Search results for: UK Acute kidney injury

Authors: P. B. Thumar

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Today’s athletes face acute and unique challenges as the competition standards are higher and tougher. There are certain moments during a competition that appear to carry great psychological significance when the momentum starts to shift in one direction or another. These situations require athletes to remain completely focused and calm in facing the difficult circumstances. The purpose of the study was to compare the Mental Toughness level among the players of the team and individual sports. Purposive sampling was done in which subjects for the present study were the male students of The M. S. University of Baroda, Vadodara studying various courses in the academic year 2014-15. Thus, a total number of 120 boys were identified and included in the study from which 60 boys had participated in individual sports and 60 in team sports. ‘The Mental Toughness Questionnaire’ prepared by Dr. Alan Goldberg was used to determine mental toughness level of the players of the team and individual sports. The scores arrived from 60 individual players and 60 team players were compared by applying the t-test. Significant difference was found on overall Mental Toughness and in subcomponents there was significant difference in ability to handle pressure, concentration and confidence whereas there was no significant difference in reboundability and motivation among team and individual sports players. This could be largely due the nature of both sports. Team players of MSU found to be having more overall mental toughness, and team players are able to handle pressure more than individual players, can concentrate more and are also more confident while playing in the team. Team preparation and training prior to competition could have increased the level of ability to handle pressure, concentration and confidence of team players.

Keywords: mental toughness, reboundability, confidence, team sports, individual sports

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Authors: Yao Song, Danni Cheng, Jianjun Ren

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Objectives: We aimed to explore the prognostic effects of absolute values and dynamic changes of common hematological indices on oropharynx squamous cell carcinoma (OPSCC) patients treated with radiation. Methods and materials: The absolute values of white blood cell (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), hemoglobin (Hb), platelet (Plt), albumin (Alb), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline (within 45 days before radiation), 1-, 3-, 6- and 12-months after the start of radiotherapy were retrospectively collected. Locally-estimated smoothing scatterplots were used to describe the smooth trajectory of each index. A mixed-effect model with a random slope was fitted to describe the changing rate and trend of indices over time. Cox proportional hazard analysis was conducted to assess the correlation between hematological indices and treatment outcomes. Results: Of the enrolled 85 OPSCC patients, inflammatory indices, such as WBC and ALC, dropped rapidly during acute treatment and gradually recovered, while NLR and PLR increased at first three months and subsequently declined within 3-12 months. Higher absolute value or increasing trend of nutritional indices (Alb and Hb) was associated with better prognosis (all p<0.05). In contrast, patients with higher absolute value or upward trend of inflammatory indices (WBC, ANC, Plt, PLR and NLR) had worse survival (all p<0.05). Conclusions: The absolute values and dynamic changes of hematological indices were valuable prognostic factors for OPSCC patients who underwent radiotherapy.

Keywords: hematological indices, oropharyngeal cancer, radiotherapy, NLR, PLR

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Authors: P. G. Siddheshwar, B. N. Veena

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Rayleigh-B´enard convection of a nanoliquid in shallow, square and tall enclosures is studied using the Khanafer-Vafai-Lightstone single-phase model. The thermophysical properties of water, copper, copper-oxide, alumina, silver and titania at 3000 K under stagnant conditions that are collected from literature are used in calculating thermophysical properties of water-based nanoliquids. Phenomenological laws and mixture theory are used for calculating thermophysical properties. Free-free, rigid-rigid and rigid-free boundary conditions are considered in the study. Intractable Lorenz model for each boundary combination is derived and then reduced to the tractable Ginzburg-Landau model. The amplitude thus obtained is used to quantify the heat transport in terms of Nusselt number. Addition of nanoparticles is shown not to alter the influence of the nature of boundaries on the onset of convection as well as on heat transport. Amongst the three enclosures considered, it is found that tall and shallow enclosures transport maximum and minimum energy respectively. Enhancement of heat transport due to nanoparticles in the three enclosures is found to be in the range 3% - 11%. Comparison of results in the case of rigid-rigid boundaries is made with those of an earlier work and good agreement is found. The study has limitations in the sense that thermophysical properties are calculated by using various quantities modelled for static condition.

Keywords: enclosures, free-free, rigid-rigid, rigid-free boundaries, Ginzburg-Landau model, Lorenz model

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Authors: Chao Sima, Shanaz Ghandhi, Sally A. Amundson, Michael L. Bittner, David J. Brenner

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In a large-scale radiologic emergency, potentially affected population need to be triaged efficiently using various biomarkers where personal dosimeters are not likely worn by the individuals. It has long been established that radiation injury can be estimated effectively using panels of genetic biomarkers. Furthermore, the rate of radiation, in addition to dose of radiation, plays a major role in determining biological responses. Therefore, a better and more accurate triage involves estimating both the dose level of the exposure and the length of time of that exposure. To that end, a large in vivo study was carried out on mice with internal emitter caesium-137 (¹³⁷Cs). Four different injection doses of ¹³⁷Cs were used: 157.5 μCi, 191 μCi, 214.5μCi, and 259 μCi. Cohorts of 6~7 mice from the control arm and each of the dose levels were sacrificed, and blood was collected 2, 3, 5, 7 and 14 days after injection for microarray RNA gene expression analysis. Using a generalized linear model with penalized maximum likelihood, a panel of 244 genes was established and both the doses of injection and the number of days after injection were accurately predicted for all 155 subjects using this panel. This has proven that microarray gene expression can be used effectively in radiation biodosimetry in predicting both the dose levels and the length of exposure time, which provides a more holistic view on radiation exposure and helps improving radiation damage assessment and treatment.

