Search results for: medication errors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1289

Search results for: medication errors

299 Nimart-trained Nurses' Perspectives Regarding Virally Unsuppressed Children HIV-positive on Antiretroviral Therapy and Missing Scheduled Clinic Visits: Mopani District, Limpopo Province

Authors: Linneth Nkateko Mabila, Patrick Hulisani Demana, Tebogo Maria Mothiba

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Background: Sustaining adherence to antiretroviral therapy (ART) over the long term by people, especially children living with Human-Immunodeficiency Virus (HIV), requires accurate and consistent monitoring, and this is a particular challenge for countries in sub-Saharan Africa. However, the regularity and punctuality in monthly antiretroviral treatment collections indicate medication adherence to a certain extent since it has been revealed to be a significant determinant of the outcome of ART. Aim: This study assessed and described the pattern of monthly antiretroviral treatment collections among a cohort of virally unsuppressed HIV-positive children initiated and managed on ART in the rural public clinics of Mopani District, Limpopo, and explored the nurses' perceptions and views of the findings. Methods: A facility-based mixed-methods study was conducted to assess the honoring of scheduled monthly treatment collection practices by a cohort of HIV-positive children under 15 years initiated and managed on ART by Nurse Initiated Management of Antiretroviral Treatment (NIMART)-trained professional nurses (PNs) from 01 January 2015 to 31 December 2015 in public PHC clinics of Mopani District Municipality. This was followed by the exploration of the nurses' perceptions and views regarding this issue to share their experiences and knowledge acquired through managing these children on ART. Results: From a total of 7105 analysable visits, only 44% (3134) were honored as scheduled, with 40% (2828) of children presenting to the clinics after the scheduled appointment date – they missed their appointments, and 11% (768) of treatment collections that took place before the scheduled appointment date. This finding was further confirmed by 90% (97) of the nurses, who reported that they have children who miss scheduled appointments in their public clinics. The primary reasons for children missing appointments were related to caregivers' forgetfulness and conflict between the school schedule and the dates of clinic visits. Conclusion: We confirmed a high prevalence of non-adherence to scheduled monthly ART collections and the existence of health system, social, and caregiver-related factors that threaten treatment adherence and proper clinical outcomes. These findings suggest an urgent need for intervention since non-adherence to ARV therapy can be life-threatening to the child and poses the danger of reduced life expectancy.

Keywords: antiretroviral therapy (art), nimart, virally unsuppressed children, missed appointments

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298 New Derivatives 7-(diethylamino)quinolin-2-(1H)-one Based Chalcone Colorimetric Probes for Detection of Bisulfite Anion in Cationic Micellar Media

Authors: Guillermo E. Quintero, Edwin G. Perez, Oriel Sanchez, Christian Espinosa-Bustos, Denis Fuentealba, Margarita E. Aliaga

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Bisulfite ion (HSO3-) has been used as a preservative in food, drinks, and medication. However, it is well-known that HSO3- can cause health problems like asthma and allergic reactions in people. Due to the above, the development of analytical methods for detecting this ion has gained great interest. In line with the above, the current use of colorimetric and/or fluorescent probes as a detection technique has acquired great relevance due to their high sensitivity and accuracy. In this context, 2-quinolinone derivatives have been found to possess promising activity as antiviral agents, sensitizers in solar cells, antifungals, antioxidants, and sensors. In particular, 7-(diethylamino)-2-quinolinone derivatives have attracted attention in recent years since their suitable photophysical properties become promising fluorescent probes. In Addition, there is evidence that photophysical properties and reactivity can be affected by the study medium, such as micellar media. Based on the above background, 7-(diethylamino)-2-quinolinone derivatives based chalcone will be able to be incorporated into a cationic micellar environment (Cetyltrimethylammonium bromide, CTAB). Furthermore, the supramolecular control induced by the micellar environment will increase the reactivity of these derivatives towards nucleophilic analytes such as HSO3- (Michael-type addition reaction), leading to the generation of new colorimetric and/or fluorescent probes. In the present study, two derivatives of 7-(diethylamino)-2-quinolinone based chalcone DQD1-2 were synthesized according to the method reported by the literature. These derivatives were structurally characterized by 1H, 13C NMR, and HRMS-ESI. In addition, UV-VIS and fluorescence studies determined absorption bands near 450 nm, emission bands near 600 nm, fluorescence quantum yields near 0.01, and fluorescence lifetimes of 5 ps. In line with the foregoing, these photophysical properties aforementioned were improved in the presence of a cationic micellar medium using CTAB thanks to the formation of adducts presenting association constants of the order of 2,5x105 M-1, increasing the quantum yields to 0.12 and the fluorescence lifetimes corresponding to two lifetimes near to 120 and 400 ps for DQD1 and DQD2. Besides, thanks to the presence of the micellar medium, the reactivity of these derivatives with nucleophilic analytes, such as HSO3-, was increased. This was achieved through kinetic studies, which demonstrated an increase in the bimolecular rate constants in the presence of a micellar medium. Finally, probe DQD1 was chosen as the best sensor since it was assessed to detect HSO3- with excellent results.

Keywords: bisulfite detection, cationic micelle, colorimetric probes, quinolinone derivatives

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297 Access of Refugees in Rural Areas to Regular Medication during COVID-19 Era: International Organization for Migration, Jordan Experience

Authors: Rasha Shoumar

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Background: Since the onset of the Syria crisis in 2011, Jordan has hosted many Syrian refugees, many of which are residing in urban and rural areas. Vulnerability of refugees has increased due to the COVID-19 pandemic, adding to their already existing challenge in access to medical services, rendering them vulnerable to the complications of untreated medical conditions and amplifying their risk for severe COVID-19 disease. To improve health outcomes and access to health care services in a COVID-19 context, IOM (The International Organization for Migration) provided health services including awareness raising, direct primary health care through mobile teams and referrals to secondary services were extended to the vulnerable populations of refugees. Method: 6 community health volunteers were trained and deployed to different governorates to provide COVID-19 and non-communicable disease awareness and collect data rated to non-communicable disease and access to medical health services. Primary health care services were extended to 7 governorates through a mobile medical team, providing medical management. The collected Data was reviewed and analyzed. Results: 2150 refugees in rural areas were reached out by community health volunteers, out of which 78 received their medications through the Ministry of Health, 121 received their medications through different non-governmental organizations, 665 patients couldn’t afford buying any medications, 1286 patients were occasionally buying their medications when they were able to afford it. 853 patients received medications and follow up through IOM mobile clinics, the most common conditions were hypertension, diabetes, hyperlipidemia, anemia, heart disease, thyroid disease, asthma, seizures, and psychiatric conditions. 709 of these patients had more than 3 of the comorbidities. Multiple cases were referred for secondary and tertiary lifesaving interventions. Conclusion: Non communicable diseases are highly prevalent among refugee population in Jordan, access to medical services have proven to be a challenge in rural areas especially during the COVID-19 era, many of the patients have multiple uncontrolled medical conditions placing them at risk for complications and risk for severe COVID-19 disease. Deployment of mobile clinics to rural areas plays an essential role in managing such medical conditions, thus improving the continuum of health care approach, physical and mental wellbeing of refugees and reducing the risk for severe COVID-19 disease among this group, taking us one step forward toward universal health access.

