Search results for: early discharge

Authors: A. M. U. P. Kumari, Vidanapathirana. J., Amarasekara J., Karunanayaka L.

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Leptospirosis is a zoonotic infection with significant morbidity and mortality. As an occupational disease, it has become a global concern due to its disease burden in endemic countries and rural areas. The aim of this study was to assess disease burden in terms of DALYs of leptospirosis. A hospital-based descriptive cross-sectional study was conducted using 450 clinically diagnosed leptospirosis patients admitted to base and above hospitals in Monaragala district, Sri Lanka, using a pretested interviewer administered questionnaire. The patients were followed up till normal day today life after discharge. Estimation of DALYs was done using laboratory confirmed leptospirosis patients. Leptospirosis disease burden in the Monaragala district was 44.9 DALYs per 100,000 population which includes 33.18 YLLs and 10.9 YLDs. The incidence of leptospirosis in the Monaragala district during the study period was 59.8 per 100,000 population, and the case fatality rate (CFR) was 1.5% due to delay in health seeking behaviour; 75% of deaths were among males due to multi organ failure. The disease burden of leptospirosis in the Moneragala district was significantly high, and urgent efforts to control and prevent leptospirosis should be a priority.

Keywords: human leptospirosis, disease burden, disability adjusted life Years, Sri Lanka

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Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney

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Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.

Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements

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Authors: Kaan Koyuncu, Umut Celen Arican, Sevilay Can

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In the maritime industry, there have been regulations to prevent pollution, and the first attempt to offer a legal basis was Marpol Convention which was held in 1973 in order to provide a framework for the disposal of ship wastes. Based on this convention, ports are obliged to build waste receiving facilities. European Union regulations make several member countries to follow these directions, In Turkey, under Blue Card System, the quantity and types of wastes, the delivery time, the capacity of the receiving facilities, and other required information can be monitored online. Therefore, yachts and other boats with the bilge, sewage, and waste which illegally discharge into the sea, can be blocked. This system is an outcome of the law adopted from European Union regulations. In this study, the present systems in Turkey which occurred in 2010 after the integration of the system, which has been put in the force in 2000 in Europe will be analyzed and interpreted to provide a useful comparison, a practical guide, and a roadmap for potential improvements.

Keywords: Europe-Turkey, blue card, marine environment, ship waste tracking system

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Authors: Keyao Li, Sai On Cheung

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Incorporation of alternative dispute resolution (ADR) mechanism has been the main feature of current trend of construction project dispute resolution (CPDR). ADR approaches have been identified as efficient mechanisms and are suitable alternatives to litigation and arbitration. Moreover, the use of ADR in this multi-tiered dispute resolution process often leads to repeated evaluations of a same dispute. Multi-tiered CPDR may become a breeding ground for cognitive biases. When completed knowledge is not available at the early tier of construction dispute resolution, disputing parties may form preconception of the dispute matter or the counterpart. This preconception would influence their information processing in the subsequent tier. Disputing parties tend to search and interpret further information in a self-defensive way to confirm their early positions. Their imbalanced information collection would boost their confidence in the held assessments. Their attitudes would be hardened and difficult to compromise. The occurrence of cognitive bias, therefore, impedes efficient dispute settlement. This study aims to explore ways to minimize bias in CPDR. Based on a comprehensive literature review, three types of bias minimizing approaches were collected: strategy-based, attitude-based and process-based. These approaches were further operationalized into bias minimizing measures. To verify the usefulness and practicability of these bias minimizing measures, semi-structured interviews were conducted with ten CPDR third party neutral professionals. All of the interviewees have at least twenty years of experience in facilitating settlement of construction dispute. The usefulness, as well as the implications of the bias minimizing measures, were validated and suggested by these experts. There are few studies on cognitive bias in construction management in general and in CPDR in particular. This study would be the first of its type to enhance the efficiency of construction dispute resolution by highlighting strategies to minimize the biases therein.

Keywords: bias, construction project dispute resolution, minimization, multi-tiered, semi-structured interview

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Authors: S. Visetpotjanakit, N. Nakkaew

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Determination of low level ⁹⁰Sr in seawater has been widely developed for the purpose of environmental monitoring and radiological research because ⁹⁰Sr is one of the most hazardous radionuclides released from atmospheric during the testing of nuclear weapons, waste discharge from the generation nuclear energy and nuclear accident occurring at power plants. A liquid extraction technique using bis-2-etylhexyl-phosphoric acid to separate and purify yttrium followed by Cherenkov counting using a liquid scintillation counter to determine ⁹⁰Y in secular equilibrium to ⁹⁰Sr was developed to monitor ⁹⁰Sr in the Asia Pacific Ocean. The analytical performance was validated for the accuracy, precision, and trueness criteria. Sr-90 determination in seawater using various low concentrations in a range of 0.01 – 1 Bq/L of 30 liters spiked seawater samples and 0.5 liters of IAEA-RML-2015-01 proficiency test sample was performed for statistical evaluation. The results had a relative bias in the range from 3.41% to 12.28%, which is below accepted relative bias of ± 25% and passed the criteria confirming that our analytical approach for determination of low levels of ⁹⁰Sr in seawater was acceptable. Moreover, the approach is economical, non-laborious and fast.

