Search results for: dive duration
302 Randomized Controlled Trial of Ultrasound Guided Bilateral Intermediate Cervical Plexus Block in Thyroid Surgery
Authors: Neerja Bharti, Drishya P.
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Introduction: Thyroidectomies are extensive surgeries involving a significant degree of tissue handling and dissection and are associated with considerable postoperative pain. Regional anaesthesia techniques have immerged as possible inexpensive and safe alternatives to opioids in the management of pain after thyroidectomy. The front of the neck is innervated by branches from the cervical plexus, and hence, several approaches for superficial and deep cervical plexus block (CPB) have been described to provide postoperative analgesia after neck surgery. However, very few studies have explored the analgesic efficacy of intermediate CPB for thyroid surgery. In this study, we have evaluated the effects of ultrasound-guided bilateral intermediate CPB on perioperative opioid consumption in patients undergoing thyroidectomy under general anesthesia. Methods: In this prospective randomized controlled study, fifty ASA grade I-II adult patients undergoing thyroidectomy were randomly divided into two groups: the study group received ultrasound-guided bilateral intermediate CPB with 10 ml 0.5% ropivacaine on each side, while the control group received the same block with 10 ml normal saline on each side just after induction of anesthesia. Anesthesia was induced with propofol, fentanyl, and vecuronium and maintained with propofol infusion titrated to maintain the BIS between 40 and 60. During the postoperative period, rescue analgesia was provided with PCA fentanyl, and the pain scores, total fentanyl consumption, and incidence of nausea and vomiting during 24 hours were recorded, and overall patient satisfaction was assessed. Results: The groups were well-matched with respect to age, gender, BMI, and duration of surgery. The difference in intraoperative propofol and fentanyl consumption was not statistically significant between groups. However, the intraoperative haemodynamic parameters were better maintained in the study group than in the control group. The postoperative pain scores, as measured by VAS at rest and during movement, were lower, and the total fentanyl consumption during 24 hours was significantly less in the study group as compared to the control group. Patients in the study group reported better satisfaction scores than those in the control group. No adverse effects of ultrasound-guided intermediate CPB block were reported. Conclusion: We concluded that ultrasound-guided intermediate cervical plexus block is a safe and effective method for providing perioperative analgesia during thyroid surgery.Keywords: thyroidectomy, cervical plexus block, pain relief, opioid consumption
Procedia PDF Downloads 96301 On the Dwindling Supply of the Observable Cosmic Microwave Background Radiation
Authors: Jia-Chao Wang
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The cosmic microwave background radiation (CMB) freed during the recombination era can be considered as a photon source of small duration; a one-time event happened everywhere in the universe simultaneously. If space is divided into concentric shells centered at an observer’s location, one can imagine that the CMB photons originated from the nearby shells would reach and pass the observer first, and those in shells farther away would follow as time goes forward. In the Big Bang model, space expands rapidly in a time-dependent manner as described by the scale factor. This expansion results in an event horizon coincident with one of the shells, and its radius can be calculated using cosmological calculators available online. Using Planck 2015 results, its value during the recombination era at cosmological time t = 0.379 million years (My) is calculated to be Revent = 56.95 million light-years (Mly). The event horizon sets a boundary beyond which the freed CMB photons will never reach the observer. The photons within the event horizon also exhibit a peculiar behavior. Calculated results show that the CMB observed today was freed in a shell located at 41.8 Mly away (inside the boundary set by Revent) at t = 0.379 My. These photons traveled 13.8 billion years (Gy) to reach here. Similarly, the CMB reaching the observer at t = 1, 5, 10, 20, 40, 60, 80, 100 and 120 Gy are calculated to be originated at shells of R = 16.98, 29.96, 37.79, 46.47, 53.66, 55.91, 56.62, 56.85 and 56.92 Mly, respectively. The results show that as time goes by, the R value approaches Revent = 56.95 Mly but never exceeds it, consistent with the earlier statement that beyond Revent the freed CMB photons will never reach the observer. The difference Revert - R can be used as a measure of the remaining observable CMB photons. Its value becomes smaller and smaller as R approaching Revent, indicating a dwindling supply of the observable CMB radiation. In this paper, detailed dwindling effects near the event horizon are analyzed with the help of online cosmological calculators based on the lambda cold dark matter (ΛCDM) model. It is demonstrated in the literature that assuming the CMB to be a blackbody at recombination (about 3000 K), then it will remain so over time under cosmological redshift and homogeneous expansion of space, but with the temperature lowered (2.725 K now). The present result suggests that the observable CMB photon density, besides changing with space expansion, can also be affected by the dwindling supply associated with the event horizon. This raises the question of whether the blackbody of CMB at recombination can remain so over time. Being able to explain the blackbody nature of the observed CMB is an import part of the success of the Big Bang model. The present results cast some doubts on that and suggest that the model may have an additional challenge to deal with.Keywords: blackbody of CMB, CMB radiation, dwindling supply of CMB, event horizon
Procedia PDF Downloads 119300 Ultra-Wideband Antennas for Ultra-Wideband Communication and Sensing Systems
Authors: Meng Miao, Jeongwoo Han, Cam Nguyen
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Ultra-wideband (UWB) time-domain impulse communication and radar systems use ultra-short duration pulses in the sub-nanosecond regime, instead of continuous sinusoidal waves, to transmit information. The pulse directly generates a very wide-band instantaneous signal with various duty cycles depending on specific usages. In UWB systems, the total transmitted power is spread over an extremely wide range of frequencies; the power spectral density is extremely low. This effectively results in extremely small interference to other radio signals while maintains excellent immunity to interference from these signals. UWB devices can therefore work within frequencies already allocated for other radio services, thus helping to maximize this dwindling resource. Therefore, impulse UWB technique is attractive for realizing high-data-rate, short-range communications, ground penetrating radar (GPR), and military radar with relatively low emission power levels. UWB antennas are the key element dictating the transmitted and received pulse shape and amplitude in both time and frequency domain. They should have good impulse response with minimal distortion. To facilitate integration with transmitters and receivers employing microwave integrated circuits, UWB antennas enabling direct integration are preferred. We present the development of two UWB antennas operating from 3.1 to 10.6 GHz and 0.3-6 GHz for UWB systems that provide direct integration with microwave integrated circuits. The operation of these antennas is based on the principle of wave propagation on a non-uniform transmission line. Time-domain EM simulation is conducted to optimize the antenna structures to minimize reflections occurring at the open-end transition. Calculated and measured results of these UWB antennas are presented in both frequency and time domains. The antennas have good time-domain responses. They can transmit and receive pulses effectively with minimum distortion, little ringing, and small reflection, clearly demonstrating the signal fidelity of the antennas in reproducing the waveform of UWB signals which is critical for UWB sensors and communication systems. Good performance together with seamless microwave integrated-circuit integration makes these antennas good candidates not only for UWB applications but also for integration with printed-circuit UWB transmitters and receivers.Keywords: antennas, ultra-wideband, UWB, UWB communication systems, UWB radar systems
Procedia PDF Downloads 238299 Applications of Space Technology in Flood Risk Mapping in Parts of Haryana State, India
Authors: B. S. Chaudhary
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The severity and frequencies of different disasters on the globe is increasing in recent years. India is also facing the disasters in the form of drought, cyclone, earthquake, landslides, and floods. One of the major causes of disasters in northern India is flood. There are great losses and extensive damage to the agricultural crops, property, human, and animal life. This is causing environmental imbalances at places. The annual global figures for losses due to floods run into over 2 billion dollar. India is a vast country with wide variations in climate and topography. Due to widespread and heavy rainfall during the monsoon months, floods of varying magnitude occur all over the country during June to September. The magnitude depends upon the intensity of rainfall, its duration and also the ground conditions at the time of rainfall. Haryana, one of the agriculturally dominated northern states is also suffering from a number of disasters such as floods, desertification, soil erosion, land degradation etc. Earthquakes are also frequently occurring but of small magnitude so are not causing much concern and damage. Most of the damage in Haryana is due to floods. Floods in Haryana have occurred in 1978, 1988, 1993, 1995, 1998, and 2010 to mention a few. The present paper deals with the Remote Sensing and GIS applications in preparing flood risk maps in parts of Haryana State India. The satellite data of various years have been used for mapping of flood affected areas. The Flooded areas have been interpreted both visually and digitally and two classes-flooded and receded water/ wet areas have been identified for each year. These have been analyzed in GIS environment to prepare the risk maps. This shows the areas of high, moderate and low risk depending on the frequency of flood witness. The floods leave a trail of suffering in the form of unhygienic conditions due to improper sanitation, water logging, filth littered in the area, degradation of materials and unsafe drinking water making the people prone to many type diseases in short and long run. Attempts have also been made to enumerate the causes of floods. The suggestions are given for mitigating the fury of floods and proper management issues related to evacuation and safe places nearby.Keywords: flood mapping, GIS, Haryana, India, remote sensing, space technology
