Search results for: Lindsay Prior
463 Synthesis and Characterization of Highly Oriented Bismuth Oxyiodide Thin Films for the Photocatalytical Degradation of Pharmaceuticals Compounds in Water
Authors: Juan C. Duran-Alvarez, Daniel Mejia, Rodolfo Zanella
Abstract:
Heterogeneous photocatalysis is a promising method to achieve the complete degradation and mineralization of organic pollutants in water via their exhaustive oxidation. In order to take this advanced oxidation process towards sustainability, it is necessary to reduce the energy consumption, referred as the light sources and the post-treatment operations. For this, the synthesis of new nanostructures of low band gap semiconductors in the form of thin films is in continuous development. In this work, thin films of the low band gap semiconductor bismuth oxyiodide (BiOI) were synthesized via the Successive Ionic Layer Adsorption and Reaction (SILAR) method. For this, Bi(NO3)3 and KI solutions were prepared, and glass supports were immersed in each solution under strict rate and time immersion conditions. Synthesis was performed at room temperature and a washing step was set prior to each immersion. Thin films with an average thickness below 100 nm were obtained upon a cycle of 30 immersions, as determined by AFM and profilometry measurements. Cubic BiOI nanocrystals with average size of 17 nm and a high orientation to the 001 plane were observed by XRD. In order to optimize the synthesis method, several Bi/I ratios were tested, namely 1/1, 1/5, 1/10, 1/20 and 1/50. The highest crystallinity of the BiOI films was observed when the 1/5 ratio was used in the synthesis. Non-stoichiometric conditions also resulted in the highest uniformity of the thin layers. PVP was used as an additive to improve the adherence of the BiOI thin films to the support. The addition of 0.1 mg/mL of PVP during the washing step resulted in the highest adherence of the thin films. In photocatalysis tests, degradation rate of the antibiotic ciprofloxacin as high as 75% was achieved using visible light (380 to 700 nm) irradiation for 5 h in batch tests. Mineralization of the antibiotic was also observed, although in a lower extent; ~ 30% of the total organic carbon was removed upon 5 h of visible light irradiation. Some ciprofloxacin by-products were identified throughout the reaction; and some of these molecules displayed residual antibiotic activity. In conclusion, it is possible to obtain highly oriented BiOI thin films under ambient conditions via the SILAR method. Non-stoichiometric conditions using PVP additive are necessary to increase the crystallinity and adherence of the films, which are photocatalytically active to remove recalcitrant organic pollutants under visible light irradiation.Keywords: bismuth oxyhalides, photocatalysis, thin films, water treatment
Procedia PDF Downloads 112462 Immuno-Modulatory Role of Weeds in Feeds of Cyprinus Carpio
Authors: Vipin Kumar Verma, Neeta Sehgal, Om Prakash
Abstract:
Cyprinus carpio has a wide spread occurrence in the lakes and rivers of Europe and Asia. Heavy losses in natural environment due to anthropogenic activities, including pollution as well as pathogenic diseases have landed this fish in IUCN red list of vulnerable species. The significance of a suitable diet in preserving the health status of fish is widely recognized. In present study, artificial feed supplemented with leaves of two weed plants, Eichhornia crassipes and Ricinus communis were evaluated for their role on the fish immune system. To achieve this objective fish were acclimatized to laboratory conditions (25 ± 1 °C; 12 L: 12D) for 10 days prior to start of experiment and divided into 4 groups: non-challenged (negative control= A), challenged [positive control (B) and experimental (C & D)]. Group A, B were fed with non-supplemented feed while group C & D were fed with feed supplemented with 5% Eichhornia crassipes and 5% Ricinus communis respectively. Supplemented feeds were evaluated for their effect on growth, health, immune system and disease resistance in fish when challenged with Vibrio harveyi. Fingerlings of C. carpio (weight, 2.0±0.5 g) were exposed with fresh overnight culture of V. harveyi through bath immunization (concentration 2 Χ 105) for 2 hours on 10 days interval for 40 days. The growth was monitored through increase in their relative weight. The rate of mortality due to bacterial infection as well as due to effect of feed was recorded accordingly. Immune response of fish was analyzed through differential leucocyte count, percentage phagocytosis and phagocytic index. The effect of V. harveyi on fish organs were examined through histo-pathological examination of internal organs like spleen, liver and kidney. The change in the immune response was also observed through gene expression analysis. The antioxidant potential of plant extracts was measured through DPPH and FRAP assay and amount of total phenols and flavonoids were calculates through biochemical analysis. The chemical composition of plant’s methanol extracts was determined by GC-MS analysis, which showed presence of various secondary metabolites and other compounds. Investigation revealed immuno-modulatory effect of plants, when supplemented with the artificial feed of fish.Keywords: immuno-modulation, gc-ms, Cyprinus carpio, Eichhornia crassipes, Ricinus communis
Procedia PDF Downloads 481461 The Impact of Childhood Cancer on Young Adult Survivors: A Life Course Perspective
Authors: Bridgette Merriman, Wen Fan
Abstract:
Background: Existing cancer survivorship literature explores varying physical, psychosocial, and psychological late effects experienced by survivors of childhood cancer. However, adolescent and young adult (AYA) survivors of childhood cancer are understudied compared to their adult and pediatric cancer counterparts. Furthermore, existing quality of life (QoL) research fails to account for how cancer survivorship affects survivors across the lifespan. Given that prior research suggests positive cognitive appraisals of adverse events - such as cancer - mitigate detrimental psychosocial symptomologies later in life; it is crucial to understand cancer’s impacts on AYA survivors of childhood malignancies across the life course in order to best support these individuals and prevent maladaptive psychosocial outcomes. Methods: This qualitative study adopted the life-course perspective to investigate the experiences of AYA survivors of childhood malignancies. Eligible patients included AYA 21-30 years old who were diagnosed with cancer <18 years old and off active treatment for >2 years. Participants were recruited through social media posts. Study fulfillment included taking part in one semi-structured video interview to explore areas of survivorship previously identified as being specific to AYA survivors. Interviews were transcribed, coded, and analyzed in accordance with narrative analysis and life-course theory. This study was approved by the Boston College Institutional Review Board. Results: Of 28 individuals who met inclusion criteria and expressed interest in the study, nineteen participants (12 women, 7 men, mean age 25.4 years old) completed the study. Life course theory analysis revealed that events relating to childhood cancer are interconnected throughout the life course rather than isolated events. This “trail of survivorship” includes age at diagnosis, transitioning to life after cancer, and relationships with other childhood survivors. Despite variability in objective characteristics surrounding these events, participants recalled positive experiences regarding at least one checkpoint, ultimately finding positive meaning from their cancer experience. Conclusions: These findings suggest that favorable subjective experiences at these checkpoints are critical in fostering positive conceptions of childhood malignancy for AYA survivors of childhood cancer. Ultimately, healthcare professionals and communities may use these findings to guide support resources and interventions for childhood cancer patients and AYA survivors, therein minimizing detrimental psychosocial effects and maximizing resiliency.Keywords: medical sociology, pediatric oncology, survivorship, qualitative, life course perspective
Procedia PDF Downloads 63460 Computational Modelling of pH-Responsive Nanovalves in Controlled-Release System
Authors: Tomilola J. Ajayi
Abstract:
A category of nanovalves system containing the α-cyclodextrin (α-CD) ring on a stalk tethered to the pores of mesoporous silica nanoparticles (MSN) is theoretically and computationally modelled. This functions to control opening and blocking of the MSN pores for efficient targeted drug release system. Modeling of the nanovalves is based on the interaction between α-CD and the stalk (p-anisidine) in relation to pH variation. Conformational analysis was carried out prior to the formation of the inclusion complex, to find the global minimum of both neutral and protonated stalk. B3LYP/6-311G**(d, p) basis set was employed to attain all theoretically possible conformers of the stalk. Six conformers were taken into considerations, and the dihedral angle (θ) around the reference atom (N17) of the p-anisidine stalk was scanned from 0° to 360° at 5° intervals. The most stable conformer was obtained at a dihedral angle of 85.3° and was fully optimized at B3LYP/6-311G**(d, p) level of theory. The most stable conformer obtained from conformational analysis was used as the starting structure to create the inclusion complexes. 9 complexes were formed by moving the neutral guest into the α-CD cavity along the Z-axis in 1 Å stepwise while keeping the distance between dummy atom and OMe oxygen atom on the stalk restricted. The dummy atom and the carbon atoms on α-CD structure were equally restricted for orientation A (see Scheme 1). The generated structures at each step were optimized with B3LYP/6-311G**(d, p) methods to determine their energy minima. Protonation of the nitrogen atom on the stalk occurs at acidic pH, leading to unsatisfactory host-guest interaction in the nanogate; hence there is dethreading. High required interaction energy and conformational change are theoretically established to drive the release of α-CD at a certain pH. The release was found to occur between pH 5-7 which agreed with reported experimental results. In this study, we applied the theoretical model for the prediction of the experimentally observed pH-responsive nanovalves which enables blocking, and opening of mesoporous silica nanoparticles pores for targeted drug release system. Our results show that two major factors are responsible for the cargo release at acidic pH. The higher interaction energy needed for the complex/nanovalve formation to exist after protonation as well as conformational change upon protonation are driving the release due to slight pH change from 5 to 7.Keywords: nanovalves, nanogate, mesoporous silica nanoparticles, cargo
Procedia PDF Downloads 116459 Culturally Relevant Pedagogy: A Cross-Cultural Comparison
Authors: Medha Talpade, Salil Talpade
Abstract:
The intent of this quantitative project was to compare the values and perceptions of students from a predominantly white college (PWI) to those from a historically black college (HBCU) about culturally relevant teaching and learning practices in the academic realm. The reason for interrelating student culture with teaching practices is to enable a pedagogical response to the low retention rates of African American students and first generation Caucasian students in high schools, colleges, and their low rates of social mobility and educational achievement. Culturally relevant pedagogy, according to related research, is deemed rewarding to students, teachers, the local and national community. Critical race theory (CRT) is the main framework used in this project to explain the ubiquity of a culturally relevant pedagogy. The purpose of this quantitative study was to test the critical race theory that relates the presence of the factors associated with culturally relevant teaching strategies with perceived relevance. The culturally relevant teaching strategies were identified based on the recommendations and findings of past research. Participants in this study included approximately 145 students from a HBCU and 55 students from the PWI. A survey consisting of 37 items related to culturally relevant pedagogy was administered. The themes used to construct the items were: Use of culturally-specific examples in class whenever possible; use of culturally-specific presentational models, use of relational reinforcers, and active engagement. All the items had a likert-type response scale. Participants reported their degree of agreement (5-point scale ranging from strongly disagree to strongly agree) and importance (3-point scale ranging from not at all important to very important) with each survey item. A new variable, Relevance was formed based on the multiplicative function of importance and presence of a teaching and learning strategy. A set of six demographic questions were included in the survey. A consent form based on NIH and APA ethical standards was distributed prior to survey administration to the volunteers. Results of a Factor Analyses on the data from the PWI and the HBCU, and a ANOVA indicated significant differences on ‘Relevance’ related to specific themes. Results of this study are expected to inform educational practices and improve teaching and learning outcomes.Keywords: culturally relevant pedagogy, college students, cross-cultural, applied psychology
Procedia PDF Downloads 427458 Simulation of the Visco-Elasto-Plastic Deformation Behaviour of Short Glass Fibre Reinforced Polyphthalamides
Authors: V. Keim, J. Spachtholz, J. Hammer
Abstract:
The importance of fibre reinforced plastics continually increases due to the excellent mechanical properties, low material and manufacturing costs combined with significant weight reduction. Today, components are usually designed and calculated numerically by using finite element methods (FEM) to avoid expensive laboratory tests. These programs are based on material models including material specific deformation characteristics. In this research project, material models for short glass fibre reinforced plastics are presented to simulate the visco-elasto-plastic deformation behaviour. Prior to modelling specimens of the material EMS Grivory HTV-5H1, consisting of a Polyphthalamide matrix reinforced by 50wt.-% of short glass fibres, are characterized experimentally in terms of the highly time dependent deformation behaviour of the matrix material. To minimize the experimental effort, the cyclic deformation behaviour under tensile and compressive loading (R = −1) is characterized by isothermal complex low cycle fatigue (CLCF) tests. Combining cycles under two strain amplitudes and strain rates within three orders of magnitude and relaxation intervals into one experiment the visco-elastic deformation is characterized. To identify visco-plastic deformation monotonous tensile tests either displacement controlled or strain controlled (CERT) are compared. All relevant modelling parameters for this complex superposition of simultaneously varying mechanical loadings are quantified by these experiments. Subsequently, two different material models are compared with respect to their accuracy describing the visco-elasto-plastic deformation behaviour. First, based on Chaboche an extended 12 parameter model (EVP-KV2) is used to model cyclic visco-elasto-plasticity at two time scales. The parameters of the model including a total separation of elastic and plastic deformation are obtained by computational optimization using an evolutionary algorithm based on a fitness function called genetic algorithm. Second, the 12 parameter visco-elasto-plastic material model by Launay is used. In detail, the model contains a different type of a flow function based on the definition of the visco-plastic deformation as a part of the overall deformation. The accuracy of the models is verified by corresponding experimental LCF testing.Keywords: complex low cycle fatigue, material modelling, short glass fibre reinforced polyphthalamides, visco-elasto-plastic deformation
Procedia PDF Downloads 210457 Vocal Advocacy: A Case Study at the First Black College Regarding Students Experiencing an Empowerment Workshop
Authors: Denise F. Brown, Melina McConatha
Abstract:
African Americans utilizing the art of vocal expressions, particularly for self-expression, has been a historical avenue of advocating for social justice and human rights. Vocal expressions can take many forms, such as singing, poetry, storytelling, and acting. Many well-known artists, politicians, leaders, and teachers used their voices to promote the causes and concerns of the African American community as well as the expression of their own experiences of being 'black' in America. The purpose of this project was to evaluate the perceptions of African American students in utilizing their voices for self-awareness, interview skills, and social change after attending a three-part workshop on vocal advocacy. This research utilized the framework of black feminism to understand empowerment in advocacy and self-expression. Students participated in learning about the power of their voices, and what purpose presence, and passion they discovered through the Immersive Voice workshop. There were three areas covered in the workshop. The first area was the power of the voice, the second area was the application of vocal passion, and the third area was applying the vocal power to express personal interest, interests of advocating for others, and confidence and speaking to others to further careers, i.e., using vocal power for job interviewing skills. The students were instructed to prepare for the workshops by completing a pre-workshop open-ended survey. There were a total of 15 students that participated. After the workshop ended, the students were instructed to complete a post-workshop survey. The surveys were assessed by evaluating both themes and codes from student's written feedback. From the pre-workshop survey, students were given a survey for them to provide feedback regarding the power of voice prior to participating in the workshops. From the student's responses, the theme (advocating for self and others) emerged as it related to student's feedback on what it means to advocate. There were three codes that led to the theme, having knowledge about advocating for self and others, gaining knowledge to advocate for self and others, and using that knowledge to advocate for self and others. After the students completed participation in the workshops, a post workshop- survey was given to the students. Students' feedback was assessed, and the same theme emerged, 'advocating for self and others.' The codes related to the theme, however, were different and included using vocal power (a term students learned during the workshop) to represent self, represent others, and obtain a job/career. In conclusion, the results of the survey showed that students still perceived advocating as speaking up for themselves and other people. After the workshop, students still continued to associate advocacy with helping themselves and helping others but were able to be more specific about how the sound of their voice could help in advocating, and how they could use their voice to represent themselves in getting a job or starting a career.Keywords: advocacy, command, self-expression, voice