Keywords: caesium-137, gene expression microarray, multivariate responses prediction, radiation biodosimetry

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Authors: Manoj Kumar, Sujata Mohanty, D. N. Rao, Arul Selvi, Sanjeev K. Bhoi

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Background: Hematopoietic progenitor cells (HPC) mobilized from bone marrow to peripheral blood has been observed in severe trauma and hemorrhagic shock patients. Granulocyte-colony stimulating factor (G-CSF) is a potent stimulator that mobilized HPC from bone marrow to peripheral blood. Objective: Our aim of the study was to investigate the serum G-CSF levels and correlate with HPC and outcome. Methods: Peripheral blood sample from 50 hemorrhagic shock patients was collected on arrival for determination of G-CSF and peripheral blood HPC (PBHPC) and compared with healthy control (n=15). Determination of serum levels of G-CSF by sandwich ELISA and PBHPC by Sysmex XE-2100. Data were categorized by age, sex, Injury Severity Score (ISS), and laboratory data was prospectively collected. Data are expressed as mean±SD and median (min, max). Results: Significantly increased the serum level of G-CSF (264.8 vs. 79.1 pg/ml) and peripheral blood HPC (0.1 vs. 0.01 %) in the T/HS patients when compared with control group. Conclusions: Our studies suggest serum G-CSF elevated in T/HS patients. The elevated in G-CSF was also associated with mobilization of HPC from BM to peripheral blood HPC. Increased the levels of G-CSF in T/HS may play a significant role in the alteration of the hematopoietic compartment.

Keywords: granulocyte colony stimulating factor, G-CSF, hematopoietic progenitor cells, HPC, trauma hemorrhagic shock, T/HS, outcome

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Authors: Ashish Jaiswal, Ashwin Ramesh Babu, Mohammad Zaki Zadeh, Fillia Makedon, Glenn Wylie

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Functional magnetic resonance imaging (fMRI) is a neuroimaging technique that records neural activations in the brain by capturing the blood oxygen level in different regions based on the task performed by a subject. Given fMRI data, the problem of predicting the state of cognitive fatigue in a person has not been investigated to its full extent. This paper proposes tackling this issue as a multi-class classification problem by dividing the state of cognitive fatigue into six different levels, ranging from no-fatigue to extreme fatigue conditions. We built a spatio-temporal model that uses convolutional neural networks (CNN) for spatial feature extraction and a long short-term memory (LSTM) network for temporal modeling of 4D fMRI scans. We also applied a self-supervised method called MoCo (Momentum Contrast) to pre-train our model on a public dataset BOLD5000 and fine-tuned it on our labeled dataset to predict cognitive fatigue. Our novel dataset contains fMRI scans from Traumatic Brain Injury (TBI) patients and healthy controls (HCs) while performing a series of N-back cognitive tasks. This method establishes a state-of-the-art technique to analyze cognitive fatigue from fMRI data and beats previous approaches to solve this problem.

Keywords: fMRI, brain imaging, deep learning, self-supervised learning, contrastive learning, cognitive fatigue

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Authors: Maryam Zahedifard, Fadhil Lafta Faraj, Maryam Hajrezaie, Nazia Abdul Majid, Mahmood Ameen Abdulla, Hapipah Mohd Ali

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In the current study, we prepared two new quinazoline schiff bases through condensation reaction of 2-aminobenzhydrazide with 5-bromosalicylaldehyde and 3-methoxy-5-bromosalicylaldehyde. The chemical structures of both newly synthesized compounds (1 and 2) were confirmed by FT-IR and X-ray crystallography studies. The cytotoxic effect of compounds was investigated against MCF-7 human breast cancer cells. MTT results showed that (1) and (2) decreased the viability of MCF-7 cells in a time-dependent manner, exhibiting an IC50 value of 3.23 ± 0.28 µg/mL and 3.41 ± 0.34 µg/mL, respectively, after a 72-hours treatment period. In contrast, they did not show significant anti-proliferative effect towards MCF-10A normal breast cells and WRL-68 normal liver cells. We found a perturbation in mitochondrial membrane potential and increased cytochrome c release from the mitochondria to the cytosol, suggesting an activation of apoptosis by compounds, which was confirmed by activation of the initiator caspase-9 and the executioner caspases-3/7. (1) was also able to trigger extrinsic pathway via activation of caspase-8 and inhibition of NF-κB translocation. The acute toxicity test showed no toxicity effect of the compounds in rats. Our results showed that the selected synthesized compounds are highly potent to induce apoptosis in MCF-7 cells via either intrinsic or extrinsic mitochondrial pathway.

Keywords: Quinazoline Schiff base, apoptosis, MCF-7 human breast cancer cell line, caspase, NF-κB translocation

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Authors: Michael Munther, Keivan Davami

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One significant roadblock for additively manufactured (AM) parts is the buildup of residual tensile stresses during the fabrication process. These residual stresses are formed due to the intense localized thermal gradients and high cooling rates that cause non-uniform material expansion/contraction and mismatched strain profiles during powder-bed fusion techniques, such as direct metal laser sintering (DMLS). The residual stresses adversely affect the fatigue life of the AM parts. Moreover, if the residual stresses become higher than the material’s yield strength, they will lead to acute geometric distortion. These are limiting the applications and acceptance of AM components for safety-critical applications. Herein, we discuss laser shock peening method as an advanced technique for the manipulation of the residual stresses in AM parts. An X-ray diffraction technique is used for the measurements of the residual stresses before and after the laser shock peening process. Also, the hardness of the structures is measured using a nanoindentation technique. Maps of nanohardness and modulus are obtained from the nanoindentation, and a correlation is made between the residual stresses and the mechanical properties. The results indicate that laser shock peening is able to induce compressive residual stresses in the structure that mitigate the tensile residual stresses and increase the hardness of AM IN718, a superalloy, almost 20%. No significant changes were observed in the modulus after laser shock peening. The results strongly suggest that laser shock peening can be used as an advanced post-processing technique to optimize the service lives of critical components for various applications.