Keywords: COVID-19, refugees, mobile clinics, primary health care

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296 Investigating Unplanned Applications and Admissions to Hospitals of Children with Cancer

Authors: Hacer Kobya Bulut, Ilknur Kahriman, Birsel C. Demirbag

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Introduction and Purpose: The lives of children with cancer are affected by long term hospitalizations in a negative way due to complications arising from diagnosis or treatment. However, the children's parents are known to have difficulties in meeting their children’s needs and providing home care after cancer treatment or during remission process. Supporting these children and their parents by giving a planned discharge training starting from the hospital and home care leads to reducing hospital applications, hospitalizations, hospital costs, shortening the length of hospital stay and increasing the satisfaction of the children with cancer and their families. This study was conducted to investigate the status of children and their parents' unplanned application to hospital and re-hospitalization. Methods: The study was carried out with 65 children with hematological malignancy in 0-17 age group and their families in a hematology clinic and polyclinic of a university hospital in Trabzon. Data were collected with survey methodology between August-November, 2015 through face to face interview using numbers, percentage and chi-square test in the evaluation. Findings: Most of the children were leukemia (90.8%) and 49.2% had been ill over 13 months. Few of the parents (32.3%) stated that they had received discharge and home care training (24.6%) but most of them (69.2%) found themselves enough in providing home care. Very few parents (6.2%) received home care training after their children being discharged and the majority of parents (61.5%) faced difficulties in home care and had no one to call around them. The parents expressed that in providing care to their children with hematological malignance, they faced difficulty in feeding them (74.6%), explaining their disease (50.0%), giving their oral medication (47.5%), providing hygiene (43.5%) and providing oral care (39.3%). The question ‘What are the emergency situations in which you have to bring your children to a doctor immediately?' was replied as fever (89.2%), severe nausea and vomiting (87.7%), hemorrhage (86.2%) and pain (81.5%). The study showed that 50.8% of the children had unplanned applications to hospitals and 33.8% of them identified as unplanned hospitalization and the first causes of this were fever and pain. The study showed that the frequency of applications (%78.8) and hospitalizations (%81.8) was higher for boys and a statistically significant difference was found between gender and unplanned applications (X=4.779; p=0.02). Applications (48.5%) and hospitalizations (40.9%) were found lower for the parents who had received hospital discharge training, and a significant difference was determined between receiving training and unplanned hospitalizations (X=8.021; p=0.00). Similarly, applications (30.3%) and hospitalizations (40.9%) was found lower for the ones who had received home care training, and a significant difference was determined between receiving home care training and unplanned hospitalizations (X=4.758; p=0.02). Conclusion: It was found out that caregivers of children with cancer did not receive training related to home care and complications about treatment after discharging from hospital, so they faced difficulties in providing home care and this led to an increase in unplanned hospital applications and hospitalizations.

Keywords: cancer, children, unplanned application, unplanned hospitalization

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295 Decision Making in Medicine and Treatment Strategies

Authors: Kamran Yazdanbakhsh, Somayeh Mahmoudi

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Three reasons make good use of the decision theory in medicine: 1. Increased medical knowledge and their complexity makes it difficult treatment information effectively without resorting to sophisticated analytical methods, especially when it comes to detecting errors and identify opportunities for treatment from databases of large size. 2. There is a wide geographic variability of medical practice. In a context where medical costs are, at least in part, by the patient, these changes raise doubts about the relevance of the choices made by physicians. These differences are generally attributed to differences in estimates of probabilities of success of treatment involved, and differing assessments of the results on success or failure. Without explicit criteria for decision, it is difficult to identify precisely the sources of these variations in treatment. 3. Beyond the principle of informed consent, patients need to be involved in decision-making. For this, the decision process should be explained and broken down. A decision problem is to select the best option among a set of choices. The problem is what is meant by "best option ", or know what criteria guide the choice. The purpose of decision theory is to answer this question. The systematic use of decision models allows us to better understand the differences in medical practices, and facilitates the search for consensus. About this, there are three types of situations: situations certain, risky situations, and uncertain situations: 1. In certain situations, the consequence of each decision are certain. 2. In risky situations, every decision can have several consequences, the probability of each of these consequences is known. 3. In uncertain situations, each decision can have several consequences, the probability is not known. Our aim in this article is to show how decision theory can usefully be mobilized to meet the needs of physicians. The decision theory can make decisions more transparent: first, by clarifying the data systematically considered the problem and secondly by asking a few basic principles should guide the choice. Once the problem and clarified the decision theory provides operational tools to represent the available information and determine patient preferences, and thus assist the patient and doctor in their choices.

Keywords: decision making, medicine, treatment strategies, patient

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294 Probability Sampling in Matched Case-Control Study in Drug Abuse

Authors: Surya R. Niraula, Devendra B Chhetry, Girish K. Singh, S. Nagesh, Frederick A. Connell

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Background: Although random sampling is generally considered to be the gold standard for population-based research, the majority of drug abuse research is based on non-random sampling despite the well-known limitations of this kind of sampling. Method: We compared the statistical properties of two surveys of drug abuse in the same community: one using snowball sampling of drug users who then identified “friend controls” and the other using a random sample of non-drug users (controls) who then identified “friend cases.” Models to predict drug abuse based on risk factors were developed for each data set using conditional logistic regression. We compared the precision of each model using bootstrapping method and the predictive properties of each model using receiver operating characteristics (ROC) curves. Results: Analysis of 100 random bootstrap samples drawn from the snowball-sample data set showed a wide variation in the standard errors of the beta coefficients of the predictive model, none of which achieved statistical significance. One the other hand, bootstrap analysis of the random-sample data set showed less variation, and did not change the significance of the predictors at the 5% level when compared to the non-bootstrap analysis. Comparison of the area under the ROC curves using the model derived from the random-sample data set was similar when fitted to either data set (0.93, for random-sample data vs. 0.91 for snowball-sample data, p=0.35); however, when the model derived from the snowball-sample data set was fitted to each of the data sets, the areas under the curve were significantly different (0.98 vs. 0.83, p < .001). Conclusion: The proposed method of random sampling of controls appears to be superior from a statistical perspective to snowball sampling and may represent a viable alternative to snowball sampling.