Keywords: proficiency test, radiation monitoring, seawater, strontium determination

Procedia PDF Downloads 152

Authors: Warda Jabeen, Romaisa Shamim Khan, Osama Shakeel, Ahmed Faraz Bhatti, Raza Hussain

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Background: The worldwide incidence of cutaneous melanoma (CM) has been on the rise over the past few decades. Primary prevention and early treatment remain the focus of management to reduce the burden of disease. This entails identification of risk factors to prompt early diagnosis. In Pakistan, there is a scarcity of clinico-pathological data relating to cutaneous malignant melanoma. Objective: The purpose of this study was to analyze the epidemiological and clinical characteristics of patients presenting with cutaneous malignant melanoma in Pakistan, and to compare the results with other studies. Method: Shaukat Khanum Memorial Cancer Hospital and Research Centre is currently the only dedicated cancer hospital in the country, accepting patients from all over Pakistan. Majority of the patients, however, belong to the northern half of the country. From the recorded data of the hospital, all cutaneous melanoma cases were identified and evaluated. Results: Between 1997 and 2017, a total of 169 cutaneous melanoma patients were registered at Shaukat Khanum. Mean age was 47.5 years. The highest incidence of melanoma was seen in the age group 40-59 years (n=69, 40.8%). Most commonly reported clinical subtype was unspecified melanoma (n=154, 91%). Amongst those in which T stage was reported, the most frequently observed T-stage at presentation was T4 (n=23, 13.6%). With regards to body distribution, in our study CM was seen most commonly in the lower limb including the hip. The yearly incidence of melanoma has increased/remained stable from 2007 to 2017. Conclusion: cutaneous malignant melanoma is a fairly common disease in Pakistan. Patients tend to present at a more advanced stage as compared to patients in developed countries. Identification of risk factors and tumor characteristics is therefore of paramount importance to deal with these patients.

Keywords: epidemiology of cutaneous malignant melanoma, cutaneous malignant melanoma, Pakistan, skin cancer

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Authors: Zahra Fotovatnia, Jeffery A. Jones, Alexandra Gottardo

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Speech communication often occurs in environments where noise conceals part of a message. Listeners should compensate for the lack of auditory information by picking up distinct acoustic cues and using semantic and sentential context to recreate the speaker’s intended message. This situation seems to be more challenging in a nonnative than native language. On the other hand, early bilinguals are expected to show an advantage over the late bilingual and monolingual speakers of a language due to their better executive functioning components. In this study, English monolingual speakers were compared with early and late nonnative speakers of English to understand speech in noise processing (SIN) and the underlying neurobiological features of this phenomenon. Auditory mismatch negativities (MMNs) were recorded using a double-oddball paradigm in response to a minimal pair that differed in their middle vowel (beat/bit) at Wilfrid Laurier University in Ontario, Canada. The results did not show any significant structural and electroneural differences across groups. However, vocabulary knowledge correlated positively with performance on tests that measured SIN processing in participants who learned English after age 6. Moreover, their performance on the test negatively correlated with the integral area amplitudes in the left superior temporal gyrus (STG). In addition, the STG was engaged before the inferior frontal gyrus (IFG) in noise-free and low-noise test conditions in all groups. We infer that the pre-attentive processing of words engages temporal lobes earlier than the fronto-central areas and that vocabulary knowledge helps the nonnative perception of degraded speech.

Keywords: degraded speech perception, event-related brain potentials, mismatch negativities, brain regions

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Authors: Alicia Greenbank, Efrat Bengio

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The aim of this research was to examine the efficacy of the first course in Israel, whose objective is to train student teachers in the special education department to work cooperatively with parents of children with special needs. Studies often highlight the importance of cooperation between teachers and parents of students with special needs. Israel’s Special Education Law defines parents as complete partners, and the Ministry of Education encourages and even requires that partnership be present. Yet this partnership is difficult to achieve many kindergarten teachers, and teachers have a lot of difficulties establishing and managing a pattern of cooperation with their students’ parents. Often we see different perspectives on the child's development and needs, distrust, lack of appreciation, and communication difficulties on both sides – parents & teachers. The course describes a method of instilling the need for cooperation at an early stage of teacher training-in the teacher training program. 22 students in the special education program for early childhood education in the fourth year of learning took part in the course. The fourth-year is the experiential training year and the first time that students have worked in a school. The course consisted of 14 sessions. Seven parents of students with different disabilities participated at 6 of the sessions. The changes in the students' attitudes towards partnership and their ability to manage this partnership were carried out by examining the reports written by the students before the meetings with the parents and the reflections they wrote after each meeting with the parents and at the end of the course. Three themes emerged from the narrative analysis, corresponding to the three preconditions for joint activities with parents — Approach, Attitude, Appropriate Atmosphere, according to the Four A’s Model. The findings showed that a course combining meetings with parents of children with special needs offers many benefits for teacher training. The course raised student awareness of the question partnership, changed students’ approaches and attitudes towards the parents, stressed the importance of partnership, and provided students with tools for working with parents through the school. Based on the findings of this study, courses in this format can be applied in order to cooperate between teachers and parents, for example, parents of gifted children with special needs.

