Search results for: potential outcome

Authors: Kevin Syam, Devendra K. Chauhan, Mandeep Singh Dhillon

Abstract:

Background: The posterior horn of medial meniscus (PHMM) is a secondary stabilizer against anterior translation of tibia. Cadaveric studies have revealed increased strain on the ACL graft and greater instrumented laxity in Posterior horn deficient knees. Clinical studies have shown higher prevalence of radiological OA after ACL reconstruction combined with menisectomy. However, functional outcomes in ACL reconstructed knee in the absence of Posterior horn is less discussed, and specific role of posterior horn is ill-documented. This study evaluated functional and radiological outcomes in posterior horn preserved and posterior horn sacrificed ACL reconstructed knees. Materials: Of the 457 patients who had ACL reconstruction done over a 6 year period, 77 cases with minimum follow up of 18 months were included in the study after strict exclusion criteria (associated lateral meniscus injury, other ligamentous injuries, significant cartilage degeneration, repeat injury and contralateral knee injuries were excluded). 41 patients with intact menisci were compared with 36 patients with absent posterior horn of medial meniscus. Radiological and clinical tests for instability were conducted, and knees were evaluated using subjective International Knee Documentation Committee (IKDC) score and the Orthopadische Arbeitsgruppe Knie score (OAK). Results: We found a trend towards significantly better overall outcome (OAK) in cases with intact PHMM at average follow-up of 43.03 months (p value 0.082). Cases with intact PHMM had significantly better objective stability (p value 0.004). No significant differences were noted in the subjective IKDC score (p value 0.526) and the functional OAK outcome (category D) (p value 0.363). More cases with absent posterior horn had evidence of radiological OA (p value 0.022) even at mid-term follow-up. Conclusion: Even though the overall OAK and subjective IKDC scores did not show significant difference between the two subsets, the poorer outcomes in terms of objective stability and radiological OA noted in the absence of PHMM, indicates the importance of preserving this important part of the meniscus.

Keywords: ACL, functional outcome, knee, posterior of medial meniscus

Procedia PDF Downloads 346

Authors: Holly Sandberg, Christina McCoy, Khaled Mansy

Abstract:

Eucalyptus Cloeziana, commonly known as Gympie Messmate, is a fast-growing hardwood native to Australia. Its quick growth makes it advantageous for carbon sequestering, while its strength class lends itself to structural applications. Market research shows that the demand for timber is growing, especially mass timber. An environmental product declaration, or EPD, for eucalyptus Cloeziana in the Australian market has been evaluated and compared to the EPD’s of steel and Douglas fir of the same region. An EPD follows a product throughout its life cycle, stating values for global warming potential, ozone depletion potential, acidification potential, eutrophication potential, photochemical ozone creation potential, and abiotic depletion potential. This paper highlights the market potential, as well as the environmental benefits and challenges to using Gympie Messmate as a structural building material. In addition, a case study is performed to compare steel, Douglas fir, and eucalyptus in terms of embodied carbon and structural weight within a single structural bay. Comparisons among the three materials highlight both the differences in structural capabilities as well as environmental impact.

Keywords: eucalyptus, timber, construction, structural, material

Procedia PDF Downloads 159

Authors: Smitha Yadav, Snehal Pathak

Abstract:

Aggregate compositions in the construction and demolition (C&D) waste have potential to replace normal aggregates. However, to re-utilise these aggregates, the concrete produced with these recycled aggregates needs to provide the desired compressive strength and durability. This paper examines the performance of recycled aggregate concrete made up of 60% recycled aggregates of 20 mm size in terms of durability tests namely rapid chloride permeability, drying shrinkage, water permeability, modulus of elasticity and creep without compromising the compressive strength. The experimental outcome indicates that recycled aggregate concrete provides strength and durability same as controlled concrete when processed for removal of adhered mortar.

Keywords: compressive strength, recycled aggregate, shrinkage, rapid chloride permeation test, modulus of elasticity, water permeability

Procedia PDF Downloads 290

Authors: Emran M. Badghish

Abstract:

Overweight and obesity have now become an epidemic around the globe, both in high-, as well as low-income regions. It is important to use preventive measures that are cost-effective. Schools are the essence of building societies and engaging them in healthy nutrition will offer a way to reach individuals at an early stage in life, with many positive and significant impacts. Aim: Provide healthy food in schools of children aged 5 to 18 years old. Methods: Distributing healthy food to a school and implementation of a star rating system for healthier foods, with five stars for the healthiest option to a half a star for the unhealthiest. The stars system was developed in Australia and should motivate children to consume the healthier nutritional options. Each canteen should be allowed a minimum of 3.5 stars rating for the food provided. Outcome Measurement: Body-mass-index as an indicator of overweight and obesity should be checked at the beginning of the study annually for five years for all children. Another side measurement is the performance by checking the grades and a questionnaire on eating habits at the start of the study and yearly. Expected Outcome: A lower health-risk behaviour and assistance to children in reaching their potentials as they will adapt to eating healthier. Nutrition during childhood has the potential to prevent obesity, type 2 diabetes, dental diseases, hypertension and, in later life, cardiovascular disease, osteoporosis and a variety of cancers. In Australia NSW starting from 2016 is expecting a 5% reduction of childhood overweight and obesity by 2025. As for Saudi-Arabia, it is expected to have an, even more, reduction by 2023 as a lot of our children are canteen-dependent. Conclusion: Introducing healthy food in schools is a preventative method that would have significant influence on the reduction of the prevalence of obesity in Saudi-Arabia and improves its general health.