Keywords: additive manufacturing, Inconel 718, laser shock peening, residual stresses

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Authors: Robert C. Pritchett, Elizabeth Broad, Kelly L. Pritchett

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Individuals a with spinal cord injuries have been suggested to be at risk for a 25(OH)D insufficiency. However, little is known regarding the relationship between seasonal Vitamin D status and performance in a spinally injured athletic population. Purpose: The purpose of this study was: 1) to examine the seasonal change in 25(OH)D concentrations and 2) to determine whether 25(OH)D status impacts athletic performance in US Paralympic athletes. Methods: 25 (OH)D concentrations were measured in 11 outdoor track athletes ( 5 men/6 females), between fall (October/November) and winter(February). Dietary intake and lifestyle habits were assessed via questionnaire, and performance measurements were assessed using a 20meter sprint test. 25(OH)D concentrations were assessed using a blood spot method (ZRT Laboratory). Results: There was no significant change in 25 (OH) D concentrations across seasons (P=0.505; 31 + 6.35 ng/mL, 29 + 8.72 ng/mL (mean + SD) for Fall and Winter, respectively. In the Fall,42% of the athletes had sufficient levels (>32ng/mL), and 58% were insufficient. (20ng/mL -31ng/mL) where as the winter levels dropped with 33% being sufficient and 58% being insufficient and 1% being deficient (<20ng/mL). There was a weak but significant correlation between a change in 25(OH)D concentrations, and change in 20m sprint time (p<0.05; r=0.408). Conclusion: A substantial proportion of elite athletes with an SCI have low vitamin D status. However, results suggest there was little seasonal variation in 25(OH)D status in elite track athletes with an SCI. Furthermore, any change that was observed demonstrated a very weak relationship with a change in performance.

Keywords: 25(oh)d, performance, spinal cord injuries, elite, sprint, concentration

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Authors: Amanuel Bekuma, Rebecca Swift, Sarah Jackson, Ben Biddulph

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Economic loss to frost damage is increasing over the past years in the Western Australian Wheatbelt. Agronomic, genetic, and climatic works have still found a weak correlation between temperature and frost damage. One possibility that has not been explored within the Australian cropping system is whether ice nucleation active bacteria (INB) either present in situ on crop residue or introduced by rainfall could be responsible for the increased sensitivity of cereal plants to frost at different stages of development. This study investigated upper and lower leaf canopy, stubble, and soil as a potential site of ice nucleation activity (INA) and tracked the changes in INA during the plant development. We found that older leaves of wheat are the primary sites of ice nucleation (-4.7 to -6.3°C) followed by stubble (-5.7 to -6.7°C) which increases the risk of frost damage during heading and flowering (the most susceptible stages). However, healthy and green upper canopy leaves (flag and flag-2) and the soil have lower INA (< -11°C) during the frost-sensitive stage of wheat. We anticipate the higher INA on the stubble and older leaves to be due to the presence of biologically active ice-nucleating bacteria (INB), known to cause frost injury to sensitive plants at -5°C. Stubble retained or applied during the growing season further exacerbates additional frost risk by potentially increasing the INB load. The implications of the result for stubble and frost risk management in a frost-prone landscape will be discussed.

Keywords: frost, ice-nucleation-activity, stubble, wheat

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Authors: Andi Darmawan, Dewi Retno Sari Saputro, Purnami Widyaningsih

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Diabetes mellitus (DM) is a chronic disease in human that occurred if pancreas cannot produce enough of insulin hormone or the body uses ineffectively insulin hormone which causes increasing level of glucose in the blood, or it was called hyperglycemia. In Indonesia, DM is a serious disease on health because it can cause blindness, kidney disease, diabetic feet (gangrene), and stroke. The type of DM criteria can also be divided based on the main causes; they are DM type 1, type 2, and gestational. Diabetes type 1 or previously known as insulin-independent diabetes is due to a lack of production of insulin hormone. Diabetes type 2 or previously known as non-insulin dependent diabetes is due to ineffective use of insulin while gestational diabetes is a hyperglycemia that found during pregnancy. The most one type commonly found in patient is DM type 2. The main factors of this disease are genetic (A) and life style (E). Those disease with 2 factors can be constructed with additive genetic and unique environment (AE) model. In this article was discussed parameter estimation of AE model using Bayesian method and the inheritance character simulation on parent-offspring. On the AE model, there are response variable, predictor variables, and parameters were capable of representing the number of population on research. The population can be measured through a taken random sample. The response and predictor variables can be determined by sample while the parameters are unknown, so it was required to estimate the parameters based on the sample. Estimation of AE model parameters was obtained based on a joint posterior distribution. The simulation was conducted to get the value of genetic variance and life style variance. The results of simulation are 0.3600 for genetic variance and 0.0899 for life style variance. Therefore, the variance of genetic factor in DM type 2 is greater than life style.