Procedia PDF Downloads 106456 Risk of Mortality and Spectrum of Second Primary Malignancies in Mantle Cell Lymphoma before and after Ibrutinib Approval: A Population-Based Study
Authors: Karthik Chamari, Vasudha Rudraraju, Gaurav Chaudhari
Abstract:
Background: Mantle cell lymphoma (MCL) is one of the mature B cell non-Hodgkin lymphomas (NHL). The course of MCL is moderately aggressive and variable, and it has median overall survival of 8 to 10 years. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, was approved by the United States (US) Food and Drug Administration in November of 2013 for the treatment of MCL patients who have received at least one prior therapy. In this study, we aimed to evaluate whether there has been a change in survival and patterns of second primary malignancies (SPMs) among the MCL population in the US after ibrutinib approval. Methods: Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER)-18, we conducted a retrospective study with patients diagnosed with MCL (ICD-0-3 code 9673/3) between 2007 and 2018. We divided patients into two six-year cohorts, pre-ibrutinib approval (2007-2012) and post-ibrutinib approval (2013-2018), and compared relative survival rates (RSRs) and standardized incidence ratios (SIRs) of SPMs between cohorts. Results: We included 9,257 patients diagnosed with MCL between 2007 and 2018 in the SEER-18 survival and SIR registries. Of these, 4,205 (45%) patients were included in the pre-ibrutinib cohort, and 5052 (55%) patients were included in the post-ibrutinib cohort. The median follow-up duration for the pre-ibrutinib cohort was 54 months (range 0 to 143 months), and the post-ibrutinib cohort was 20 months (range 0 to 71 months). There was a significant difference in the five-year RSRs between pre-ibrutinib and post-ibrutinib cohorts (57.5% vs. 62.6%, p < 0.005). Out of the 9,257 patients diagnosed with MCL, 920 developed SPMs. A higher proportion of SPMs occurred in the post-ibrutinib cohort (63%) when compared with the pre-ibrutinib cohort (37%). Non-hematological malignancies comprised most of all SPMs. A higher incidence of non-hematological malignancies occurred in the post-ibrutinib cohort (SIR 1.42, 95% CI 1.29 to 1.56) when compared with the pre-ibrutinib cohort (SIR 1.14, 95% CI 1 to 1.3). There was a statistically significant increase in the incidence of cancers of the respiratory tract (SIR 1.77, 95% CI 1.43 to 2.18), urinary tract (SIR 1.61, 95% CI 1.23 to 2.06) when compared with other non-hematological malignancies in post-ibrutinib cohort. Conclusions: Our study results suggest the relative survival rates have increased since the approval of ibrutinib for mantle cell lymphoma patients. Additionally, for some unclear reasons, the incidence of SPM’s (non-hematological malignancies), mainly cancers of the respiratory tract, urinary tract, have increased in the six years following the approval of ibrutinib. Further studies should be conducted to determine the cause of these findings.Keywords: mantle cell lymphoma, Ibrutinib, relative survival analysis, secondary primary cancers
Procedia PDF Downloads 180455 Regeneration of a Liquid Desiccant Using Membrane Distillation to Unlock Coastal Desert Agriculture Potential
Authors: Kimberly J. Cribbs, Ryan M. Lefers, TorOve Leiknes, Noreddine Ghaffour
Abstract:
In Gulf Cooperation Council (GCC) countries, domestic agriculture is hindered by a lack of freshwater, poor soil quality, and ambient temperatures unsuitable for cultivation resulting in a heavy reliance on imported food. Attempts to minimize the risk of food insecurity by growing crops domestically creates a significant demand on limited freshwater resources in this region. Cultivating food in a greenhouse allows some of these challenges, such as poor soil quality and temperatures unsuitable for cultivation, to be overcome. One of the most common methods for greenhouse cooling is evaporative cooling. This method cools the air by the evaporation of water and requires a large amount of water relative to that needed for plant growth and air with a low relative humidity. Considering that much of the population in GCC countries live within 100 km of a coast and that sea water can be utilized for evaporative cooling, coastal agriculture could reduce the risk of food insecurity and water demand. Unfortunately, coastal regions tend to experience both high temperatures and high relative humidity causing evaporative cooling by itself to be inadequate. Therefore, dehumidification is needed prior to utilizing evaporative cooling. Utilizing a liquid desiccant for air dehumidification is promising, but the desiccant regeneration to retain its dehumidification potential remains a significant obstacle for the adoption of this technology. This project studied the regeneration of a magnesium chloride (MgCl₂) desiccant solution from 20wt% to 30wt% by direct contact membrane distillation (DCMD) and explored the possibility of using the recovered water for irrigation. Two 0.2 µm hydrophobic PTFE membranes were tested at feed temperatures of 80, 70, and 60°C and with a permeate temperature of 20°C. It was observed that the permeate flux increases as the difference between the feed and coolant temperature increases and also as the feed concentration decreases. At 21wt% the permeate flux was 34,17, and 14 L m⁻² h⁻¹ for feed temperatures of 80, 70, and 60°C, respectively. Salt rejection decreased overtime; however, it remained greater than 99.9% over an experimental time span of 10 hours. The results show that DCMD can successfully regenerate the magnesium chloride desiccant solution.Keywords: agriculture, direct contact membrane distillation, GCC countries, liquid desiccant, water recovery
Procedia PDF Downloads 143454 Developing a Sustainable System to Deliver Early Intervention for Emotional Health through Australian Schools
Authors: Rebecca-Lee Kuhnert, Ron Rapee
Abstract:
Up to 15% of Australian youth will experience an emotional disorder, yet relatively few get the help they need. Schools provide an ideal environment through which we can identify young people who are struggling and provide them with appropriate help. Universal mental health screening is a method by which all young people in school can be quickly assessed for emotional disorders, after which identified youth can be linked to appropriate health services. Despite the obvious logic of this process, universal mental health screening has received little scientific evaluation and even less application in Australian schools. This study will develop methods for Australian education systems to help identify young people (aged 9-17 years old) who are struggling with existing and emerging emotional disorders. Prior to testing, a series of focus groups will be run to get feedback and input from young people, parents, teachers, and mental health professionals. They will be asked about their thoughts on school-based screening methods and and how to best help students at risk of emotional distress. Schools (n=91) across New South Wales, Australia will be randomised to do either immediate screening (in May 2021) or delayed screening (in February 2022). Students in immediate screening schools will complete a long online mental health screener consisting of standard emotional health questionnaires. Ultimately, this large set of items will be reduced to a small number of items to form the final brief screener. Students who score in the “at-risk” range on any measure of emotional health problems will be identified to schools and offered pathways to relevant help according to the most accepted and approved processes identified by the focus groups. Nine months later, the same process will occur among delayed screening schools. At this same time, students in the immediate screening schools will complete screening for a second time. This will allow a direct comparison of the emotional health and help-seeking between youth whose schools had engaged in the screening and pathways to care process (immediate) and those whose schools had not engaged in the process (delayed). It is hypothesised that there will be a significant increase in students who receive help from mental health support services after screening, compared with baseline. It is also predicted that all students will show significantly less emotional distress after screening and access to pathways of care. This study will be an important contribution to Australian youth mental health prevention and early intervention by determining whether school screening leads to a greater number of young people with emotional disorders getting the help that they need and improving their mental health outcomes.Keywords: children and young people, early intervention, mental health, mental health screening, prevention, school-based mental health