Keywords: drug abuse, matched case-control study, non-probability sampling, probability sampling

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293 Emergency Surgery in the Elderly, What Particularities

Authors: Mekroud Amel

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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

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292 Chronolgy and Developments in Inventory Control Best Practices for FMCG Sector

Authors: Roopa Singh, Anurag Singh, Ajay

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Agriculture contributes a major share in the national economy of India. A major portion of Indian economy (about 70%) depends upon agriculture as it forms the main source of income. About 43% of India’s geographical area is used for agricultural activity which involves 65-75% of total population of India. The given work deals with the Fast moving Consumer Goods (FMCG) industries and their inventories which use agricultural produce as their raw material or input for their final product. Since the beginning of inventory practices, many developments took place which can be categorised into three phases, based on the review of various works. The first phase is related with development and utilization of Economic Order Quantity (EOQ) model and methods for optimizing costs and profits. Second phase deals with inventory optimization method, with the purpose of balancing capital investment constraints and service level goals. The third and recent phase has merged inventory control with electrical control theory. Maintenance of inventory is considered negative, as a large amount of capital is blocked especially in mechanical and electrical industries. But the case is different in food processing and agro-based industries and their inventories due to cyclic variation in the cost of raw materials of such industries which is the reason for selection of these industries in the mentioned work. The application of electrical control theory in inventory control makes the decision-making highly instantaneous for FMCG industries without loss in their proposed profits, which happened earlier during first and second phases, mainly due to late implementation of decision. The work also replaces various inventories and work-in-progress (WIP) related errors with their monetary values, so that the decision-making is fully target-oriented.

Keywords: control theory, inventory control, manufacturing sector, EOQ, feedback, FMCG sector

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291 An Experiment Research on the Effect of Brain-Break in the Classroom on Elementary School Students’ Selective Attention

Authors: Hui Liu, Xiaozan Wang, Jiarong Zhong, Ziming Shao

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Introduction: Related research shows that students don’t concentrate on teacher’s speaking in the classroom. The d2 attention test is a time-limited test about selective attention. The d2 attention test can be used to evaluate individual selective attention. Purpose: To use the d2 attention test tool to measure the difference between the attention level of the experimental class and the control class before and after Brain-Break and to explore the effect of Brain-Break in the classroom on students' selective attention. Methods: According to the principle of no difference in pre-test data, two classes in the fourth- grade of Shenzhen Longhua Central Primary School were selected. After 20 minutes of class in the third class in the morning and the third class in the afternoon, about 3-minute Brain-Break intervention was performed in the experimental class for 10 weeks. The normal class in the control class did not intervene. Before and after the experiment, the d2 attention test tool was used to test the attention level of the two-class students. The paired sample t-test and independent sample t-test in SPSS 23.0 was used to test the change in the attention level of the two-class classes around 10 weeks. This article only presents results with significant differences. Results: The independent sample t-test results showed that after ten-week of Brain-Break, the missed errors (E1 t = -2.165 p = 0.042), concentration performance (CP t = 1.866 p = 0.05), and the degree of omissions (Epercent t = -2.375 p = 0.029) in experimental class showed significant differences compared with control class. The students’ error level decreased and the concentration increased. Conclusions: Adding Brain-Break interventions in the classroom can effectively improve the attention level of fourth-grade primary school students to a certain extent, especially can improve the concentration of attention and decrease the error rate in the tasks. The new sport's learning model is worth promoting

Keywords: cultural class, micromotor, attention, D2 test

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290 Behavioral and EEG Reactions in Children during Recognition of Emotionally Colored Sentences That Describe the Choice Situation

Authors: Tuiana A. Aiusheeva, Sergey S. Tamozhnikov, Alexander E. Saprygin, Arina A. Antonenko, Valentina V. Stepanova, Natalia N. Tolstykh, Alexander N. Savostyanov

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Situation of choice is an important condition for the formation of essential character qualities of a child, such as being initiative, responsible, hard-working. We have studied the behavioral and EEG reactions in Russian schoolchildren during recognition of syntactic errors in emotionally colored sentences that describe the choice situation. Twenty healthy children (mean age 9,0±0,3 years, 12 boys, 8 girls) were examined. Forty sentences were selected for the experiment; the half of them contained a syntactic error. The experiment additionally had the hidden condition: 50% of the sentences described the children's own choice and were emotionally colored (positive or negative). The other 50% of the sentences described the forced-choice situation, also with positive or negative coloring. EEG were recorded during execution of error-recognition task. Reaction time and quality of syntactic error detection were chosen as behavioral measures. Event-related spectral perturbation (ERSP) was applied to characterize the oscillatory brain activity of children. There were two time-frequency intervals in EEG reactions: (1) 500-800 ms in the 3-7 Hz frequency range (theta synchronization) and (2) 500-1000 ms in the 8-12 Hz range (alpha desynchronization). We found out that behavioral and brain reactions in child brain during recognition of positive and negative sentences describing forced-choice situation did not have significant differences. Theta synchronization and alpha desynchronization were stronger during recognition of sentences with children's own choice, especially with negative coloring. Also, the quality and execution time of the task were higher for this types of sentences. The results of our study will be useful for improvement of teaching methods and diagnostics of children affective disorders.

Keywords: choice situation, electroencephalogram (EEG), emotionally colored sentences, schoolchildren

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289 Modelling of Heat Generation in a 18650 Lithium-Ion Battery Cell under Varying Discharge Rates

Authors: Foo Shen Hwang, Thomas Confrey, Stephen Scully, Barry Flannery

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Thermal characterization plays an important role in battery pack design. Lithium-ion batteries have to be maintained between 15-35 °C to operate optimally. Heat is generated (Q) internally within the batteries during both the charging and discharging phases. This can be quantified using several standard methods. The most common method of calculating the batteries heat generation is through the addition of both the joule heating effects and the entropic changes across the battery. In addition, such values can be derived by identifying the open-circuit voltage (OCV), nominal voltage (V), operating current (I), battery temperature (T) and the rate of change of the open-circuit voltage in relation to temperature (dOCV/dT). This paper focuses on experimental characterization and comparative modelling of the heat generation rate (Q) across several current discharge rates (0.5C, 1C, and 1.5C) of a 18650 cell. The analysis is conducted utilizing several non-linear mathematical functions methods, including polynomial, exponential, and power models. Parameter fitting is carried out over the respective function orders; polynomial (n = 3~7), exponential (n = 2) and power function. The generated parameter fitting functions are then used as heat source functions in a 3-D computational fluid dynamics (CFD) solver under natural convection conditions. Generated temperature profiles are analyzed for errors based on experimental discharge tests, conducted at standard room temperature (25°C). Initial experimental results display low deviation between both experimental and CFD temperature plots. As such, the heat generation function formulated could be easier utilized for larger battery applications than other methods available.