Keywords: food, healthy, children, obesity, schools

Procedia PDF Downloads 181

Authors: Nji Clement Bang, Rosemary Shafack M., Kum Henry Asei, Yaro Loveline Y

Abstract:

Scholars perceive learner-centered teaching-learning reform as roles and resources in teacher education (TE) and professional outcome with transformative learning (TL) continuum dimensions. But, teaching-learning reform is fast proliferating amidst debilitating stakeholder systemic dichotomies, resources, commitment, resistance and poor quality outcome that necessitate stronger TE and professional continuums. Scholars keep seeking greater understanding of themes in teaching-learning reform, TE and professional outcome as continuums and how policymakers, student-teachers, teacher trainers and local communities concerned with initial TE can promote continuous holistic quality performance. To sustain the debate continuum and answer the overarching question, we use mixed-methods research-design with diverse literature and 409 sample-data. Onset text, interview and questionnaire analyses reveal debilitating teaching-learning reform in TE continuums that need TL revival. Follow-up focus group discussion and teaching considering TL insights reinforce holistic teaching-learning in TE. Therefore, significant increase in diverse prior-experience articulation1; critical reflection-discourse engagement2; teaching-practice interaction3; complex-activity constrain control4 and formative outcome- reintegration5 reinforce teaching-learning in learning-to-teach role-resource pathways and outcomes. Themes reiterate complex teaching-learning in TE programs that suits TL journeys and student-teachers and students cum teachers, workers/citizens become akin, transformative-learners who evolve personal and collective roles-resources towards holistic-lifelong-learning outcomes. The article could assist debate about quality teaching-learning reform through TL dimensions as TE and professional role-resource continuums.

Keywords: transformative learning perspectives, teacher education, initial teacher education, learner-centered pedagogical reform, life-long learning

Procedia PDF Downloads 61

Authors: Cora Fernandez Dacosta, John A. Posada, Andrea Ramirez

Abstract:

The biodegradable family of polymers polyhydroxyalkanoates are interesting substitutes for convectional fossil-based plastics. However, the manufacturing and environmental impacts associated with their production via intracellular bacterial fermentation are strongly dependent on the raw material used and on energy consumption during the extraction process, limiting their potential for commercialization. Industrial wastewater is studied in this paper as a promising alternative feedstock for waste valorization. Based on results from laboratory and pilot-scale experiments, a conceptual process design, techno-economic analysis and life cycle assessment are developed for the large-scale production of the most common type of polyhydroxyalkanoate, polyhydroxbutyrate. Intracellular polyhydroxybutyrate is obtained via fermentation of microbial community present in industrial wastewater and the downstream processing is based on chemical digestion with surfactant and hypochlorite. The economic potential and environmental performance results help identifying bottlenecks and best opportunities to scale-up the process prior to industrial implementation. The outcome of this research indicates that the fermentation of wastewater towards PHB presents advantages compared to traditional PHAs production from sugars because the null environmental burdens and financial costs of the raw material in the bioplastic production process. Nevertheless, process optimization is still required to compete with the petrochemicals counterparts.

Keywords: circular economy, life cycle assessment, polyhydroxyalkanoates, waste valorization

Procedia PDF Downloads 437

Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares

Abstract:

Introduction: Despite improvements in stroke management, it remains the leading cause of disability worldwide. It has been suggested that enhancing brain angiogenesis after stroke will improve stroke outcome. Promoting post stroke angiogenesis requires the upregulation of angiogenic factors with a simultaneous reduction of anti-angiogenic factors. Thrombospondin-1 is the main anti-angiogenic protein in the living cells. Counterintuitively, it has been shown that animals with Thrombospondin-1 knockdown will have better stroke outcome. Data about the clinical significance of Thrombspondin-1 levels at the time of admission is still lacking. The objective of this work is to assess the association between serum Thrombospondin-1 levels measured at the time of admission and baseline neurologic severity after stroke. Patients and Methods: Blood samples were collected from patients admitted to the King Abdullah University Hospital (KAUH) with ischemic stroke at the time of admission and serum Thrombopsondin-1 levels were measured using ELISA. Patients neurologic severity was evaluated using the National Institute of Health Stroke Scale (NIHSS). Results: Samples from 50 patients admitted between January 2016 and December 2016 were collected. The median age of participants was 68 years and the median NIHSS was 3. Multinomial regression identified serum Thrombospondin-1 as an independent predictor of stroke outcome (p=0.003). Baseline serum Thrombsopondin-1 was negatively associated with NIHSS at the time of admission (spearman rho correlation coefficient=0.272, p=0.032). Conclusion: Serum Thrombospondin-1 at the time of admission may be a useful marker of stroke severity that predicts more severe neurologic severity.

Keywords: thrombospondin, stroke, neuroprotection, biomarkers

Procedia PDF Downloads 117

Authors: Sao-Jeng Chao, Chia-Yun Wei, Si-Han Lai, Cheng-Yu Huang, Yu-Han Teng

Abstract:

In Taiwan, the landforms are mainly dominated by mountains and hills. Many road sections of the National Highway are impossible to avoid problems such as slope excavation or slope filling. In order to increase the safety of the slope, various slope protection methods are used to stabilize the slope, especially the soil anchor technique is the most common. This study is inspired by the soil liquefaction potential map. The concept of the potential map is widely used. The typhoon, earth-rock flow, tsunami, flooded area, and the recent discussion of soil liquefaction have safety potential concepts. This paper brings the concept of safety potential to the anchored slope. Because the soil anchor inspection is only the concept of points, this study extends the concept of the point to the surface, using the Quantum GIS program to present the slope damage area, and depicts the slope appearance and soil anchor point with the slope as-built drawing. The soil anchor scores are obtained by anchor inspection data, and the low, medium and high potential areas are remitted by interpolation. Thus, the area where the anchored slope may be harmful is judged and relevant maintenance is provided. The maintenance units can thus prevent judgment and deal with the anchored slope as soon as possible.