Procedia PDF Downloads 92453 Spontaneous Rupture of Splenic Artery Pseudoaneurysm; A Rare Presentation of Acute Abdominal Pain in the Emergency Department: Case Report
Authors: Zainab Elazab, Azhar Aziz
Abstract:
Background: Spontaneous Splenic artery pseudoaneurysm rupture is a rare condition which is potentially life threatening, if not detected and managed early. We report a case of abdominal pain with intraperitoneal free fluid, which turned out to be spontaneous rupture of a splenic artery pseudoaneurysm, and was treated with arterial embolization. Case presentation: A 28-year old, previously healthy male presented to the ED with a history of sudden onset upper abdominal pain and fainting attack. The patient denied any history of trauma or prior similar attacks. On examination, the patient had tachycardia and a low-normal BP (HR 110, BP 106/66) but his other vital signs were normal (Temp. 37.2, RR 18 and SpO2 100%). His abdomen was initially soft with mild tenderness in the upper region. Blood tests showed leukocytosis of 12.3 X109/L, Hb of 12.6 g/dl and lactic acid of 5.9 mmol/L. Ultrasound showed trace of free fluid in the perihepatic and perisplenic areas, and a splenic hypoechoic lesion. The patient remained stable; however, his abdomen became increasingly tender with guarding. We made a provisional diagnosis of a perforated viscus and the patient was started on IV fluids and IV antibiotics. An erect abdominal x-ray did not show any free air under the diaphragm so a CT abdomen was requested. Meanwhile, bedside ultrasound was repeated which showed increased amount of free fluid, suggesting intra-abdominal bleeding as the most probable etiology for the condition. His CT abdomen revealed a splenic injury with multiple lacerations, a focal intrasplenic enhancing area on venous phase scan (suggesting a pseudoaneurysm with associated splenic intraparenchymal, sub capsular and perisplenic hematomas). Free fluid in the subhepatic and intraperitoneal regions along the small bowel was also detected. Angiogram was done which confirmed a diagnosis of pseudoaneurysm of intrasplenic arterial branch, and angio-embolization was done to control the bleeding. The patient was later discharged in good condition with a surgery follow-up. Conclusion: Splenic artery pseudoaneurysm rupture is a rare cause of abdominal pain which should be considered in any case of abdominal pain with intraperitoneal bleeding. Early management is crucial as it carries a high mortality. Bedside ultrasound is a useful tool to help for early diagnosis of such cases.Keywords: abdominal pain, pseudo aneurysm, rupture, splenic artery
Procedia PDF Downloads 305452 Methodologies for Deriving Semantic Technical Information Using an Unstructured Patent Text Data
Authors: Jaehyung An, Sungjoo Lee
Abstract:
Patent documents constitute an up-to-date and reliable source of knowledge for reflecting technological advance, so patent analysis has been widely used for identification of technological trends and formulation of technology strategies. But, identifying technological information from patent data entails some limitations such as, high cost, complexity, and inconsistency because it rely on the expert’ knowledge. To overcome these limitations, researchers have applied to a quantitative analysis based on the keyword technique. By using this method, you can include a technological implication, particularly patent documents, or extract a keyword that indicates the important contents. However, it only uses the simple-counting method by keyword frequency, so it cannot take into account the sematic relationship with the keywords and sematic information such as, how the technologies are used in their technology area and how the technologies affect the other technologies. To automatically analyze unstructured technological information in patents to extract the semantic information, it should be transformed into an abstracted form that includes the technological key concepts. Specific sentence structure ‘SAO’ (subject, action, object) is newly emerged by representing ‘key concepts’ and can be extracted by NLP (Natural language processor). An SAO structure can be organized in a problem-solution format if the action-object (AO) states that the problem and subject (S) form the solution. In this paper, we propose the new methodology that can extract the SAO structure through technical elements extracting rules. Although sentence structures in the patents text have a unique format, prior studies have depended on general NLP (Natural language processor) applied to the common documents such as newspaper, research paper, and twitter mentions, so it cannot take into account the specific sentence structure types of the patent documents. To overcome this limitation, we identified a unique form of the patent sentences and defined the SAO structures in the patents text data. There are four types of technical elements that consist of technology adoption purpose, application area, tool for technology, and technical components. These four types of sentence structures from patents have their own specific word structure by location or sequence of the part of speech at each sentence. Finally, we developed algorithms for extracting SAOs and this result offer insight for the technology innovation process by providing different perspectives of technology.Keywords: NLP, patent analysis, SAO, semantic-analysis
Procedia PDF Downloads 259451 Comprehensive Geriatric Assessments: An Audit into Assessing and Improving Uptake on Geriatric Wards at King’s College Hospital, London
Authors: Michael Adebayo, Saheed Lawal
Abstract:
The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality
Procedia PDF Downloads 79450 Just a Heads Up: Approach to Head Shape Abnormalities
Authors: Noreen Pulte
Abstract:
Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags
Procedia PDF Downloads 92449 Temperature Dependent Magneto-Transport Properties of MnAl Binary Alloy Thin Films
Authors: Vineet Barwal, Sajid Husain, Nanhe Kumar Gupta, Soumyarup Hait, Sujeet Chaudhary
Abstract:
High perpendicular magnetic anisotropy (PMA) and low damping constant (α) in ferromagnets are one of the few necessary requirements for their potential applications in the field of spintronics. In this regards, ferromagnetic τ-phase of MnAl possesses the highest PMA (Ku > 107 erg/cc) at room temperature, high saturation magnetization (Ms~800 emu/cc) and a Curie temperature of ~395K. In this work, we have investigated the magnetotransport behaviour of this potentially useful binary system MnₓAl₁₋ₓ films were synthesized by co-sputtering (pulsed DC magnetron sputtering) on Si/SiO₂ (where SiO₂ is native oxide layer) substrate using 99.99% pure Mn and Al sputtering targets. Films of constant thickness (~25 nm) were deposited at the different growth temperature (Tₛ) viz. 30, 300, 400, 500, and 600 ºC with a deposition rate of ~5 nm/min. Prior to deposition, the chamber was pumped down to a base pressure of 2×10⁻⁷ Torr. During sputtering, the chamber was maintained at a pressure of 3.5×10⁻³ Torr with the 55 sccm Ar flow rate. Films were not capped for the purpose of electronic transport measurement, which leaves a possibility of metal oxide formation on the surface of MnAl (both Mn and Al have an affinity towards oxide formation). In-plane and out-of-plane transverse magnetoresistance (MR) measurements on films sputtered under optimized growth conditions revealed non-saturating behavior with MR values ~6% and 40% at 9T, respectively at 275 K. Resistivity shows a parabolic dependence on the field H, when the H is weak. At higher H, non-saturating positive MR that increases exponentially with the strength of magnetic field is observed, a typical character of hopping type conduction mechanism. An anomalous decrease in MR is observed on lowering the temperature. From the temperature dependence of reistivity, it is inferred that the two competing states are metallic and semiconducting, respectively and the energy scale of the phenomenon produces the most interesting effects, i.e., the metal-insulator transition and hence the maximum sensitivity to external fields, at room temperature. Theory of disordered 3D systems effectively explains the crossover temperature coefficient of resistivity from positive to negative with lowering of temperature. These preliminary findings on the MR behavior of MnAl thin films will be presented in detail. The anomalous large MR in mixed phase MnAl system is evidently useful for future spintronic applications.Keywords: magnetoresistance, perpendicular magnetic anisotropy, spintronics, thin films
