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1972 The Silent Tuberculosis: A Case Study to Highlight Awareness of a Global Health Disease and Difficulties in Diagnosis
Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das
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Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge
Procedia PDF Downloads 1931971 Experiences of Pediatric Cancer Patients and Their Families: A Focus Group Interview
Authors: Bu Kyung Park
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Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis
Procedia PDF Downloads 1801970 The New World Kirkpatrick Model as an Evaluation Tool for a Publication Writing Programme
Authors: Eleanor Nel
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Research output is an indicator of institutional performance (and quality), resulting in increased pressure on academic institutions to perform in the research arena. Research output is further utilised to obtain research funding. Resultantly, academic institutions face significant pressure from governing bodies to provide evidence on the return for research investments. Research output has thus become a substantial discourse within institutions, mainly due to the processes linked to evaluating research output and the associated allocation of research funding. This focus on research outputs often surpasses the development of robust, widely accepted tools to additionally measure research impact at institutions. A publication writing programme, for enhancing research output, was launched at a South African university in 2011. Significant amounts of time, money, and energy have since been invested in the programme. Although participants provided feedback after each session, no formal review was conducted to evaluate the research output directly associated with the programme. Concerns in higher education about training costs, learning results, and the effect on society have increased the focus on value for money and the need to improve training, research performance, and productivity. Furthermore, universities rely on efficient and reliable monitoring and evaluation systems, in addition to the need to demonstrate accountability. While publishing does not occur immediately, achieving a return on investment from the intervention is critical. A multi-method study, guided by the New World Kirkpatrick Model (NWKM), was conducted to determine the impact of the publication writing programme for the period of 2011 to 2018. Quantitative results indicated a total of 314 academics participating in 72 workshops over the study period. To better understand the quantitative results, an open-ended questionnaire and semi-structured interviews were conducted with nine participants from a particular faculty as a convenience sample. The purpose of the research was to collect information to develop a comprehensive framework for impact evaluation that could be used to enhance the current design and delivery of the programme. The qualitative findings highlighted the critical role of a multi-stakeholder strategy in strengthening support before, during, and after a publication writing programme to improve the impact and research outputs. Furthermore, monitoring on-the-job learning is critical to ingrain the new skills academics have learned during the writing workshops and to encourage them to be accountable and empowered. The NWKM additionally provided essential pointers on how to link the results more effectively from publication writing programmes to institutional strategic objectives to improve research performance and quality, as well as what should be included in a comprehensive evaluation framework.Keywords: evaluation, framework, impact, research output
Procedia PDF Downloads 751969 The Descending Genicular Artery Perforator Free Flap as a Reliable Flap: Literature Review
Authors: Doran C. Kalmin
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The descending genicular artery (DGA) perforator free flap provides an alternative to free flap reconstruction based on a review of the literature detailing both anatomical and clinical studies. The descending genicular artery (DGA) supplies skin, muscle, tendon, and bone located around the medial aspect of the knee that has been used in several pioneering reports in reconstructing defects located in various areas throughout the body. After the success of the medial femoral condyle flap in early studies, a small number of studies have been published detailing the use of the DGA in free flap reconstruction. Despite early success in the use of the DGA flap, acceptance within the Plastic and Reconstructive Surgical community has been limited due primarily to anatomical variations of the pedicle. This literature review is aimed at detailing the progression of the DGA perforator free flap and its variations as an alternative and reliable free flap for reconstruction of composite defects with an exploration into both anatomical and clinical studies. A literature review was undertaken, and the progression of the DGA flap is explored from the early review by Acland et al. pioneering the saphenous free flap to exploring modern changes and studies of the anatomy of the DGA. An extensive review of the literature was undertaken that details the anatomy and its variations, approaches to harvesting the flap, the advantages, and disadvantages of the DGA perforator free flap as well as flap outcomes. There are 15 published clinical series of DGA perforator free flaps that incorporate cutaneous, osteoperiosteal, cartilage, osteocutaneous, osteoperiosteal and muscle, osteoperiosteal and subcutaneous and tendocutatenous. The commonest indication for using a DGA free flap was for non-union of bone, particularly that of the scaphoid whereby the medial femoral condyle could be used. In the case series, a success rate of over 90% was established, showing that these early studies have had good success with a wide range of tissue transfers. The greatest limitation is the anatomical variation of the DGA and therefore, the challenges associated with raising the flap. Despite the variation in anatomy and around 10-15% absence of the DGA, the saphenous artery can be used as well as the superior medial genicular artery if the vascular bone is required as part of the flap. Despite only a handful of anatomical and clinical studies describing the DGA perforator free flap, it ultimately provides a reliable flap that can include a variety of composite structure used for reconstruction in almost any area throughout the body. Although it has limitations, it provides a reliable option for free flap reconstruction that can routinely be performed as a single-stage procedure.Keywords: anatomical study, clinical study, descending genicular artery, literature review, perforator free flap reconstruction
Procedia PDF Downloads 1431968 Emerging VC Industry and the Important Role of Marketing Expectations in Project Selection: Evidence on Russian Data
Authors: I. Rodionov, A. Semenov, E. Gosteva, O. Sokolova
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Currently, the venture capital becomes more and more advanced and effective source of the innovation project financing, connected with a high-risk level. In the developed countries, it plays a key role in transforming innovation projects into successful businesses and creating prosperity of the modern economy. Actually, in Russia there are many necessary preconditions for creation of the effective venture investment system: the network of the public institutes for innovation financing operates; there is a significant number of the small and medium-sized enterprises, capable to sell production with good market potential. However, the current system does not confirm the necessary level of efficiency in practice that can be substantially explained by the absence of the accurate plan of action to form the national venture model and by the lack of experience of successful venture deals with profitable exits in Russian economy. This paper studies the influence of various factors on the venture industry development by the example of the IT-sector in Russia. The choice of the sector is based on the fact, that this segment is the main driver of the venture capital market growth in Russia, and the necessary set of data exists. The size of investment of the second round is used as the dependent variable. To analyse the influence of the previous round such determinant as the volume of the previous (first) round investments is used. There is also used a dummy variable in regression to examine that the participation of an investor with high reputation and experience in the previous round can influence the size of the next investment round. The regression analysis of short-term interrelations between studied variables reveals prevailing influence of the volume of the first round investments on the venture investments volume of the second round. Because of the research, the participation of investors with first-class reputation has a small impact on an indicator of the value of investment of the second round. The expected positive dependence of the second round investments on the forecasted market growth rate now of the deal is also rejected. So, the most important determinant of the value of the second-round investment is the value of first–round investment, so it means that the most competitive on the Russian market are the start-up teams which can attract more money on the start, and the target market growth is not the factor of crucial importance.Keywords: venture industry, venture investment, determinants of the venture sector development, IT-sector
