Search results for: pain score
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2904

Search results for: pain score

1884 Outcomes of Educating Care Giver in Tracheostomy Wound Care for Discharge Planning of Tracheostomy Patients at the Ear, Nose, Throat, and Eye Ward of Songkhla Hospital Thailand

Authors: Kingkan Chumjamras

Abstract:

There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

Procedia PDF Downloads 426
1883 Comparison of Mini-BESTest versus Berg Balance Scale to Evaluate Balance Disorders in Parkinson's Disease

Authors: R. Harihara Prakash, Shweta R. Parikh, Sangna S. Sheth

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The purpose of this study was to explore the usefulness of the Mini-BESTest compared to the Berg Balance Scale in evaluating balance in people with Parkinson's Disease (PD) of varying severity. Evaluation were done to obtain (1) the distribution of patients scores to look for ceiling effects, (2) concurrent validity with severity of disease, and (3) the sensitivity & specificity of separating people with or without postural response deficits. Methods and Material: Seventy-seven(77) people with Parkinson's Disease were tested for balance deficits using the Berg Balance Scale, Mini-BESTest. Unified Parkinson’s Disease Rating Scale (UPDRS) III and the Hoehn & Yahr (H&Y) disease severity scales were used for classification. Materials used in this study were case record sheet, chair without arm rests or wheels, Incline ramp, stopwatch, a box, 3 meter distance measured out and marked on the floor with tape [from chair]. Statistical analysis used: Multiple Linear regression was carried out of UPDRS jointly on the two scores for the Berg and Mini-BESTest. Receiver operating characteristic curves for classifying people into two groups based on a threshold for the H&Y score, to discriminate between mild PD versus more severe PD.Correlation co-efficient to find relativeness between the two variables. Results: The Mini-BESTest is highly correlated with the Berg (r = 0.732,P < 0.001), but avoids the ceiling compression effect of the Berg for mild PD (skewness −0.714 Berg, −0.512 Mini-BESTest). Consequently, the Mini-BESTest is more effective than the Berg for predicting UPDRS Motor score (P < 0.001 Mini-BESTest versus P = 0.72 Berg), and for discriminating between those with and without postural response deficits as measured by the H&Y (ROC).

Keywords: balance, berg balance scale, MINI BESTest, parkinson's disease

Procedia PDF Downloads 390
1882 The Effect of Whole-Body Vertical Rhythm Training on Fatigue, Physical Activity, and Quality of Life to the Middle-Aged and Elderly with Hemodialysis Patients

Authors: Yen-Fen Shen, Meng-Fan Li

Abstract:

The study aims to investigate the effect of full-body vertical rhythmic training on fatigue, physical activity, and quality of life among middle-aged and elderly hemodialysis patients. The study adopted a quasi-experimental research method and recruited 43 long-term hemodialysis patients from a medical center in northern Taiwan, with 23 and 20 participants in the experimental and control groups, respectively. The experimental group received full-body vertical rhythmic training as an intervention, while the control group received standard hemodialysis care without any intervention. Both groups completed the measurements by using "Fatigue Scale", "Physical Activity Scale" and "Chinese version of the Kidney Disease Quality of Life Questionnaire" before and after the study. The experimental group underwent a 10-minute full-body vertical rhythmic training three times per week, which lasted for eight weeks before receiving regular hemodialysis treatment. The data were analyzed by SPSS 25 software, including descriptive statistics such as frequency distribution, percentages, means, and standard deviations, as well as inferential statistics, including chi-square, independent samples t-test, and paired samples t-test. The study results are summarized as follows: 1. There were no significant differences in demographic variables, fatigue, physical activity, and quality of life between the experimental and control groups in the pre-test. 2. After the intervention of the “full-body vertical rhythmic training,” the experimental group showed significantly better results in the category of "feeling tired and fatigued in the lower back", "physical functioning role limitation", "bodily pain", "social functioning", "mental health", and "impact of kidney disease on life quality." 3. The paired samples t-test results revealed that the control group experienced significant differences between the pre-test and post-test in the categories of feeling tired and fatigued in the lower back, bodily pain, social functioning mental health, and impact of kidney disease on life quality, with scores indicating a decline in life quality. Conversely, the experimental group only showed a significant worsening in bodily pain" and the impact of kidney disease on life quality, with lower change values compared to the control group. Additionally, there was an improvement in the condition of "feeling tired and fatigued in the lower back" for the experimental group. Conclusion: The intervention of the “full-body vertical rhythmic training” had a certain positive effect on the quality of life of the experimental group. While it may not entirely enhance patients' quality of life, it can mitigate the negative impact of kidney disease on certain aspects of the body. The study provides clinical practice, nursing education, and research recommendations based on the results and discusses the limitations of the research.

Keywords: hemodialysis, full-body vertical rhythmic training, fatigue, physical activity, quality of life

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1881 The Application of Lesson Study Model in Writing Review Text in Junior High School

Authors: Sulastriningsih Djumingin

Abstract:

This study has some objectives. It aims at describing the ability of the second-grade students to write review text without applying the Lesson Study model at SMPN 18 Makassar. Second, it seeks to describe the ability of the second-grade students to write review text by applying the Lesson Study model at SMPN 18 Makassar. Third, it aims at testing the effectiveness of the Lesson Study model in writing review text at SMPN 18 Makassar. This research was true experimental design with posttest Only group design involving two groups consisting of one class of the control group and one class of the experimental group. The research populations were all the second-grade students at SMPN 18 Makassar amounted to 250 students consisting of 8 classes. The sampling technique was purposive sampling technique. The control class was VIII2 consisting of 30 students, while the experimental class was VIII8 consisting of 30 students. The research instruments were in the form of observation and tests. The collected data were analyzed using descriptive statistical techniques and inferential statistical techniques with t-test types processed using SPSS 21 for windows. The results shows that: (1) of 30 students in control class, there are only 14 (47%) students who get the score more than 7.5, categorized as inadequate; (2) in the experimental class, there are 26 (87%) students who obtain the score of 7.5, categorized as adequate; (3) the Lesson Study models is effective to be applied in writing review text. Based on the comparison of the ability of the control class and experimental class, it indicates that the value of t-count is greater than the value of t-table (2.411> 1.667). It means that the alternative hypothesis (H1) proposed by the researcher is accepted.