Procedia PDF Downloads 117448 Identification of a Lead Compound for Selective Inhibition of Nav1.7 to Treat Chronic Pain
Authors: Sharat Chandra, Zilong Wang, Ru-Rong Ji, Andrey Bortsov
Abstract:
Chronic pain (CP) therapeutic approaches have limited efficacy. As a result, doctors are prescribing opioids for chronic pain, leading to opioid overuse, abuse, and addiction epidemic. Therefore, the development of effective and safe CP drugs remains an unmet medical need. Voltage-gated sodium (Nav) channels act as cardiovascular and neurological disorder’s molecular targets. Nav channels selective inhibitors are hard to design because there are nine closely-related isoforms (Nav1.1-1.9) that share the protein sequence segments. We are targeting the Nav1.7 found in the peripheral nervous system and engaged in the perception of pain. The objective of this project was to screen a 1.5 million compound library for identification of inhibitors for Nav1.7 with analgesic effect. In this study, we designed a protocol for identification of isoform-selective inhibitors of Nav1.7, by utilizing the prior information on isoform-selective antagonists. First, a similarity search was performed; then the identified hits were docked into a binding site on the fourth voltage-sensor domain (VSD4) of Nav1.7. We used the FTrees tool for similarity searching and library generation; the generated library was docked in the VSD4 domain binding site using FlexX and compounds were shortlisted using a FlexX score and SeeSAR hyde scoring. Finally, the top 25 compounds were tested with molecular dynamics simulation (MDS). We reduced our list to 9 compounds based on the MDS root mean square deviation plot and obtained them from a vendor for in vitro and in vivo validation. Whole-cell patch-clamp recordings in HEK-293 cells and dorsal root ganglion neurons were conducted. We used patch pipettes to record transient Na⁺ currents. One of the compounds reduced the peak sodium currents in Nav1.7-HEK-293 stable cell line in a dose-dependent manner, with IC50 values at 0.74 µM. In summary, our computer-aided analgesic discovery approach allowed us to develop pre-clinical analgesic candidate with significant reduction of time and cost.Keywords: chronic pain, voltage-gated sodium channel, isoform-selective antagonist, similarity search, virtual screening, analgesics development
Procedia PDF Downloads 120447 Supply Chain Design: Criteria Considered in Decision Making Process
Authors: Lenka Krsnakova, Petr Jirsak
Abstract:
Prior research on facility location in supply chain is mostly focused on improvement of mathematical models. It is due to the fact that supply chain design has been for the long time the area of operational research that underscores mainly quantitative criteria. Qualitative criteria are still highly neglected within the supply chain design research. Facility location in the supply chain has become multi-criteria decision-making problem rather than single criteria decision due to changes of market conditions. Thus, both qualitative and quantitative criteria have to be included in the decision making process. The aim of this study is to emphasize the importance of qualitative criteria as key parameters of relevant mathematical models. We examine which criteria are taken into consideration when Czech companies decide about their facility location. A literature review on criteria being used in facility location decision making process creates a theoretical background for the study. The data collection was conducted through questionnaire survey. Questionnaire was sent to manufacturing and business companies of all sizes (small, medium and large enterprises) with the representation in the Czech Republic within following sectors: automotive, toys, clothing industry, electronics and pharmaceutical industry. Comparison of which criteria prevail in the current research and which are considered important by companies in the Czech Republic is made. Despite the number of articles focused on supply chain design, only minority of them consider qualitative criteria and rarely process supply chain design as a multi-criteria decision making problem. Preliminary results of the questionnaire survey outlines that companies in the Czech Republic see the qualitative criteria and their impact on facility location decision as crucial. Qualitative criteria as company strategy, quality of working environment or future development expectations are confirmed to be considered by Czech companies. This study confirms that the qualitative criteria can significantly influence whether a particular location could or could not be right place for a logistic facility. The research has two major limitations: researchers who focus on improving of mathematical models mostly do not mention criteria that enter the model. Czech supply chain managers selected important criteria from the group of 18 available criteria and assign them importance weights. It does not necessarily mean that these criteria were taken into consideration when the last facility location was chosen, but how they perceive that today. Since the study confirmed the necessity of future research on how qualitative criteria influence decision making process about facility location, the authors have already started in-depth interviews with participating companies to reveal how the inclusion of qualitative criteria into decision making process about facility location influence the company´s performance.Keywords: criteria influencing facility location, Czech Republic, facility location decision-making, qualitative criteria
Procedia PDF Downloads 318446 Soil Improvement through Utilization of Calcifying Bhargavaea cecembensis N1 in an Affordable Whey Culture Medium
Authors: Fatemeh Elmi, Zahra Etemadifar
Abstract:
Improvement of soil mechanical properties is crucial before its use in construction, as the low mechanical strength and unstable structure of soil in many parts of the world can lead to the destruction of engineering infrastructure, resulting in financial and human losses. Although, conventional methods, such as chemical injection, are often utilized to enhance soil strength and stiffness, they are generally expensive, require heavy machinery, and cause significant environmental effects due to chemical usage, and also disrupt urban infrastructure. Moreover, they are not suitable for treating large volume of soil. Recently, an alternative method to improve various soil properties, including strength, hardness, and permeability, has received much attention: the application of biological methods. One of the most widely used is biocementation, which is based on the microbial precipitation of calcium carbonte crystalls using ureolytic bacteria However, there are still limitations to its large-scale use that need to be resolved before it can be commercialized. These issues have not received enough attention in prior research. One limitation of MICP (microbially induced calcium carbonate precipitation) is that microorganisms cannot operate effectively in harsh and variable environments, unlike the controlled conditions of a laboratory. Another limitation of applying this technique on a large scale is the high cost of producing a substantial amount of bacterial culture and reagents required for soil treatment. Therefore, the purpose of the present study was to investigate soil improvement using the biocementation activity of poly-extremophile, calcium carbonate crystal- producing bacterial strain, Bhargavaea cecembensis N1, in whey as an inexpensive medium. This strain was isolated and molecularly identified from sandy soils in our previous research, and its 16S rRNA gene sequences was deposited in the NCBI Gene Bank with an accession number MK420385. This strain exhibited a high level of urease activity (8.16 U/ml) and produced a large amount of calcium carbonate (4.1 mg/ ml). It was able to improve the soil by increasing the compressive strength up to 205 kPa and reducing permeability by 36%, with 20% of the improvement attributable of calcium carbonate production. This was achieved using this strain in a whey culture medium. This strain can be an eco-friendly and economical alternative to conventional methods in soil stabilization, and other MICP related applications.Keywords: biocementation, Bhargavaea cecembensis, soil improvement, whey culture medium
Procedia PDF Downloads 49445 A Look into Surgical Site Infections: Impact of Collective Interventions
Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff
Abstract:
Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement
Procedia PDF Downloads 474444 Non-Cytotoxic Natural Sourced Inorganic Hydroxyapatite (HAp) Scaffold Facilitate Bone-like Mechanical Support and Cell Proliferation
Authors: Sudip Mondal, Biswanath Mondal, Sudit S. Mukhopadhyay, Apurba Dey
Abstract:
Bioactive materials improve devices for a long lifespan but have mechanical limitations. Mechanical characterization is one of the very important characteristics to evaluate the life span and functionality of the scaffold material. After implantation of scaffold material the primary stage rejection of scaffold occurs due to non biocompatible effect of host body system. The second major problems occur due to the effect of mechanical failure. The mechanical and biocompatibility failure of the scaffold materials can be overcome by the prior evaluation of the scaffold materials. In this study chemically treated Labeo rohita scale is used for synthesizing hydroxyapatite (HAp) biomaterial. Thermo-gravimetric and differential thermal analysis (TG-DTA) is carried out to ensure thermal stability. The chemical composition and bond structures of wet ball-milled calcined HAp powder is characterized by Fourier Transform Infrared spectroscopy (FTIR), X-ray Diffraction (XRD), Field Emission Scanning Electron Microscopy (FE-SEM), Transmission Electron Microscopy (TEM), Energy Dispersive X-ray (EDX) analysis. Fish scale derived apatite materials consists of nano-sized particles with Ca/P ratio of 1.71. The biocompatibility through cytotoxicity evaluation and MTT assay are carried out in MG63 osteoblast cell lines. In the cell attachment study, the cells are tightly attached with HAp scaffolds developed in the laboratory. The result clearly suggests that HAp material synthesized in this study do not have any cytotoxic effect, as well as it has a natural binding affinity for mammalian cell lines. The synthesized HAp powder further successfully used to develop porous scaffold material with suitable mechanical property of ~0.8GPa compressive stress, ~1.10 GPa a hardness and ~ 30-35% porosity which is acceptable for implantation in trauma region for animal model. The histological analysis also supports the bio-affinity of processed HAp biomaterials in Wistar rat model for investigating the contact reaction and stability at the artificial or natural prosthesis interface for biomedical function. This study suggests the natural sourced fish scale-derived HAp material could be used as a suitable alternative biomaterial for tissue engineering application in near future.Keywords: biomaterials, hydroxyapatite, scaffold, mechanical property, tissue engineering
Procedia PDF Downloads 452443 The Impact of the Covid-19 Pandemic on Marine-Wildlife Tourism in Massachusetts, United States
Authors: K. C. Bloom, Cynde McInnis
Abstract:
The Covid-19 pandemic has caused immense changes in the way that we live, work and travel. The impact of these changes is readily apparent in tourism to Massachusetts and the region of New England. Whereas, in general, Massachusetts and New England are a hotspot for travelers from around the world, this form of travel has largely been shut down due to the pandemic. One such area where the impact has been felt is in marine-based wildlife tourism. Massachusetts is home to not only whales but also seals and great white sharks. Prior to the pandemic, whale watching had long been a popular activity while seal and shark tourism has been a developing one. Given that seeing a great white shark was rare in New England for many years, shark tourism has not played a role in the economies of the region until recently. While whales have steadily been found within the marine environments of Massachusetts and whale watching has been a popular attraction since the mid-1970s, the lack of great white sharks in New England was, in part, a response to a change in their environment in that a favorite food source, the gray seals, were culled by regional fishermen as the fishermen believed that seals were taking their catch. This retaliatory behavior ended when the Marine Mammal Protection Act of 1972 (MMPA) was passed. The MMPA prohibited the killing of seals and since then the seal population has increased to traditional numbers (Tech Times, 2014). Given the increase in the seal population in New England, and especially Cape Cod, Massachusetts, there has been a similar increase in the numbers of great white sharks. In fact, over the time between 2004 and 2014, the number of sightings increased from an average of two per year to more than 20 (NY Post, 7/21/14). This has increased even more over the last six years. As a result, residents and businesses in Massachusetts have begun to embrace the great whites as a potential tourism draw. Local business owners are considering opening up cage diving and shark viewing businesses while there has also been an increase in shark-related merchandise throughout the Cape Cod region. Combined with a large whale watching industry, marine-based wildlife tourism is big business to Massachusetts. With the Covid-19 pandemic shuttering international travel, this study aims to look at the impacts of the pandemic on this industry. Through interviews with marine-based wildlife tourism businesses as well as survey data collection from visitors, this study looks at the holistic impacts of the Covid-19 pandemic on an important part of the marine tourism industry in the state.Keywords: marine tourism, ecotourism, Covid, wildlife
Procedia PDF Downloads 153442 Attitudes Towards the Supernatural in Benjamin Britten’s The Turn of the Screw
Authors: Yaou Zhang
Abstract:
Background: Relatively little scholarly attention has been paid to the production of Benjamin Britten’s chamber opera The Turn of the Screw. As one of Britten’s most remarkable operas. The story of the libretto was from Henry James’s novella of the same name. The novella was created in 1898 and one of the primary questions addressed to people in the story is “how real the ghosts are,” which leads the story to a huge ambiguity in readers’ minds. Aims: This research focuses on the experience of seeing the opera on stage over several decades. This study of opera productions over time not only provides insight into how stage performances can alter audience members' perceptions of the opera in the present but also reveals a landscape of shifting aesthetics and receptions. Methods: To examine the hypotheses in interpretation and reception, the qualitative analysis is used to examine the figures of ghosts in different productions across the time from 1954 to 2021 in the UK: by accessing recordings, newspapers, and reviews for the productions that are sourced from online and physical archives. For instance, the field research is conducted on the topic by arranging interviews with the creative team and visiting Opera North in Leeds and Britten-Pears Foundation. The collected data reveals the “hidden identity” in creative teams’ interpretations, social preferences, and rediscover that have previously remained unseen. Results: This research presents an angle of Britten’s Screw by using the third position; it shows how the attention moved from the stage of “do the ghosts really exist” to “traumatised children.” Discussion: Critics and audiences have debated whether the governess hallucinates the ghosts in the opera for decades. While, in recent years, directors of new productions have given themselves the opportunity to go deeper into Britten's musical structure and offer the opera more space to be interpreted, rather than debating if "ghosts actually exist" or "the psychological problems of the governess." One can consider and reflect that the questionable actions of the children are because they are suffering from trauma, whether the trauma comes from the ghosts, the hallucinating governess, or some prior experiences: various interpretations cause one result that children are the recipients of trauma. Arguably, the role of the supernatural is neither simply one of the elements of a ghost story nor simply one of the parts of the ambiguity between the supernatural and the hallucination of the governess; rather, the ghosts and the hallucinating governess can exist at the same time - the combination of the supernatural’s and the governess’s behaviours on stage generates a sharper and more serious angle that draws our attention to the traumatized children.Keywords: benjamin britten, chamber opera, production, reception, staging, the turn of the screw
Procedia PDF Downloads 103441 Best Practice for Post-Operative Surgical Site Infection Prevention
Authors: Scott Cavinder
Abstract:
Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery
Procedia PDF Downloads 76440 A Comparative Study to Evaluate Changes in Intraocular Pressure with Thiopentone Sodium and Etomidate in Patients Undergoing Surgery for Traumatic Brain Injury
Authors: Vasudha Govil, Prashant Kumar, Ishwar Singh, Kiranpreet Kaur
Abstract:
Traumatic brain injury leads to elevated intracranial pressure. Intraocular pressure (IOP) may also be affected by intracranial pressure. Increased venous pressure in the cavernous sinus is transmitted to the episcleral veins, resulting in an increase in IOP. All drugs used in anesthesia induction can change IOP. Irritation of the gag reflex after usage of the endotracheal tube can also increase IOP; therefore, the administration of anesthetic drugs, which make the lowest change in IOP, is important, while cardiovascular depression must also be avoided. Thiopentone decreases IOP by 40%, whereas etomidate decreases IOP by 30-60% for up to 5 minutes. Hundred patients (age 18-55 years) who underwent emergency craniotomy for TBI are selected for the study. Patients are randomly assigned to two groups of 50 patients each accord¬ing to the drugs used for induction: group T was given thiopentone sodium (5mg kg-1) and group E was given etomi¬date (0.3mg kg-1). Preanaesthesia intraocular pressure (IOP) was measured using Schiotz tonometer. Induction of anesthesia was achieved with etomidate (0.3mg kg-1) or thiopentone (5mg kg-1) along with fentanyl (2 mcg kg-1). Intravenous rocuronium (0.9mg kg-1) was given to facilitate intubation. Intraocular pressure was measured after 1 minute of induction agent administration and 5 minutes after intubation. Maintainance of anesthesia was done with isoflurane in 50% nitrous oxide with fresh gas flow of 5 litres. At the end of the surgery, the residual neuromuscular block was reversed and the patient was shifted to ward/ICU. Patients in both groups were comparable in terms of demographic profile. There was no significant difference between the groups for the hemody¬namic and respiratory variables prior to thiopentone or etomidate administration. Intraocular pressure in thiopentone group in left eye and right eye before induction was 14.97±3.94 mmHg and 14.72±3.75 mmHg respectively and for etomidate group was 15.28±3.69 mmHg and 15.54±4.46 mmHg respectively. After induction IOP decreased significantly in both the eyes (p<0.001) in both the groups. After 5 min of intubation IOP was significantly less than the baseline in both the eyes but it was more than the IOP after induction with the drug. It was found that there was no statistically significant difference in IOP between the two groups at any point of time. Both the drugs caused a significant decrease in IOP after induction and after 5 minutes of endotracheal intubation. The mechanism of decrease in IOP by intravenous induction agents is debatable. Systemic hypotension after the induction of anaesthesia has been shown to cause a decrease in intra-ocular pressure. A decrease in the tone of the extra-ocular muscles can also result in a decrease in intra-ocular pressure. We observed that it is appropriate to use etomidate as an induction agent when elevation of intra-ocular pressure is undesirable owing to the cardiovascular stability it confers in the patients.Keywords: etomidate, intraocular pressure, thiopentone, traumatic
Procedia PDF Downloads 122439 Private Coded Computation of Matrix Multiplication
Authors: Malihe Aliasgari, Yousef Nejatbakhsh
Abstract:
The era of Big Data and the immensity of real-life datasets compels computation tasks to be performed in a distributed fashion, where the data is dispersed among many servers that operate in parallel. However, massive parallelization leads to computational bottlenecks due to faulty servers and stragglers. Stragglers refer to a few slow or delay-prone processors that can bottleneck the entire computation because one has to wait for all the parallel nodes to finish. The problem of straggling processors, has been well studied in the context of distributed computing. Recently, it has been pointed out that, for the important case of linear functions, it is possible to improve over repetition strategies in terms of the tradeoff between performance and latency by carrying out linear precoding of the data prior to processing. The key idea is that, by employing suitable linear codes operating over fractions of the original data, a function may be completed as soon as enough number of processors, depending on the minimum distance of the code, have completed their operations. The problem of matrix-matrix multiplication in the presence of practically big sized of data sets faced with computational and memory related difficulties, which makes such operations are carried out using distributed computing platforms. In this work, we study the problem of distributed matrix-matrix multiplication W = XY under storage constraints, i.e., when each server is allowed to store a fixed fraction of each of the matrices X and Y, which is a fundamental building of many science and engineering fields such as machine learning, image and signal processing, wireless communication, optimization. Non-secure and secure matrix multiplication are studied. We want to study the setup, in which the identity of the matrix of interest should be kept private from the workers and then obtain the recovery threshold of the colluding model, that is, the number of workers that need to complete their task before the master server can recover the product W. The problem of secure and private distributed matrix multiplication W = XY which the matrix X is confidential, while matrix Y is selected in a private manner from a library of public matrices. We present the best currently known trade-off between communication load and recovery threshold. On the other words, we design an achievable PSGPD scheme for any arbitrary privacy level by trivially concatenating a robust PIR scheme for arbitrary colluding workers and private databases and the proposed SGPD code that provides a smaller computational complexity at the workers.Keywords: coded distributed computation, private information retrieval, secret sharing, stragglers
Procedia PDF Downloads 113438 Long Term Survival after a First Transient Ischemic Attack in England: A Case-Control Study
Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski
Abstract:
Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model
Procedia PDF Downloads 140437 An Econometric Analysis of the Flat Tax Revolution
Authors: Wayne Tarrant, Ethan Petersen
Abstract:
The concept of a flat tax goes back to at least the Biblical tithe. A progressive income tax was first vociferously espoused in a small, but famous, pamphlet in 1848 (although England had an emergency progressive tax for war costs prior to this). Within a few years many countries had adopted the progressive structure. The flat tax was only reinstated in some small countries and British protectorates until Mart Laar was elected Prime Minister of Estonia in 1992. Since Estonia’s adoption of the flat tax in 1993, many other formerly Communist countries have likewise abandoned progressive income taxes. Economists had expectations of what would happen when a flat tax was enacted, but very little work has been done on actually measuring the effect. With a testbed of 21 countries in this region that currently have a flat tax, much comparison is possible. Several countries have retained progressive taxes, giving an opportunity for contrast. There are also the cases of Czech Republic and Slovakia, which have adopted and later abandoned the flat tax. Further, with over 20 years’ worth of economic history in some flat tax countries, we can begin to do some serious longitudinal study. In this paper we consider many economic variables to determine if there are statistically significant differences from before to after the adoption of a flat tax. We consider unemployment rates, tax receipts, GDP growth, Gini coefficients, and market data where the data are available. Comparisons are made through the use of event studies and time series methods. The results are mixed, but we draw statistically significant conclusions about some effects. We also look at the different implementations of the flat tax. In some countries there are equal income and corporate tax rates. In others the income tax has a lower rate, while in others the reverse is true. Each of these sends a clear message to individuals and corporations. The policy makers surely have a desired effect in mind. We group countries with similar policies, try to determine if the intended effect actually occurred, and then report the results. This is a work in progress, and we welcome the suggestion of variables to consider. Further, some of the data from before the fall of the Iron Curtain are suspect. Since there are new ruling regimes in these countries, the methods of computing different statistical measures has changed. Although we first look at the raw data as reported, we also attempt to account for these changes. We show which data seem to be fictional and suggest ways to infer the needed statistics from other data. These results are reported beside those on the reported data. Since there is debate about taxation structure, this paper can help inform policymakers of change the flat tax has caused in other countries. The work shows some strengths and weaknesses of a flat tax structure. Moreover, it provides beginnings of a scientific analysis of the flat tax in practice rather than having discussion based solely upon theory and conjecture.Keywords: flat tax, financial markets, GDP, unemployment rate, Gini coefficient
