Search results for: common bile duct exploration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6881

Search results for: common bile duct exploration

5831 The Role of International Organizations in the Implementation of Return Migration Policy in Cameroon

Authors: Charles Simplice Mbatsogo Mebo

Abstract:

With growth picking up again, Africa seems increasingly attractive for its own nationals who return home through new opportunities available for them. The purpose of our research paper is to understand the role of the international partners in Cameroon, with regards to their support for the return and reintegration of migrants. We, therefore, questioned the relevance and effectiveness and efficacy of international instruments in reintegrating returnees to Cameroon. After our analysis that was conducted on the basis of a documentary exploration, interviews, and field surveys, it appears that the contribution of the international partners in Cameroon is proven in relation to their participation in the financing and placement of returned experts. However, their contribution remains insufficient due to their low level of deployment and the insignificant impact of their investments on the reintegration of Cameroonian Diasporas. The research also reveals some exogenous and endogenous constraints that hinder international institutions' actions in terms of accompanying migrants returning to Cameroon. Finally, for a better management of the returnees' issue, it is necessary to set up a mechanism to raise awareness and a coordination system of all international actors involved. It is also relevant to reform the migration policy, build institutional capacities, and improve the juridical-administrative and economic environment so as to favor co-development in Cameroon.

Keywords: international partners, returnees, diaspora, migration policy, co-development

Procedia PDF Downloads 149
5830 Application of Aerogeomagnetic and Ground Magnetic Surveys for Deep-Seated Kimberlite Pipes in Central India

Authors: Utkarsh Tripathi, Bikalp C. Mandal, Ravi Kumar Umrao, Sirsha Das, M. K. Bhowmic, Joyesh Bagchi, Hemant Kumar

Abstract:

The Central India Diamond Province (CIDP) is known for the occurrences of primary and secondary sources for diamonds from the Vindhyan platformal sediments, which host several kimberlites, with one operating mine. The known kimberlites are Neo-Proterozoic in age and intrude into the Kaimur Group of rocks. Based on the interpretation of areo-geomagnetic data, three potential zones were demarcated in parts of Chitrakoot and Banda districts, Uttar Pradesh, and Satna district, Madhya Pradesh, India. To validate the aero-geomagnetic interpretation, ground magnetic coupled with a gravity survey was conducted to validate the anomaly and explore the possibility of some pipes concealed beneath the Vindhyan sedimentary cover. Geologically the area exposes the milky white to buff-colored arkosic and arenitic sandstone belonging to the Dhandraul Formation of the Kaimur Group, which are undeformed and unmetamorphosed providing almost transparent media for geophysical exploration. There is neither surface nor any geophysical indication of intersections of linear structures, but the joint patterns depict three principal joints along NNE-SSW, ENE-WSW, and NW-SE directions with vertical to sub-vertical dips. Aeromagnetic data interpretation brings out three promising zones with the bi-polar magnetic anomaly (69-602nT) that represent potential kimberlite intrusive concealed below at an approximate depth of 150-170m. The ground magnetic survey has brought out the above-mentioned anomalies in zone-I, which is congruent with the available aero-geophysical data. The magnetic anomaly map shows a total variation of 741 nT over the area. Two very high magnetic zones (H1 and H2) have been observed with around 500 nT and 400 nT magnitudes, respectively. Anomaly zone H1 is located in the west-central part of the area, south of Madulihai village, while anomaly zone H2 is located 2km apart in the north-eastern direction. The Euler 3D solution map indicates the possible existence of the ultramafic body in both the magnetic highs (H1 and H2). The H2 high shows the shallow depth, and H1 shows a deeper depth solution. In the reduced-to-pole (RTP) method, the bipolar anomaly disappears and indicates the existence of one causative source for both anomalies, which is, in all probabilities, an ultramafic suite of rock. The H1 magnetic high represents the main body, which persists up to depths of ~500m, as depicted through the upward continuation derivative map. Radially Averaged Power Spectrum (RAPS) shows the thickness of loose sediments up to 25m with a cumulative depth of 154m for sandstone overlying the ultramafic body. The average depth range of the shallower body (H2) is 60.5-86 meters, as estimated through the Peters half slope method. Magnetic (TF) anomaly with BA contour also shows high BA value around the high zones of magnetic anomaly (H1 and H2), which suggests that the causative body is with higher density and susceptibility for the surrounding host rock. The ground magnetic survey coupled with the gravity confirms a potential target for further exploration as the findings are co-relatable with the presence of the known diamondiferous kimberlites in this region, which post-date the rocks of the Kaimur Group.

Keywords: Kaimur, kimberlite, Euler 3D solution, magnetic

Procedia PDF Downloads 71
5829 Impact of Hashtags in Tweets Regarding COVID-19 on the Psyche of Pakistanis: A Critical Discourse Analytical Study

Authors: Muhammad Hamza

Abstract:

This study attempts to analyze the social media reports regarding Covid-19 that impacted the psyche of Pakistanis. This Study is delimited to hashtags from Tweets on a social media platform. During Covid-19, it has been observed that it affected the psychological conditions of Pakistanis. With the application of the three-dimensional model presented by Fairclough, together with a data analytic software “FireAnt” i.e., social media and data analysis toolkit, which is used to filter, identify, report and export data from social media accurately. A detailed and explicit exploration of the various hashtags by users from different fields was conducted. This study conducted a quantitative as well as qualitative methods of analysis. The study examined the perspectives of the Pakistanis behind the use of various hashtags with the lenses of Critical Discourse Analysis (CDA). While conducting this research, CDA was helpful to reveal the connection between the psyche of the people and the Covid-19 pandemic. It was found that how different Pakistanis used social media and how Covid-19 impacted their psyche. After collecting and analyzing the hashtags from twitter it was concluded that majority of people received negative impact from social media reports, while, some people used their hashtags positively and were found positive during Covid-19, and some people were found neutral.

