Search results for: left regular
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2364

Search results for: left regular

864 Marker-Controlled Level-Set for Segmenting Breast Tumor from Thermal Images

Authors: Swathi Gopakumar, Sruthi Krishna, Shivasubramani Krishnamoorthy

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Contactless, painless and radiation-free thermal imaging technology is one of the preferred screening modalities for detection of breast cancer. However, poor signal to noise ratio and the inexorable need to preserve edges defining cancer cells and normal cells, make the segmentation process difficult and hence unsuitable for computer-aided diagnosis of breast cancer. This paper presents key findings from a research conducted on the appraisal of two promising techniques, for the detection of breast cancer: (I) marker-controlled, Level-set segmentation of anisotropic diffusion filtered preprocessed image versus (II) Segmentation using marker-controlled level-set on a Gaussian-filtered image. Gaussian-filtering processes the image uniformly, whereas anisotropic filtering processes only in specific areas of a thermographic image. The pre-processed (Gaussian-filtered and anisotropic-filtered) images of breast samples were then applied for segmentation. The segmentation of breast starts with initial level-set function. In this study, marker refers to the position of the image to which initial level-set function is applied. The markers are generally placed on the left and right side of the breast, which may vary with the breast size. The proposed method was carried out on images from an online database with samples collected from women of varying breast characteristics. It was observed that the breast was able to be segmented out from the background by adjustment of the markers. From the results, it was observed that as a pre-processing technique, anisotropic filtering with level-set segmentation, preserved the edges more effectively than Gaussian filtering. Segmented image, by application of anisotropic filtering was found to be more suitable for feature extraction, enabling automated computer-aided diagnosis of breast cancer.

Keywords: anisotropic diffusion, breast, Gaussian, level-set, thermograms

Procedia PDF Downloads 378
863 Anti-Inflammatory, Anti-Nociceptive and Anti-Arthritic Effects of Mirtazapine, Venalfaxine and Escitalopram in Rats

Authors: Sally A. El Awdan

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Objective and Design: The purpose of this study was to evaluate the anti inflammatory, anti-arthritic and analgesic effects of antidepressants. Methods: Carrageenan model was used to assess effect on acute inflammation. Paw volume were measured at 1, 2, 3 and 4th hour post challenge. Anti-nociceptive effect was evaluated by hot plate method. Chronic inflammation was developed using Complete Freund's Adjuvant (CFA). The animals were injected with Freund’s adjuvant in sub-plantar tissue of the right posterior paw. Paw volume, ankle flexion scores, adjuvant-induced hyperalgesia and serum cytokine levels were assessed. Results: Results obtained demonstrate that mirtazapine, venalfaxine and escitalopram significantly and dose-dependently inhibited carrageenan-induced rat paw oedema. Mirtazapine, venalfaxine and escitalopram increased the reaction time of rats in hot plate test. We observed an increase in paw volume, ankle flexion scores, thermal hyperalgesia, serum levels of interleukin-1β, PGE2 and TNF-α, induced by intraplantar CFA injection. Regular treatment up to 28 days of adjuvant-induced arthritic rats with mirtazapine, venalfaxine and escitalopram showed anti anti-inflammatory and analgesic activities by suppressing the paw volume, recovering the paw withdrawal latency, and by inhibiting the ankle flexion scores in CFA-induced rats. In addition significant reduction in serum levels of interleukin-1β, PGE2 and TNF-α level in arthritic rats was reduced by treatment with drugs. Conclusion: These results suggest that antidepressants have significant anti-inflammatory and anti-nociceptive effects in acute and chronic models in rats, which may be associated with the reduction of interleukin-1β, PGE2 and TNF-α levels.

Keywords: antidepressants, carrageenan, anti-nociceptive, Complete Freund's Adjuvant

Procedia PDF Downloads 490
862 Mike Hat: Coloured-Tape-in-Hat as a Head Circumference Measuring Instrument for Early Detection of Hydrocephalus in an Infant

Authors: Nyimas Annissa Mutiara Andini

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Every year, children develop hydrocephalus during the first year of life. If it is not treated, hydrocephalus can lead to brain damage, a loss in mental and physical abilities, and even death. To be treated, first, we have to do a proper diagnosis using some examinations especially to detect hydrocephalus earlier. One of the examination that could be done is using a head circumference measurement. Increased head circumference is a first and main sign of hydrocephalus, especially in infant (0-1 year age). Head circumference is a measurement of a child's head largest area. In this measurement, we want to get the distance from above the eyebrows and ears and around the back of the head using a measurement tape. If the head circumference of an infant is larger than normal, this infant might potentially suffer hydrocephalus. If early diagnosis and timely treatment of hydrocephalus could be done most children can recover successfully. There are some problems with early detection of hydrocephalus using regular tape for head circumference measurement. One of the problem is the infant’s comfort. We need to make the infant feel comfort along the head circumference measurement to get a proper result of the examination. For that, we can use a helpful stuff, like a hat. This paper is aimed to describe the possibility of using a head circumference measuring instrument for early detection of hydrocephalus in an infant with a mike hat, coloured-tape-in-hat. In the first life, infants’ head size is about 35 centimeters. First three months after that infants will gain 2 centimeters each month. The second three months, infant’s head circumference will increase 1 cm each month. And for the six months later, the rate is 0.5 cm per month, and end up with an average of 47 centimeters. This formula is compared to the WHO’s head circumference growth chart. The shape of this tape-in-hat is alike an upper arm measurement. This tape-in-hat diameter is about 47 centimeters. It contains twelve different colours range by age. If it is out of the normal colour, the infant potentially suffers hydrocephalus. This examination should be done monthly. If in two times of measurement there still in the same range abnormal of head circumference, or a rapid growth of the head circumference size, the infant should be referred to a pediatrician. There are the pink hat for girls and blue hat for boys. Based on this paper, we know that this measurement can be used to help early detection of hydrocephalus in an infant.

