Search results for: bone fracture risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7201

Search results for: bone fracture risk

5701 Identification of Architectural Design Error Risk Factors in Construction Projects Using IDEF0 Technique

Authors: Sahar Tabarroki, Ahad Nazari

Abstract:

The design process is one of the most key project processes in the construction industry. Although architects have the responsibility to produce complete, accurate, and coordinated documents, architectural design is accompanied by many errors. A design error occurs when the constraints and requirements of the design are not satisfied. Errors are potentially costly and time-consuming to correct if not caught early during the design phase, and they become expensive in either construction documents or in the construction phase. The aim of this research is to identify the risk factors of architectural design errors, so identification of risks is necessary. First, a literature review in the design process was conducted and then a questionnaire was designed to identify the risks and risk factors. The questions in the form of the questionnaire were based on the “similar service description of study and supervision of architectural works” published by “Vice Presidency of Strategic Planning & Supervision of I.R. Iran” as the base of architects’ tasks. Second, the top 10 risks of architectural activities were identified. To determine the positions of possible causes of risks with respect to architectural activities, these activities were located in a design process modeled by the IDEF0 technique. The research was carried out by choosing a case study, checking the design drawings, interviewing its architect and client, and providing a checklist in order to identify the concrete examples of architectural design errors. The results revealed that activities such as “defining the current and future requirements of the project”, “studies and space planning,” and “time and cost estimation of suggested solution” has a higher error risk than others. Moreover, the most important causes include “unclear goals of a client”, “time force by a client”, and “lack of knowledge of architects about the requirements of end-users”. For error detecting in the case study, lack of criteria, standards and design criteria, and lack of coordination among them, was a barrier, anyway, “lack of coordination between architectural design and electrical and mechanical facility”, “violation of the standard dimensions and sizes in space designing”, “design omissions” were identified as the most important design errors.

Keywords: architectural design, design error, risk management, risk factor

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5700 Strategies to Promote Safety and Reduce the Vulnerability of Urban Worn-out Textures to the Potential Risk of Earthquake

Authors: Bahareh Montakhabi

Abstract:

Earthquake is known as one of the deadliest natural disasters, with a high potential for damage to life and property. Some of Iran's cities were completely destroyed after major earthquakes, and the people of the region suffered a lot of mental, financial and psychological damage. Tehran is one of the cities located on the fault line. According to experts, the only city that could be severely damaged by a moderate earthquake in Earthquake Engineering Intensity Scale (EEIS) (70% destruction) is Tehran because Tehran is built precisely on the fault. Seismic risk assessment (SRA) of cities in the scale of urban areas and neighborhoods is the first phase of the earthquake crisis management process, which can provide the information required to make optimal use of available resources and facilities in order to reduce the destructive effects and consequences of an earthquake. This study has investigated strategies to promote safety and reduce the vulnerability of worn-out urban textures in the District 12 of Tehran to the potential risk of earthquake aimed at prioritizing the factors affecting the vulnerability of worn-out urban textures to earthquake crises and how to reduce them, using the analytical-exploratory method, analytical hierarchy process (AHP), Expert choice and SWOT technique. The results of SWAT and AHP analysis of the vulnerability of the worn-out textures of District 12 to internal threats (1.70) and external threats (2.40) indicate weak safety of the textures of District 12 regarding internal and external factors and a high possibility of damage.

Keywords: risk management, vulnerability, worn-out textures, earthquake

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5699 The Predictability of Three Implants to Support a Fixed Prosthesis in the Edentulous Mandible

Authors: M. Hirani, M. Devine, O. Obisesan, C. Bryant

Abstract:

Introduction: The use of four or more implants to support a fixed prosthesis in the edentulous mandible is well documented, with high levels of clinical outcomes recorded. Despite this, the use of three implant-supported fixed prostheses offers the potential to deliver a more cost-effective method of oral rehabilitation in the lower arch, an important consideration given that edentulism is most prevalent in low-income subpopulations. The purpose of this study aimed to evaluate the implant and prosthetic survival rate, changes in marginal bone level, and patient satisfaction associated with a three-implant-supported fixed prosthesis for rehabilitation of the edentulous mandible over a follow-up period of at least one year. Methods: A comprehensive literature search was performed to evaluate studies that met the selection criteria. The information extracted included the study design and population, participant demographics, observation period, loading protocol, and the number of implants placed together with the required outcome measures. Mean values and standard deviations (SD) were calculated using SPSS® (IBM Corporation, New York, USA), and the level of statistical significance across all comparative studies described was set at P < 0.05. Results: The eligible studies included a total of 1968 implants that were placed in 652 patients. The subjects ranged in age from 33-89 years, with a mean of 63.2 years. The mean cumulative implant and prosthetic survival rates were 95.5% and 96.2%, respectively, over a mean follow-up period of 3.25 years. The mean marginal bone loss recorded was 1.04 mm, and high patient satisfaction rates were reported across the studies. Conclusion: Current evidence suggests that a three implant-supported fixed prosthesis for the edentulous mandible is a successful treatment strategy presenting high implant and prosthetic survival rates over the short-to-medium term. Further well-designed controlled clinical trials are required to evaluate longer-term outcomes, with supplemental data correlating implant dimensions and prosthetic design.

Keywords: implants, mandible, fixed, prosthesis

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5698 Incidence and Risk Factors of Central Venous Associated Infections in a Tunisian Medical Intensive Care Unit

Authors: Ammar Asma, Bouafia Nabiha, Ghammam Rim, Ezzi Olfa, Ben Cheikh Asma, Mahjoub Mohamed, Helali Radhia, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

Abstract:

Background: Central venous catheter associated infections (CVC-AI) are among the serious hospital-acquired infections. The aims of this study are to determine the incidence of CVC-AI, and their risk factors among patients followed in a Tunisian medical intensive care unit (ICU). Materials / Methods: A prospective cohort study conducted between September 15th, 2015 and November 15th, 2016 in an 8-bed medical ICU including all patients admitted for more than 48h. CVC-AI were defined according to CDC of ATLANTA criteria. The enrollment was based on clinical and laboratory diagnosis of CVC-AI. For all subjects, age, sex, underlying diseases, SAPS II score, ICU length of stay, exposure to CVC (number of CVC placed, site of insertion and duration catheterization) were recorded. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: Among 192 eligible patients, 144 patients (75%) had a central venous catheter. Twenty-eight patients (19.4%) had developed CVC-AI with density rate incidence 20.02/1000 CVC-days. Among these infections, 60.7% (n=17) were systemic CVC-AI (with negative blood culture), and 35.7% (n=10) were bloodstream CVC-AI. The mean SAPS II of patients with CVC-AI was 32.76 14.48; their mean Charlson index was 1.77 1.55, their mean duration of catheterization was 15.46 10.81 days and the mean duration of one central line was 5.8+/-3.72 days. Gram-negative bacteria was determined in 53.5 % of CVC-AI (n= 15) dominated by multi-drug resistant Acinetobacter baumani (n=7). Staphylococci were isolated in 3 CVC-AI. Fourteen (50%) patients with CVC-AI died. Univariate analysis identified men (p=0.034), the referral from another hospital department (p=0.03), tobacco (p=0.006), duration of sedation (p=0.003) and the duration of catheterization (p=0), as possible risk factors of CVC-AI. Multivariate analysis showed that independent factors of CVC-AI were, male sex; OR= 5.73, IC 95% [2; 16.46], p=0.001, Ramsay score; OR= 1.57, IC 95% [1.036; 2.38], p=0.033, and duration of catheterization; OR=1.093, IC 95% [1.035; 1.15], p=0.001. Conclusion: In a monocenter cohort, CVC-AI had a high density and is associated with poor outcome. Identifying the risk factors is necessary to find solutions for this major health problem.