Procedia PDF Downloads 3521967 Preventable Stress and Trauma, and Menstrual Health Management: Experiences of Adolescent Girls from India
Authors: Daisy Dutta, Chhanda Chakraborti
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Background and significance of the study: Menstrual Hygiene Management (MHM) is poor in many Lower and Middle-Income Countries (LMIC) such as India. Poor and inadequate menstrual hygiene has an adverse effect on the health and social life of adolescent girls and women. There are many well-known barriers to adequate Menstrual Hygiene Management (MHM); e.g., lack of awareness, lack of WASH (Water, Sanitation and Hygiene) facilities, lack of affordable menstrual absorbents, etc. But, there is a unique barrier which is very much avoidable; i.e., lack of proper guidance and counseling about menstruation. Menstruation is associated with various social and cultural restrictions and taboos and being a taboo topic; often there is no discussion in the society on this topic. Thus, many adolescent girls encounter the menarche with a lot of unnecessary and avoidable trauma, stress and awkwardness. This trauma, stress, and anxiety are even more prevalent among adolescent girls residing in rural areas. This study argues that this unnecessary stress and anxiety of the adolescent girls can be alleviated by reinforcing social support and adequate information and guidance about MHM and eliminating the futile socio-cultural restrictions during menstruation. Methodology: A qualitative study was conducted in a North-eastern State of India where 45 adolescent girls were interviewed both from rural and urban areas. The adolescent girls were asked about their experiences of stress and anxiety on their first menstruation, their preparedness for menarche, their source of information and guidance, their hygiene-practices, and the various restrictions they follow. Findings: Maximum number of girls did not receive any information about menstruation before menarche. Most of them reported that they were terrified about their first menstruation as they were unprepared. Among those who were aware before menarche, reported that they did not receive proper guidance to manage their menstruation in a hygienic manner. Hygiene-related practices are also influenced by their knowledge about MHM. In maximum cases, girls are bound to follow certain cultural and religious restrictions even if they don’t want to follow which created additional stress in managing their menstruation with dignity. Conclusion: Lack of proper guidance and counseling about menstruation and MHM along with an array of socio-cultural restrictions can enhance a negative attitude in adolescent girls towards menstruation due to which they have to go through an extra and unnecessary burden of stress and trauma. This stress and trauma is preventable by improving the provisions of proper guidance and counseling about menstruation in a supportive environment.Keywords: adolescent girls, menstrual hygiene management, socio-cultural restrictions, stress, trauma
Procedia PDF Downloads 1781966 In-Flight Radiometric Performances Analysis of an Airborne Optical Payload
Authors: Caixia Gao, Chuanrong Li, Lingli Tang, Lingling Ma, Yaokai Liu, Xinhong Wang, Yongsheng Zhou
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Performances analysis of remote sensing sensor is required to pursue a range of scientific research and application objectives. Laboratory analysis of any remote sensing instrument is essential, but not sufficient to establish a valid inflight one. In this study, with the aid of the in situ measurements and corresponding image of three-gray scale permanent artificial target, the in-flight radiometric performances analyses (in-flight radiometric calibration, dynamic range and response linearity, signal-noise-ratio (SNR), radiometric resolution) of self-developed short-wave infrared (SWIR) camera are performed. To acquire the inflight calibration coefficients of the SWIR camera, the at-sensor radiances (Li) for the artificial targets are firstly simulated with in situ measurements (atmosphere parameter and spectral reflectance of the target) and viewing geometries using MODTRAN model. With these radiances and the corresponding digital numbers (DN) in the image, a straight line with a formulation of L = G × DN + B is fitted by a minimization regression method, and the fitted coefficients, G and B, are inflight calibration coefficients. And then the high point (LH) and the low point (LL) of dynamic range can be described as LH= (G × DNH + B) and LL= B, respectively, where DNH is equal to 2n − 1 (n is the quantization number of the payload). Meanwhile, the sensor’s response linearity (δ) is described as the correlation coefficient of the regressed line. The results show that the calibration coefficients (G and B) are 0.0083 W·sr−1m−2µm−1 and −3.5 W·sr−1m−2µm−1; the low point of dynamic range is −3.5 W·sr−1m−2µm−1 and the high point is 30.5 W·sr−1m−2µm−1; the response linearity is approximately 99%. Furthermore, a SNR normalization method is used to assess the sensor’s SNR, and the normalized SNR is about 59.6 when the mean value of radiance is equal to 11.0 W·sr−1m−2µm−1; subsequently, the radiometric resolution is calculated about 0.1845 W•sr-1m-2μm-1. Moreover, in order to validate the result, a comparison of the measured radiance with a radiative-transfer-code-predicted over four portable artificial targets with reflectance of 20%, 30%, 40%, 50% respectively, is performed. It is noted that relative error for the calibration is within 6.6%.Keywords: calibration and validation site, SWIR camera, in-flight radiometric calibration, dynamic range, response linearity
Procedia PDF Downloads 2691965 Influence of Wind Induced Fatigue Damage in the Reliability of Wind Turbines
Authors: Emilio A. Berny-Brandt, Sonia E. Ruiz
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Steel tubular towers serving as support structures for large wind turbines are subject to several hundred million stress cycles arising from the turbulent nature of the wind. This causes high-cycle fatigue which can govern tower design. The practice of maintaining the support structure after wind turbines reach its typical 20-year design life have become common, but without quantifying the changes in the reliability on the tower. There are several studies on this topic, but most of them are based on the S-N curve approach using the Miner’s rule damage summation method, the de-facto standard in the wind industry. However, the qualitative nature of Miner’s method makes desirable the use of fracture mechanics to measure the effects of fatigue in the capacity curve of the structure, which is important in order to evaluate the integrity and reliability of these towers. Temporal and spatially varying wind speed time histories are simulated based on power spectral density and coherence functions. Simulations are then applied to a SAP2000 finite element model and step-by-step analysis is used to obtain the stress time histories for a range of representative wind speeds expected during service conditions of the wind turbine. Rainflow method is then used to obtain cycle and stress range information of each of these time histories and a statistical analysis is performed to obtain the distribution parameters of each variable. Monte Carlo simulation is used here to evaluate crack growth over time in the tower base using the Paris-Erdogan equation. A nonlinear static pushover analysis to assess the capacity curve of the structure after a number of years is performed. The capacity curves are then used to evaluate the changes in reliability of a steel tower located in Oaxaca, Mexico, where wind energy facilities are expected to grow in the near future. Results show that fatigue on the tower base can have significant effects on the structural capacity of the wind turbine, especially after the 20-year design life when the crack growth curve starts behaving exponentially.Keywords: crack growth, fatigue, Monte Carlo simulation, structural reliability, wind turbines
Procedia PDF Downloads 5141964 Urban Furniture in a New Setting of Public Spaces within the Kurdistan Region: Educational Targets and Course Design Process
Authors: Sinisa Prvanov