Keywords: Covid, Covid-19, psyche, Covid Pakistan

Procedia PDF Downloads 54
5828 The Colorectal Cancer in Patients of Eastern Algeria

Authors: S. Tebibel, C. Mechati, S. Messaoudi

Abstract:

Algeria is currently experiencing the same rate of cancer progression as that registered these last years in the western countries. Colorectal cancer, constituting increasingly a major public health problem, is the most common form of cancer after breast and Neck-womb cancer at the woman and prostate cancer at the man. Our work is based on a retrospective study to determine the cases of colorectal cancer through eastern Algeria. Our goal is to carry out an epidemiological, histological and immune- histochemical study to investigate different techniques for the diagnosis of colorectal cancer and their interests and specific in detecting the disease. The study includes 110 patients (aged between 20 to 87 years) with colorectal cancer where the inclusions and exclusions criteria were established. In our study, colorectal cancer, expresses a male predominance, with a sex ratio of 1, 99 and the most affected age group is between 50 and 59 years. We noted that the colon cancer rate is higher than rectal cancer rate, whose frequencies are respectively 60,91 % and 39,09 %. In the series of colon cancer, the ADK lieberkunien is histological the most represented type, or 85,07 % of all cases. In contrast, the proportion of ADK mucinous (colloid mucous) is only 1,49% only. Well-differentiated ADKS, are very significant in our series, they represent 83,58 % of cases. Adenocarcinoma moderately and poorly differentiated, whose proportions are respectively 2,99 % and 0.05 %. For histological varieties of rectal ADK, we see in our workforce that ADK lieberkunien represent the most common histological form, or 76,74%, while the mucosal colloid is 13,95 %. Research of the mutation on the gene encoding K-ras, a major step in the targeted therapy of colorectal cancers, is underway in our study. Colorectal cancer is the subject of much promising research concern: the evaluation of new therapies (antiangiogenic monoclonal antibodies), the search for predictors of sensitivity to chemotherapy and new prognostic markers using techniques of molecular biology and proteomics.

Keywords: adenocarcinoma, age, colorectal cancer, epidemiology, histological section, sex

Procedia PDF Downloads 339
5827 Art Street as a Way for Reflective Thinking in the Filed of Adult and Primary Education: Examples of Educational Techniques

Authors: Georgia H. Mega

Abstract:

Art street, a category of artwork displayed in public spaces, has been recognized as a potential tool for promoting reflective thinking in both adult and primary education. Educational techniques that encourage critical and creative thinking, as well as deeper reflection, have been developed and applied in educational curricula. This paper aims to explore the potential of art street in cultivating learners' reflective awareness toward multiculturalism. The main objective of this case study is to investigate the possibilities that art street offers in terms of developing learners' critical reflection, regardless of their age. The study compares two art street works from Greece and Norway, focusing on their common theme of multiculturalism. The study adopts a qualitative methodology, specifically a case study approach. This approach allows for an in-depth analysis of the two selected art street works and their impact on learners' reflective thinking. The study demonstrates that art street can effectively cultivate learners' reflective awareness of multiculturalism. The selected works of art, despite being created by different artists and displayed in different cities, share similar content and convey messages that facilitate reflective dialogue on cultural osmosis. Both adult and primary education approaches utilize the same art street works to achieve reflective awareness. This paper contributes to the existing literature on reflective learning processes by highlighting the potential of art street as a means for encouraging reflective thinking. It builds upon the theoretical frameworks of adult education theorists such as Freire and Mezirow, as well as those of primary education theorists such as Perkins and Project Zero. Data for this study were collected through observation and analysis of two art street works, one from Greece and one from Norway. These works were selected based on their common theme of multiculturalism. Analysis Procedures: The collected data were analyzed using qualitative analysis techniques. The researchers examined the content and messages conveyed by the selected art street works and explored their impact on learners' reflective thinking. The central question addressed in this study is whether art street can develop learners' critical reflection toward multiculturalism, regardless of their age. The findings of this study support the notion that art street can effectively cultivate learners' reflective awareness toward multiculturalism. The selected art street works, despite their differences in origin and location, share common themes that encourage reflective dialogue. The use of art street in both adult and primary education approaches showcases its potential as a tool for promoting reflective learning processes. Overall, this paper contributes to the understanding of art street as a means for reflective thinking in the field of adult and primary education.

Keywords: art street, educational techniques, multiculturalism, observation of artworks, reflective awareness

Procedia PDF Downloads 71
5826 Synthesis, Biological Evaluation and Molecular Modeling Studies on Chiral Chloroquine Analogues as Antimalarial Agents

Authors: Srinivasarao Kondaparla, Utsab Debnath, Awakash Soni, Vasantha Rao Dola, Manish Sinha, Kumkum Kumkum Srivastava, Sunil K. Puri, Seturam B. Katti

Abstract:

In a focused exploration, we have designed synthesized and biologically evaluated chiral conjugated new chloroquine (CQ) analogs with substituted piperazines as antimalarial agents. In vitro as well as in vivo studies revealed that compound 7c showed potent activity [for in vitro IC₅₀= 56.98nM (3D7), 97.76nM (K1); for in vivo (up to at the dose of 12.5 mg/kg); SI = 3510] as a new lead of antimalarial agent. Other compounds 6b, 6d, 7d, 7h, 8c, 8d, 9a, and 9c are also showing moderate activity against CQ-sensitive (3D7) strain and superior activity against resistant (K1) strain of P. falciparum. Furthermore, we have carried out docking and 3D-QSAR studies of all in-house data sets (168 molecules) of chiral CQ analogs to explain the structure activity relationships (SAR). Our new findings specified the significance of H-bond interaction with the side chain of heme for biological activity. In addition, the 3D-QSAR study against 3D7 strain indicated the favorable and unfavorable sites of CQ analogs for incorporating steric, hydrophobic and electropositive groups to improve the antimalarial activity.

Keywords: piperazines, CQ-sensitive strain-3D7, in-vitro and in-vivo assay, docking, 3D-QSAR

Procedia PDF Downloads 168
5825 The Use of Medicinal Plants among Middle Aged People in Rural Area, West Java, Indonesia

Authors: Rian Diana, Naufal Muharam Nurdin, Faisal Anwar, Hadi Riyadi, Ali Khomsan

Abstract:

The use of traditional medicine (herbs and medicinal plants) are common among Indonesian people especially the elderly. Few study explore the use of medicinal plants in middle aged people. This study aims to collect information on the use of medicinal plants in middle aged people in rural areas. This cross sectional study included 224 subjects aged 45-59 years old and conducted in Cianjur District, West Java in 2014. Semi-structured questionnaires were used to collect information about preference in treatment of illness, the use of medicinal plants, and their purposes. Information also recorded plant names, parts used, mode of preparation, and dosage. Buying drugs in stall (83.9%) is the first preference in treatment of illness, followed by modern treatment 19.2% (doctors) and traditional treatment 17.0% (herbs/medicinal plants). 87 subjects (38.8%) were using herbs and medicinal plants for curative (66.7%), preventive (31.2%), and rehabilitative (2.1%) purposes. In this study, 48 species are used by the subjects. Physalis minima L. 'cecenet', Orthosiphon aristatus Mic. 'kumis kucing', and Annona muricata 'sirsak' are commonly used for the treatment of hypertension and stiffness. Leaves (64.6%) are the most common part used. Medicinal plants were washed and boiled in a hot water. Subject drinks the herbs with a different dosage. One in three middle aged people used herbal and medicinal plants for curative and preventive treatment particularly hypertension and stiffness. Increasing knowledge about herbal or medicinal plants dosage and their interaction with medical drugs are important to do.Doses vary between 1-3 glasses/day for treatment and 1-2 glasses/months for prevention of diseases.