Procedia PDF Downloads 209298 The Impact of COVID-19 on Italian Tourism: the Current Scenario, Opportunity and Future Tourism Organizational Strategies
Authors: Marco Camilli
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This article examines the impact of the pandemic outbreak of COVID-19 in the tourism sector in Italy, analyzing the current scenario, the government decisions and the private company reaction for the summer season 2020. The framework of the data analyzed shows how massive it’s the impact of the pandemic outbreak in the tourism revenue, and the weaknesses of the measures proposed. Keywords Travel &Tourism, Transportation, Sustainability, COVID-19, Businesses Introduction The current COVID-19 scenario shows a shocking situation for the tourism and transportation sectors: it could be the most affected by the Coronavirus in Italy. According to forecasts, depending on the duration of the epidemic outbreak and the lockdown strategy applied by the Government, businesses in the supply chain could lose between 24 and 66 billion in turnover in the period of 2020-21, with huge diversified impacts at the national and regional level. Many tourist companies are on the verge of survival and if there are no massive measures by the government they risk closure. Data analysis The tourism and transport sector could be among the sectors most damaged by Covid-19 in Italy. Considering the two-year period 2020-21, companies operating in the travel & tourism sector (Tour operator, Travel Agencies, Hotel, Guides, Bus Company, etc..) could in suffer losses in revenues of 24 to 64 billion euros, especially in the sectors such as the travel agencies, hotel and rental. According to Statista Research Department, from April 2020 estimated that the coronavirus (COVID-19) pandemic will have a significant impact on revenues of the tourism industry in Italy. Revenues are expected to decrease by over 40 billion euros in the first semester of 2020, compared to the same period of the previous year. According to the study, hotel and non-hotel accommodations will experience the highest loss. Revenues of this sector are expected to decrease by 13 billion euros compared to the first semester of 2019 when accommodations registered revenues for about 17 billion euros. According to Statista.com, in 2020, Italy is expected to register a decrease of roughly 28.5 million tourist arrivals due to the impact of coronavirus (COVID-19) on the country's tourist sector. According to the estimate, the region of Veneto will record the highest drop with a decrease of roughly 4.61 million arrivals. Similarly, Lombardy is expected to register a decrease of about 3.87 million arrivals in 2020.Keywords: travel and tourism, sustainability, COVID-19, businesses, transportation
Procedia PDF Downloads 200297 High Physical Properties of Biochar Issued from Cashew Nut Shell to Adsorb Mycotoxins (Aflatoxins and Ochratoxine A) and Its Effects on Toxigenic Molds
Authors: Abderahim Ahmadou, Alfredo Napoli, Noel Durand, Didier Montet
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Biochar is a microporous and adsorbent solid carbon product obtained from the pyrolysis of various organic materials (biomass, agricultural waste). Biochar is distinguished from vegetable charcoal by its manufacture methods. Biochar is used as the amendment in soils to give them favorable characteristics under certain conditions, i.e., absorption of water and its release at low speed. Cashew nuts shell from Mali is usually discarded on land by local processors or burnt as a mean for waste management. The burning of this biomass poses serious socio-environmental problems including greenhouse gas emission and accumulation of tars and soot on houses closed to factories, leading to neighbor complaints. Some mycotoxins as aflatoxins are carcinogenic compounds resulting from the secondary metabolism of molds that develop on plants in the field and during their conservation. They are found at high level on some seeds and nuts in Africa. Ochratoxin A, member of mycotoxins, is produced by various species of Aspergillus and Penicillium. Human exposure to Ochratoxin A can occur through consumption of contaminated food products, particularly contaminated grain, as well as coffee, wine grapes. We showed that cashew shell biochars produced at 400, 600 and 800°C adsorbed aflatoxins (B1, B2, G1, G2) at 100% by filtration (rapid contact) as well as by stirring (long contact). The average percentage of adsorption of Ochratoxin A was 35% by filtration and 80% by stirring. The duration of the biochar-mycotoxin contact was a significant parameter. The effect of biochar was also tested on two strains of toxigenic molds: Aspergillus parasiticus (producers of Aflatoxins) and Aspergillus carbonarius (producers of Ochratoxins). The growth of the strain Aspergillus carbonarius was inhibited at up to 60% by the biochar at 600°C. An opposite effect to the inhibition was observed on Aspergillus parasiticus using the same biochar. In conclusion, we observed that biochar adsorbs mycotoxins: Aflatoxins and Ochratoxin A to different degrees; 100% adsorption of aflatoxins under all conditions (filtration and stirring) and adsorption of Ochratoxin A varied depending on the type of biochar and the experiment conditions (35% by filtration and 85% by stirring). The effects of biochar at 600 °C on the toxigenic molds: Aspergillus parasiticus and Aspergillus carbonarius, varied according to the experimental conditions and the strains. We observed an opposite effect on the growth with an inhibition of Aspergillus carbonarius up to 60% and a stimulated growth of Aspergillus parasiticus.Keywords: biochar, cashew nut shell, mycotoxins, toxicogenic molds
Procedia PDF Downloads 195296 Analytical and Numerical Studies on the Behavior of a Freezing Soil Layer
Authors: X. Li, Y. Liu, H. Wong, B. Pardoen, A. Fabbri, F. McGregor, E. Liu
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The target of this paper is to investigate how saturated poroelastic soils subject to freezing temperatures behave and how different boundary conditions can intervene and affect the thermo-hydro-mechanical (THM) responses, based on a particular but classical configuration of a finite homogeneous soil layer studied by Terzaghi. The essential relations on the constitutive behavior of a freezing soil are firstly recalled: ice crystal - liquid water thermodynamic equilibrium, hydromechanical constitutive equations, momentum balance, water mass balance, and the thermal diffusion equation, in general, non-linear case where material parameters are state-dependent. The system of equations is firstly linearized, assuming all material parameters to be constants, particularly the permeability of liquid water, which should depend on the ice content. Two analytical solutions solved by the classic Laplace transform are then developed, accounting for two different sets of boundary conditions. Afterward, the general non-linear equations with state-dependent parameters are solved using a commercial code COMSOL based on finite elements method to obtain numerical results. The validity of this numerical modeling is partially verified using the analytical solution in the limiting case of state-independent parameters. Comparison between the results given by the linearized analytical solutions and the non-linear numerical model reveals that the above-mentioned linear computation will always underestimate the liquid pore pressure and displacement, whatever the hydraulic boundary conditions are. In the nonlinear model, the faster growth of ice crystals, accompanying the subsequent reduction of permeability of freezing soil layer, makes a longer duration for the depressurization of water liquid and slower settlement in the case where the ground surface is swiftly covered by a thin layer of ice, as well as a bigger global liquid pressure and swelling in the case of the impermeable ground surface. Nonetheless, the analytical solutions based on linearized equations give a correct order-of-magnitude estimate, especially at moderate temperature variations, and remain a useful tool for preliminary design checks.Keywords: chemical potential, cryosuction, Laplace transform, multiphysics coupling, phase transformation, thermodynamic equilibrium
Procedia PDF Downloads 80295 Medical Complications in Diabetic Recipients after Kidney Transplantation
Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy
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Diabetes mellitus is the most common etiology of end-stage renal disease (ESRD). Also, diabetic nephropathy is the etiology of ESRD in approximately 23% of kidney transplant recipients. A successful kidney transplant improves the quality of life and reduces the mortality risk for most patients. However, patients require close follow-up after transplantation due to medical complications. Diabetes mellitus can affect patient morbidity and mortality due to possible effects of immunosuppressive therapy on glucose metabolism. We compared the frequency of medical complications and the outcomes in diabetic and non-diabetic kidney transplant recipients. Materials and Methods: This retrospective study conducted in 498 patients who underwent kidney transplant surgery at our center in 10-year periods. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). The medical complications, graft functions, causes of graft loss and death were obtained from medical records. Results: There was no significant difference between recipient age, duration of dialysis, body mass index, gender, donor type, donor age, dialysis type, histories of HBV, HCV and coronary artery disease between two groups. The history of hypertension in diabetics was higher (69% vs. 36%, p < 0.001). The ratios of hypertension (50.1% vs. 57.1%), pneumonia (21.9% vs. 20%), urinary infection (16.9% vs. 20%), transaminase elevation (11.5% vs. 20%), hyperpotasemia (14.7% vs. 17.1%), hyponatremia (9.7% vs. 20%), hypotension (7.1% vs. 7.9%), hypocalcemia (1.4% vs. 0%), thrombocytopenia (8.6% vs. 8.6%), hypoglycemia (0.7% vs. 0%) and neutropenia (1.8% vs. 0%) were comparable in non-diabetic and diabetic groups, respectively. The frequency of hyperglycaemia in diabetics was higher (8.6% vs. 54.3%, p < 0.001). After transplantation, primary non-function (3.4% vs. 2.6%), delayed graft function (25.1% vs. 34.2%) and acute rejection (7.3% vs. 10.5%) ratios of in non-diabetic and diabetic groups were similar, respectively. Hospitalization durations in non-diabetics and diabetics were 22.5 ± 17.5 and 18.7 ± 13 day (p=0.094). Mean serum creatinine levels in non-diabetics and diabetics were 1.54 ± 0.74 and 1.52 ± 0.62 mg/dL at 6th month. Forty patients had graft loss. The ratios of graft loss and death in non-diabetic and diabetic groups were 8.2% vs. 7.1% and 7.1% vs. 2.6% (p > 0.05). There was no significant relationship between graft and patient survivals with the development of medical complication. Conclusion: As a result, medical complications are common in the early period. Hyperglycaemia was frequently seen following transplantation due to the effects of immunosuppressant regimens. However, the frequency of other medical complications in diabetic patients did not differ from non-diabetic one. The most important cause of death is still infections. The development of medical complications during the first 6 months did not significantly affect transplant outcomes.Keywords: kidney transplantation, diabetes mellitus, complication, graft function
Procedia PDF Downloads 330294 Bioefficacy of Ocimum sanctum on Survival, Development and Reproduction of Dengue Vector Aedes aegypti L. (Diptera: Culicidae)
Authors: Mohd Shazad, K. K. Gupta
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Vector borne diseases are a serious global concern. Aedes aegypti, the primary vector for viruses that cause dengue fever, dengue haemorrhagic fever, chikungunya and yellow fever is widespread over large areas of the tropics and subtropics. In last decade, diseases transmitted by Aedes aegypti are of serious concern. In past decade, number of cases of dengue fever, dengue hemorrhagic fever, and chikungunya has increased multifold. Present research work focused on impact of ethanol extract of Ocimum sanctum on dengue vector Aedes aegypti. 0-24 hr. old fourth instar larvae of lab-bred population of Aedes aegypti were exposed to ethanol leaf extract of Ocimum with concentrations ranging from 50 ppm to 400 ppm. Survival and development and the treated larvae and reproductive behaviour of the adults emerged from the treated larvae was evaluated. Our results indicated larvicidal potential of the leaf ethanol extract. The influence of the extract was dose dependent. 77.2% mortality was observed in the larvae exposed to 400 ppm for 24 hr. Treatment at lower concentrations revealed delayed toxicity. The larvae survived after treatment showed severe developmental anomalies. Consequently, there was the significant increase in duration of fourth instar larva. The L4 treated with 400-ppm extract moulted after 4.6 days; this was in sharp contrast to control where the larval period of the fourth instar lasts three days. The treated fourth instar larvae in many cases transformed into larva-pupa intermediates with the combination of larva, pupa characters. The larva-pupa intermediates had reduced life span and failed to moult successfully. The adults emerged from the larvae treated with lower doses had reduced reproductive potential. The females exhibited longer preoviposition period, reduced oviposition rate, abnormal oviposition behaviour and decreased fertility. Our studies indicated the possibility of the presence of JH mimic or JH analogue in the leaf ethanol extract of Ocimum. The present research work explored the potentials of Ocimum sanctum, also known as the queen of herbs, in integrated vector management programme of Aedes aegypti, which is a serious threat to human health.Keywords: Aedes aegypti, development, mortality, Ocimum sanctum reproduction
Procedia PDF Downloads 244293 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
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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 185292 Implementation of Enhanced Recovery after Cesarean Section at Koidu Government Hospital, Sierra Leone 2024. A Quality Improvement Project
Authors: Hailemariam Getachew, John Sandi, Isata Dumbuya, Patricia Efe.Azikiwe, Evaline Nginge, Moses Mugisha, Eseoghene Dase, Foday Mandaray, Grace Moore
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Enhanced recovery after cesarean section (ERAC) is a standardized peri- operative care program that comprises the multidisciplinary team's collective efforts working in collaboration throughout the peri-operative period with the principal goal to improve quality of surgical care, decrease surgical related complications, and increasing patient satisfaction. Objective: The main objective of this project is to improve the implementation of enhanced recovery after cesarean section at Koidu Government hospital. Identified gap: Even though the hospital is providing comprehensive maternal and child care service, there are gaps in the implementation of ERAC. According to our survey, we found that there is low (13.3%) utilization of WHO surgical safety checklist, only limited (15.9%) patients get opioid free analgesia, pain was not recorded as a vital sign, there is no standardized checklist for hand over to and from Post Anesthesia care Unit(PACU). Furthermore, there is inconsistent evidence based post-operative care and there is no local consensus protocol and guideline as well. Implementation plan: we aimed at designing standardized protocol, checklist and guideline, provide training, build staff capacity, document pain as vital sign, perform regional analgesia, and provide evidence based post-operative care, monitoring and evaluation. Result: Data from 389 cesarean mothers showed that, Utilization of the WHO surgical safety check list found to be 95%, and pain assessment and documentation was done for all surgical patients. Oral feeding, ambulation and catheter removal was performed as per the ERAC standard for all patients. Postoperative complications drastically decreased from 13.6% to 8.1%. While, the rate of readmission was kept below 1%. Furthermore, the duration of hospital stay decreased from 4.64 days to 3.12 days. Conclusion The successful implementation of ERAC protocols demonstrates through this Quality Improvement Project that, the effectiveness of the protocols in improving recovery and patient outcome following cesarean section.Keywords: cesarean delivery, enhanced recovery, quality improvement, patient outcome
Procedia PDF Downloads 11291 An Evaluation of the Use of Telematics for Improving the Driving Behaviours of Young People
Authors: James Boylan, Denny Meyer, Won Sun Chen
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Background: Globally, there is an increasing trend of road traffic deaths, reaching 1.35 million in 2016 in comparison to 1.3 million a decade ago, and overall, road traffic injuries are ranked as the eighth leading cause of death for all age groups. The reported death rate for younger drivers aged 16-19 years is almost twice the rate reported for older drivers aged 25 and above, with a rate of 3.5 road traffic fatalities per annum for every 10,000 licenses held. Telematics refers to a system with the ability to capture real-time data about vehicle usage. The data collected from telematics can be used to better assess a driver's risk. It is typically used to measure acceleration, turn, braking, and speed, as well as to provide locational information. With the Australian government creating the National Telematics Framework, there has been an increase in the government's focus on using telematics data to improve road safety outcomes. The purpose of this study is to test the hypothesis that improvements in telematics measured driving behaviour to relate to improvements in road safety attitudes measured by the Driving Behaviour Questionnaire (DBQ). Methodology: 28 participants were recruited and given a telematics device to insert into their vehicles for the duration of the study. The participant's driving behaviour over the course of the first month will be compared to their driving behaviour in the second month to determine whether feedback from telematics devices improves driving behaviour. Participants completed the DBQ, evaluated using a 6-point Likert scale (0 = never, 5 = nearly all the time) at the beginning, after the first month, and after the second month of the study. This is a well-established instrument used worldwide. Trends in the telematics data will be captured and correlated with the changes in the DBQ using regression models in SAS. Results: The DBQ has provided a reliable measure (alpha = .823) of driving behaviour based on a sample of 23 participants, with an average of 50.5 and a standard deviation of 11.36, and a range of 29 to 76, with higher scores, indicating worse driving behaviours. This initial sample is well stratified in terms of gender and age (range 19-27). It is expected that in the next six weeks, a larger sample of around 40 will have completed the DBQ after experiencing in-vehicle telematics for 30 days, allowing a comparison with baseline levels. The trends in the telematics data over the first 30 days will be compared with the changes observed in the DBQ. Conclusions: It is expected that there will be a significant relationship between the improvements in the DBQ and the trends in reduced telematics measured aggressive driving behaviours supporting the hypothesis.Keywords: telematics, driving behavior, young drivers, driving behaviour questionnaire
Procedia PDF Downloads 106290 Coulomb-Explosion Driven Proton Focusing in an Arched CH Target
Authors: W. Q. Wang, Y. Yin, D. B. Zou, T. P. Yu, J. M. Ouyang, F. Q. Shao