Keywords: central venous catheter associated infection, intensive care unit, prospective cohort studies, risk factors

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5697 Process Flows and Risk Analysis for the Global E-SMC

Authors: Taeho Park, Ming Zhou, Sangryul Shim

Abstract:

With the emergence of the global economy, today’s business environment is getting more competitive than ever in the past. And many supply chain (SC) strategies and operations have significantly been altered over the past decade to overcome more complexities and risks imposed onto the global business. First, offshoring and outsourcing are more adopted as operational strategies. Manufacturing continues to move to better locations for enhancing competitiveness. Second, international operations are a challenge to a company’s SC system. Third, the products traded in the SC system are not just physical goods, but also digital goods (e.g., software, e-books, music, video materials). There are three main flows involved in fulfilling the activities in the SC system: physical flow, information flow, and financial flow. An advance of the Internet and electronic communication technologies has enabled companies to perform the flows of SC activities in electronic formats, resulting in the advent of an electronic supply chain management (e-SCM) system. A SC system for digital goods is somewhat different from the supply chain system for physical goods. However, it involves many similar or identical SC activities and flows. For example, like the production of physical goods, many third parties are also involved in producing digital goods for the production of components and even final products. This research aims at identifying process flows of both physical and digital goods in a SC system, and then investigating all risk elements involved in the physical, information, and financial flows during the fulfilment of SC activities. There are many risks inherent in the e-SCM system. Some risks may have severe impact on a company’s business, and some occur frequently but are not detrimental enough to jeopardize a company. Thus, companies should assess the impact and frequency of those risks, and then prioritize them in terms of their severity, frequency, budget, and time in order to be carefully maintained. We found risks involved in the global trading of physical and digital goods in four different categories: environmental risk, strategic risk, technological risk, and operational risk. And then the significance of those risks was investigated through a survey. The survey asked companies about the frequency and severity of the identified risks. They were also asked whether they had faced those risks in the past. Since the characteristics and supply chain flows of digital goods are varying industry by industry and country by country, it is more meaningful and useful to analyze risks by industry and country. To this end, more data in each industry sector and country should be collected, which could be accomplished in the future research.

Keywords: digital goods, e-SCM, risk analysis, supply chain flows

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5696 Poisoning in Morocco: Evolution and Risk Factors

Authors: El Khaddam Safaa, Soulaymani Abdelmajid, Mokhtari Abdelghani, Ouammi Lahcen, Rachida Soulaymani-Beincheikh

Abstract:

The poisonings represent a problem of health in the world and Morocco, The exact dimensions of this phenomenon are still poorly recorded that we see the lack of exhaustive statistical data. The objective of this retrospective study of a series of cases of the poisonings declared at the level of the region of Tadla-Azilal and collected by the Moroccan Poison Control and Pharmacovigilance Center. An epidemiological profile of the poisonings was to raise, to determine the risk factors influencing the vital preview of the poisoned And to follow the evolution of the incidence, the lethality, and the mortality. During the period of study, we collected and analyzed 9303 cases of poisonings by different incriminated toxic products with the exception of the scorpion poisonings. These poisonings drove to 99 deaths. The epidemiological profile which we raised, showed that the poisoned were of any age with an average of 24.62±16.61 years, The sex-ratio (woman/man) was 1.36 in favor of the women. The difference between both sexes is highly significant (χ2 = 210.5; p<0,001). Most of the poisoned which declared to be of urban origin (60.5 %) (χ2=210.5; p<0,001). Carbon monoxide was the most incriminated among the cases of poisonings (24.15 %), them putting in head, followed by some pesticides and farm produces (21.44 %) and food (19.95 %). The analysis of the risk factors showed that the grown-up patients whose age is between 20 and 74 years have twice more risk of evolving towards the death (RR=1,57; IC95 % = 1,03-2,38) than the other age brackets, so the male genital organ was the most exposed (explained) to the death that the female genital organ (RR=1,59; IC95 % = 1,07-2,38) The patients of rural origin had presented 5 times more risk (RR=4,713; IC95 % = 2,543-8,742). Poisoned by the mineral products had presented the maximum of risk on the vital preview death (RR=23,19, IC95 % = 2,39-224,1). The poisonings by pesticides produce a risk of 9 (RR=9,31; IC95 % = 6,10-14,18). The incidence was 3,3 cases of 10000 inhabitants, and the mortality was 0,004 cases of 1000 inhabitants (that is 4 cases by 1000 000 inhabitants). The rate of lethality registered annually was 10.6 %. The evolution of the indicators of health according to the years showed that the rate of statement measured by the incidence increased by a significant way. We also noted an improvement in the coverage which (who) ended up with a decrease in the rate of the lethality and the mortality during last years. The fight anti-toxic is a work of length time. He asks for a lot of work various levels. It is necessary to attack the delay accumulated by our country on the various legal, institutional and technical aspects. The ideal solution is to develop and to set up a national strategy.

Keywords: epidemiology, poisoning, risk factors, indicators of health, Tadla-Azilal grated by anti-toxic fight

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5695 Sol-Gel Derived 58S Bioglass Substituted by Li and Mg: A Comparative Evaluation on in vitro Bioactivity, MC3T3 Proliferation and Antibacterial Efficiency

Authors: Amir Khaleghipour, Amirhossein Moghanian, Elhamalsadat Ghaffari

Abstract:

Modified bioactive glass has been considered as a promising multifunctional candidate in bone repair and regeneration due to its attractive properties. The present study mainly aims to evaluate how the individual substitution of lithium (L-BG) and magnesium (M-BG) for calcium can affect the in vitro bioactivity of sol-gel derived substituted 58S bioactive glass (BG); and to present one composition in both of the 60SiO₂–(36-x)CaO–4P₂O₅–(x)Li₂O and 60SiO₂–(36-x)CaO–4P₂O₅–(x)MgO quaternary systems (where x= 0, 5, 10 mol.%) with improved biocompatibility, enhanced alkaline phosphatase (ALP) activity, and the most efficient antibacterial activity against methicillin-resistant Staphylococcus aureus bacteria. To address these aims, and study the effect of CaO/Li₂O and CaO/MgO substitution up to 10 mol % in 58S-BGs, the samples were characterized by X-ray diffraction, Fourier transform infrared spectroscopy, inductively coupled plasma atomic emission spectrometry and scanning electron microscopy after immersion in simulated body fluid up to 14 days. Results indicated that substitution of either CaO/ Li₂O and CaO/ MgO had a retarding effect on in vitro hydroxyapatite (HA) formation due to the lower supersaturation degree for nucleation of HA compared with 58s-BG. Meanwhile, magnesium had a more pronounced effect. The 3-(4, 5dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and alkaline phosphatase (ALP) assays showed that both substitutions of CaO/ Li₂O and CaO/ MgO up to 5mol % in 58s-BGs led to increased biocompatibility and stimulated proliferation of the pre-osteoblast MC3T3 cells with respect to the control. On the other hand, substitution of either Li or Mg for Ca in the 58s BG composition resulted in improved bactericidal efficiency against MRSA bacteria. Taken together, sample 58s-BG with 5 mol % CaO/Li₂O substitution (BG-5L) was considered as a multifunctional biomaterial in bone repair/regeneration with improved biocompatibility, enhanced ALP activity as well enhanced antibacterial efficiency against methicillin-resistant Staphylococcus aureus (MRSA) bacteria among all of the synthesized L-BGs and M-BGs.