Keywords: anchor, slope, potential map, lift-off test, existing load

Procedia PDF Downloads 124

Authors: Soheila Zhaeentan, Anders Von Heijne, Elisabet Hagert, André Stark, Björn Salomonsson

Abstract:

Recommended treatment for traumatic rotator cuff tear (TRCT) is surgery within a few weeks after injury if the diagnosis is made early, especially if a functional impairment of the shoulder exists. This may lead to the assumption that a poor outcome then can be expected in delayed surgical treatment, when the patient is diagnosed at a later stage. The aim of this study was to investigate if a surgical repair later than three months after injury may result in successful outcomes and patient satisfaction. There is evidence in literature that good results of treatment can be expected up to three months after the injury, but little is known of later treatment with cuff repair. 73 patients (75 shoulders), 58 males/17 females, mean age 59 (range 34-­‐72), who had undergone surgical intervention for TRCT between January 1999 to December 2011 at our clinic, were included in this study. Patients were assessed by MRI investigation, clinical examination, Western Ontario Rotator Cuff index (WORC), Oxford Shoulder Score, Constant-­‐Murley Score, EQ-­‐5D and patient subjective satisfaction at follow-­‐up. The patients treated surgically within three months ( < 12 weeks) after injury (39 cases) were compared with patients treated more than three months ( ≥ 12 weeks) after injury (36 cases). WORC was used as the primary outcome measure and the other variables as secondary. A senior consultant radiologist, blinded to patient category and clinical outcome, evaluated all MRI-­‐images. Rotator cuff integrity, presence of arthritis, fatty degeneration and muscle atrophy was evaluated in all cases. The average follow-­‐up time was 56 months (range 14-­‐149) and the average time from injury to repair was 16 weeks (range 3-­‐104). No statistically significant differences were found for any of the assessed parameters or scores between the two groups. The mean WORC score was 77 (early group, range 25-­‐ 100 and late group, range 27-­‐100) for both groups (p= 0.86), Constant-­‐Murley Score (p= 0.91), Oxford Shoulder Score (p= 0.79), EQ-­‐5D index (p= 0.86). Re-­‐tear frequency was 24% for both groups, and the patients with re-­‐tear reported less satisfaction with outcome. Discussion and conclusion: This study shows that surgical repair of TRCT performed later than three months after injury may result in good functional outcomes and patient satisfaction. However, this does not motivate an intentional delay in surgery when there is an indication for surgical repair as that delay may adversely affect the possibility to perform a repair. Our results show that surgeons may safely consider surgical repair even if a delay in diagnosis has occurred. A retrospective cohort study on 75 shoulders shows good functional result after traumatic rotator cuff tear (TRCT) treated surgically up to one year after the injury.

Keywords: traumatic rotator cuff injury, time to surgery, surgical outcome, retrospective cohort study

Procedia PDF Downloads 205

Authors: Erika Humphreys

Abstract:

The effectiveness of treating anxiety with Reiki is explored within ten quantitative studies. The methodology utilized for a critical appraisal and systematic review of the literature is explained with inclusion and exclusion criteria. The theoretical framework for the project is grounded in the work of Hildegard Peplau, whose nursing theory based on the therapeutic use of self is foundational for Reiki implementation. A thorough critique of the literature is conducted for key components of robustness and believability. This critique is conducted using a structured guide addressing synthesized strengths and weaknesses of the body of literature. A synthesis of the literature explores the findings of the studies. This synthesis reports on Reiki’s effectiveness in treating anxiety within a variety of patient settings and populations, its effect on subscales of anxiety, physiological manifestations of anxiety, and pain associated with anxiety. Cultural considerations affecting Reiki’s potential effectiveness are discussed. Gaps in the literature are examined, including the studies’ narrow sample population, lack of participant exclusionary factors for controlled outcome data, and the lack of studies across time. Implications for future research are discussed with recommendations for expanded research that includes a broader variety of settings, age groups, and patient diagnoses, including anxiety disorders, for research data that is transferable. Implications for further practice for the advanced practice registered nurse (APRN) are explored, with the potential benefits for both providers and patients, including improved patient satisfaction and expansion of provider treatment modalities.

Keywords: Reiki, anxiety, complementary alternative medicine, pandemic

Procedia PDF Downloads 141

Authors: Aisling Gough, Ruth F. Hunter, Jianjun Tang, Sarah F. Brennan, Oliver Smith, Mark A. Tully, Chris Patterson, Alberto Longo, George Hutchinson, Lindsay Prior, David French, Jean Adams, Emma McIntosh, Frank Kee

Abstract:

Background: As a large proportion of the UK workforce is employed in sedentary occupations, worksite interventions have the potential to contribute significantly to the health of the population. The UK Government is currently encouraging the use of financial incentives to promote healthier lifestyles but there is a dearth of evidence regarding the effectiveness and sustainability of incentive schemes to promote physical activity in the workplace. Methods: A large cluster RCT is currently underway, incorporating nested behavioural economic field experiments and process evaluation, to evaluate the effectiveness of a Physical Activity Loyalty Scheme. Office-based employees were recruited from large public sector organisations in Lisburn and Belfast (Northern Ireland) and randomised to an Intervention or Control group. Participants in the Intervention Group were encouraged to take part in 150 minutes of physical activity per week through provision of financial incentives (retailer vouchers) to those who met physical activity targets throughout the course of the 6 month intervention. Minutes of physical activity were monitored when participants passed by sensors (holding a keyfob) placed along main walking routes, parks and public transport stops nearby their workplace. Participants in the Control Group will complete the same outcome assessments (waiting-list control). The primary outcome is steps per day measured via pedometers (7 days). Secondary outcomes include health and wellbeing (Short Form-8, EuroQol-5D-5L, Warwick Edinburgh Mental Well Being Scale), and work absenteeism and presenteeism. Data will be collected at baseline, 6, 12 and 18 months. Information on PAL card & website usage, voucher downloads and redemption of vouchers will also be collected as part of a comprehensive process evaluation. Results: In total, 853 participants have been recruited from 9 workplaces in Lisburn, 12 buildings within the Stormont Estate, Queen’s University Belfast and Belfast City Hospital. Participants have been randomised to intervention and control groups. Baseline and 6-month data for the Physical Activity Loyalty Scheme has been collected. Findings regarding the effectiveness of the intervention from the 6-month follow-up data will be presented. Discussion: This study will address the gap in knowledge regarding the effectiveness and cost-effectiveness of a workplace-based financial incentive scheme to promote a healthier lifestyle. As the UK workforce is increasingly sedentary, workplace-based physical activity interventions have significant potential in terms of encouraging employees to partake in physical activity during the working day which could lead to substantial improvements in physical activity levels overall. Implications: If a workplace based physical activity intervention such as this proves to be both effective and cost-effective, there is great potential to contribute significantly to the health and wellbeing of the workforce in the future. Workplace-based physical activity interventions have the potential to improve the physical and mental health of employees which may in turn lead to economic benefits for the employer, such as reduction in rates of absenteeism and increased productivity.

