Search results for: prospective cohort studies
11455 Age-Dependent Anatomical Abnormalities of the Amygdala in Autism Spectrum Disorder and their Implications for Altered Socio-Emotional Development
Authors: Gabriele Barrocas, Habon Issa
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The amygdala is one of various brain regions that tend to be pathological in individuals with autism spectrum disorder (ASD). ASD is a prevalent and heterogeneous developmental disorder affecting all ethnic and socioeconomic groups and consists of a broad range of severity, etiology, and behavioral symptoms. Common features of ASD include but are not limited to repetitive behaviors, obsessive interests, and anxiety. Neuroscientists view the amygdala as the core of the neural system that regulates behavioral responses to anxiogenic and threatening stimuli. Despite this consensus, many previous studies and literature reviews on the amygdala’s alterations in individuals with ASD have reported inconsistent findings. In this review, we will address these conflicts by highlighting recent studies which reveal that anatomical and related socio-emotional differences detected between individuals with and without ASD are highly age-dependent. We will specifically discuss studies using functional magnetic resonance imaging (fMRI), structural MRI, and diffusion tensor imaging (DTI) to provide insights into the neuroanatomical substrates of ASD across development, with a focus on amygdala volumes, cell densities, and connectivity.Keywords: autism, amygdala, development, abnormalities
Procedia PDF Downloads 12511454 Identification of Hub Genes in the Development of Atherosclerosis
Authors: Jie Lin, Yiwen Pan, Li Zhang, Zhangyong Xia
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Atherosclerosis is a chronic inflammatory disease characterized by the accumulation of lipids, immune cells, and extracellular matrix in the arterial walls. This pathological process can lead to the formation of plaques that can obstruct blood flow and trigger various cardiovascular diseases such as heart attack and stroke. The underlying molecular mechanisms still remain unclear, although many studies revealed the dysfunction of endothelial cells, recruitment and activation of monocytes and macrophages, and the production of pro-inflammatory cytokines and chemokines in atherosclerosis. This study aimed to identify hub genes involved in the progression of atherosclerosis and to analyze their biological function in silico, thereby enhancing our understanding of the disease’s molecular mechanisms. Through the analysis of microarray data, we examined the gene expression in media and neo-intima from plaques, as well as distant macroscopically intact tissue, across a cohort of 32 hypertensive patients. Initially, 112 differentially expressed genes (DEGs) were identified. Subsequent immune infiltration analysis indicated a predominant presence of 27 immune cell types in the atherosclerosis group, particularly noting an increase in monocytes and macrophages. In the Weighted gene co-expression network analysis (WGCNA), 10 modules with a minimum of 30 genes were defined as key modules, with blue, dark, Oliver green and sky-blue modules being the most significant. These modules corresponded respectively to monocyte, activated B cell, and activated CD4 T cell gene patterns, revealing a strong morphological-genetic correlation. From these three gene patterns (modules morphology), a total of 2509 key genes (Gene Significance >0.2, module membership>0.8) were extracted. Six hub genes (CD36, DPP4, HMOX1, PLA2G7, PLN2, and ACADL) were then identified by intersecting 2509 key genes, 102 DEGs with lipid-related genes from the Genecard database. The bio-functional analysis of six hub genes was estimated by a robust classifier with an area under the curve (AUC) of 0.873 in the ROC plot, indicating excellent efficacy in differentiating between the disease and control group. Moreover, PCA visualization demonstrated clear separation between the groups based on these six hub genes, suggesting their potential utility as classification features in predictive models. Protein-protein interaction (PPI) analysis highlighted DPP4 as the most interconnected gene. Within the constructed key gene-drug network, 462 drugs were predicted, with ursodeoxycholic acid (UDCA) being identified as a potential therapeutic agent for modulating DPP4 expression. In summary, our study identified critical hub genes implicated in the progression of atherosclerosis through comprehensive bioinformatic analyses. These findings not only advance our understanding of the disease but also pave the way for applying similar analytical frameworks and predictive models to other diseases, thereby broadening the potential for clinical applications and therapeutic discoveries.Keywords: atherosclerosis, hub genes, drug prediction, bioinformatics
Procedia PDF Downloads 6611453 An ERP Study of Chinese Pseudo-Object Structures
Authors: Changyin Zhou
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Verb-argument relation is a very important aspect of syntax-semantics interaction in sentence processing. Previous ERP (event related potentials) studies in this field mainly concentrated on the relation between the verb and its core arguments. The present study aims to reveal the ERP pattern of Chinese pseudo-object structures (SOSs), in which a peripheral argument is promoted to occupy the position of the patient object, as compared with the patient object structures (POSs). The ERP data were collected when participants were asked to perform acceptability judgments about Chinese phrases. Our result shows that, similar to the previous studies of number-of-argument violations, Chinese SOSs show a bilaterally distributed N400 effect. But different from all the previous studies of verb-argument relations, Chinese SOSs demonstrate a sustained anterior positivity (SAP). This SAP, which is the first report related to complexity of argument structure operation, reflects the integration difficulty of the newly promoted arguments and the progressive nature of well-formedness checking in the processing of Chinese SOSs.Keywords: Chinese pseudo-object structures, ERP, sustained anterior positivity, verb-argument relation
Procedia PDF Downloads 43411452 Academic Entitlement And Grade Negotiation Styles Among Ug Students: A Correlation Study
Authors: Athira M., Prakasha G. S.