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This research is an attempt to analyze the existing urban form of outdoor public space of Duhok city and to give proposals for their improvements in terms of urban seating. The aim of this research is to identify the main urban furniture elements and behaviour of users of three central parks of Duhok city, recognizing their functionality and the most common errors. Citizens needs, directly related to the physical characteristics of the environment, are categorized in terms of contact with nature. Parks as significant urban environments express their aesthetic preferences, as well as the need for recreation and play. Citizens around the world desire to contact with nature and places where they can socialize, play and practice different activities, but also participate in building their community and feeling the identity of their cities. The aim of this research is also to reintegrate these spaces in the wider urban context of the city of Duhok, to develop new functions by designing new seating patterns, more improved urban furniture, and necessary supporting facilities and equipment. Urban furniture is a product that uses an enormous number of people in public space. It has a high level of wear and damage due to intense use, exposure to sunlight and weather conditions. Iraq has a hot and dry climate characterized by long, warm, dry summers and short, cold winters. The climate is determined by the Iraq location at the crossroads of Arab desert areas and the subtropical humid climate of the Persian Gulf. The second part of this analysis will describe the possibilities of traditional and contemporary materials as well as their advantages in urban furniture production, providing users protection from extreme local climate conditions, but also taking into account solidities and unwelcome consequences, such as vandalism. In addition, this research represents a preliminary stage in the development of IND307 furniture design course for needs of the Department of Interior design, at the American University in Duhok. Based on results obtained in this research, the course would present a symbiosis between people and technology, promotion of new street furniture design that perceives pedestrian activities in an urban setting, and practical use of anthropometric measurements as a tool for technical innovations.Keywords: Furniture design, Street furniture, Social interaction, Public space
Procedia PDF Downloads 1341963 The Willingness to Pay of People in Taiwan for Flood Protection Standard of Regions
Authors: Takahiro Katayama, Hsueh-Sheng Chang
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Due to the global climate change, it has increased the extreme rainfall that led to serious floods around the world. In recent years, urbanization and population growth also tend to increase the number of impervious surfaces, resulting in significant loss of life and property during floods especially for the urban areas of Taiwan. In the past, the primary governmental response to floods was structural flood control and the only flood protection standards in use were the design standards. However, these design standards of flood control facilities are generally calculated based on current hydrological conditions. In the face of future extreme events, there is a high possibility to surpass existing design standards and cause damages directly and indirectly to the public. To cope with the frequent occurrence of floods in recent years, it has been pointed out that there is a need for a different standard called FPSR (Flood Protection Standard of Regions) in Taiwan. FPSR is mainly used for disaster reduction and used to ensure that hydraulic facilities draining regional flood immediately under specific return period. FPSR could convey a level of flood risk which is useful for land use planning and reflect the disaster situations that a region can bear. However, little has been reported on FPSR and its impacts to the public in Taiwan. Hence, this study proposes a quantity procedure to evaluate the FPSR. This study aimed to examine FPSR of the region and public perceptions of and knowledge about FPSR, as well as the public’s WTP (willingness to pay) for FPSR. The research is conducted via literature review and questionnaire method. Firstly, this study will review the domestic and international research on the FPSR, and provide the theoretical framework of FPSR. Secondly, CVM (Contingent Value Method) has been employed to conduct this survey and using double-bounded dichotomous choice, close-ended format elicits households WTP for raising the protection level to understand the social costs. The samplings of this study are citizens living in Taichung city, Taiwan and 700 samplings were chosen in this study. In the end, this research will continue working on surveys, finding out which factors determining WTP, and provide some recommendations for adaption policies for floods in the future.Keywords: climate change, CVM (Contingent Value Method), FPSR (Flood Protection Standard of Regions), urban flooding
Procedia PDF Downloads 2491962 Synthesis of Multi-Functional Iron Oxide Nanoparticles for Targeted Drug Delivery in Cancer Treatment
Authors: Masome Moeni, Roya Abedizadeh, Elham Aram, Hamid Sadeghi-Abandansari, Davood Sabour, Robert Menzel, Ali Hassanpour
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Significant number of studies and preclinical research in formulation of cancer nano-pharmaceutics have led to an improvement in cancer care. Nonetheless, the antineoplastic agents have ‘failed to live up to its promise’ since their clinical performance is moderately low. For almost ninety years, iron oxide nanoparticles (IONPS) have managed to keep its reputation in clinical application due to their low toxicity, versatility and multi-modal capabilities. Drug Administration approved utilization of IONPs for diagnosis of cancer as contrast media in magnetic resonance imaging, as heat mediator in magnetic hyperthermia and for the treatment of iron deficiency. Furthermore, IONPs have high drug-loading capacity, which makes them good candidates as therapeutic agent transporters. There are yet challenges to overcome for successful clinical application of IONPs, including stability of drug and poor delivery, which might lead to (i) drug resistance, (ii) shorter blood circulation time, and (iii) rapid elimination and adverse side effects from the system. In this study, highly stable and super paramagnetic IONPs were prepared for efficient and targeted drug delivery in cancer treatment. The synthesis procedure was briefly involved the production of IONPs via co-precipitation followed by coating with tetraethyl orthosilicate and 3-aminopropylethoxysilane and grafting with folic acid for stability targeted purposes and controlled drug release. Physiochemical and morphological properties of modified IONPs were characterised using different analytical techniques. The resultant IONPs exhibited clusters of 10 nm spherical shape crystals with less than 100 nm size suitable for drug delivery. The functionalized IONP showed mesoporous features, high stability, dispersibility and crystallinity. Subsequently, the functionalized IONPs were successfully loaded with oxaliplatin, a chemotherapeutic agent, for a controlled drug release in an actively targeting cancer cells. FT-IR observations confirmed presence of oxaliplatin functional groups, while ICP-MS results verified the drug loading was ~ 1.3%.Keywords: cancer treatment, chemotherapeutic agent, drug delivery, iron oxide, multi-functional nanoparticle
Procedia PDF Downloads 801961 Predicting Mortality among Acute Burn Patients Using BOBI Score vs. FLAMES Score
Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah
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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.Keywords: BOBI, burns, FLAMES, scoring systems, outcome
Procedia PDF Downloads 3341960 Relationship between Readability of Paper-Based Braille and Character Spacing
Authors: T. Nishimura, K. Doi, H. Fujimoto, T. Wada
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The Number of people with acquired visual impairments has increased in recent years. In specialized courses at schools for the blind and in Braille lessons offered by social welfare organizations, many people with acquired visual impairments cannot learn to read adequately Braille. One of the reasons is that the common Braille patterns for people visual impairments who already has mature Braille reading skill being difficult to read for Braille reading beginners. In addition, there is the scanty knowledge of Braille book manufacturing companies regarding what Braille patterns would be easy to read for beginners. Therefore, it is required to investigate a suitable Braille patterns would be easy to read for beginners. In order to obtain knowledge regarding suitable Braille patterns for beginners, this study aimed to elucidate the relationship between readability of paper-based Braille and its patterns. This study focused on character spacing, which readily affects Braille reading ability, to determine a suitable character spacing ratio (ratio of character spacing to dot spacing) for beginners. Specifically, considering beginners with acquired visual impairments who are unfamiliar with reading Braille, we quantitatively evaluated the effect of character spacing ratio on Braille readability through an evaluation experiment using sighted subjects with no experience of reading Braille. In this experiment, ten sighted adults took the blindfold were asked to read test piece (three Braille characters). Braille used as test piece was composed of five dots. They were asked to touch the Braille by sliding their forefinger on the test piece immediately after the test examiner gave a signal to start the experiment. Then, they were required to release their forefinger from the test piece when they perceived the Braille characters. Seven conditions depended on character spacing ratio was held (i.e., 1.2, 1.4, 1.5, 1.6, 1.8, 2.0, 2.2 [mm]), and the other four depended on the dot spacing (i.e., 2.0, 2.5, 3.0, 3.5 [mm]). Ten trials were conducted for each conditions. The test pieces are created using by NISE Graphic could print Braille adjusted arbitrary value of character spacing and dot spacing with high accuracy. We adopted the evaluation indices for correct rate, reading time, and subjective readability to investigate how the character spacing ratio affects Braille readability. The results showed that Braille reading beginners could read Braille accurately and quickly, when character spacing ratio is more than 1.8 and dot spacing is more than 3.0 mm. Furthermore, it is difficult to read Braille accurately and quickly for beginners, when both character spacing and dot spacing are small. For this study, suitable character spacing ratio to make reading easy for Braille beginners is revealed.Keywords: Braille, character spacing, people with visual impairments, readability
