Search results for: methods of preventing the premature dirtiness of transmission oil
1225 The Effects of Exercise Training on LDL Mediated Blood Flow in Coronary Artery Disease: A Systematic Review
Authors: Aziza Barnawi
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Background: Regular exercise reduces risk factors associated with cardiovascular diseases. Over the past decade, exercise interventions have been introduced to reduce the risk of and prevent coronary artery disease (CAD). Elevated low-density lipoproteins (LDL) contribute to the formation of atherosclerosis, its manifestations on the endothelial narrow the coronary artery and affect the endothelial function. Therefore, flow-mediated dilation (FMD) technique is used to assess the function. The results of previous studies have been inconsistent and difficult to interpret across different types of exercise programs. The relationship between exercise therapy and lipid levels has been extensively studied, and it is known to improve the lipid profile and endothelial function. However, the effectiveness of exercise in altering LDL levels and improving blood flow is controversial. Objective: This review aims to explore the evidence and quantify the impact of exercise training on LDL levels and vascular function by FMD. Methods: Electronic databases were searched PubMed, Google Scholar, Web of Science, the Cochrane Library, and EBSCO using the keywords: “low and/or moderate aerobic training”, “blood flow”, “atherosclerosis”, “LDL mediated blood flow”, “Cardiac Rehabilitation”, “low-density lipoproteins”, “flow-mediated dilation”, “endothelial function”, “brachial artery flow-mediated dilation”, “oxidized low-density lipoproteins” and “coronary artery disease”. The studies were conducted for 6 weeks or more and influenced LDL levels and/or FMD. Studies with different intensity training and endurance training in healthy or CAD individuals were included. Results: Twenty-one randomized controlled trials (RCTs) (14 FMD and 7 LDL studies) with 776 participants (605 exercise participants and 171 control participants) met eligibility criteria and were included in the systematic review. Endurance training resulted in a greater reduction in LDL levels and their subfractions and a better FMD response. Overall, the training groups showed improved physical fitness status compared with the control groups. Participants whose exercise duration was ≥150 minutes /week had significant improvement in FMD and LDL levels compared with those with <150 minutes/week.Conclusion: In conclusion, although the relationship between physical training, LDL levels, and blood flow in CAD is complex and multifaceted, there are promising results for controlling primary and secondary prevention of CAD by exercise. Exercise training, including resistance, aerobic, and interval training, is positively correlated with improved FMD. However, the small body of evidence for LDL studies (resistance and interval training) did not prove to be significantly associated with improved blood flow. Increasing evidence suggests that exercise training is a promising adjunctive therapy to improve cardiovascular health, potentially improving blood flow and contributing to the overall management of CAD.Keywords: exercise training, low density lipoprotein, flow mediated dilation, coronary artery disease
Procedia PDF Downloads 671224 Attention and Memory in the Music Learning Process in Individuals with Visual Impairments
Authors: Lana Burmistrova
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Introduction: The influence of visual impairments on several cognitive processes used in the music learning process is an increasingly important area in special education and cognitive musicology. Many children have several visual impairments due to the refractive errors and irreversible inhibitors. However, based on the compensatory neuroplasticity and functional reorganization, congenitally blind (CB) and early blind (EB) individuals use several areas of the occipital lobe to perceive and process auditory and tactile information. CB individuals have greater memory capacity, memory reliability, and less false memory mechanisms are used while executing several tasks, they have better working memory (WM) and short-term memory (STM). Blind individuals use several strategies while executing tactile and working memory n-back tasks: verbalization strategy (mental recall), tactile strategy (tactile recall) and combined strategies. Methods and design: The aim of the pilot study was to substantiate similar tendencies while executing attention, memory and combined auditory tasks in blind and sighted individuals constructed for this study, and to investigate attention, memory and combined mechanisms used in the music learning process. For this study eight (n=8) blind and eight (n=8) sighted individuals aged 13-20 were chosen. All respondents had more than five years music performance and music learning experience. In the attention task, all respondents had to identify pitch changes in tonal and randomized melodic pairs. The memory task was based on the mismatch negativity (MMN) proportion theory: 80 percent standard (not changed) and 20 percent deviant (changed) stimuli (sequences). Every sequence was named (na-na, ra-ra, za-za) and several items (pencil, spoon, tealight) were assigned for each sequence. Respondents had to recall the sequences, to associate them with the item and to detect possible changes. While executing the combined task, all respondents had to focus attention on the pitch changes and had to detect and describe these during the recall. Results and conclusion: The results support specific features in CB and EB, and similarities between late blind (LB) and sighted individuals. While executing attention and memory tasks, it was possible to observe the