Keywords: Partnership with parents in special education, parents of children with disabilities, parents of children with special needs, parents’ involvement in special education

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Authors: Vaclav Musil, Robert Cep, Sarka Malotova, Jiri Hajnys, Frantisek Spalek

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The new designs of satellite gears comprising a number of small gears pose high requirements on the precise production of small module gears. The objective of the experimental activity stated in this article was to compare the conventional rolling gear cutting technology with the modern wire electrical discharge machining (WEDM) technology for the production of small module gear m=0.6 mm (thickness of 2.5 mm and material 30CrMoV9). The WEDM technology lies in copying the profile of gearing from the rendered trajectory which is then transferred to the track of a wire electrode. During the experiment, we focused on the comparison of these production methods. Main measured parameters which significantly influence the lifetime and noise was chosen. The first parameter was to compare the precision of gearing profile in respect to the mathematic model. The second monitored parameter was the roughness and surface topology of the gear tooth side. The experiment demonstrated high accuracy of WEDM technology, but a low quality of machined surface.

Keywords: precision of gearing, small module gears, surface topology, WEDM technology

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Authors: Courret Gilles, Pidoux Damien

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Considering that sunshine is the ultimate reference in lighting, we have examined the spectral correlation between a series of electric light sources and sunlight. As the latter is marked by fluctuations, we have taken two spectra of reference: on the one hand, the CIE daylight standard illuminant, and on the other hand, the global illumination by the clear sky with the sun at 30° above the horizon. We determined the coefficients of correlation between the spectra filtered by the sensitivity of the CIE standard observer for photopic vision. We also calculated the luminous efficiency of the radiation in order to compare the ideal energy performances as well as the CIE color indexes Ra, Ra14, and Rf, since the choice of a light source requires a trade-off between color rendering and luminous efficiency. The benchmarking includes the most commonly used bulbs, various white LED (Lighting Emitting Diode) of warm white or cold white types, incandescent halogen as well as two HID lamps (High-Intensity Discharge) and two plasma lamps of different types, a solar simulator and a new version of the sulfur lamp. The latter obtains the best correlation, whether in comparison with the solar spectrum or that of the standard illuminant.

Keywords: electric light sources, plasma lamp, daylighting, sunlight, spectral correlation

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Authors: Nacera Yassa, Abdelmalek Saidoune, Ghania Ouadfel, Hamza Houassine

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The rapid advancement in electrical technologies has underscored the increasing importance of multiphase machines across various industrial sectors. These machines offer significant advantages in terms of efficiency, compactness, and reliability compared to their single-phase counterparts. However, early detection and diagnosis of electrical faults remain critical challenges to ensure the durability and safety of these complex systems. This paper presents an advanced analytical model for multiphase machines, with a particular focus on dual stator asynchronous machines. The primary objective is to develop a robust diagnostic tool capable of effectively detecting and locating electrical faults in these machines, including short circuits, winding faults, and voltage imbalances. The proposed methodology relies on an analytical approach combining electrical machine theory, modeling of magnetic and electrical circuits, and advanced signal analysis techniques. By employing detailed analytical equations, the developed model accurately simulates the behavior of multiphase machines in the presence of electrical faults. The effectiveness of the proposed model is demonstrated through a series of case studies and numerical simulations. In particular, special attention is given to analyzing the dynamic behavior of machines under different types of faults, as well as optimizing diagnostic and recovery strategies. The obtained results pave the way for new advancements in the field of multiphase machine diagnostics, with potential applications in various sectors such as automotive, aerospace, and renewable energies. By providing precise and reliable tools for early fault detection, this research contributes to improving the reliability and durability of complex electrical systems while reducing maintenance and operation costs.

Keywords: faults, diagnosis, modelling, multiphase machine

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Authors: Tahsien Okasha

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Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page.". The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: organ transplant, clinical pathway, postoperative care, same page

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Authors: Mike-Franck Mienlam Essi, Joseph Quentin Yene Atangana, Mbida Yem

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The Kribi-Campo sub-basin belongs to the southern domain of the Cameroon Atlantic Margin in the Gulf of Guinea. It is the African homologous segment of the Sergipe-Alagoas Basin, located at the northeast side of the Brazil margin. The onset of the seafloor spreading period in the Southwest African Margin in general and the study area particularly remains controversial. Various studies locate this event during the Cretaceous times (Early Aptian to Late Albian), while others suggested that this event occurred during Pre-Cretaceous period (Palaeozoic or Jurassic). This work analyses 02 Cameroon Span seismic lines to re-examine the Early marine incursion period of the study area for a better understanding of the margin evolution. The methodology of analysis in this study is based on the delineation of the first seismic sequence, using the reflector’s terminations tracking and the analysis of its internal reflections associated to the external configuration of the package. The results obtained indicate from the bottom upwards that the first deposits overlie a first seismic horizon (H1) associated to “onlap” terminations at its top and underlie a second horizon which shows “Downlap” terminations at its top (H2). The external configuration of this package features a prograded fill pattern, and it is observed within the depocenter area with discontinuous reflections that pinch out against the basement. From east to west, this sequence shows two seismic facies (SF1 and SF2). SF1 has parallel to subparallel reflections, characterized by high amplitude, and SF2 shows parallel and stratified reflections, characterized by low amplitude. The distribution of these seismic facies reveals a lateral facies variation observed. According to the fundamentals works on seismic stratigraphy and the literature review of the geological context of the study area, particularly, the stratigraphical natures of the identified horizons and seismic facies have been highlighted. The seismic horizons H1 and H2 correspond to Top basement and “Downlap Surface,” respectively. SF1 indicates continental sediments (Sands/Sandstone) and SF2 marine deposits (shales, clays). Then, the prograding configuration observed suggests a marine regression. The correlation of these results with the lithochronostratigraphic chart of Sergipe-Alagoas Basin reveals that the first marine deposits through the study area are dated from Pre-Cretaceous times (Palaeozoic or Jurassic). The first deposits onto the basement represents the end of a cycle of sedimentation. The hypothesis of Mike.F. Mienlam Essi is with the Earth Sciences Department of the Faculty of Science of the University of Yaoundé I, P.O. BOX 812 CAMEROON (e-mail: [email protected]). Joseph.Q. Yene Atangana is with the Earth Sciences Department of the Faculty of Science of the University of Yaoundé I, P.O. BOX 812 CAMEROON (e-mail: [email protected]). Mbida Yem is with the Earth Sciences Department of the Faculty of Science of the University of Yaoundé I, P.O. BOX 812 CAMEROON (e-mail: [email protected]). Cretaceous seafloor spreading through the study area is the onset of another cycle of sedimentation. Furthermore, the presence of marine sediments into the first deposits implies that this package could contain marine source rocks. The spatial tracking of these deposits reveals that they could be found in some onshore parts of the Kribi-Campo area or even in the northern side.