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High-energy-density state, i.e., matter and radiation at energy densities in excess of 10^11 J/m^3, is related to material, nuclear physics, astrophysics, and geophysics. Laser-driven particle beams are better suited to heat the matter as a trigger due to their unique properties of ultrashort duration and low emittance. Compared to X-ray and electron sources, it is easier to generate uniformly heated large-volume material for the proton and ion beams because of highly localized energy deposition. With the construction of state-of-art high power laser facilities, creating of extremely conditions of high-temperature and high-density in laboratories becomes possible. It has been demonstrated that on a picosecond time scale the solid density material can be isochorically heated to over 20 eV by the ultrafast proton beam generated from spherically shaped targets. For the above-mentioned technique, the proton energy density plays a crucial role in the formation of warm dense matter states. Recently, several methods have devoted to realize the focusing of the accelerated protons, involving externally exerted static-fields or specially designed targets interacting with a single or multi-pile laser pulses. In previous works, two co-propagating or opposite direction laser pulses are employed to strike a submicron plasma-shell. However, ultra-high pulse intensities, accurately temporal synchronization and undesirable transverse instabilities for a long time are still intractable for currently experimental implementations. A mechanism of the focusing of laser-driven proton beams from two-ion-species arched targets is investigated by multi-dimensional particle-in-cell simulations. When an intense linearly-polarized laser pulse impinges on the thin arched target, all electrons are completely evacuated, leading to a Coulomb-explosive electric-field mostly originated from the heavier carbon ions. The lighter protons in the moving reference frame by the ionic sound speed will be accelerated and effectively focused because of this radially isotropic field. At a 2.42×10^21 W/cm^2 laser intensity, a ballistic proton bunch with its energy-density as high as 2.15×10^17 J/m^3 is produced, and the highest proton energy and the focusing position agree well with that from the theory.Keywords: Coulomb explosion, focusing, high-energy-density, ion acceleration
Procedia PDF Downloads 344289 Created Duration and Stillness: Chinese Director Zhang Ming Images to Matrophobia Dreamland in Films
Authors: Sicheng Liu
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Zhang Ming is a never-A-listed writer-director in China who is famous for his poetic art-house filmmaking in mainland China, and his complex to spectacles of tiny places in south China. Entirely, Zhang’s works concentrate on the interconnection amongst settlement images, desirable fictional storytelling, and the dilemma of alienated interpersonal relationships. Zhang uses his pendulous camerawork to reconstruct the spectacles of his hometown and detached places in northern China, such as hometown Wushan county, lower-tier cities or remote areas that close to nature, where the old spectacles are experiencing great transformation and vanishment. Under his camera, the cities' geo-cultural and geopolitical implications which are not only a symbolic meaning that these places are not only settlements for residents to live but also representations to the abstraction of time-lapse, dimensional disorientation and revealment to people’s innerness. Zhang Ming is good at creating the essay-like expression, poetic atmosphere and vague metaphors in films, so as to show the sensitivity, aimlessness and slight anxiety of Chinese wenren (intellectuals), whose unique and objective experiences to a few aspects inside or outside their the living circumstance, typically for example, transformation of the environment, obscure expression to inner desire and aspirations, personal loneliness because of being isolated, slight anxiety to the uncertainty of life, and other mental dilemma brought by maladjustment. Also, Zhang’s works impressed the audience as slow cinemas, via creating stillness, complicity and fluidity of images and sound, by decompressing liner time passing and wandering within the enclosed loopback-space with his camera, so as to produce poeticized depiction and mysterious dimensions in films. This paper aims to summarize these mentioned features of Zhang’s films, by analyzing filmic texts and film-making styles, in order to prove an outcome that as a wenren-turned-filmmaker, Zhang Ming is good at use metaphor to create an artistic situation to depict the poetry in films and portray characteristics. In addition to this, Zhang Ming’s style relatively reflects some aesthetic features of Chinese wenren cinema.Keywords: Chinese wenren cinema, intellectuals’ awareness, slow cinema, slowness and dampness, people and environment
Procedia PDF Downloads 203288 Change of Bone Density with Treatments of Intravenous Zoledronic Acid in Patients with Osteoporotic Distal Radial Fractures
Authors: Hong Je Kang, Young Chae Choi, Jin Sung Park, Isac Kim
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Purpose: Osteoporotic fractures are an important among postmenopausal women. When osteoporotic distal radial fractures occur, osteoporosis must be treated to prevent the hip and spine fractures. Intravenous injection of Zoledronic acid is expected to improve preventing osteoporotic fractures. Many articles reported the effect of intravenous Zoledronic acid to BMD of the hip and spine fracture or non-fracture patients with low BMD. However, that with distal radial fractures has rarely been reported. Therefore, the authors decided to study the effect of Zoledronic acid in BMD score, bone union, and bone turnover markers in the patients who underwent volar plating due to osteoporotic distal radial fractures. Materials: From April 2018 to May 2022, postmenopausal women aged 55 years or older who had osteoporotic distal radial fractures and who underwent surgical treatment using volar plate fixation were included. Zoledronic acid (5mg) was injected intravenously between 3 and 5 days after surgery. BMD scores after 1 year of operation were compared with the initial scores. Bone turnover markers were measured before surgery, after 3 months, and after 1 year. Radiological follow-up was performed every 2 weeks until the bone union and at 1 year postoperatively. Clinical outcome indicators were measured one year after surgery, and the occurrence of side effects was observed. Result: Total of 23 patients were included, with a lumbar BMD T score of -2.89±0.2 before surgery to -2.27±0.3 one year after surgery (p=0.012) and a femoral neck BMD T score of -2.45±0.3 before surgery to -2.36±0.3 (p=0.041) after one year, and all were statistically significant. Measured as bone resorption markers, serum CTX-1 was 337.43±10.4 pg/mL before surgery, 160.86±8.7 pg/mL (p=0.022) after three months, and 250.12±12.7 pg/mL (p=0.031) after one year. Urinary NTX-1 was 39.24±2.2 ng/mL before surgery, 24.46±1.2 ng/mL (p=0.014) after three months and 30.35±1.6 ng/mL (p=0.042) after one year. Measured as bone formation markers, serum osteocalcin was 13.04±1.1 ng/mL before surgery, 8.84±0.7 ng/mL (p=0.037) after 3 months and 11.1±0.4 ng/mL (p=0.026) after one year. Serum bone-specific ALP was 11.24±0.9 IU/L before surgery, 8.25±0.9 IU/L (p=0.036) after three months, and 10.2±0.9 IU/L (p=0.027) after one year. All were statistically significant. All cases showed bone union within an average of 6.91±0.3 weeks without any signs of failure. Complications were found in 5 out of 23 cases (21.7%), such as headache, nausea, muscle pain, and fever. Conclusion: When Zoledronic acid was used, BMD was improved in both the spine and femoral neck. This may reduce the likelihood and subsequent morbidity of additional osteoporotic fractures. This study is meaningful in that there was no difference in the duration of bone union and radiological characteristics in patients with distal radial fractures administrated with intravenous BP early after the fractures, and improvement in BMD and bone turnover indicators was measured.Keywords: zeoldreonic acid, BMD, osteoporosis, distal radius
Procedia PDF Downloads 115287 Effects of Heat Treatment on the Mechanical Properties of Kenaf Fiber
Authors: Paulo Teodoro De Luna Carada, Toru Fujii, Kazuya Okubo
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Natural fibers have wide variety of uses (e.g., rope, paper, and building materials). One specific application of it is in the field of composite materials (i.e., green composites). Huge amount of research are being done in this field due to rising concerns in the harmful effects of synthetic materials to the environment. There are several natural fibers used in this field, one of which can be extracted from a plant called kenaf (Hibiscus cannabinus L.). Kenaf fiber is regarded as a good alternative because the plant is easy to grow and the fiber is easy to extract. Additionally, it has good properties. Treatments, which are classified as mechanical or chemical in nature, can be done in order to improve the properties of the fiber. The aim of this study is to assess the effects of heat treatment in kenaf fiber. It specifically aims to observe the effect in the tensile strength and modulus of the fiber. Kenaf fiber bundles with an average diameter of at most 100μm was used for this purpose. Heat treatment was done using a constant temperature oven with the following heating temperatures: (1) 160̊C, (2) 180̊C, and (3) 200̊C for a duration of one hour. As a basis for comparison, tensile test was first done to kenaf fibers without any heat treatment. For every heating temperature, three groups of samples were prepared. Two groups of which were for doing tensile test (one group was tested right after heat treatment while the remaining group was kept inside a closed container with relative humidity of at least 95% for two days). The third group was used to observe how much moisture the treated fiber will absorb when it is enclosed in a high moisture environment for two days. The results showed that kenaf fiber can retain its tensile strength when heated up to a temperature of 160̊C. However, when heated at a temperature of about 180̊C or higher, the tensile strength decreases significantly. The same behavior was observed for the tensile modulus of the fiber. Additionally, the fibers which were stored for two days absorbed nearly the same amount of moisture (about 20% of the dried weight) regardless of the heating temperature. Heat treatment might have damaged the fiber in some way. Additional test was done in order to see if the damage due to heat treatment is attributed to changes in the viscoelastic property of the fiber. The findings showed that kenaf fibers can be heated for at most 160̊C to attain good tensile strength and modulus. Additionally, heating the fiber at high temperature (>180̊C) causes changes in its viscoelastic property. The results of this study is significant for processes which requires heat treatment not only in kenaf fiber but might also be helpful for natural fibers in general.Keywords: heat treatment, kenaf fiber, natural fiber, mechanical properties