Keywords: alkaline, alkaline earth, bioactivity, biomedical applications, sol-gel processes

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5694 Exposure Assessment for Worker Exposed to Heavy Metals during Road Marking Operations

Authors: Yin-Hsuan Wu, Perng-Jy Tsai, Ying-Fang Wang, Shun-Hui Chung

Abstract:

The present study was conducted to characterize exposure concentrations, concentrations deposited on the different respiratory regions, and resultant health risks associated with heavy metal exposures for road marking workers. Road marking workers of three similar exposure groups (SEGs) were selected, including the paint pouring worker, marking worker, and preparing worker. Personal exposure samples were collected using an inhalable dust sampler (IOM), and the involved particle size distribution samples were estimated using an eight-stage Marple personal cascade impactor during five working days. In total, 25 IOM samples and 20 Marple samples were collected. All collected samples were analyzed for their heavy metal contents using the ICP/MS. The resultant heavy metal particle size distributions were also used to estimate the fractions of particle deposited on the head airways (Chead), tracheobronchial (Cthorac) and alveolar regions (Cresp) of the exposed workers. In addition, Pb and Cr were selected to estimate the incremental cancer risk, and Zn, Ti, and Mo were selected to estimate the corresponding non-cancer risk in the present study. Results show that three heavy metals, including Pb, Cr, and Ti, were found with the highest concentrations for the SEG of the paint pouring worker (=0.585±2.98, 0.307±1.71, 0.902±2.99 μg/m³, respectively). For the fraction of heavy metal particle deposited on the respiratory tract, both alveolar and head regions were found with the highest values (=23-43% and 39-61%, respectively). For both SEGs of the paint pouring and marking, 51% of Cr, 59-61% of Zn, and 48-51% of Ti were found to be deposited on the alveolar region, and 41-43% of Pb was deposited on the head region. Finally, the incremental cancer risk for the SEGs of the paint pouring, marking, and preparing were found as 1.08×10⁻⁵, 2.78×10⁻⁶, and 2.20×10⁻⁶, respectively. In addition, the estimated non-cancer risk for the above three SEGs was found to be consistently less than unity. In conclusion, though the estimated non-cancer risk was less than unity, all resultant incremental cancer risk was greater than 10⁻⁶ indicating the abatement of workers’ exposure is necessary. It is suggested that strategies, including placing on the molten kettle, substitution the currently used paints for less heavy metal containing paints, and wearing fume protecting personal protective equipment can be considered in the future from reducing the worker’s exposure aspect.

Keywords: health risk assessment, heavy metal, respiratory track deposition, road marking

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5693 Risk Factors for Postoperative Fever in Patients Undergoing Lumbar Fusion

Authors: Bang Haeyong

Abstract:

Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative fever after lumbar fusion. Methods: This study was a retrospective chart review of 291 patients who underwent lumbar fusion between March 2015 and February 2016 at the Asan Medical Center. Information was extracted from electronic medical records. Postoperative fever was measured at Tmax > 37.7 ℃ and Tmax > 38.3 ℃. The presence of postoperative fever, blood culture, urinary excretion, and/or chest x-ray were evaluated. Patients were evaluated for infection after lumbar fusion. Results: We found 222 patients (76.3%) had a postoperative temperature of 37.7 ℃, and 162 patients (55.7%) had a postoperative temperature of 38.3 ℃ or higher. The percentage of febrile patients trended down following the mean 1.8days (from the first postoperative day to seventh postoperative day). Infection rate was 9 patients (3.1%), respiratory virus (1.7%), urinary tract infection (0.3%), phlebitis (0.3%), and surgical site infection (1.4%). There was no correlation between Tmax > 37.7℃ or Tmax > 38.3℃, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Risk factors for increased postoperative fever following surgery were confirmed to be delay of defecation (OR=1.37, p=.046), and shorten of remove drainage (OR=0.66, p=.037). Conclusions: The incidence of fever was 76.3% after lumbar fusion and the drainage time was faster in the case of fever. It was thought that the bleeding was absorbed at the operation site and fever occurred. The prevalence of febrile septicemia was higher in patients with long bowel movements before surgery than after surgery. Clinical symptoms should be considered because postoperative fever cannot be determined by fever alone because fever and infection are not significant.

Keywords: lumbar surgery, fever, postoperative, risk factor

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5692 Personality-Focused Intervention for Adolescents: Impact on Bullying and Distress

Authors: Erin V. Kelly, Nicola C. Newton, Lexine A. Stapinski, Maree Teesson

Abstract:

Introduction: There is a lack of targeted prevention programs for reducing bullying and distress among adolescents involved in bullying. The current study aimed to examine the impact of a personality-targeted intervention (Preventure) on bullying (victimization and perpetration) and distress among adolescent victims/bullies with high-risk personality types. Method: A cluster randomized trial (RCT) was conducted in 26 secondary schools (2190 students) in NSW and Victoria, Australia, as part of the Climate Schools and Preventure trial. The schools were randomly allocated to Preventure (13 schools received Preventure, 13 did not). Students were followed up at 4 time points (6, 12, 24 and 36 months post-baseline). Preventure involves two group sessions, based on cognitive behavioral therapy, and tailored to four personality types shown to increase risk of substance misuse and other emotional and behavioural problems, including impulsivity, sensation-seeking, anxiety sensitivity and hopelessness. Students were allocated to the personality-targeted groups based on their scores on the Substance Use Risk Profile Scale. Bullying was measured using an amended version of the Revised Olweus Bully/Victim Scale. Psychological distress was measured using the Kessler Psychological Distress Scale. Results: Among high-risk students classified as victims at baseline, those in Preventure schools reported significantly less victimization and distress over time than those in control schools. Among high-risk students classified as bullies at baseline, those in Preventure schools reported significantly less distress over time than those in control schools (no difference for perpetration). Conclusion: Preventure is a promising intervention for reducing bullying victimization and psychological distress among adolescents involved in bullying.