Procedia PDF Downloads 2851959 From Preoccupied Attachment Pattern to Depression: Serial Mediation Model on the Female Sample
Authors: Tatjana Stefanovic Stanojevic, Milica Tosic Radev, Aleksandra Bogdanovic
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Depression is considered to be a leading cause of death and disability in the female population, and that is the reason why understanding the dynamics of the onset of depressive symptomatology is important. A review of the literature indicates the relationship between depressive symptoms and insecure attachment patterns, but very few studies have examined the mechanism underlying this relation. The aim of the study was to examine the pathway from the preoccupied attachment pattern to depressive symptomatology, as well as to test the mediation effect of mentalization, social anxiety and rumination in this relationship using a serial mediation model. The research was carried out on a geographical cluster sample from the general population of Serbia included within the project ‘Indicators and models of family and work roles harmonization’ funded by the Ministry of Education, Science and Technological Development of the Republic of Serbia. This research was carried out on a subsample of 791 working-age female adults from 37 urban and rural locations distributed through 20 administrative districts of Serbia. The respondents filled in a battery of instruments, including Relationship Questionnaire - Clinical Version (RQ - CV), The Mentalization Scale (MentS), Scale of Social Anxiety (SA), Patient Ruminative Thought Style Questionnaire (RTSQ), Health Questionnaire (PHQ-9). The results confirm our assumption that the total indirect effect of the preoccupied attachment pattern to depressive symptoms is significant across all mediators separately. More importantly, this effect is still present in a model with a sequential mediator relationship, where social anxiety, rumination, and mentalization were perceived as serial mediators of a relationship between preoccupied attachment and depressive symptoms (estimated indirect effect=0.004, boot-strapped 95% CI=0.002 to 0.007). Our findings suggest that there is a significant specific indirect effect of the preoccupied attachment pattern to depressive symptoms, occurring through mentalization, social anxiety and rumination, indicating that preoccupied attachment cause decrease of a self related mentalization, which in turn causes increasing of social anxiety and rumination, concluding in depressive symptoms as a final consequence. The finding that the path from the preoccupied attachment pattern to depressive symptoms is typical in women is understandable from the perspective of both evolutionary and culturally conditioned gender differences. The practical implications of the study are reflected in the recommendations for the prevention and forehand psychotherapy response among preoccupied women with depressive symptomatology. Treatment of this specific group of depressed patients should be focused on strengthening mentalization, learning to accept and to understand herself better, reducing anxiety in situations where mistakes are visible to others, and replacing the rumination strategy with more constructive coping strategies.Keywords: preoccupied attachment, depression, serial mediation model, mentalization, rumination
Procedia PDF Downloads 1401958 Hydration Evaluation In A Working Population in Greece
Authors: Aikaterini-Melpomeni Papadopoulou, Kyriaki Apergi, Margarita-Vasiliki Panagopoulou, Olga Malisova
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Introduction: Adequate hydration is a vital factor that enhances concentration, memory, and decision-making abilities throughout the workday. Various factors may affect hydration status in workplace settings, and many variables, such as age, gender and activity level affect hydration needs. Employees frequently overlook their hydration needs amid busy schedules and demanding tasks, leading to dehydration that can negatively affect cognitive function, productivity, and overall well-being In addition, dietary habits, including fluid intake and food choices, can either support or hinder optimal hydration. However, factors that affect hydration balance among workers in Greece have not been adequately studied. Objective: This study aims to evaluate the hydration status of the working population in Greece and investigate the various factors that impact hydration status in workplace settings, considering demographic, dietary, and occupational influences in a Greek sample of employees from diverse working environments Materials & Methods: The study included 212 participants (46.2% women) from the working population in Greece. Water intake from both solid and liquid foods was recorded using a semi-quantified drinking frequency questionnaire the validated Water Balance Questionnaire was used to evaluate hydration status. The calculation of water from solid and liquid foods was based on data from the USDA National Nutrient Database. Water balance was calculated subtracting the total fluid loss from the total fluid intake in the body. Furthermore, the questionnaire including additional questions on drinking habits and work-related factors.volunteers answered questions of different categories such as a) demographic socio-economic b) work style characteristics c) health, d) physical activity, e) food and fluid intake, f) fluid excretion and g) trends on fluid and water intake. Individual and multivariate regression analyses were performed to assess the relationships between demographic, work-related factors, and hydration balance. Results: Analysis showed that demographic factors like gender, age, and BMI, as well as certain work-related factors, had a weak and statistically non-significant effect on hydration balance. However, the use of a bottle or water container during work hours (b = 944.93, p < 0.001) and engaging in intense physical activity outside of work (b = -226.28, p < 0.001) were found to have a significant impact. Additionally, the consumption of beverages other than water (b = -416.14, p = 0.059) could negatively impact hydration balance. On average, the total consumption of the sample is 3410 ml of water daily, with men consuming approximately 440 ml / day more water (3470 ml / day) compared to women (3030 ml / day) with this difference also being statistically significant. Finally, the water balance, defined as the difference between water intake and water excretion, was found to be negative on average for the entire sample. Conclusions: This study is among the first to explore hydration status within the Greek working population. Findings indicate that awareness of adequate hydration and individual actions, such as using a water bottle during work, may influence hydration balance.Keywords: hydration, working population, water balance, workplace behavior
Procedia PDF Downloads 51957 Getting It Right Before Implementation: Using Simulation to Optimize Recommendations and Interventions After Adverse Event Review
Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos
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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation
Procedia PDF Downloads 1501956 Causes, Consequences, and Alternative Strategies of Illegal Migration in Ethiopia: The Case of Tigray Region
Authors: Muuz Abraha Meshesha