Keywords: application, lesson study, review text, writing

Procedia PDF Downloads 197
1880 Computerized Scoring System: A Stethoscope to Understand Consumer's Emotion through His or Her Feedback

Authors: Chen Yang, Jun Hu, Ping Li, Lili Xue

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Most companies pay careful attention to consumer feedback collection, so it is popular to find the ‘feedback’ button of all kinds of mobile apps. Yet it is much more changeling to analyze these feedback texts and to catch the true feelings of a consumer regarding either a problem or a complimentary of consumers who hands out the feedback. Especially to the Chinese content, it is possible that; in one context the Chinese feedback expresses positive feedback, but in the other context, the same Chinese feedback may be a negative one. For example, in Chinese, the feedback 'operating with loudness' works well with both refrigerator and stereo system. Apparently, this feedback towards a refrigerator shows negative feedback; however, the same feedback is positive towards a stereo system. By introducing Bradley, M. and Lang, P.'s Affective Norms for English Text (ANET) theory and Bucci W.’s Referential Activity (RA) theory, we, usability researchers at Pingan, are able to decipher the feedback and to find the hidden feelings behind the content. We subtract 2 disciplines ‘valence’ and ‘dominance’ out of 3 of ANET and 2 disciplines ‘concreteness’ and ‘specificity’ out of 4 of RA to organize our own rating system with a scale of 1 to 5 points. This rating system enables us to judge the feelings/emotion behind each feedback, and it works well with both single word/phrase and a whole paragraph. The result of the rating reflects the strength of the feeling/emotion of the consumer when he/she is typing the feedback. In our daily work, we first require a consumer to answer the net promoter score (NPS) before writing the feedback, so we can determine the feedback is positive or negative. Secondly, we code the feedback content according to company problematic list, which contains 200 problematic items. In this way, we are able to collect the data that how many feedbacks left by the consumer belong to one typical problem. Thirdly, we rate each feedback based on the rating system mentioned above to illustrate the strength of the feeling/emotion when our consumer writes the feedback. In this way, we actually obtain two kinds of data 1) the portion, which means how many feedbacks are ascribed into one problematic item and 2) the severity, how strong the negative feeling/emotion is when the consumer is writing this feedback. By crossing these two, and introducing the portion into X-axis and severity into Y-axis, we are able to find which typical problem gets the high score in both portion and severity. The higher the score of a problem has, the more urgent a problem is supposed to be solved as it means more people write stronger negative feelings in feedbacks regarding this problem. Moreover, by introducing hidden Markov model to program our rating system, we are able to computerize the scoring system and are able to process thousands of feedback in a short period of time, which is efficient and accurate enough for the industrial purpose.

Keywords: computerized scoring system, feeling/emotion of consumer feedback, referential activity, text mining

Procedia PDF Downloads 169
1879 Real-World Economic Burden of Musculoskeletal Disorders in Nigeria

Authors: F. Fatoye, C. E. Mbada, T. Gebrye, A. O. Ogunsola, C. Fatoye, O. Oyewole

Abstract:

Musculoskeletal disorders (MSDs) such as low back pain (LBP), cervical spondylosis (CSPD), sprain, osteoarthritis (OA), and post immobilization stiffness (PIS) have a major impact on individuals, health systems and society in terms of morbidity, long-term disability, and economics. This study estimated the direct and indirect costs of common MSDs in Osun State, Nigeria. A review of medical charts for adult patients attending Physiotherapy Outpatient Clinic at the Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria between 2009 and 2018 was carried out. The occupational class of the patients was determined using the International Labour Classification (ILO). The direct and indirect costs were estimated using a cost-of-illness approach. Physiotherapy related health resource use, and costs of the common MSDs, including consultation fee, total fee charge per session, costs of consumables were estimated. Data were summarised using descriptive statistics mean and standard deviation (SD). Overall, 1582 (Male = 47.5%, Female = 52.5%) patients with MSDs population with a mean age of 47.8 ± 25.7 years participated in this study. The mean (SD) direct costs estimate for LBP, CSPD, PIS, sprain, OA, and other conditions were $18.35 ($17.33), $34.76 ($17.33), $32.13 ($28.37), $35.14 ($44.16), $37.19 ($41.68), and $15.74 ($13.96), respectively. The mean (SD) indirect costs estimate of LBP, CSPD, PIS, sprain, OA, and other MSD conditions were $73.42 ($43.54), $140.57 ($69.31), $128.52 ($113.46), sprain $140.57 ($69.31), $148.77 ($166.71), and $62.98 ($55.84), respectively. Musculoskeletal disorders contribute a substantial economic burden to individuals with the condition and society. The unacceptable economic loss of MSDs should be reduced using appropriate strategies. Further research is required to determine the clinical and cost effectiveness of strategies to improve health outcomes of patients with MSDs. The findings of the present study may assist health policy and decision makers to understand the economic burden of MSDs and facilitate efficient allocation of healthcare resources to alleviate the burden associated with these conditions in Nigeria.

Keywords: economic burden, low back pain, musculoskeletal disorders, real-world

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1878 Developing a Model to Objectively Assess the Culture of Individuals and Teams in Order to Effectively and Efficiently Achieve Sustainability in the Manpower

Authors: Ahmed Mohamed Elnady Mohamed Elsafty

Abstract:

This paper explains a developed applied objective model to measure the culture qualitatively and quantitatively, whether in individuals or in teams, in order to be able to use culture correctly or modify it efficiently. This model provides precise measurements and consistent interpretations by being comprehensive, updateable, and protected from being misled by imitations. Methodically, the provided model divides the culture into seven dimensions (total 43 cultural factors): First dimension is outcome-orientation which consists of five factors and should be highest in leaders. Second dimension is details-orientation which consists of eight factors and should be in highest intelligence members. Third dimension is team-orientation which consists of five factors and should be highest in instructors or coaches. Fourth dimension is change-orientation which consists of five factors and should be highest in soldiers. Fifth dimension is people-orientation which consists of eight factors and should be highest in media members. Sixth dimension is masculinity which consists of seven factors and should be highest in hard workers. Last dimension is stability which consists of seven factors and should be highest in soft workers. In this paper, the details of all cultural factors are explained. Practically, information collection about each cultural factor in the targeted person or team is essential in order to calculate the degrees of all cultural factors using the suggested equation of multiplying 'the score of factor presence' by 'the score of factor strength'. In this paper, the details of how to build each score are explained. Based on the highest degrees - to identify which cultural dimension is the prominent - choosing the tested individual or team in the supposedly right position at the right time will provide a chance to use minimal efforts to make everyone aligned to the organization’s objectives. In other words, making everyone self-motivated by setting him/her at the right source of motivation is the most effective and efficient method to achieve high levels of competency, commitment, and sustainability. Modifying a team culture can be achieved by excluding or including new members with relatively high or low degrees in specific cultural factors. For conclusion, culture is considered as the software of the human beings and it is one of the major compression factors on the managerial discretion. It represents the behaviors, attitudes, and motivations of the human resources which are vital to enhance quality and safety, expanding the market share, and defending against attacks from external environments. Thus, it is tremendously essential and useful to use such a comprehensive model to measure, use, and modify culture.