Keywords: adolescents, bullying, personality, prevention

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5691 Management of Diabetics on Hemodialysis

Authors: Souheila Zemmouchi

Abstract:

Introduction: Diabetes is currently the leading cause of end-stage chronic kidney disease and dialysis, so it adds additional complexity to the management of chronic hemodialysis patients. These patients are extremely fragile because of their multiple cardiovascular and metabolic comorbidities. Clear and complete description of the experience: the management of a diabetic on hemodialysis is particularly difficult due to frequent hypoglycaemia and significant inter and perdialyticglycemic variability that is difficult to predict. The aim of our study is to describe the clinical-biological profile and to assess the cardiovascular risk of diabetics undergoing chronic hemodialysis, and compare them with non-diabetic hemodialysis patients. Methods: This cross-sectional, descriptive, and analytical study was carried out between January 01 and December 31, 2018, involving 309 hemodialysis patients spread over 4 centersThe data were collected prospectively then compiled and analyzed by the SPSS Version 10 software The FRAMINGHAM RISK SCORE has been used to assess cardiovascular risk in all hemodialysis patients Results: The survey involved 309 hemodialysis patients, including 83 diabetics, for a prevalence of 27% The average age 53 ± 10.2 years. The sex ratio is 1.5. 50% of diabetic hemodialysis patients retained residual diuresis against 32% in non-diabetics. In the group of diabetics, we noted more hypertension (70% versus 38% non-diabetics P 0.004), more intradialytichypoglycemia (15% versus 3% non-diabetics P 0.007), initially, vascular exhaustion was found in 4 diabetics versus 2 non-diabetics. 70% of diabetics with anuria had postdialytichyperglycemia. The study found a statistically significant difference between the different levels of cardiovascular risk according to the diabetic status. Conclusion: There are many challenges in the management of diabetics on hemodialysis, both to optimize glycemic control according to an individualized target and to coordinate comprehensive and effective care.

Keywords: hemodialysis, diabetes, chronic renal failure, glycemic control

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5690 Explanatory Variables for Crash Injury Risk Analysis

Authors: Guilhermina Torrao

Abstract:

An extensive number of studies have been conducted to determine the factors which influence crash injury risk (CIR); however, uncertainties inherent to selected variables have been neglected. A review of existing literature is required to not only obtain an overview of the variables and measures but also ascertain the implications when comparing studies without a systematic view of variable taxonomy. Therefore, the aim of this literature review is to examine and report on peer-reviewed studies in the field of crash analysis and to understand the implications of broad variations in variable selection in CIR analysis. The objective of this study is to demonstrate the variance in variable selection and classification when modeling injury risk involving occupants of light vehicles by presenting an analytical review of the literature. Based on data collected from 64 journal publications reported over the past 21 years, the analytical review discusses the variables selected by each study across an organized list of predictors for CIR analysis and provides a better understanding of the contribution of accident and vehicle factors to injuries acquired by occupants of light vehicles. A cross-comparison analysis demonstrates that almost half the studies (48%) did not consider vehicle design specifications (e.g., vehicle weight), whereas, for those that did, the vehicle age/model year was the most selected explanatory variable used by 41% of the literature studies. For those studies that included speed risk factor in their analyses, the majority (64%) used the legal speed limit data as a ‘proxy’ of vehicle speed at the moment of a crash, imposing limitations for CIR analysis and modeling. Despite the proven efficiency of airbags in minimizing injury impact following a crash, only 22% of studies included airbag deployment data. A major contribution of this study is to highlight the uncertainty linked to explanatory variable selection and identify opportunities for improvements when performing future studies in the field of road injuries.

Keywords: crash, exploratory, injury, risk, variables, vehicle

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5689 Uptake of Hepatitis B Vaccine among Hepatitis C Positive Patients and Their Vaccine Response in Myanmar

Authors: Zaw Z Aung

Abstract:

Background: High-risk groups for hepatitis B infection (HBV) are people who injected drugs (PWID), men who have sex with men (MSM), people living with HIV (PLHIV) and persons with hepatitis C (HCV), etc. HBV/HCV coinfected patients are at increased risk of cirrhosis, hepatic decompensation and hepatocellular carcinoma. To the best of author’s knowledge, there is currently no data for hepatitis B vaccine utilization in HCV positive patients and their antibody response. Methodology: From February 2018 to May 2018, consented participants at or above 18 years who came to the clinic in Mandalay were tested with the anti-HCV rapid test. Those who tested HCV positive (n=168) were further tested with hepatitis B profile and asked about their previous hepatitis B vaccination history and risk factors. Results: Out of 168 HCV positive participants, three were excluded for active HBV infections. The remaining 165 were categorized into previously vaccinated 64% (n=106) and unvaccinated 36% (n=59) There were three characteristics groups- PWID monoinfected (n=77), General Population (GP) monoinfected (n=22) and HIV/HCV coinfected participants (n=66). Unvaccinated participants were highest in HIV/HCV, with 68%(n=45) followed by GP (23%, n=5) and PWID (12%, n=9). Among previously vaccinated participants, the highest percentage was PWID (88%, n=68), the second highest was GP (77%, n=17) and lowest in HIV/HCV patients (32%, n=21). 63 participants completed third doses of vaccination (PWID=36, GP=13, HIV/HCV=14). 53% of participants who completed 3 dose of hepatitis B were non-responders (n=34): HIV/HCV (86%, n=12), PWID (44%, n=16), and GP (46%, n=6) Conclusion: Even in the presence of effective and safe hepatitis B vaccine, uptake is low among high risk groups especially PLHIV that needs to be improved. Integration or collaboration of hepatitis B vaccination program, HIV/AIDS and hepatitis C treatment centers is desirable. About half of vaccinated participants were non-responders so that optimal doses, schedule and follow-up testing need to be addressed carefully for those groups.

Keywords: Hepatitis B vaccine, Hepatitis C, HIV, Myanmar

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5688 Dynamic Behavior of the Nanostructure of Load-Bearing Biological Materials

Authors: Mahan Qwamizadeh, Kun Zhou, Zuoqi Zhang, Yong Wei Zhang

Abstract:

Typical load-bearing biological materials like bone, mineralized tendon and shell, are biocomposites made from both organic (collagen) and inorganic (biomineral) materials. This amazing class of materials with intrinsic internally designed hierarchical structures show superior mechanical properties with regard to their weak components from which they are formed. Extensive investigations concentrating on static loading conditions have been done to study the biological materials failure. However, most of the damage and failure mechanisms in load-bearing biological materials will occur whenever their structures are exposed to dynamic loading conditions. The main question needed to be answered here is: What is the relation between the layout and architecture of the load-bearing biological materials and their dynamic behavior? In this work, a staggered model has been developed based on the structure of natural materials at nanoscale and Finite Element Analysis (FEA) has been used to study the dynamic behavior of the structure of load-bearing biological materials to answer why the staggered arrangement has been selected by nature to make the nanocomposite structure of most of the biological materials. The results showed that the staggered structures will efficiently attenuate the stress wave rather than the layered structure. Furthermore, such staggered architecture is effectively in charge of utilizing the capacity of the biostructure to resist both normal and shear loads. In this work, the geometrical parameters of the model like the thickness and aspect ratio of the mineral inclusions selected from the typical range of the experimentally observed feature sizes and layout dimensions of the biological materials such as bone and mineralized tendon. Furthermore, the numerical results validated with existing theoretical solutions. Findings of the present work emphasize on the significant effects of dynamic behavior on the natural evolution of load-bearing biological materials and can help scientists to design bioinspired materials in the laboratories.