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Illegal Migration, specifically Trafficking in person is one of the primary issues of the day affecting all states of the world with variation on the extent of the root causes and consequences that led people to migrate irregularly and the consequences it is costing on humanity. This paper intends to investigate the root causes and consequences of illegal migration in Ethiopia’s Tigray Regional state and come up with alternative intervening strategy. To come up with pertinent and robust research finding, this study employed mixed research approach involving qualitative and quantitative data in line with purposive and snow ball sampling selection technique. The study revealed that, though poverty is the most commonly sensed pushing factor for people to illegally migrate, the issue of psycho-social orientation and attitudinal immersion of the local community for illegal migration, both in thinking and action is the most pressing problem that urges serious intervention. Trafficking in persons and Illegal migration in general, is becoming the norm of the day in the study area that overtly reveal illegal migration is an issue beyond livelihood securing demand in practice. Basically, parties engaged in illegal migration and the accomplice with human traffickers these days in the study area are found to be more than urgency for food security and a need to escape from livelihood impoverishment. Therefore, this study come up with a new paradigm insight indicating that illegal migration is believed by the local community members as an optional path way of doing business in illegal way while the attitude of the community and officials authorized to regulate is being part of the channel or to the least tolerant of this grave global danger. The study also found that the effect of illegal migration is significantly manifested in long run than in short term periods. Therefore, a need for critical consideration on attitudinal based intervention and youth oriented and enforceable legal and policy framework accountability framework is required to face and control illegal migration by international, national, local stakeholders. Besides this, economy based development interventions that could engage and reorient the youth, as primary victims of trafficking, and expansion of large scale projects that can employ large number of youths at a time.Keywords: human traficking, illegal migration, migration, tigray region
Procedia PDF Downloads 611955 Neonatal Sepsis in Dogs Attend in Veterinary Hospital of the Sao Paulo State University, Botucatu, Brazil – Incidence, Clinical Aspects and Mortality
Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Vivane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado
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Neonatal sepsis is a systemic response to the acute generalized infection caused by one or more bacterial agents, representing the main infectious cause of neonatal mortality in dogs during the first three weeks of life. This study aims to describe the incidence of sepsis in neonate dogs, as well as the main clinical signs and mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. Seven hundred thirty-five neonates, 14% (98/703) presented neonatal sepsis. The main sources of infection for the neonates were intrauterine (72.5%, 71/98), lactogenic (13.2%, 13/98), umbilical (5.1%, 5/98) and unidentified sources (9.2%, 9/98). The main non-specific clinical signs observed in the newborns were weakness, depression, impaired or absent reflexes, hypothermia, hypoglycemia, dehydration, reduced muscle tonus and diarrhea. The newborns also manifested clinical signs of severe infection, such as hyperemia in the abdominal and anal regions, omphalitis, hematuria, abdomen and extremities with purplish-blue coloration necrosing injuries in the pads, bradycardia, dyspnea, epistaxis, hypotension and evolution to septic shock. Infections acquired during intrauterine life led to the onset of the clinical signs at the time of birth, with fast evolution during the first hours of life. On the other hand, infections acquired via milk or umbilical cord presented clinical signs later. The total mortality rate was 5.4% (38/703) and the mortality rate among the neonates with sepsis was 38.7% (38/98). The early mortality rate (0 to 2 days) accounted for 86.9% (33/38) and the late mortality rate (3 to 30 days) for 13.1% (5/38) of the deaths among the newborns with sepsis. The main bacterial agents observed were Staphylococcus spp., Streptococcus spp., Proteus spp. Mannheimia spp. and Escherichia coli. Neonatal sepsis evolves quickly and may lead to high mortality in a litter. The prognosis is usually favorable if the diagnosis is reached early and the antibiotic therapy instituted as soon as possible, even before the results of blood cultures and antibiograms. The therapeutic recommendations should meet the special physiological conditions of a neonate in terms of metabolism and excretion of medication. Therefore, it is of utmost importance that the veterinarian is knowledgeable regarding neonatology to provide effective intervention and improve the survival rates of these patients.Keywords: Neonatal infection , bacteria, puppies, newborn
Procedia PDF Downloads 1141954 Utilizing Fly Ash Cenosphere and Aerogel for Lightweight Thermal Insulating Cement-Based Composites
Authors: Asad Hanif, Pavithra Parthasarathy, Zongjin Li
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Thermal insulating composites help to reduce the total power consumption in a building by creating a barrier between external and internal environment. Such composites can be used in the roofing tiles or wall panels for exterior surfaces. This study purposes to develop lightweight cement-based composites for thermal insulating applications. Waste materials like silica fume (an industrial by-product) and fly ash cenosphere (FAC) (hollow micro-spherical shells obtained as a waste residue from coal fired power plants) were used as partial replacement of cement and lightweight filler, respectively. Moreover, aerogel, a nano-porous material made of silica, was also used in different dosages for improved thermal insulating behavior, while poly vinyl alcohol (PVA) fibers were added for enhanced toughness. The raw materials including binders and fillers were characterized by X-Ray Diffraction (XRD), X-Ray Fluorescence spectroscopy (XRF), and Brunauer–Emmett–Teller (BET) analysis techniques in which various physical and chemical properties of the raw materials were evaluated like specific surface area, chemical composition (oxide form), and pore size distribution (if any). Ultra-lightweight cementitious composites were developed by varying the amounts of FAC and aerogel with 28-day unit weight ranging from 1551.28 kg/m3 to 1027.85 kg/m3. Excellent mechanical and thermal insulating properties of the resulting composites were obtained ranging from 53.62 MPa to 8.66 MPa compressive strength, 9.77 MPa to 3.98 MPa flexural strength, and 0.3025 W/m-K to 0.2009 W/m-K as thermal conductivity coefficient (QTM-500). The composites were also tested for peak temperature difference between outer and inner surfaces when subjected to heating (in a specially designed experimental set-up) by a 275W infrared lamp. The temperature difference up to 16.78 oC was achieved, which indicated outstanding properties of the developed composites to act as a thermal barrier for building envelopes. Microstructural studies were carried out by Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectroscopy (EDS) for characterizing the inner structure of the composite specimen. Also, the hydration products were quantified using the surface area mapping and line scale technique in EDS. The microstructural analyses indicated excellent bonding of FAC and aerogel in the cementitious system. Also, selective reactivity of FAC was ascertained from the SEM imagery where the partially consumed FAC shells were observed. All in all, the lightweight fillers, FAC, and aerogel helped to produce the lightweight composites due to their physical characteristics, while exceptional mechanical properties, owing to FAC partial reactivity, were achieved.Keywords: aerogel, cement-based, composite, fly ash cenosphere, lightweight, sustainable development, thermal conductivity
Procedia PDF Downloads 2221953 Honey Intoxication: A Unique Cause of Sudden Cardiac Collapse
Authors: Bharat Rawat, Shekhar Rajbhandari, Yadav Bhatta, Jay Prakash Jaiswal, Shivaji Bikram Silwal, Rajiv Shrestha, Shova Sunuwar
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Introduction: The honey produced by the bees fed on Rhobdodendron species containing grayanotoxin is known as mad honey. Grayanotoxin is found in honey obtained from the nectar of Rhododendron species growing on the mountains of the Black Sea region of Turkey and also in Japan, Nepal, Brazil, parts of North America, and Europe. Although the incidence of grayanotoxin poisoning is rare, there is concern that the number of cases per year will rise with the increasing demand for organic products. Mad honey intoxication might present with mild symptoms of cardiovascular, gastrointestinal and neurological systems or might also present with a life-threatening form with AV block and cardiovascular collapse. In this article, we describe the summary of five cases, which came to our hospital with mad honey related cardiac complications. Findings: In last one year, five cases presented in the emergency department with sudden onset of Loss of consciousness, dizziness, shortness of breath. They felt difficulty after the consumption of 1-3 teaspoonful of wild honey. The honey was brought from most of the rural parts of Nepal like khotang. Some of them also came with vomiting, dizziness, and loose stool. On examination, most of them had severe bradycardia and low blood pressure. No abnormalities were detected on systemic examinations. In one patient, ECG and cardiac enzymes showed features of the acute coronary syndrome, but his treadmill test done few days later was normal. All patients were managed with inj. Atropine, I/V normal saline, and other supportive measures and discharged in a stable condition within one or two days. Conclusions: Rhododendrons is the national flower of Nepal. The specific species of rhododendron found in Nepal which contains the toxin is not known. Bees feeding on these rhododendrons are known to transfer the grayanotoxin to the honey they produce. Most symptoms are mild and resolve themselves without medical intervention. Signs and symptoms of grayanotoxin poisoning rarely last more than 24 hours and are usually not fatal. Some signs of mad honey poisoning include Bradycardia, Cardiac arrhythmia, Hypotension, Nausea and Vomiting. They respond to close monitoring and appropriate supportive treatment. Normally, patients recover completely with no residual damage to the heart or its conduction system.Keywords: rhobdodendron, honey, grayanotoxin, bradycardia
