Search results for: early multilingualism
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3699

Search results for: early multilingualism

2769 Toy Engagement Patterns in Infants with a Familial History of Autism Spectrum Disorder

Authors: Vanessa Do, Lauren Smith, Leslie Carver

Abstract:

It is widely known that individuals with autism spectrum disorder (ASD) may exhibit sensitivity to stimuli. Even at a young age, they tend to display stimuli-related discomfort in their behavior during play. Play serves a crucial role in a child’s early years as it helps support healthy brain development, socio-emotional skills, and adaptation to their environment There is research dedicated to studying infant preferences for toys, especially in regard to: gender preferences, the advantages of promoting play, and the caregiver’s role in their child’s play routines. However, there is a disproportionate amount of literature examining how play patterns may differ in children with sensory sensitivity, such as children diagnosed with ASD. Prior literature has studied and found supporting evidence that individuals with ASD have deficits in social communication and have increased presence of repetitive behaviors and/or restricted interests, which also display in early childhood play patterns. This study aims to examine potential differences in toy preference between infants with (FH+) and without (FH-) a familial history of ASD ages 6. 9, and 12 months old. More specifically, this study will address the question, “do FH+ infants tend to play more with toys that require less social engagement compared to FH- infants?” Infants and their caregivers were recruited and asked to engage in a free-play session in their homes that lasted approximately 5 minutes. The sessions were recorded and later coded offline for engagement behaviors categorized by toy; each toy that the infants interacted with was coded as belonging to one of 6 categories: sensory (designed to stimulate one or more senses such as light-up toys or musical toys) , construction (e.g., building blocks, rubber suction cups), vehicles (e.g., toy cars), instructional (require steps to accomplish a goal such as flip phones or books), imaginative (e.g., dolls, stuffed animals), and miscellaneous (toys that do not fit into these categories). Toy engagement was defined as the infant looking and touching the toy (ILT) or looking at the toy while their caregiver was holding it (IL-CT). Results reported include/will include the proportion of time the infant was actively engaged with the toy out of the total usable video time per subject — distractions observed during the session were excluded from analysis. Data collection is still ongoing; however, the prediction is that FH+ infants will have higher engagement with sensory and construction toys as they require the least amount of social effort. Furthermore, FH+ infants will have the least engagement with the imaginative toys as prior literature has supported the claim that individuals with ASD have a decreased likelihood to engage in play that requires pretend play and other social skills. Looking at what toys are more or less engaging to FH+ infants is important as it provides significant contributions to their healthy cognitive, social, and emotional development. As play is one of the first ways for a child to understand the complexities of the larger world, the findings of this study may help guide further research into encouraging play with toys that are more engaging and sensory-sensitive for children with ASD.

Keywords: autism engagement, children’s play, early development, free-play, infants, toy

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2768 “CheckPrivate”: Artificial Intelligence Powered Mobile Application to Enhance the Well-Being of Sextual Transmitted Diseases Patients in Sri Lanka under Cultural Barriers

Authors: Warnakulasuriya Arachichige Malisha Ann Rosary Fernando, Udalamatta Gamage Omila Chalanka Jinadasa, Bihini Pabasara Amandi Amarasinghe, Manul Thisuraka Mandalawatta, Uthpala Samarakoon, Manori Gamage

Abstract:

The surge in sexually transmitted diseases (STDs) has become a critical public health crisis demanding urgent attention and action. Like many other nations, Sri Lanka is grappling with a significant increase in STDs due to a lack of education and awareness regarding their dangers. Presently, the available applications for tracking and managing STDs cover only a limited number of easily detectable infections, resulting in a significant gap in effectively controlling their spread. To address this gap and combat the rising STD rates, it is essential to leverage technology and data. Employing technology to enhance the tracking and management of STDs is vital to prevent their further propagation and to enable early intervention and treatment. This requires adopting a comprehensive approach that involves raising public awareness about the perils of STDs, improving access to affordable healthcare services for early detection and treatment, and utilizing advanced technology and data analysis. The proposed mobile application aims to cater to a broad range of users, including STD patients, recovered individuals, and those unaware of their STD status. By harnessing cutting-edge technologies like image detection, symptom-based identification, prevention methods, doctor and clinic recommendations, and virtual counselor chat, the application offers a holistic approach to STD management. In conclusion, the escalating STD rates in Sri Lanka and across the globe require immediate action. The integration of technology-driven solutions, along with comprehensive education and healthcare accessibility, is the key to curbing the spread of STDs and promoting better overall public health.

Keywords: STD, machine learning, NLP, artificial intelligence

Procedia PDF Downloads 81
2767 Influence of Auditory Visual Information in Speech Perception in Children with Normal Hearing and Cochlear Implant

Authors: Sachin, Shantanu Arya, Gunjan Mehta, Md. Shamim Ansari

Abstract:

The cross-modal influence of visual information on speech perception can be illustrated by the McGurk effect which is an illusion of hearing of syllable /ta/ when a listener listens one syllable, e.g.: /pa/ while watching a synchronized video recording of syllable, /ka/. The McGurk effect is an excellent tool to investigate multisensory integration in speech perception in both normal hearing and hearing impaired populations. As the visual cue is unaffected by noise, individuals with hearing impairment rely more than normal listeners on the visual cues.However, when non congruent visual and auditory cues are processed together, audiovisual interaction seems to occur differently in normal and persons with hearing impairment. Therefore, this study aims to observe the audiovisual interaction in speech perception in Cochlear Implant users compares the same with normal hearing children. Auditory stimuli was routed through calibrated Clinical audiometer in sound field condition, and visual stimuli were presented on laptop screen placed at a distance of 1m at 0 degree azimuth. Out of 4 presentations, if 3 responses were a fusion, then McGurk effect was considered to be present. The congruent audiovisual stimuli /pa/ /pa/ and /ka/ /ka/ were perceived correctly as ‘‘pa’’ and ‘‘ka,’’ respectively by both the groups. For the non- congruent stimuli /da/ /pa/, 23 children out of 35 with normal hearing and 9 children out of 35 with cochlear implant had a fusion of sounds i.e. McGurk effect was present. For the non-congruent stimulus /pa/ /ka/, 25 children out of 35 with normal hearing and 8 children out of 35 with cochlear implant had fusion of sounds.The children who used cochlear implants for less than three years did not exhibit fusion of sound i.e. McGurk effect was absent in this group of children. To conclude, the results demonstrate that consistent fusion of visual with auditory information for speech perception is shaped by experience with bimodal spoken language during early life. When auditory experience with speech is mediated by cochlear implant, the likelihood of acquiring bimodal fusion is increased and it greatly depends on the age of implantation. All the above results strongly support the need for screening children for hearing capabilities and providing cochlear implants and aural rehabilitation as early as possible.