Keywords: cameroon span seismic, early marine incursion, kribi-campo sub-basin, pre-cretaceous period, sergipe-alagoas basin

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Authors: Laura Hervai

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One of the most significant phenomena of the 2000s was the emergence of social media sites and web 2.0 that revolutionized communication processes. Social networking platforms have fundamentally changed social and political participation of the public, which require organisations in the public and non-profit sector not only to adapt to these new trends but also to actively engage their audiences. Opportunity for interaction, freer expression of opinion and the proliferation of user generated content are major changes brought by web 2.0 technologies. Furthermore, due to the wide penetration of mobile technologies, social media sites are capable of connecting underdeveloped regions to the global flow of information. Taking advantage of these characteristics, organisations have the opportunity to engage much wider audiences, exploit new ways to raise awareness or reach out to regions that are difficult to access. The early adopters of these new communication tools soon recognized the need of developing social media guidelines for their organisations as well as the increased workload that they require. While ten years ago communication officers could handle their organisation’s social media presence, today it is a separate profession. International organisations face several challenges related to their social media presence. Early adopters have contributed to the development of best practices among which the ethics of social media usage still remained problematic. Another challenge for international organisations is to adapt to country-specific social media trends while they have to comply with the requirements of their parent organisation as well. However in the 21st century social media presence can be crucial to the successful operation of international organisations, their importance is still not taken seriously enough. The measurement of the effects and influence of social networking on the organisations’ productivity is an unsolved problem thus further research should focus on this matter. Research methods included primary research of major IGOs’ and NGOs’ social media presence and guidelines along with secondary research of social media statistics and scientific articles in the topic.

Keywords: international organisations, non-profit sector, NGO, social media, social network

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Authors: Mrinal Kanti Bhowmik, Usha Rani Gogoi Jr., Anjan Kumar Ghosh, Debotosh Bhattacharjee

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In the last few decades, breast thermography has achieved an average sensitivity and specificity of 90% for breast tumor detection. Breast thermography is a non-invasive, cost-effective, painless and radiation-free breast imaging modality which makes a significant contribution to the evaluation and diagnosis of patients, suspected of having breast cancer. An abnormal breast thermogram may indicate significant biological risk for the existence or the development of breast tumors. Breast thermography can detect a breast tumor, when the tumor is in its early stage or when the tumor is in a dense breast. The infrared breast thermography is very sensitive to environmental changes for which acquisition of breast thermography should be performed under strictly controlled conditions by undergoing some standard protocols. Several factors like air, temperature, humidity, etc. are there to be considered for characterizing thermal images as an imperative tool for detecting breast cancer. A detailed study of various breast thermogram acquisition protocols adopted by different researchers in their research work is provided here in this paper. After going through a rigorous study of different breast thermogram acquisition protocols, a new standard breast thermography acquisition setup is proposed here in this paper for proper and accurate capturing of the breast thermograms. The proposed breast thermogram acquisition setup is being built in the Radiology Department, Agartala Government Medical College (AGMC), Govt. of Tripura, Tripura, India. The breast thermograms are captured using FLIR T650sc thermal camera with the thermal sensitivity of 20 mK at 30 degree C. The paper is an attempt to highlight the importance of different critical parameters of breast thermography like different thermography views, patient preparation protocols, acquisition room requirements, acquisition system requirements, etc. This paper makes an important contribution by providing a detailed survey and a new efficient approach on breast thermogram capturing.