Keywords: head circumference, hydrocephalus, infant, mike hat

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861 Cytotoxicity thiamethoxam Study on the Hepatopancreas and Its Reversibility under the Effect of Ginger in Helix aspersa

Authors: Samira Bensoltane, Smina Ait Hamlet, Samti Meriem, Semmasel Asma

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Living organisms in the soil are subject to regular fluctuations of abiotic parameters, as well as a chemical contamination of the environment due to human activities. They are subject to multiple stressors they face. The aim of our work was to study the effects of insecticide: thiamethoxam (neonicotinoid), and the potential reversibility of the effects by an antioxidant: ginger on a bioindicator species in ecotoxicology, the land snail Helix aspersa. The effects were studied by a targeted cell approach of evaluating the effect of these molecules on tissue and cellular aspect of hepatopancreas through histological study. Treatment with thiamethoxam concentrations 10, 20, and 40 mg/l shows signs of inflammation even at low concentrations and from the 5th day of treatment. Histological examination of the hepatopancreas of snails treated with thiamethoxam showed significant changes from the lowest concentrations tested , note intertubular connective tissue enlargement, necrosis deferent types of cells (cells with calcium , digestive, excretory) , also damage acini, alteration of the apical membrane and lysis of the basement membrane in a dose- dependent manner. After 10 days of treatment and with 40 mg/l, the same changes were observed with a very advanced degeneration of the wall of the member that could be confused with the cell debris. For cons, the histological study of the hepatopancreas in Helix aspersa treated with ginger for a period of 15 days after stopping treatment with thiamethoxam has shown a partial regeneration of hepatopancreatic tissue snails treated with all concentrations of thiamethoxam and especially in the intertubular connective tissue of the wall and hepatopancreatic digestive tubules. Finally, we can conclude that monitoring the effect of the insecticide thiamethoxam showed significant alterations, however, treatment with ginger shows regeneration of damaged cells themselves much sharper at low concentration (10 mg/L).

Keywords: Helix aspersa, insecticides, thiamethoxam, ginger, hepatopancreas

Procedia PDF Downloads 215
860 Promoting Early Learning of Children under Five Years in an Economically Disadvantaged Community in Sri Lanka through Health Promotion Approach

Authors: Najith Duminda Galmangoda Guruge, Nadeeka Rathnayake, Vinodani Wimalasena, Dinesha Wijesooriya

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Investing in Early Learning can improve children’ interests for education and makes them ready for school. Children in economically disadvantaged communities may have reduced readiness for schools. Health Promotion approach enables communities including disadvantaged to control over their health. Mothers of children under the age five in ‘Alapathwewa’ community (n=40) were selected as the sample with the aim to promote early learning of children to improve their school readiness. Mothers in ‘Morakeewa’ community (n=40) were the control. Interventions were for a period of 2 years and children of these mothers were followed up to school entry. Importance of early learning and possibility of providing quality learning environments for children at a low cost was discussed with mothers in an experimental setting by facilitators. Mothers were enabled to make age-appropriate baby rooms which provide learning opportunities. Collective community playhouses and play areas were developed by mothers to provide opportunities for children to interact and learn with each other. Mothers started discussing with each other and sharing experiences. The progress was monitored by mothers at regular intervals. Data regarding school competencies of children were obtained from school teachers. School teachers measured thirteen competencies of children on a scale of ‘very good, good, moderate and weak’. All children in the experimental group were in ‘very good’ level in two competencies, ‘communicate friendly with others’ and ‘express ideas well’. Children in the experimental group reported a significantly higher achievement of all thirteen competencies (p < .05) than children in control. Providing quality early learning environments for children even in economically disadvantaged settings makes them ready for schools. Through a Health Promotion approach, early learning experiences for children can be provided at a low cost.

Keywords: disadvantaged, early learning, economically, health promotion

Procedia PDF Downloads 257
859 A Structuring and Classification Method for Assigning Application Areas to Suitable Digital Factory Models

Authors: R. Hellmuth

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The method of factory planning has changed a lot, especially when it is about planning the factory building itself. Factory planning has the task of designing products, plants, processes, organization, areas, and the building of a factory. Regular restructuring is becoming more important in order to maintain the competitiveness of a factory. Restrictions in new areas, shorter life cycles of product and production technology as well as a VUCA world (Volatility, Uncertainty, Complexity and Ambiguity) lead to more frequent restructuring measures within a factory. A digital factory model is the planning basis for rebuilding measures and becomes an indispensable tool. Furthermore, digital building models are increasingly being used in factories to support facility management and manufacturing processes. The main research question of this paper is, therefore: What kind of digital factory model is suitable for the different areas of application during the operation of a factory? First, different types of digital factory models are investigated, and their properties and usabilities for use cases are analysed. Within the scope of investigation are point cloud models, building information models, photogrammetry models, and these enriched with sensor data are examined. It is investigated which digital models allow a simple integration of sensor data and where the differences are. Subsequently, possible application areas of digital factory models are determined by means of a survey and the respective digital factory models are assigned to the application areas. Finally, an application case from maintenance is selected and implemented with the help of the appropriate digital factory model. It is shown how a completely digitalized maintenance process can be supported by a digital factory model by providing information. Among other purposes, the digital factory model is used for indoor navigation, information provision, and display of sensor data. In summary, the paper shows a structuring of digital factory models that concentrates on the geometric representation of a factory building and its technical facilities. A practical application case is shown and implemented. Thus, the systematic selection of digital factory models with the corresponding application cases is evaluated.

Keywords: building information modeling, digital factory model, factory planning, maintenance

Procedia PDF Downloads 109
858 Smart Wheel Chair: A Design to Accommodate Vital Sign Monitoring

Authors: Stephanie Nihan, Jayson M. Fadrigalan, Pyay P. San, Steven M. Santos, Weihui Li

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People of all ages who use wheelchairs are left with the inconvenience of not having an easy way to take their vital signs. Typically, patients are required to visit the hospital in order to take the vital signs. VitalGO is a wheel chair system that equipped with medical devices to take vital signs and then transmit data to a mobile application for convenient, long term health monitoring. The vital signs include oxygen saturation, heart rate, and blood pressure, breathing rate and body temperature. Oxygen saturation and heart rate are monitored through pulse oximeter. Blood pressure is taken through a radar sensor. Breathing rate is derived through thoracic impedance while body temperature is measured through an infrared thermometer. The application receives data through bluetooth and stores in a database for review in a simple graphical interface. The application will have the ability to display this data over various time intervals such as a day, week, month, 3 months, 6 months and a year. The final system for the mobile app can also provide an interface for both the user and their physician(s) to record notes or keep record of daily symptoms that a patient might be having. The user’s doctor will be granted access by the user to view the patient information for assistance with a more accurate diagnosis. Also, this wheelchair accessory conveniently includes a foldable table/desk as somewhere to place an electronic device that may be used to access the app. The foldable table will overall contribute to the wheelchair user’s increased comfort and will give them somewhere to place food, a book, or any other form of entertainment that would normally be hard to juggle on their lap.