Keywords: cochlear implant, congruent stimuli, mcgurk effect, non-congruent stimuli

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2766 A Review of Evidence on the Use of Digital Healthcare Interventions to Provide Follow-Up Care for Coeliac Disease Patients

Authors: R. Cooper, M. Kurien

Abstract:

Background: Coeliac Disease affects around 1 in 100 people. Untreated, it can result in serious morbidity such as malabsorption and cancers. The only treatment is to adhere to a gluten free diet (GFD). International guidelines recommend that people with the coeliac disease receive follow-up healthcare annually to detect complications early and support their adherence to a GFD. However, there is a finite amount of healthcare in the UK, and as such, not all patients receive follow-up care as recommended by the guidelines. Furthermore, there is an increasing number of patients being diagnosed with coeliac disease. Given the potential severe morbidity that non-adherence to a GFD could result in, alongside reports that the rate of non- GFD adherence could be as high as 91%, it is imperative that action is taken. One potential solution to this would be to provide follow-up care digitally through utilising technology. This abstract reports on a rapid review undertaken to explore the existing evidence in this area. Methods: In June 2020, 11 bibliographic databases were searched to find any pertinent studies. The inclusion criteria required the study to be written in the English language and report on the use of digital healthcare interventions for people with Coeliac Disease. Results: A small amount of evidence (n=8) was found which met our inclusion criteria and pertained to the provision of CD follow-up digitally. These studies focussed either on educating and supporting patients to adhere to a GFD or providing consultation remotely with a focus on detecting complications early. These studies showed that there is potential for digital healthcare interventions to positively impact people with coeliac disease. However, it is suggested that the effectiveness of these interventions may depend on local circumstances, individual knowledge of CD and general attitudes. Conclusion: The above studies suggest that providing follow-up care digitally may offer a potential solution; however, the evidence about how this should be done and in what circumstances this will work for individuals is scarce. In the light of the COVID-19 pandemic, the introduction of digital healthcare interventions appears to be highly topical, and as such, this review may benefit from being refreshed in the future.

Keywords: coeliac disease, follow-up, gluten free diet, digital healthcare interventions

Procedia PDF Downloads 175
2765 Biofuels from Hybrid Poplar: Using Biochemicals and Wastewater Treatment as Opportunities for Early Adoption

Authors: Kevin W. Zobrist, Patricia A. Townsend, Nora M. Haider

Abstract:

Advanced Hardwood Biofuels Northwest (AHB) is a consortium funded by the United States Department of Agriculture (USDA) to research the potential for a system to produce advanced biofuels (jet fuel, diesel, and gasoline) from hybrid poplar in the Pacific Northwest region of the U.S. An Extension team was established as part of the project to examine community readiness and willingness to adopt hybrid as a purpose-grown bioenergy crop. The Extension team surveyed key stakeholder groups, including growers, Extension professionals, policy makers, and environmental groups, to examine attitudes and concerns about growing hybrid poplar for biofuels. The surveys found broad skepticism about the viability of such a system. The top concern for most stakeholder groups was economic viability and the availability of predictable markets. Growers had additional concerns stemming from negative past experience with hybrid poplar as an unprofitable endeavor for pulp and paper production. Additional barriers identified included overall land availability and the availability of water and water rights for irrigation in dry areas of the region. Since the beginning of the project, oil and natural gas prices have plummeted due to rapid increases in domestic production. This has exacerbated the problem with economic viability by making biofuels even less competitive than fossil fuels. However, the AHB project has identified intermediate market opportunities to use poplar as a renewable source for other biochemicals produced by petroleum refineries, such as acetic acid, ethyl acetate, ethanol, and ethylene. These chemicals can be produced at a lower cost with higher yields and higher, more-stable prices. Despite these promising market opportunities, the survey results suggest that it will still be challenging to induce growers to adopt hybrid poplar. Early adopters will be needed to establish an initial feedstock supply for a budding industry. Through demonstration sites and outreach events to various stakeholder groups, the project attracted interest from wastewater treatment facilities, since these facilities are already growing hybrid poplar plantations for applying biosolids and treated wastewater for further purification, clarification, and nutrient control through hybrid poplar’s phytoremediation capabilities. Since these facilities are already using hybrid poplar, selling the wood as feedstock for a biorefinery would be an added bonus rather than something requiring a high rate of return to compete with other crops and land uses. By holding regional workshops and conferences with wastewater professionals, AHB Extension has found strong interest from wastewater treatment operators. In conclusion, there are several significant barriers to developing a successful system for producing biofuels from hybrid poplar, with the largest barrier being economic viability. However, there is potential for wastewater treatment facilities to serve as early adopters for hybrid poplar production for intermediate biochemicals and eventually biofuels.

Keywords: hybrid poplar, biofuels, biochemicals, wastewater treatment

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2764 Language Skills in the Emergent Literacy of Spanish-Speaking Children with Autism Spectrum Disorders

Authors: Adriana Salgado, Sandra Castaneda, Ivan Perez

Abstract:

Learning to read and write is a complex process involving several cognitive skills, contextual, and cultural environments. The basis of this development is linguistic skills, such as the ability to name and understand vocabulary, retell a story, phonological awareness, letter knowledge, among others. In children with autism spectrum disorder (ASD), one of the main concerns is related to language disorders. Nevertheless, most of the children with ASD are able to decode written information but have difficulties in reading comprehension. The research of these processes in the Spanish-speaking population is limited. However, the increasing prevalence of this diagnosis (1 in 115 children) in Mexico has implications at different levels. Educational research is an important area of interest in ASD children, such as emergent literacy. Reading and writing expand the possibilities of academic, cultural, and social information access. Taking this information into account, the objective of this research was to identify the relationship between language skills, alphabet knowledge, phonological awareness, and early reading and writing in ASD Spanish-speaking children. The method used for this research was based on tasks that were selected, adapted and in some cases designed to measure initial reading and writing, as well as language skills (naming, receptive vocabulary, and narrative skills), phonological awareness (similar phonological word pairs, beginning sound awareness and spelling) and letter knowledge, in a sample of 45 children (38 boys and 7 girls) with prior diagnosis of ASD. Descriptive analyses, as well as bivariate correlations, cluster analysis, and canonical correspondence, were obtained for the data results. Results showed that variability was large; however, it was possible to characterize the sample in low, medium, and high score groups regarding children performance. The low score group (46.7% of the sample), had a null or deficient performance in language skills and phonological awareness, some could identify up to five letters of the alphabet, showed no early reading skills but they could scribble. The middle score group was characterized by a highly variable performance in different tasks, with better language skills in receptive and naming vocabulary, some narrative, letter knowledge, and phonological awareness (beginning sound awareness) skills. The high score group, (24.4% of the sample) had the best performance in language skills in relation to the sample data, as well as in the rest of the measured skills. Finally, scores were canonically correlated between naming, receptive vocabulary, narrative, phonological awareness, letter knowledge and initial learning of reading and writing skills for the high score group and letter knowledge, naming and receptive vocabulary for the lower score group, which is consistent with previous research in typical and ASD children. In conclusion, the obtained data is consistent with previous studies. Despite large variability, it was possible to identify performance profiles and relations based on linguistic, phonological awareness, and letter knowledge skills. These skills were predictor variables of the initial development of reading and writing. The above has implications for a future program and strategies development that may benefit the acquisition of reading and writing in ASD children.

Keywords: autism, autism spectrum disorders, early literacy, emergent literacy

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2763 Language Education Policy in Arab Schools in Israel

Authors: Fatin Mansour Daas

Abstract:

Language education responds to and is reflective of emerging social and political trends. Language policies and practices are shaped by political, economic, social and cultural considerations. Following this, Israeli language education policy as implemented in Arab schools in Israel is influenced by the particular political and social situation of Arab-Palestinian citizens of Israel. This national group remained in their homeland following the war in 1948 between Israel and its Arab neighbors and became Israeli citizens following the establishment of the State of Israel. This study examines language policy in Arab schools in Israel from 1948 until the present time in light of the unique experience of the Palestinian Arab homeland minority in Israel with a particular focus on questions of politics and identity. The establishment of the State of Israel triggered far-reaching political, social and educational transformations within Arab Palestinian society in Israel, including in the area of language and language studies. Since 1948, the linguistic repertoire of Palestinian Arabs in Israel has become more complex and diverse, while the place and status of different languages have changed. Following the establishment of the State of Israel, only Hebrew and Arabic were retained as the official languages, and Israeli policy reflected this in schools as well: with the advent of the Jewish state, Hebrew language education among Palestinians in Israel has increased. Similarly, in Arab Palestinian schools in Israel, English is taught as a third language, Hebrew as a second language, and Arabic as a first language – even though it has become less important to native Arabic speakers. This research focuses on language studies and language policy in the Arab school system in Israel from 1948 onwards. It will analyze the relative focus of language education between the different languages, the rationale of various language education policies, and the pedagogic approach used to teach each language and student achievements vis-à-vis language skills. This study seeks to understand the extent to which Arab schools in Israel are multi-lingual by examining successes, challenges and difficulties in acquiring the respective languages. This qualitative study will analyze five different components of language education policy: (1) curriculum, (2) learning materials; (3) assessment; (4) interviews and (5) archives. Firstly, it consists of an analysis examining language education curricula, learning materials and assessments used in Arab schools in Israel from 1948-2018 including a selection of language textbooks for the compulsory years of study and the final matriculation (Bagrut) examinations. The findings will also be based on archival material which traces the evolution of language education policy in Arabic schools in Israel from the years 1948-2018. This archival research, furthermore, will reveal power relations and general decision-making in the field of the Arabic education system in Israel. The research will also include interviews with Ministry of Education staff who provide instructional oversight in the instruction of the three languages in the Arabic education system in Israel. These interviews will shed light on the goals of language education as understood by those who are in charge of implementing policy.

Keywords: language education policy, languages, multilingualism, language education, educational policy, identity, Palestinian-Arabs, Arabs in Israel, educational school system

Procedia PDF Downloads 91
2762 Improvement of Compressive and Tensile Strengths of Concrete Using Polypropylene Fibers

Authors: Omar Asad Ahmad, Mohammed Awwad

Abstract:

Concrete is one of the essential elements that used in different types of construction these days, but it has many problems when interacts with environmental elements such as water, air, temperature, dust, and humidity. Also concrete made with Portland cement has certain characteristics: it is relatively strong in compression but weak in tension and tends to be brittle. These disadvantages make concrete limited to use in certain conditions. The most common problems appears on concrete are manifested by tearing, cracking, corrosion and spalling, which will lead to do some defect in concrete then in the whole construction, The fundamental objective of this research was to provide information about the hardened properties of concrete achieved by using easily available local raw materials in Jordan to support the practical work with partners in assessing the practicability of the mixes with polypropylene, and to facilitate the introduction of polypropylene fiber concrete (PFC) technology into general construction practice. Investigate the effect of the polypropylene fibers in PCC mixtures and on materials properties such as compressive strength, and tensile strength. Also to investigate the use of polypropylene fibers in plain cubes and cylindrical concrete to improve its compressive and tensile strengths to reduce early cracking and inhibit later crack growth. Increasing the hardness of concrete in this research is the main purpose to measure the deference of compressive strength and tensile strength between plain concrete and concrete mixture with polypropylene fibers different additions and to investigate its effect on reducing the early and later cracking problem. To achieve the goals of research 225 concrete test sample were prepared to measure it’s compressive strength and tensile strength, the concrete test sample were three classes (A,B,C), sub-classified to standard , and polypropylene fibers added by the volume of concrete (5%, 10%, 15%, and 20%). The investigation of polypropylene fibers mixture with concrete shows that the strengths of the cement are increased and the cracking decreased. The results show that for class A the recommended addition were 5% of polypropylene fibers additions for compressive strength and 10 % for tensile strength revels the best compressive strength that reach 26.67 Mpa and tensile strength that reach 2.548 Mpa records. Achieved results show that for classes B and C the recommend additions were 10 % polypropylene fibers revels the best compressive strength records where they reach 21.11 and 33.78 Mpa, records reach for tensile strength 2.707 and 2.65 Mpa respectively.