Keywords: computational fluid dynamics, curve fitting, lithium-ion battery, voltage drop

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288 Investment and Economic Growth: An Empirical Analysis for Tanzania

Authors: Manamba Epaphra

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This paper analyzes the causal effect between domestic private investment, public investment, foreign direct investment and economic growth in Tanzania during the 1970-2014 period. The modified neo-classical growth model that includes control variables such as trade liberalization, life expectancy and macroeconomic stability proxied by inflation is used to estimate the impact of investment on economic growth. Also, the economic growth models based on Phetsavong and Ichihashi (2012), and Le and Suruga (2005) are used to estimate the crowding out effect of public investment on private domestic investment on one hand and foreign direct investment on the other hand. A correlation test is applied to check the correlation among independent variables, and the results show that there is very low correlation suggesting that multicollinearity is not a serious problem. Moreover, the diagnostic tests including RESET regression errors specification test, Breusch-Godfrey serial correlation LM test, Jacque-Bera-normality test and white heteroskedasticity test reveal that the model has no signs of misspecification and that, the residuals are serially uncorrelated, normally distributed and homoskedastic. Generally, the empirical results show that the domestic private investment plays an important role in economic growth in Tanzania. FDI also tends to affect growth positively, while control variables such as high population growth and inflation appear to harm economic growth. Results also reveal that control variables such as trade openness and life expectancy improvement tend to increase real GDP growth. Moreover, a revealed negative, albeit weak, association between public and private investment suggests that the positive effect of domestic private investment on economic growth reduces when public investment-to-GDP ratio exceeds 8-10 percent. Thus, there is a great need for promoting domestic saving so as to encourage domestic investment for economic growth.

Keywords: FDI, public investment, domestic private investment, crowding out effect, economic growth

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287 Loss Function Optimization for CNN-Based Fingerprint Anti-Spoofing

Authors: Yehjune Heo

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As biometric systems become widely deployed, the security of identification systems can be easily attacked by various spoof materials. This paper contributes to finding a reliable and practical anti-spoofing method using Convolutional Neural Networks (CNNs) based on the types of loss functions and optimizers. The types of CNNs used in this paper include AlexNet, VGGNet, and ResNet. By using various loss functions including Cross-Entropy, Center Loss, Cosine Proximity, and Hinge Loss, and various loss optimizers which include Adam, SGD, RMSProp, Adadelta, Adagrad, and Nadam, we obtained significant performance changes. We realize that choosing the correct loss function for each model is crucial since different loss functions lead to different errors on the same evaluation. By using a subset of the Livdet 2017 database, we validate our approach to compare the generalization power. It is important to note that we use a subset of LiveDet and the database is the same across all training and testing for each model. This way, we can compare the performance, in terms of generalization, for the unseen data across all different models. The best CNN (AlexNet) with the appropriate loss function and optimizers result in more than 3% of performance gain over the other CNN models with the default loss function and optimizer. In addition to the highest generalization performance, this paper also contains the models with high accuracy associated with parameters and mean average error rates to find the model that consumes the least memory and computation time for training and testing. Although AlexNet has less complexity over other CNN models, it is proven to be very efficient. For practical anti-spoofing systems, the deployed version should use a small amount of memory and should run very fast with high anti-spoofing performance. For our deployed version on smartphones, additional processing steps, such as quantization and pruning algorithms, have been applied in our final model.

Keywords: anti-spoofing, CNN, fingerprint recognition, loss function, optimizer

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286 The Use of Unmanned Aerial System (UAS) in Improving the Measurement System on the Example of Textile Heaps

Authors: Arkadiusz Zurek

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The potential of using drones is visible in many areas of logistics, especially in terms of their use for monitoring and control of many processes. The technologies implemented in the last decade concern new possibilities for companies that until now have not even considered them, such as warehouse inventories. Unmanned aerial vehicles are no longer seen as a revolutionary tool for Industry 4.0, but rather as tools in the daily work of factories and logistics operators. The research problem is to develop a method for measuring the weight of goods in a selected link of the clothing supply chain by drones. However, the purpose of this article is to analyze the causes of errors in traditional measurements, and then to identify adverse events related to the use of drones for the inventory of a heap of textiles intended for production purposes. On this basis, it will be possible to develop guidelines to eliminate the causes of these events in the measurement process using drones. In a real environment, work was carried out to determine the volume and weight of textiles, including, among others, weighing a textile sample to determine the average density of the assortment, establishing a local geodetic network, terrestrial laser scanning and photogrammetric raid using an unmanned aerial vehicle. As a result of the analysis of measurement data obtained in the facility, the volume and weight of the assortment and the accuracy of their determination were determined. In this article, this work presents how such heaps are currently being tested, what adverse events occur, indicate and describes the current use of photogrammetric techniques of this type of measurements so far performed by external drones for the inventory of wind farms or construction of the station and compare them with the measurement system of the aforementioned textile heap inside a large-format facility.

Keywords: drones, unmanned aerial system, UAS, indoor system, security, process automation, cost optimization, photogrammetry, risk elimination, industry 4.0

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285 Enhancing Warehousing Operation In Cold Supply Chain Through The Use Of IOT And Lifi Technologies

Authors: Sarah El-Gamal, Passent Hossam, Ahmed Abd El Aziz, Rojina Mahmoud, Ahmed Hassan, Dalia Hilal, Eman Ayman, Hana Haytham, Omar Khamis

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Several concerns fall upon the supply chain, especially the cold supply chain. According to the literature, the main challenges in the cold supply chain are the distribution and storage phases. In this research, researchers focused on the storage area, which contains several activities such as the picking activity that faces a lot of obstacles and challenges The implementation of IoT solutions enables businesses to monitor the temperature of food items, which is perhaps the most critical parameter in cold chains. Therefore, researchers proposed a practical solution that would help in eliminating the problems related to ineffective picking for products, especially fish and seafood products, by using IoT technology, most notably LiFi technology. Thus, guaranteeing sufficient picking, reducing waste, and consequently lowering costs. A prototype was specially designed and examined. This research is a single case study research. Two methods of data collection were used; observation and semi-structured interviews. Semi-structured interviews were conducted with managers and decision maker at Carrefour Alexandria to validate the problem and the proposed practical solution using IoTandLiFi technology. A total of three interviews were conducted. As a result, a SWOT analysis was achieved in order to highlight all the strengths and weaknesses of using the recommended Lifi solution in the picking process. According to the investigations, it was found that the use of IoT and LiFi technology is cost effective, efficient, and reduces human errors, minimize the percentage of product waste and thus save money and cost. Thus, increasing customer satisfaction and profits gained.