Keywords: culture dimensions, culture factors, culture measurement, cultural analysis, cultural modification, self-motivation, alignment to objectives, competency, sustainability

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1877 A Deep Learning Approach to Detect Complete Safety Equipment for Construction Workers Based on YOLOv7

Authors: Shariful Islam, Sharun Akter Khushbu, S. M. Shaqib, Shahriar Sultan Ramit

Abstract:

In the construction sector, ensuring worker safety is of the utmost significance. In this study, a deep learning-based technique is presented for identifying safety gear worn by construction workers, such as helmets, goggles, jackets, gloves, and footwear. The suggested method precisely locates these safety items by using the YOLO v7 (You Only Look Once) object detection algorithm. The dataset utilized in this work consists of labeled images split into training, testing and validation sets. Each image has bounding box labels that indicate where the safety equipment is located within the image. The model is trained to identify and categorize the safety equipment based on the labeled dataset through an iterative training approach. We used custom dataset to train this model. Our trained model performed admirably well, with good precision, recall, and F1-score for safety equipment recognition. Also, the model's evaluation produced encouraging results, with a [email protected] score of 87.7%. The model performs effectively, making it possible to quickly identify safety equipment violations on building sites. A thorough evaluation of the outcomes reveals the model's advantages and points up potential areas for development. By offering an automatic and trustworthy method for safety equipment detection, this research contributes to the fields of computer vision and workplace safety. The proposed deep learning-based approach will increase safety compliance and reduce the risk of accidents in the construction industry.

Keywords: deep learning, safety equipment detection, YOLOv7, computer vision, workplace safety

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1876 The Value of Dynamic Magnetic Resonance Defecography in Assessing the Severity of Defecation Disorders

Authors: Ge Sun, Monika Trzpis, Robbert J. de Haas, Paul M. A. Broens

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Introduction: Dynamic magnetic resonance defecography is frequently used to assess defecation disorders. We aimed to investigate the usefulness of dynamic magnetic resonance defecography for assessing the severity of defecation disorder. Methods: We included patients retrospectively from our tertiary referral hospital who had undergone dynamic magnetic resonance defecography, anorectal manometry, and anal electrical sensitivity tests to assess defecation disorders between 2014 and 2020. The primary outcome was the association between the dynamic magnetic resonance defecography variables and the severity of defecation disorders. We assessed the severity of fecal incontinence and constipation with the Wexner incontinence and Agachan constipation scores. Results: Out of the 32 patients included, 24 completed the defecation questionnaire. During defecation, the M line length at magnetic resonance correlated with the Agachan score (r = 0.45, p = 0.03) and was associated with anal sphincter pressure (r=0.39, p=0.03) just before defecation. During rest and squeezing, the H line length at imaging correlated with the Wexner incontinence score (r=0.49, p=0.01 and r=0.69, p< 0.001, respectively). H line length also correlated positively with the anal electrical sensation threshold during squeezing (r=0.50, p=0.004) and during rest (r= 0.42, p=0.02). Conclusions: The M and H line lengths at dynamic magnetic resonance defecography can be used to assess the severity of constipation and fecal incontinence respectively and reflect anatomic changes of the pelvic floor. However, as these anatomic changes are generally late-stage and irreversible, anal manometry seems a better diagnostic approach to assess early and potentially reversible changes in patients with defecation disorders.

Keywords: defecation disorders, dynamic magnetic resonance defecography, anorectal manometry, anal electrical sensitivity tests, H line, M line

Procedia PDF Downloads 100
1875 First Aid Awareness Campaign for Two Undergraduate Nursing Cohorts

Authors: Mona Afifi, Yara Al Qahtani, Afnan Al Dosari, Amnah Hamdi

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Background: First aid is the care provided outside the hospital. It is important in saving lives. Delay in helping the victims may result in serious complication or even death. Many people die in Saudi Arabia because they don’t get proper first aid interventions. According to Traffic Safety council in KSA (2012), in the year of 2011 there was 7153 deaths from car accident in KAS. Subjects and method: Quasi-experimental research design was utilized to assess the effect of a structured 45-minute educational session on 82 undergraduate nursing students’ knowledge about first aid. Two tools were developed for the purpose of the current study. First tool containing the sociodemographic data including age, gender, level, and previous participation in a first aid course, and 55 statements specific to different situations that requires first aid. Concept and Knowledge of First Aid has 9 questions, cardiopulmonary resuscitation has 12 questions, Bleeding and Shock have 7 questions, Road Traffic Accidents has 5 questions, Fracture and Trauma have 4 questions, wound has 5 questions, sunstroke has 4 questions, bits and stings has 4 questions and burn has 5 questions. The second tool was to evaluate the campaign session. Result: The overall knowledge score showed significant difference between the pre and post awareness session (59.58 and 93.00 respectively, p=.000). Mean score shows significant difference in pre-tests between third and fourth year nursing students indicating that knowledge of fourth year students is higher compared to third year students with the mean knowledge scores of 69.56 and 60.88 respectively (p=0.006). Conclusion: Results of the current study indicate that the level of the knowledge in the post test session was higher than in the pre session. Also results showed that the fourth year student`s knowledge in pre-test was better compared to previous year.

Keywords: first aid, awareness campaign, undergraduate nursing students, knowledge

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1874 Relation between Biochemical Parameters and Bone Density in Postmenopausal Women with Osteoporosis

Authors: Shokouh Momeni, Mohammad Reza Salamat, Ali Asghar Rastegari

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Background: Osteoporosis is the most prevalent metabolic bone disease in postmenopausal women associated with reduced bone mass and increased bone fracture. Measuring bone density in the lumbar spine and hip is a reliable measure of bone mass and can therefore specify the risk of fracture. Dual-energy X-ray absorptiometry(DXA) is an accurate non-invasive system measuring the bone density, with low margin of error and no complications. The present study aimed to investigate the relationship between biochemical parameters with bone density in postmenopausal women. Materials and methods: This cross-sectional study was conducted on 87 postmenopausal women referred to osteoporosis centers in Isfahan. Bone density was measured in the spine and hip area using DXA system. Serum levels of calcium, phosphorus, alkaline phosphatase and magnesium were measured by autoanalyzer and serum levels of vitamin D were measured by high-performance liquid chromatography(HPLC). Results: The mean parameters of calcium, phosphorus, alkaline phosphatase, vitamin D and magnesium did not show a significant difference between the two groups(P-value>0.05). In the control group, the relationship between alkaline phosphatase and BMC and BA in the spine was significant with a correlation coefficient of -0.402 and 0.258, respectively(P-value<0.05) and BMD and T-score in the femoral neck area showed a direct and significant relationship with phosphorus(Correlation=0.368; P-value=0.038). There was a significant relationship between the Z-score with calcium(Correlation=0.358; P-value=0.044). Conclusion: There was no significant relationship between the values ​​of calcium, phosphorus, alkaline phosphatase, vitamin D and magnesium parameters and bone density (spine and hip) in postmenopaus

Keywords: osteoporosis, menopause, bone mineral density, vitamin d, calcium, magnesium, alkaline phosphatase, phosphorus

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1873 Study of Demographic, Hematological Profile and Risk Stratification in Chronic Myeloid Leukemia Patients