Keywords: wheel chair, vital sign, mobile application, telemedicine

Procedia PDF Downloads 330
857 Haemodynamics Study in Subject Specific Carotid Bifurcation Using FSI

Authors: S. M. Abdul Khader, Anurag Ayachit, Raghuvir Pai, K. A. Ahmed, V. R. K Rao, S. Ganesh Kamath

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The numerical simulation has made tremendous advances in investigating the blood flow phenomenon through elastic arteries. Such study can be useful in demonstrating the disease progression and haemodynamics of cardiovascular diseases such as atherosclerosis. In the present study, patient specific case diagnosed with partially stenosed complete right ICA and normal left carotid bifurcation without any atherosclerotic plaque formation is considered. 3D patient specific carotid bifurcation model is generated based on CT scan data using MIMICS-4.0 and numerical analysis is performed using FSI solver in ANSYS-14.5. The blood flow is assumed to be incompressible, homogenous and Newtonian, while the artery wall is assumed to be linearly elastic. The two-way sequentially-coupled transient FSI analysis is performed using FSI solver for three pulse cycles. The haemodynamic parameters such as flow pattern, Wall Shear Stress, pressure contours and arterial wall deformation are studied at the bifurcation and critical zones such as stenosis. The variation in flow behavior is studied throughout the pulse cycle. Also, the simulation results reveals that there is a considerable increase in the flow behavior in stenosed carotid in contrast to the normal carotid bifurcation system. The investigation also demonstrates the disturbed flow pattern especially at the bifurcation and stenosed zone elevating the haemodynamics, particularly during peak systole and later part of the pulse cycle. The results obtained agree well with the clinical observation and demonstrates the potential of patient specific numerical studies in prognosis of disease progression and plaque rupture.

Keywords: fluid-structure interaction, arterial stenosis, wall shear stress, carotid artery bifurcation

Procedia PDF Downloads 571
856 Track and Evaluate Cortical Responses Evoked by Electrical Stimulation

Authors: Kyosuke Kamada, Christoph Kapeller, Michael Jordan, Mostafa Mohammadpour, Christy Li, Christoph Guger

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Cortico-cortical evoked potentials (CCEP) refer to responses generated by cortical electrical stimulation at distant brain sites. These responses provide insights into the functional networks associated with language or motor functions, and in the context of epilepsy, they can reveal pathological networks. Locating the origin and spread of seizures within the cortex is crucial for pre-surgical planning. This process can be enhanced by employing cortical stimulation at the seizure onset zone (SOZ), leading to the generation of CCEPs in remote brain regions that may be targeted for disconnection. In the case of a 24-year-old male patient suffering from intractable epilepsy, corpus callosotomy was performed as part of the treatment. DTI-MRI imaging, conducted using a 3T MRI scanner for fiber tracking, along with CCEP, is used as part of an assessment for surgical planning. Stimulation of the SOZ, with alternating monophasic pulses of 300µs duration and 15mA current intensity, resulted in CCEPs on the contralateral frontal cortex, reaching a peak amplitude of 206µV with a latency of 31ms, specifically in the left pars triangularis. The related fiber tracts were identified with a two-tensor unscented Kalman filter (UKF) technique, showing transversal fibers through the corpus callosum. The CCEPs were monitored through the progress of the surgery. Notably, the SOZ-associated CCEPs exhibited a reduction following the resection of the anterior portion of the corpus callosum, reaching the identified connecting fibers. This intervention demonstrated a potential strategy for mitigating the impact of intractable epilepsy through targeted disconnection of identified cortical regions.

Keywords: CCEP, SOZ, Corpus callosotomy, DTI

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855 Millennial Teachers of Canada: Innovation within the Boxed-In Constraints of Tradition

Authors: Lena Shulyakovskaya

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Every year, schools aim to develop and adopt new technology and pedagogy as a way to equip today's students with the needed 21st Century skills. However, the field of primary and secondary education may not be as open to embracing change in reality. Despite the drive to reform and innovation, the field of education in Canada is still very much steeped in tradition and uses many of the practices that came into effect over 50 years ago. Among those are employment and retention practices. Millennials are the youngest generation of professionals entering the workplace at this time and the ones leaving their jobs within just a few years. Almost half of new teachers leave Canadian schools within their first five years on the job. This paper discusses one of the contributing factors that lead Canadian millennial teachers to either leave or stay in the profession - standardized education system. Using an exploratory case study approach, in-depth interviews with former and current millennial teachers were conducted to learn about their experiences within the K-12 system. Among the findings were the young teachers' concerns about the constant changes to teaching practices and technological implementations that claimed to advance teaching and learning, and yet in reality only disguised and reiterated the same traditional, outdated, and standardized practices that already existed. Furthermore, while many millennial teachers aspired to be innovative with their curriculum and teaching practices, they felt trapped and helpless in the hands of school leaders who were very reluctant to change. While many new program ideas and technological advancements are being made openly available to teachers on a regular basis, it is important to consider the education field as a whole and how it plays into the teachers' ability to realistically implement changes. By the year 2025, millennials will make up approximately 75% of the North American workforce. It is important to examine generational differences among teachers and understand how millennial teachers may be shaping the future of primary and secondary schools, either by staying or leaving the profession.

Keywords: 21st century skills, millennials, teacher attrition, tradition

Procedia PDF Downloads 226
854 An Exponential Field Path Planning Method for Mobile Robots Integrated with Visual Perception

Authors: Magdy Roman, Mostafa Shoeib, Mostafa Rostom

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Global vision, whether provided by overhead fixed cameras, on-board aerial vehicle cameras, or satellite images can always provide detailed information on the environment around mobile robots. In this paper, an intelligent vision-based method of path planning and obstacle avoidance for mobile robots is presented. The method integrates visual perception with a new proposed field-based path-planning method to overcome common path-planning problems such as local minima, unreachable destination and unnecessary lengthy paths around obstacles. The method proposes an exponential angle deviation field around each obstacle that affects the orientation of a close robot. As the robot directs toward, the goal point obstacles are classified into right and left groups, and a deviation angle is exponentially added or subtracted to the orientation of the robot. Exponential field parameters are chosen based on Lyapunov stability criterion to guarantee robot convergence to the destination. The proposed method uses obstacles' shape and location, extracted from global vision system, through a collision prediction mechanism to decide whether to activate or deactivate obstacles field. In addition, a search mechanism is developed in case of robot or goal point is trapped among obstacles to find suitable exit or entrance. The proposed algorithm is validated both in simulation and through experiments. The algorithm shows effectiveness in obstacles' avoidance and destination convergence, overcoming common path planning problems found in classical methods.