Keywords: cold supply chain, picking process, temperature control, IOT, warehousing, LIFI

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284 Derivatives Balance Method for Linear and Nonlinear Control Systems

Authors: Musaab Mohammed Ahmed Ali, Vladimir Vodichev

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work deals with an universal control technique or single controller for linear and nonlinear stabilization and tracing control systems. These systems may be structured as SISO and MIMO. Parameters of controlled plants can vary over a wide range. Introduced a novel control systems design method, construction of stable platform orbits using derivative balance, solved transfer function stability preservation problem of linear system under partial substitution of a rational function. Universal controller is proposed as a polar system with the multiple orbits to simplify design procedure, where each orbit represent single order of controller transfer function. Designed controller consist of proportional, integral, derivative terms and multiple feedback and feedforward loops. The controller parameters synthesis method is presented. In generally, controller parameters depend on new polynomial equation where all parameters have a relationship with each other and have fixed values without requirements of retuning. The simulation results show that the proposed universal controller can stabilize infinity number of linear and nonlinear plants and shaping desired previously ordered performance. It has been proven that sensor errors and poor performance will be completely compensated and cannot affect system performance. Disturbances and noises effect on the controller loop will be fully rejected. Technical and economic effect of using proposed controller has been investigated and compared to adaptive, predictive, and robust controllers. The economic analysis shows the advantage of single controller with fixed parameters to drive infinity numbers of plants compared to above mentioned control techniques.

Keywords: derivative balance, fixed parameters, stable platform, universal control

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283 Improved Regression Relations Between Different Magnitude Types and the Moment Magnitude in the Western Balkan Earthquake Catalogue

Authors: Anila Xhahysa, Migena Ceyhan, Neki Kuka, Klajdi Qoshi, Damiano Koxhaj

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The seismic event catalog has been updated in the framework of a bilateral project supported by the Central European Investment Fund and with the extensive support of Global Earthquake Model Foundation to update Albania's national seismic hazard model. The earthquake catalogue prepared within this project covers the Western Balkan area limited by 38.0° - 48°N, 12.5° - 24.5°E and includes 41,806 earthquakes that occurred in the region between 510 BC and 2022. Since the moment magnitude characterizes the earthquake size accurately and the selected ground motion prediction equations for the seismic hazard assessment employ this scale, it was chosen as the uniform magnitude scale for the catalogue. Therefore, proxy values of moment magnitude had to be obtained by using new magnitude conversion equations between the local and other magnitude types to this unified scale. The Global Centroid Moment Tensor Catalogue was considered the most authoritative for moderate to large earthquakes for moment magnitude reports; hence it was used as a reference for calibrating other sources. The best fit was observed when compared to some regional agencies, whereas, with reports of moment magnitudes from Italy, Greece and Turkey, differences were observed in all magnitude ranges. For teleseismic magnitudes, to account for the non-linearity of the relationships, we used the exponential model for the derivation of the regression equations. The obtained regressions for the surface wave magnitude and short-period body-wave magnitude show considerable differences with Global Earthquake Model regression curves, especially for low magnitude ranges. Moreover, a conversion relation was obtained between the local magnitude of Albania and the corresponding moment magnitude as reported by the global and regional agencies. As errors were present in both variables, the Deming regression was used.

Keywords: regression, seismic catalogue, local magnitude, tele-seismic magnitude, moment magnitude

Procedia PDF Downloads 47
282 Development of Electric Generator and Water Purifier Cart

Authors: Luisito L. Lacatan, Gian Carlo J. Bergonia, Felipe C. Buado III, Gerald L. Gono, Ron Mark V. Ortil, Calvin A. Yap

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This paper features the development of a Mobile Self-sustaining Electricity Generator for water distillation process with MCU- based wireless controller & indicator designed to solve the problem of scarcity of clean water. It is a fact that pure water is precious nowadays and its value is more precious to those who do not have or enjoy it. There are many water filtration products in existence today. However, none of these products fully satisfies the needs of families needing clean drinking water. All of the following products require either large sums of money or extensive maintenance, and some products do not even come with a guarantee of potable water. The proposed project was designed to alleviate the problem of scarcity of potable water in the country and part of the purpose was also to identify the problem or loopholes of the project such as the distance and speed required to produce electricity using a wheel and alternator, the required time for the heating element to heat up, the capacity of the battery to maintain the heat of the heating element and the time required for the boiler to produce a clean and potable water. The project has three parts. The first part included the researchers’ effort to plan every part of the project from the conversion of mechanical energy to electrical energy, from purifying water to potable drinking water to the controller and indicator of the project using microcontroller unit (MCU). This included identifying the problem encountered and any possible solution to prevent and avoid errors. Gathering and reviewing related studies about the project helped the researcher reduce and prevent any problems before they could be encountered. It also included the price and quantity of materials used to control the budget.

Keywords: mobile, self – sustaining, electricity generator, water distillation, wireless battery indicator, wireless water level indicator

Procedia PDF Downloads 288
281 The Influence of Hydrolyzed Cartilage Collagen on General Mobility and Wellbeing of an Active Population

Authors: Sara De Pelsmaeker, Catarina Ferreira da Silva, Janne Prawit

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Recent studies show that enzymatically hydrolysed collagen is absorbed and distributed to joint tissues, where it has analgesic and active anti-inflammatory properties. Reviews of the associated relevant literature also support this theory. However, these studies are all using hydrolyzed collagen from animal hide or skin. This study looks into the effect of daily supplementation of hydrolyzed cartilage collagen (HCC), which has a different composition. A consumer study was set up using a double-blind placebo-controlled design with a control group using twice a day 0.5gr of maltodextrin and an experimental group using twice 0.5g of HCC, over a trial period of 12 weeks. A follow-up phase of 4 weeks without supplementation was taken into the experiment to investigate the ‘wash-out’ phase. As this consumer study was conducted during the lockdown periods, a specific app was designed to follow up with the participants. The app had the advantage that in this way, the motivation of the participants was enhanced and the drop-out range of participants was lower than normally seen in consumer studies. Participants were recruited via various sports and health clubs across the UK as we targeted a general population of people that considered themselves in good health. Exclusion criteria were ‘not experiencing any medical conditions’ and ‘not taking any prescribed medication’. A minimum requirement was that they regularly engaged in some level of physical activity. The participants had to log the type of activity that they conducted and the duration of the activity. Weekly, participants were providing feedback on their joint health and subjective pain using the validated pain measuring instrument Visual Analogue Scale (VAS). The weekly repoAbstract Public Health and Wellbeing Conferencerting section in the app was designed with simplicity and based on the accuracy demonstrated in previous similar studies to track subjective pain measures of participants. At the beginning of the trial, each participant indicated their baseline on joint pain. The results of this consumer study indicated that HCC significantly improved joint health and subjective pain scores compared to the placebo group. No significant differences were found between different demographic groups (age or gender). The level of activity, going from high intensive training to regular walking, did not significantly influence the effect of the HCC. The results of the wash-out phase indicated that when the participants stopped the HCC supplementation, their subjective pain scores increased again to the baseline. In conclusion, the results gave a positive indication that the daily supplementation of HCC can contribute to the overall mobility and wellbeing of a general active population