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The rising prevalence of academic entitlement among school and college students necessitates a comprehensive investigation. This study focuses on discovering gender differentials in academic entitlement and their nexus with diverse grade negotiation behaviors within the undergraduate (UG) student cohort. Grade negotiation behaviors, encompassing a range from amicable discussions to more assertive tactics, are influenced by students' perceptions of their academic entitlement. The research delves into the broader significance of academic entitlement, considering its implications for student-teacher conflicts and the dynamics it introduces into the educational field. Employing a quantitative research approach, data from UG students is meticulously analyzed. Mann-Whitney U tests unveil pronounced gender difference in academic entitlement, with females demonstrating higher entitlement levels. Furthermore, the study unearths significant correlations between academic entitlement and specific negotiation styles, notably yielding and forcing strategies, albeit with minimal impact on academic performance. These findings provide a foundational understanding for educators and institutions to foster equitable learning environments and formulate effective conflict resolution strategies, ultimately elevating the quality of the educational experience. Moreover, this study opens avenues for future research, exploring interventions to enhance negotiation skills and diving deeper into the intricate dimensions of academic entitlement within academic life.Keywords: academic entitlement, grade negotiation, negotiation styles, student-teacher conflict
Procedia PDF Downloads 4311451 Macrocycles Enable Tuning of Uranyl Electrochemistry by Lewis Acids
Authors: Amit Kumar, Davide Lionetti, Victor Day, James Blakemore
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Capture and activation of the water-soluble uranyl dication (UO22+) remains a challenging problem, as few rational approaches are available for modulating the reactivity of this species. Here, we report the divergent synthesis of heterobimetallic complexes in which UO22+ is held in close proximity to a range of redox-inactive metals by tailored macrocyclic ligands. Crystallographic and spectroscopic studies confirm assembly of homologous UVI(μ-OAr)2Mn+ cores with a range of mono-, di-, and trivalent Lewis acids (Mn+). X-ray diffraction (XRD) and cyclic voltammetry (CV) data suggest preferential binding of K+ in an 18-crown-6-like cavity and Na+ in a 15-crown-5-like cavity, both appended to Schiff-base type sites that selectively bind UO22+. CV data demonstrate that the UVI/UV reduction potential in these complexes shifts positive and the rate of electron transfer decreases with increasing Lewis acidity of the incorporated redox-inactive metals. Moreover, spectroelectrochemical studies confirm the formation of [UV] species in the case of monometallic UO22+ complex, consistent with results from prior studies. However, unique features were observed during spectroelectrochemical studies in the presence of the K+ ion, suggesting new insights into electronic structure may be accessible with the heterobimetallic complexes. Overall, these findings suggest that interactions with Lewis acids could be effectively leveraged for rational tuning of the electronic and thermochemical properties of the 5f elements, reminiscent of strategies more commonly employed with 3d transition metals.Keywords: electrochemistry, Lewis acid, macrocycle, uranyl
Procedia PDF Downloads 14211450 The Psychological Impact of War Trauma on Refugees
Authors: Anastasia Papachristou, Anastasia Ntikoudi, Vasileios Saridakis
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The safety and health care needs of refugees have become an increasingly important issue all over the world especially during last few decades. Wars are the primary reason for refugees to leave their countries. Moreover, refugees are frequently exposed to a variety of stressors such as socioeconomic disadvantages, poverty, changes in family structure and functioning, losing social support, difficulty to access education, living in very crowded places, experiencing racism and isolation. This systematic review included research studies published between 2007-2017 from the search databases Medline, Scopus, Cinahl and PubMed, with keywords 'war survivors', 'war trauma', 'psychiatric disorders', 'refugees'. In order to meet the purpose of the systematic review, further research for complementary studies was conducted into the literature references of the research articles included in this study that would meet the criteria. Overall, 14 studies were reviewed and evaluated. The majority of them demonstrated that the most common psychiatric disorders observed among war refugees are post-traumatic stress disorder (PTSD), depression, anxiety and multiple somatic complaints. Moreover, significant relationship was shown between the number of traumatic events experienced by the refugees and sociodemographic features such as gender, age and previous family history of any psychological disorder. War violence is highly traumatic, causing multiple, long-term negative outcomes such as the aforementioned psychiatric disorders. The number of the studies reviewed in this systematic review is not representative of the problem and its significance. The need for care of the survivors and their families is vital. Further research is necessary in order to clarify the role of predictive factors in the development and maintenance of post-traumatic stress and the rest psychiatric disorders following war trauma. In conclusion, it is necessary to have large multicenter studies in the future in order to be able to draw reliable conclusions about the effects of war.Keywords: psychiatric disorders, refugees, war survivors, war trauma
Procedia PDF Downloads 19911449 Spectrum of Acute Kidney Injury in Obstetrics
Authors: Seema Chopra, Amandeep Kaur, Vanita Suri, Shalini Gainder, Minakshi Rohilla