Keywords: load-bearing biological materials, nanostructure, staggered structure, stress wave decay

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5687 Static Application Security Testing Approach for Non-Standard Smart Contracts

Authors: Antonio Horta, Renato Marinho, Raimir Holanda

Abstract:

Considered as an evolution of the Blockchain, the Ethereum platform, besides allowing transactions of its cryptocurrency named Ether, it allows the programming of decentralised applications (DApps) and smart contracts. However, this functionality into blockchains has raised other types of threats, and the exploitation of smart contracts vulnerabilities has taken companies to experience big losses. This research intends to figure out the number of contracts that are under risk of being drained. Through a deep investigation, more than two hundred thousand smart contracts currently available in the Ethereum platform were scanned and estimated how much money is at risk. The experiment was based in a query run on Google Big Query in July 2022 and returned 50,707,133 contracts published on the Ethereum platform. After applying the filtering criteria, the experimentgot 430,584 smart contracts to download and analyse. The filtering criteria consisted of filtering out: ERC20 and ERC721 contracts, contracts without transactions, and contracts without balance. From this amount of 430,584 smart contracts selected, only 268,103 had source codes published on Etherscan, however, we discovered, using a hashing process, that there were contracts duplication. Removing the duplicated contracts, the process ended up with 20,417 source codes, which were analysed using the open source SAST tool smartbugswith oyente and securify algorithms. In the end, there was nearly $100,000 at risk of being drained from the potentially vulnerable smart contracts. It is important to note that the tools used in this study may generate false positives, which may interfere with the number of vulnerable contracts. To address this point, our next step in this research is to develop an application to test the contract in a parallel environment to verify the vulnerability. Finally, this study aims to alert users and companies about the risk on not properly creating and analysing their smart contracts before publishing them into the platform. As any other application, smart contracts are at risk of having vulnerabilities which, in this case, may result in direct financial losses.

Keywords: blockchain, reentrancy, static application security testing, smart contracts

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5686 Health Exposure Assessment of Sulfur Loading Operation

Authors: Ayman M. Arfaj, Jose Lauro M. Llamas, Saleh Y Qahtani

Abstract:

Sulfur Loading Operation (SLO) is an operation that poses risk of exposure to toxic gases such as Hydrogen Sulfid and Sulfur Dioxide during molten sulfur loading operation. In this operation molten sulfur is loaded into a truck tanker in a liquid state and the temperature of the tanker must maintain liquid sulfur within a 43-degree range — between 266 degrees and 309 degrees Fahrenheit in order for safe loading and unloading to occur. Accordingly, in this study, the e potential risk of occupational exposure to the airborne toxic gases was assessed at three sulfur loading facilities. The concentrations of toxic airborne substances such as Hydrogen Sulfide (H2S) and Sulfur Dioxide (SO2), were monitored during operations at the different locations within the sulfur loading operation facilities. In addition to extensive real-time monitoring, over one hundred and fifty samples were collected and analysed at internationally accredited laboratories. The concentrations of H2S, and SO2 were all found to be well below their respective occupational exposure limits. Very low levels of H2S account for the odours observed intermittingly during mixing and application operations but do not pose a considerable health risk and hence these levels are considered a nuisance. These results were comparable to those reported internationally. Aside from observing the usual general safe work practices such as wearing safety glasses, there are no specific occupational health related concerns at the examined sulfur loading facilities.

Keywords: exposure assessment, sulfur loading operation, health risk study, molten sulfur, toxic airborne substances, air contaminants monitoring

Procedia PDF Downloads 77
5685 Rheological Properties of PP/EVA Blends

Authors: Othman Y. Alothman

Abstract:

The study aims to investigate the effects of blend ratio, VA content and temperature on the rheological properties of PPEVA blends. The results show that all pure polymers and their blends show typical shear thinning behaviour. All neat polymers exhibit power-low type flow behaviour, with the viscosity order as EVA328 > EVA206 > PP in almost all frequency ranges. As temperature increases, the viscosity of all polymers decreases as expected, and the viscosity becomes more sensitive to the addition of EVA. Two different regions can be observed on the flow curve of some of the polymers and their blends, which is thought to be due to slip-stick transition or melt fracture.

Keywords: polypropylene, ethylene vinyl acetate, blends, rheological properties

Procedia PDF Downloads 475
5684 Dry Binder Mixing of Field Trial Investigation Using Soil Mix Technology: Case Study on Contaminated Site Soil

Authors: Mary Allagoa, Abir Al-Tabbaa

Abstract:

The study explores the use of binders and additives, such as Portland cement, pulverized fuel ash, ground granulated blast furnace slag, and MgO, to decrease the concentration and leachability of pollutants in contaminated site soils. The research investigates their effectiveness and associated risks of using the binders, with a focus on Total Heavy metals (THM) and Total Petroleum Hydrocarbon (TPH). The goal of this research is to evaluate the performance and effectiveness of binders and additives in remediating soil pollutants. The study aims to assess the suitability of the mixtures for ground improvement purposes, determine the optimal dosage, and investigate the associated risks. The research utilizes physical (unconfined compressive strength) and chemical tests (batch leachability test) to assess the efficacy of the binders and additives. A completely randomized design one-way ANOVA is used to determine the significance within mix binders of THM. The study also employs incremental lifetime cancer risk assessments (ILCR) and other indexes to evaluate the associated risks. The study finds that Ground Granulated Blast Furnace Slag (GGBS): MgO is the most effective binder for remediation, particularly when using low dosages of MgO combined with higher dosages of GGBS binders on TPH. The results indicate that binders and additives can encapsulate and immobilize pollutants, thereby reducing their leachability and toxicity. The mean unconfined compressive strength of the soil ranges from 285.0- 320.5 kPa, while THM levels are less than 10 µg/l in GGBS: MgO and CEM: PFA but below 1 µg/l in CEM I based. The ILCR ranged from 6.77E-02 - 2.65E-01 and 5.444E-01 – 3.20 E+00, with the highest values observed under extreme conditions. The hazard index (HI), Risk allowable daily dose intake (ADI), and Risk chronic daily intake (CDI) were all less than 1 for the THM. The study identifies MgO as the best additive for use in soil remediation.

Keywords: risk ADI, risk CDI, ILCR, novel binders, additives binders, hazard index

Procedia PDF Downloads 810
5683 Consumer Health Risk Assessment from Some Heavy Metal Bioaccumulation in Common Carp (Cyprinus Carpio) from Lake Koka, Ethiopia

Authors: Mathewos Temesgen, Lemi Geleta

Abstract:

Lake Koka is one of the Ethiopian Central Rift Valleys lakes, where the absorbance of domestic, agricultural, and industrial waste from the nearby industrial and agro-industrial activities is very common. The aim of this research was to assess the heavy metal bioaccumulation in edible parts of common carp (Cyprinus carpio) in Lake Koka and the health risks associated with the dietary intake of the fish. Three sampling sites were selected randomly for primary data collection. Physicochemical parameters (pH, Total Dissolved Solids, Dissolved Oxygen and Electrical Conductivity) were measured in-situ. Four heavy metals (Cd, Cr, Pb, and Zn) in water and bio-accumulation in the edible parts of the fish were analyzed with flame atomic absorption spectrometry. The mean values of TDS, EC, DO and pH of the lake water were 458.1 mg/L, 905.7 µ s/cm, 7.36 mg/L, and 7.9, respectively. The mean concentrations of Zn, Cr, and Cd in the edible part of fish were also 0.18 mg/kg, ND-0.24 mg/kg, and ND-0.03 mg/kg, respectively. Pb was, however, not identified. The amount of Cr in the examined fish muscle was above the level set by FAO, and the accumulation of the metals showed marked differences between sampling sites (p<0.05). The concentrations of Cd, Pb and were below the maximum permissible limit. The results also indicated that Cr has a high transfer factor value and Zn has the lowest. The carcinogenic hazard ratio values were below the threshold value (<1) for the edible parts of fish. The estimated weekly intake of heavy metals from fish muscles ranked as Cr>Zn>Cd, but the values were lower than the Reference Dose limit for metals. The carcinogenic risk values indicated a low health risk due to the intake of individual metals from fish. Furthermore, the hazard index of the edible part of fish was less than unity. Generally, the water quality is not a risk for the survival and reproduction of fish, and the heavy metal contents in the edible parts of fish exhibited low carcinogenic risk through the food chain.