Keywords: polypropylene, effects, compressive, tensile, strengths, concrete, construction

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2761 Parents' Perception on the Use of Mobile Technology by Young Children

Authors: Jason Gan

Abstract:

Technology has been around for many years, those that play a crucial part of our lives have evolved quick and fast, from televisions to computers and now mobile technology has also become a part of our lives. However in Singapore a nation with a strong reliance and following in technology, how are young children (0 to 8 years old) coping with these high technology equipment especially mobile technology and why and what are parents doing to manage this trend in the nation. This study aims to uncover some of the parents’ perception behind the use of mobile technology by their children.

Keywords: technology, preschoolers, ICT and Singapore, early childhood

Procedia PDF Downloads 434
2760 Trends of Public-Private Partnership Infrastructure in Thailand

Authors: Wasaporn Techapeeraparnich

Abstract:

Bringing private investor involving in providing public infrastructure have been increasingly used worldwide, and there is no exception for developing countries like Thailand. Recently, there is a huge investment opportunity for public-private partnership (PPP) in Thailand, especially in the transportation sector. This paper analyses the development of the PPP since the early beginning of PPP in different service sectors. It also summarizes the development of PPP and its application in terms of usage, opportunities and trends particularly in the transport sector. The results are aimed to draw some lessons learned for future development.

Keywords: case study, public-private partnership, transportation, Thailand

Procedia PDF Downloads 434
2759 The Canaanite Trade Network between the Shores of the Mediterranean Sea

Authors: Doaa El-Shereef

Abstract:

The Canaanite civilization was one of the early great civilizations of the Near East, they influenced and been influenced from the civilizations of the ancient world especially the Egyptian and Mesopotamia civilizations. The development of the Canaanite trade started from the Chalcolithic Age to the Iron Age through the oldest trade route in the Middle East. This paper will focus on defining the Canaanites and from where did they come from and the meaning of the term Canaan and how the Ancient Manuscripts define the borders of the land of Canaan and this essay will describe the Canaanite trade route and their exported goods such as cedar wood, and pottery.

Keywords: archaeology, bronze age, Canaanite, colonies, Massilia, pottery, shipwreck, vineyards

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2758 Monitoring the Fiscal Health of Taiwan’s Local Government: Application of the 10-Point Scale of Fiscal Distress

Authors: Yuan-Hong Ho, Chiung-Ju Huang

Abstract:

This article presents a monitoring indicators system that predicts whether a local government in Taiwan is heading for fiscal distress and identifies a suitable fiscal policy that would allow the local government to achieve fiscal balance in the long run. This system is relevant to stockholders’ interest, simple for national audit bodies to use, and provides an early warning of fiscal distress that allows preventative action to be taken.

Keywords: fiscal health, fiscal distress, monitoring signals, 10-point scale

Procedia PDF Downloads 459
2757 The Role of Emotions in the Consumer: Theoretical Review and Analysis of Components

Authors: Mikel Alonso López

Abstract:

The early eighties saw the rise of a new research trend in several prestigious journals, mainly articles that related emotions with the decision-making processes of the consumer, and stopped treating them as external elements. That is why we ask questions such as: what are emotions? Are there different types of emotions? What components do they have? Which theories exist about them? In this study, we will review the main theories and components of emotion analysing the cognitive factor and the different emotional states that are generally recognizable with a focus in the classic debate as to whether they occur before the cognitive process or the affective process.

Keywords: emotion, consumer behaviour, feelings, decision making

Procedia PDF Downloads 347
2756 Establishing a Drug Discovery Platform to Progress Compounds into the Clinic

Authors: Sheraz Gul

Abstract:

The requirements for progressing a compound to clinical trials is well established and relies on the results from in-vitro and in-vivo animal tests to indicate that it is likely to be safe and efficacious when testing in humans. The typical data package required will include demonstrating compound safety, toxicity, bioavailability, pharmacodynamics (potential effects of the compound on body systems) and pharmacokinetics (how the compound is potentially absorbed, distributed, metabolised and eliminated after dosing in humans). If the desired criteria are met and the compound meets the clinical Candidate criteria and is deemed worthy of further development, a submission to regulatory bodies such as the US Food & Drug Administration for an exploratory Investigational New Drug Study can be made. The purpose of this study is to collect data to establish that the compound will not expose humans to unreasonable risks when used in limited, early-stage clinical studies in patients or normal volunteer subjects (Phase I). These studies are also designed to determine the metabolism and pharmacologic actions of the drug in humans, the side effects associated with increasing doses, and, if possible, to gain early evidence on their effectiveness. In order to reach the above goals, we have developed a pre-clinical high throughput Absorption, Distribution, Metabolism and Excretion–Toxicity (ADME–Toxicity) panel of assays to identify compounds that are likely to meet the Lead and Candidate compound acceptance criteria. This panel includes solubility studies in a range of biological fluids, cell viability studies in cancer and primary cell-lines, mitochondrial toxicity, off-target effects (across the kinase, protease, histone deacetylase, phosphodiesterase and GPCR protein families), CYP450 inhibition (5 different CYP450 enzymes), CYP450 induction, cardio-toxicity (hERG) and gene-toxicity. This panel of assays has been applied to multiple compound series developed in a number of projects delivering Lead and clinical Candidates and examples from these will be presented.

Keywords: absorption, distribution, metabolism and excretion–toxicity , drug discovery, food and drug administration , pharmacodynamics

Procedia PDF Downloads 173
2755 Comparing SVM and Naïve Bayes Classifier for Automatic Microaneurysm Detections

Authors: A. Sopharak, B. Uyyanonvara, S. Barman

Abstract:

Diabetic retinopathy is characterized by the development of retinal microaneurysms. The damage can be prevented if disease is treated in its early stages. In this paper, we are comparing Support Vector Machine (SVM) and Naïve Bayes (NB) classifiers for automatic microaneurysm detection in images acquired through non-dilated pupils. The Nearest Neighbor classifier is used as a baseline for comparison. Detected microaneurysms are validated with expert ophthalmologists’ hand-drawn ground-truths. The sensitivity, specificity, precision and accuracy of each method are also compared.