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Background: Acute kidney injury (AKI) associated with pregnancy is a serious medical complication which can lead to significant maternal as well as perinatal morbidity and mortality. Material and methods: This prospective observational study was carried out in the Obstetrics and Gynaecology department and dialysis unit of Nephrology department of PGIMER, Chandigarh from July 2013 to June 2014. Forty antenatal/postnatal/postabortal patients who fulfilled the AKIN criteria were enrolled in the study. All patients were followed up till 3 months postpartum. Results: Majority of the patients 23/40 (57.5%) with AKI presented in postpartum period, 14/40 (35%) developed AKI in antenatal period, and 3/40 (7.5%) were postabortal. AKI was attributable mostly to sepsis in 11/40 (27.5%) and PPH in 5/40 (12.5%). Hypertension and its complications causing AKI included eclampsia in 5/40 (12.5%) followed by 3/40 (7.5%) as HELLP syndrome and abruption placentae in 2/40(5%) patients. Three patients each (7.5%) had AFLP, TMA, and HEV as the cause of AKI. Renal replacement therapy in the form of hemodialysis was the treatment in majority of them (28 (70%)). After the acute event, 25 (62.5%) had complete recovery of their renal functions at 3 months follow up. Maternal mortality was seen in 25% (n=10) of the study patients. Conclusion: Timely initiation of RRT in patients with AKI associated with pregnancy has a good maternal outcome in the form of complete recovery of renal functions in 62.5% (25/40) of patients.Keywords: AKI, dialysis, hypertension, sepsis, renal parameters
Procedia PDF Downloads 16211448 River Bank Erosion Studies: A Review on Investigation Approaches and Governing Factors
Authors: Azlinda Saadon
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This paper provides detail review on river bank erosion studies with respect to their processes, methods of measurements and factors governing river bank erosion. Bank erosion processes are commonly associated with river changes initiation and development, through width adjustment and planform evolution. It consists of two main types of erosion processes; basal erosion due to fluvial hydraulic force and bank failure under the influence of gravity. Most studies had only focused on one factor rather than integrating both factors. Evidences of previous works have shown integration between both processes of fluvial hydraulic force and bank failure. Bank failure is often treated as probabilistic phenomenon without having physical characteristics and the geotechnical aspects of the bank. This review summarizes the findings of previous investigators with respect to measurement techniques and prediction rates of river bank erosion through field investigation, physical model and numerical model approaches. Factors governing river bank erosion considering physical characteristics of fluvial erosion are defined.Keywords: river bank erosion, bank erosion, dimensional analysis, geotechnical aspects
Procedia PDF Downloads 43511447 Vehicle Risk Evaluation in Low Speed Accidents: Consequences for Relevant Test Scenarios
Authors: Philip Feig, Klaus Gschwendtner, Julian Schatz, Frank Diermeyer
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Projects of accident research analysis are mostly focused on accidents involving personal damage. Property damage only has a high frequency of occurrence combined with high economic impact. This paper describes main influencing parameters for the extent of damage and presents a repair cost model. For a prospective evaluation method of the monetary effect of advanced driver assistance systems (ADAS), it is necessary to be aware of and quantify all influencing parameters. Furthermore, this method allows the evaluation of vehicle concepts in combination with an ADAS at an early point in time of the product development process. In combination with a property damage database and the introduced repair cost model relevant test scenarios for specific vehicle configurations and their individual property damage risk may be determined. Currently, equipment rates of ADAS are low and a purchase incentive for customers would be beneficial. The next ADAS generation will prevent property damage to a large extent or at least reduce damage severity. Both effects may be a purchasing incentive for the customer and furthermore contribute to increased traffic safety.Keywords: accident research, accident scenarios, ADAS, effectiveness, property damage analysis
Procedia PDF Downloads 34011446 Evaluation of Medication Administration Process in a Paediatric Ward
Authors: Zayed Alsulami, Asma Aldosseri, Ahmed Ezziden, Abdulrahman Alonazi
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Children are more susceptible to medication errors than adults. Medication administration process is the last stage in the medication treatment process and most of the errors detected in this stage. Little research has been undertaken about medication errors in children in the Middle East countries. This study was aimed to evaluate how the paediatric nurses adhere to the medication administration policy and also to identify any medication preparation and administration errors or any risk factors. An observational, prospective study of medication administration process from when the nurses preparing patient medication until administration stage (May to August 2014) was conducted in Saudi Arabia. Twelve paediatric nurses serving 90 paediatric patients were observed. 456 drug administered doses were evaluated. Adherence rate was variable in 7 steps out of 16 steps. Patient allergy information, dose calculation, drug expiry date were the steps in medication administration with lowest adherence rates. 63 medication preparation and administration errors were identified with error rate 13.8% of medication administrations. No potentially life-threating errors were witnessed. Few logistic and administrative factors were reported. The results showed that the medication administration policy and procedure need an urgent revision to be more sensible for nurses in practice. Nurses’ knowledge and skills regarding the medication administration process should be improved.Keywords: medication sasfety, paediatric, medication errors, paediatric ward
Procedia PDF Downloads 39411445 Accuracy of Fitbit Charge 4 for Measuring Heart Rate in Parkinson’s Patients During Intense Exercise
Authors: Giulia Colonna, Jocelyn Hoye, Bart de Laat, Gelsina Stanley, Jose Key, Alaaddin Ibrahimy, Sule Tinaz, Evan D. Morris
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Parkinson’s disease (PD) is the second most common neurodegenerative disease and affects approximately 1% of the world’s population. Increasing evidence suggests that aerobic physical exercise can be beneficial in mitigating both motor and non-motor symptoms of the disease. In a recent pilot study of the role of exercise on PD, we sought to confirm exercise intensity by monitoring heart rate (HR). For this purpose, we asked participants to wear a chest strap heart rate monitor (Polar Electro Oy, Kempele). The device sometimes proved uncomfortable. Looking forward to larger clinical trials, it would be convenient to employ a more comfortable and user friendly device. The Fitbit Charge 4 (Fitbit Inc) is a potentially comfortable, user-friendly solution since it is a wrist-worn heart rate monitor. Polar H10 has been used in large trials, and for our purposes, we treated it as the gold standard for the beat-to-beat period (R-R interval) assessment. In previous literature, it has been shown that Fitbit Charge 4 has comparable accuracy to Polar H10 in healthy subjects. It has yet