Procedia PDF Downloads 3461952 Electron Density Discrepancy Analysis of Energy Metabolism Coenzymes
Authors: Alan Luo, Hunter N. B. Moseley
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Many macromolecular structure entries in the Protein Data Bank (PDB) have a range of regional (localized) quality issues, be it derived from x-ray crystallography, Nuclear Magnetic Resonance (NMR) spectroscopy, or other experimental approaches. However, most PDB entries are judged by global quality metrics like R-factor, R-free, and resolution for x-ray crystallography or backbone phi-psi distribution statistics and average restraint violations for NMR. Regional quality is often ignored when PDB entries are re-used for a variety of structurally based analyses. The binding of ligands, especially ligands involved in energy metabolism, is of particular interest in many structurally focused protein studies. Using a regional quality metric that provides chemically interpretable information from electron density maps, a significant number of outliers in regional structural quality was detected across x-ray crystallographic PDB entries for proteins bound to biochemically critical ligands. In this study, a series of analyses was performed to evaluate both specific and general potential factors that could promote these outliers. In particular, these potential factors were the minimum distance to a metal ion, the minimum distance to a crystal contact, and the isotropic atomic b-factor. To evaluate these potential factors, Fisher’s exact tests were performed, using regional quality criteria of outlier (top 1%, 2.5%, 5%, or 10%) versus non-outlier compared to a potential factor metric above versus below a certain outlier cutoff. The results revealed a consistent general effect from region-specific normalized b-factors but no specific effect from metal ion contact distances and only a very weak effect from crystal contact distance as compared to the b-factor results. These findings indicate that no single specific potential factor explains a majority of the outlier ligand-bound regions, implying that human error is likely as important as these other factors. Thus, all factors, including human error, should be considered when regions of low structural quality are detected. Also, the downstream re-use of protein structures for studying ligand-bound conformations should screen the regional quality of the binding sites. Doing so prevents misinterpretation due to the presence of structural uncertainty or flaws in regions of interest.Keywords: biomacromolecular structure, coenzyme, electron density discrepancy analysis, x-ray crystallography
Procedia PDF Downloads 1281951 Variable Mapping: From Bibliometrics to Implications
Authors: Przemysław Tomczyk, Dagmara Plata-Alf, Piotr Kwiatek
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Literature review is indispensable in research. One of the key techniques used in it is bibliometric analysis, where one of the methods is science mapping. The classic approach that dominates today in this area consists of mapping areas, keywords, terms, authors, or citations. This approach is also used in relation to the review of literature in the field of marketing. The development of technology has resulted in the fact that researchers and practitioners use the capabilities of software available on the market for this purpose. The use of science mapping software tools (e.g., VOSviewer, SciMAT, Pajek) in recent publications involves the implementation of a literature review, and it is useful in areas with a relatively high number of publications. Despite this well-grounded science mapping approach having been applied in the literature reviews, performing them is a painstaking task, especially if authors would like to draw precise conclusions about the studied literature and uncover potential research gaps. The aim of this article is to identify to what extent a new approach to science mapping, variable mapping, takes advantage of the classic science mapping approach in terms of research problem formulation and content/thematic analysis for literature reviews. To perform the analysis, a set of 5 articles on customer ideation was chosen. Next, the analysis of key words mapping results in VOSviewer science mapping software was performed and compared with the variable map prepared manually on the same articles. Seven independent expert judges (management scientists on different levels of expertise) assessed the usability of both the stage of formulating, the research problem, and content/thematic analysis. The results show the advantage of variable mapping in the formulation of the research problem and thematic/content analysis. First, the ability to identify a research gap is clearly visible due to the transparent and comprehensive analysis of the relationships between the variables, not only keywords. Second, the analysis of relationships between variables enables the creation of a story with an indication of the directions of relationships between variables. Demonstrating the advantage of the new approach over the classic one may be a significant step towards developing a new approach to the synthesis of literature and its reviews. Variable mapping seems to allow scientists to build clear and effective models presenting the scientific achievements of a chosen research area in one simple map. Additionally, the development of the software enabling the automation of the variable mapping process on large data sets may be a breakthrough change in the field of conducting literature research.Keywords: bibliometrics, literature review, science mapping, variable mapping
Procedia PDF Downloads 1191950 Exploring Causes of Irregular Migration: Evidence from Rural Punjab, India
Authors: Kulwinder Singh
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Punjab is one of the major labour exporting states of India. Every year more than 20,000 youths from Punjab attempt irregular migration. About 84 irregular migrants are from rural areas and 16 per cent from urban areas. Irregular migration could only be achieved if be organized through highly efficient international networks with the countries of origin, transit, and destination. A good number of Punjabis continue to immigrate into the UK for work through unauthorized means entering the country on visit visas and overstaying or getting ‘smuggled into’ the country with the help of transnational networks of agents. Although, the efforts are being made by the government to curb irregular migration through The Punjab Prevention of Human Smuggling Rules (2012, 2014) and Punjab Travel Regulation Act (2012), but yet it exists parallel to regular migration. Despite unprecedented miseries of irregular migrants and strict laws implemented by the state government to check this phenomenon, ‘why do Punjabis migrate abroad irregularly’ is the important question to answer. This study addresses this question through the comparison of irregular migration with regular one. In other words, this analysis reveals major causes, specifically economic ones, of irregular migration from rural Punjab. This study is unique by presenting economics of irregular migration, given previous studies emphasize the role of sociological and psychological factors. Addressing important question “why do Punjabis migrate abroad irregularly?”, the present study reveals that Punjabi, being far-sighted, endeavor irregular migration as it is, though, economically nonviable in short run, but offers lucrative economic gains as gets older. Despite its considerably higher cost viz-a-viz regular migration, it is the better employment option to irregular migrants with higher permanent income than local low paid jobs for which risking life has become the mindset of the rural Punjabis. Although, it carries considerably lower economic benefits as compared to regular migration, but provides the opportunity of migrating abroad to less educated, semi-skilled and language-test ineligible Punjabis who cannot migrate through regular channels. As its positive impacts on source and destination countries are evident, it might not be restricted, rather its effective management, through liberalising restrictive migration policies by destination nations, can protect the interests of all involved stakeholders.Keywords: cost, migration, income, irregular, regular, remittances
Procedia PDF Downloads 1221949 Is the Addition of Computed Tomography with Angiography Superior to a Non-Contrast Neuroimaging Only Strategy for Patients with Suspected Stroke or Transient Ischemic Attack Presenting to the Emergency Department?