tendency in CB and EB by using more precise execution tactics and usage of more advanced periodic memory, while focusing on auditory and tactile stimuli. While executing memory and combined tasks, CB and EB individuals used passive working memory to recall standard sequences, active working memory to recall deviant sequences and combined strategies. Based on the observation results, assessment of blind respondents and recording specifics, following attention and memory correlations were identified: reflective attention and STM, reflective attention and periodic memory, auditory attention and WM, tactile attention and WM, auditory tactile attention and STM. The results and the summary of findings highlight the attention and memory features used in the music learning process in the context of blindness, and the tendency of the several attention and memory types correlated based on the task, strategy and individual features.Keywords: attention, blindness, memory, music learning, strategy
Procedia PDF Downloads 1761223 The Use of Stroke Journey Map in Improving Patients' Perceived Knowledge in Acute Stroke Unit
Authors: C. S. Chen, F. Y. Hui, B. S. Farhana, J. De Leon
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Introduction: Stroke can lead to long-term disability, affecting one’s quality of life. Providing stroke education to patient and family members is essential to optimize stroke recovery and prevent recurrent stroke. Currently, nurses conduct stroke education by handing out pamphlets and explaining their contents to patients. However, this is not always effective as nurses have varying levels of knowledge and depth of content discussed with the patient may not be consistent. With the advancement of information technology, health education is increasingly being disseminated via electronic software and studies have shown this to have benefitted patients. Hence, a multi-disciplinary team consisting of doctors, nurses and allied health professionals was formed to create the stroke journey map software to deliver consistent and concise stroke education. Research Objectives: To evaluate the effectiveness of using a stroke journey map software in improving patients’ perceived knowledge in the acute stroke unit during hospitalization. Methods: Patients admitted to the acute stroke unit were given stroke journey map software during patient education. The software consists of 31 interactive slides that are brightly coloured and 4 videos, based on input provided by the multi-disciplinary team. Participants were then assessed with pre-and-post survey questionnaires before and after viewing the software. The questionnaire consists of 10 questions with a 5-point Likert scale which sums up to a total score of 50. The inclusion criteria are patients diagnosed with ischemic stroke and are cognitively alert and oriented. This study was conducted between May 2017 to October 2017. Participation was voluntary. Results: A total of 33 participants participated in the study. The results demonstrated that the use of a stroke journey map as a stroke education medium was effective in improving patients’ perceived knowledge. A comparison of pre- and post-implementation data of stroke journey map revealed an overall mean increase in patients’ perceived knowledge from 24.06 to 40.06. The data is further broken down to evaluate patients’ perceived knowledge in 3 domains: (1) Understanding of disease process; (2) Management and treatment plans; (3) Post-discharge care. Each domain saw an increase in mean score from 10.7 to 16.2, 6.9 to 11.9 and 6.6 to 11.7 respectively. Project Impact: The implementation of stroke journey map has a positive impact in terms of (1) Increasing patient’s perceived knowledge which could contribute to greater empowerment of health; (2) Reducing need for stroke education material printouts making it environmentally friendly; (3) Decreasing time nurses spent on giving education resulting in more time to attend to patients’ needs. Conclusion: This study has demonstrated the benefit of using stroke journey map as a platform for stroke education. Overall, it has increased patients’ perceived knowledge in understanding their disease process, the management and treatment plans as well as the discharge process.Keywords: acute stroke, education, ischemic stroke, knowledge, stroke
Procedia PDF Downloads 1581222 The Problems of Women over 65 with Incontinence Diagnosis: A Case Study in Turkey
Authors: Birsel Canan Demirbag, Kıymet Yesilcicek Calik, Hacer Kobya Bulut
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Objective: This study was conducted to evaluate the problems of women over 65 with incontinence diagnosis. Methods: This descriptive study was conducted with women over 65 with incontinence diagnosis in four Family Health Centers in a city in Eastern Black Sea region between November 1, and December 20, 2015. 203, 107, 178, 180 women over 65 were registered in these centers and 262 had incontinence diagnosis at least once and had an ongoing complaint. 