Keywords: bio-accumulation, cyprinus carpio, hazard index, heavy metals, Lake Koka

Procedia PDF Downloads 114
5682 Antioxidant Potential of Pomegranate Rind Extract Attenuates Pain, Inflammation and Bone Damage in Experimental Rats

Authors: Ritu Karwasra, Surender Singh

Abstract:

Inflammation is an important physiological response of the body’s self-defense system that helps in eliminating and protecting organism from harmful stimuli and in tissue repair. It is a highly regulated protective response which helps in eliminating the initial cause of cell injury, and initiates the process of repair. The present study was designed to evaluate the ameliorative effect of pomegranate rind extract on pain and inflammation. Hydroalcoholic standardized rind extract of pomegranate at doses 50, 100 and 200 mg/kg and indomethacin (3 mg/kg) was tested against eddy’s hot plate induced thermal algesia, carrageenan (acute inflammation) and Complete Freund’s Adjuvant (chronic inflammation) induced models in Wistar rats. Parameters analyzed were inhibition of paw edema, measurement of joint diameter, levels of GSH, TBARS, SOD, TNF-α, radiographic imaging, tissue histology and synovial expression of pro-inflammatory cytokine receptor (TNF-R1). Radiological and light microscopical analysis were carried out to find out the bone damage in CFA-induced chronic inflammatory model. Findings of the present study revealed that pomegranate rind extract at a dose of 200 mg/kg caused a significant (p<0.05) reduction in paw swelling in both the inflammatory models. Nociceptive threshold was also significantly (p<0.05) improved. Immunohistochemical analysis of TNF-R1 in CFA-induced group showed elevated level, whereas reduction in level of TNF-R1 was observed in pomegranate (200 mg/kg). Henceforth, we might say that pomegranate produced a dose-dependent reduction in inflammation and pain along with the reduction in levels of oxidative stress markers and tissue histology, and the effect was found to be comparable to that of indomethacin. Thus, it can be concluded that pomegranate is a potential therapeutic target in the pathogenesis of inflammation and pain, and punicalagin is the major constituents found in rind extract might be responsible for the activity.

Keywords: carrageenan, inflammation, nociceptive-threshold, pomegranate, histopathology

Procedia PDF Downloads 219
5681 Determination of the Informativeness of Instrumental Research Methods in Assessing Risk Factors for the Development of Renal Dysfunction in Elderly Patients with Chronic Ischemic Heart Disease

Authors: Aksana N. Popel, Volha A. Sujayeva, Olga V. Kоshlataja, Irеna S. Karpava

Abstract:

Introduction: It is a known fact that cardiovascular pathology and its complications cause a more severe course and worse prognosis in patients with comorbid kidney pathology. Chronic kidney disease (CKD) is associated with inflammation, endothelial dysfunction, and increased activity of the sympathoadrenal system. This circumstance increases the risk of cardiovascular diseases and the progression of kidney pathology. The above determines the need to identify cardiorenal changes at early stages to reduce the risks of cardiovascular complications and the progression of CKD. Objective: To identify risk factors (RF) for the development of CKD in elderly patients with chronic ischemic heart disease (CIHD). Methods: The study included 64 patients (40 women and 24 men) with a mean age of 74.4±4.5 years with coronary heart disease, without a history of structural kidney pathology and CKD. All patients underwent transthoracic echocardiography (TTE) and kidney ultrasound (KU) using GE Vivid 9 equipment (GE HealthCare, USA), and cardiac computed tomography (CCT) using Siemens Somatom Force equipment (Siemens Healthineers AG, Germany) in 3 months and in 1 year. Data obtained were analyzed using multiple regression analysis and nonparametric Mann-Whitney test. Statistical analysis was performed using the STATISTICA 12.0 program (StatSoft Inc.). Results: Initially, CKD was not diagnosed in all patients. In 3 months, CKD was diagnosed: stage C1 had 11 people (18%), stage C2 had 4 people (6%), stage C3A had 11 people (18%), stage C3B had 2 people (3%). After 1 year, CKD was diagnosed: stage C1 had 22 people (35%), stage C2 had 5 people (8%), stage C3A had 17 people (27%), stage C3B had 10 people (15%). In 3 months, statistically significant (p<0.05) risk factors were: 1) according to TTE: mitral peak E-wave velocity (U=678, p=0.039), mitral E-velocity DT (U=514, p=0.0168), mitral peak A-wave velocity (U=682, p=0.013). In 1 year, statistically significant (p<0.05) risk factors were: according to TTE: left ventricular (LV) end-systolic volume in B-mode (U=134, p=0.006), LV end-diastolic volume in B-mode (U=177, p=0.04), LV ejection fraction in B-mode (U=135, p=0.006), left atrial volume (U=178, p=0.021), LV hypertrophy (U=294, p=0.04), mitral valve (MV) fibrosis (U=328, p=0.01); according CCT: epicardial fat thickness (EFT) on the right ventricle (U=8, p=0.015); according to KU: interlobar renal artery resistance index (RI) (U=224, p=0.02), segmental renal artery RI (U=409, p=0.016). Conclusions: Both TTE and KU are very informative methods to determine the additional risk factors of CKD development and progression. The most informative risk factors were LV global systolic and diastolic functions, LV and LA volumes. LV hypertrophy, MV fibrosis, interlobar renal artery and segmental renal artery RIs, EFT.

Keywords: chronic kidney disease, ischemic heart disease, prognosis, risk factors

Procedia PDF Downloads 25
5680 Half Dose Tissue Plasminogen Activator for Intermediate-Risk Pulmonary Embolism

Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson

Abstract:

Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.

Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event

Procedia PDF Downloads 75
5679 The Value of Audit in Managing Supplier’s Process Improvement

Authors: Mohammad E. Nikoofal, Mehmet Gumus

Abstract:

Besides the many benefits of outsourcing, firms are still concerned about the lack of critical information regarding both the risk levels and actions of their suppliers that are just a few links away. In this paper, we study the effectiveness of audit for the manufacturer in managing her supplier’s process improvement effort when the supplier is privately informed about his disruption risk and actions. By comparing the agency costs associated with the optimal menu of contracts with and without audit, we completely characterize the value of audit for all the cases from the perspectives of both manufacturer, and supplier as well as total supply chain. First, the analysis of value of audit from the manufacturer’s perspective shows that she can strictly benefit from auditing her supplier’s actions. To the best of our knowledge, this result has not been documented before in the principal-agent literature under a standard setting where the agent is assumed to be risk-neutral and not protected by limited liability constraints. Second, we find that not only the manufacturer but also the supplier can strictly benefit from audit. Third, the audit enables the manufacturer to customize her contract offerings based on the reliability of the supplier. Finally, by analyzing the impact of problem parameters on the value of audit, we identify the conditions under which an audit would be beneficial for individual supply chain parties as well as total supply chain.