Keywords: diabetic retinopathy, microaneurysm, naive Bayes classifier, SVM classifier

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2754 Computational Pipeline for Lynch Syndrome Detection: Integrating Alignment, Variant Calling, and Annotations

Authors: Rofida Gamal, Mostafa Mohammed, Mariam Adel, Marwa Gamal, Marwa kamal, Ayat Saber, Maha Mamdouh, Amira Emad, Mai Ramadan

Abstract:

Lynch Syndrome is an inherited genetic condition associated with an increased risk of colorectal and other cancers. Detecting Lynch Syndrome in individuals is crucial for early intervention and preventive measures. This study proposes a computational pipeline for Lynch Syndrome detection by integrating alignment, variant calling, and annotation. The pipeline leverages popular tools such as FastQC, Trimmomatic, BWA, bcftools, and ANNOVAR to process the input FASTQ file, perform quality trimming, align reads to the reference genome, call variants, and annotate them. It is believed that the computational pipeline was applied to a dataset of Lynch Syndrome cases, and its performance was evaluated. It is believed that the quality check step ensured the integrity of the sequencing data, while the trimming process is thought to have removed low-quality bases and adaptors. In the alignment step, it is believed that the reads were accurately mapped to the reference genome, and the subsequent variant calling step is believed to have identified potential genetic variants. The annotation step is believed to have provided functional insights into the detected variants, including their effects on known Lynch Syndrome-associated genes. The results obtained from the pipeline revealed Lynch Syndrome-related positions in the genome, providing valuable information for further investigation and clinical decision-making. The pipeline's effectiveness was demonstrated through its ability to streamline the analysis workflow and identify potential genetic markers associated with Lynch Syndrome. It is believed that the computational pipeline presents a comprehensive and efficient approach to Lynch Syndrome detection, contributing to early diagnosis and intervention. The modularity and flexibility of the pipeline are believed to enable customization and adaptation to various datasets and research settings. Further optimization and validation are believed to be necessary to enhance performance and applicability across diverse populations.

Keywords: Lynch Syndrome, computational pipeline, alignment, variant calling, annotation, genetic markers

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2753 Exploring the In-Between: An Examination of the Contextual Factors That Impact How Young Children Come to Value and Use the Visual Arts in Their Learning and Lives

Authors: S. Probine

Abstract:

The visual arts have been proven to be a central means through which young children can communicate their ideas, reflect on experience, and construct new knowledge. Despite this, perceptions of, and the degree to which the visual arts are valued within education, vary widely within political, educational, community and family contexts. These differing perceptions informed my doctoral research project, which explored the contextual factors that affect how young children come to value and use the visual arts in their lives and learning. The qualitative methodology of narrative inquiry with inclusion of arts-based methods was most appropriate for this inquiry. Using a sociocultural framework, the stories collected were analysed through the sociocultural theories of Lev Vygotsky as well as the work of Urie Bronfenbrenner, together with postmodern theories about identity formation. The use of arts-based methods such as teacher’s reflective art journals and the collection of images by child participants and their parent/caregivers allowed the research participants to have a significant role in the research. Three early childhood settings at which the visual arts were deeply valued as a meaning-making device in children’s learning, were purposively selected to be involved in the research. At each setting, the study found a unique and complex web of influences and interconnections, which shaped how children utilised the visual arts to mediate their thinking. Although the teachers' practices at all three centres were influenced by sociocultural theories, each settings' interpretations of these theories were unique and resulted in innovative interpretations of the role of the teacher in supporting visual arts learning. These practices had a significant impact on children’s experiences of the visual arts. For many of the children involved in this study, visual art was the primary means through which they learned. The children in this study used visual art to represent their experiences, relationships, to explore working theories, their interests (including those related to popular culture), to make sense of their own and other cultures, and to enrich their imaginative play. This research demonstrates that teachers have fundamental roles in fostering and disseminating the importance of the visual arts within their educational communities.

Keywords: arts-based methods, early childhood education, teacher's visual arts pedagogies, visual arts

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2752 A Nutrient Formulation Affects Brain Myelination in Infants: An Investigative Randomized Controlled Trial

Authors: N. Schneider, M. Bruchhage, M. Hartweg, G. Mutungi, J. O Regan, S. Deoni

Abstract:

Observational neuroimaging studies suggest differences between breast-fed and formula-fed infants in developmental myelination, a key brain process for learning and cognitive development. However, the possible effects of a nutrient formulation on myelin development in healthy term infants in an intervention study have not been investigated. Objective was, therefore, to investigate the efficacy of a nutrient formulation with higher levels of myelin-relevant nutrients as compared to a control formulation with lower levels of the same nutrients on brain myelination and cognitive development in the first 6 months of life. The study is an ongoing randomized, controlled, double-blind, two-center, parallel-group clinical trial with a nonrandomized, non-blinded arm of exclusively breastfed infants. The current findings result from a staged statistical analysis at 6 months; the recruitment and intervention period has been completed for all participants. Follow-up visits at 12, 18 and 24 months are still ongoing. N= 81 enrolled full term, neurotypical infants of both sexes were randomized into either the investigational (N= 42) or the control group (N= 39), and N= 108 children in the breast-fed arm served as a natural reference group. The effect of a blend of docosahexaenoic acid, arachidonic acid, iron, vitamin B12, folic acid as well as sphingomyelin from a uniquely proceed whey protein concentrate enriched in alpha-lactalbumin and phospholipids in an infant nutrition product matrix was investigated. The main outcomes for the staged statistical analyses at 6 months included brain myelination measures derived from MRI. Additional outcomes were brain volume, cognitive development and safety. The full analyses set at 6 months comprised N= 66 infants. Higher levels of myelin-relevant nutrients compared to lower levels resulted in significant differences in myelin structure, volume, and rate of myelination as early as 3 and 6 months of life. The cross-sectional change of means between groups for whole-brain myelin volume was 8.4% for investigational versus control formulation (3.5% versus the breastfeeding reference) group at 3 months and increased to 36.4% for investigational versus control formulation (14.1% versus breastfeeding reference) at 6 months. No statistically significant differences were detected for early cognition scores. Safety findings were largely similar across groups. This is the first pediatric nutritional neuroimaging study demonstrating the efficacy of a myelin nutrient blend on developmental myelination in well-nourished term infants. Myelination is a critical process in learning and development. The effects were demonstrated across the brain, particularly in temporal and parietal regions, known to be functionally involved in sensory, motor and language skills. These first results add to the field of nutritional neuroscience by demonstrating early life nutrition benefits for brain architecture which may be foundational for later cognitive and behavioral outcomes. ClinicalTrials.gov Identifier: NCT03111927 (Infant Nutrition and Brain Development - Full-Text View - ClinicalTrials.gov).