Keywords: VAS-score, food supplement, mobility, joint health

Procedia PDF Downloads 140
280 Development of an Innovative Mobile Phone Application for Employment of Persons With Disabilities Toward the Inclusive Society

Authors: Marutani M, Kawajiri H, Usui C, Takai Y, Kawaguchi T

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Background: To build the inclusive society, the Japanese government provides “transition support for employment system” for Persons with Disabilities (PWDs). It is, however, difficult to provide appropriate accommodations due to their changeable health conditions. Mobile phone applications (App) are useful to monitor their health conditions and their environments, and effective to improve reasonable accommodations for PWDs. Purpose: This study aimed to develop an App that PWDs input their self-assessment and make their health conditions and environment conditions visible. To attain the goal, we investigated the items of the App for the first step. Methods: Qualitative and descriptive design was used for this study. Study participants were recruited by snowball sampling in July and August 2023. They had to have had minimum of five-years of experience to support PWDs’ employment. Semi-structured interviews were conducted on their assessment regarding PWDs’ conditions of daily activities, their health conditions, and living and working environment. Verbatim transcript was created from each interview content. We extracted the following items in tree groups from each verbatim transcript: daily activities, health conditions, and living and working. Results: Fourteen participants were involved (average years of experience: 10.6 years). Based on the interviews, tree item groups were enriched. The items of daily activities were divided into fifty-five. The example items were as follows: “have meals on one’s style” “feel like slept well” “wake-up time, bedtime, and mealtime are usually fixed.” “commute to the office and work without barriers.” Thirteen items of health conditions were obtained like “feel no anxiety” “relieve stress” “focus on work and training” “have no pain” “have the physical strength to work for one day.” The items of categories of living and working environments were divided into fifteen-two. The example items were as follows: “have no barrier in home” “have supportive family members” “have time to take medication on time while at work” “commute time is just right” “people at the work understand the symptoms” “room temperature and humidity are just right” “get along well with friends in my own way.” The participants also mentioned the styles to input self-assessment like that a face scale would be preferred to number scale. Conclusion: The items were enriched existent paper-based assessment items in terms of living and working environment because those were obtained from the perspective of PWDs. We have to create the app and examine its usefulness with PWDs toward inclusive society.

Keywords: occupational health, innovatiove tool, people with disability, employment

Procedia PDF Downloads 35
279 Evaluation of the Standard Practice of Availability of Anti-Tuberculosis Drugs in Community Pharmacies

Authors: Udaykumar R., M. S. Ganachari

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In order to engage community pharmacies in Tuberculosis care, a survey has been conducted in Belgaum city, Karnataka state, India. After the survey divided into two groups one is control group and another one is intervention group. One is dispensing of anti-tuberculosis drugs, and another one is non-availability of anti-tuberculosis drugs. Those community pharmacists who are voluntarily interesting for becoming DOTS (Directly observed treatment short course) provider and RNTCP (Revised national tuberculosis control programme) objectives. Structured training is conducted for community pharmacist who are dispensing anti-tuberculosis drugs. The training module includes record maintaining, reporting to the RNTCP, Medication adherence etc. In case of non-availability of anti-tuberculosis drugs, the district RNTCP has been given training for community pharmacist by providing free of drugs to the community pharmacies. So, community pharmacies can dispense anti-tuberculosis drugs to the patients. The target of this study is Private community pharmacies. A simple random sampling method is used and 550 private community pharmacy shops has been involved in Belgaum city of Karnataka state, India. Significance of the Study: This study mainly focused on training of DOTS (Directly observed treatment short course) to the private community pharmacist. Indian Govt. Considers Private Providers as Assets for TB Control and Care to Achieve National Strategic Plan for TB Elimination 2017-2025. The Govt. has not fully tapped the Potential of Private Pharmacies to Fight TB. Providing DOTS as per patient’s convenience through community DOT Providers with periodic monitoring may reduce the treatment Default. We explore RNTCP objectives interventions that can have directly managed by private community pharmacy shop. Objectives: Survey of anti-tuberculosis drugs in Community pharmacy shop in Belgaum city. Interested community pharmacist who are willing to become DOTS (Directly observed treatment short course) Provider. Major Findings:Most of the community pharmacist are dispensing anti-tuberculosis drugs without having knowledge of DOTS therapy and RNTCP objectives. No community pharmacist is aware of RNTCP and Tuberculosis burden in India. Most of the Pharmacist agreed to come for RNTCP Training module for the community pharmacist. Some of the community pharmacist not dispensing anti-tuberculosis drugs and they agreed to become official DOTS provider. Concluding Statement: Awareness of role of community pharmacist on tuberculosis control and care has been neglected. More than 50% of tuberculosis patients seeking treatments from privatesector. In this study finds the major gap between government and private sector on tuberculosis treatment.

Keywords: community pharmacist, directly observed treatment short course(DOTS), revised national tuberculosis control programme (RNTCP), private pharmacies, anti-tuberculosis drugs

Procedia PDF Downloads 105
278 Detection of Resistive Faults in Medium Voltage Overhead Feeders

Authors: Mubarak Suliman, Mohamed Hassan

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Detection of downed conductors occurring with high fault resistance (reaching kilo-ohms) has always been a challenge, especially in countries like Saudi Arabia, on which earth resistivity is very high in general (reaching more than 1000 Ω-meter). The new approaches for the detection of resistive and high impedance faults are based on the analysis of the fault current waveform. These methods are still under research and development, and they are currently lacking security and dependability. The other approach is communication-based solutions which depends on voltage measurement at the end of overhead line branches and communicate the measured signals to substation feeder relay or a central control center. However, such a detection method is costly and depends on the availability of communication medium and infrastructure. The main objective of this research is to utilize the available standard protection schemes to increase the probability of detection of downed conductors occurring with a low magnitude of fault currents and at the same time avoiding unwanted tripping in healthy conditions and feeders. By specifying the operating region of the faulty feeder, use of tripping curve for discrimination between faulty and healthy feeders, and with proper selection of core balance current transformer (CBCT) and voltage transformers with fewer measurement errors, it is possible to set the pick-up of sensitive earth fault current to minimum values of few amps (i.e., Pick-up Settings = 3 A or 4 A, …) for the detection of earth faults with fault resistance more than (1 - 2 kΩ) for 13.8kV overhead network and more than (3-4) kΩ fault resistance in 33kV overhead network. By implementation of the outcomes of this study, the probability of detection of downed conductors is increased by the utilization of existing schemes (i.e., Directional Sensitive Earth Fault Protection).