Keywords: supply disruption, adverse selection, moral hazard incentives, audit

Procedia PDF Downloads 461
5678 Allopurinol Prophylactic Therapy in the Prevention of Contrast Induced Nephropathy in High Risk Patients Undergoing Coronary Angiography: A Prospective Randomized Controlled Trial

Authors: Seyed Fakhreddin Hejazi, Leili Iranirad, Mohammad Sadeghi, Mohsen Talebizadeh

Abstract:

Background: Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures. We performed this clinical trial to assess the preventive effect of allopurinol against CIN in high-risk patients undergoing coronary angiography. Methods: In this prospective randomized controlled trial, 140 patients with at least two risk factors for CIN undergoing coronary angiography were randomly assigned to either the allopurinol group or the control group. Patients in the allopurinol group received 300 mg allopurinol 24 hours before a procedure and intravenous hydration for 12 hours before and after coronary angiography, whereas patients in the control group received intravenous hydration. Serum creatinine (SCr), blood urea nitrogen (BUN) and uric acid were measured before contrast exposure and at 48 hours. CIN was defined as an increase of 25% in serum creatinine (SCr) or >0.5 mg/dl 48 hours after contrast administration. Results: CIN occurred in 11 out of 70 (7.9%) patients in the control group and in 8 out of 70 (5.7%) patients in the allopurinol group. There was no significant difference in the incidence of CIN between the two groups at 48 hours after administering the radiocontrast agent (p = 0.459). However, there were significant differences between the two groups in SCr, BUN, uric acid, and eGFR 48 hours after radiocontrast administration (p < 0.05). Conclusion: Our findings revealed that allopurinol had no substantial efficacy over hydration protocol in high-risk patients for the development of CIN.

Keywords: contrast-induced nephropathy, allopurinol, coronary angiography, contrast agent

Procedia PDF Downloads 247
5677 A Regional Analysis on Co-movement of Sovereign Credit Risk and Interbank Risks

Authors: Mehdi Janbaz

Abstract:

The global financial crisis and the credit crunch that followed magnified the importance of credit risk management and its crucial role in the stability of all financial sectors and the whole of the system. Many believe that risks faced by the sovereign sector are highly interconnected with banking risks and most likely to trigger and reinforce each other. This study aims to examine (1) the impact of banking and interbank risk factors on the sovereign credit risk of Eurozone, and (2) how the EU Credit Default Swaps spreads dynamics are affected by the Crude Oil price fluctuations. The hypothesizes are tested by employing fitting risk measures and through a four-staged linear modeling approach. The sovereign senior 5-year Credit Default Swap spreads are used as a core measure of the credit risk. The monthly time-series data of the variables used in the study are gathered from the DataStream database for a period of 2008-2019. First, a linear model test the impact of regional macroeconomic and market-based factors (STOXX, VSTOXX, Oil, Sovereign Debt, and Slope) on the CDS spreads dynamics. Second, the bank-specific factors, including LIBOR-OIS spread (the difference between the Euro 3-month LIBOR rate and Euro 3-month overnight index swap rates) and Euribor, are added to the most significant factors of the previous model. Third, the global financial factors including EURO to USD Foreign Exchange Volatility, TED spread (the difference between 3-month T-bill and the 3-month LIBOR rate based in US dollars), and Chicago Board Options Exchange (CBOE) Crude Oil Volatility Index are added to the major significant factors of the first two models. Finally, a model is generated by a combination of the major factor of each variable set in addition to the crisis dummy. The findings show that (1) the explanatory power of LIBOR-OIS on the sovereign CDS spread of Eurozone is very significant, and (2) there is a meaningful adverse co-movement between the Crude Oil price and CDS price of Eurozone. Surprisingly, adding TED spread (the difference between the three-month Treasury bill and the three-month LIBOR based in US dollars.) to the analysis and beside the LIBOR-OIS spread (the difference between the Euro 3M LIBOR and Euro 3M OIS) in third and fourth models has been increased the predicting power of LIBOR-OIS. Based on the results, LIBOR-OIS, Stoxx, TED spread, Slope, Oil price, OVX, FX volatility, and Euribor are the determinants of CDS spreads dynamics in Eurozone. Moreover, the positive impact of the crisis period on the creditworthiness of the Eurozone is meaningful.

Keywords: CDS, crude oil, interbank risk, LIBOR-OIS, OVX, sovereign credit risk, TED

Procedia PDF Downloads 144
5676 Effective Factors on Self-Care in Women with Osteoporosis: A Study with Content Analysis Approach

Authors: Arezoo Fallahi, Siamak Derakhshan, Parvaneh Taymoori, Babak Nematshahrbabaki

Abstract:

Background: Osteoporosis, the most common metabolic bone disease, is an important health care issue. Not only the cost of disease is high but also is one of the causes of disability and mortality and effect on quality of life. Although self-care is effective on disease, s control and treatment but still effective factors on self-care of patient, s viewpoint have not been survey. The aim of this study was to explore effective factors on self-care in women with osteoporosis. Materials and methods: This study was done by conventional content analysis approach in year 2014. Through purposeful sampling 15 women referred to bone mass densitometry centers participated in this study. Inclusion criteria were: Women older than 50 years old with osteoporosis, final diagnosis of osteoporosis for over six –month period, T-score index below -2.5 (lower back or hip), drug use by patients with a physician’s prescription, ability in speaking and attending to participate in the study. Data was collected by face to face and group semi-structure deep interviews and analyzed via content analysis method. To support of rigor of data, criteria credibility, confirmability and transferability were used. Results: during data analysis five categories developed: “hope and disability in the face of illness”, “mutual roles of physician”, “role of family” and “administrative centers and organizations”. To perform self-care behaviors, the participations of this study emphasized on pay attention to their own healthy, regarding patients' rights by physician, pay attention to women's health by men, and the role of media especially radio and television. Conclusion: the finding of the study showed that women’s responsibility with osteoporosis for their health is not a factor but it is multifactorial. Increasing life expectancy in patients, attention to patients needs by physician, increasing health promotion programs in the media and enhancing role of family may provide conditions and infrastructure to empowerment women in doing self-care behavior.