to be determined if the Fitbit is as accurate as the Polar H10 in subjects with PD or in clinical populations, generally. Goal: To compare the Fitbit Charge 4 to the Polar H10 for monitoring HR in PD subjects engaging in an intensive exercise program. Methods: A total of 596 exercise sessions from 11 subjects (6 males) were collected simultaneously by both devices. Subjects with early-stage PD (Hoehn & Yahr <=2) were enrolled in a 6 months exercise training program designed for PD patients. Subjects participated in 3 one-hour exercise sessions per week. They wore both Fitbit and Polar H10 during each session. Sessions included rest, warm-up, intensive exercise, and cool-down periods. We calculated the bias in the HR via Fitbit under rest (5min) and intensive exercise (20min) by comparing the mean HR during each of the periods to the respective means measured by the Polar (HRFitbit – HRPolar). We also measured the sensitivity and specificity of Fitbit for detecting HRs that exceed the threshold for intensive exercise, defined as 70% of an individual’s theoretical maximum HR. Different types of correlation between the two devices were investigated. Results: The mean bias was 1.68 bpm at rest and 6.29 bpm during high intensity exercise, with an overestimation by Fitbit in both conditions. The mean bias of Fitbit across both rest and intensive exercise periods was 3.98 bpm. The sensitivity of the device in identifying high intensity exercise sessions was 97.14 %. The correlation between the two devices was non-linear, suggesting a saturation tendency of Fitbit to saturate at high values of HR. Conclusion: The performance of Fitbit Charge 4 is comparable to Polar H10 for assessing exercise intensity in a cohort of PD subjects. The device should be considered a reasonable replacement for the more cumbersome chest strap technology in future similar studies of clinical populations.Keywords: fitbit, heart rate measurements, parkinson’s disease, wrist-wearable devices
Procedia PDF Downloads 10811444 The Relationship between Human Neutrophil Elastase Levels and Acute Respiratory Distress Syndrome in Patients with Thoracic Trauma
Authors: Wahyu Purnama Putra, Artono Isharanto
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Thoracic trauma is trauma that hits the thoracic wall or intrathoracic organs, either due to blunt trauma or sharp trauma. Thoracic trauma often causes impaired ventilation-perfusion due to damage to the lung parenchyma. This results in impaired tissue oxygenation, which is one of the causes of acute respiratory distress syndrome (ARDS). These changes are caused by the release of pro-inflammatory mediators, plasmatic proteins, and proteases into the alveolar space associated with ongoing edema, as well as oxidative products that ultimately result in severe inhibition of the surfactant system. This study aims to predict the incidence of acute respiratory distress syndrome (ARDS) through human neutrophil elastase levels. This study examines the relationship between plasma elastase levels as a predictor of the incidence of ARDS in thoracic trauma patients in Malang. This study is an observational cohort study. Data analysis uses the Pearson correlation test and ROC curve (receiver operating characteristic curve). It can be concluded that there is a significant (p= 0.000, r= -0.988) relationship between elastase levels and BGA-3. If the value of elastase levels is limited to 23.79 ± 3.95, the patient will experience mild ARDS. While if the value of elastase levels is limited to 57.68 ± 18.55, in the future, the patient will experience moderate ARDS. Meanwhile, if the elastase level is between 107.85 ± 5.04, the patient will likely experience severe ARDS. Neutrophil elastase levels correlate with the degree of severity of ARDS incidence.Keywords: ARDS, human neutrophil elastase, severity, thoracic trauma
Procedia PDF Downloads 14811443 A Study of Ocular Morbidity in Road Traffic Accidents
Authors: Nikhat Iqbal Tamboli
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INTRODUCTION: road traffic accidents (RTAs) are one of the leading and common causes of ocular injuries especially in developing countries like India which are preventable with certain measures and so it is of public health importance. AIM: To study incidence and clinical presentation of ocular morbidity in road traffic accidents. METHOD: Prospective cross-sectional study was conducted on 360 patients reported in department of ophthalmology. Detailed ocular examination and relevant investigations done. RESULTS: Incidence of ocular injuries is 23%. male:female ratio is 4.5:1.Cases having Sub conjunctival haemorrhage [74].eccymosis[217]. lid lcerations [164]orbital fracture[12] corneal tear [7]corneal abrasion[2] sclera tear[6] hyphaema[4] traumatic mydriasis [7]traumatic cataract [2]vitreous haemorrhage [1]traumatic optic neuropathy[1].Maximum cases in age group 20-40 years, with two wheeler vehicles 94.7% .Under influence of alcohol 13.3%. CONCLUSION: Younger age group with male preponderance is involved in ocular trauma due to road traffic accidents .maximum cases reported are with anterior segment injuries. Alcohol and two wheeler vehicles are common risk factors. Injuries involving cornea had bad prognosis and involving retina had worst prognosis.Keywords: ocular morbidity, eye trauma, RTA, eye injury
Procedia PDF Downloads 6611442 Soil Bearing Capacity of Shallow Foundation and Consolidation Settlement at Around the Prospective Area of Sei Gong Dam Batam
Authors: Andri Hidayat, Zufialdi Zakaria, Raden Irvan Sophian
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Batam city within next five years are expected to experience water crisis. Sei Gong dam which is located in the Sijantung village, Galang District, Batam City, Riau Islands Province is one of 13 dams that will be built to solve the problems of raw water crisis in the Batam city. The purpose of this study are to determine the condition of engineering geology around Sei Gong Dam area, knowing the value of the soil bearing capacity and recommended pile foundation, and knowing the characteristics of the soil consolidation as one of the factors that affect the incidence of soil subsidence. Based on calculations for shallow foundation in general - soil shear condition and local - soil condition indicates that the highest value in ultimate soil bearing capacity (qu) for each depth was in the square foundations at two meters depth. The zonations of shallow foundation of the research area are divided into five zones, they are bearing capacity zone <10 ton/m2, bearing capacity zone 10-15 ton/m2, bearing capacity zone 15-20 ton/m2, bearing capacity zone 20-25 ton/m2, and bearing capacity zone >25 ton/m2. Based on the parameters of soil engineering analysis, Sei Gong Dam areas at the middle part has a higher value for land subsidence.Keywords: ultimate bearing capacity, type of foundation, consolidation, land subsidence, Batam