Keywords: acquisition protocol, breast cancer, breast thermography, infrared thermography

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Authors: Azar Heidarizadi, Mahdieh Salimi, Hossein Mozdarani

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Introduction: As a complex disease, breast cancer results from several genetic and epigenetic changes. Lactoferrin, a member of the transferrin family, is reported to have a number of biological functions, including DNA synthesis, immune responses, iron transport, etc., any of which could play a role in tumor progression. The aim of this study was to investigate the bioinformatics data and experimental assay to find the pattern of promoter methylation and gene expression of LTF in breast cancer in order to study its potential role in cancer management. Material and Methods: In order to evaluate the methylation status of the LTF promoter, we studied the MS-PCR and Real-Time PCR on samples from patients with breast cancer and normal cases. 67 patient samples were conducted for this study, including tumoral, plasma, and normal tissue adjacent samples, as well as 30 plasma from normal cases and 10 tissue breast reduction cases. Subsequently, bioinformatics analyses such as cBioPortal databases, string, and genomatix were conducted to disclose the prognostic value of LTF in breast cancer progression. Results: The analysis of LTF expression showed an inverse relationship between the expression level of LTF and the stages of tissues of breast cancer patients (p<0.01). In fact, stages 1 and 2 had a high expression in LTF, while, in stages 3 and 4, a significant reduction was observable (p < 0.0001). LTF expression frequently alters with a decrease in the expression in ER⁺, PR⁺, and HER2⁺ patients (P < 0.01) and an increase in the expression in the TNBC, LN¯, ER¯, and PR- patients (P < 0.001). Also, LTF expression is significantly associated with metastasis and lymph node involvement factors (P < 0.0001). The sensitivity and specificity of LTF were detected, respectively. A negative correlation was detected between the results of level expression and methylation of the LTF promoter. Conclusions: The altered expression of LTF observed in breast cancer patients could be considered as a promotion in cell proliferation and metastasis even in the early stages of cancer.

Keywords: LTF, expression, methylation, breast cancer

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Authors: M. Iqbal Mahmud, Haeng Muk Cho, Seo Hyun Sang, Wang Wen Hai, Chang Heon Yi, Man Ik Hwang, Dae Hoon Kang

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Solenoid operated electromagnetic control valve (ECV) playing an important role for car’s air conditioning control system. ECV is used in external variable displacement swash plate type compressor and controls the entire air conditioning system by means of a pulse width modulation (PWM) input signal supplying from an external source (controller). Complete form of ECV contains number of internal features like valve body, core, valve guide, plunger, guide pin, plunger spring, bellows etc. While designing the ECV; dimensions of different internal items must meet the standard requirements as it is quite challenging. In this research paper, especially the dimensioning of ECV body and its three pressure ports through which the air/refrigerant passes are considered. Here internal leakage test analysis of ECV body is being carried out from its discharge port (Pd) to crankcase port (Pc) when the guide valve is placed inside it. The experiments have made both in ordinary and digital system using different assumptions and thereafter compare the results.

Keywords: electromagnetic control valve (ECV), leakage, pressure port, valve body, valve guide

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Authors: Maatouk Mohamed, Nouira Mariem, Hamdi Kbir Gh, Mahjoubi M. F., Ben Moussa M.

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Background and aim: Preoperative biliary drainage (PBD) has been introduced to lower bilirubin levels and to control the negative effects of obstructive jaundice in patients with malignant obstructive jaundice undergoing pancreaticoduodenectomy (PD). The optimal time interval between PBD and PD is still not clear. Delaying surgery by 4 to 6 weeks is the commonly accepted practice. However, delayed PD has been shown to decrease the rate of resection and adversely affect the tumor grading and prognosis. Thus, the purpose of our systematic review and meta-analysis was to evaluate the optimal period for PBD prior to PD: short or prolonged in terms of postoperative morbidity and survival outcomes. Methods: Trials were searched in PubMed, Science Direct, Google Scholar, and Cochrane Library until November 2022. Studies using PBD in patients with malignant obstructive jaundice that compared short duration group (SDG) (surgery performed within 3-4 weeks) with prolonged duration group (PDG) (at least 3-4 weeks after PBD) were included in this study. The risk of bias was assessed using the Rob v2 and Robins-I tools. The priori protocol was published in PROSPERO (ID: CRD42022381405). Results: Seven studies comprising 1625 patients (SDG 870, PDG 882) were included. All studies were non-randomized, and only one was prospective. No significant differences were observed between the SDG and PDG in mortality (OR= 0.59; 95% CI [0.30, 1.17], p=0.13), major morbidity (Chi² = 30.28, p <0.00001; I² = 87%), pancreatic fistula (Chi² = 6.61, p = 0.25); I² = 24%), post pancreatectomy haemorrhage (OR= 1.16; 95% CI [0.67, 2.01], p=0.59), positive drainage culture (OR= 0.36; 95% CI [0.10, 1.32], p=0.12), septic complications (OR= 0.78; 95% CI [0.23, 2.72], p=0.70), wound infection (OR= 0.08, p=0.07), operative time (MD= 0.21; p=0.21). Conclusion: Early surgery within 3 or 4 weeks after biliary drainage is both safe and effective. Thus, it is reasonable to suggest early surgery following PBD for patients having resectable periampullary cancers.