Keywords: herbs, hypertension, medicinal plants, middle age, rural

Procedia PDF Downloads 240
5824 Geoelectric Survey for Groundwater Potential in Waziri Umaru Federal Polytechnic, Birnin Kebbi, Nigeria

Authors: Ibrahim Mohammed, Suleiman Taofiq, Muhammad Naziru Yahya

Abstract:

Geoelectrical measurements using Schlumberger Vertical Electrical Sounding (VES) method were carried out in Waziri Umaru Federal Polytechnic, Birnin Kebbi, Nigeria, with the aim of determining the groundwater potential in the area. Twelve (12) Vertical Electric Sounding (VES) data were collected using Terrameter (ABEM SAS 300c) and analyzed using computer software (IPI2win), which gives an automatic interpretation of the apparent resistivity. The results of the interpretation of VES data were used in the characterization of three to five geo-electric layers from which the aquifer units were delineated. Data analysis indicated that water bearing formation exists in the third and fourth layers having resistivity range of 312 to 767 Ωm and 9.51 to 681 Ωm, respectively. The thickness of the formation ranges from 14.7 to 41.8 m, while the depth is from 8.22 to 53.7 m. Based on the result obtained from the interpretation of the data, five (5) VES stations were recommended as the most viable locations for groundwater exploration in the study area. The VES stations include VES A4, A5, A6, B1, and B2. The VES results of the entire area indicated that the water bearing formation occurs at maximum depth of 53.7 m at the time of this survey.

Keywords: aquifer, depth, groundwater, resistivity, Schlumberger

Procedia PDF Downloads 159
5823 The Changes of Functions of Leishan Miao New-Year in Southeast Guizhou

Authors: Lanyan Peng, Ling Chen

Abstract:

Leishan Miao New-Year is one of the grandest festivals in the southeastern of Guizhou Province in China. It was officially listed in the National Intangible Cultural Heritage List in 2008, as a traditional folk cultural activity organized by the local Miao people. With the rise of cultural tourism, after 19 years of exploration, the local government has successfully built Miao New-Year into a cultural card that is well-known at home and abroad. During the Miao New-Year period, it has attracted 3.8 million tourists and achieves a win-win situation in the economy and culture. However, tourism development has changed the living environment and living state of the local people. And it is accompanied by changes in the form of the festival, the content of the festival, and the local people’s needs and attitudes to the festival. This paper uses the field investigation method to achieve 410 questionnaires and 35 interviews, exploring the process and the reasons for changes of Leishan Miao New-Year’s cultural function. Among all the functions, the economic function, identity function, and entertainment function have been enhanced, and the marriage and love function has been extended. In the meanwhile, sacrificial function has been weakened. There are some trends in functions. The function of commemorating ancestor and self-entertainment has been changed to entertaining people and economic pursuit.

Keywords: Miao New-Year, Miao nationality, festival function, changes

Procedia PDF Downloads 116
5822 Locating the Davao Film Culture: An Exploration of the Relationship of Geography and the Cinema of a Regional City Center

Authors: Sarah Isabelle Torres

Abstract:

Using Lefebvre’s (1991) Spatial Triad, this study explores the relationship of geography and cinema and asks the question: how does geography shape the film culture of a regional city center located at the periphery of a country’s capital? This research aims to locate the contemporary film scene of the city in question, Davao City, Mindanao through contextualizing the politics and culture of its tri-people. This study shows that primarily because of local filmmakers' affection and sense of place, progressive films focusing on the tri-people and their struggles mainly due to issues on land have been born. To further understand the city’s film culture, this study maps the following areas: 1) filmmakers and cineastes, 2) films, 3) film festivals, 4) financial stakeholders, 5) institutions, and 6) screening places. From these, the researcher learned that although the local film community has established itself for decades, problems on audience, funding, and institutional support continue to persist. Aside from mapping, this study also explores Davao’s political, economic, and cultural position within the regional and the national arenas.

Keywords: cinema studies, Davao City, film culture, geography, Philippines, place, regional cinema, space

Procedia PDF Downloads 151
5821 Changing Dynamics of Women Entrepreneurship: A Literature Review of a Decade

Authors: Viral Nagori, Preeti Shroff, Prathana Dodia

Abstract:

The paper presents the study on women entrepreneurship over the last decade in Indian and Global Context. This research study has its basis primarily in the literature review. The research methodology classifies the literature review paper based on different parameters of women entrepreneurship. The literature review relies on research papers in journals, articles in periodicals, and books published on women entrepreneurship. To accomplish this, the criteria included finding the most relevant, recent, and cited studies on women entrepreneurship over the last decade. It aims to evaluate the issues and challenges faced by women entrepreneurs. The finding suggested that there are several common obstacles, which hinders the pathway to success towards being a successful woman entrepreneur. The paper also describes such common obstacles like the level of education, family responsibilities, lack of business information, religious and cultural constraints, limited mobility, exposure, lack of working capital, and more. The in-depth analysis of literature review indicates that despite the numerous barriers, the arrival of social media has played a crucial role in enabling women to start and scale up their enterprises. Further, technology innovation has given them access to have relevant market information, increase reach and network with the customers. It enabled them to achieve work life balance and pursuing entrepreneur in them. The paper also describes the Government and Nongovernmental initiatives for promotion of women entrepreneurship. At the end, the study provides insights into the changing dynamics of women entrepreneurship in the current scenario and future prospects.

Keywords: changing dynamics, government initiatives, literature review, social media, technology innovation, women entrepreneurship

Procedia PDF Downloads 150
5820 Bio-polymer Materials for Sustainable Consumer and Medical Applications

Authors: Sonny Yip Hong Choy

Abstract:

With the ubiquity of 3D printing technology in the last decade, a wide array of material choices are available for Fused Deposition Modelling (FDM) 3D printing technology. Exploration into creating printable bio-polymers has also seen progress recently in attempts to further the sustainability agenda and circular economy. By tackling waste and pollution via recycling and reusing, food by-products resulting from mass food production may see opportunities for renewed value and alternate applications through 3D printing. To date, many pure polymers, blends, as well as composites have been developed specifically for FDM printing contexts to heighten the physical performance of final printed products. This review article covers general information on various FDM printed polymers and composites while exploring experiments designed to create printable biopolymers made from reused food by-products. The biopolymer-based composites preparation is described in detail, while their advantages and disadvantages are also discussed. In addition, this article shares knowledge and highlights experimentation that aims to achieve acceptable 3D-printed biopolymer composite properties that may address the functional requirements of different application contexts. Furthermore, the article describes a brief overview of the potential applications of such bio-polymers and the future scope in this field.