Procedia PDF Downloads 37611441 Behavior of Oil Palm Shell Reinforced Concrete Beams Added with Kenaf Fibres
Authors: Sharifah M. Syed Mohsin, Sayid J. Azimi, Abdoullah Namdar
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The present article reports the findings of a study into the behavior of oil palm shell reinforced concrete (OPSRC) beams with the addition of kenaf fibres. The work aim is to examine the potential of using kenaf fibres to improve the strength and ductility of the OPSRC beams and also observe its potential in serving as part of shear reinforcement in the beams. Two different arrangements of the shear links in OPSRC beams with a selection of kenaf fibres (amount of [10kg/m] ^3 and [20kg/m] ^3) content are tested under monotonic loading. In the first arrangement, the kenaf fibres are added to the beam which has full shear reinforcement to study the structural behavior of OPSRC beams with fibres. In the second arrangement, the spacing between the shear links in the OPSRC beams are increased by 50% and experimental work is carried out to study the effect of kenaf fibres without compromising the beams strength and ductility. The results show that the addition of kenaf fibres enhanced the load carrying capacity, ductility and also altered the failure mode of the beams from a brittle shear mode to a flexural ductile one. Furthermore, the study depicts that kenaf fibres are compatible with OPSRC and suggest prospective results.Keywords: oil palm shell reinforced concrete, kenaf fibres, peak strength, ductility
Procedia PDF Downloads 43111440 Use of Oral Midazolam in Endoscopy
Authors: Alireza Javadzadeh
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Background: The purpose of this prospective, randomized study was to compare the safety and efficacy of oral versus i.v. midazolam in providing sedation for pediatric upper gastrointestinal (GI) endoscopy. Methods: Sixty-one children (age < 16 years) scheduled for upper GI endoscopy were studied. Patients were randomly assigned to receive oral or i.v. midazolam. Measurements were made and compared for vital signs, level of sedation, pre- and post-procedure comfort, anxiety during endoscopy, ease of separation from parents, ease and duration of procedure, and recovery time. Results: Patients were aged 1–16 years (mean 7.5 ± 3.42 years); 30 patients received oral medication, and 31 received i.v. medication. There were no statistically significant differences in age or gender between groups. There were no significant differences in level of sedation, ease of separation from parents, ease of ability to monitor the patient during the procedure, heart rate, systolic arterial pressure, or respiratory rate. Oxygen saturation was significantly lower in the i.v. group than the oral group 10 and 30 min after removal of the endoscope, and recovery time was longer in the oral than the i.v. group. Conclusions: Oral administration of midazolam is a safe and effective method of sedation that significantly reduces anxiety and improves overall tolerance for children undergoing esophagogastroduodenoscopy.Keywords: children, endoscopy, midazolam, oral, sedation
Procedia PDF Downloads 34511439 Environmental Risk Assessment for Beneficiary Use of Coal Combustion Residues Using Leaching Environmental Assessment Framework
Authors: D. V. S. Praneeth, V. R. Sankar Cheela, Brajesh Dubey
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Coal Combustion (CC) residues are the major by-products from thermal power plants. The disposal of ash on to land creates havoc to environment and humans. The leaching of the constituent elements pollutes ground water. Beneficiary use of coal combustion residues in structural components is being investigated as a part of this study. This application reduces stress on the convention materials in the construction industry. The present study involves determination of leaching parameters of the CC residues. Batch and column studies are performed based on Leaching Environmental Assessment Framework (LEAF) protocol. The column studies are conducted to simulate the real time percolation conditions in the field. The structural and environmental studies are performed to determine the usability of CC residues as bricks. The physical, chemical, geo environmental and mechanical properties of the alternate materials are investigated. Scanning electron microscopy (SEM), X-Ray Diffraction analysis (XRD), X-ray fluorescence (XRF) and Energy Dispersive X-ray Spectroscopy tests were conducted to determine the characteristics of CC residue ash and bricks.Keywords: coal combustion residues, LEAF, leaching, SEM
Procedia PDF Downloads 31411438 Robots for the Elderly at Home: For Men Only
Authors: Christa Fricke, Sibylle Meyer, Gert G. Wagner
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Our research focuses on the question of whether assistive and social robotics could pose a promising strategy to support the independent living of elderly people and potentially relieve relatives of any anxieties. To answer the question of how elderly people perceive the potential of robotics, we analysed the data from the Berlin Aging Study BASE-II (https://www.base2.mpg.de/de) (N=1463) and data from the German SYMPARTNER study (http://www.sympartner.de) (N=120) and compared those to a control group made up of people younger than 30 years (BASE II: N=241; SYMPARTNER: N=30). BASE-II is a cohort study of people living in Berlin, Germany. The sample covers more than 2200 cases; a questionnaire on the use and acceptance of assistive and social robots was carried out with a sub-sample of 1463 respondents in 2015. The SYMPARTNER study was done by SIBIS institute of Social Research, Berlin and included a total of 120 persons between the ages of 60 and 87 in Berlin and the rural German federal state of Thuringia. Both studies included a control group of persons between the ages of 20 and 35 (BASE II: N=241; SYMPARTNER: N=30). Additional data, representative for the whole population in Germany, will be surveyed in fall 2017 (Survey “Technikradar” [technology radar] by the National Academy of Science and Engineering). Since this survey is including some identical questions as BASE-II/SYMPARTNER, comparative results can be presented at 20th International Conference on Social Robotics in New York 2018. The complexity of the data gathered in BASE-II and SYMPARTNER, encompassing detailed socio-economic background characteristics as well as personality traits such as the personal attitude to risk taking, locus of control and Big Five, proves highly valuable and beneficial. Results show that participants’ expressions of resentment against robots are comparatively low. Participants’ personality traits play a role, however the effect sizes are small. Only 15 percent of participants