Keywords: sensitive earth fault, zero sequence current, grounded system, resistive fault detection, healthy feeder

Procedia PDF Downloads 91
277 Dwindling the Stability of DNA Sequence by Base Substitution at Intersection of COMT and MIR4761 Gene

Authors: Srishty Gulati, Anju Singh, Shrikant Kukreti

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The manifestation of structural polymorphism in DNA depends on the sequence and surrounding environment. Ample of folded DNA structures have been found in the cellular system out of which DNA hairpins are very common, however, are indispensable due to their role in the replication initiation sites, recombination, transcription regulation, and protein recognition. We enumerate this approach in our study, where the two base substitutions and change in temperature embark destabilization of DNA structure and misbalance the equilibrium between two structures of a sequence present at the overlapping region of the human COMT gene and MIR4761 gene. COMT and MIR4761 gene encodes for catechol-O-methyltransferase (COMT) enzyme and microRNAs (miRNAs), respectively. Environmental changes and errors during cell division lead to genetic abnormalities. The COMT gene entailed in dopamine regulation fosters neurological diseases like Parkinson's disease, schizophrenia, velocardiofacial syndrome, etc. A 19-mer deoxyoligonucleotide sequence 5'-AGGACAAGGTGTGCATGCC-3' (COMT19) is located at exon-4 on chromosome 22 and band q11.2 at the intersection of COMT and MIR4761 gene. Bioinformatics studies suggest that this sequence is conserved in humans and few other organisms and is involved in recognition of transcription factors in the vicinity of 3'-end. Non-denaturating gel electrophoresis and CD spectroscopy of COMT sequences indicate the formation of hairpin type DNA structures. Temperature-dependent CD studies revealed an unusual shift in the slipped DNA-Hairpin DNA equilibrium with the change in temperature. Also, UV-thermal melting techniques suggest that the two base substitutions on the complementary strand of COMT19 did not affect the structure but reduces the stability of duplex. This study gives insight about the possibility of existing structurally polymorphic transient states within DNA segments present at the intersection of COMT and MIR4761 gene.

Keywords: base-substitution, catechol-o-methyltransferase (COMT), hairpin-DNA, structural polymorphism

Procedia PDF Downloads 100
276 Improving Fingerprinting-Based Localization System Using Generative AI

Authors: Getaneh Berie Tarekegn

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A precise localization system is crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. The most common method for providing continuous positioning services in outdoor environments is by using a global navigation satellite system (GNSS). Due to nonline-of-sight, multipath, and weather conditions, GNSS systems do not perform well in dense urban, urban, and suburban areas.This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. It also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

Procedia PDF Downloads 25
275 Hypotonia - A Concerning Issue in Neonatal Care

Authors: Eda Jazexhiu-Postoli, Gladiola Hoxha, Ada Simeoni, Sonila Biba

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Background Neonatal hypotonia represents a commonly encountered issue in the Neonatal Intensive Care Unit and newborn nursery. The differential diagnosis is broad, encompassing chromosome abnormalities, primary muscular dystrophies, neuropathies and inborn errors of metabolism. Aim of study Our study describes some of the main clinical features of hypotonia in newborns and presents clinical cases of neonatal hypotonia we treated in our Neonatal unit in the last 3 years. Case reports Four neonates born in our hospital presented with hypotonia after birth, one preterm newborn 35-36 weeks of gestational age and three other term newborns (38-39 weeks of gestational age). Prenatal data revealed a decrease in fetal movements in both cases. Intrapartum meconium-stained amniotic fluid was found in 75% of our hypotonic newborns. Clinical features included inability to establish effective respiratory movements and need for resuscitation in the delivery room, respiratory distress syndrome, feeding difficulties and need for oro-gastric tube feeding, dysmorphic features, hoarse voice and moderate to severe muscular hypotonia. The genetic workup revealed the diagnosis of Autosomal Recessive Congenital Myasthenic Syndrome 1-B, Sotos Syndrome, Spinal Muscular Atrophy Type 1 and Transient Hypotonia of the Newborn. Two out of four hypotonic neonates were transferred to the Pediatric Intensive Care Unit and died at the age of three to five months old. Conclusion Hypotonia is a concerning finding in neonatal care and it is suggested by decreased intrauterine fetal movements, failure to establish first breaths, respiratory distress and feeding difficulties in the neonate. Prognosis is determined by its etiology and time of diagnosis and intervention.

Keywords: hypotonic neonate, respiratory distress, feeding difficulties, fetal movements

Procedia PDF Downloads 82
274 Effects of Neem (Azadirachta indica A. Juss) Kernel Inclusion in Broiler Diet on Growth Performance, Organ Weight and Gut Morphometry

Authors: Olatundun Bukola Ezekiel, Adejumo Olusoji

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A feeding trial was conducted with 100 two-weeks old broiler chicken to evaluate the influence of inclusion in broiler diets at 0, 2.5, 5, 7.5 and 10% neem kernel (used to replace equal quantity of maize) on their performance, organ weight and gut morphometry. The birds were randomly allotted to five dietary treatments, each treatment having four replicates consisting of five broilers in a completely randomized design. The diets were formulated to be iso-nitrogenous (23% CP). Weekly feed intake and changes in body weight were calculated and feed efficiency determined. At the end of the 28-day feeding trial, four broilers per treatment were selected and sacrificed for carcass evaluation. Results were subjected to statistical analysis using the analysis of variance procedures of Statistical Analysis Software The treatment means were presented with group standard errors of means and where significant, were compared using the Duncan multiple range test of the same software. The results showed that broilers fed 2.5% neem kernel inclusion diets had growth performance statistically comparable to those fed the control diet. Birds on 5, 7.5 and 10% neem kernel diets showed significant (P<0.05) increase in relative weight of liver. The absolute weight of spleen also increased significantly (P<0.05) in birds on 10 % neem kernel diet. More than 5 % neem kernel diets gave significant (P<0.05) increase in the relative weight of the kidney. The length of the small intestine significantly increased in birds fed 7.5 and 10% neem kernel diets. Significant differences (P<0.05) did not occur in the length of the large intestine, right and left caeca. It is recommended that neem kernel can be included up to 2.5% in broiler chicken diet without any deleterious effects on the performance and physiological status of the birds.