Authors: Rajandeep Kaur, Rajeev Gupta

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Background: Chronic myeloid leukemia (CML) is the most common leukaemia in India. The annual incidence of chronic myeloid leukemia in India was originally reported to be 0.8 to 2.2 per 1,00,000 population. CML is a clonal disorder that is usually easily diagnosed because the leukemic cells of more than 95% of patients have a distinctive cytogenetic abnormality, the Philadelphia chromosome (Ph1). The approval of tyrosine kinase inhibitors (TKIs), which target BCR-ABL1 kinase activity, has significantly reduced the mortality rate associated with chronic myeloid leukemia (CML) and revolutionized treatment. Material and Methods: 80 diagnosed cases of CML were taken. Investigations were done. Bone marrow and molecular studies were also done and with EUTOS, patients were stratified into low and high-risk groups and then treatment with Imatinib was given to all patients and the molecular response was evaluated at 6 months and 12 months follow up with BCR-ABL by RT-PCR quantitative assay. Results: In the study population, out of 80 patients in the study population, 40 were females and 40 were males, with M: F is 1:1. Out of total 80 patients’ maximum patients (54) were in 31-60 years age group. Our study showed a most common symptom of presentation is abdominal discomfort followed by fever. Out of the total 80 patients, 25 (31.3%) patients had high EUTOS scores and 55 (68.8%) patients had low EUTOS scores. On 6 months follow up 36.3% of patients had Complete Molecular Response, 16.3% of patients had Major Molecular Response and 47.5% of patients had No Molecular Response but on 12 months follow up 71.3% of patients had Complete Molecular Response, 16.25% of patients had Major Molecular Response and 12.5% patients had No Molecular Response. Conclusion: In this study, we found a significant correlation between EUTOS score and Molecular response at 6 months and 12 months follow up after Imatinib therapy.

Keywords: chronic myeloid leukemia, European treatment and outcome study score, hematological response, molecular response, tyrosine kinase inhibitor

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1872 Proximate Composition and Sensory Properties of Complementary Food from Fermented Acha (Digitaria exilis), Soybean and Orange-Flesh Sweet Potato Blends

Authors: N. C. Okoronkwo, I. E. Mbaeyi-Nwaoha, C. P. Agbata

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Childhood malnutrition is one of the most persistent public health problems throughout developing countries, including Nigeria. Demographic and Health survey data from twenty-one developing countries indicated that poor complementary feeding of children aged 6- 23 months contributes to negative growth trends. To reduce malnutrition among children in the society, formulation of complimentary food rich in essential nutrient for optimum growth and development of infants is essential. This study focused on the evaluation of complementary food produced by solid-state fermentation of Acha and Soybean using Rhizopus oligosporus (2710) and Orange-fleshed sweet potatoes (OFSP) using Lactobacillus planterum (B-41621). The raw materials were soaked separately, each in four volumes of 0.9M acetic acid for 16 hours, rinsed with clean water, steam cooked and cooled. Solid-state fermentation (SSF) was carried out by inoculating Acha and Soybean with spore suspension (1x 10⁶spores/ml) of Rhizopus oligosporus (2710) and OFSP with spore suspension (1x 106spores/ml) of Lactobacillus planterum (B-41621). Fermentation which lasted for 72hours was carried out with 24hours sampling. The samples were blended in the following ratios: Acha and soybean 100: 100 (AS), Acha/soybean and OFSP 50: 50(ASO), made into gruel and compared with a commercial infant formula (Cerelac) which served as the control (CTRL). The samples were analyzed for proximate composition using AOAC methods and sensory attributes using a hedonic scale. Results showed that moisture, crude protein, fibre and ash content increased significantly (p<0.05) as fermentation progressed, while carbohydrate and fat content decreased. The protein, moisture, fibre and ash content ranged from 17.10-19.02%, 54.97-56.27%, 7.08-7.60% and2.09-2.38%, respectively, while carbohydrate and fat content ranged from 12.95-10.21% and 5.81-4.52%, respectively. In sensory scores, there were no significant (p>0.05) difference between the average mean scores of colours, texture and consistency of the samples. The sensory score for the overall acceptability ranged from 6.20-7.80. Sample CTRL had the highest score, while sample ASO had the least score. There was no significant (p>0.05) difference between samples CTRL and AS. Solid-state fermentation improved the nutritional content and flavour of the developed complementary food, which is needed for infant growth and development.

Keywords: Complementary food, malnutrition, proximate composition, solid-state fermentation

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1871 Combined Effect of Therapeutic Exercises and Shock Wave versus Therapeutic Exercises and Phonophoresis in Treatment of Shoulder Impingement Syndrome: A Randomized Controlled Trial

Authors: Mohamed M. Mashaly, Ahmed M. F. El Shiwi

Abstract:

Background: Shoulder impingement syndrome is an encroachment of subacromial tissues, rotator cuff, subacromial bursa, and the long head of the biceps tendon, as a result of narrowing of the subacromial space. Activities requiring repetitive or sustained use of the arms over head often predispose the rotator cuff tendon to injury. Purpose: To compare between Combined effect therapeutic exercises and Shockwave therapy versus therapeutic exercises and phonophoresis in the treatment of shoulder impingement syndrome. Methods: Thirty patients diagnosed as shoulder impingement syndrome stage II Neer classification due to mechanical causes. Patients were randomly distributed into two equal groups. The first group consisted of 15 patients with a mean age of (45.46+8.64) received therapeutic exercises (stretching exercise of posterior shoulder capsule and strengthening exercises of shoulder muscles) and shockwave therapy (6000 shocks, 2000/session, 3 sessions, 2 weeks apart, 0.22mJ/mm^2) years. The second group consisted of 15 patients with a mean age of 46.26 (+ 8.05) received same therapeutic exercises and phonophoresis (3 times per week, each other day, for 4 consecutive weeks). Patients were evaluated pretreatment and post treatment for shoulder pain severity, shoulder functional disability, shoulder flexion, abduction and internal rotation motions. Results: Patients of both groups showed significant improvement in all the measured variables. In between groups difference the shock wave group showed a significant improvement in all measured variables than phonophoresis group. Interpretation/Conclusion: Combined effect of therapeutic exercises and shock wave were more effective than therapeutic exercises and phonophoresis on decreasing shoulder pain severity, shoulder functional disability, increasing in shoulder flexion, abduction, internal rotation in patients with shoulder impingement syndrome.

Keywords: shoulder impingement syndrome, therapeutic exercises, shockwave, phonophoresis

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1870 Cirrhosis Mortality Prediction as Classification using Frequent Subgraph Mining

Authors: Abdolghani Ebrahimi, Diego Klabjan, Chenxi Ge, Daniela Ladner, Parker Stride

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In this work, we use machine learning and novel data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. To the best of our knowledge, this is the first work to apply modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Keywords: machine learning, liver cirrhosis, subgraph mining, supervised learning

Procedia PDF Downloads 132
1869 Unsupervised Echocardiogram View Detection via Autoencoder-Based Representation Learning

Authors: Andrea Treviño Gavito, Diego Klabjan, Sanjiv J. Shah

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Echocardiograms serve as pivotal resources for clinicians in diagnosing cardiac conditions, offering non-invasive insights into a heart’s structure and function. When echocardiographic studies are conducted, no standardized labeling of the acquired views is performed. Employing machine learning algorithms for automated echocardiogram view detection has emerged as a promising solution to enhance efficiency in echocardiogram use for diagnosis. However, existing approaches predominantly rely on supervised learning, necessitating labor-intensive expert labeling. In this paper, we introduce a fully unsupervised echocardiographic view detection framework that leverages convolutional autoencoders to obtain lower dimensional representations and the K-means algorithm for clustering them into view-related groups. Our approach focuses on discriminative patches from echocardiographic frames. Additionally, we propose a trainable inverse average layer to optimize decoding of average operations. By integrating both public and proprietary datasets, we obtain a marked improvement in model performance when compared to utilizing a proprietary dataset alone. Our experiments show boosts of 15.5% in accuracy and 9.0% in the F-1 score for frame-based clustering, and 25.9% in accuracy and 19.8% in the F-1 score for view-based clustering. Our research highlights the potential of unsupervised learning methodologies and the utilization of open-sourced data in addressing the complexities of echocardiogram interpretation, paving the way for more accurate and efficient cardiac diagnoses.