Keywords: preoperative biliary drainage, pancreatic cancer, pancreatic surgery, complication

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Authors: Saboor Saeed, Chunming Jiang

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Eosinophilic Granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a rare systemic vasculitis of small and medium-sized vessels that primarily develops in middle-aged individuals. It is characterized by asthma, blood eosinophilia, and extra pulmonary manifestations. In childhood, EGPA is extremely rare. Pulmonary and cardiac involvement is predominant in pediatric EGPA, and mortality is substantial. Generally, EGPA will develop in three stages: a) The allergic phase is commonly associated with asthma, allergic rhinitis, and sinusitis, b) the eosinophilic phase, in which the main pathology is related to the infiltration of eosinophilic organs, i.e., lung, heart, and gastrointestinal system, c) vasculitis phase involved purpura, peripheral neuropathy, and some constitutional symptoms. The key to the treatment of EGPA lies in the early diagnosis of the disease. Early application of glucocorticoids and immunosuppressants can improve symptoms and the overall prognosis of EGPA. Case Description: We presented a case of an 8-year-old boy with a history of short asthma, marked eosinophilia, and multi-organ involvement. The extremely high eosinophil level in the blood (72.50%) prompted the examination of eosinophilic leukemia before EGPA diagnosis was made. Subsequently, this disease was successfully treated. This case report shows a typical case of CSS in childhood because of the extreme eosinophilia. It emphasizes the importance of EGPA is a life-threatening cause of children's eosinophilia. Conclusion: EGPA in children has unique clinical, imaging, and histological characteristics different from those of adults. In pediatric patients, the development and diagnosis of systemic symptoms are often delayed, mainly occurring in the eosinophilic phase, which will lead to specific manifestations. At the same time, we cannot detect a genetic relationship related to EGPA.

Keywords: Churg Strauss syndrome, asthma, vasculitis, hypereosinophilia, eosinophilic granulomatosis polyangiitis

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Authors: Devendra Kumar Pandey, Debabrata Chakraborty

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The advancement in various concrete ingredients like plasticizers, additives and fibers, etc. has enabled concrete technologists to develop many viable varieties of special concretes in recent decades. Such various varieties of concrete have significant enhancement in green as well as hardened properties of concrete. A prudent selection of appropriate type of concrete can resolve many design and application issues in construction projects. This paper focuses on usage of self-compacting concrete, high early strength concrete, structural lightweight concrete, fiber reinforced concrete, high performance concrete and ultra-high strength concrete in the structures. The modified properties of strength at various ages, flowability, porosity, equilibrium density, flexural strength, elasticity, permeability etc. need to be carefully studied and incorporated into the design of the structures. The paper demonstrates various mixture combinations and the concrete properties that can be leveraged. The selection of such products based on the end use of structures has been proposed in order to efficiently utilize the modified characteristics of these concrete varieties. The study involves mapping the characteristics with benefits and savings for the structure from design perspective. Self-compacting concrete in the structure is characterized by high shuttering loads, better finish, and feasibility of closer reinforcement spacing. The structural design procedures can be modified to specify higher formwork strength, height of vertical members, cover reduction and increased ductility. The transverse reinforcement can be spaced at closer intervals compared to regular structural concrete. It allows structural lightweight concrete structures to be designed for reduced dead load, increased insulation properties. Member dimensions and steel requirement can be reduced proportionate to about 25 to 35 percent reduction in the dead load due to self-weight of concrete. Steel fiber reinforced concrete can be used to design grade slabs without primary reinforcement because of 70 to 100 percent higher tensile strength. The design procedures incorporate reduction in thickness and joint spacing. High performance concrete employs increase in the life of the structures by improvement in paste characteristics and durability by incorporating supplementary cementitious materials. Often, these are also designed for slower heat generation in the initial phase of hydration. The structural designer can incorporate the slow development of strength in the design and specify 56 or 90 days strength requirement. For designing high rise building structures, creep and elasticity properties of such concrete also need to be considered. Lastly, certain structures require a performance under loading conditions much earlier than final maturity of concrete. High early strength concrete has been designed to cater to a variety of usages at various ages as early as 8 to 12 hours. Therefore, an understanding of concrete performance specifications for special concrete is a definite door towards a superior structural design approach.

Keywords: high performance concrete, special concrete, structural design, structural lightweight concrete

Procedia PDF Downloads 294

Authors: Tahsien Okasha

Abstract:

Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page." .The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: postoperative care, organ transplant, clinical pathway, patient

Procedia PDF Downloads 434

Authors: Jose Melena, Rosa Santander, Tanya Gonzalez, Richard Duque, Juan Illanes

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Ecuador is one of the countries with the greatest aquatic biodiversity worldwide. In particular, there are at least a dozen native marine species with great aquaculture potential locally. This research concerns one of those species. It has proposed to implement experimental protocols in order to induce spawning and to generate the early larval development of the giant reef clam P. multicostata under controlled conditions. Bioassays were carried out with one adult batch (n= 8) with an average valvar length of 118,4 ± 5,8 mm, which were collected near of the Puerto Santa Rosa (2° 12' 30'' S, 80° 58' 28'' W), Santa Elena Province. During a short acclimation stage, the eight adults of giant reef clam P. multicostata were exposed to thermal stress. Briefly, the experimental protocol for spawning induction was based on the application of 20°C for 1 h and 30°C for 1 h on P. multicostata broodstock at least three consecutive times by one day. After spawning, collected sexual material was released for external fertilization process. After the delivery of gametes, it was achieved 3,25 × 10⁶ viable zygotes. As results, fertilized eggs had 56 µm diameter; while first and second cell divisions were observed to 2,5 h post-fertilization, with individual average length of 68 ± 5 µm and polar body. Latter cell divisions, including gastrula stage, appeared at 9 h post-fertilization, with individual average length of 73 ± 4 µm and trochophore stage at 15 h post-fertilization with individual average length of 75 ± 4 µm. In addition, veliger stage was registered at 20 h post-fertilization with individual average length of 82 ± 6 µm. Umboned larvae appeared at day 8 post-fertilization, with individual average length of 148 ± 6 µm. These pioneering results worldwide can strengthen the local conservation process of the overexploited P. multicostata and to encourage its production for commercial purposes.