Keywords: behaviour change, cluster randomised controlled trial, loyalty scheme, physical activity

Procedia PDF Downloads 304

Authors: Rupesh K. Chaudhary, Narinder P. Jain, Rajesh Mahajan, Rajat Manchanda

Abstract:

Introduction: Delirium is a complex, multifactorial neuropsychiatric syndrome comprising a broad range of cognitive and neurobehavioral symptoms. In critically ill patients, it may develop secondary to multiple predisposing factors. Although it can be transient and irreversible but if left untreated may lead to long term cognitive dysfunction. Early identification and assessment of risk factors usually help in appropriate management of delirium which in turn leads to decreased hospital stay, cost of therapy and mortality. Aim and Objective: Aim of the present study was to estimate the incidence of delirium using a validated scale in medical ICU patients and to determine the associated risk factors and outcomes. Material and Method: A prospective study in an 18-bed medical-intensive care unit (ICU) was undertaken. A total of 357 consecutive patients admitted to ICU for more than 24 hours were assessed. These patients were screened with the help of Confusion Assessment Method for Intensive Care Unit -CAM-ICU, Richmond Agitation and Sedation Scale, Screening Checklist for delirium and APACHE II. Appropiate statistical analysis was done to evaluate the risk factors influencing mortality in delirium. Results: Delirium occurred in 54.6% of 194 patients. Risk of delirium was independently associated with a history of hypertension, diabetes but not with severity of illness APACHE II score. Delirium was linked to longer ICU stay 13.08 ± 9.6 ver 7.07 ± 4.98 days, higher ICU mortality (35.8% % vs. 17.0%). Conclusion: Our study concluded that delirium poses a great risk factor in the outcome of the patient and carries high mortality, so a timely intervention helps in addressing these issues.

Keywords: delirium, risk factors, outcome, intervention

Procedia PDF Downloads 148

Authors: Risikat Oladoyin S. Dauda, Onyebuchi Iwegbu

Abstract:

This study investigates the response of human development outcomes to selected macroeconomic indicators in Nigeria. Human development outcomes is measured by human development index while the selected macroeconomic variables are inflation rate, real interest rate, government capital expenditure, real exchange rate, current account balance, and savings. Structural Vector Autoregression (SVAR) technique is employed in examining the response of human development index to the macroeconomic shocks. The result from the forecast error variance decomposition and Impulse-Response analysis reveals that fiscal policy (government capital expenditure) shock is the greatest determinant of human development outcomes. This result reiterates the role which the government plays in improving the welfare of the citizenry. The fiscal policy tool is pivotal in human development which comes in the form of investment in education, health, housing, and infrastructure. Further conclusion drawn from this study is that human development outcome positively and significantly responds to shocks from real interest rate, a monetary policy transmission variable and is felt greatly in the short run period. The policy implication of this study is that if capital budget implementation falls below expectations, human development will be engendered. Hence, efforts should be made to ensure that full implementation and appraisal of government capital expenditure is taken sacrosanct as any shock from such plan, engenders human development outcome.

Keywords: human development outcome, macroeconomic outcomes, structural vector autoregression, SVAR

Procedia PDF Downloads 138

Authors: Eva Kirzner

Abstract:

Based on outcome studies published over the past two decades, in 2018, the ACC/AHA published new guidelines for the management of hypercholesterolemia that incorporate the use of coronary artery calcium (CAC) scanning as a decision tool for ascertaining which patients may benefit from statin therapy. This use is based on the recognition that the absence of calcium on CAC scanning (i.e., a CAC score of zero) usually signifies the absence of significant atherosclerotic deposits in the coronary arteries. Specifically, in patients with a high risk for atherosclerotic cardiovascular disease (ASCVD), initiation of statin therapy is generally recommended to decrease ASCVD risk. However, among patients with intermediate ASCVD risk, the need for statin therapy is less certain. However, there is a need for new outcome studies that provide evidence that the management of hypercholesterolemia based on these new ACC/AHA recommendations is safe for patients. Based on a Pub-Med and Google Scholar literature search, four relevant population-based or patient-based cohort studies that studied the relationship between CAC scanning, risk assessment or mortality, and statin therapy that were published between 2017 and 2021 were identified (see references). In each of these studies, patients were assessed for their baseline risk for atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohorts Equation (PCE), an ACC/AHA calculator for determining patient risk based on assessment of patient age, gender, ethnicity, and coronary artery disease risk factors. The combined findings of these four studies provided concordant evidence that a zero CAC score defines patients who remain at low clinical risk despite the non-use of statin therapy. Thus, these new studies confirm the use of CAC scanning as a safe tool for reducing the potential overuse of statin therapy among patients with zero CAC scores. Incorporating these new data suggest the following best practice: (1) ascertain ASCVD risk according to the PCE in all patients; (2) following an initial attempt trial to lower ASCVD risk with optimal diet among patients with elevated ASCVD risk, initiate statin therapy for patients who have a high ASCVD risk score; (3) if the ASCVD score is intermediate, refer patients for CAC scanning; and (4) and if the CAC score is zero among the intermediate risk ASCVD patients, statin therapy can be safely withheld despite the presence of an elevated serum cholesterol level.

Keywords: cholesterol, cardiovascular disease, statin therapy, coronary calcium

Procedia PDF Downloads 98

Authors: Ilija Kelepurovski, Stefan Lazorovski, Pece Petkovski, Marian Anakievski, Svetlana Petkovska

Abstract:

Introduction: Benign prostatic hyperplasia (BPH) is a common condition that affects men over the age of 50 and is characterized by an enlarged prostate gland that can cause lower urinary tract symptoms (LUTS). Uroflowmetry and cystoscopy are two commonly used diagnostic tests to evaluate LUTS and diagnose BPH. While both tests can be useful, there is a risk of overusing cystoscopy and underusing uroflowmetry in the evaluation of LUTS. The aim of this study was to compare the use of uroflowmetry and cystoscopy in a prospective cohort of 100 patients with suspected BPH or other urinary tract conditions and to assess the diagnostic yield of each test. Materials and Methods: This was a prospective study of 100 male patients over the age of 50 with suspected BPH or other urinary tract conditions who underwent uroflowmetry and cystoscopy for the evaluation of LUTS at a single tertiary care center. Inclusion criteria included male patients over the age of 50 with suspected BPH or other urinary tract conditions, while exclusion criteria included previous urethral or bladder surgery, active urinary tract infection, and significant comorbidities. The primary outcome of the study was the frequency of cystoscopy in the evaluation of LUTS, and the secondary outcome was the diagnostic yield of each test. Results: Of the 100 patients included in the study, 86 (86%) were diagnosed with BPH and 14 (14%) had other urinary tract conditions. The mean age of the study population was 67 years. Uroflowmetry was performed on all 100 patients, while cystoscopy was performed on 70 (70%) of the patients. The diagnostic yield of uroflowmetry was high, with a clear diagnosis made in 92 (92%) of the patients. The diagnostic yield of cystoscopy was also high, with a clear diagnosis made in 63 (90%) of the patients who underwent the procedure. There was no statistically significant difference in the diagnostic yield of uroflowmetry and cystoscopy (p = 0.20). Discussion: Our study found that uroflowmetry is an effective and well-tolerated diagnostic tool for evaluating LUTS and diagnosing BPH, with a high diagnostic yield and low risk of complications. Cystoscopy is also a useful diagnostic tool, but it is more invasive and carries a small risk of complications such as bleeding or urinary tract infection. Both tests had a high diagnostic yield, suggesting that either test can provide useful information in the evaluation of LUTS. However, the fact that 70% of the study population underwent cystoscopy raises concerns about the potential overuse of this test in the evaluation of LUTS. This is especially relevant given the focus on patient-centered care and the need to minimize unnecessary or invasive procedures. Our findings underscore the importance of considering the clinical context and using evidence-based guidelines. Conclusion: In this prospective study of 100 patients with suspected BPH or other urinary tract conditions, we found that uroflowmetry and cystoscopy were both valuable diagnostic tools for the evaluation of LUTS. However, the potential overuse of cystoscopy in this population warrants further investigation and highlights the need for careful consideration of the optimal use of diagnostic tests in the evaluation of LUTS and the diagnosis of BPH. Further research is needed to better understand the relative roles of uroflowmetry and cystoscopy in the diagnostic workup of patients with LUTS, and to develop evidence-based guidelines for their appropriate use.

Keywords: uroflowmetry, cystoscopy, LUTS, BPH

Procedia PDF Downloads 61

Authors: G. Gnanachandrasamy, Y. Zhou, S. Venkatramanan, T. Ramkumar, S. Wang

Abstract:

The natural resources of groundwater are the most precious resources around the world that balances are shrinking day by day. In connection, there is an urgency need for demarcation of potential groundwater zone. For these rationale integration of geographical information system (GIS) and remote sensing techniques (RS) for the hydrological studies have become a dramatic change in the field of hydrological research. These techniques are provided to locate the potential zone of groundwater. This research has been made to indent groundwater potential zone in Ariyalur of the southern part of India with help of GIS and remote sensing techniques. To identify the groundwater potential zone used by different thematic layers of geology, geomorphology, drainage, drainage density, lineaments, lineaments density, soil and slope with inverse distance weighting (IDW) methods. From the overall result reveals that the potential zone of groundwater in the study area classified into five classes named as very good (12.18 %), good (22.74 %), moderate (32.28 %), poor (27.7 %) and very poor (5.08 %). This technique suggested that very good potential zone of groundwater occurred in patches of northern and central parts of Jayamkondam, Andimadam and Palur regions in Ariyalur district. The result exhibited that inverse distance weighting method offered in this research is an effective tool for interpreting groundwater potential zones for suitable development and management of groundwater resources in different hydrogeological environments.

Keywords: GIS, groundwater potential zone, hydrology, remote sensing

Procedia PDF Downloads 180

Authors: Shivkanya Fuloria, Neeraj Kumar Fuloria, Sokinder Kumar

Abstract:

m-Cresol and oxadiazoles are the potent antimicrobial moieties. 2-(m-Tolyloxy)acetohydrazide (1) on cyclization with aromatic acids yielded 2-(aryl)-5-(m-tolyloxymethyl)-1,3,4-oxadiazole (1A-E). The structures of newer oxadiazoles were confirmed by elemental and spectral analysis. The newer compounds were evaluated for their antimicrobial potential. The compound 1E containing strong electron withdrawing group showed maximum antimicrobial potential. Other compounds also displayed antimicrobial potential to certain extent. The SAR of newer oxadiazoles indicated that substitution of strong electronegative group in the tolyloxy derived oxadiazoles enhanced their antimicrobial potential.

Keywords: antibacterial, cresol, hydrazide, oxadiazoles

Procedia PDF Downloads 435

Authors: Mayank, Navneet Kaur, Narinder Singh

Abstract:

The V599 mutations in the BRAF protein are extremely oncogenic, responsible for countless of malignant conditions. Along with wild type, V599E, V599D, and V599R are the important mutated variants of the BRAF proteins. The BRAF inhibitory anticancer agents are continuously developing, and sorafenib is a BRAF inhibitor that is under clinical use. The crystal structure of sorafenib bounded to wild type, and V599 is known, showing a similar interaction pattern in both the case. The mutated 599th residue, in both the case, is also found not interacting directly with the co-crystallized sorafenib molecule. However, the IC50 value of sorafenib was found extremely different in both the case, i.e., 22 nmol/L for wild and 38 nmol/L for V599E protein. Molecular docking study and MMGBSA binding energy results also revealed a significant difference in the binding pattern of sorafenib in both the case. Therefore, to explore the role of distinctively situated 599th residue, we have further conducted comprehensive computational studies. The molecular dynamics simulation, residue interaction network (RIN) analysis, and residue correlation study results revealed the importance of the 599th residue on the therapeutic outcome and overall dynamic of the BRAF protein. Therefore, although the position of 599th residue is very much distinctive from the ligand-binding cavity of BRAF, still it has exceptional control over the overall functional outcome of the protein. The insight obtained here may seem extremely important and guide us while designing ideal BRAF inhibitory anticancer molecules.