Keywords: artificial intelligence, echocardiographic view detection, echocardiography, machine learning, self-supervised representation learning, unsupervised learning

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1868 The Outcome of Early Balance Exercises and Agility Training in Sports Rehabilitation for Patients Post Anterior Cruciate Ligament (ACL) Reconstruction

Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun

Abstract:

Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.

Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance

Procedia PDF Downloads 250
1867 Healthcare Utilization and Costs of Specific Obesity Related Health Conditions in Alberta, Canada

Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

Abstract:

Obesity-related health conditions impose a substantial economic burden on payers due to increased healthcare use. Estimates of healthcare resource use and costs associated with obesity-related comorbidities are needed to inform policies and interventions targeting these conditions. Methods: Adults living with obesity were identified (a procedure-related body mass index code for class 2/3 obesity between 2012 and 2019 in Alberta, Canada; excluding those with bariatric surgery), and outcomes were compared over 1-year (2019/2020) between those who had and did not have specific obesity-related comorbidities. The probability of using a healthcare service (based on the odds ratio of a zero [OR-zero] cost) was compared; 95% confidence intervals (CI) were reported. Logistic regression and a generalized linear model with log link and gamma distribution were used for total healthcare cost comparisons ($CDN); cost ratios and estimated cost differences (95% CI) were reported. Potential socio-demographic and clinical confounders were adjusted for, and incremental cost differences were representative of a referent case. Results: A total of 220,190 adults living with obesity were included; 44% had hypertension, 25% had osteoarthritis, 24% had type-2 diabetes, 17% had cardiovascular disease, 12% had insulin resistance, 9% had chronic back pain, and 4% of females had polycystic ovarian syndrome (PCOS). The probability of hospitalization, ED visit, and ambulatory care was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (hospitalization: 1.8-times [OR-zero: 0.57 [0.55/0.59]] / ED visit: 1.9-times [OR-zero: 0.54 [0.53/0.56]] / ambulatory care visit: 2.4-times [OR-zero: 0.41 [0.40/0.43]]), cardiovascular disease (2.7-times [OR-zero: 0.37 [0.36/0.38]] / 1.9-times [OR-zero: 0.52 [0.51/0.53]] / 2.8-times [OR-zero: 0.36 [0.35/0.36]]), osteoarthritis (2.0-times [OR-zero: 0.51 [0.50/0.53]] / 1.4-times [OR-zero: 0.74 [0.73/0.76]] / 2.5-times [OR-zero: 0.40 [0.40/0.41]]), type-2 diabetes (1.9-times [OR-zero: 0.54 [0.52/0.55]] / 1.4-times [OR-zero: 0.72 [0.70/0.73]] / 2.1-times [OR-zero: 0.47 [0.46/0.47]]), hypertension (1.8-times [OR-zero: 0.56 [0.54/0.57]] / 1.3-times [OR-zero: 0.79 [0.77/0.80]] / 2.2-times [OR-zero: 0.46 [0.45/0.47]]), PCOS (not significant / 1.2-times [OR-zero: 0.83 [0.79/0.88]] / not significant), and insulin resistance (1.1-times [OR-zero: 0.88 [0.84/0.91]] / 1.1-times [OR-zero: 0.92 [0.89/0.94]] / 1.8-times [OR-zero: 0.56 [0.54/0.57]]). After fully adjusting for potential confounders, the total healthcare cost ratio was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (1.54-times [1.51/1.56]), cardiovascular disease (1.45-times [1.43/1.47]), osteoarthritis (1.36-times [1.35/1.38]), type-2 diabetes (1.30-times [1.28/1.31]), hypertension (1.27-times [1.26/1.28]), PCOS (1.08-times [1.05/1.11]), and insulin resistance (1.03-times [1.01/1.04]). Conclusions: Adults with obesity who have specific disease-related health conditions have a higher probability of healthcare use and incur greater costs than those without specific comorbidities; incremental costs are larger when other obesity-related health conditions are not adjusted for. In a specific referent case, hypertension was costliest (44% had this condition with an additional annual cost of $715 [$678/$753]). If these findings hold for the Canadian population, hypertension in persons with obesity represents an estimated additional annual healthcare cost of $2.5 billion among adults living with obesity (based on an adult obesity rate of 26%). Results of this study can inform decision making on investment in interventions that are effective in treating obesity and its complications.

Keywords: administrative data, healthcare cost, obesity-related comorbidities, real world evidence

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1866 Cognitive Impairment in Chronic Renal Patients on Hemodialysis

Authors: Fabiana Souza Orlandi, Juliana Gomes Duarte, Gabriela Dutra Gesualdo

Abstract:

Chronic renal disease (CKD), accompanied by hemodialysis, causes chronic renal failure in a number of situations that compromises not only physical, personal and environmental aspects, but also psychological, social and family aspects. Objective: To verify the level of cognitive impairment of chronic renal patients on hemodialysis. Methodology: This is a descriptive, cross-sectional study. The present study was performed in a Dialysis Center of a city in the interior of the State of São Paulo. The inclusion criteria were: being 18 years or older; have a medical diagnosis of CKD; being in hemodialysis treatment in this unit; and agree to participate in the research, with the signature of the Informed Consent (TCLE). A total of 115 participants were evaluated through the Participant Characterization Instrument and the Addenbrooke Cognitive Exam - Revised Version (ACE-R), being scored from 0 to 100, stipulating the cut-off note for the complete battery <78 and subdivided into five domains: attention and guidance; memory; fluency; language; (66.9%) and caucasian (54.7%), 53.7 (±14.8) years old. Most of the participants were retired (74.7%), with incomplete elementary schooling (36.5%) and the average time of treatment was 46 months. Most of the participants (61.3%) presented impairment in the area of attention and orientation, 80.4% in the spatial visual domain. Regarding the total ACE-R score, 75.7% of the participants presented scores below the established cut grade. Conclusion: There was a high percentage (75.7%) below the cut-off score established for ACE-R, suggesting that there may be some cognitive impairment among these participants, since the instrument only performs a screening on cognitive health. The results of the study are extremely important so that possible interventions can be traced in order to minimize impairment, thus improving the quality of life of chronic renal patients.