received domestic robots with great scepticism. Participants aged older than 70 years expressed greatest rejection of the robotic assistant. The effect sizes however account for only a few percentage points. Overall, participants were surprisingly open to the robot and its usefulness. The analysis also shows that men’s acceptance of the robot is generally greater than that of women (with odds ratios of about 0.6 to 0.7). This applies to both assistive robots in the private household and in care environments. Men expect greater benefits of the robot than women. Women tend to be more sceptical of their technical feasibility than men. Interview results prove our hypothesis that men, in particular of the age group 60+, are more accustomed to delegate household chores to women. A delegation to machines instead of humans, therefore, seems palpable. The answer to the title question of this planned presentation is: social and assistive robots at home robots are not only accepted by men – but by fewer women than men.Keywords: acceptance, care, gender, household
Procedia PDF Downloads 19711437 Diagnosis and Management of Obesity Among South Asians: A Paradigm
Authors: Deepa Vasudevan, Thomas Northrup, Angela Stotts, Michelle Klawans
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To date, we have conducted three studies on this subject. The research done to date is through three studies. The initial study was to document that modified criteria independently identified higher numbers of overweight/obese South Asian Indians. The second study was to document physician knowledge of appropriate diagnosis of obesity among South Asian Indians. The final study was an intervention to evaluate the efficacy of a training module on improving physician diagnosis and counseling of overweight/obese Asian patients.Keywords: South Asian Indians, obesity, physicians, BMI and waist circumference
Procedia PDF Downloads 40711436 Power Recovery in Egyptian Natural Gas Pressure Reduction Stations Using Turboexpander Systems
Authors: Kamel A. Elshorbagy, Mohamed A. Hussein, Rola S. Afify
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Natural gas pressure reduction is typically achieved using pressure reducing valves, where isenthalpic expansion takes place with considerable amount of wasted energy in an irreversible throttling process of the gas. Replacing gas-throttling process by an expansion process in a turbo expander (TE) converts the pressure of natural gas into mechanical energy transmitted to a loading device (i.e. an electric generator). This paper investigates the performance of a turboexpander system for power recovery at natural gas pressure reduction stations. There is a considerable temperature drop associated with the turboexpander process. Essential preheating is required, using gas fired boilers, to avoid undesirable effects of a low outlet temperature. Various system configurations were simulated by the general flow sheet simulator HYSYS and factors affecting the overall performance of the systems were investigated. Power outputs and fuel requirements were found using typical gas flow variation data. The simulation was performed for two case studies in which real input data are used. These case studies involve a domestic (commercial) and an industrial natural gas pressure reduction stations in Egypt. Economic studies of using the turboexpander system in both of the two natural gas pressure reduction stations are conducted using precise data obtained through communication with several companies working in this field. The results of economic analysis, for the two case studies, prove that using turboexpander systems in Egyptian natural gas reduction stations can be a successful project for energy conservation.Keywords: natural gas, power recovery, reduction stations, turboexpander systems
Procedia PDF Downloads 32311435 Multivariate Analysis of Causes of Death among Hepatocellular Carcinoma Patients: A Seer-Based Study
Authors: Peri Harish Kumar, Sai Sharan Dwarka, Tajbinder Singh Bains, Suneet John Joseph, Chaitanya Kiran, Sambhu Dutta, Sarah Makram, Mohamed Sayed Zaazouee, Alaa Ahmed Elshanbary
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Objective: To identify cancer and non-cancer causes of death in hepatocellular carcinoma (HCC) patients over different time periods after diagnosis and to compare the mortality risk of each cause in HCC patients with the general population. Methods: In this retrospective cohort study, data of 67,637 HCC patients from 1975 to 2016 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. We investigated the association between different causes of death and the following variables: age, race, tumor stage at diagnosis, and treatment (surgery, chemotherapy, and radiotherapy); each according to the periods of <1 year, 1-5 years, 5-10 years, and >10 years following the diagnosis. Standardized mortality ratios (SMRs) and their 95% confidence intervals (CIs) were calculated for cancer and non-cancer deaths in each of the mentioned periods following diagnosis. Results: Data of 67,637 patients, of whom 50,571 patients died during the follow-up period, were analyzed. Most deaths were due to HCC itself (35,535, 70.3%), followed by other cancers (3,983, 7.9%). Common causes of non-cancer mortality included infectious and parasitic diseases including HIV (2,823 patients, SMR=105.68, 95% CI: 101.82-109.65), chronic liver disease (2,719 patients, SMR=76.56, 95% CI: 73.71,79.5), and heart diseases (1,265 patients, SMR=2.26, 95% CI: 2.14-2.39), with higher mortality risk in HCC patients than in the general population. Conclusion: Cancers stand for most deaths in patients with HCC. Besides, infectious, and parasitic diseases including HIV represent the commonest non-cancer cause of mortality.Keywords: hepatocellular carcinoma, seer, causes of death, mortality
Procedia PDF Downloads 8811434 Teaching Young Learners How to Work Together: Pedagogical Ideas for Language Teachers
Authors: Tomas Kos
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An increasing body of research has explored patterns of interaction and peer support among young learners. Although some studies suggest that young learners can collaborate and support each other, other studies indicate that young learners may lack the ability to work together and support one another when interacting on classroom tasks. Moreover, despite the claims that peer collaboration is conducive to learning, studies have not paid enough attention to the “how” to enhance peer collaboration on classroom tasks. To fill this gap, this “how-to” article proposes that teaching young learners how to work together is a powerful pedagogical tool that can greatly improve collaborative behavior and a sense of mutuality among young learners. This article will pay particular attention to primary schools and the context of English as a foreign language. It will first review literature related to patterns of interaction and peer support conducted in the cognitive and sociocultural framework. It will then address what it actually means to collaborate. At the heart of the article, it will discuss some practical pedagogical ideas for language teachers, which entail teaching collaborative principles and strategies that will help their students to support each other and engage in communication with each other.Keywords: young learners, peer collaboration, peer interaction, peer support, patterns of interaction