Keywords: BRAF, oncogenic, sorafenib, computational studies

Procedia PDF Downloads 101

Authors: Paulos Meles Yihdego

Abstract:

To address the environmental impact of the cement industry and road building waste, the use of chemical stabilizers in conjunction with recycled asphalt and cement components was investigated. The silica-based chemical stabilizers and their potential effects on the base layer stabilized by cement are discussed in this paper. Strength, moisture compaction interaction, and microstructural characteristics are all examined. According to the outcome, using this stabilizer has improved the mechanical properties. The inclusion of chemical stabilizers in the combination, which is responsible for the mixture's improved strength, raised the intensity of the C-S-H (Calcium Silicate Hydrate) gel, according to a microstructural study. The design was demonstrated to be durable by the little ettringites found in the later phases. The application of this stabilizer ensures a strong, eco-friendly, durable base layer.

Keywords: ettringites, microstructure analysis, durability properties, cement stabilized base

Procedia PDF Downloads 48

Authors: Nilanchali Singh, Alka Kriplani, Reeta Mahey, Garima Kachhawa

Abstract:

Objective: Resection of larger uterine septa does improve obstetric performance but whether smaller septa need resection and their impact on obstetric outcome is not clear. We wanted to evaluate the role of septal resection of septa of various sizes in obstetric performance. Methods: This retrospective cohort study comprised of 107 patients with uterine septum. The patients were categorized on the basis of extent of uterine septum into four groups: a) Subsepta (< 1/3rd), b) Septum > 1/3 to ½, c) Septum>1/2 to whole uterine cervix, d) Septum traversing whole of uterine cavity and cervix. Out of these 107 patients, 74 could be contacted telephonically and outcomes recorded. Sensitivity and specificity of investigative modalities were calculated. Results: Infertility was seen in maximum number of cases in complete septa (100%), whereas abortions were seen more commonly, in subsepta (18%). MRI had maximum sensitivity and positive predictive value, followed by hysteron-salpingography. Tubal block, fibroid, endometriosis, pelvic adhesions, ovarian pathologies were seen in some but no definite association of these pathologies was seen with any subgroup of septa. Almost five-year follow-up was recorded in all the subgroups. Significant reduction in infertility was seen in all septal subgroup (p=0.046, 0.032 & 0.05) patients except in subsepta (< 1/3rd uterine cavity) after septum resection. Abortions were significantly reduced (p=0.048) in third subgroup (i.e. septum > ½ to upto internal os) after hysteroscopic septum resection. Take home baby rate was 33% in subsepta and around 50% in the remaining subgroups of septa. Conclusions: Septal resection improves obstetric performance in patients with uterine septa of various sizes. Whether septal resection improves obstetric performance in patients with subsepta or very small septa, is controversial. Larger studies addressing this issue need to be planned.

Keywords: septal resection, obstetric outcome, infertility, septum size

Procedia PDF Downloads 300

Authors: Sarah E. Nelson, Casey Weiner, Alexander Sigmon, Jun Hua, Haris I. Sair, Jose I. Suarez, Robert D. Stevens

Abstract:

Graph-theoretical information from structural connectomes indicated significant connectivity changes and improved acute prognostication in a Random Forest (RF) model in aneurysmal subarachnoid hemorrhage (aSAH), which can lead to significant morbidity and mortality and has traditionally been fraught by poor methods to predict outcome. This study’s hypothesis was that structural connectivity changes occur in canonical brain networks of acute aSAH patients, and that these changes are associated with functional outcome at six months. In a prospective cohort of patients admitted to a single institution for management of acute aSAH, patients underwent diffusion tensor imaging (DTI) as part of a multimodal MRI scan. A weighted undirected structural connectome was created of each patient’s images using Constant Solid Angle (CSA) tractography, with 176 regions of interest (ROIs) defined by the Johns Hopkins Eve atlas. ROIs were sorted into four networks: Default Mode Network, Executive Control Network, Salience Network, and Whole Brain. The resulting nodes and edges were characterized using graph-theoretic features, including Node Strength (NS), Betweenness Centrality (BC), Network Degree (ND), and Connectedness (C). Clinical (including demographics and World Federation of Neurologic Surgeons scale) and graph features were used separately and in combination to train RF and Logistic Regression classifiers to predict two outcomes: dichotomized modified Rankin Score (mRS) at discharge and at six months after discharge (favorable outcome mRS 0-2, unfavorable outcome mRS 3-6). A total of 56 aSAH patients underwent DTI a median (IQR) of 7 (IQR=8.5) days after admission. The best performing model (RF) combining clinical and DTI graph features had a mean Area Under the Receiver Operator Characteristic Curve (AUROC) of 0.88 ± 0.00 and Area Under the Precision Recall Curve (AUPRC) of 0.95 ± 0.00 over 500 trials. The combined model performed better than the clinical model alone (AUROC 0.81 ± 0.01, AUPRC 0.91 ± 0.00). The highest-ranked graph features for prediction were NS, BC, and ND. These results indicate reorganization of the connectome early after aSAH. The performance of clinical prognostic models was increased significantly by the inclusion of DTI-derived graph connectivity metrics. This methodology could significantly improve prognostication of aSAH.

Keywords: connectomics, diffusion tensor imaging, graph theory, machine learning, subarachnoid hemorrhage

Procedia PDF Downloads 173

Authors: Pongsakorn Komutpol, Pravej Serichetaphongse, Soontra Panmekiate, Atiphan Pimkhaokham

Abstract:

Statement of Problem: The important parameter of esthetic assessment in anterior maxillary implant include pink esthetic of gingiva and white esthetic of restoration. While the 3 dimensional (3D) implant position are recently concerned as a key for succeeding in implant treatment. However, to our knowledge, the authors did not come across any publication that demonstrated the relations of esthetic outcome and 3D implant position. Objectives: To investigate the correlation between positional accuracy of single-tooth implant restoration (STIR) in all 3 dimensions and their esthetic outcomes. Materials and Methods: 17 patients’ data who had a STIR at central incisor with pristine contralateral tooth were included in this study. Intraoral photographs, dental models, and cone beam computed tomography (CBCT) images were retrieved. The esthetic outcome was assessed in accordance with pink esthetic score and white esthetic score (PES/WES). While the number of correct position in each dimension (mesiodistal, labiolingual, apicocoronal) of the implant were evaluated and defined as 'right' or 'wrong' according to ITI consensus conference by one investigator using CBCT data. The different mean score between right and wrong position in all dimensions was analyzed by Mann-Whitney U test with 0.05 was the significant level of the study. Results: The average score of PES/WES was 15.88 ± 1.65 which was considered as clinically acceptable. The average PES/WES score in 1, 2 and 3 right dimension of the implant position were 16.71, 15.75 and 15.17 respectively. None of the implants placed wrongly in all three dimensions. Statistically significant difference of the PES/WES score was found between the implants that placed right in 3 dimensions and 1 dimension (p = 0.041). Conclusion: This study supported the principle of 3D position of implant. The more properly implant was placed, the higher esthetic outcome was found.