Procedia PDF Downloads 353286 Uniform and Controlled Cooling of a Steel Block by Multiple Jet Impingement and Airflow
Authors: E. K. K. Agyeman, P. Mousseau, A. Sarda, D. Edelin
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During the cooling of hot metals by the circulation of water in canals formed by boring holes in the metal, the rapid phase change of the water due to the high initial temperature of the metal leads to a non homogenous distribution of the phases within the canals. The liquid phase dominates towards the entrance of the canal while the gaseous phase dominates towards the exit. As a result of the different thermal properties of both phases, the metal is not uniformly cooled. This poses a problem during the cooling of moulds, where a uniform temperature distribution is needed in order to ensure the integrity of the part being formed. In this study, the simultaneous use of multiple water jets and an airflow for the uniform and controlled cooling of a steel block is investigated. A circular hole is bored at the centre of the steel block along its length and a perforated steel pipe is inserted along the central axis of the hole. Water jets that impact the internal surface of the steel block are generated from the perforations in the steel pipe when the water within it is put under pressure. These jets are oriented in the opposite direction to that of gravity. An intermittent airflow is imposed in the annular space between the steel pipe and the surface of hole bored in the steel block. The evolution of the temperature with respect to time of the external surface of the block is measured with the help of thermocouples and an infrared camera. Due to the high initial temperature of the steel block (350 °C), the water changes phase when it impacts the internal surface of the block. This leads to high heat fluxes. The strategy used to control the cooling speed of the block is the intermittent impingement of its internal surface by the jets. The intervals of impingement and of non impingement are varied in order to achieve the desired result. An airflow is used during the non impingement periods as an additional regulator of the cooling speed and to improve the temperature homogeneity of the impinged surface. After testing different jet positions, jet speeds and impingement intervals, it’s observed that the external surface of the steel block has a uniform temperature distribution along its length. However, the temperature distribution along its width isn’t uniform with the maximum temperature difference being between the centre of the block and its edge. Changing the positions of the jets has no significant effect on the temperature distribution on the external surface of the steel block. It’s also observed that reducing the jet impingement interval and increasing the non impingement interval slows down the cooling of the block and improves upon the temperature homogeneity of its external surface while increasing the duration of jet impingement speeds up the cooling process.Keywords: cooling speed, homogenous cooling, jet impingement, phase change
Procedia PDF Downloads 125285 The Analysis of Movement Pattern during Reach and Grasp in Stroke Patients: A Kinematic Approach
Authors: Hyo Seon Choi, Ju Sun Kim, DY Kim
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Introduction: This study was aimed to evaluate temporo-spatial patterns during the reach and grasp task in hemiplegic stroke patients and to identify movement pattern according to severity of motor impairment. Method: 29 subacute post-stroke patients were enrolled in this study. The temporo-spatial and kinematic data were obtained during reach and grasp task through 3D motion analysis (VICON). The reach and grasp task was composed of four sub-tasks: reach (T1), transport to mouth (T2), transport back to table (T3) and return (T4). The movement time, joint angle and sum of deviation angles from normative data were compared between affected side and unaffected side. They were also compared between two groups (mild to moderate group: 28~66, severe group: 0~27) divided by upper-Fugl-Meyer Assessment (FMA) scale. Result: In affected side, total time and durations of all four tasks were significantly longer than those in unaffected side (p < 0.001). The affected side demonstrated significant larger shoulder abduction, shoulder internal rotation, wrist flexion, wrist pronation, thoracic external rotation and smaller shoulder flexion during reach and grasp task (p < 0.05). The significant differences between mild to moderate group and severe group were observed in total duration, durations of T1, T2, and T3 in reach and grasp task (p < 0.01). The severe group showed significant larger shoulder internal rotation during T2 (p < 0.05) and wrist flexion during T2, T3 (p < 0.05) than mild to moderate group. In range of motion during each task, shoulder abduction-adduction during T2 and T3, shoulder internal-external rotation during T2, elbow flexion-extension during T1 showed significant difference between two groups (p < 0.05). The severe group had significant larger total deviation angles in shoulder internal-external rotation and wrist extension-flexion during reach and grasp task (p < 0.05). Conclusion: This study suggests that post-stroke hemiplegic patients have an unique temporo-spatial and kinematic patterns during reach and grasp task, and the movement pattern may be related to affected upper limb severity. These results may be useful to interpret the motion of upper extremity in stroke patients.Keywords: Fugl-Meyer Assessment (FMA), motion analysis, reach and grasp, stroke
Procedia PDF Downloads 238284 Health Behaviors Related to Preventing Disease of Hand Foot and Mouth Disease of Child Caregivers in Child Development Center Ubon Ratchathani Province, Thailand
Authors: Comsun Thongchai, Vorapoj Promasatayaprot
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Background: Child development center is a day care center that gathers large numbers of children in the same areas. As a result, it provides high opportunity for infection, especially gastrointestinal and respiratory infections. Ubon Ratchathani has been a province with an increasing number of cases of Hand foot and mouth disease each year reported between 2014 and 2016. Accorded to a recent investigation reported, HFMD occurred in the Child Development Center and kindergartens, this was a place where HFMD spreads. This research was aimed to investigate the knowledge, attitude and behavior about hand foot and mouth disease preventing of child caregivers in child development centers, Ubon Ratchathani Province. Method: Descriptive study was conducted between April and July, 2017. The study instruments used questionnaires and in-depth interviews on their practices of prevention and environment management of HFMD. The samples of survey questionnaires were caregivers who are working in 160 child development centers of the 160 parishes in Ubon Ratchathani province. The data was analyzed by percentages, means and standard deviations and Pearson Product Moment Correlation Coefficient. Result: The results showed that the majority were female (96.3%), average age 41 years (68.3%), marital status were couples (85.7%) and studied in undergraduate (75.2%). with a period of performance as teachers in child development centers range from 10 to 14 years were percentage 58.7 and 71.8 percent of them had been trained by health worker about the control HFMD. The knowledge for preventive in hand foot mouth disease on child caregivers was at high level. The mean score was 2.76 (S.D. = 0.114). The attitude of child caregivers was at a moderate level. Its mean score was 2.28 (S.D. = 0.247). On the other hand, the level of environmental management to prevent HFMD was low. The mean score was 1.34 (S.D. = 0.215). The factor of personal characteristics as gender, age, educational level, duration at work, knowledge and attitude of preventive HFMD was associated with Preventive of Behaviors to a statistically significant level (p<0.05 respectively). Conclusion: These results should be concerned to develop knowledge and improving practice for preventive hand foot mouth disease of child caregivers in child development centers by training. Preparation of media education, Surveillance of hand foot mouth disease and health behaviors promotion with community participation need to be supported continuously.Keywords: preventive behavior, child development center, hand foot mouth disease, Thailand
Procedia PDF Downloads 196283 Course Perceiving Differences among College Science Students from Various Cultures: A Case Study in the US
Authors: Yuanyuan Song