Keywords: food by-products, bio-polymers, FDM, 3d printing

Procedia PDF Downloads 76
5819 Using the ISO 9705 Room Corner Test for Smoke Toxicity Quantification of Polyurethane

Authors: Gabrielle Peck, Ryan Hayes

Abstract:

Polyurethane (PU) foam is typically sold as acoustic foam that is often used as sound insulation in settings such as night clubs and bars. As a construction product, PU is tested by being glued to the walls and ceiling of the ISO 9705 room corner test room. However, when heat is applied to PU foam, it melts and burns as a pool fire due to it being a thermoplastic. The current test layout is unable to accurately measure mass loss and doesn’t allow for the material to burn as a pool fire without seeping out of the test room floor. The lack of mass loss measurement means gas yields pertaining to smoke toxicity analysis can’t be calculated, which makes data comparisons from any other material or test method difficult. Additionally, the heat release measurements are not representative of the actual measurements taken as a lot of the material seeps through the floor (when a tray to catch the melted material is not used). This research aimed to modify the ISO 9705 test to provide the ability to measure mass loss to allow for better calculation of gas yields and understanding of decomposition. It also aimed to accurately measure smoke toxicity in both the doorway and duct and enable dilution factors to be calculated. Finally, the study aimed to examine if doubling the fuel loading would force under-ventilated flaming. The test layout was modified to be a combination of the SBI (single burning item) test set up inside oof the ISO 9705 test room. Polyurethane was tested in two different ways with the aim of altering the ventilation condition of the tests. Test one was conducted using 1 x SBI test rig aiming for well-ventilated flaming. Test two was conducted using 2 x SBI rigs (facing each other inside the test room) (doubling the fuel loading) aiming for under-ventilated flaming. The two different configurations used were successful in achieving both well-ventilated flaming and under-ventilated flaming, shown by the measured equivalence ratios (measured using a phi meter designed and created for these experiments). The findings show that doubling the fuel loading will successfully force under-ventilated flaming conditions to be achieved. This method can therefore be used when trying to replicate post-flashover conditions in future ISO 9705 room corner tests. The radiative heat generated by the two SBI rigs facing each other facilitated a much higher overall heat release resulting in a more severe fire. The method successfully allowed for accurate measurement of smoke toxicity produced from the PU foam in terms of simple gases such as oxygen depletion, CO and CO2. Overall, the proposed test modifications improve the ability to measure the smoke toxicity of materials in different fire conditions on a large-scale.

Keywords: flammability, ISO9705, large-scale testing, polyurethane, smoke toxicity

Procedia PDF Downloads 72
5818 Literature Review of Empirical Studies on the Psychological Processes of End-of-Life Cancer Patients

Authors: Kimiyo Shimomai, Mihoko Harada

Abstract:

This study is a literature review of the psychological reactions that occur in end-of-life cancer patients who are nearing death. It searched electronic databases and selected literature related to psychological studies of end-of-life patients. There was no limit on the search period, and the search was conducted until the second week of December 2021. The keywords were specified as “death and dying”, “terminal illness”, “end-of-life”, “palliative care”, “psycho-oncology” and “research”. These literatures referred to Holly (2017): Comprehensive Systematic Review for Advanced Practice Nursing, P268 Figure 10.3 to ensure quality. These literatures were selected with a dissertation score of 4 or 5. The review was conducted in two stages with reference to the procedure of George (2002). First, these references were searched for keywords in the database, and then relevant references were selected from the psychology and nursing studies of end-of-life patients. The number of literatures analyzed was 76 for overseas and 17 for domestic. As for the independent variables, "physical variable" was the most common in 36 literatures (66.7%), followed by "psychological variable" in 35 literatures (64.8%), "spiritual variable" in 21 literatures (38%), and "social variable" in 17 literatures. (31.5%), "Variables related to medical care / treatment" were 16 literatures (29.6%). To summarize the relationship between these independent variables and the dependent variable, when the dependent variable is "psychological variable", the independent variables are "psychological variable", "social variable", and "physical variable". Among the independent variables, the physical variables were the most common. The psychological responses that occur in end-stage cancer patients who are nearing death are mutually influenced by psychological, social, and physical variables. Therefore, it supported the "total pain" advocated by Cicely Saunders.

Keywords: cancer patient, end-of-life, literature review, psychological process

Procedia PDF Downloads 124
5817 Managing Incomplete PSA Observations in Prostate Cancer Data: Key Strategies and Best Practices for Handling Loss to Follow-Up and Missing Data

Authors: Madiha Liaqat, Rehan Ahmed Khan, Shahid Kamal

Abstract:

Multiple imputation with delta adjustment is a versatile and transparent technique for addressing univariate missing data in the presence of various missing mechanisms. This approach allows for the exploration of sensitivity to the missing-at-random (MAR) assumption. In this review, we outline the delta-adjustment procedure and illustrate its application for assessing the sensitivity to deviations from the MAR assumption. By examining diverse missingness scenarios and conducting sensitivity analyses, we gain valuable insights into the implications of missing data on our analyses, enhancing the reliability of our study's conclusions. In our study, we focused on assessing logPSA, a continuous biomarker in incomplete prostate cancer data, to examine the robustness of conclusions against plausible departures from the MAR assumption. We introduced several approaches for conducting sensitivity analyses, illustrating their application within the pattern mixture model (PMM) under the delta adjustment framework. This proposed approach effectively handles missing data, particularly loss to follow-up.

Keywords: loss to follow-up, incomplete response, multiple imputation, sensitivity analysis, prostate cancer

Procedia PDF Downloads 80
5816 Development of a Real-Time Brain-Computer Interface for Interactive Robot Therapy: An Exploration of EEG and EMG Features during Hypnosis

Authors: Maryam Alimardani, Kazuo Hiraki

Abstract:

This study presents a framework for development of a new generation of therapy robots that can interact with users by monitoring their physiological and mental states. Here, we focused on one of the controversial methods of therapy, hypnotherapy. Hypnosis has shown to be useful in treatment of many clinical conditions. But, even for healthy people, it can be used as an effective technique for relaxation or enhancement of memory and concentration. Our aim is to develop a robot that collects information about user’s mental and physical states using electroencephalogram (EEG) and electromyography (EMG) signals and performs costeffective hypnosis at the comfort of user’s house. The presented framework consists of three main steps: (1) Find the EEG-correlates of mind state before, during, and after hypnosis and establish a cognitive model for state changes, (2) Develop a system that can track the changes in EEG and EMG activities in real time and determines if the user is ready for suggestion, and (3) Implement our system in a humanoid robot that will talk and conduct hypnosis on users based on their mental states. This paper presents a pilot study in regard to the first stage, detection of EEG and EMG features during hypnosis.