Keywords: path planning, collision avoidance, convergence, computer vision, mobile robots

Procedia PDF Downloads 192
853 Ectopic Pregnancy: A Case of Consecutive Occurrences of Different Types

Authors: Wania Mohammad Akram, Swetha Kannan, Urooj Shahid, Aisha Sajjad

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Ovarian ectopic pregnancy, a rare manifestation of ectopic gestation, involves the implantation of a fertilized egg on the ovarian surface. This condition poses diagnostic challenges and is associated with significant maternal morbidity if not promptly managed. This report presents the case of a 33-year-old nulliparous woman with a history of polycystic ovary syndrome (PCOS) undergoing ovulation induction therapy. Following her first conception in October 2021, she presented with symptoms of per vaginal spotting and low back pain, prompting a diagnosis of left adnexal ectopic pregnancy confirmed by transvaginal ultrasound and serum beta-human chorionic gonadotropin (B-HCG) levels. Medical management with methotrexate was initiated successfully. In August 2022, the patient conceived again, with subsequent ultrasound revealing a large pelvic collection suggestive of a complex ectopic pregnancy involving both ovaries. Despite initial stability, she developed abdominal pain necessitating emergency laparoscopy, which revealed an ovarian ectopic pregnancy with hemoperitoneum. Laparotomy was performed due to the complexity of the presentation, and histopathology confirmed viable chorionic villi within ovarian tissue. This case underscores the clinical management challenges posed by ovarian ectopic pregnancies, particularly in patients with previous ectopic pregnancies. The discussion reviews current literature on diagnostic modalities, treatment strategies, and outcomes associated with ovarian ectopic pregnancies, emphasizing the role of surgical intervention in cases refractory to conservative management. Tailored approaches considering individual patient factors are crucial to optimize outcomes and preserve fertility in such complex scenarios.

Keywords: obgyn, ovarian ectopic pregnancy, laproscopy, pcos

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852 Diagnosing Depression during Pregnancy-Identifying Risk Factors of Prenatal Depression in Polish Women

Authors: Olga Plaza, Katarzyna Kosinska-Kaczynska, Stepan Feduniw, Dominika Pazdzior, Kinga Zebrowska, Katarzyna Kwiatkowska

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Introduction: The main causes of depression among pregnant women remain unclear. However, it is clear that pregnancy carries a higher risk of depression occurrence. Left untreated, prenatal depression can be a cause of serious both maternal and neonatal complications. Aim of the study: The aim of the study was to define potential risk factors of prenatal depression and to assess the frequency of its occurrence among pregnant women. Material and Methods: A prospective cross-sectional study was performed among 346 women. The self- composed questionnaire consisting of 46 questions, was distributed via the Internet between November 2017 and March 2018. The questionnaire contained the Edinburgh Postnatal Depression Scale (EPDS), in which the results of 13 and more points (out of 30) suggested possible prenatal depression. Statistical analysis was performed with Chi2 Pearson. P value < 0.05 was considered significant. Results: 37.57% (n=130) of women had a score of 13 or more points. Women with depressive symptoms (DS) reported lack of support from the partner (46.9% vs. 16.2%; p < 0.001) as well as other family members (40.8% vs. 14.4%; p < 0.001), current pregnancy being unplanned (21.5% vs. 12.5%; p=0.014) and low socio-economic status (10% vs. 0.9%; p < 0.001). Both early and advanced maternal age seemed to play a role in occurrence of DS: in women aged 17-24 40.8% declared symptoms (vs 28.7%; p < 0.01), in mothers aged ≥37 6.2% did (vs 0.5%; p < 0.001). Smoking during pregnancy was also more frequent among patients with DS (31.5% vs. 18.1%; p=0.004). Previous diagnosis of depression or other mood disorders significantly increased a chance of DS occurrence (respectively- 17.7% vs. 4.6%; p < 0.001 and 49.2% vs. 25%; p<0.001). Parental diagnosis of mood disorders and other mental disorders was also more frequent in this group of patients (respectively- 24.6% vs. 15.7%; p= 0.026 and 26.4% vs. 9.7%; p < 0.001). Only 23.8% of women with DS sought help from healthcare professionals, with 21.5% receiving pharmacological treatment. Conclusions: Pregnant women often report having DS. Evaluation of risk factors of DS and possible prenatal depression is essential in proper screening for depression among pregnant women.

Keywords: obstetrics, polish women, prenatal care, prenatal depression, risk factors

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851 Programmatic Actions of Social Welfare State in Service to Justice: Law, Society and the Third Sector

Authors: Bruno Valverde Chahaira, Matheus Jeronimo Low Lopes, Marta Beatriz Tanaka Ferdinandi

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This paper proposes to dissect the meanings and / or directions of the State, in order, to present the State models to elaborate a conceptual framework about its function in the legal scope. To do so, it points out the possible contracts established between the State and the Society, since the general principles immanent in them can guide the models of society in force. From this orientation arise the contracts, whose purpose is by the effect to modify the status (the being and / or the opinion) of each of the subjects in presence - State and Society. In this logic, this paper announces the fiduciary contracts and “veredicção”(portuguese word) contracts, from the perspective of semiotics discourse (or greimasian). Therefore, studies focus on the issue of manifest language in unilateral and bilateral or reciprocal relations between the State and Society. Thus, under the biases of the model of the communicative situation and discourse, the guidelines of these contractual relations will be analyzed in order to see if there is a pragmatic sanction: positive when the contract is signed between the subjects (reward), or negative when the contract between they are broken (punishment). In this way, a third path emerges which, in this specific case, passes through the subject-third sector. In other words, the proposal, which is systemic in nature, is to analyze whether, since the contract of the welfare state is not carried out in the constitutional program on fundamental rights: education, health, housing, an others. Therefore, in the structure of the exchange demanded by the society according to its contractual obligations (others), the third way (Third Sector) advances in the empty space left by the State. In this line, it presents the modalities of action of the third sector in the social scope. Finally, the normative communication organization of these three subjects is sought in the pragmatic model of discourse, namely: State, Society and Third Sector, in an attempt to understand the constant dynamics in the Law and in the language of the relations established between them.