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Background: As we all know, culture plays a pivotal role in the realm of education, influencing study perceptions and outcomes. Nevertheless, there remains a need to delve into how culture specifically impacts the perception of courses. Therefore, the impact of culture on students' perceptions and academic performance is explored in this study. Drawing from cultural constructionism and conflict theories, it is posited that when students hailing from diverse cultures and backgrounds converge in the same classroom, their perceptions of course content may diverge significantly. This study seeks to unravel the tangible disparities and ascertain how cultural nuances shape students' perceptions of classroom content when encountering diverse cultural contexts within the same learning environment. Methodology: Given the diverse cultural backgrounds of students within the US, this study draws upon data collected from a course offered by a US college. In pursuit of answers to these inquiries, a qualitative approach was employed, involving semi-structured interviews conducted in a college-level science class in the US during 2023. The interviews encompassed approximately nine questions, spanning demographic particulars, cultural backgrounds, science learning experiences, academic outcomes, and more. Participants were exclusively drawn from science-related majors, with each student originating from a distinct cultural context. All participants were undergraduates, and most of them were from eighteen to twenty-five years old, totaling six students who attended the class and willingly participated in the interviews. The duration of each interview was approximately twenty minutes. Results: The findings gleaned from the interview data underscore the notable impact of varying cultural contexts on students' perceptions. This study argues that female science students, for instance, are influenced by gender dynamics due to the predominant male presence in science majors, creating an environment where female students feel reticent about expressing themselves in public. Students of East Asian origin exhibit a stronger belief in the efficacy of personal efforts when contrasted with their North American counterparts. Minority students indicated that they grapple with integration into the predominantly white mainstream society, influencing their eagerness to engage in classroom activities that are conducted by white professors. All of them emphasized the importance of learning science.Keywords: multiculture education, educational sociology, educational equality, STEM education
Procedia PDF Downloads 60282 A Pilot Randomized Controlled Trial of a Physical Activity Intervention in a Low Socioeconomic Population: Focus on Mental Contrasting with Implementation Intentions
Authors: Shaun G. Abbott, Rebecca C. Reynolds, John B. F. de Wit
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Low physical activity (PA) levels are a major public health concern in Australia. There is some evidence that PA interventions can increase PA levels via various methods, including online delivery. Low Socioeconomic Status (SES) people participate in less PA than the rest of the population, partly due to poor self-regulation behaviors associated with socioeconomic characteristics. Interventions that involve a particular method of self-regulation, Mental Contrasting with Implementation Intentions (MCII), has regularly achieved healthy behavior change, but few studies focus on PA behavior outcomes and no studies examining the effect of MCII on the PA behaviors of low SES people has been done. In this study, a pilot randomized controlled trial (RCT) will deliver MCII for PA behavior change to individuals of relative disadvantage for the first time. The current pilot study will predict sample size for a future full RCT and test the hypothesis that sedentary participants from areas of relative socioeconomic disadvantage of Sydney, who learn the MCII technique will be more physically active, have improved anthropometry and psychological indicators at the completion of a 12-week intervention compared to baseline and control. Eligible participants of relative socioeconomic disadvantage will be randomly assigned to either the ‘PA Information Plus MCII Intervention Group’ or a ‘PA Information-Only Control Group’. Both groups will attend a baseline and 12-week face-to-face consultation; where PA, anthropometric and psychological data will be gathered. The intervention group will be guided through an MCII session at the baseline appointment to establish a PA goal to aim to achieve over 12 weeks. Other than these baseline and 12-week consultations, all participant interaction will occur online. All participants will receive a ‘Fitbit’ accelerometer to record objectively. PA as a daily step count, along with a PA diary for the duration of the study. PA data will be recorded on a personalized online spreadsheet. Both groups will receive a standard PA information email at weeks 2, 4, and 8. The intervention group will also receive scripted follow-up online appointments to discuss goal progress. The current pilot study is in recruitment stage with findings to be presented at the conference in December if selected.Keywords: implementation intentions, mental contrasting, motivation, pedometer, physical activity, socioeconomic
Procedia PDF Downloads 306281 Factors Contributing to Adverse Maternal and Fetal Outcome in Patients with Eclampsia
Authors: T. Pradhan, P. Rijal, M. C. Regmi
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Background: Eclampsia is a multisystem disorder that involves vital organs and failure of these may lead to deterioration of maternal condition and hypoxia and acidosis of fetus resulting in high maternal and perinatal mortality and morbidity. Thus, evaluation of the contributing factors for this condition and its complications leading to maternal deaths should be the priority. Formulating the plan and protocol to decrease these losses should be our goal. Aims and Objectives: To evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia and to correlate the risk factors associated with maternal and fetal morbidity and mortality. Methods: All patients with eclampsia admitted in Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to patients, and attendants like Antenatal clinic visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate and the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition like maternal Intensive Care Unit admission, neurological impairment and mortality were noted before discharge. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS 11). Mean and percentage were calculated for demographic variables. Pearson’s correlation test and chi-square test were applied to find the relation between the risk factors and the outcomes. P value less than 0.05 was considered significant. Results: There were 10,000 antenatal deliveries during the study period. Fifty-two patients with eclampsia were admitted. All of the patients were unbooked for our institute. Thirty-nine patients were antepartum eclampsia. Thirty-one patients required mechanical ventilator support. Twenty-four patients were delivered by emergency c-section and 21 babies were Low Birth Weight and there were 9 stillbirths. There was one maternal mortality and 45 patients were discharged with improvement but 3 patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate. Conclusion: Early detection and management of hypertensive complicating pregnancy during antenatal clinic check up. Early hospitalization and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes.Keywords: eclampsia, maternal mortality, perinatal mortality, risk factors
Procedia PDF Downloads 169280 Mechanisms Underlying Comprehension of Visualized Personal Health Information: An Eye Tracking Study
Authors: Da Tao, Mingfu Qin, Wenkai Li, Tieyan Wang
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While the use of electronic personal health portals has gained increasing popularity in the healthcare industry, users usually experience difficulty in comprehending and correctly responding to personal health information, partly due to inappropriate or poor presentation of the information. The way personal health information is visualized may affect how users perceive and assess their personal health information. This study was conducted to examine the effects of information visualization format and visualization mode on the comprehension and perceptions of personal health information among personal health information users with eye tracking techniques. A two-factor within-subjects experimental design was employed, where participants were instructed to complete a series of personal health information comprehension tasks under varied types of visualization mode (i.e., whether the information visualization is static or dynamic) and three visualization formats (i.e., bar graph, instrument-like graph, and text-only format). Data on a set of measures, including comprehension performance, perceptions, and eye movement indicators, were collected during the task completion in the experiment. Repeated measure analysis of variance analyses (RM-ANOVAs) was used for data analysis. The results showed that while the visualization format yielded no effects on comprehension performance, it significantly affected users’ perceptions (such as perceived ease of use and satisfaction). The two graphic visualizations yielded significantly higher favorable scores on subjective evaluations than that of the text format. While visualization mode showed no effects on users’ perception measures, it significantly affected users' comprehension performance in that dynamic visualization significantly reduced users' information search time. Both visualization format and visualization mode had significant main effects on eye movement behaviors, and their interaction effects were also significant. While the bar graph format and text format had similar time to first fixation across dynamic and static visualizations, instrument-like graph format had a larger time to first fixation for dynamic visualization than for static visualization. The two graphic visualization formats yielded shorter total fixation duration compared with the text-only format, indicating their ability to improve information comprehension efficiency. The results suggest that dynamic visualization can improve efficiency in comprehending important health information, and graphic visualization formats were favored more by users. The findings are helpful in the underlying comprehension mechanism of visualized personal health information and provide important implications for optimal design and visualization of personal health information.Keywords: eye tracking, information comprehension, personal health information, visualization
Procedia PDF Downloads 108279 Prevalence and Factors Associated with Illicit Drug Use Among Undergraduate Students in the University of Lagos, Nigeria
Authors: Abonyi, Emmanuel Ebuka, Amina Jafaru O.