Keywords: hypnosis, EEG, robotherapy, brain-computer interface (BCI)

Procedia PDF Downloads 253
5815 Adobe Attenuation Coefficient Determination and Its Comparison with Other Shielding Materials for Energies Found in Common X-Rays Procedures

Authors: Camarena Rodriguez C. S., Portocarrero Bonifaz A., Palma Esparza R., Romero Carlos N. A.

Abstract:

Adobe is a construction material that fulfills the same function as a conventional brick. Widely used since ancient times, it is present in an appreciable percentage of buildings in Latin America. Adobe is a mixture of clay and sand. The interest in the study of the properties of this material arises due to its presence in the infrastructure of hospital´s radiological services, located in places with low economic resources, for the attenuation of radiation. Some materials such as lead and concrete are the most used for shielding and are widely studied in the literature. The present study will determine the mass attenuation coefficient of Adobe. The minimum required thicknesses for the primary and secondary barriers will be estimated for the shielding of radiological facilities where conventional and dental X-rays are performed. For the experimental procedure, an X-ray source emitted direct radiation towards different thicknesses of an Adobe barrier, and a detector was placed on the other side. For this purpose, an UNFORS Xi solid state detector was used, which collected information on the difference of radiation intensity. The initial parameters of the exposure started at 45 kV; and then the tube tension was varied in increments of 5 kV, reaching a maximum of 125 kV. The X-Ray tube was positioned at a distance of 0.5 m from the surface of the Adobe bricks, and the collimation of the radiation beam was set for an area of 0.15 m x 0.15 m. Finally, mathematical methods were applied to determine the mass attenuation coefficient for different energy ranges. In conclusion, the mass attenuation coefficient for Adobe was determined and the approximate thicknesses of the most common Adobe barriers in the hospital buildings were calculated for their later application in the radiological protection.

Keywords: Adobe, attenuation coefficient, radiological protection, shielding, x-rays

Procedia PDF Downloads 156
5814 Simultaneous Bilateral Patella Tendon Rupture: A Systematic Review

Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema

Abstract:

Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.

Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma

Procedia PDF Downloads 129
5813 Patterns of Malignant and Benign Breast Lesions in Hail Region: A Retrospective Study at King Khalid Hospital

Authors: Laila Seada, Ashraf Ibrahim, Amjad Al Shammari

Abstract:

Background and Objectives: Breast carcinoma is the most common cancer of females in Hail region, accounting for 31% of all diagnosed cancer cases followed by thyroid carcinoma (25%) and colorectal carcinoma (13%). Methods: In the present retrospective study, all cases of breast lesions received at the histopathology department in King Khalid Hospital, Hail, during the period from May 2011 to April 2016 have been retrieved from department files. For all cases, a trucut biopsy, lumpectomy, or modified radical mastectomy was available for histopathologic diagnosis, while 105/140 (75%) had, as well, preoperative fine needle aspirates (FNA). Results: 49 cases out of 140 (35%) breast lesions were carcinomas: 44/49 (89.75%) was invasive ductal, 2/49(4.1%) invasive lobular carcinomas, 1/49(2.05%) intracystic low grade papillary carcinoma and 2/49 (4.1%) ductal carcinoma in situ (DCIS). Mean age for malignant cases was 45.06 (+/-10.58): 32.6% were below the age of 40 and 30.6 below 50 years, 18.3% below 60 and 16.3% below 70 years. For the benign group, mean age was 32.52 (+/10.5) years. Benign lesions were in order of frequency: 34 fibroadenomas, 14 fibrocystic disease, 12 chronic mastitis, five granulomatous mastitis, three intraductal papillomas, and three benign phyllodes tumor. Tubular adenoma, lipoma, skin nevus, pilomatrixoma, and breast reduction specimens constituted the remaining specimens. Conclusion: Breast lesions are common in our series and invasive carcinoma accounts for more than 1/3rd of the lumps, with 63.2% incidence in pre-menopausal ladies, below the age of 50 years. FNA as a non-invasive procedure, proved to be an effective tool in diagnosing both benign and malignant/suspicious breast lumps and should continue to be used as a first assessment line of palpable breast masses.

Keywords: age incidence, breast carcinoma, fine needle aspiration, hail region

Procedia PDF Downloads 270
5812 Frequency Control of Self-Excited Induction Generator Based Microgrid during Transition from Grid Connected to Island Mode

Authors: Azhar Ulhaq, Zubair Yameen, Almas Anjum

Abstract:

Frequency behaviour of self-excited induction generator (SEIG) wind turbines during control mode transition from grid connected to islanded mode is studied in detail. A robust control scheme for frequency regulation based on combined action of STATCOM, energy storage system (ESS) and pitch angle control for wind powered microgrid (MG) is proposed. Suggested STATCOM controller comprises a 3-phase voltage source converter (VSC) that contains insulated gate bipolar transistors (IGBTs) based pulse width modulation (PWM) inverters along with a capacitor bank. Energy storage system control consists of current controlled voltage source converter and battery bank. Both of them acting simultaneously after detection of island compensates for reactive and active power demands, thus regulating frequency at point of common coupling (PCC) and also improves load stability. STATCOM integrates at point of common coupling and ESS is connected to microgrids main bus. Results reveal that proposed control not only stabilizes frequency during transition duration but also minimizes sudden frequency imbalance caused by load variation or wind intermittencies in islanded operation. System is investigated with and without suggested control scheme. The efficacy of proposed strategy has been verified by simulation in MATLAB/Simulink.