Keywords: access to justice, state, social rights, third sector

Procedia PDF Downloads 143
850 A Serious Game to Upgrade the Learning of Organizational Skills in Nursing Schools

Authors: Benoit Landi, Hervé Pingaud, Jean-Benoit Culie, Michel Galaup

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Serious games have been widely disseminated in the field of digital learning. They have proved their utility in improving skills through virtual environments that simulate the field where new competencies have to be improved and assessed. This paper describes how we created CLONE, a serious game whose purpose is to help nurses create an efficient work plan in a hospital care unit. In CLONE, the number of patients to take care of is similar to the reality of their job, going far beyond what is currently practiced in nurse school classrooms. This similarity with the operational field increases proportionally the number of activities to be scheduled. Moreover, very often, the team of nurses is composed of regular nurses and nurse assistants that must share the work with respect to the regulatory obligations. Therefore, on the one hand, building a short-term planning is a complex task with a large amount of data to deal with, and on the other, good clinical practices have to be systematically applied. We present how reference planning has been defined by addressing an optimization problem formulation using the expertise of teachers. This formulation ensures the gameplay feasibility for the scenario that has been produced and enhanced throughout the game design process. It was also crucial to steer a player toward a specific gaming strategy. As one of our most important learning outcomes is a clear understanding of the workload concept, its factual calculation for each caregiver along time and its inclusion in the nurse reasoning during planning elaboration are focal points. We will demonstrate how to modify the game scenario to create a digital environment in which these somewhat abstract principles can be understood and applied. Finally, we give input on an experience we had on a pilot of a thousand undergraduate nursing students.

Keywords: care planning, workload, game design, hospital nurse, organizational skills, digital learning, serious game

Procedia PDF Downloads 189
849 Completion of the Modified World Health Organization (WHO) Partograph during Labour in Public Health Institutions of Addis Ababa, Ethiopia

Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. Methods: A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study. Results: All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed. Conclusions: This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.

Keywords: modified WHO partograph, completion, public health institutions, Addis Ababa, Ethiopia

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848 Monitoring and Management of Aquatic Macroinvertebrates for Determining the Level of Water Pollution Catchment Basin of Debed River, Armenia

Authors: Inga Badasyan

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Every year we do monitoring of water pollution of catchment basin of Debed River. Next, the Ministry of Nature Protection does modeling programme. Finely, we are managing the impact of water pollution in Debed river. Ecosystem technologies efficiency performance were estimated based on the physical, chemical, and macrobiological analyses of water on regular base between 2012 to 2015. Algae community composition was determined to assess the ecological status of Debed river, while vegetation was determined to assess biodiversity. Last time, experts werespeaking about global warming, which is having bad impact on the surface water, freshwater, etc. As, we know that global warming is caused by the current high levels of carbon dioxide in the water. Geochemical modelling is increasingly playing an important role in various areas of hydro sciences and earth sciences. Geochemical modelling of highly concentrated aqueous solutions represents an important topic in the study of many environments such as evaporation ponds, groundwater and soils in arid and semi-arid zones, costal aquifers, etc. The sampling time is important for benthic macroinvertebrates, for that reason we have chosen in the spring (abundant flow of the river, the beginning of the vegetation season) and autumn (the flow of river is scarce). The macroinvertebrates are good indicator for a chromic pollution and aquatic ecosystems. Results of our earlier investigations in the Debed river reservoirs clearly show that management problem of ecosystem reservoirs is topical. Research results can be applied to studies of monitoring water quality in the rivers and allow for rate changes and to predict possible future changes in the nature of the lake.

Keywords: ecohydrological monitoring, flood risk management, global warming, aquatic macroinvertebrates

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847 An Investigation into the Ideological Facets Involved in Western Interpretations of the History of Communism

Authors: Anna Stoutenburg

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With the rise of the so-called 'new left' within the United States, marked by social democratic figures such as Bernie Sanders and Alexandria Ocasio-Cortez, significant questions have been raised in response to those who would identify with the term 'socialist'. These queries typically revolve around the negatively perceived legacy of past and present countries that share the term in question, with the stark conclusion that not only is socialism a structure that does not work economically, but that it also tends to inflict more harm on those living under it that would be endured in a country functioning under capitalism. In order to examine these claims, the goal of this paper is to examine the legacy of anti-communist historiography in a western context, with the Union of Soviet Socialist Republics, China, and modern Venezuela used as case studies for how this phenomenon operates. Not only will key portions of each nation’s history be re-examined, but there will also be a critical analysis of source cultivation and usage among western historians. The intent of this paper is not merely to deride previous attempts at historicizing and reporting on the events of the nations, but rather to attempt to glean a clearer picture that is free from anti-communist sentiments. Theoretical works that will be consulted in order to define this project are 'The Historiography of Communism' by Michael Brown, as well as 'Beyond Philosophy: Ethics, History, Marxism, and Liberation Theology' by Enrique Dussel. The latter will provide insights concerning why these questions are relevant in a larger context, namely by articulating how the means of liberation understood through an analectic method can be achieved structurally. For a majority of leftists, this question is integral, and by using history as a tool, the ways that political organizing can be used can be better understood, bridging the gap between the common assumption that the communist legacy is a dire one and the idea that it is something which needs to be completely lauded.

Keywords: anti-communism, history, ideology, Marxism

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846 Normalized P-Laplacian: From Stochastic Game to Image Processing

Authors: Abderrahim Elmoataz

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More and more contemporary applications involve data in the form of functions defined on irregular and topologically complicated domains (images, meshs, points clouds, networks, etc). Such data are not organized as familiar digital signals and images sampled on regular lattices. However, they can be conveniently represented as graphs where each vertex represents measured data and each edge represents a relationship (connectivity or certain affinities or interaction) between two vertices. Processing and analyzing these types of data is a major challenge for both image and machine learning communities. Hence, it is very important to transfer to graphs and networks many of the mathematical tools which were initially developed on usual Euclidean spaces and proven to be efficient for many inverse problems and applications dealing with usual image and signal domains. Historically, the main tools for the study of graphs or networks come from combinatorial and graph theory. In recent years there has been an increasing interest in the investigation of one of the major mathematical tools for signal and image analysis, which are Partial Differential Equations (PDEs) variational methods on graphs. The normalized p-laplacian operator has been recently introduced to model a stochastic game called tug-of-war-game with noise. Part interest of this class of operators arises from the fact that it includes, as particular case, the infinity Laplacian, the mean curvature operator and the traditionnal Laplacian operators which was extensiveley used to models and to solve problems in image processing. The purpose of this paper is to introduce and to study a new class of normalized p-Laplacian on graphs. The introduction is based on the extension of p-harmonious function introduced in as discrete approximation for both infinity Laplacian and p-Laplacian equations. Finally, we propose to use these operators as a framework for solving many inverse problems in image processing.