Keywords: women, osteoporosis, self-care, content analysis

Procedia PDF Downloads 463
5675 Mixed Mode Fracture Analyses Using Finite Element Method of Edge Cracked Heavy Annulus Pulley

Authors: Bijit Kalita, K. V. N. Surendra

Abstract:

The pulley works under both compressive loading due to contacting belt in tension and central torque due to cause rotation. In a power transmission system, the belt pulley assemblies offer a contact problem in the form of two mating cylindrical parts. In this work, we modeled a pulley as a heavy two-dimensional circular disk. Stress analysis due to contact loading in the pulley mechanism is performed. Finite element analysis (FEA) is conducted for a pulley to investigate the stresses experienced on its inner and outer periphery. In most of the heavy-duty applications, most frequently used mechanisms to transmit power in applications such as automotive engines, industrial machines, etc. is Belt Drive. Usually, very heavy circular disks are used as pulleys. A pulley could be entitled as a drum and may have a groove between two flanges around the circumference. A rope, belt, cable or chain can be the driving element of a pulley system that runs over the pulley inside the groove. A pulley is experienced by normal and shear tractions on its contact region in the process of motion transmission. The region may be belt-pulley contact surface or pulley-shaft contact surface. In 1895, Hertz solved the elastic contact problem for point contact and line contact of an ideal smooth object. Afterward, this hypothesis is generally utilized for computing the actual contact zone. Detailed stress analysis in such contact region of such pulleys is quite necessary to prevent early failure. In this paper, the results of the finite element analyses carried out on the compressed disk of a belt pulley arrangement using fracture mechanics concepts are shown. Based on the literature on contact stress problem induced in the wide field of applications, generated stress distribution on the shaft-pulley and belt-pulley interfaces due to the application of high-tension and torque was evaluated in this study using FEA concepts. Finally, the results obtained from ANSYS (APDL) were compared with the Hertzian contact theory. The study is mainly focused on the fatigue life estimation of a rotating part as a component of an engine assembly using the most famous Paris equation. Digital Image Correlation (DIC) analyses have been performed using the open-source software. From the displacement computed using the images acquired at a minimum and maximum force, displacement field amplitude is computed. From these fields, the crack path is defined and stress intensity factors and crack tip position are extracted. A non-linear least-squares projection is used for the purpose of the estimation of fatigue crack growth. Further study will be extended for the various application of rotating machinery such as rotating flywheel disk, jet engine, compressor disk, roller disk cutter etc., where Stress Intensity Factor (SIF) calculation plays a significant role on the accuracy and reliability of a safe design. Additionally, this study will be progressed to predict crack propagation in the pulley using maximum tangential stress (MTS) criteria for mixed mode fracture.

Keywords: crack-tip deformations, contact stress, stress concentration, stress intensity factor

Procedia PDF Downloads 124
5674 An Intelligent Steerable Drill System for Orthopedic Surgery

Authors: Wei Yao

Abstract:

A steerable and flexible drill is needed in orthopaedic surgery. For example, osteoarthritis is a common condition affecting millions of people for which joint replacement is an effective treatment which improves the quality and duration of life in elderly sufferers. Conventional surgery is not very accurate. Computer navigation and robotics can help increase the accuracy. For example, In Total Hip Arthroplasty (THA), robotic surgery is currently practiced mainly on acetabular side helping cup positioning and orientation. However, femoral stem positioning mostly uses hand-rasping method rather than robots for accurate positioning. The other case for using a flexible drill in surgery is Anterior Cruciate Ligament (ACL) Reconstruction. The majority of ACL Reconstruction failures are primarily caused by technical mistakes and surgical errors resulting from drilling the anatomical bone tunnels required to accommodate the ligament graft. The proposed new steerable drill system will perform orthopedic surgery through curved tunneling leading to better accuracy and patient outcomes. It may reduce intra-operative fractures, dislocations, early failure and leg length discrepancy by making possible a new level of precision. This technology is based on a robotically assisted, steerable, hand-held flexible drill, with a drill-tip tracking device and a multi-modality navigation system. The critical differentiator is that this robotically assisted surgical technology now allows the surgeon to prepare 'patient specific' and more anatomically correct 'curved' bone tunnels during orthopedic surgery rather than drilling straight holes as occurs currently with existing surgical tools. The flexible and steerable drill and its navigation system for femoral milling in total hip arthroplasty had been tested on sawbones to evaluate the accuracy of the positioning and orientation of femoral stem relative to the pre-operative plan. The data show the accuracy of the navigation system is better than traditional hand-rasping method.

Keywords: navigation, robotic orthopedic surgery, steerable drill, tracking

Procedia PDF Downloads 167
5673 Emotion and Risk Taking in a Casino Game

Authors: Yulia V. Krasavtseva, Tatiana V. Kornilova

Abstract:

Risk-taking behaviors are not only dictated by cognitive components but also involve emotional aspects. Anticipatory emotions, involving both cognitive and affective mechanisms, are involved in decision-making in general, and risk-taking in particular. Affective reactions are prompted when an expectation or prediction is either validated or invalidated in the achieved result. This study aimed to combine predictions, anticipatory emotions, affective reactions, and personality traits in the context of risk-taking behaviors. An experimental online method Emotion and Prediction In a Casino (EPIC) was used, based on a casino-like roulette game. In a series of choices, the participant is presented with progressively riskier roulette combinations, where the potential sums of wins and losses increase with each choice and the participant is given a choice: to 'walk away' with the current sum of money or to 'play' the displayed roulette, thus accepting the implicit risk. Before and after the result is displayed, participants also rate their emotions, using the Self-Assessment Mannequin [Bradley, Lang, 1994], picking a picture, representing the intensity of pleasure, arousal, and dominance. The following personality measures were used: 1) Personal Decision-Making Factors [Kornilova, 2003] assessing risk and rationality; 2) I7 – Impulsivity Questionnaire [Kornilova, 1995] assessing impulsiveness, risk readiness, and empathy and 3) Subjective Risk Intelligence Scale [Craparo et al., 2018] assessing negative attitude toward uncertainty, emotional stress vulnerability, imaginative capability, and problem-solving self-efficacy. Two groups of participants took part in the study: 1) 98 university students (Mage=19.71, SD=3.25; 72% female) and 2) 94 online participants (Mage=28.25, SD=8.25; 89% female). Online participants were recruited via social media. Students with high rationality rated their pleasure and dominance before and after choices as lower (ρ from -2.6 to -2.7, p < 0.05). Those with high levels of impulsivity rated their arousal lower before finding out their result (ρ from 2.5 - 3.7, p < 0.05), while also rating their dominance as low (ρ from -3 to -3.7, p < 0.05). Students prone to risk-rated their pleasure and arousal before and after higher (ρ from 2.5 - 3.6, p < 0.05). High empathy was positively correlated with arousal after learning the result. High emotional stress vulnerability positively correlates with arousal and pleasure after the choice (ρ from 3.9 - 5.7, p < 0.05). Negative attitude to uncertainty is correlated with high anticipatory and reactive arousal (ρ from 2.7 - 5.7, p < 0.05). High imaginative capability correlates negatively with anticipatory and reactive dominance (ρ from - 3.4 to - 4.3, p < 0.05). Pleasure (.492), arousal (.590), and dominance (.551) before and after the result were positively correlated. Higher predictions positively correlated with reactive pleasure and arousal. In a riskier scenario (6/8 chances to win), anticipatory arousal was negatively correlated with the pleasure emotion (-.326) and vice versa (-.265). Correlations occur regardless of the roulette outcome. In conclusion, risk-taking behaviors are linked not only to personality traits but also to anticipatory emotions and affect in a modeled casino setting. Acknowledgment: The study was supported by the Russian Foundation for Basic Research, project 19-29-07069.

Keywords: anticipatory emotions, casino game, risk taking, impulsiveness

Procedia PDF Downloads 133
5672 An Experience of HIV Testing and Counseling Services at a Tertiary Care Center of Bangladesh

Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti

Abstract:

Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.

Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior

Procedia PDF Downloads 295