Keywords: accuracy, dental implant, esthetic, 3D implant position

Procedia PDF Downloads 155

Authors: Rohit Gupta, Ravinder Agarwal

Abstract:

Surface electromyographic (sEMG) signal has the potential to identify the human activities and intention. This potential is further exploited to control the artificial limbs using the sEMG signal from residual limbs of amputees. The paper deals with the development of multichannel cost efficient sEMG signal interface for research application, along with evaluation of proposed class dependent statistical approach of the feature selection method. The sEMG signal acquisition interface was developed using ADS1298 of Texas Instruments, which is a front-end interface integrated circuit for ECG application. Further, the sEMG signal is recorded from two lower limb muscles for three locomotions namely: Plane Walk (PW), Stair Ascending (SA), Stair Descending (SD). A class dependent statistical approach is proposed for feature selection and also its performance is compared with 12 preexisting feature vectors. To make the study more extensive, performance of five different types of classifiers are compared. The outcome of the current piece of work proves the suitability of the proposed feature selection algorithm for locomotion recognition, as compared to other existing feature vectors. The SVM Classifier is found as the outperformed classifier among compared classifiers with an average recognition accuracy of 97.40%. Feature vector selection emerges as the most dominant factor affecting the classification performance as it holds 51.51% of the total variance in classification accuracy. The results demonstrate the potentials of the developed sEMG signal acquisition interface along with the proposed feature selection algorithm.

Keywords: classifiers, feature selection, locomotion, sEMG

Procedia PDF Downloads 274

Authors: Jui Afrin, Akhtarul Islam

Abstract:

In this paper, the solution of glucose, yeast and glucose yeast mixture are being used as sample solution for determining the chemical oxygen demand (COD). In general COD determination method used to determine the different rang of oxidative potential. But in this work has shown to determine the definite oxidative potential for different concentration for known COD value and wanted to see the difference between experimental value and the theoretical value for evaluating the method drawbacks. In this study, made the values of oxidative potential like 400 mg/L, 500 mg/L, 600 mg/L, 700 mg/L and 800mg/L for various sample solutions and determined the oxidative potential according to our developed method. Plotting the experimental COD values vs. sample solutions of various concentrations in mg/L to draw the curve. From these curves see that the curves for glucose solution is not linear; its deviate from linearity for the lower concentration and the reason for this deviation is unknown. If these drawback can be removed this method can be effectively used to determine Oxidative Potential of Industrial wastewater (such as: Leather industry wastewater, Municipal wastewater, Food industry wastewater, Textile wastewater, Pharmaceuticals waste water) that’s why more experiment and study required.

Keywords: bod (biological oxygen demand), cod (chemical oxygen demand), oxidative potential, titration, waste water, development

Procedia PDF Downloads 216

Authors: Geday Elias, Montaigne Etienne, Padilla Martine, Tollossa Degefa

Abstract:

Smallholder farmers’ participation in agricultural value chain identified as a pathway to get out of poverty trap in Ethiopia. The smallholder dairy activities have a huge potential in poverty reduction through enhancing income, achieving food and nutritional security in the country. However, much less is known about the effects of smallholder’s participation in milk value chain on household food security and nutrition. This paper therefore, aims at evaluating the effects of smallholders’ participation in milk value chain on household food security taking in to account the four pillars of food security measurements (availability, access, utilization and stability). Using a semi-structured interview, a cross sectional farm household data collected from a randomly selected sample of 333 households (170 in Amhara and 163 in Oromia regions).Binary logit and propensity score matching( PSM) models are employed to examine the mechanisms through which smallholder’s participation in the milk value chain affects household food security where crop production, per capita calorie intakes, diet diversity score, and food insecurity access scale are used to measure food availability, access, utilization and stability respectively. Our findings reveal from 333 households, only 34.5% of smallholder farmers are participated in the milk value chain. Limited access to inputs and services, limited access to inputs markets and high transaction costs are key constraints for smallholders’ limited access to the milk value chain. To estimate the true average participation effects of milk value chain for participated households, the outcome variables (food security) of farm households who participated in milk value chain are compared with the outcome variables if the farm households had not participated. The PSM analysis reveals smallholder’s participation in milk value chain has a significant positive effect on household income, food security and nutrition. Smallholder farmers who are participated in milk chain are better by 15 quintals crops production and 73 percent of per capita calorie intakes in food availability and access respectively than smallholder farmers who are not participated in the market. Similarly, the participated households are better in dietary quality by 112 percents than non-participated households. Finally, smallholders’ who are participated in milk value chain are better in reducing household vulnerability to food insecurity by an average of 130 percent than non participated households. The results also shows income earned from milk value chain participation contributed to reduce capital’s constraints of the participated households’ by higher farm income and total household income by 5164 ETB and 14265 ETB respectively. This study therefore, confirms the potential role of smallholders’ participation in food value chain to get out of poverty trap through improving rural household income, food security and nutrition. Therefore, identified the determinants of smallholder participation in milk value chain and the participation effects on food security in the study areas are worth considering as a positive knock for policymakers and development agents to tackle the poverty trap in the study area in particular and in the country in general.