Keywords: energy storage system, island, wind, STATCOM, self-excited induction generator, SEIG, transient

Procedia PDF Downloads 149
5811 Treating On-Demand Bonds as Cash-In-Hand: Analyzing the Use of “Unconscionability” as a Ground for Challenging Claims for Payment under On-Demand Bonds

Authors: Asanga Gunawansa, Shenella Fonseka

Abstract:

On-demand bonds, also known as unconditional bonds, are commonplace in the construction industry as a means of safeguarding the employer from any potential non-performance by a contractor. On-demand bonds may be obtained from commercial banks, and they serve as an undertaking by the issuing bank to honour payment on demand without questioning and/or considering any dispute between the employer and the contractor in relation to the underlying contract. Thus, whether or not a breach had occurred under the underlying contract, which triggers the demand for encashment by the employer, is not a question the bank needs to be concerned with. As a result, an unconditional bond allows the beneficiary to claim the money almost without any condition. Thus, an unconditional bond is as good as cash-in-hand. In the past, establishing fraud on the part of the employer, of which the bank had knowledge, was the only ground on which a bank could dishonour a claim made under an on-demand bond. However, recent jurisprudence in common law countries shows that courts are beginning to consider unconscionable conduct on the part of the employer in claiming under an on-demand bond as a ground that contractors could rely on the prevent the banks from honouring such claims. This has created uncertainty in connection with on-demand bonds and their liquidity. This paper analyzes recent judicial decisions in four common law jurisdictions, namely, England, Singapore, Hong Kong, and Sri Lanka, to identify the scope of using the concept of “unconscionability” as a ground for preventing unreasonable claims for encashment of on-demand bonds. The objective of this paper is to argue that on-demand bonds have lost their effectiveness as “cash-in-hand” and that this is, in fact, an advantage and not an impediment to international commerce, as the purpose of such bonds should not be to provide for illegal and unconscionable conduct by the beneficiaries.

Keywords: fraud, performance guarantees, on-demand bonds, unconscionability

Procedia PDF Downloads 100
5810 Exploring the Relationship between Mediolateral Center of Pressure and Galvanic Skin Response during Balance Tasks

Authors: Karlee J. Hall, Mark Laylor, Jessy Varghese, Paula Polastri, Karen Van Ooteghem, William McIlroy

Abstract:

Balance training is a common part of physiotherapy treatment and often involves a set of proprioceptive exercises which the patient carries out in the clinic and as part of their exercise program. Understanding all contributing factors to altered balance is of utmost importance to the clinical success of treatment of balance dysfunctions. A critical role for the autonomic nervous system (ANS) in the control of balance reactions has been proposed previously, with evidence for potential involvement being inferred from the observation of phasic galvanic skin responses (GSR) evoked by external balance perturbations. The current study explored whether the coupling between ANS reactivity and balance reactions would be observed during spontaneously occurring instability while standing, including standard positions typical of physiotherapy balance assessments. It was hypothesized that time-varying changes in GSR (ANS reactivity) would be associated with time-varying changes in the mediolateral center of pressure (ML-COP) (somatomotor reactivity). Nine individuals (5 females, 4 males, aged 19-37 years) were recruited. To induce varying balance demands during standing, the study compared ML-COP and GSR data across different task conditions varying the availability of vision and width of the base of support. Subjects completed 3, 30-second trials for each of the following stance conditions: standard, narrow, and tandem eyes closed, tandem eyes open, tandem eyes open with dome to shield visual input, and restricted peripheral visual field. ANS activity was evaluated by measures of GSR recorded from Ag-AgCl electrodes on the middle phalanges of digits 2 and 4 on the left hand; balance measures include ML-COP excursion frequency and amplitude recorded from two force plates embedded in the floor underneath each foot. Subjects were instructed to stand as still as possible with arms crossed in front of their chest. When comparing mean task differences across subjects, there was an expected increase in postural sway from tasks with a wide stance and no sensory restrictions (least challenging) to those with a narrow stance and no vision (most challenging). The correlation analysis revealed a significant positive relationship between ML-COP variability and GSR variability when comparing across tasks (r=0.94, df=5, p < 0.05). In addition, correlations coincided within each subject and revealed a significant positive correlation in 7 participants (r= 0.47, 0.57, 0.62, 0.62, 0.81, 0.64, 0.69 respectively, df=19, p < 0.05) and no significant relationship in 2 participants (r=0.36, 0.29 respectively, df=19, p > 0.05). The current study revealed a significant relationship between ML-COP and GSR during balance tasks, revealing the ANS reactivity associated with naturally occurring instability when standing still, which is proportional to the degree of instability. Understanding the link between ANS activity and control of COP is an important step forward in the enhancement of assessment of contributing factors to poor balance and treatment of balance dysfunctions. The next steps will explore the temporal association between the time-varying changes in COP and GSR to establish if the ANS reactivity phase leads or lags the evoked motor reactions, as well as exploration of potential biomarkers for use in screening of ANS activity as a contributing factor to altered balance control clinically.

Keywords: autonomic nervous system, balance control, center of pressure, somatic nervous system

Procedia PDF Downloads 166
5809 Efficacy of Music for Improving Language in Children with Special Needs

Authors: Louisa Han Lin Tan, Poh Sim Kang, Wei Ming Loi, Susan Jane Rickard Liow

Abstract:

The efficacy of music for improving speech and language has been shown across ages and diagnoses. Across the world, the wide range of therapy settings and increasing number of children diagnosed with special needs demand more cost and time effective service delivery. However, research exploring co-treatment models on children other than those with Autism Spectrum Disorder remains sparse. The aim of this research was to determine the efficacy of music for improving language in children with special needs, and generalizability of therapy effects. 25 children (7 to 12 years) were split into three groups – A, B and control. A cross-over design with direct therapy (storytelling) with or without music, and indirect therapy was applied with two therapy phases lasting 6 sessions each. Therapy targeted three prepositions in each phase. Baseline language abilities were assessed, with re-assessment after each phase. The introduction of music in therapy led to significantly greater improvement (p=.046, r=.53) in associated language abilities, with case studies showing greater effectiveness in developmentally appropriate target prepositions. However, improvements were not maintained once direct therapy ceased. As such, the incorporation of music could lead to greater efficiency and effectiveness of language therapy in children with special needs, but sustainability and generalizability of therapy effects both require further exploration.