Keywords: cognition, chronic renal insufficiency, adult health, dialysis

Procedia PDF Downloads 359
1865 Image Quality and Dose Optimisations in Digital and Computed Radiography X-ray Radiography Using Lumbar Spine Phantom

Authors: Elhussaien Elshiekh

Abstract:

A study was performed to management and compare radiation doses and image quality during Lumbar spine PA and Lumbar spine LAT, x- ray radiography using Computed Radiography (CR) and Digital Radiography (DR). Standard exposure factors such as kV, mAs and FFD used for imaging the Lumbar spine anthropomorphic phantom obtained from average exposure factors that were used with CR in five radiology centres. Lumbar spine phantom was imaged using CR and DR systems. Entrance surface air kerma (ESAK) was calculated X-ray tube output and patient exposure factor. Images were evaluated using visual grading system based on the European Guidelines on Quality Criteria for diagnostic radiographic images. The ESAK corresponding to each image was measured at the surface of the phantom. Six experienced specialists evaluated hard copies of all the images, the image score (IS) was calculated for each image by finding the average score of the Six evaluators. The IS value also was used to determine whether an image was diagnostically acceptable. The optimum recommended exposure factors founded here for Lumbar spine PA and Lumbar spine LAT, with respectively (80 kVp,25 mAs at 100 cm FFD) and (75 kVp,15 mAs at 100 cm FFD) for CR system, and (80 kVp,15 mAs at100 cm FFD) and (75 kVp,10 mAs at 100 cm FFD) for DR system. For Lumbar spine PA, the lowest ESAK value required to obtain a diagnostically acceptable image were 0.80 mGy for DR and 1.20 mGy for CR systems. Similarly for Lumbar spine LAT projection, the lowest ESAK values to obtain a diagnostically acceptable image were 0.62 mGy for DR and 0.76 mGy for CR systems. At standard kVp and mAs values, the image quality did not vary significantly between the CR and the DR system, but at higher kVp and mAs values, the DR images were found to be of better quality than CR images. In addition, the lower limit of entrance skin dose consistent with diagnostically acceptable DR images was 40% lower than that for CR images.

Keywords: image quality, dosimetry, radiation protection, optimization, digital radiography, computed radiography

Procedia PDF Downloads 44
1864 Perspectives and Challenges Functional Bread with Yeast Extract to Improve Human Diet

Authors: Jelena Filipović, Milenko Košutić, Vladimir Filipović

Abstract:

In the last decades, the urban population has been characterized by sedentary lifestyles, low physical activity, and "fast food". These changes in diet and physical nonactivity have been associated with an increase in chronic diseases. Bread is one of the most popular wheat products consumed worldwide. Spelt wheat has shown potential in various food applications, including bread, pasta, breakfast cereal, and other products of altered nutritional characteristics compared to conventional wheat products. It has very high protein content and even 30 to 60% higher concentration of mineral elements Fe, Zn, Cu, Mg and P compared to Triticum Aestivum. Spelt wheat is growing without the use of pesticides in harsh ecological conditions and it is an old cultivar. So it can be used for organic and health-safe food. Changes in the formulation of bread with the aim of improving its nutritional and functional properties usually lead to changes in the dough's properties, which are related to the quality of the finished product. The aim of this paper is to research the impact of adding yeast extract to bread on sensory characteristics and consumer acceptance of a new product as a key factor for the successful marketing of a distinct product. The sensory analysis of bread with 5% yeast extract is as follows: the technological quality is very good (3.8), and the color of the product is excellent (4.85). Based on data, consumers' survey declared that they liked the taste of bread with 5% yeast extract (74%), consumers marked the product as likable (70%), and 75% of the total number of respondents would buy this new product. This paper is promoting a type of bread with 5% yeast extract (Z score 0.80) to improve diet and a product intended for consumers conscious about their health and diet.

Keywords: bread, yeast extract, sensory analysis, consumer survey, score analysis

Procedia PDF Downloads 51
1863 Comparative Efficacy of Prolene and Polyester Mesh for the Repair of Abdominal Wall Defect in Pigeons (Columba livia)

Authors: Muhammad Naveed Ali, Hamad Bin Rashid, Muhammad Arif Khan, Abdul Basit, Hafiz Muhammad Arshad

Abstract:

Abdominal defects are very common in pigeons. A new technique is known as intraabdominal mesh transplant that give better protection for herniorrhaphy. The aim of this study was to determine the performance of hernia mesh. In this study, an efficacy of two synthetic hernia mesh implants viz. conventional Prolene and a lightweight mesh monofilament polyester were assessed for the abdominal wall repair in pigeons. Twenty four healthy pigeons were selected and randomly distributed into three groups, A, B and C (n=8). In all groups, experimental laparotomy was performed; thereafter, abdominal muscles and peritoneum were sutured together, while, a 2 x 2 cm defect was created in the abdominal muscles. For onlay hernioplasty, the hernia mesh (Prolene mesh: group A; Polyester mesh: group B) was implanted over the external oblique muscles of the abdomen. In group C (control), the mesh was not implanted; instead, the laparotomy incision was closed after a herniorrhaphy. Post-operative pain wound healing, adhesion formation, histopathological findings and formation of hematoma, abscess and seroma were assessed as short-term complications. Post-operatively, pain at surgical site was significantly less (P < 0.001) in group B (Polyester mesh); wound healing was also significantly better and rapid in group B (P < 0.05) than in group A (Prolene mesh). Group B (Polyester mesh) also depicted less than 25% adhesions when assessed on the basis of a Quantitative Modified Diamond scale; a Qualitative Adhesion Tenacity scale also depicted either no adhesions or flimsy adhesions (n=2) in group B (Polyester mesh), in contrast to group A (Prolene), which manifested greater adhesion formation and presence of dense adhesions requiring blunt dissection. There were observed hematoma, seroma and abscess formations in birds treated by Prolene mesh only. Conclusively, the polyester mesh proved superior to the Prolene mesh regarding lesser adhesion, better in wound healing, and no short-term follow-up complications.

Keywords: adhesion, mesh, polyester, prolene

Procedia PDF Downloads 244
1862 The Relationship between Land Use Factors and Feeling of Happiness at the Neighbourhood Level

Authors: M. Moeinaddini, Z. Asadi-Shekari, Z. Sultan, M. Zaly Shah

Abstract:

Happiness can be related to everything that can provide a feeling of satisfaction or pleasure. This study tries to consider the relationship between land use factors and feeling of happiness at the neighbourhood level. Land use variables (beautiful and attractive neighbourhood design, availability and quality of shopping centres, sufficient recreational spaces and facilities, and sufficient daily service centres) are used as independent variables and the happiness score is used as the dependent variable in this study. In addition to the land use variables, socio-economic factors (gender, race, marital status, employment status, education, and income) are also considered as independent variables. This study uses the Oxford happiness questionnaire to estimate happiness score of more than 300 people living in six neighbourhoods. The neighbourhoods are selected randomly from Skudai neighbourhoods in Johor, Malaysia. The land use data were obtained by adding related questions to the Oxford happiness questionnaire. The strength of the relationship in this study is found using generalised linear modelling (GLM). The findings of this research indicate that increase in happiness feeling is correlated with an increasing income, more beautiful and attractive neighbourhood design, sufficient shopping centres, recreational spaces, and daily service centres. The results show that all land use factors in this study have significant relationship with happiness but only income, among socio-economic factors, can affect happiness significantly. Therefore, land use factors can affect happiness in Skudai more than socio-economic factors.