Keywords: AE model, Bayesian method, diabetes mellitus type 2, genetic, life style

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Authors: Yilin Liao, Hewen Li, Paula McConvey

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Speed skaters often face a risk of concussion when they fall on the ice floor and impact crash mats during practices and competitive races. Several variables, including those related to the skater, the crash mat, and the impact position (body side/head/feet impact), are believed to influence the severity of the skater's concussion. While computer simulation modeling can be employed to analyze these accidents, the simulation process is time-consuming and does not provide rapid information for coaches and teams to assess the skater's injury risk in competitive events. This research paper promotes the exploration of the feasibility of using AI techniques for evaluating skater’s potential concussion severity, and to develop a fast concussion prediction tool using artificial neural networks to reduce the risk of treatment delays for injured skaters. The primary data is collected through virtual tests and physical experiments designed to simulate skater-mat impact. It is then analyzed to identify patterns and correlations; finally, it is used to train and fine-tune the artificial neural networks for accurate prediction. The development of the prediction tool by employing machine learning strategies contributes to the application of AI methods in sports science and has theoretical involvements for using AI techniques in predicting and preventing sports-related injuries.

Keywords: artificial neural networks, concussion, machine learning, impact, speed skater

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Authors: Gehan A. Hegazy, Hesham N. Mustafa, Sally A. El Awdan, Marawan AbdelBaset

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Doxorubicin (DOX) is a chemotherapeutic agent used for the treatment of different cancers and its clinical usage is hindered by the oxidative injury-related cardiotoxicity. This work aims to declare if the harmful effects of DOX on the heart can be alleviated with the use of Coenzyme Q10 (CoQ10) or L-carnitine. The study was performed on seventy-two female Wistar albino rats divided into six groups, 12 animals each: Control group; DOX group (10 mg/kg); CoQ10 group (200 mg/kg); L-carnitine group (100 mg/kg); DOX + CoQ10 group; DOX + L-carnitine group. CoQ10 and L-carnitine treatment orally started five days before a single dose of 10 mg/kg DOX that injected intraperitoneally (IP) then the treatment continued for ten days. At the end of the study, serum biochemical parameters of cardiac damage, oxidative stress indices, and histopathological changes were investigated. CoQ10 or L-carnitine showed noticeable effects in improving cardiac functions evidenced reducing serum enzymes as serum interleukin-1 beta (IL-1), tumor necrosis factor alpha (TNF-), leptin, lactate dehydrogenase (LDH), Cardiotrophin-1, Troponin-I and Troponin-T. Also, alleviate oxidative stress, decrease of cardiac Malondialdehyde (MDA), Nitric oxide (NO) and restoring cardiac reduced glutathione levels to normal levels. Both corrected the cardiac alterations histologically and ultrastructurally. With visible improvements in -SMA, vimentin and eNOS immunohistochemical markers. CoQ10 or L-carnitine supplementation improves the functional and structural integrity of the myocardium.

Keywords: CoQ10, doxorubicin, L-Carnitine, cardiotoxicity

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Authors: K. Rusnakova, D. Gerych, M. Stehlik

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Postural stability is a complex process involving actions of biomechanical, motor, sensory and central nervous system components. Numerous joint systems, muscles involved, the complexity of sporting movements and situations require perfect coordination of the body's movement patterns. To adapt to a constantly changing situation in such a dynamic environment as physical performance, optimal input of information from visual, vestibular and somatosensory sensors are needed. Combat soldiers are required to perform physically and mentally demanding tasks in adverse conditions, and poor postural stability has been identified as a risk factor for lower extremity musculoskeletal injury. The aim of this study is to investigate whether some personality traits are related to the performance of static postural stability among soldiers of combat troops. NEO personality inventory (NEO-PI-R) was used to identify personality traits and the Nintendo Wii Balance Board was used to assess static postural stability of soldiers. Postural stability performance was assessed by changes in center of pressure (CoP) and center of gravity (CoG). A posturographic test was performed for 60 s with eyes opened during quiet upright standing. The results showed that facets of neuroticism and conscientiousness personality traits were significantly correlated with measured parameters of CoP and CoG. This study can help for better understanding the relationship between personality traits and static postural stability. The results can be used to optimize the training process at the individual level.

Keywords: neuroticism, conscientiousness, postural stability, combat troops

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Authors: Nastaran Rezaei, Mohammad Saeed Mossadegh, Farhan Kocheyli, Khalil Talebi Jahromi, Aurang Kavousi

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Integrated Pest Management (IPM) aims to combine biological and chemical strategies and measures, hence highlighting the study of acute toxicity and sub-lethal effects of pesticides comprehensively. The present research focused on the side effects of thiamethoxam and pirimicarb sub-lethal concentrations on demographic parameters of Diaeretiella rapae (McIntosh Laboratory) (Hymenoptera: Braconidae). Adult parasitoids were exposed to LC₂₅ of insecticides as well as distilled water as the control. The results showed that thiamethoxam adversely affected population parameters (r, λ, R₀, T), adults' longevity, females' oviposition period and mean fecundity, and a similar trend was obtained for pirimicarb with the exception of generation time (T), the latter did not significantly change compared to the control. The intrinsic rate of increase (r) in the control and those treated with pirimicarb and thiamethoxam were 0.2801, 0.2064, 0.1525 days^-1, respectively, and the sex ratio was biased toward females in all treatments. Furthermore, none of the insecticides influenced total pre-oviposition period (TPOP) and offspring emergence rate. In general, these results indicated that both insecticides potentially distort the demographic parameters of the parasitoid even at sub-lethal concentrations, and then they should not be considered for IPM program in the presence of D. rapae.