Keywords: normalized p-laplacian, image processing, stochastic game, inverse problems

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845 Transfer of Contractual Right of Suit Evidenced in Carriage Contract of Bill of Lading in Nigeria

Authors: Eunice Chiamaka Allen-Ngbale

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Prior to bill of lading (BOL), merchants travelled along with their goods; then recorded the goods in the ship’s mates’ register; and finally started selling the goods while in transit by way of BOL, indicative that BOL is negotiable. Common law doctrine of privity of contract did not allow the transfer of right to sue to a non-party to the contract. This created hardship to cargo owners, which made many jurisdictions enact laws in this regard. Bill of Lading Act 1855 (BLA) was enacted in the United Kingdom, which applied as statute of general application under section 375 Merchant Shipping Act 1990 (MSA) in Nigeria; and conferred contractual rights of the suit on consignees and endorsees, but on the passing of ownership upon or by reason of such consignment or endorsement on the shipment of the goods simultaneously. The repeal of section 375 MSA by section 439 MSA 2007 created a lacuna, and the doctrine of privity of contract is the extant law in Nigeria. The aim of this study is to evaluate laws governing the transfer of the contractual right of suit to a third party under the bill of lading in Nigeria. The specific objectives of this study are to ascertain: (i) whether the extant law of common law doctrine of privity of the contract covers the transfer of the right of suit to the third party under the bill of lading in Nigeria; (ii) impediment(s) of the common law to transfer such right in Nigeria in the absence of any legislation; (iii) the level of applicability of the doctrine of privity of contract as it relates to transfer of the contractual right of suit to third party under the bill of lading in Nigeria; and (iv) whether to proffer possible suggestion on how to fill the lacuna left by the repeal of Merchant Shipping Act 1990. This work adopted a doctrinal approach with reliance on primary and secondary source materials. It finds that the common law doctrine of privity of contract in Nigeria is retrogressive. This work recommends for amendment of the relevant statute to cure this defect/lacuna like other commonwealth nations for best international practices.

Keywords: contract of carriage by sea, doctrine of privity of contract, lawful holder of bill of lading, third party right of suit

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844 Quantitative Evaluation of Mitral Regurgitation by Using Color Doppler Ultrasound

Authors: Shang-Yu Chiang, Yu-Shan Tsai, Shih-Hsien Sung, Chung-Ming Lo

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Mitral regurgitation (MR) is a heart disorder which the mitral valve does not close properly when the heart pumps out blood. MR is the most common form of valvular heart disease in the adult population. The diagnostic echocardiographic finding of MR is straightforward due to the well-known clinical evidence. In the determination of MR severity, quantification of sonographic findings would be useful for clinical decision making. Clinically, the vena contracta is a standard for MR evaluation. Vena contracta is the point in a blood stream where the diameter of the stream is the least, and the velocity is the maximum. The quantification of vena contracta, i.e. the vena contracta width (VCW) at mitral valve, can be a numeric measurement for severity assessment. However, manually delineating the VCW may not accurate enough. The result highly depends on the operator experience. Therefore, this study proposed an automatic method to quantify VCW to evaluate MR severity. Based on color Doppler ultrasound, VCW can be observed from the blood flows to the probe as the appearance of red or yellow area. The corresponding brightness represents the value of the flow rate. In the experiment, colors were firstly transformed into HSV (hue, saturation and value) to be closely align with the way human vision perceives red and yellow. Using ellipse to fit the high flow rate area in left atrium, the angle between the mitral valve and the ultrasound probe was calculated to get the vertical shortest diameter as the VCW. Taking the manual measurement as the standard, the method achieved only 0.02 (0.38 vs. 0.36) to 0.03 (0.42 vs. 0.45) cm differences. The result showed that the proposed automatic VCW extraction can be efficient and accurate for clinical use. The process also has the potential to reduce intra- or inter-observer variability at measuring subtle distances.

Keywords: mitral regurgitation, vena contracta, color doppler, image processing

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843 Flood Mapping and Inoudation on Weira River Watershed (in the Case of Hadiya Zone, Shashogo Woreda)

Authors: Alilu Getahun Sulito

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Exceptional floods are now prevalent in many places in Ethiopia, resulting in a large number of human deaths and property destruction. Lake Boyo watershed, in particular, had also traditionally been vulnerable to flash floods throughout the Boyo watershed. The goal of this research is to create flood and inundation maps for the Boyo Catchment. The integration of Geographic information system(GIS) technology and the hydraulic model (HEC-RAS) were utilized as methods to attain the objective. The peak discharge was determined using Fuller empirical methodology for intervals of 5, 10, 15, and 25 years, and the results were 103.2 m3/s, 158 m3/s, 222 m3/s, and 252 m3/s, respectively. River geometry, boundary conditions, manning's n value of varying land cover, and peak discharge at various return periods were all entered into HEC-RAS, and then an unsteady flow study was performed. The results of the unsteady flow study demonstrate that the water surface elevation in the longitudinal profile rises as the different periods increase. The flood inundation charts clearly show that regions on the right and left sides of the river with the greatest flood coverage were 15.418 km2 and 5.29 km2, respectively, flooded by 10,20,30, and 50 years. High water depths typically occur along the main channel and progressively spread to the floodplains. The latest study also found that flood-prone areas were disproportionately affected on the river's right bank. As a result, combining GIS with hydraulic modelling to create a flood inundation map is a viable solution. The findings of this study can be used to care again for the right bank of a Boyo River catchment near the Boyo Lake kebeles, according to the conclusion. Furthermore, it is critical to promote an early warning system in the kebeles so that people can be evacuated before a flood calamity happens. Keywords: Flood, Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

Keywords: Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

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842 Promoting Personhood and Citizenship Amongst Individuals with Learning Disabilities: An Occupational Therapy Approach

Authors: Rebecca Haythorne

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Background: Agendas continuously emphasise the need to increase work based training and opportunities for individuals with learning disabilities. However research and statistics suggest that there is still significant stigma and stereotypes as to what they can contribute, or gain from being part of the working environment. Method: To tackles some of these prejudices an Occupational Therapy based intervention was developed for learning disability service users working at a social enterprise farm. The intervention aimed to increase positive public perception around individual capabilities and encourage individuals with learning disabilities to take ownership and be proud of their individual personhood and citizenship. This was achieved by using components of the Model of Human Occupation to tailor the intervention to individual values, skills and working contributions. The final project involved making creative wall art for public viewing, focusing on 'who works there and what they do'. This was accompanied by a visitor information guide, allowing individuals to tell visitors about themselves, the work they do and why it is meaningful to them. Outcomes: The intervention has helped to increased metal well-being and confidence of learning disability service users “people will know I work here now” and “I now have something to show my family about the work I do at the farm”. The intervention has also increased positive public perception and community awareness “you can really see the effort that’s gone into doing this” and “it’s a really visual experience to see people you don’t expect to see doing this type of work”. Resources left behind have further supported individuals to take ownership in creating more wall art to be sold at the farm shop. Conclusion: the intervention developed has helped to improve mental well-being of both service users and staff and improve community awareness. Due to this, the farm has decided to roll out the intervention to other areas of the social enterprise and is considering having more Occupational Therapy involvement in the future.