Procedia PDF Downloads 15711433 The Effect of Remifentanil on Emergence Agitation after Sevoflurane Anesthesia in Children: A Meta-Analysis
Authors: Jong Yeop Kim, Sung Young Park, Dae Hee Kim, Han Bum Joe, Ji Young Yoo, Jong Bum Choi, Sook Young Lee
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Emergence agitation (EA) is commonly reported adverse events after sevoflurane anesthesia in pediatric patients. The efficacy of prophylactic remifentanil, one of mu opioid agonist, in preventing EA is controversial. This meta-analysis assessed the effectiveness of remifentanil to decrease the incidence of EA from sevoflurane anesthesia in children. We searched for randomized controlled trials comparing sevoflurane alone anesthesia with sevoflurane and remifentanil anesthesia to prevent EA in the Cochrane Library, Embase, Pubmed, and KoreaMed, and included 6 studies with 361 patients. The number of patients of reporting EA was summarized using risk ratio (RR) with 95% confidence interval (CI), with point estimates and 95CIs derived from a random effects Mantel-Haenszel method. Overall incidence of EA was about 41%. Compared with sevoflurane alone anesthesia, intravenous infusion of remifentanil with sevoflurane significantly reduced the incidence of EA (RR 0.53, 95% CI 0.39-0.73, P < 0.0001), (heterogeneity, I2 = 0, P = 0.42). This meta-analysis suggested that continuous infusion of remifentanil could be effective in decreasing the EA of about 47% after sevoflurane anesthesia. However, considering limitations of the included studies, more randomized controlled studies are required to verify our results.Keywords: emergence agitation, meta-analysis, remifentanil, pediatrics
Procedia PDF Downloads 37511432 Interpersonal Emotion Regulation in Adolescence: An Enhanced Critical Incident Study
Authors: Setareh Shayanfar
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Given the increasing importance of peer relationships during adolescence, the present study aimed to examine peer interactions that facilitate or hinder adolescents’ regulation of negative emotions. Using the Enhanced Critical Incident Technique, 1-hour semi-structured interviews were conducted with 16 junior high school adolescents. Participants were asked to recall situations when they experienced strong negative emotions during the past school year, indicate the peer interactions that helped or hindered their emotion regulation, and identify prospective interactions with the potential to help regulate their emotions. Data analysis extracted 182 critical incidents, including 109 helping incidents, 45 hindering incidents, and 28 wish list items, which generated 10 categories nested within four overarching themes: Positive Personal Support included (a) supportive presence, (b) expressing concern, (c) empathizing, and (d) encouraging and cheering up; while Strategy Transmission included (e) sharing perspective, and (f) giving advice; Activated Support included (g) taking action, and (h) distracting; while Negative Personal Interactions included (i) withdrawing and (j) punishing. Implications for mental health and service providers, as well as recommendations for future research, are presented.Keywords: adolescence, emotion regulation, enhanced critical incident technique, peers
Procedia PDF Downloads 14411431 Building Bricks Made of Fly-Ash Mixed with Sand or Ceramic Dust: Synthesis and a Comparative Study
Authors: Md. R. Shattique, Md. T. Zaki, Md. G. Kibria
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Fly-ash bricks give a comprehensive solution towards recycling of fly-ash and since there is no requirement of firing to produce them, they are also eco-friendly bricks; little or no carbon-dioxide is emitted during their entire production cycle. As bricks are the most essential and widely utilized building materials in the construction industry, the significance of developing an alternate eco-friendly brick is substantial in modern times. In this paper, manufacturing and potential utilization of Fly-ash made building bricks have been studied and was found to be a prospective substitute for fired clay bricks that contribute greatly to polluting the environment. Also, a comparison between sand made and ceramic dust made Fly-ash bricks have been carried out experimentally. The ceramic dust made bricks seem to show higher compressive strength at lower unit volume weight compared to sand made Fly-ash bricks. Moreover, the water absorption capacity of ceramic dust Fly-ash bricks was lower than sand made bricks. Then finally a statistical comparison between fired clay bricks and fly-ash bricks were carried out. All the requirements for good quality building bricks are matched by the fly-ash bricks. All the facts from this study pointed out that these bricks give a new opportunity for being an alternate building material.Keywords: coal fly-ash, ceramic dust, burnt clay bricks, sand, gypsum, absorption capacity, unit volume weight, compressive strength
Procedia PDF Downloads 42211430 The Effect of a Multidisciplinary Spine Clinic on Treatment Rates and Lead Times to Care
Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky
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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive
Procedia PDF Downloads 14011429 Comparison of Analgesic Efficacy of Ropivacaine and Levobupivacaine in Labour Analgesia by Dural Puncture Epidural Technique – A Prospective Double-blinded Randomized Trial
Authors: J. Punj, R. K. Pandey, V. Darlong, K. Thangavel