Keywords: Diaeretiella rapae, Lipaphis erysimi, life-table study, pirimicarb, thiamethoxam

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Authors: Rukia Yosuf

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Diabetes is a national healthcare crisis related to both macrovascular and microvascular complications. We hypothesized that higher levels of physical activity are associated with lower total and visceral fat mass, lower systolic blood pressure, and increased insulin sensitivity. Participant inclusion criteria: 21-50 years old, BMI ≥ 30 kg/m2, hemoglobin A1C 5.7-6.4, fasting glucose 100-125 mg/dL, and HOMA IR ≥ 2.5. Exclusion criteria: history of diabetes, hypertension, HIV, renal disease, hearing loss, alcoholic intake over four drinks daily, use of organic nitrates or PDE5 inhibitors, and decreased cardiac function. Total physical activity was measured using accelerometers, body composition using DXA, and insulin resistance via fsIVGTT. Clinical and biochemical cardiometabolic risk factors, blood pressure and heart rate were obtained using a calibrated sphygmomanometer. Anthropometric measures, fasting glucose, insulin, lipid profile, C-reactive protein, and BMP were analyzed using standard procedures. Within our study, we found correlations between levels of physical activity in a heterogeneous group of prediabetic adults. Patients with more physical activity had a higher degree of insulin sensitivity, lower blood pressure, total visceral adipose tissue, and overall lower total mass. Total physical activity levels showed small, but significant correlations with systolic blood pressure, visceral fat, lean mass and insulin sensitivity. After normalizing for the race, age, and gender using multiple regression, these associations were no longer significant considering our small sample size. More research into prediabetes will decrease the population of diabetics overall. In the future, we could increase sample size and conduct cross sectional and longitudinal studies in various populations with prediabetes.

Keywords: diabetes, kidney disease, nephrology, prediabetes

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Authors: Olga Colbert

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The present work examines the representation of dreaming in Charles Dickens’ novels, particularly Oliver Twist. Dickens showed great interest in the science of dreaming and had ample knowledge of the latest dream theories in the Victorian era, as can be seen in his personal correspondence, most notably in his famous letter to Dr. Thomas Stone on 2/2/1851. This essay places Dickens’ personal writings side by side with his novels to elucidate whether the scientific paradigm about dreaming included in the novel is consistent with the current (in Dickens’ time) scientific knowledge, or whether it is anachronistic or visionary (ahead of his time). Oliver Twist is particularly useful because it contains entire passages pondering on the nature of dreaming, enumerating types of common dreams, and taking a stand on the interference of sensory perception during the dreaming state. The author is particularly intrigued by Dickens’ assumption of the commonality and universality of lucid dreaming as revealed in these passages. This essay places popular Victorian dream theories, such as those contained in Robert Macnish’s The Philosophy of Sleep, side by side with recent dream theory, particularly psychophysiologist Stephen LaBerge’s numerous articles and books on the topic of lucid dreaming to see if Dickens deviated in any way from the reigning paradigm of the Victorian era in his representation of dreaming in his novels. While Dickens puts to great narrative use many of the characteristics of dreaming described by leading Victorian theorists, the author of this study argues, however, that Dickens’ most visionary statements derive from his acute observations of his own dreaming experiences.

Keywords: consciousness, Dickens, dreaming, lucid dreaming, Victorian

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Authors: Lolwa Alansari, Abdelhamid Azhaghdani, Sufia Athar, Hanen Mrabet, Annaliza Cruz, Tamara Alshadafat, Almunzer Zakaria

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Introduction: Improving the patient experience is a fundamental pillar of healthcare's quadruple aims. Recognizing the importance of patient experiences and perceptions in healthcare interactions is pivotal for driving quality improvement. This abstract centers around the Patient Experience Program, an endeavor crafted with the purpose of comprehending and elevating the experiences of patients in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). Methodology: This comprehensive endeavor unfolded through a structured sequence of phases following Plan-Do-Study-Act (PDSA) model, spanning over 12 months, focused on enhancing patient experiences in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). The study meticulously examined the journeys of patients with acute obstetrics and gynecological conditions, collecting data from over 100 participants monthly. The inclusive approach covered patients of different priority levels (1-5) admitted for acute conditions, with no exclusions. Historical data from March and April 2022 serves as a benchmark for comparison, strengthening causality claims by providing a baseline understanding of OB/GYN ED performance before interventions. Additionally, the methodology includes the incorporation of staff engagement surveys to comprehensively understand the experiences of healthcare professionals with the implemented improvements. Data extraction involved administering open-ended questions and comment sections to gather rich qualitative insights. The survey covered various aspects of the patient journey, including communication, emotional support, timely access to care, care coordination, and patient-centered decision-making. The project's data analysis utilized a mixed-methods approach, combining qualitative techniques to identify recurring themes and extract actionable insights and quantitative methods to assess patient satisfaction scores and relevant metrics over time, facilitating the measurement of intervention impact and longitudinal tracking of changes. From the themes we discovered in both the online and in-person patient experience surveys, several key findings emerged that guided us in initiating improvements, including effective communication and information sharing, providing emotional support and empathy, ensuring timely access to care, fostering care coordination and continuity, and promoting patient-centered decision-making. Results: The project yielded substantial positive outcomes, significantly improving patient experiences in the OB/GYN ED. Patient satisfaction levels rose from 62% to a consistent 98%, with notable improvements in satisfaction with care plan information and physician care. Waiting time satisfaction increased from 68% to a steady 97%. The project positively impacted nurses' and midwives' job satisfaction, increasing from 64% to an impressive 94%. Operational metrics displayed positive trends, including a decrease in the "left without being seen" rate from 3% to 1%, the discharge against medical advice rate dropping from 8% to 1%, and the absconded rate reducing from 3% to 0%. These outcomes underscore the project's effectiveness in enhancing both patient and staff experiences in the healthcare setting. Conclusion: The use of a patient experience questionnaire has been substantiated by evidence-based research as an effective tool for improving the patient experience, guiding interventions, and enhancing overall healthcare quality in the OB/GYN ED. The project's interventions have resulted in a more efficient allocation of resources, reduced hospital stays, and minimized unnecessary resource utilization. This, in turn, contributes to cost savings for the healthcare facility.