Keywords: brain development, infant nutrition, MRI, myelination

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2751 Assessment and Optimisation of Building Services Electrical Loads for Off-Grid or Hybrid Operation

Authors: Desmond Young

Abstract:

In building services electrical design, a key element of any project will be assessing the electrical load requirements. This needs to be done early in the design process to allow the selection of infrastructure that would be required to meet the electrical needs of the type of building. The type of building will define the type of assessment made, and the values applied in defining the maximum demand for the building, and ultimately the size of supply or infrastructure required, and the application that needs to be made to the distribution network operator, or alternatively to an independent network operator. The fact that this assessment needs to be undertaken early in the design process provides limits on the type of assessment that can be used, as different methods require different types of information, and sometimes this information is not available until the latter stages of a project. A common method applied in the earlier design stages of a project, typically during stages 1,2 & 3, is the use of benchmarks. It is a possibility that some of the benchmarks applied are excessive in relation to the current loads that exist in a modern installation. This lack of accuracy is based on information which does not correspond to the actual equipment loads that are used. This includes lighting and small power loads, where the use of more efficient equipment and lighting has reduced the maximum demand required. The electrical load can be used as part of the process to assess the heat generated from the equipment, with the heat gains from other sources, this feeds into the sizing of the infrastructure required to cool the building. Any overestimation of the loads would contribute to the increase in the design load for the heating and ventilation systems. Finally, with the new policies driving the industry to decarbonise buildings, a prime example being the recently introduced London Plan, loads are potentially going to increase. In addition, with the advent of the pandemic and changes to working practices, and the adoption of electric heating and vehicles, a better understanding of the loads that should be applied will aid in ensuring that infrastructure is not oversized, as a cost to the client, or undersized to the detriment of the building. In addition, more accurate benchmarks and methods will allow assessments to be made for the incorporation of energy storage and renewable technologies as these technologies become more common in buildings new or refurbished.

Keywords: energy, ADMD, electrical load assessment, energy benchmarks

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2750 An Insight into Early Stage Detection of Malignant Tumor by Microwave Imaging

Authors: Muhammad Hassan Khalil, Xu Jiadong

Abstract:

Detection of malignant tumor inside the breast of women is a challenging field for the researchers. MWI (Microwave imaging) for breast cancer diagnosis has been of interest for last two decades, newly it suggested for finding cancerous tissues of women breast. A simple and basic idea of the mathematical modeling is used throughout this paper for imaging of malignant tumor. In this paper, the authors explained inverse scattering method in the microwave imaging and also present some simulation results.

Keywords: breast cancer detection, microwave imaging, tomography, tumor

Procedia PDF Downloads 411
2749 Free Fibular Flaps in Management of Sternal Dehiscence

Authors: H. N. Alyaseen, S. E. Alalawi, T. Cordoba, É. Delisle, C. Cordoba, A. Odobescu

Abstract:

Sternal dehiscence is defined as the persistent separation of sternal bones that are often complicated with mediastinitis. Etiologies that lead to sternal dehiscence vary, with cardiovascular and thoracic surgeries being the most common. Early diagnosis in susceptible patients is crucial to the management of such cases, as they are associated with high mortality rates. A recent meta-analysis of more than four hundred thousand patients concluded that deep sternal wound infections were the leading cause of mortality and morbidity in patients undergoing cardiac procedures. Long-term complications associated with sternal dehiscence include increased hospitalizations, cardiac infarctions, and renal and respiratory failures. Numerous osteosynthesis methods have been described in the literature. Surgical materials offer enough rigidity to support the sternum and can be flexible enough to allow physiological breathing movements of the chest; however, these materials fall short when managing patients with extensive bone loss, osteopenia, or general poor bone quality, for such cases, flaps offer a better closure system. Early utilization of flaps yields better survival rates compared to delayed closure or to patients treated with sternal rewiring and closed drainage. The utilization of pectoralis major flaps, rectus abdominus, and latissimus muscle flaps have all been described in the literature as great alternatives. Flap selection depends on a variety of factors, mainly the size of the sternal defect, infection, and the availability of local tissues. Free fibular flaps are commonly harvested flaps utilized in reconstruction around the body. In cases regarding sternal reconstruction with free fibular flaps, the literature exclusively discussed the flap applied vertically to the chest wall. We present a different technique applying the free fibular triple barrel flap oriented in a transverse manner, in parallel to the ribs. In our experience, this method could have enhanced results and improved prognosis as it contributes to the normal circumferential shape of the chest wall.

Keywords: sternal dehiscence, management, free fibular flaps, novel surgical techniques

Procedia PDF Downloads 94
2748 Application of Heritage Clay Roof Tiles in Malaysia’s Government Buildings: Conservation Challenges

Authors: Mohd Sabere Sulaiman, Masyitah Abd Aziz, Norsiah Hassan, Jamilah Halina Abdul Halim, Mohd Saipul Asrafi Haron

Abstract:

The use of clay roof tiles was spread out through Asia and Europe, including Malaysia, since the early 17th Century. Most of the common type of clay roof tiles are used in a flat and rectangular shape, measurement, styles, and characteristics through each tradition and interest, including responsive to the climate. Various types of heritage clay roof tiles were used in Malaysia’s Government Buildings dated 1865, 1919, 1936, and so forth, which mostly were imported from India, France, and Italy. Until now, these heritage clay roof tiles are still found throughout Malaysia, including the ‘Interlocking’ clay roof tile type. This study is to investigate and overview the existence of heritage clay roof tiles used in Malaysia; the ‘interlocking’ type with ‘lip’ and ‘hooks’, through literature reviews as desktop study besides carried out a preliminary observation on various sites and interviews. From the literatures, the last production and used of the local heritage clay roof tiles in Malaysia dated in mid 1900s in Batu Arang, Selangor. The brick factory was abandoned since early 2000s. Although the modern ‘Interlocking’ type were produced to duplicate its form, pattern, and size of the original one, they still facing the problem to blend and merged, which end up dismantling the original version, or replacing one to one condition and even replaced overall with the modern materials. This is quite contradicting with the basic principles of building conservation and had become a challenge. Initial findings from the preliminary observation on site in various state in Malaysia shows some evidence that the heritage clay roof tiles are still intact and been used. Some of them might change to modern roof materials such as metal deck, probably due to easy maintenance and cheaper. Also, some are still struggling to maintain and retain its looks and authenticity of the roof while facing the increasing of material cost. Those improper alteration and changes made is due to lack of knowledge among the owner and end user. Various aspect needs to be considered in order to sustain its usage and its original looks by looking at the proper maintenance aspects of the heritage clay roof tiles to prolong the building life for future generation preferences.