Keywords: neighbourhood land use, neighbourhood design, happiness, socio-economic factors, generalised linear modelling

Procedia PDF Downloads 146
1861 OnabotulinumtoxinA Injection for Glabellar Frown Lines as an Adjunctive Treatment for Depression

Authors: I. Witbooi, J. De Smidt, A. Oelofse

Abstract:

Negative emotions that are common in depression are coupled with the activation of the corrugator supercilli and procerus muscles in the glabellar region of the face. This research investigated the impact of OnabotulinumtoxinA (BOTOX) in the improvement of emotional states in depressed subjects by relaxing the mentioned muscles. The aim of the study was to investigate the effectiveness of BOTOX treatment for glabellar frown lines as an adjunctive therapy for Major Depressive Disorder (MDD) and to improve the quality of life and self-esteem of the subjects. It is hypothesized that BOTOX treatment for glabellar frown lines reduces depressive symptoms significantly and therefore augment conventional antidepressant medication. Forty-five (45) subjects diagnosed with MDD were assigned to a treatment (n = 15), placebo (n = 15), and control (n = 15) group. The treatment group received BOTOX injection, while the placebo group received saline injection into the Procerus and Corrugator supercilli muscles with follow-up visits every 3 weeks (weeks 3, 6 and 12 respectively). The control group received neither BOTOX nor saline injections and were only interviewed again on the 12th week. To evaluate the effect of BOTOX treatment in the glabellar region on depressive symptoms, the Montgomery-Asberg Depression Rating (MADRS) scale and the Beck Depression Inventory (BDI) were used. The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) and Rosenberg Self-Esteem Scale (RSES) were used in the assessment of self-esteem and quality of life. Participants were followed up for a 12 week period. The expected primary outcome measure is the response to treatment, and it is defined as a ≥ 50% reduction in MADRS score from baseline. Other outcome measures include a clinically significant decrease in BDI scores and the increase in quality of life and self-esteem respectively. Initial results show a clear trend towards such differences. Results showed trends towards expected differences. Patients in the Botox group had a mean MADRS score of 14.0 at 3 weeks compared to 20.3 of the placebo group. This trend was still visible at 6 weeks with the Botox and placebo group scoring an average of 10 vs. 18 respectively. The mean difference in MDRS scores from baseline to 3 weeks were 9.3 and 2.0 for the Botox and placebo group respectively. Similarly, the BDI scores were lower in the Botox group (17.25) compared to the placebo group (19.43). The two self-esteem questionnaires showed expected results at this stage with the RSES 19.1 in the Botox group compared to 18.6 in the placebo group. Similarly, the Botox patients had a higher score for the Q-LES-Q-SF of 49.2 compared to 46.1 for the placebo group. Conclusions: Initial results clearly demonstrated that the use of Botox had positive effects on both scores of depressions and that of self-esteem when compared to a placebo group.

Keywords: adjunctive therapy, depression, glabellar area, OnabotulinumtoxinA

Procedia PDF Downloads 132
1860 Clustering for Detection of the Population at Risk of Anticholinergic Medication

Authors: A. Shirazibeheshti, T. Radwan, A. Ettefaghian, G. Wilson, C. Luca, Farbod Khanizadeh

Abstract:

Anticholinergic medication has been associated with events such as falls, delirium, and cognitive impairment in older patients. To further assess this, anticholinergic burden scores have been developed to quantify risk. A risk model based on clustering was deployed in a healthcare management system to cluster patients into multiple risk groups according to anticholinergic burden scores of multiple medicines prescribed to patients to facilitate clinical decision-making. To do so, anticholinergic burden scores of drugs were extracted from the literature, which categorizes the risk on a scale of 1 to 3. Given the patients’ prescription data on the healthcare database, a weighted anticholinergic risk score was derived per patient based on the prescription of multiple anticholinergic drugs. This study was conducted on over 300,000 records of patients currently registered with a major regional UK-based healthcare provider. The weighted risk scores were used as inputs to an unsupervised learning algorithm (mean-shift clustering) that groups patients into clusters that represent different levels of anticholinergic risk. To further evaluate the performance of the model, any association between the average risk score within each group and other factors such as socioeconomic status (i.e., Index of Multiple Deprivation) and an index of health and disability were investigated. The clustering identifies a group of 15 patients at the highest risk from multiple anticholinergic medication. Our findings also show that this group of patients is located within more deprived areas of London compared to the population of other risk groups. Furthermore, the prescription of anticholinergic medicines is more skewed to female than male patients, indicating that females are more at risk from this kind of multiple medications. The risk may be monitored and controlled in well artificial intelligence-equipped healthcare management systems.

Keywords: anticholinergic medicines, clustering, deprivation, socioeconomic status

Procedia PDF Downloads 201
1859 A Cross-Sectional Study on the Correlation between Body Mass Index and Self-Esteem among Children Ages 9-12 Years Old in a Public Elementary School in Makati, Philippines

Authors: Jerickson Abbie Flores, Jana Fragante, Jan Paolo Dipasupil, Jan Jorge Francisco

Abstract:

Malnutrition is one of the rapidly growing health problems affecting the world at present. Children affected are not only at risk for significant health problems, but are also faced with psychological and social consequences, including low self-esteem. School-age children are specifically vulnerable to develop poor self-esteem especially when their peers find them physically unattractive. Thus, malnutrition, whether obesity or undernourishment, contributes a significant role to a developing child’s health and behavior. This research aims to determine if there is a significant difference on the level of self-esteem among Filipino children ages 9-12 years old with abnormal body mass index (BMI) and those children with desirable BMI. Using a cross-sectional study design, the correlation between body mass index (BMI) and self-esteem was observed among children ages 9-12 years old. Participants took the Hare self esteem questionnaire, which is specifically designed to measure self-esteem in school age children. The lowest possible score is 15 and the highest possible score is 45. A total of 1140 students with ages 9-12 years old from Cembo Elementary School (public school) participated in the study. Among the participants, 239 out of the 1140 have desirable body mass index, 878 are underweight, and 23 are overweight. Using the test questionnaire, the computed mean scores were 36.599, 36.045 and 36.583 for normal, underweight and overweight categories respectively. Using Pearson’s Correlation Test and Spearman’s Correlation Coefficient Test, the study showed positive correlation (p value of 0.047 and 0.004 respectively) between BMI and Self-esteem scores which indicates that the higher the BMI, the higher the self-esteem of the participants.