Keywords: patient experience, patient survey, person centered care, quality initiatives

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Authors: Onimisi Ekuh Abdullahi, Lasbat Omoshalewa Akinsemoyin

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In Nigeria, over two decades now, there has been a steady increase in the insecurity of human lives and physical properties. In the South-South Nigeria, there is an acute insecurity of militants destroying oil pipe-lines and kidnapping cases; in the Middle-Belt zone, insecurity centers on kidnapping and in a few states crises between Herdsmen and Farmers range like wildfire; in the South-Western zone, kidnapping is vile, in the North-East zone the issue of Boko Haram has become World-wide concern, and in North-west zone, cattle rustlers and religious crisis are of great concern. At the initial stage, the Nigerian Police Force was called upon to quell the crisis. It soon became obvious that the dimension of the crisis was beyond police force. The Nigerian Armed Forces were called to maintain peace and order because the magnitude of the crisis was threatening the national unity and cohesion. The main objective of this paper, was to examine the investigative techniques of criminal by the military in Nigeria. Specifically to examine the physical and psychological force; the abusive techniques and tactics; and suggest modern psychological techniques of interrogating criminals accepted to Human Right Activists and the rule of law. The process is to create room behaviour and practices that carefully monitored the trust and reliability of admissions produced by Psychological manipulative process in Nigeria.

Keywords: military, Nigerian criminal, physical, psychological force

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Authors: Donna L. Roberts

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2019 marked 23 years since Purdue Pharma launched its flagship drug, OxyContin, that unleashed an unprecedented epidemic touching both celebrities and common citizens, metropolitan, suburbia and rural areas and all levels of socioeconomic status. From rural Appalachia to East LA individuals, families and communities have been devastated by a trajectory of addiction that often began with the legitimate prescription of a pain killer for anything from a tooth extraction to a sports injury to recovery from surgery or chronic arthritis. Far from being a serendipitous progression of events, the proliferation of this new breed of 'miracle drug' was instead a carefully crafted marketing program aimed at both the medical community and common citizens. This research represents and in-depth investigation of the evolution of the marketing, distribution and promotion of prescription opioids by pharmaceutical companies and its relationship to the propagation of the opioid crisis. Specifically, key components of Purdue Pharma’s aggressive marketing campaign, including its bonus system and sales incentives, were analyzed in the context of the sociopolitical environment that essential created the proverbial 'perfect storm' for the changing manner in which pain is treated in the U.S. The analyses of these series of events clearly indicate their role in first, the increase in prescription of opioids for non-terminal pain relief and subsequently, the incidence of related addiction, overdose, and death. Through this examination of the conditions that facilitated and maintained this drug crisis, perhaps we can begin to chart a course toward its resolution.

Keywords: addiction, opioid, opioid crisis, Purdue Pharma

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Authors: Mukul Anand

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Quality oriented affordable shelter for all has always been the key issue in the housing sector of our country. Homelessness is the acute form of housing need. It is a paradox that in spite of innumerable government initiated programmes for affordable housing, certain section of society is still devoid of shelter. About nineteen million (18.78 million) households grapple with housing shortage in Urban India in 2012. In Indian scenario there is major mismatch between the people for whom the houses are being built and those who need them. The prime force faced by public authorities in facilitation of quality housing for all is high cost of construction. The present paper will comprehend executable techniques for dilution of cost factor in housing the homeless. The key actors responsible for delivery of cheap housing stock such as capacity building, resource optimization, innovative low cost building material and indigenous skeleton housing system will also be incorporated in developing these techniques. Time performance, which is an important angle of above actors, will also be explored so as to increase the effectiveness of low cost housing. Along with this best practices will be taken up as case studies where both conventional techniques of housing and innovative low cost housing techniques would be cited. Transportation consists of approximately 30% of total construction budget. Thus use of alternative local solutions depending upon the region would be covered so as to highlight major components of low cost housing. Government is laid back regarding base line information on use of innovative low cost method and technique of resource optimization. Therefore, the paper would be an attempt to bring to light simpler solutions for achieving low cost housing.

Keywords: construction, cost, housing, optimization, shelter

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Authors: M. Mokhber, J. Hedayati

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From the managerial perspective, it is important to devise an operational plan based on top priorities due to limited resources, diversity of measures and high costs needed to improve safety in infrastructure. Dealing with the high-risk corridors across Iran, this study prioritized the corridors according to statistical data on accidents involving fatalities, injury or damage over three consecutive years. In collaboration with the Iranian Police Department, data were collected and modified. Then, the prioritization criteria were specified based on the expertise opinions and international standards. In this study, the prioritization criteria included accident severity and accident density. Finally, the criteria were standardized and weighted (equal weights) to score each high-risk corridor. The prioritization phase involved the scoring and weighting procedure. The high-risk corridors were divided into twelve groups out of 50. The results of data analysis for a three-year span suggested that the first three groups (150 corridors) along with a quarter of Iranian road network length account for nearly 60% of traffic accidents. In the next step, according to variables including weather conditions particular roads for the purpose of winter safety measures were extracted from the abovementioned categories. According to the results ranking, ‎‏9‏‎ roads with the overall ‎length of about ‎‎‏1000‏‎ Km of high-risk corridors are considered as preferences of ‎safety measures‎.