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Background: Dural puncture epidural (DPE) technique has been introduced recently for labour analgesia however, no study has compared ropivacaine and levobupivacaine for the same. Methods: The primary aim of the study was to compare time to onset of the Numerical Pain Rating Score (NPRS) ≤ 1 in labour analgesia with both drugs. After obtaining ethics and patient consent, ASA I and ASA II parturient with single foetus in vertex presentation and cervical dilatation <5.0 cm were included. DPE was performed with 16/ 26 G combined spinal epidural (CSE) technique, and parturients randomized into two groups. In Group R ( Ropivacaine) 20 ml 0.125% ropivacaine+ fentanyl 2µg/ml was injected to a maximum of 20 ml in 20 minutes and in Group L (Levobupivacaine), 20 ml 0.125% levobupivacaine + fentanyl 2µg/ml was injected. Outcomes were assessed at 0.5,2,4,6,8,10,12,14,16,18,20 and 30 minutes, then every 90 minutes until delivery. Appropriate statistical analysis was done, and p value of <0.05 was considered statistically significant. Results: The median time to onset of NPRS ≤1 in both groups was comparable (group R= 16 minutes vs group L= 18 minutes (p = 0.076). Volume of drug for NPR ≤1 in both groups was also comparable (Group R 15.95± 2.03 ml vs Group L 16.35 ± 1.34 ml (p=0.47). Conclusion: DPE with 16 G epidural needle and 26 gauge spinal needle with both 0.125% ropivacaine and 0.125% levobupivacaine results in similar efficacy of labour analgesia.Keywords: dural puncture epidural, labour analgesia, obstetric analgesia, hypotension
Procedia PDF Downloads 8711428 An Experimental Study of Iron Smelting Techniques Used in the South East Rajasthan, with Special Reference to Nathara-Ki-Pal, Udaipur
Authors: Udaya Kumar
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The aim of this paper is to discuss recent research conducted in experimental studies related to the process of the iron smelting. The paper will discuss issues related to the selection of iron ore, structure of furnace, making of tuyeres, fashioning of blowers and firing temperatures through experiments conducted recently and scientific analyses of experimental work. Experiments were conducted in order to investigate iron smelting techniques used at the Early Historic site of Nathara-Ki-Pal. (73°47’E; 24°16N is located about 70 km south-east of Udaipur city). Geographically, Nathara-Ki-Pal has located the foot hills of Aravalli’s. Iron ore and iron slag can be seen on the surface of the site. The remains of 4 broken furnaces were recovered during excavations (2007 and 2008) and the site was excavated by Prof. Pandey from the Department of Archaeology of the Institute of Rajasthan studies, Rajasthan Vidyapeeth University. This shows that the site of Nathara-Ki-Pal was a center of iron smelting. Results of experiments performed both in the field reconstruction of a bloomery furnace and in the laboratory are discussed.Keywords: experimental studies, furnace, smelting techniques, making of tuyeres
Procedia PDF Downloads 18811427 Potentially Inappropriate Prescribing in Elderly Population
Authors: Ajit Kumar Sah, Rajesh Kumar Jha, Phoolgen Sah, Dev Kumar Shah
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Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The purpose of this study was to determine the prevalence of potentially inappropriate medicine (PIM) prescribing in older Nepalese patients in a medicine outpatient department. Beers’ criteria are the most widely used tools to assess PIM to elderly patients. Prospective observational analysis of drugs prescribed in medicine out-patient department (OPD) of a hospital of Bharatpur, Chitwan, Nepal during November 2011 to October 2012 to 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM) in elderly patients was analyzed using Beers Criteria updated to 2013. In the 869 patients included the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%), amlodipine (23.16%), paracetamol (17.6%), salbutamol (15.72%) and vitamin B complex (13.26%). The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with a number of medications prescribed. Further research is warranted to study the impact of PIMs towards health-related outcomes in these elderly.Keywords: Beers criteria, elderly, polypharmacy, potentially inappropriate medicines
Procedia PDF Downloads 56611426 Use of Proton Pump Inhibitors Medications during the First Years of Life and Late Complications
Authors: Kamelia Hamza
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Background: Proton pump inhibitors (PPIs) are the most prescribed drug classes for pediatric gastroesophageal reflux disease (GERD).Many patients are treated with these drugs for atypical manifestations attributed to gastroesophageal reflux (GER), even in the absence of proved causal relationship. There is an impression of increase use of PPI's treatment for reflux in "clalit health services," the largest health organization in Israel. In the recent years, the medicine is given without restriction, it's not limited to pediatric gastroenterologists only, but pediatricians and family doctors. The objective of this study is to evaluate the hypothesis that exposure to PPIs during the first year of life is associated with an increased risk of developing late adverse diseases: pneumonia, asthma, AGE, IBD, celiac disease, allergic disorders, obesity, attention deficit hyperactivity disorders (ADHD), autism spectrum disorders (ASD). Methods: The study is a retrospective case-control cohort study based on a computerized database of Clalit Health Services (CHS). It includes 9844 children born between 2002-2018 and reported to complain of at least one of the symptoms (reflux/ spitting up, irritability, feeding difficulties, colics). The study population included the study group (n=4922) of children exposed to PPIs at any time prior to the first year of life and a control group (n=4922) child not exposed to PPIs who were matched to each case of the study group on age, race, socioeconomic status, and year of birth. The prevalence of late complications/diseases in the study group was compared with the prevalence of late complications/diseases diagnosis between 2002-2020 in the control group. Odds ratios and 95% confidence intervals were calculated by using logistic regression models. Results: We found that compared to the control group, children exposed to PPIs in the first year of life had an increased risk of developing several late complications/ disorders: pneumonia, asthma, various allergies (urticaria, allergic rhinitis, or allergic conjunctivitis) OR, inhalant allergies, and food allergies. In addition, they showed an increased risk of being diagnosed with ADHD or ASD, but children exposed to PPIs in the first year of life had decrease the risk of obesity by 17% (OR 0.825, 95%CI 0.697-0.976). Conclusions: We found significant associations between the use of PPIs during the first year of life and subsequent development of late complications/diseases such as respiratory diseases, allergy diseases, ADHD, and ASD. More studies are needed to prove causality and determine the mechanism behind the effect of PPIs and the development of late complications.Keywords: acid suppressing medications, proton pump inhibitors, histamine 2 blocker, late complications, gastroesophageal reflux, gastroesophageal reflux disease, acute gastroenteritis, community acquired pneumonia, asthma, allergic diseases, obesity, inflammatory bowel diseases, ulcerative colitis, crohn disease, attention deficit hyperactivity disorders, autism spectrum disorders
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