Keywords: citizenship, intervention, occupational therapy, personhood

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841 Prasugrel as First-line Therapy for Stemi Patients Undergoing PPCI

Authors: Diab Z., Hamad A., Dixit A., Al-Rikabi M., Keshaverzi F.

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Introduction: According to the NICE guidelines, 2020Prasugrel is the recommended first line treatment in adults with acute coronary syndromes (ACS) in patients with ST-segment-elevation myocardial infarction (STEMI), defined as ST elevation or new left bundle branch block on ECG , that cardiologists intend to treat with primary percutaneous coronary intervention (PCI). The current literature suggests that this is largely due to safety and efficacy, and cost effectiveness. We wanted to do an audit to examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI. AIM: To examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI Methods: We looked at the patients presented to MRI during1^st of January 2022 to 28th February 2022. We included all the people who were above 18 and were brought to the hospital through the PPCI pathway and diagnosed as ACS and underwent PPCI. We excluded Patients who were brought to the hospital through the PPCI pathway and underwent coronary angiography and their diagnosis was found other than STEMI or if the outcome was death before discharge or they were above age >75 (as per guideline increase bleeding risk of prasugrel in a person aged 75 or older). Results: The total number of patients was 100. There were a total of seventy patients who had STEMI and fit the criteria for inclusion. Out of these, only 72.9% (51) were given Prasugrel as a first line. Seventeen (17) 24.3% STEMI patients were candidates for prasugrel as first-line therapy but were instead offered (clopidogrel/ticagrelor). Two 2 (2.9%) STEMI patients were not given prasugrel as first-line therapy because of C/I (CVA) or the use of anticoagulant Nine 9 (9%) of them died before discharge. Eleven 11 (11%) were above the age of 75. Ten 10 (10%) of patients had a diagnosis other than STEMI. Conclusions and recommendations: Our audit has shown the need to increase awareness amongst staff re: the first line use of Prasugrel as per NICE guidelines. We aim to arrange awareness sessions for staff and increase visibility of the guidelines for the staff to encourage them to adhere to the guideline. Further research is needed to find the optimum treatment in patients above 75.

Keywords: pasurgrel, PCI, NICE, STEMI

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840 Selection of Optimal Reduced Feature Sets of Brain Signal Analysis Using Heuristically Optimized Deep Autoencoder

Authors: Souvik Phadikar, Nidul Sinha, Rajdeep Ghosh

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In brainwaves research using electroencephalogram (EEG) signals, finding the most relevant and effective feature set for identification of activities in the human brain is a big challenge till today because of the random nature of the signals. The feature extraction method is a key issue to solve this problem. Finding those features that prove to give distinctive pictures for different activities and similar for the same activities is very difficult, especially for the number of activities. The performance of a classifier accuracy depends on this quality of feature set. Further, more number of features result in high computational complexity and less number of features compromise with the lower performance. In this paper, a novel idea of the selection of optimal feature set using a heuristically optimized deep autoencoder is presented. Using various feature extraction methods, a vast number of features are extracted from the EEG signals and fed to the autoencoder deep neural network. The autoencoder encodes the input features into a small set of codes. To avoid the gradient vanish problem and normalization of the dataset, a meta-heuristic search algorithm is used to minimize the mean square error (MSE) between encoder input and decoder output. To reduce the feature set into a smaller one, 4 hidden layers are considered in the autoencoder network; hence it is called Heuristically Optimized Deep Autoencoder (HO-DAE). In this method, no features are rejected; all the features are combined into the response of responses of the hidden layer. The results reveal that higher accuracy can be achieved using optimal reduced features. The proposed HO-DAE is also compared with the regular autoencoder to test the performance of both. The performance of the proposed method is validated and compared with the other two methods recently reported in the literature, which reveals that the proposed method is far better than the other two methods in terms of classification accuracy.

Keywords: autoencoder, brainwave signal analysis, electroencephalogram, feature extraction, feature selection, optimization

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839 Integrated Education at Jazan University: Budding Hope for Employability

Authors: Jayanthi Rajendran

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Experience is what makes a man perfect. Though we tend to learn many a different things in life through practice still we need to go an extra mile to gain experience which would be profitable only when it is integrated with regular practice. A clear phenomenal idea is that every teacher is a learner. The centralized idea of this paper would focus on the integrated practices carried out among the students of Jizan University which enhances learning through experiences. Integrated practices like student-directed activities, balanced curriculum, phonological based activities and use of consistent language would enlarge the vision and mission of students to earn experience through learning. Students who receive explicit instruction and guidance could practice the skills and strategies through student-directed activities such as peer tutoring and cooperative learning. The second effective practice is to use consistent language. Consistent language provides students a model for talking about the new concepts which also enables them to communicate without hindrances. Phonological awareness is an important early reading skill for all students. Students generally have phonemic awareness in their home language can often transfer that knowledge to a second language. And also a balanced curriculum requires instruction in all the elements of reading. Reading is the most effective skill when both basic and higher-order skills are included on a daily basis. Computer based reading and listening skills will empower students to understand a language in a better way. English language learners can benefit from sound reading instruction even before they are fully proficient in English as long as the instruction is comprehensible. Thus, if students have to be well equipped in learning they should foreground themselves in various integrated practices through multifarious experience for which teachers are moderators and trainers. This type of learning prepares the students for a constantly changing society which helps them to meet the competitive world around them for better employability fulfilling the vision and mission of the institution.