Keywords: effects, food security and nutrition, milk, participation, smallholders, value chain

Procedia PDF Downloads 320

Authors: Seokbeen Lim, Gilwon Yoon

Abstract:

The readiness potential in brain waves is a brain activity related with an intention whose potential arises even before its conscious intention. This study was carried out in order to understand the generation and mechanism of the readiness potential more. The experiment with two subjects was conducted in two ways following the Oddball task protocol. Firstly, auditory stimuli were randomly presented to the subjects. The subject was allowed to press the keyboard with the right index finger only when the subject heard the target stimulus but not the standard stimulus. Secondly, unlike the first one, the auditory stimuli were randomly presented, and the subjects pressed the keyboard in the same manner, but at the same time with grasping action of the left hand. The readiness potential showed up for both of these experiments. In the first Oddball experiment, the readiness potential was detected only when the target stimulus was presented. However, in the second Oddball experiment with the left hand action of grasping something, the readiness potential was detected at the presentation of for both standard and target stimuli. However, detected readiness potentials with the target stimuli were larger than those of the standard stimuli. We found an interesting phenomenon that the readiness potential was able to be detected even the standard stimulus. This indicates that motor-related readiness potentials can be generated only by the intention to move. These results present a new perspective in psychology and brain engineering since subconscious brain action may be prior to conscious recognition of the intention.

Keywords: readiness potential, auditory stimuli, event-related potential, electroencephalography, oddball task

Procedia PDF Downloads 189

Authors: Gauri Shankar Shah

Abstract:

Objectives: The Type I diabetes mellitus in children is frequently a missed diagnosis and children presents in emergency with diabetic ketoacidosis having significant morbidity and mortality. The present study was done to find out the clinical presentation and outcome at a tertiary-care centre. Methods: This was retrospective analysis of data of Type I diabetes mellitus reporting to our centre during last one year (2012-2013). Results: There were 12 patients (8 males) and the age group was 4-14 years (mean ± 3.7). The presenting symptoms were fever, vomiting, altered sensorium and fast breathing in 8 (66.6%), 6 (50%), 4 (33.3%), and 4 (33.3%) cases, respectively. The classical triad of polyuria, polydypsia, and polyphagia were present only in two patients (33.2%). Seizures and epigastric pain were found in two cases each (33.2%). The four cases (33.3%) presented with diabetic ketoacidosis due to discontinuation of insulin doses, while 2 had hyperglycemia alone. The hemogram revealed mean hemoglobin of 12.1± 1.6 g/dL and total leukocyte count was 22,883.3 ± 10,345.9 per mm3, with polymorphs percentage of 73.1 ± 9.0%. The mean blood sugar at presentation was 740 ± 277 mg/ dl (544–1240). HbA1c ranged between 7.1-8.8 with mean of 8.1±0.6 %. The mean sodium, potassium, blood ph, pCO2, pO2 and bicarbonate were 140.8 ± 6.9 mEq/L, 4.4 ± 1.8mEq/L, 7.0 ± 0.2, 20.2 ± 10.8 mmHg, 112.6 ± 46.5 mmHg and 9.2 ± 8.8 mEq/L, respectively. All the patients were managed in pediatric intensive care unit as per our protocol, recovered and discharged on intermediate insulin given twice daily. Conclusions: Thus, it shows that these patients have uncontrolled hyperglycemia and often presents in emergency with ketoacidosis and deranged biochemical profile. The regular administration of insulin, frequent monitoring of blood sugar and health education are required to have better metabolic control and good quality of life.

Keywords: type I diabetes mellitus, hyperglycemia, outcome, glycemic control

Procedia PDF Downloads 242

Authors: Catherine Equey Balzli

Abstract:

Old age retirement pensions are an important concern among the Swiss but estimating one’s income after retirement is difficult due to the Swiss insurance system’s complexity. This project’s aim is to prepare for developing a digital platform that will allow individuals to plan for retirement in a simplified manner. The main objective of the platform will be to give individuals the tools to check that their savings and retirement benefits will allow them to continue the lifestyle to which they are accustomed once they are retired. The research results from qualitative (focus group) and quantitative (survey) methodologies, recommend the scope and functionalities for a digital platform to be developed. A main outcome is the need to limit the platform’s scope to old-age pension only (excluding survivors’ or disability pensions, for instance). Furthermore, an outcome regarding the functionalities is the proposition of scenarios such as early retirement, changes to income, or modifications to personal status. The development of the digital platform will be a subsequent project.

Keywords: benefit statement, digital platform, retirement financial planning, social insurance

Procedia PDF Downloads 95

Authors: Reza Ziaie Moayad, Azam Kouhpeyma

Abstract:

In-situ testing is preferred to evaluate the liquefaction potential in cohesionless soils due to high disturbance during sampling. Although new in-situ methods with high accuracy have been developed, standard penetration test, the simplest and the oldest in-situ test, is still used due to the profusion of the recorded data. This paper reviews the Iranian standard of evaluating liquefaction potential in soils (codes 525) and compares the liquefaction assessment methods based on SPT results on cohesionless soil in this standard with the international standards. To this, methods for assessing liquefaction potential which are presented by Cetin et al. (2004), Boulanger and Idriss (2014) are compared with what is presented in standard 525. It is found that although the procedure used in Iranian standard of evaluating the potential of liquefaction has not been updated according to the new findings, it is a conservative procedure.

Keywords: cohesionless soil, liquefaction, SPT, standard 525

Procedia PDF Downloads 149

Authors: A. Mohammadpour, Ebrahim Najafi Kajabad, Ghazale Ipakchi

Abstract:

Presently, computer networks’ security rise in importance and many studies have also been conducted in this field. By the penetration of the internet networks in different fields, many things need to be done to provide a secure industrial and non-industrial network. Fire walls, appropriate Intrusion Detection Systems (IDS), encryption protocols for information sending and receiving, and use of authentication certificated are among things, which should be considered for system security. The aim of the present study is to use the outcome of several algorithms, which cause decline in IDS errors, in the way that improves system security and prevents additional overload to the system. Finally, regarding the obtained result we can also detect the amount and percentage of more sub attacks. By running the proposed system, which is based on the use of multi-algorithmic outcome and comparing that by the proposed single algorithmic methods, we observed a 78.64% result in attack detection that is improved by 3.14% than the proposed algorithms.

Keywords: intrusion detection systems, clustering, k-means, k-medoids, SV clustering, ensemble

Procedia PDF Downloads 203