Keywords: body mass index, malnutrition, school-age children, self-esteem

Procedia PDF Downloads 274
1858 Perspectives and Challenges a Functional Bread With Yeast Extract to Improve Human Diet

Authors: Jelena Filipović, Milenko Košutić, Vladimir Filipović

Abstract:

In the last decades urban population is characterized by sedentary lifestyles, low physical activity and "fast food". These changes in diet and physical non activity have been associated with the increase of chronic non diseases. Bread is one of the most popularly wheat products consumed worldwide. Spelt wheat has shown potential in various food applications, including bread, pasta, breakfast cereal and other products of altered nutritional characteristics compared to conventional wheat products. It has very high protein content and even 30 to 60% higher concentration of mineral elements Fe, Zn, Cu, Mg and P compared to Triticum Aestivum. Spelt wheat is growing without the use of pesticides in harsh ecological conditions and it is an old cultivar. So it can be used for organic and health safe food. Changes in the formulation of bread with the aim to improve their nutritional and functional properties usually lead to changes in the dough properties which is related reflected to the quality of the finished product. The aim of this paper is researching the impact of adding yeast extract to bread on sensory characteristics and consumer acceptance of a new product as a key factor for successful marketing of a new product. The sensory analysis of bread with 5% yeast extract is as follows: the technological quality is very good (3.8) and the color of the product is excellent (4.85). Based on data consumers survey declared that they liked the taste of bread with 5% yeast extract (74%), consumers marked the product as likeable (70%), and 75% of the total number of respondents would buy this new product. This paper is promoting a new type of bread with 5% yeast extract (Z score 0.80) to improve diet and novel functional product which intended for consumers conscious about their health and diet.

Keywords: bread, yeast extract, sensory analysis, consumer survey, score analysis Z

Procedia PDF Downloads 49
1857 Assessment of the Road Safety Performance in National Scale

Authors: Abeer K. Jameel, Harry Evdorides

Abstract:

The Assessment of the road safety performance is a challengeable issue. This is not only because of the ineffective and unreliability of road and traffic crash data system but also because of its systematic character. Recent strategic plans and interventions implemented in some of the developed countries where a significant decline in the rate of traffic and road crashes considers that the road safety is a system. This system consists of four main elements which are: road user, road infrastructure, vehicles and speed in addition to other supporting elements such as the institutional framework and post-crash care system. To assess the performance of a system, it is required to assess all its elements. To present an understandable results of the assessment, it is required to present a unique term representing the performance of the overall system. This paper aims to develop an overall performance indicator which may be used to assess the road safety system. The variables of this indicators are the main elements of the road safety system. The data regarding these variables will be collected from the World Health Organization report. Multi-criteria analysis method is used to aggregate the four sub-indicators for the four variables. Two weighting methods will be assumed, equal weights and different weights. For the different weights method, the factor analysis method is used. The weights then will be converting to scores. The total score will be the overall indicator for the road safety performance in a national scale. This indicator will be used to compare and rank countries according to their road safety performance indicator. The country with the higher score is the country which provides most sustainable and effective interventions for successful road safety system. These indicator will be tested by comparing them with the aggregate real crash rate for each country.

Keywords: factor analysis, Multi-criteria analysis, road safety assessment, safe system indicator

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1856 The Potential of Acanthaster Plancii Fractions as Anti-Atherosclerotic Agent by Inhibiting the Expression of Proprotein Convertase Subtilisin-Kexin Type 9

Authors: Nurjannatul Naim Kamaruddin, Tengku Sifziuzl Tengku Muhammad, Aina Farahiyah Abdul Manan, Habsah Mohamad

Abstract:

Atherosclerosis which leads to cardiovascular diseases such as myocardial infarction, unstable angina (ischemic heart pain), sudden cardiac death and stroke is the principal cause of death worldwide. It has been a very critical issue as current common drug treatment, statin therapy has left bad side effects like rhabdomyolysis, atrial fibrillation, liver disease, abdominal and chest pain. Interestingly, the discoveries of proprotein convertase subtilisin-kexin type 9 have paved a new way in the treatment of atherosclerosis. This serine protease is believed to involve in the regulation of LDL- uptake by LDL-receptor. Therefore, this study was conducted to evaluate the potential of Acanthaster plancii fractions to reduce the transcriptional activity of the PCSK9 promoter. In this study, the marine organism which is Acanthaster plancii has been used as the source for marine compounds in inhibiting PCSK9. The cytotoxicity activity of ten fractions from the methanol extracts of Acanthaster plancii was investigated on HepG2 cell lines using MTS assay and dual glo luciferase assay was carried out later to analyses the effects of the samples in reducing the transcriptional activity of the PCSK9 promoter. Both assays used fractions with five different concentrations, 3.13µg/mL, 6.25µg/mL, 12.5µg/mL, 25µg/mL, and 50µg/mL. MTS assay indicated that the fractions are non-cytotoxic towards HepG2 cell lines as their IC50 value is greater than 30µg/mL. Whilst, for the dual glo luciferase assay, among all the fractions, Enhance Fraction 2 (EF2) showed the best potential in reducing the transcriptional activity of the PCSK9 promoter. The results indicated that this EF2 gave the lowest PCSK9 promoter expression at low concentration which is 0.2 fold change at 6.25µg/mL. This finding suggested that further analysis should be done to validate the potential of Acanthaster plancii as the source of anti-atherosclerotic agent.

Keywords: Acanthaster plancii, atherosclerosis, luciferase assay, PCSK9

Procedia PDF Downloads 139
1855 Smart Safari: Safari Guidance Mobile Application

Authors: D. P. Lawrence, T. M. M. D. Ariyarathna, W. N. K. De Silva, M. D. S. C. De Silva, Lasantha Abeysiri, Pradeep Abeygunawardhna

Abstract:

Safari traveling is one of the most famous hobbies all over the world. In Sri Lanka, 'Yala' is the second-largest national park, which is a better place to go for a safari. Many number of local and foreign travelers are coming to go for a safari in 'Yala'. But 'Yala' does not have a mobile application that is made to facilitate the traveler with some important features that the traveler wants to achieve in the safari experience. To overcome these difficulties, the proposed mobile application by adding those identified features to make travelers, guiders, and administration's works easier. The proposed safari traveling guidance mobile application is called 'SMART SAFARI' for the 'Yala' National Park in Sri Lanka. There are four facilities in this mobile application that provide for travelers as well as the guiders. As the first facility, the guider and traveler can view the created map of the park, and the guider can add temporary locations of animals and special locations on the map. This is a Geographic Information System (GIS) to capture, analyze, and display geographical data. And as the second facility is to generate optimal paths according to the travelers' requirements through the park by using machine learning techniques. In the third part, the traveler can get information about animals using an animal identification system by capturing the animal. As in the other facility, the traveler will be facilitated to add reviews and a rate and view those comments under categorized sections and pre-defined score range. With those facilities, this user-friendly mobile application provides the user to get a better experience in safari traveling, and it will probably help to develop tourism culture in Sri Lanka.

Keywords: animal identification system, geographic information system, machine learning techniques, pre defined score range

Procedia PDF Downloads 126