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Background: Illicit substance use among students is a phenomenon that has been widely studied, but it remains of interest due to its high prevalence and potential consequences. It is a major mental health concern among university students which may result in behavioral and academic problems, psychiatric disorders, and infectious diseases. Thus, this study was done to ascertain the prevalence and factors associated with the use of illicit drugs among these groups of people. Methods: A cross-sectional and descriptive survey was conducted among undergraduate students of the University of Lagos for the duration of three(3) months (August to October 2021). A total number of 938 undergraduate students were selected from seventeen faculties in the university. Pretested questionnaires were administered, completed, and returned. The data were analyzed using descriptive statistics and multivariate regression analysis. Results: From the data collected, it was observed that out of 938 undergraduate students of the University of Lagos that completed and returned the questionnaires, 56.3% were female and 43.7% were male. No gender differences were observed in the prevalence of use of any of the illicit substances. The result showed that the majority of the students that participated in the research were females(56.6%); it was observed that there were a total of 541 2nd-year students(57.7%) and 397 final-year students(42.3). Students between the age brackets of 20- 24 years had the highest frequency of 648(69.1%) of illicit drug use and students in none health-related disciplines. The result also showed that the majority of the students reported that they use Marijuana (31.7%), while lifetime use of LSD (6.3%), Heroin(4.8%), Cocaine (4.7%), and Ecstasy(4.5), Ketamine (3.4%). Besides, the use of alcohol was below average(44.1%). Additionally, Marijuana was among the ones that were mostly taken by students having a higher percentage and most of these respondents had experienced relationship problems with their family and intentions (50.9%). From the responses obtained, major reasons students indulge in illicit drug use were; curiosity to experiment, relief of stress after rigorous academic activities, social media influence, and peer pressure. Most Undergraduate students are in their most hyperactive stage in life, which makes them vulnerable to always want to explore practically every adventure. Hence, individual factors and social media influence are identified as major contributors to the prevalence of illicit drug use among undergraduate students at the University of Lagos, Nigeria. Conclusion: Control programs are most needed among the students. They should be comprehensive and focused on students' psycho-education about substances and their related negative consequences, plus the promotion of students' life skills, and integration into the family – and peer-based preventive interventions.Keywords: illicit drugs, addiction, undergraduate students, prevalence, substances
Procedia PDF Downloads 104278 Analysis of Delays during Initial Phase of Construction Projects and Mitigation Measures
Authors: Sunaitan Al Mutairi
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A perfect start is a key factor for project completion on time. The study examined the effects of delayed mobilization of resources during the initial phases of the project. This paper mainly highlights the identification and categorization of all delays during the initial construction phase and their root cause analysis with corrective/control measures for the Kuwait Oil Company oil and gas projects. A relatively good percentage of the delays identified during the project execution (Contract award to end of defects liability period) attributed to mobilization/preliminary activity delays. Data analysis demonstrated significant increase in average project delay during the last five years compared to the previous period. Contractors had delays/issues during the initial phase, which resulted in slippages and progressively increased, resulting in time and cost overrun. Delays/issues not mitigated on time during the initial phase had very high impact on project completion. Data analysis of the delays for the past five years was carried out using trend chart, scatter plot, process map, box plot, relative importance index and Pareto chart. Construction of any project inside the Gathering Centers involves complex management skills related to work force, materials, plant, machineries, new technologies etc. Delay affects completion of projects and compromises quality, schedule and budget of project deliverables. Works executed as per plan during the initial phase and start-up duration of the project construction activities resulted in minor slippages/delays in project completion. In addition, there was a good working environment between client and contractor resulting in better project execution and management. Mainly, the contractor was on the front foot in the execution of projects, which had minimum/no delays during the initial and construction period. Hence, having a perfect start during the initial construction phase shall have a positive influence on the project success. Our research paper studies each type of delay with some real example supported by statistic results and suggests mitigation measures. Detailed analysis carried out with all stakeholders based on impact and occurrence of delays to have a practical and effective outcome to mitigate the delays. The key to improvement is to have proper control measures and periodic evaluation/audit to ensure implementation of the mitigation measures. The focus of this research is to reduce the delays encountered during the initial construction phase of the project life cycle.Keywords: construction activities delays, delay analysis for construction projects, mobilization delays, oil & gas projects delays
Procedia PDF Downloads 318277 Using Signature Assignments and Rubrics in Assessing Institutional Learning Outcomes and Student Learning
Authors: Leigh Ann Wilson, Melanie Borrego
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The purpose of institutional learning outcomes (ILOs) is to assess what students across the university know and what they do not. The issue is gathering this information in a systematic and usable way. This presentation will explain how one institution has engineered this process for both student success and maximum faculty curriculum and course design input. At Brandman University, there are three levels of learning outcomes: course, program, and institutional. Institutional Learning Outcomes (ILOs) are mapped to specific courses. Faculty course developers write the signature assignments (SAs) in alignment with the Institutional Learning Outcomes for each course. These SAs use a specific rubric that is applied consistently by every section and every instructor. Each year, the 12-member General Education Team (GET), as a part of their work, conducts the calibration and assessment of the university-wide SAs and the related rubrics for one or two of the five ILOs. GET members, who are senior faculty and administrators who represent each of the university's schools, lead the calibration meetings. Specifically, calibration is a process designed to ensure the accuracy and reliability of evaluating signature assignments by working with peer faculty to interpret rubrics and compare scoring. These calibration meetings include the full time and adjunct faculty members who teach the course to ensure consensus on the application of the rubric. Each calibration session is chaired by a GET representative as well as the course custodian/contact where the ILO signature assignment resides. The overall calibration process GET follows includes multiple steps, such as: contacting and inviting relevant faculty members to participate; organizing and hosting calibration sessions; and reviewing and discussing at least 10 samples of student work from class sections during the previous academic year, for each applicable signature assignment. Conversely, the commitment for calibration teams consist of attending two virtual meetings lasting up to three hours in duration. The first meeting focuses on interpreting the rubric, and the second meeting involves comparing scores for sample work and sharing feedback about the rubric and assignment. Next, participants are expected to follow all directions provided and participate actively, and respond to scheduling requests and other emails within 72 hours. The virtual meetings are recorded for future institutional use. Adjunct faculty are paid a small stipend after participating in both calibration meetings. Full time faculty can use this work on their annual faculty report for "internal service" credit.Keywords: assessment, assurance of learning, course design, institutional learning outcomes, rubrics, signature assignments
Procedia PDF Downloads 280276 Performance Assessment of the Gold Coast Desalination Plant Offshore Multiport Brine Diffuser during ‘Hot Standby’ Operation
Authors: M. J. Baum, B. Gibbes, A. Grinham, S. Albert, D. Gale, P. Fisher
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Alongside the rapid expansion of Seawater Reverse Osmosis technologies there is a concurrent increase in the production of hypersaline brine by-products. To minimize environmental impact, these by-products are commonly disposed into open-coastal environments via submerged diffuser systems as inclined dense jet outfalls. Despite the widespread implementation of this process, diffuser designs are typically based on small-scale laboratory experiments under idealistic quiescent conditions. Studies concerning diffuser performance in the field are limited. A set of experiments were conducted to assess the near field characteristics of brine disposal at the Gold Coast Desalination Plant offshore multiport diffuser. The aim of the field experiments was to determine the trajectory and dilution characteristics of the plume under various discharge configurations with production ranging 66 – 100% of plant operative capacity. The field monitoring system employed an unprecedented static array of temperature and electrical conductivity sensors in a three-dimensional grid surrounding a single diffuser port. Complimenting these measurements, Acoustic Doppler Current Profilers were also deployed to record current variability over the depth of the water column and wave characteristics. Recorded data suggested the open-coastal environment was highly active over the experimental duration with ambient velocities ranging 0.0 – 0.5 m∙s-1, with considerable variability over the depth of the water column observed. Variations in background electrical conductivity corresponding to salinity fluctuations of ± 1.7 g∙kg-1 were also observed. Increases in salinity were detected during plant operation and appeared to be most pronounced 10 – 30 m from the diffuser, consistent with trajectory predictions described by existing literature. Plume trajectories and respective dilutions extrapolated from salinity data are compared with empirical scaling arguments. Discharge properties were found to adequately correlate with modelling projections. Temporal and spatial variation of background processes and their subsequent influence upon discharge outcomes are discussed with a view to incorporating the influence of waves and ambient currents in the design of brine outfalls into the future.Keywords: brine disposal, desalination, field study, negatively buoyant discharge