Keywords: high-risk corridors, HRCs, road safety rating, road scoring, winter safety measures

Procedia PDF Downloads 171

Authors: Abu Salim Mustafa

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Water plays a major role in maintaining life on earth, but it can also serve as a matrix for pathogenic organisms, posing substantial health threats to humans. Although, outbreaks of diseases attributable to drinking water may not be common in industrialized countries, they still occur and can lead to serious acute, chronic, or sometimes fatal health consequences. The analysis of drinking water samples from different regions of Kuwait was performed in this study for bacterial and viral contaminations. Drinking tap water samples were collected from 15 different locations of the six Kuwait governorates. All samples were analyzed by confocal microscopy for the presence of bacteria. The samples were cultured in vitro to detect cultivable organisms. DNA was isolated from the cultured organisms and the identity of the bacteria was determined by sequencing the bacterial 16S rRNA genes, followed by BLAST analysis in the database of NCBI, USA. RNA was extracted from water samples and analyzed by real-time PCR for the detection of viruses with potential health risks, i.e. Astrovirus, Enterovirus, Norovirus, Rotavirus, and Hepatitis A. Confocal microscopy showed the presence of bacteria in some water samples. The 16S rRNA gene sequencing of culture grown organisms, followed by BLAST analysis, identified the presence of several non-pathogenic bacterial species. However, one sample had Acinetobacter baumannii, which often causes opportunistic infections in immunocompromised people, but none of the studied viruses could be detected in the drinking water samples analyzed. The results indicate that drinking water samples analyzed from various locations in Kuwait are relatively safe for drinking and do not contain many harmful pathogens.

Keywords: drinking water, microbial contaminant, 16S rDNA, Kuwait

Procedia PDF Downloads 148

Authors: Lucia Salvioni, Pietro Giorgio Lovaglio, Valerio Leoni, Miriam Colombo, Luisa Fiandra

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The involvement of plasmatic surfactant protein-D (SP-D) in pulmonary diseases has been long investigated, and over the last two years, more interest has been directed to determine its role as a marker of COVID-19. In this direction, several studies aimed to correlate pulmonary surfactant proteins with the clinical manifestations of the virus indicated SP-D as a prognostic biomarker of COVID-19 pneumonia severity. The present work has performed a retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio (Lombardia, Italy) with the aim to assess differences in the hematic SP-D concentrations among COVID-19 patients and healthy donors and the role of SP-D as a prognostic marker of severity and/or of mortality risk. The obtained results showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors, so as between dead and survived patients. SP-D values were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. SP-D levels at admission and increasing differences among follow-up and admission values resulted in the strongest significant risk factors of mortality. Therefore, this study demonstrated the role of SP-D as a predictive marker of SARS-CoV-2 infection and its outcome. A significant correlation of SP-D with patient mortality indicated that it is also a prognostic factor in terms of mortality, and its early detection should be considered to design adequate preventive treatments for COVID-19 patients.

Keywords: SARS-CoV-2 infection, COVID-19, surfactant protein-D (SP-D), mortality, biomarker

Procedia PDF Downloads 71

Authors: Babak Mirbaha, Mahmoud Saffarzadeh, Fatemeh Mohajeri

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Road traffic accidents lead to a higher rate of death and injury, especially in vulnerable road users such as pedestrians. Improving the safety of facilities for pedestrians is a major concern for policymakers because of the high number of pedestrian fatalities and direct and indirect costs which are imposed to the society. This study focuses on the idea of determining the willingness to pay of pedestrians for increasing their safety while crossing the street. In this study, three different scenarios including crossing the street with zebra crossing facilities, crossing the street with zebra crossing facilities and installing a pedestrian traffic light and constructing a pedestrian bridge with escalator are presented. The research was conducted based on stated preferences method. The required data were collected from a questionnaire that consisted of three parts: pedestrian’s demographic characteristics, travel characteristics and scenarios. Four different payment amounts are presented for each scenario and a logit model has been built for each proposed payment. The results show that sex, age, education, average household income and individual salary have significant effect on choosing a scenario. Among the policies that have been mentioned through the questionnaire scenarios, the scenario of crossing the street with zebra crossing facilities and installing a traffic lights is the most frequent, with willingness to pay 10,000 Rials and the scenario of crossing the street with a zebra crossing with a willingness to pay 100,000 Rials having the least frequency. For all scenarios, as the payment is increasing, the willingness to pay decreases.

Keywords: pedestrians, willingness to pay, safety, immunization

Procedia PDF Downloads 148

Authors: Kunwar Paritosh, Vivekanand Vivekanand, Nidhi Pareek

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Presently, India depends primarily on fossil fuels for its acute energy demand. The swift in development of India in last two decades is accentuating its natural resources and compelling expenditures to cope energy security for the habitats. A total inhabitant of 1.2 billion, observing growing industrialization; is generating 68.8 million tonnes of municipal solid waste per year, 53.7 million tonnes is collected, and only trifling amount of 10.3 million tonnes of waste is treated per year that integrates to a massive amount of unimaginable land hill. In India, waste is mostly landfilled and/or incinerated with low technology and is poorly managed. Underutilization of this waste not only gulps resources but also stresses environment, public health and bionetwork thus affecting the bioeconomy negatively. It also creates conditions that invoke inevitable expenditures and loss of its renewable energy potential. The non-scientific approach to manage waste may lead to an economy downfall, underutilization and degradation of natural resources. Waste treatment technologies must be scientifically tailored and engineered as per the type of waste where it may be utilized as a source of energy (here biogas) and nutrients employing anaerobic digestion to the sorted waste. This paper presents a brief review on current practices, key achievements and forthcoming aspects of harnessing energy from municipal solid waste in Indian scenario.