Authors: Alisha M. Ebrahim, Bijoy K. Menon, Eddy Lang, Shelagh B. Coutts, Katie Lin
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Introduction: Frontline emergency physicians require clear and evidence-based approaches to guide neuroimaging investigations for patients presenting with suspected acute stroke or transient ischemic attack (TIA). Various forms of computed tomography (CT) are currently available for initial investigation, including non-contrast CT (NCCT), CT angiography head and neck (CTA), and CT perfusion (CTP). However, there is uncertainty around optimal imaging choice for cost-effectiveness, particularly for minor or resolved neurological symptoms. In addition to the cost of CTA and CTP testing, there is also a concern for increased incidental findings, which may contribute to the burden of overdiagnosis. Methods: In this cross-sectional observational study, analysis was conducted on 586 anonymized triage and diagnostic imaging (DI) reports for neuroimaging orders completed on patients presenting to adult emergency departments (EDs) with a suspected stroke or TIA from January-December 2019. The primary outcome of interest is the diagnostic yield of NCCT+CTA compared to NCCT alone for patients presenting to urban academic EDs with Canadian Emergency Department Information System (CEDIS) complaints of “symptoms of stroke” (specifically acute stroke and TIA indications). DI reports were coded into 4 pre-specified categories (endorsed by a panel of stroke experts): no abnormalities, clinically significant findings (requiring immediate or follow-up clinical action), incidental findings (not meeting prespecified criteria for clinical significance), and both significant and incidental findings. Standard descriptive statistics were performed. A two-sided p-value <0.05 was considered significant. Results: 75% of patients received NCCT+CTA imaging, 21% received NCCT alone, and 4% received NCCT+CTA+CTP. The diagnostic yield of NCCT+CTA imaging for prespecified clinically significant findings was 24%, compared to only 9% in those who received NCCT alone. The proportion of incidental findings was 30% in the NCCT only group and 32% in the NCCT+CTA group. CTP did not significantly increase the yield of significant or incidental findings. Conclusion: In this cohort of patients presenting with suspected stroke or TIA, an NCCT+CTA neuroimaging strategy had a higher diagnostic yield for clinically significant findings than NCCT alone without significantly increasing the number of incidental findings identified.Keywords: stroke, diagnostic yield, neuroimaging, emergency department, CT
Procedia PDF Downloads 981948 QSAR Study on Diverse Compounds for Effects on Thermal Stability of a Monoclonal Antibody
Authors: Olubukayo-Opeyemi Oyetayo, Oscar Mendez-Lucio, Andreas Bender, Hans Kiefer
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The thermal melting curve of a protein provides information on its conformational stability and could provide cues on its aggregation behavior. Naturally-occurring osmolytes have been shown to improve the thermal stability of most proteins in a concentration-dependent manner. They are therefore commonly employed as additives in therapeutic protein purification and formulation. A number of intertwined and seemingly conflicting mechanisms have been put forward to explain the observed stabilizing effects, the most prominent being the preferential exclusion mechanism. We attempted to probe and summarize molecular mechanisms for thermal stabilization of a monoclonal antibody (mAb) by developing quantitative structure-activity relationships using a rationally-selected library of 120 osmolyte-like compounds in the polyhydric alcohols, amino acids and methylamines classes. Thermal stabilization potencies were experimentally determined by thermal shift assays based on differential scanning fluorimetry. The cross-validated QSAR model was developed by partial least squares regression using descriptors generated from Molecular Operating Environment software. Careful evaluation of the results with the use of variable importance in projection parameter (VIP) and regression coefficients guided the selection of the most relevant descriptors influencing mAb thermal stability. For the mAb studied and at pH 7, the thermal stabilization effects of tested compounds correlated positively with their fractional polar surface area and inversely with their fractional hydrophobic surface area. We cannot claim that the observed trends are universal for osmolyte-protein interactions because of protein-specific effects, however this approach should guide the quick selection of (de)stabilizing compounds for a protein from a chemical library. Further work with a large variety of proteins and at different pH values would help the derivation of a solid explanation as to the nature of favorable osmolyte-protein interactions for improved thermal stability. This approach may be beneficial in the design of novel protein stabilizers with optimal property values, especially when the influence of solution conditions like the pH and buffer species and the protein properties are factored in.Keywords: thermal stability, monoclonal antibodies, quantitative structure-activity relationships, osmolytes
Procedia PDF Downloads 3291947 Funding Innovative Activities in Firms: The Ownership Structure and Governance Linkage - Evidence from Mongolia
Authors: Ernest Nweke, Enkhtuya Bavuudorj
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The harsh realities of the scandalous failure of several notable corporations in the past two decades have inextricably resulted in a surge in corporate governance studies. Nevertheless, little or no attention has been paid to corporate governance studies in Mongolian firms and much less to the comprehension of the correlation among ownership structure, corporate governance mechanisms and trend of innovative activities. Innovation is the bed rock of enterprise success. However, the funding and support for innovative activities in many firms are to a great extent determined by the incentives provided by the firm’s internal and external governance mechanisms. Mongolia is an East Asian country currently undergoing a fast-paced transition from socialist to democratic system and it is a widely held view that private ownership as against public ownership fosters innovation. Hence, following the privatization policy of Mongolian Government which has led to the transfer of the ownership of hitherto state controlled and state directed firms to private individuals and organizations, expectations are high that sufficient motivation would be provided for firm managers to engage in innovative activities. This research focuses on the relationship between ownership structure, corporate governance on one hand and the level of innovation on the hand. The paper is empirical in nature and derives data from both reliable secondary and primary sources. Secondary data for the study was in respect of ownership structure of Mongolian listed firms and innovation trend in Mongolia generally. These were analyzed using tables, charts, bars and percentages. Personal interviews and surveys were held to collect primary data. Primary data was in respect of corporate governance practices in Mongolian firms and were collected using structured questionnaire. Out of a population of three hundred and twenty (320) companies listed on the Mongolian Stock Exchange (MSE), a sample size of thirty (30) randomly selected companies was utilized for the study. Five (5) management level employees were surveyed in each selected firm giving a total of one hundred and fifty (150) respondents. Data collected were analyzed and research hypotheses tested using Chi-Square test statistic. Research results showed that corporate governance mechanisms were better and have significantly improved overtime in privately held as opposed to publicly owned firms. Consequently, the levels of innovation in privately held firms were considerably higher. It was concluded that a significant and positive relationship exists between private ownership and good corporate governance on one hand and the level of funding provided for innovative activities in Mongolian firms on the other hand.Keywords: corporate governance, innovation, ownership structure, stock exchange
Procedia PDF Downloads 1941946 Salmonella Emerging Serotypes in Northwestern Italy: Genetic Characterization by Pulsed-Field Gel Electrophoresis
Authors: Clara Tramuta, Floris Irene, Daniela Manila Bianchi, Monica Pitti, Giulia Federica Cazzaniga, Lucia Decastelli
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This work presents the results obtained by the Regional Reference Centre for Salmonella Typing (CeRTiS) in a retrospective study aimed to investigate, through Pulsed-field Gel Electrophoresis (PFGE) analysis, the genetic relatedness of emerging Salmonella serotypes of human origin circulating in North-West of Italy. Furthermore, the goal of this work was to create a Regional database to facilitate foodborne outbreak investigation and to monitor them at an earlier stage. A total of 112 strains, isolated from 2016 to 2018 in hospital laboratories, were included in this study. The isolates were previously identified as Salmonella according to standard microbiological techniques and serotyping was performed according to ISO 6579-3 and the Kaufmann-White scheme using O and H antisera (Statens Serum Institut®). All strains were characterized by PFGE: analysis was conducted according to a standardized PulseNet protocol. The restriction enzyme XbaI was used to generate several distinguishable genomic fragments on the agarose gel. PFGE was performed on a CHEF Mapper system, separating large fragments and generating comparable genetic patterns. The agarose gel was then stained with GelRed® and photographed under ultraviolet transillumination. The PFGE patterns obtained from the 112 strains were compared using Bionumerics version 7.6 software with the Dice coefficient with 2% band tolerance and 2% optimization. For each serotype, the data obtained with the PFGE were compared according to the geographical origin and the year in which they were isolated. Salmonella strains were identified as follow: S. Derby n. 34; S. Infantis n. 38; S. Napoli n. 40. All the isolates had appreciable restricted digestion patterns ranging from approximately 40 to 1100 kb. In general, a fairly heterogeneous distribution of pulsotypes has emerged in the different provinces. Cluster analysis indicated high genetic similarity (≥ 83%) among strains of S. Derby (n. 30; 88%), S. Infantis (n. 36; 95%) and S. Napoli (n. 38; 95%) circulating in north-western Italy. The study underlines the genomic similarities shared by the emerging Salmonella strains in Northwest Italy and allowed to create a database to detect outbreaks in an early stage. Therefore, the results confirmed that PFGE is a powerful and discriminatory tool to investigate the genetic relationships among strains in order to monitoring and control Salmonellosis outbreak spread. Pulsed-field gel electrophoresis (PFGE) still represents one of the most suitable approaches to characterize strains, in particular for the laboratories for which NGS techniques are not available.Keywords: emerging Salmonella serotypes, genetic characterization, human strains, PFGE