Keywords: challenges, clay, interlocking, maintenance

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2747 Hypothalamic Para-Ventricular and Supra-Optic Nucleus Histo-Morphological Alterations in the Streptozotocin-Diabetic Gerbils (Gerbillus Gerbillus)

Authors: Soumia Hammadi, Imane Nouacer, Lamine Hamida, Younes A. Hammadi, Rachid Chaibi

Abstract:

Aims and objective: In the present work, we investigate the impact of both acute and chronic diabetes mellitus induced by streptozotocin (STZ) on the hypothalamus of the small gerbil (Gerbillus gerbillus). In this purpose, we aimed to study the histologic structure of the gerbil’s hypothalamic supraoptic (NSO) and paraventricular nucleus (NPV) at two distinct time points: two days and 30 days after diabetes onset. Methods: We conducted our investigation using 19 adult male gerbils weighing 25 to 28 g, divided into three groups as follow: Group I: Control gerbils (n=6) received an intraperitoneal injection of citrate buffer. Group II: STZ-diabetic gerbils (n=8) received a single intraperitoneal injection of STZ at a dose of 165 mg/kg of body weight. Diabetes onset (D0) is considered with the first hyperglycemia level exceeding 2,5 g/L. This group was further divided into two subgroups: Group II-1: Experimental Gerbils, at acute state of diabetes (n=8) sacrificed after 02 days of diabetes onset, Group II-2: Experimental Gerbils at chronic state of diabetes (n=7) sacrificed after 30 days of diabetes onset. Two and 30 days after diabetes onset, gerbils had blood drawn from the retro-orbital sinus into EDTA tubes. After centrifugation at -4°C, plasma was frozen at -80°C for later measurement of Cortisol, ACTH, and insulin. Afterward, animals were decapitated; their brain was removed, weighed, fixed in aqueous bouin, and processed and stained with Toluidine Bleu stain for histo-stereological analysis. A comparison was done with control gerbils treated with citrate buffer. Results: Compared to control gerbils, at 02 Days post diabetes onset, the neuronal somata of the paraventricular (NPV) and supraoptic nuclei (NSO) expressed numerous vacuoles of various sizes, we distinct also a neuronal juxtaposition and several unidentifiable vacuolated profiles were also seen in the neuropile. At the same time, we revealed the presence of à shrunken and condensed nuclei, which seem to touch the parvocellular neurons ( NPV); this leads us to suggest the presence of an apoptotic process in the early stage of diabetes. At 30 days of diabetes mellitus, the NPV manifests a few neurons with a distant appearance, in addition the magnocellular neurons in both NPV and NSO were hypertrophied with a rich euchromatin nucleus, a well-defined nucleolus, and a granular cytoplasm. Despite the neuronal degeneration at this stage, unexpectedly, ACTH registers a continuous significant high level compared to the early stage of diabetes mellitus and to control gerbils. Conclusion: The results suggest that the induction of diabetes mellitus using STZ in the small gerbils lead to alterations in the structure and morphology of the hypothalamus and hyper-secretion of ACTH and cortisol, possibly indicating hyperactivity of the hypothalamo-pituitary adrenal axis (HPA) during both the early and later stages of the disease. The subsequent quantitative evaluation of CRH, immunehistochemical evaluation of apoptosis, and oxidative stress assessment could corroborate our results.

Keywords: diabetes type 1., streptozotocin., small gerbil., hypothalamus., paraventricular nucleus., supraoptic nucleus.

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2746 Tablet Computer Based Cognitive Rehabilitation Program, Injini, for Children with Cognitive Impairment

Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

Abstract:

Cognitive impairment is commonly encountered problem in children with various clinical diseases, including Down syndrome, autism spectrum disorder, brain injury, and others. Cognitive impairment limits participation in education and society, and this further hinders development in cognition. However, young children with cognitive impairment tend not to respond well to traditional cognitive treatments, therefore alternative treatment choices are need. As a cognitive training program, touch screen technology can easily be applied to very young children by involving visual and auditory support. Injini was developed as tablet computer based cognitive rehabilitation program for young children or individuals with severe cognitive impairment, which targeted on cognitive ages of 18 to 36 months. The aim of this study was to evaluate the efficacy of a tablet computer based cognitive rehabilitation program (Injini) for children with cognitive impairment. 38 children between cognitive ages of 18 to 36 months confirmed by cognitive evaluations were recruited and randomly assigned to the intervention group (n=20) and the control group (n=18). The intervention group received tablet computer based cognitive rehabilitation program (Injini) for 30 minutes per session, twice a week, over a period of 12 weeks, in addition to the traditional rehabilitation program. The control group received traditional rehabilitation program only. Mental score of Bayley Scales of Infant Development II (BSID II), Pediatric Evaluation of Disability Inventory (PEDI), Laboratory Temperament Assessment Battery (Lab-TAB), Early Childhood Behavior Questionnaire (ECBQ), and Goal Attainment Scale (GAS) were evaluated before and after 12 weeks of therapeutic intervention. When comparing the baseline characteristics, there was no significant difference between the two groups in the measurements of cognitive function. After 12 weeks of treatment, both group showed improvements in all measurements. However, in comparison of improvements after treatment, the intervention group showed more improvements in the mental score of BSID II, social function domain of PEDI, observation domain of Lab-TAB, and GAS, as compared to the control group. Application of the tablet computer based cognitive rehabilitation program (Injini) would be beneficial for improvement of cognitive function in young children with cognitive impairment.

Keywords: cognitive therapy, computer-assisted therapy, early intervention, tablets

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2745 Defining the Term of Strategy within Military Point of View

Authors: Ismail Menderes Sema, Murat Sözen, M. K. Barış

Abstract:

The strategy is about winning or preventing your enemy from winning. The origin of the term comes from the military. After utilizing the strategy for limited military purposes in early ages, soldiers and statesmen used the term together to achieve the goals of states. In ancient times, those people who made strategy and implemented it was the same. With the industrial revolution, the strategy changed like everything and the term “grand strategy” came forward. Today, from business to economy, management to philosophy there is a broad using of the term strategy. Economic strategy, business strategy, trade strategy, irrigation strategy, and even recruitment strategy are used by professionals. The purpose of this study is to analyze the evolution of the strategy and clarify actually what is about.