Procedia PDF Downloads 239275 The Importance of Anthropometric Indices for Assessing the Physical Development and Physical Fitness of Young Athletes
Authors: Akbarova Gulnozakhon
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Relevance. Physical exercises can prolong the function of the growth zones of long tubular bones, delay the fusion of the epiphyses and diaphyses of bones and, thus, increase the growth of the body. At the same time, intensive strength exercises can accelerate the process of ossification of bone growth zones and slow down their growth in length. The influence of physical exercises on the process of biological maturation is noted. Gymnastics, which requires intense speed and strength loads, delays puberty. On the other hand, it is indicated that the relatively slow puberty of gymnasts is associated with the selection of girls with a special somatotype in this sport. It was found that the later onset of menstruation in female athletes does not have a negative effect on the maturation process and fertility (the ability to procreate). Observations are made about the normalizing influence of sports on the puberty of girls. The purpose of the study. Our goal is to study physical activity of varying intensity on the formation of secondary sexual characteristics and hormonal status of girls in adolescence. Each biological process peculiar to a given organism is not in a stationary state, but fluctuates with a certain frequency. According to the duration, there are, for example, circadian cycles, and infradian cycles, a typical example of which is the menstrual cycle. Materials and methods, results. Violations of menstrual function in athletes were detected by applying a questionnaire survey that contains several paragraphs and sub-paragraphs where passport data, anthropometric indicators, taking into account anthropometric indices, information about the menstrual cycle are indicated. Of 135 female athletes aged 1-3 to 16 years engaged in various sports - gymnasts, menstrual function disorders were noted in 86.7% (primary or secondary amenorrhea, irregular MC), in swimming-in 57.1%. The general condition also changes during the menstrual cycle. In a large percentage of cases, athletes indicate an increase in irritability in the premenstrual (45%) and menstrual (36%) phases. During these phases, girls note an increase in fatigue of 46.5% and 58% (respectively). In girls, secondary sexual characteristics continue to form during puberty and the clearest indicator of the onset of puberty is the age of the onset of the first menstruation - menarche. Conclusions. 1. Physical exercise has a positive effect on all major systems of the body and thus promotes health.2. Along with a beneficial effect on human health, physical exercise, if the requirements of sports are not observed, can be harmful.Keywords: girls health, anthropometric, physical development, reproductive health
Procedia PDF Downloads 102274 Frequency of Surgical Complications in Diabetic Patients after Kidney Transplantation
Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy
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The improvement of surgical techniques in recent years has reduced the frequency of postoperative complications in kidney transplant recipients. Novel immunosuppressive agents have reduced rates of graft loss due to acute rejection to less than 1%. However, surgical complications may still lead graft loss and morbidity in recipients. Because of potent immunosuppression, impaired wound healing and complications are frequent after transplantation. We compared the frequency of post-operative surgical complications in diabetic and non-diabetic patients after kidney transplantation. Materials and Methods: This retrospective study conducted in consecutive patients (213 females, 285 males, median age 39 years) who underwent kidney transplant surgery at our center between December 2005 and October 2015. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). Characteristics of both groups were obtained from medical records. Results: We performed 225 living and 273 deceased donor transplantations. Renal replacement type was hemodialysis in 60.8%, peritoneal dialysis in 17.3% and preemptive in 12%. The mean body mass indexes of the recipients were 24 ± 4.6 kg/m², donor age was 48.6 ± 14.3 years, cold ischemic time was 11.3 ± 6.1 hours, surgery time was 4.9 ± 1.2 hours, and recovery time was 54±31 min. The mean hospitalization duration was 19.1 ± 13.5 days. The frequency of postoperative surgical complications was 43.8%. There was no significant difference between the ratios of post-operative surgical complications in non-diabetic (43.5%) and diabetic (47.4%) groups (p=0.648). Post-operative surgical complications were lymphocele (24.6% vs. 23.7%), delayed wound healing (13.2% vs. 7.6%), hematoma (7.8% vs.15.8 %), urinary leak (4.6% vs. 5.3%), hemorrhage (5.1% vs. 0%), hydronephrosis (2.2% vs. 0%), renal artery thrombosis (1.5% vs. 0%), renal vein thrombosis (1% vs. 2.6%), urinoma (0.7% vs. 0%), urinary obstruction (0.5% vs. 0%), ureteral stenosis (0.5% vs. 0%) and ureteral reflux (0.2% vs. 0%) in non-diabetic and diabetic groups, respectively (p > 0.05). Mean serum creatinine levels in non-diabetics and diabetics were 1.43 ± 0.81 and 1.61 ± 0.96 mg/dL at 1st month (p=0.198). At the 6th month, the mean graft and patient survival times in patients with post-operative surgical complications were significantly lower than in those who did not (162.9 ± 3.4 vs. 175.6 ± 1.5 days, p=0.008, and 171 ± 2.9 vs. 176.1 ± 1.6 days, p=0.047, respectively). However, patient survival durations of non-diabetic (173 ± 27) and diabetic (177 ± 13 day) groups were comparable (p=0.396). Conclusion: As a result, we concluded that surgical complications such as lymphocele and delayed wound healing were common and that frequency of these complications in diabetic recipients did not differ from non-diabetic one. All persons involved in the postoperative care of kidney transplant recipients be aware of the potential surgical complications for rapid diagnosis and treatment.Keywords: kidney transplantation, diabetes mellitus, surgery, complication
Procedia PDF Downloads 178273 Pulmonary Complications of Dengue Infection
Authors: Shilpa Avarebeel
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Background: India is one of the seven identified countries in South-East Asia region, regularly reporting dengue infection and may soon transform into a major niche for dengue epidemics. Objective: To study the clinical profile of dengue in our setting with special reference to respiratory complication. Study design: Descriptive and exploratory study, for one year in 2014. All patients confirmed as dengue infection were followed and their clinical profile, along with outcome was determined. Study proforma was designed based on the objective of the study and it was pretested and used after modification. Data was analyzed using statistical software SPSS-Version 16. Data were expressed as mean ±S .D for parametric variables and actual frequencies or percentage for non-parametric data. Comparison between groups was done using students’ t-test for independent groups, Chie square test, one-way ANOVA test, Karl Pearson’s correlation test. Statistical significance is taken at P < 0.05. Results: Study included 134 dengue positive cases. 81% had dengue fever, 18% had dengue hemorrhagic fever, and one had dengue shock syndrome. Most of the cases reported were during the month of June. Maximum number of cases was in the age group of 26-35 years. Average duration of hospital stay was less than seven days. Fever and myalgia was present in all the 134 patients, 16 had bleeding manifestation. 38 had respiratory symptoms, 24 had breathlessness, and 14 had breathlessness and dry cough. On clinical examination of patients with respiratory symptoms, all twenty-eight had hypoxia features, twenty-four had signs of pleural effusion, and four had ARDS features. Chest x-ray confirmed the same. Among the patients with respiratory symptoms, the mean platelet count was 26,537 c/cmm. There was no statistical significant difference in the platelet count in those with ARDS and other dengue complications. Average four units of platelets were transfused to all those who had ARDS in view of bleeding tendency. Mechanical ventilator support was provided for ARDS patients. Those with pleural effusion and pulmonary oedema were given NIV (non-invasive ventilation) support along with supportive care. However, steroids were given to patients with ARDS and 10 patients with signs of respiratory distress. 100%. Mortality was seen in patients with ARDS. Conclusion: Dengue has to be checked for those presenting with fever and breathlessness. Supportive treatments remain the cornerstone of treatment. Platelet transfusion has to be given only by clinical judgment. Steroids have no role except in early ARDS, which is controversial. Early NIV support helps in speedy recovery of dengue patients with respiratory distress.Keywords: adult respiratory distress syndrome, dengue fever, non-invasive ventilation, pulmonary complication
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