Keywords: Ecuador, larval development, Periglypta multicostata, spawning induction

Procedia PDF Downloads 123

Authors: Saman Javadi, Mohammad Hassan Mahmoudi, Fatemeh Jafari, Aminreza Neshat

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Urmia Lake’s water level has been dropped during the past decade. Although the most common reason in studies was declared climate change, but observation of adjacent lake (like Van in Turkey) is not the same as the common reason. Most of studies were focused on climate and land use change, but groundwater resource as one of the most important element is negligible. Due to population and agriculture activities growth, exploration of groundwater resource has been increased. In as much as continued decline of water levels can lead to saltwater intrusion, reduce stream discharge near outcrop regions and threaten groundwater quality, aquifers of this region were affected by saltwater intrusion of Urmia Lake. In this research comparison of saltwater intrusion into eastern and western coastal aquifer was studied. In conclusion eastern aquifers are in a critical situation; vice versa the western ones are in a better situation. Thus applying management of groundwater operation would be necessary for eastern aquifers.

Keywords: coastal aquifer, groundwater over-exploration, saltwater intrusion, Urmia Lake

Procedia PDF Downloads 519

Authors: A. A. A. Indira Pratyaksa, Achmad Zaki

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In every organization, there would be a demographic of young employees. They see themselves are the future leaders of the company. A special program needs to be prepared for them as a form of retention programs. Early Professional Program (EPD) must address challenges in the future. Aspects of the development of competence of young employees also become one of the answers in accelerating existing business processes. The role of the supervisor is the key success of EPD. Pertamina, thus, is better prepared to realize the vision and mission.

Keywords: young employee, competencies, development, leader, coaching

Procedia PDF Downloads 527

Authors: Alebachew Halefom, Navsal Kumar, Arunava Poddar

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The purpose of this work is to specify the parameter values, the base flow index (BFI), and to rank the methods that should be used for base flow separation. Three different digital graphical approaches are chosen and used in this study for the purpose of comparison. The daily time series discharge data were collected from the site for a period of 30 years (1986 up to 2015) and were used to evaluate the algorithms. In order to separate the base flow and the surface runoff, daily recorded streamflow (m³/s) data were used to calibrate procedures and get parameter values for the basin. Additionally, the performance of the model was assessed by the use of the standard error (SE), the coefficient of determination (R²), and the flow duration curve (FDC) and baseflow indexes. The findings indicate that, in general, each strategy can be used worldwide to differentiate base flow; however, the Sliding Interval Method (SIM) performs significantly better than the other two techniques in this basin. The average base flow index was calculated to be 0.72 using the local minimum method, 0.76 using the fixed interval method, and 0.78 using the sliding interval method, respectively.

Keywords: baseflow index, digital graphical methods, streamflow, Emba Madre Watershed

Procedia PDF Downloads 58

Authors: C. Vázquez, L. M. Gigirey, C. P. del Oro, S. Seoane

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Early detection of visual problems plays a key role in the aging process. However, although vision problems are common among older people, the percentage of aging people who perform regular optometric exams is low. In fact, uncorrected refractive errors are one of the main causes of visual impairment in this group of the population. Purpose: To evaluate functional vision of older residents in order to show the urgent need of visual screening programs in Galician nursing homes. Methodology: We examined 364 older adults aged 65 years and over. To measure vision of the daily living, we tested distance and near presenting visual acuity (binocular visual acuity with habitual correction if warn, directional E-Snellen) Presenting near vision was tested at the usual working distance. We defined visual impairment (distance and near) as a presenting visual acuity less than 0.3. Exclusion criteria included immobilized residents unable to reach the USC Dual Sensory Loss Unit for visual screening. Association between categorical variables was performed using chi-square tests. We used Pearson and Spearman correlation tests and the variance analysis to determine differences between groups of interest. Results: 23,1% of participants have visual impairment for distance vision and 16,4% for near vision. The percentage of residents with far and near visual impairment reaches 8,2%. As expected, prevalence of visual impairment increases with age. No differences exist with regard to the level of functional vision between gender. Differences exist between age group respect to distance vision, but not in case of near vision. Conclusion: prevalence of visual impairment is high among the older people tested in this pilot study. This means a high percentage of older people with limitations in their daily life activities. It is necessary to develop an effective vision screening program for early detection of vision problems in Galician nursing homes.