Keywords: strategy, military, art, grand strategy, strategist

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2744 West Nile Virus in North-Eastern Italy: Overview of Integrated Surveillance Activities

Authors: Laura Amato, Paolo Mulatti, Fabrizio Montarsi, Matteo Mazzucato, Laura Gagliazzo, Michele Brichese, Manlio Palei, Gioia Capelli, Lebana Bonfanti

Abstract:

West Nile virus (WNV) re-emerged in north-eastern Italy in 2008, after ten years from its first appearance in Tuscany. In 2009, a national surveillance programme was implemented, and re-modulated in north-eastern Italy in 2011. Hereby, we present the results of surveillance activities in 2008-2016 in the north-eastern Italian regions, with inferences on WNV epidemiological trend in the area. The re-modulated surveillance programmes aimed at early detecting WNV seasonal reactivation by searching IgM antibodies in horses. In 2013, the surveillance plans were further modified including a risk-based approach. Spatial analysis techniques, including Bernoulli space-time scan-statistics, were applied to the results of 2010–2012 surveillance on mosquitoes, equines, and humans to identify areas where WNV reactivation was more likely to occur. From 2008 to 2016, residential horses tested positive for anti-WNV antibodies on a yearly basis (503 cases), also in areas where WNV circulation was not detected in mosquito populations. Surveillance activities detected 26 syndromic cases in horses, 102 infected mosquito pools and WNV in 18 dead wild birds. Human cases were also recurrently detected in the study area during the surveillance period (68 cases of West Nile neuroinvasive disease). The recurrent identification of WNV in animals, mosquitoes, and humans indicates the virus has likely become endemic in the area. In 2016, findings of WNV positives in horses or mosquitoes were included as triggers for enhancing screening activities in humans. The evolution of the epidemiological situation prompts for continuous and accurate surveillance measures. The results of the 2013-2016 surveillance indicate that the risk-based approach was effective in early detecting seasonal reactivation of WNV, key factor of the integrated surveillance strategy in endemic areas.

Keywords: arboviruses, horses, Italy, surveillance, west nile virus, zoonoses

Procedia PDF Downloads 358
2743 Ischemic Stroke Detection in Computed Tomography Examinations

Authors: Allan F. F. Alves, Fernando A. Bacchim Neto, Guilherme Giacomini, Marcela de Oliveira, Ana L. M. Pavan, Maria E. D. Rosa, Diana R. Pina

Abstract:

Stroke is a worldwide concern, only in Brazil it accounts for 10% of all registered deaths. There are 2 stroke types, ischemic (87%) and hemorrhagic (13%). Early diagnosis is essential to avoid irreversible cerebral damage. Non-enhanced computed tomography (NECT) is one of the main diagnostic techniques used due to its wide availability and rapid diagnosis. Detection depends on the size and severity of lesions and the time spent between the first symptoms and examination. The Alberta Stroke Program Early CT Score (ASPECTS) is a subjective method that increases the detection rate. The aim of this work was to implement an image segmentation system to enhance ischemic stroke and to quantify the area of ischemic and hemorrhagic stroke lesions in CT scans. We evaluated 10 patients with NECT examinations diagnosed with ischemic stroke. Analyzes were performed in two axial slices, one at the level of the thalamus and basal ganglion and one adjacent to the top edge of the ganglionic structures with window width between 80 and 100 Hounsfield Units. We used different image processing techniques such as morphological filters, discrete wavelet transform and Fuzzy C-means clustering. Subjective analyzes were performed by a neuroradiologist according to the ASPECTS scale to quantify ischemic areas in the middle cerebral artery region. These subjective analysis results were compared with objective analyzes performed by the computational algorithm. Preliminary results indicate that the morphological filters actually improve the ischemic areas for subjective evaluations. The comparison in area of the ischemic region contoured by the neuroradiologist and the defined area by computational algorithm showed no deviations greater than 12% in any of the 10 examination tests. Although there is a tendency that the areas contoured by the neuroradiologist are smaller than those obtained by the algorithm. These results show the importance of a computer aided diagnosis software to assist neuroradiology decisions, especially in critical situations as the choice of treatment for ischemic stroke.

Keywords: ischemic stroke, image processing, CT scans, Fuzzy C-means

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2742 Study Concerning the Energy-to-Mass Ratio in Pneumatic Muscles

Authors: Tudor Deaconescu, Andrea Deaconescu

Abstract:

The utilization of pneumatic muscles in the actuation of industrial systems is still in its early stages, hence studies on the constructive solutions which include an assessment of their functional performance with a focus on one of the most important characteristics-energy efficiency are required. A quality indicator that adequately reflects the energy efficiency of an actuator is the energy-to-mass ratio. This ratio is computed in the paper for various types and sizes of pneumatic muscles manufactured by Festo, and is subsequently compared to the similar ratios determined for two categories of pneumatic cylinders.

Keywords: pneumatic cylinders, pneumatic muscles, energy-to-mass ratio, muscle stroke

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2741 Outcome of Emergency Response Team System in In-Hospital Cardiac Arrest

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

Abstract:

Introduction: To improve early detection and mortality rate of In- Hospital Cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditions and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90mmHg, respiratory rate <8 or > 28 breaths per minute, O2 saturation < 90%, acute change in conscious state, acute chest pain or worried about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in In-Hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in In-Hospital cardiac arrest and overall hospital mortality rate. We conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed Chi -square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010 ,139 calls in 2011 and 245 calls in 2012.The number of ERT calls per 1000 admissions in year 2009-10 was 7.69, 5.61 in 2011 and 9.38 in 2013. The number of Code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, But we have not found difference in overall hospital mortality rate.

Keywords: emergency response team, ERT, cardiac arrest, emergency medicine

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2740 Long-Term Outcome of Emergency Response Team System in In-Hospital Cardiac Arrest

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

Abstract:

Introduction: To improve early detection and mortality rate of in-hospital cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditons and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90 mmHg, respiratory rate <8 or >28 breaths per minute, O2 saturation <90%, acute change in conscious state, acute chest pain or worry about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in in-hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in in-hospital cardiac arrest and overall hospital mortality rate, we conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed chi-square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010, 139 calls in 2011 and 245 calls in 2012. The number of ERT calls per 1000 admissions in year 2009-10 was 7.69; 5.61 in 2011 and 9.38 in 2013. The number of code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001 ). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, but we have not found difference in overall hospital mortality rate.

Keywords: cardiac arrest, outcome, in-hospital, ERT

Procedia PDF Downloads 198