10.74; 43.84; and 34.78 percent, and the death rates were 10.71; 10.95; and 11.59 percent, respectively. However, after the use of the guidelines in 2012, 2013, and 2014, there were 97, 77, and 57 patients, of which, the increases to 77, 72, and 55 patients were referred for PCI /SK medications or 79.37; 93.51; and 96.49 percent, and the death rates were reduced to 10.30; 6.49; and 1.76 percent, respectively. The results of the study revealed that the use of the guidelines for caring and referring STEMI patients at the Accident and Emergency Department increased the effectiveness and quality of nursing, especially in terms of SK medication, caring and referring patients for PCI to reduce the death rate.

Keywords: outcomes, guidelines for caring, referring, myocardial infarction, STEMI

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