Keywords: functional vision, elders, aging, nursing homes

Procedia PDF Downloads 393

Authors: Xiaodi Su, Xin Ting Zheng, Laura Sutarlie, Nur Asinah binte Mohamed Salleh, Yong Yu

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Wound healing is a dynamic process with multiple phases. Rapid profiling and quantitative characterization of inflammation and infection remain challenging. We have developed paper-like battery-free multiplexed sensors for holistic wound assessment via quantitative detection of multiple inflammation and infection markers. In one of the designs, the sensor patch consists of a wax-printed paper panel with five colorimetric sensor channels arranged in a pattern resembling a five-petaled flower (denoted as a ‘Petal’ sensor). The five sensors are for temperature, pH, trimethylamine, uric acid, and moisture. The sensor patch is sandwiched between a top transparent silicone layer and a bottom adhesive wound contact layer. In the second design, a palm-like-shaped paper strip is fabricated by a paper-cutter printer (denoted as ‘Palm’ sensor). This sensor strip carries five sensor regions connected by a stem sampling entrance that enables rapid colorimetric detection of multiple bacteria metabolites (aldehyde, lactate, moisture, trimethylamine, tryptophan) from wound exudate. For both the “\’ Petal’ and ‘Palm’ sensors, color images can be captured by a mobile phone. According to the color changes, one can quantify the concentration of the biomarkers and then determine wound healing status and identify/quantify bacterial species in infected wounds. The ‘Petal’ and ‘Palm’ sensors are validated with in-situ animal and ex-situ skin wound models, respectively. These sensors have the potential for integration with wound dressing to allow early warning of adverse events without frequent removal of the plasters. Such in-situ and early detection of non-healing condition can trigger immediate clinical intervention to facilitate wound care management.

Keywords: wound infection, colorimetric sensor, paper fluidic sensor, wound care

Procedia PDF Downloads 63

Authors: Rinlee Butch M. Cervera, Princess Stephanie P. Llanos

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Lithium iron phosphate (LiFePO₄) is a potential cathode material for lithium-ion batteries due to its promising characteristics. In this study, pure LiFePO₄ (LFP) and carbon-coated nanograined LiFePO₄ (LFP-C) is synthesized and characterized for its microstructural properties. X-ray diffraction patterns of the synthesized samples can be indexed to an orthorhombic LFP structure with about 63 nm crystallite size as calculated by using Scherrer’s equation. Agglomerated particles that range from 200 nm to 300 nm are observed from scanning electron microscopy images. Transmission electron microscopy images confirm the crystalline structure of LFP and coating of amorphous carbon layer. Elemental mapping using energy dispersive spectroscopy analysis revealed the homogeneous dispersion of the compositional elements. In addition, galvanostatic charge and discharge measurements were investigated for the cathode performance of the synthesized LFP and LFP-C samples. The results showed that the carbon-coated sample demonstrated the highest capacity of about 140 mAhg^-1 as compared to non-coated and micrograined sized commercial LFP.

Keywords: ceramics, energy storage, electrochemical measurements, transmission electron microscope

Procedia PDF Downloads 234

Authors: T. Imo, F. Latū, S. Aloi, J. Leung-Wai, V. Vaurasi, P. Amosa, M. A. Sheikh

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Contamination of heavy metals in coral reefs and coastal areas is a serious ecotoxicological and environmental problem due to direct runoff from anthropogenic wastes, commercial vessels, and discharge from industrial effluents. In Samoa, the information on the ecotoxicological impact of heavy metals on sediments is limited. This study presents baseline data on the concentration and distribution of heavy metals in sediments collected along the commercial and fishing ports in Samoa. Surface sediment samples were collected within the months of August-October 2013 from the 5 sites along the 2 ports. Sieved sample fractions were used for the evaluation of sediment physicochemical parameters namely pH, conductivity, organic matter, and bicarbonates of calcium. Heavy metal (Cu, Pb) analysis was achieved by flame atomic absorption spectrometry. Two heavy metals (Cu, Pb) were detected from each port with some concentration below the WHO permissible maximum concentration of environment quality standard. The results obtained from this study advocate for further studies regarding emerging threats of heavy metals on the vital marine resources which have significant importance to the livelihood of coastal societies, particularly Small Island States including Samoa.

Keywords: coastal environment, heavy metals, pollution, sediments

Procedia PDF Downloads 305

Authors: Hai Zeng, Yisheng Li, Jincheng Huang, Chenghui Huang, Ying Zhang

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Children are strong; the country strong, the development of children Basketball is a strategic advantage. Common forms of basketball equipment has been difficult to meet the needs of young children teaching the game of basketball, basketball development for 3-6 years old children in the form of appropriate teaching aids is a breakthrough basketball game teaching children bottlenecks, improve teaching critical path pleasure, but also the development of early childhood basketball a necessary requirement. In this study, literature, questionnaires, focus group interviews, comparative analysis, for domestic and foreign use of 12 kinds of basketball teaching aids (cloud computing MINI basketball, adjustable basketball MINI, MINI basketball court, shooting assist paw print ball, dribble goggles, dribbling machine, machine cartoon shooting, rebounding machine, against the mat, elastic belt, ladder, fitness ball), from fun and improve early childhood shooting technique, dribbling technology, as well as offensive and defensive rebounding against technology conduct research on conversion technology. The results show that by using appropriate forms of teaching children basketball aids, can effectively improve children's fun basketball game, targeted to improve a technology, different types of aids from different perspectives enrich the connotation of children basketball game. Recommended for children of color psychology, cartoon and environmentally friendly material production aids, and increase research efforts basketball aids children, encourage children to sports teachers aids applications.

Keywords: health and physical education field of curriculum outline, health fitness, sports and health curriculum reform, Taiwan, twelve years basic education

Procedia PDF Downloads 378