Keywords: broiler chicken, growth performance, gut morphometry, neem kernel, organ weight

Procedia PDF Downloads 734
273 Evaluation of the Improve Vacuum Blood Collection Tube for Laboratory Tests

Authors: Yoon Kyung Song, Seung Won Han, Sang Hyun Hwang, Do Hoon Lee

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Laboratory tests is a significant part for the diagnosis, prognosis, treatment of diseases. Blood collection is a simple process, but can be a potential cause of pre-analytical errors. Vacuum blood collection tubes used to collect and store the blood specimens is necessary for accurate test results. The purpose of this study was to validate Improve serum separator tube(SST) (Guanzhou Improve Medical Instruments Co., Ltd, China) for routine clinical chemistry laboratory testing. Blood specimens were collected from 100 volunteers in three different serum vacuum tubes (Greiner SST , Becton Dickinson SST , Improve SST). The specimens were evaluated for 16 routine chemistry tests using TBA-200FR NEO (Toshiba Medical Co. JAPAN). The results were statistically analyzed by paired t-test and Bland-Altman plot. For stability test, the initial results for each tube were compared with results of 72 hours preserved specimens. Their clinical availability was evaluated by biological Variation of Ricos data bank. Paired t-test analysis revealed that AST, ALT, K, Cl showed statistically same results but calcium (CA), phosphorus(PHOS), glucose(GLU), BUN, uric acid(UA), cholesterol(CHOL), total protein(TP), albumin(ALB), total bilirubin(TB), ALP, creatinine(CRE), sodium(NA) were different(P < 0.05) between Improve SST and Greiner SST. Also, CA, PHOS, TP, TB, AST, ALT, NA, K, Cl showed statistically the same results but GLU, BUN, UA, CHOL, ALB, ALP, CRE were different between Improve SST and Becton Dickinson SST. All statistically different cases were clinically acceptable by biological Variation of Ricos data bank. Improve SST tubes showed satisfactory results compared with Greiner SST and Becton Dickinson SST. We concluded that the tubes are acceptable for routine clinical chemistry laboratory testing.

Keywords: blood collection, Guanzhou Improve, SST, vacuum tube

Procedia PDF Downloads 218
272 Retrospective Demographic Analysis of Patients Lost to Follow-Up from Antiretroviral Therapy in Mulanje Mission Hospital, Malawi

Authors: Silas Webb, Joseph Hartland

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Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.

Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi

Procedia PDF Downloads 162
271 Services, Stigma and Discrimination: Perceptions of African Descendant Men Living with HIV/AIDS in Brazil and in the US

Authors: Aparecida De Fatima Dutra, Freddie Avant, Wilma Cordova

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People living with HIV/AIDS (PLWHA) have benefited from advances in treatment. Medical costs are a challenge for some, but the real challenge is the stigma and discrimination PLWHA continue to face, even though the disease has festered for the last four decades. Few studies regarding stigma and discrimination give voice to those affected by these practices. This study provides a voice to PLWHA in Brazil and in the US as to how they perceive stigma and discrimination, as well as services they access. The methodology of this study was designed based on phenomenological research, which is a research that aims to identify what individuals facing the same situation have to share about their experiences. Qualitative research using in- depth interviews was used in order to gather participants’ perceptions about services they access, and stigma and discrimination they experience as PLWHA (hypothesis). The target population was a minority group of 13 Afro-descendant men, mean age of 48.3, residents in East Texas, United States and Salvador, Brazil. Our findings indicate that in both countries, overall, participants have reasonable access to medication and qualified services, except for some specialties, such as dentistry. With regard to stigma and discrimination the majority of participants have not disclosed their diagnosis. They state they prefer not to disclose for fear of being ostracized and rejected. Participants who did reveal their status indicate that stigma and discrimination is a daily occurrence. These experiences tend to occur within their own families, neighborhoods, and in public health agencies where HIV/AIDS is not the focus. Participants who did offer suggestions for social change indicated they would have to reveal their status even if it means being stigmatized and discriminated against. Other factors contributing to this discrimination include skin color and poverty. This study concludes that even after decades since the spread of this epidemic, nothing has changed regarding stigma and discrimination towards PLWHA. Lack of awareness, empathy and education continue to be a major challenge, not only at a local level but across the globe. In conclusion, as documented in previous studies while stigma and discrimination towards this population prevail, negative attitudes will continue to jeopardize all individuals from receiving equal access to prevention, treatment and care. It is crucial to face stigma and discrimination not only as individual experiences, but as social practices that violate and restrict human rights and that as a result, reinforce inequality and social exclusion. Policies should be at the forefront to eliminate the stigma and discrimination PLWHA experience. Health professionals and societies must take a stand in order to promote mindfulness about the negative effect of oppression towards individuals living with HIV/AIDS and the potential global impact of these practices.

Keywords: discrimination, HIV/AIDS, human rights, stigma

Procedia PDF Downloads 308
270 A Simple and Empirical Refraction Correction Method for UAV-Based Shallow-Water Photogrammetry

Authors: I GD Yudha Partama, A. Kanno, Y. Akamatsu, R. Inui, M. Goto, M. Sekine

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The aerial photogrammetry of shallow water bottoms has the potential to be an efficient high-resolution survey technique for shallow water topography, thanks to the advent of convenient UAV and automatic image processing techniques Structure-from-Motion (SfM) and Multi-View Stereo (MVS)). However, it suffers from the systematic overestimation of the bottom elevation, due to the light refraction at the air-water interface. In this study, we present an empirical method to correct for the effect of refraction after the usual SfM-MVS processing, using common software. The presented method utilizes the empirical relation between the measured true depth and the estimated apparent depth to generate an empirical correction factor. Furthermore, this correction factor was utilized to convert the apparent water depth into a refraction-corrected (real-scale) water depth. To examine its effectiveness, we applied the method to two river sites, and compared the RMS errors in the corrected bottom elevations with those obtained by three existing methods. The result shows that the presented method is more effective than the two existing methods: The method without applying correction factor and the method utilizes the refractive index of water (1.34) as correction factor. In comparison with the remaining existing method, which used the additive terms (offset) after calculating correction factor, the presented method performs well in Site 2 and worse in Site 1. However, we found this linear regression method to be unstable when the training data used for calibration are limited. It also suffers from a large negative bias in the correction factor when the apparent water depth estimated is affected by noise, according to our numerical experiment. Overall, the good accuracy of refraction correction method depends on various factors such as the locations, image acquisition, and GPS measurement conditions. The most effective method can be selected by using statistical selection (e.g. leave-one-out cross validation).

Keywords: bottom elevation, MVS, river, SfM

Procedia PDF Downloads 285