Keywords: municipal discards, organic waste, anaerobic digestion, incineration, energy

Procedia PDF Downloads 256

Authors: Nashalla Gwyn Nyinda

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The ancient system of Tibetan Medicine, known as Sowa Rigpa across the Himalayan regions, is a systematic system of healing encouraging balance primarily through diet and behavior modifications. With the rise of the popularity of Tibetan Medicine, compliance is critical to successful treatment outcomes. As patients learn more about who they are as individuals and how their elemental balances or imbalances affect disorders and mental-emotional balance, they develop faith and dedication to their healing process. Specifically, regarding diet and behavior and the basic principles of the medical system, patient compliance increases dramatically in all treatment areas when they understand why a treatment or dietary prescription guidance is effective. Successful responses to Tibetan treatment rely on a buy-in from the patient. Trust between the slower process of Traditional medicine treatments, the Tibetan physician and the patient is a cornerstone of treatment. The resulting decrease in the use of allopathic medicine and better health outcomes for acute and chronic disorders are well documented. This paper addresses essential points of the Tibetan Medicine system, dialogue between doctor and patient focused on appropriate and seasonal changing dietetics. Such fluctuating treatment approaches, based on external elemental factors, dramatically increase treatment outcomes. Specifically, this work addresses why allopathic medicine models may need more trust development between practitioner and patient.

Keywords: compliancy in treatment, diet and lifestyle medicine, nature and elements as medicine, seasonal diets, Sowa Rigpa, traditional Tibetan medicine, treatment outcomes

Procedia PDF Downloads 56

Authors: Masoumeh Kazemi

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Depression is one of the most common mental disorders that damage mental health. In addition to mental distress, mental health damage affects other dimensions of human health, including physical and social health. According to the national study of diseases and injuries in Iran, the third health problem of the country is depression. The purpose of this study was to measure the level of depression in people referred to Karaj psychiatric treatment centers, and to investigate the relationship between depression and drug and alcohol consumption. The statistical population included 5000 people. Morgan table was used to determine the sample size. The research questions sought to identify the relationship between depression and factors such as drug and alcohol use, employment and marital status, and gender. Beck standard questionnaire was used to collect complete information. Cronbach's alpha coefficient was used to confirm the reliability of the questionnaire. To test research hypotheses, non-parametric methods of correlation coefficient, Spearman's rank, Mann-Whitney and Kruskal-Wallis tests were used. The results of using SPSS statistical software showed that there is a direct relationship between depression and drug and alcohol use. Also, the rate of depression was higher in women, widows and unemployed people. Finally, by conducting the present study, it is suggested that people use the following treatments in combination for effective recovery: 1. Cognitive Behavioral Therapy (CBT) 2. Interpersonal Therapy (IPT) 3. Treatment with appropriate medication 4. Special light therapy 5. Electric shock treatment (in acute and exceptional cases) 6. Self-help

Keywords: alcohol, depression, drug, Iran

Procedia PDF Downloads 55

Authors: Muhammad Randhawa, Muhammad Nadeem

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Guava (Psidium guajava L.) is a vital source of minerals, vitamins, dietary fiber and antioxidants. Owing to highly perishable nature and proning towards chilling injury, diseases, insect-pests and physical damage the main drawbacks of guava after harvesting, present study was designed. Due to its delicacy in physiology, economic importance, effects of pre and postharvest factors and maturity indices, guava fruits should be given prime importance for good quality attributes. In this study guava fruits were stored at 10°C with 80% relative humidity after treating with different levels of sulphate salt of magnesium followed by dipping in cellulose based edible coating hydroxy propyl methyl cellulose (HPMC). The main objective of this coating was to enhance the shelf life of guava by inhibiting the respiration and also by binding the dissolved solids with salt application. Characterization for quality attributes including physical, physiological and bio chemical analysis was performed after every 7 days interval till the fruit remains edible during the storage period of 4 weeks. Finally, data obtained was subjected to statistical analysis. It was concluded on statistical basis that Surahi variety (treated with 5% MgSO4) showed best storage stability and kept its original quality up to almost 23 days during storage.

Keywords: edible coating, guava cultivars, physicochemical attributes, storage

Procedia PDF Downloads 323

Authors: Lakshmi, Yakshita Awasthi, Deepika, Lovleen Jha, Archna Kumar

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From the back of centuries, plant-parasitic nematodes (PPN) have been recognized as a major threat to agriculturalists globally. It causes 21.3% global food loss annually. The utilization of harmful chemical pesticides to minimize the nematode population may cause acute and delayed health hazards and harmful impacts on human health. In recent years, a variety of plants have been evaluated for their nematicidal properties and efficacy in the management of plant-parasitic nematodes. Several Phyto-nematicides are available, but most of them are incapable of sustainable management of PPN, especially Meloidogyne spp. Thus, there is a great need for a new eco-friendly, highly efficient, sustainable control measure for this nematode species. Keeping all these facts and after reviewing the literature, aqueous extract of Cymbopogon citratus, Tagetes erecta, and Azadirachta indica were prepared by adding distilled water (1 g sample mixed with 10ml of water). In vitro studies were conducted to evaluate the efficacious nature of targeted botanicals against PPN Meloidogyne spp. The mortality status of PPN was recorded by counting the live and dead individuals after applying 100μl of selected extract. The impact was observed at different time durations, i.e., 24h and 48h. The result showed that the highest 100% mortality was at 48h in all three extracts. Thus, these extracts, with the addition of a suitable shelf-life enhancer, may be exploited in different nematode control programs as an economical, sustainable measure.

Keywords: Meloidogyne, Cymbopogon citratus, Tagetes erecta, Azadirachta indica, nematicidal

Procedia PDF Downloads 155