Keywords: music, language therapy, children, special needs

Procedia PDF Downloads 460
5808 Recent Findings of Late Bronze Age Mining and Archaeometallurgy Activities in the Mountain Region of Colchis (Southern Lechkhumi, Georgia)

Authors: Rusudan Chagelishvili, Nino Sulava, Tamar Beridze, Nana Rezesidze, Nikoloz Tatuashvili

Abstract:

The South Caucasus is one of the most important centers of prehistoric metallurgy, known for its Colchian bronze culture. Modern Lechkhumi – historical Mountainous Colchis where the existence of prehistoric metallurgy is confirmed by the discovery of many artifacts is a part of this area. Studies focused on prehistoric smelting sites, related artefacts, and ore deposits have been conducted during last ten years in Lechkhumi. More than 20 prehistoric smelting sites and artefacts associated with metallurgical activities (ore roasting furnaces, slags, crucible, and tuyères fragments) have been identified so far. Within the framework of integrated studies was established that these sites were operating in 13-9 centuries B.C. and used for copper smelting. Palynological studies of slags revealed that chestnut (Castanea sativa) and hornbeam (Carpinus sp.) wood were used as smelting fuel. Geological exploration-analytical studies revealed that copper ore mining, processing, and smelting sites were distributed close to each other. Despite recent complex data, the signs of prehistoric mines (trenches) haven’t been found in this part of the study area so far. Since 2018 the archaeological-geological exploration has been focused on the southern part of Lechkhumi and covered the areas of villages Okureshi and Opitara. Several copper smelting sites (Okureshi 1 and 2, Opitara 1), as well as a Colchian Bronze culture settlement, have been identified here. Three mine workings have been found in the narrow gorge of the river Rtkhmelebisgele in the vicinities of the village Opitara. In order to establish a link between the Opitara-Okureshi archaeometallurgical sites, Late Bronze Age settlements, and mines, various scientific analytical methods -mineralized rock and slags petrography and atomic absorption spectrophotometry (AAS) analysis have been applied. The careful examination of Opitara mine workings revealed that there is a striking difference between the mine #1 on the right bank of the river and mines #2 and #3 on the left bank. The first one has all characteristic features of the Soviet period mine working (e. g. high portal with angular ribs and roof showing signs of blasting). In contrast, mines #2 and #3, which are located very close to each other, have round-shaped portals/entrances, low roofs, and fairly smooth ribs and are filled with thick layers of river sediments and collapsed weathered rock mass. A thorough review of the publications related to prehistoric mine workings revealed some striking similarities between mines #2 and #3 with their worldwide analogues. Apparently, the ore extraction from these mines was conducted by fire-setting applying primitive tools. It was also established that mines are cut in Jurassic mineralized volcanic rocks. Ore minerals (chalcopyrite, pyrite, galena) are related to calcite and quartz veins. The results obtained through the petrochemical and petrography studies of mineralized rock samples from Opitara mines and prehistoric slags are in complete correlation with each other, establishing the direct link between copper mining and smelting within the study area. Acknowledgment: This work was supported by the Shota Rustaveli National Science Foundation of Georgia (grant # FR-19-13022).

Keywords: archaeometallurgy, Mountainous Colchis, mining, ore minerals

Procedia PDF Downloads 173
5807 The Importance of Jewish Influence on Foundation of Manichaean Philosophical and Religious System

Authors: Tatyana Suvorkina

Abstract:

It is indisputable that the problem of the origin of Manichaeism is very complex. Manichaeism is characterized as a syncretic religion, which was influenced by many teachings, but it is difficult to define one which can be called fundamental. The aim of this paper is an attempt to regard Jewish apocalyptic tradition as one of the most defining source of formation of Manichaean systems. To realize this aim a comparison of the Manichean texts and the Jewish apocryphal literature is made. Consideration is given first to the Coptic Manichaean treatise Kephalaia, The Cologne Mani Codex and to books of Enoch. Under the article it is not denied that Manichaeism was influenced by different doctrines and, passed through centuries, it could adapt and strengthen this influence at an even deeper level. But the fact that the Judeo-Christian environment where Mani grew up and where the first sprouts of his teaching were formed had impact on future prophet seems obvious. Nevertheless, attempts to analyze the system of Mani within the Jewish tradition are quite rare, although such studies were carried out for Gnosticism. But Manichaeism, despite the Gnostic features it contains, is not 'one of the Gnostics' to place it under this term among the rest. Frequently, gnostic currents are pointed out as the main sources for the formation of Mani’s teachings. But it seems possible that Mani's interest in Gnosticism was motivated by the fact that he considered it as something close to that interpretation of Hebrew texts, which he aspired to undertake. The question of understanding the Manichaean system is connected not only with Manichaeism but also with other dualistic teachings, which were recognized by contemporaries as Manichaean. It is seen that polemics between Manicheans and Hellenized Christianity separated from Judaism and continued to separate with every century, were polemics between adherents of initially two different worldviews who had, however, a common source. Therefore an analysis of the controversy in the context of interpretations of this common source by disputing parties is seen very important for further study.

Keywords: dualism, Jewish apocalypticism, Manichaeism, syncretism

Procedia PDF Downloads 184
5806 Exploration of Community Space Environment Renewal Strategies Based on the Concept of Disaster Chain

Authors: Ma Chaoyang

Abstract:

With the acceleration of urbanization, old communities are facing renewal problems such as an aging material environment, declining living quality, and insufficient resilience. The once glorious old communities have become the most vulnerable areas in the city. Through a re-understanding of the ‘disaster chain’ and resilient communities, it is believed that considering the construction of resilient communities during community renewal is of great significance for promoting the sustainable development of communities. This article proposes renewal strategies for old communities based on the concept of preventing the occurrence of disaster chains. After analyzing the main demand characteristics of old communities, it proposes a reflection on improving community spatial safety resilience based on the ‘broken chain’ concept. In the four stages of ‘pre-disaster, mid-disaster, and post-disaster’, it elaborates that considering the occurrence of disaster chain in community renewal is the main content of research on spatial safety resilience construction and clarifies that community resilience is the idea and principle of responding with the process of disaster chain. The study focuses on the four dimensions of ‘pre-disaster, mid-disaster, and post-disaster’. This can provide ideas and references for resilience construction in community updates.

Keywords: community updates, disaster chain concept, community resilience, space environment

Procedia PDF Downloads 49
5805 Archetypes in the Rorschach Inkblots: Imparting Universal Meaning in the Face of Ambiguity

Authors: Donna L. Roberts

Abstract:

The theory of archetypes contends that themes based on universal foundational images reside in and are transmitted generationally through the collective unconscious, which is referenced throughout an individual’s experience in order to make sense of that experience. There is then, a profoundly visceral and instinctive agreement on the gestalt of these universal themes and how they apply to the human condition throughout space and time. The inherent nature of projective tests, such as the Rorschach Inkblot, necessitates that the stimulus is ambiguous and thus elicits responses that reflect the unconscious inner psyche of the respondent. As the development of the Rorschach inkblots was relatively random and serendipitous - i.e., the inkblots were not engineered to elicit a specifically defined response - it would stand to reason that without a collective unconscious, every individual would interpret the inkblots in an individualized and unique way. Yet this is not the case. Instead, common themes appear in the images of the inkblots and their interpretation that reflect this deeper iconic understanding. This study analyzed the ten Rorschach inkblots in terms of Jungian archetypes, both with respect to the form of images on each plate and the commonly observed themes in responses. Examples of the archetypes were compared to each of the inkblots, with subsequent descriptions matched to the standard responses. The findings yielded clear and distinct instances of the universal symbolism intrinsic in the inkblot images as well as ubiquitous throughout the responses. This project illustrates the influence of the theories of psychologist Carl Gustav Jung on the interpretation of the ambiguous stimuli. It further serves to demonstrate the merit of Jungian psychology as a valuable tool with which to understand the nature of projective tests in general, Rorschach’s work specifically, and ultimately the broader implications for our collective unconscious and common humanity.