Procedia PDF Downloads 333436 The Association between C-Reactive Protein and Hypertension with Different US Participants Ethnicity-Findings from National Health and Nutrition Examination Survey 1999-2010
Authors: Ghada Abo-Zaid
Abstract:
The main objective of this study was to examine the association between the elevated level of CRP and incidence of hypertension before and after adjusting by age, BMI, gender, SES, smoking, diabetes, cholesterol LDL and cholesterol HDL and to determine whether the association were differ by race. Method: Cross sectional data for participations from age 17 to age 74 years who included in The National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010 were analysed. CRP level was classified into three categories ( > 3mg/L, between 1mg/LL and 3mg/L, and < 3 mg/L). Blood pressure categorization was done using JNC 7 algorithm Hypertension defined as either systolic blood pressure (SBP) of 140 mmHg or more and disystolic blood pressure (DBP) of 90mmHg or greater, otherwise a self-reported prior diagnosis by a physician. Pre-hypertension was defined as (139 > SBP > 120 or 89 > DPB > 80). Multinominal regression model was undertaken to measure the association between CRP level and hypertension. Results: In univariable models, CRP concentrations > 3 mg/L were associated with a 73% greater risk of incident hypertension compared with CRP concentrations < 1 mg/L (Hypertension: odds ratio [OR] = 1.73; 95% confidence interval [CI], 1.50-1.99). Ethnic comparisons showed that American Mexican had the highest risk of incident hypertension (odds ratio [OR] = 2.39; 95% confidence interval [CI], 2.21-2.58).This risk was statistically insignificant, however, either after controlling by other variables (Hypertension: OR = 0.75; 95% CI, 0.52-1.08,), or categorized by race [American Mexican: odds ratio [OR] = 1.58; 95% confidence interval [CI], 0,58-4.26, Other Hispanic: odds ratio [OR] = 0.87; 95% confidence interval [CI], 0.19-4.42, Non-Hispanic white: odds ratio [OR] = 0.90; 95% confidence interval [CI], 0.50-1.59, Non-Hispanic Black: odds ratio [OR] = 0.44; 95% confidence interval [CI], 0.22-0,87]. The same results were found for pre-hypertension, and the Non-Hispanic black showed the highest significant risk for Pre-Hypertension (odds ratio [OR] = 1.60; 95% confidence interval [CI], 1.26-2.03). When CRP concentrations were between 1.0-3.0 mg/L, in an unadjusted models prehypertension was associated with higher likelihood of elevated CRP (OR = 1.37; 95% CI, 1.15-1.62). The same relationship was maintained in Non-Hispanic white, Non-Hispanic black, and other race (Non-Hispanic white: OR = 1.24; 95% CI, 1.03-1.48, Non-Hispanic black: OR = 1.60; 95% CI, 1.27-2.03, other race: OR = 2.50; 95% CI, 1.32-4.74) while the association was insignificant with American Mexican and other Hispanic. In the adjusted model, the relationship between CRP and prehypertension were no longer available. In contrary, Hypertension was not independently associated with elevated CRP, and the results were the same after grouped by race or adjusted by the confounder variables. The same results were obtained when SBP or DBP were on a continuous measure. Conclusions: This study confirmed the existence of an association between hypertension, prehypertension and elevated level of CRP, however this association was no longer available after adjusting by other variables. Ethic group differences were statistically significant at the univariable models, while it disappeared after controlling by other variables.Keywords: CRP, hypertension, ethnicity, NHANES, blood pressure
Procedia PDF Downloads 408435 Purchasing Decision-Making in Supply Chain Management: A Bibliometric Analysis
Authors: Ahlem Dhahri, Waleed Omri, Audrey Becuwe, Abdelwahed Omri
Abstract:
In industrial processes, decision-making ranges across different scales, from process control to supply chain management. The purchasing decision-making process in the supply chain is presently gaining more attention as a critical contributor to the company's strategic success. Given the scarcity of thorough summaries in the prior studies, this bibliometric analysis aims to adopt a meticulous approach to achieve quantitative knowledge on the constantly evolving subject of purchasing decision-making in supply chain management. Through bibliometric analysis, we examine a sample of 358 peer-reviewed articles from the Scopus database. VOSviewer and Gephi software were employed to analyze, combine, and visualize the data. Data analytic techniques, including citation network, page-rank analysis, co-citation, and publication trends, have been used to identify influential works and outline the discipline's intellectual structure. The outcomes of this descriptive analysis highlight the most prominent articles, authors, journals, and countries based on their citations and publications. The findings from the research illustrate an increase in the number of publications, exhibiting a slightly growing trend in this field. Co-citation analysis coupled with content analysis of the most cited articles identified five research themes mentioned as follows integrating sustainability into the supplier selection process, supplier selection under disruption risks assessment and mitigation strategies, Fuzzy MCDM approaches for supplier evaluation and selection, purchasing decision in vendor problems, decision-making techniques in supplier selection and order lot sizing problems. With the help of a graphic timeline, this exhaustive map of the field illustrates a visual representation of the evolution of publications that demonstrate a gradual shift from research interest in vendor selection problems to integrating sustainability in the supplier selection process. These clusters offer insights into a wide variety of purchasing methods and conceptual frameworks that have emerged; however, they have not been validated empirically. The findings suggest that future research would emerge with a greater depth of practical and empirical analysis to enrich the theories. These outcomes provide a powerful road map for further study in this area.Keywords: bibliometric analysis, citation analysis, co-citation, Gephi, network analysis, purchasing, SCM, VOSviewer
Procedia PDF Downloads 78434 Investigating the Influence of Activation Functions on Image Classification Accuracy via Deep Convolutional Neural Network
Authors: Gulfam Haider, sana danish
Abstract:
Convolutional Neural Networks (CNNs) have emerged as powerful tools for image classification, and the choice of optimizers profoundly affects their performance. The study of optimizers and their adaptations remains a topic of significant importance in machine learning research. While numerous studies have explored and advocated for various optimizers, the efficacy of these optimization techniques is still subject to scrutiny. This work aims to address the challenges surrounding the effectiveness of optimizers by conducting a comprehensive analysis and evaluation. The primary focus of this investigation lies in examining the performance of different optimizers when employed in conjunction with the popular activation function, Rectified Linear Unit (ReLU). By incorporating ReLU, known for its favorable properties in prior research, the aim is to bolster the effectiveness of the optimizers under scrutiny. Specifically, we evaluate the adjustment of these optimizers with both the original Softmax activation function and the modified ReLU activation function, carefully assessing their impact on overall performance. To achieve this, a series of experiments are conducted using a well-established benchmark dataset for image classification tasks, namely the Canadian Institute for Advanced Research dataset (CIFAR-10). The selected optimizers for investigation encompass a range of prominent algorithms, including Adam, Root Mean Squared Propagation (RMSprop), Adaptive Learning Rate Method (Adadelta), Adaptive Gradient Algorithm (Adagrad), and Stochastic Gradient Descent (SGD). The performance analysis encompasses a comprehensive evaluation of the classification accuracy, convergence speed, and robustness of the CNN models trained with each optimizer. Through rigorous experimentation and meticulous assessment, we discern the strengths and weaknesses of the different optimization techniques, providing valuable insights into their suitability for image classification tasks. By conducting this in-depth study, we contribute to the existing body of knowledge surrounding optimizers in CNNs, shedding light on their performance characteristics for image classification. The findings gleaned from this research serve to guide researchers and practitioners in making informed decisions when selecting optimizers and activation functions, thus advancing the state-of-the-art in the field of image classification with convolutional neural networks.Keywords: deep neural network, optimizers, RMsprop, ReLU, stochastic gradient descent
Procedia PDF Downloads 114