Procedia PDF Downloads 1051945 From Government-Led to Collective Action: A Case Study of the Transformation of Urban Renewal Governance in Nanjing, China
Authors: Hanjun Hu, Jinxiang Zhang
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With the decline of "growthism", China's urbanization process has shifted from the stage of spatial expansion to the stage of optimization of built-up spaces, and urban renewal has gradually become a new wave of China's urban movement in recent years. The ongoing urban renewal movement in China not only needs to generate new motivation for urban development but also solve the backlog of social problems caused by rapid urbanization, which provides an opportunity for the transformation of China's urban governance model. Unlike previous approaches that focused on physical space and functional renewal, such as urban reconstruction, redevelopment, and reuse, the key challenge of urban renewal in the post-growth era lies in coordinating the complex interest relationships between multiple stakeholders. The traditional theoretical frameworks that focus on the structural relations between social groups are insufficient to explain the behavior logic and mutual cooperation mechanism of various groups and individuals in the current urban renewal practices. Therefore, based on the long-term tracking of the urban renewal practices in the Old City of Nanjing (OCN), this paper introduces the "collective action" theory to deeply analyze changes in the urban renewal governance model in OCN and tries to summarize the governance strategies that promote the formation of collective action within recent practices from a micro-scale. The study found that the practice in OCN experienced three different stages "government-led", "growth coalition" and "asymmetric game". With the transformation of government governance concepts, the rise of residents' consciousness of rights, and the wider participation of social organizations in recent years, the urban renewal in OCN is entering a new stage of "collective renewal action". Through the establishment of the renewal organization model, incentive policies, and dynamic negotiation mechanism, urban renewal in OCN not only achieves a relative balance between individual interests and collective interests but also makes the willingness of residents the dominant factor in formulating urban renewal policies. However, the presentation of "collective renewal action" in OCN is still mainly based on typical cases. Although the government is no longer the dominant role, a large number of resident-led collective actions have not yet emerged, which puts forward new research needs for a sustainable governance policy innovation in this action.Keywords: urban renewal, collective action theory, governance, cooperation mechanism, China
Procedia PDF Downloads 541944 Crafting of Paper Cutting Techniques for Embellishment of Fashion Textiles
Authors: A. Vaidya-Soocheta, K. M. Wong-Hon-Lang
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Craft and fashion have always been interlinked. The combination of both often gives stunning results. The present study introduces ‘Paper Cutting Craft Techniques’ like the Japanese –Kirigami, Mexican –PapelPicado, German –Scherenschnitte, Polish –Wycinankito in textiles to develop innovative and novel design structures as embellishments and ornamentation. The project studies various ways of using these paper cutting techniques to obtain interesting features and delicate design patterns on fabrics. While paper has its advantages and related uses, it is fragile rigid and thus not appropriate for clothing. Fabric is sturdy, flexible, dimensionally stable and washable. In the present study, the cut out techniques develop creative design motifs and patterns to give an inventive and unique appeal to the fabrics. The beauty and fascination of lace in garments have always given them a nostalgic charm. Laces with their intricate and delicate complexity in combination with other materials add a feminine touch to a garment and give it a romantic, mysterious appeal. Various textured and decorative effects through fabric manipulation are experimented along with the use of paper cutting craft skills as an innovative substitute for developing lace or “Broderie Anglaise” effects on textiles. A number of assorted fabric types with varied textures were selected for the study. Techniques to avoid fraying and unraveling of the design cut fabrics were introduced. Fabrics were further manipulated by use of interesting prints with embossed effects on cut outs. Fabric layering in combination with assorted techniques such as cutting of folded fabric, printing, appliqué, embroidery, crochet, braiding, weaving added a novel exclusivity to the fabrics. The fabrics developed by these innovative methods were then tailored into garments. The study thus tested the feasibility and practicability of using these fabrics by designing a collection of evening wear garments based on the theme ‘Nostalgia’. The prototypes developed were complemented by designing fashion accessories with the crafted fabrics. Prototypes of accessories add interesting features to the study. The adaptation and application of this novel technique of paper cutting craft on textiles can be an innovative start for a new trend in textile and fashion industry. The study anticipates that this technique will open new avenues in the world of fashion to incorporate its use commercially.Keywords: collection, fabric cutouts, nostalgia, prototypes
Procedia PDF Downloads 3561943 Methods Used to Achieve Airtightness of 0.07 Ach@50Pa for an Industrial Building
Authors: G. Wimmers
Abstract:
The University of Northern British Columbia needed a new laboratory building for the Master of Engineering in Integrated Wood Design Program and its new Civil Engineering Program. Since the University is committed to reducing its environmental footprint and because the Master of Engineering Program is actively involved in research of energy efficient buildings, the decision was made to request the energy efficiency of the Passive House Standard in the Request for Proposals. The building is located in Prince George in Northern British Columbia, a city located at the northern edge of climate zone 6 with an average low between -8 and -10.5 in the winter months. The footprint of the building is 30m x 30m with a height of about 10m. The building consists of a large open space for the shop and laboratory with a small portion of the floorplan being two floors, allowing for a mezzanine level with a few offices as well as mechanical and storage rooms. The total net floor area is 1042m² and the building’s gross volume 9686m³. One key requirement of the Passive House Standard is the airtight envelope with an airtightness of < 0.6 ach@50Pa. In the past, we have seen that this requirement can be challenging to reach for industrial buildings. When testing for air tightness, it is important to test in both directions, pressurization, and depressurization, since the airflow through all leakages of the building will, in reality, happen simultaneously in both directions. A specific detail or situation such as overlapping but not sealed membranes might be airtight in one direction, due to the valve effect, but are opening up when tested in the opposite direction. In this specific project, the advantage was the overall very compact envelope and the good volume to envelope area ratio. The building had to be very airtight and the details for the windows and doors installation as well as all transitions from walls to roof and floor, the connections of the prefabricated wall panels and all penetrations had to be carefully developed to allow for maximum airtightness. The biggest challenges were the specific components of this industrial building, the large bay door for semi-trucks and the dust extraction system for the wood processing machinery. The testing was carried out in accordance with EN 132829 (method A) as specified in the International Passive House Standard and the volume calculation was also following the Passive House guideline resulting in a net volume of 7383m3, excluding all walls, floors and suspended ceiling volumes. This paper will explore the details and strategies used to achieve an airtightness of 0.07 ach@50Pa, to the best of our knowledge the lowest value achieved in North America so far following the test protocol of the International Passive House Standard and discuss the crucial steps throughout the project phases and the most challenging details.Keywords: air changes, airtightness, envelope design, industrial building, passive house
Procedia PDF Downloads 147