Keywords: consistent language, employability, phonological awareness, balanced curriculum

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838 Efficient Compact Micro Dielectric Barrier Discharge (DBD) Plasma Reactor for Ozone Generation for Industrial Application in Liquid and Gas Phase Systems

Authors: D. Kuvshinov, A. Siswanto, J. Lozano-Parada, W. Zimmerman

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Ozone is well known as a powerful fast reaction rate oxidant. The ozone based processes produce no by-product left as a non-reacted ozone returns back to the original oxygen molecule. Therefore an application of ozone is widely accepted as one of the main directions for a sustainable and clean technologies development. There are number of technologies require ozone to be delivered to specific points of a production network or reactors construction. Due to space constrains, high reactivity and short life time of ozone the use of ozone generators even of a bench top scale is practically limited. This requires development of mini/micro scale ozone generator which can be directly incorporated into production units. Our report presents a feasibility study of a new micro scale rector for ozone generation (MROG). Data on MROG calibration and indigo decomposition at different operation conditions are presented. At selected operation conditions with residence time of 0.25 s the process of ozone generation is not limited by reaction rate and the amount of ozone produced is a function of power applied. It was shown that the MROG is capable to produce ozone at voltage level starting from 3.5kV with ozone concentration of 5.28E-6 (mol/L) at 5kV. This is in line with data presented on numerical investigation for a MROG. It was shown that in compare to a conventional ozone generator, MROG has lower power consumption at low voltages and atmospheric pressure. The MROG construction makes it applicable for emerged and dry systems. With a robust compact design MROG can be used as incorporated unit for production lines of high complexity.

Keywords: dielectric barrier discharge (DBD), micro reactor, ozone, plasma

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837 Impact Force Difference on Natural Grass Versus Synthetic Turf Football Fields

Authors: Nathaniel C. Villanueva, Ian K. H. Chun, Alyssa S. Fujiwara, Emily R. Leibovitch, Brennan E. Yamamoto, Loren G. Yamamoto

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Introduction: In previous studies of high school sports, over 15% of concussions were attributed to contact with the playing surface. While artificial turf fields are increasing in popularity due to lower maintenance costs, artificial turf has been associated with more ankle and knee injuries, with inconclusive data on concussions. In this study, natural grass and artificial football fields were compared in terms of deceleration on fall impact. Methods: Accelerometers were placed on the forehead, apex of the head, and right ear of a Century Body Opponent Bag (BOB) manikin. A Riddell HITS football helmet was secured onto the head of the manikin over the accelerometers. This manikin was dropped onto natural grass (n = 10) and artificial turf (n = 9) high school football fields. The manikin was dropped from a stationary position at a height of 60 cm onto its front, back, and left side. Each of these drops was conducted 10 times at the 40-yard line, 20-yard line, and endzone. The net deceleration on impact was calculated as a net vector from each of the three accelerometers’ x, y, and z vectors from the three different locations on the manikin’s head (9 vector measurements per drop). Results: Mean values for the multiple drops were calculated for each accelerometer and drop type for each field. All accelerometers in forward and backward falls and one accelerometer in side falls showed significantly greater impact force on synthetic turf compared to the natural grass surfaces. Conclusion: Impact force was higher on synthetic fields for all drop types for at least one of the accelerometer locations. These findings suggest that concussion risk might be higher for athletes playing on artificial turf fields.

Keywords: concussion, football, biomechanics, sports

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836 Factors Associated with Contraceptive Use and Nonuse, among Currently Married Young (15-24 Years) Women in Nepal

Authors: Bishnu Prasad Dulal, Sushil Chandra Baral, Radheshyam Bhattarai, Meera Tandan

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Background: Non-use of contraceptives is a leading cause of unintended pregnancy. This study was done to explore the potential predictors of contraceptive used by young women, and the findings can inform policy makers to design the program to reduce unintended pregnancy for younger women who have a longer time of fecundity. Methodology: A nationally representative cross-sectional household survey was conducted by Health Research and Social Development Forum in 2012. Total 2259 currently married young women (15-24 years) were selected for the analysis out of 8578 women of reproductive age interviewed from the total 10260 households using systematic sampling. Binary logistic regression was used to identify factors associated with the use of modern contraceptive methods. Findings: The prevalence of modern contraceptive methods among young women was 25.2 %. Use of contraceptives was significantly associated with age at first marriage <15 year of age (OR:1.95) and ever delivered (OR: 1.8). Muslim women were significantly less likely to use contraceptives. Development region, wealth quintile, and awareness of abortion site were also statistically associated factors to use of contraceptives. Conclusion: The prevalence of contraceptives uses among young married women (25.2%) was lower than national prevalence (43%) of contraceptives use among married women of reproductive age. Our analysis focused on examining the association between women’s characteristics-related factors and use and nonuse of modern contraceptives. Awareness of safe abortion site is significantly associated while level of education was not. It is an interesting finding but difficult to interpret which needs further analysis on the basis of education. Maybe due to the underlying socio-religious practice of Muslim people, they had lower use of contraceptives. Programmers and policy makers could better help young women by increasing intervention activities to have a regular use of contraceptive-covering poor, Dalit and Muslim, and low aged women in order to reduce unintended pregnancy.

Keywords: unintended pregnancy, contraceptive, young women, Nepal

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835 Case Presentation Ectopic Cushing's Syndrome Secondary to Thymic Neuroendocrine Tumors Secreting ACTH

Authors: Hasan Frookh Jamal

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This is a case of a 36-year-old Bahraini gentleman diagnosed to have Cushing's Syndrome with a large anterior mediastinal mass. He was sent abroad to the Speciality hospital in Jordan, where he underwent diagnostic video-assisted thoracoscopy, partial thymectomy and pericardial fat excision. Histopathology of the mass was reported to be an Atypical carcinoid tumor with a low Ki67 proliferation index of 5%, the mitotic activity of 4 MF/10HPF and pathological stage classification(pTNM): pT1aN1. MRI of the pituitary gland showed an ill-defined non-enhancing focus of about 3mm on the Rt side of the pituitary on coronal images, with a similar but smaller one on the left side, which could be due to enhancing pattern rather than a real lesion as reported. The patient underwent Ga68 Dotate PET/CT scan post-operatively, which showed multiple somatostatin receptor-positive lesions seen within the tail, body and head of the pancreas and positive somatostatin receptor lymph nodes located between the pancreatic head and IVC. There was no uptake detected at the anterior mediastinum nor at the site of thymic mass resection. There was no evidence of any positive somatostatin uptake at the soft tissue or lymph nodes. The patient underwent IPSS, which proved that the source is, in fact, an ectopic source of ACTH secretion. Unfortunately, the patient's serum cortisol remained elevated after surgery and failed to be suppressed by 1 mg ODST and by 2 days LLDST with a high ACTH value. The patient was started on Osilodrostat for treatment of hypercortisolism for the time being and his future treatment plan with Lutetium-177 Dotate therapy vs. bilateral adrenalectomy is to be considered in an MDT meeting.

Keywords: cushing syndrome, neuroendocrine tumur, carcinoid tumor, Thymoma

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