Keywords: archetypes, inkblots, projective tests, Rorschach

Procedia PDF Downloads 102
5804 A Study on Interaction between Traditional Culture and Modern Womenswear

Authors: Yu-Wei Chu, Marie Aja-Herrera, Denis Antoine, Mengjie Di

Abstract:

The purpose of this paper is to explore the innovative perspective of the local traditional culture of garments from different continents. The relationship between the local culture, the indigenous traditional technique of textile manufacture, and modern womenswear will be investigated. This will include exploring and discussing traditional techniques to create textiles reflecting different cultures and relevant handicrafts, including the history of these different peoples and regions. However, along with the improvement of technology, the diversity of culture is usually unified into a single aesthetic element, which makes fashion lack traditional cultural layers. Local cultural awareness has been gradually emerging in womenswear in recent years with the strong sweep of globalization. The possible loss of traditional art and crafts became an awareness for different cultures, who realized the necessity to protect and preserve their individual uniqueness. Modern womenswear is one of the largest markets in the fashion and apparel marketplace. Therefore, the commonalities of traditional textiles and garments for modern womenswear will be researched. Localized traditional fabrics have some elements, such as weaving techniques and other related crafts, in common with more modern manufacturing methods. In addition, the common point of traditional clothing is the use of draping, construction, and fabric manipulation. This paper aims to explore these factors, as discussed above, and also apply, in an innovative and creative manner, some of these traditional arts and crafts to modern womenswear. The combination of textile manipulation and different construction techniques can support the development of innovative womenswear to include a diversity of aesthetics. The main contribution of the paper is to find out the solution to bring local culture into the formal womenswear market with modern aesthetics to realize the ideal of traditional culture reconstruction.

Keywords: traditional culture, modern womenswear, diversity, aesthetics

Procedia PDF Downloads 112
5803 Development and Validation of Integrated Continuous Improvement Framework for Competitiveness: Mixed Research of Ethiopian Manufacturing Industries

Authors: Haftu Hailu Berhe, Hailekiros Sibhato Gebremichael, Kinfe Tsegay Beyene, Haileselassie Mehari

Abstract:

The purpose of the study is to develop and validate integrated literature-based JIT, TQM, TPM, SCM and LSS framework through a combination of the PDCA cycle and DMAIC methodology. The study adopted a mixed research approach. Accordingly, the qualitative study employed to develop the framework is based on identifying the uniqueness and common practices of JIT, TQM, TPM, SCM and LSS initiatives, the existing practice of the integration, identifying the existing gaps in the framework and practices, developing new integrated JIT, TQM, TPM, SCM and LSS practice framework. Previous very few studies of the uniqueness and common practices of the five initiatives are preserved. Whereas the quantitative study working to validate the framework is based on empirical analysis of the self-administered questionnaire using a statistical package for social science. A combination of the PDCA cycle and DMAIC methodology stand integrated CI framework is developed. The proposed framework is constructed as a project-based framework with five detailed implementation phases. Besides, the empirical analysis demonstrated that the proposed framework is valuable if adopted and implemented correctly. So far, there is no study proposed & validated the integrated CI framework within the scope of the study. Therefore, this is the earliest study that proposed and validated the framework for manufacturing industries. The proposed framework is applicable to manufacturing industries and can assist in achieving competitive advantages when the manufacturing industries, institutions and government offer unconditional efforts in implementing the full contents of the framework.

Keywords: integrated continuous improvement framework, just in time, total quality management, total productive maintenance, supply chain management, lean six sigma

Procedia PDF Downloads 131
5802 Intensive Care Unit Patient Self-Determination When Facing Cardiovascular Surgery for the First Time

Authors: Hsiao-Lin Fang

Abstract:

The Patient Self-Determination Act is based on the belief that each life is unique. The act regards each patient as an autonomous entity and explicitly protects the patient’s rights to know and make decisions and choices while ensuring that the patient’s wish for a peaceful end is granted. Even when the patient is unconscious and unable to express himself/herself, the patient’s self-determination and its exercise are still protected under the law. The act also ensures that healthcare professionals (HCPs) have a specific set of rules to follow and complete legal protection when their patients are unable to express themselves clearly. This report is about a 55-year-old female patient who weighed 110 kg and was diagnosed with acute type A aortic dissection. The case was that the patient suddenly felt backache and nausea during sleep before daybreak and was therefore transferred to this hospital from the original one. After the doctor explained the patient’s conditions, it was concluded that surgery was necessary. However, the patient’s family was immediately against the surgery after having heard its possible complications. Nevertheless, the patient was still willing to receive the surgery. Being at odds with her family, the patient decided to sign the surgery agreement herself and agreed to receive the two surgical procedures: (1) ascending aorta replacement and (2) innominate artery debranching. After the surgery, the patient did not regain consciousness and therefore received computed tomography scanning of the brain, which revealed false lumen involving proximal left common carotid artery, left subclavian artery and innominate artery, and severe compression of the true lumen with total/subtotal occlusion in the left common carotid artery. On the following day, the doctor discussed two further surgical procedures: (1) endografting for descending aorta and (2) endografting for left common carotid artery and subclavian artery with the family. However, as the patient’s postoperative recovery of consciousness only reached the level of stupor and her family had no intention of subsequent healthcare for the patient, the family made the joint decision three days later to have the endotracheal tube removed from the patient and let her die a natural death. Suggestion: An advance directive (AD) can be created beforehand. Once the patient is in a special clinical state (e.g., terminal illness, permanent vegetative state, etc.), the AD can determine whether to sustain the patient’s life through ‘medical intervention’ or to respect the patient’s rights to choose a peaceful end and receive palliative care. Through the expression of self-determination, it is possible to respect the patient’s medical practice autonomy and protect the patient’s dignity and right to a peaceful end, thereby respecting and supporting the patient’s decision. This also allows the three sides: the patient, the family and the medical team to understand the patient’s true wish in the process of advance care planning (ACP) and thereby promote harmony in the HCP-patient relationship.

Keywords: intensive care unit patient, cardiovascular surgery, self-determination, advance directive

Procedia PDF Downloads 173