177 women were volunteers for the study. During home visits and using face-to-face survey methodology, participants were given socio-demographic characteristics survey, Sandvik severity scale, Incontinence Quality of Life Scale, Urogenital Distress Inventory and a questionnaire including challenges experienced due to incontinence developed by the researcher. Data were analyzed with SPSS program using percentages, numbers, Chi-square, Man-Whitney U and t test with 95% confidence interval and a significance level p <0.05. Findings: 67 ± 1.4 was the mean age, 2.05 ± 0.04 was parity, 44.5 ± 2.12 was menopause age, 66.3% were primary school graduates, 45.7% had deceased spouse, 44.4% lived in a large family, 67.2% had their own room, 77.8% had income, 89.2% could meet self- care, 73.2% had a diagnosis of mixed incontinence, 87.5% suffered for 6-20 years % 78.2 had diuretics, antidepressants and heart medicines, 20.5% had urinary fecal cases, 80.5% had bladder training at least once, 90.1% didn’t have bladder diary calendar/control training programs, 31.1% had hysterectomy for prolapse, 97.1'i% was treated with lower urinary tract infection at least once, 66.3% saw a doctor to get drug in the last three months, 76.2 could not go out alone, 99.2 % had at least one chronic disease, 87.6 % had constipation complain, 2.9% had chronic cough., 45.1% fell due to a sudden rise for toilet. Incontinence Impact Questionnaire Average score was (QOL) 54.3 ± 21.1, Sandvik score was 12.1 ± 2.5, Urogenital Distress Inventory was 47.7 ± 9.2. Difficulties experienced due to incontinence were 99.5% feeling of unhappiness, 67.1% constant feeling of urine smell due to failing to change briefs frequently, % 87.2 move away from social life, 89.7 unable to use pad, 99.2% feeling of disturbing households / other individuals, 87.5% feel dizziness/fall due to sudden rise, 87.4% feeling of others’ imperceptions about the situation, % 94.3 insomnia, 78.2 lack of assistance, 84.7% couldn’t afford urine protection briefs. Results: With this study, it was found out that there were a lot of unsolved issues at individual and community level affecting the life quality of women with incontinence. In accordance with this common problem in women, to facilitate daily life it is obvious that regular home care training programs at institutional level in our country will be effective.Keywords: health problems, incontinence, incontinence quality of life questionnaire, old age, urinary urogenital distress inventory, Sandviken severity, women
Procedia PDF Downloads 3141221 Development of an Automatic Computational Machine Learning Pipeline to Process Confocal Fluorescence Images for Virtual Cell Generation
Authors: Miguel Contreras, David Long, Will Bachman
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Background: Microscopy plays a central role in cell and developmental biology. In particular, fluorescence microscopy can be used to visualize specific cellular components and subsequently quantify their morphology through development of virtual-cell models for study of effects of mechanical forces on cells. However, there are challenges with these imaging experiments, which can make it difficult to quantify cell morphology: inconsistent results, time-consuming and potentially costly protocols, and limitation on number of labels due to spectral overlap. To address these challenges, the objective of this project is to develop an automatic computational machine learning pipeline to predict cellular components morphology for virtual-cell generation based on fluorescence cell membrane confocal z-stacks. Methods: Registered confocal z-stacks of nuclei and cell membrane of endothelial cells, consisting of 20 images each, were obtained from fluorescence confocal microscopy and normalized through software pipeline for each image to have a mean pixel intensity value of 0.5. An open source machine learning algorithm, originally developed to predict fluorescence labels on unlabeled transmitted light microscopy cell images, was trained using this set of normalized z-stacks on a single CPU machine. Through transfer learning, the algorithm used knowledge acquired from its previous training sessions to learn the new task. Once trained, the algorithm was used to predict morphology of nuclei using normalized cell membrane fluorescence images as input. Predictions were compared to the ground truth fluorescence nuclei images. Results: After one week of training, using one cell membrane z-stack (20 images) and corresponding nuclei label, results showed qualitatively good predictions on training set. The algorithm was able to accurately predict nuclei locations as well as shape when fed only fluorescence membrane images. Similar training sessions with improved membrane image quality, including clear lining and shape of the membrane, clearly showing the boundaries of each cell, proportionally improved nuclei predictions, reducing errors relative to ground truth. Discussion: These results show the potential of pre-trained machine learning algorithms to predict cell morphology using relatively small amounts of data and training time, eliminating the need of using multiple labels in immunofluorescence experiments. With further training, the algorithm is expected to predict different labels (e.g., focal-adhesion sites, cytoskeleton), which can be added to the automatic machine learning pipeline for direct input into Principal Component Analysis (PCA) for generation of virtual-cell mechanical models.Keywords: cell morphology prediction, computational machine learning, fluorescence microscopy, virtual-cell models
Procedia PDF Downloads 1971220 Loss of the Skin Barrier after Dermal Application of the Low Molecular Methyl Siloxanes: Volatile Methyl Siloxanes, VMS Silicones
Authors: D. Glamowska, K. Szymkowska, K. Mojsiewicz- Pieńkowska, K. Cal, Z. Jankowski
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Introduction: The integrity of the outermost layer of skin (stratum corneum) is vital to the penetration of various compounds, including toxic substances. Barrier function of skin depends of its structure. The barrier function of the stratum corneum is provided by patterned lipid lamellae (binlayer). However, a lot of substances, including the low molecular methyl siloxanes (volatile methyl siloxanes, VMS) have an impact on alteration the skin barrier due to damage of stratum corneum structure. VMS belong to silicones. They are widely used in the pharmaceutical as well as cosmetic industry. Silicones fulfill the role of ingredient or excipient in medicinal products and the excipient in personal care products. Due to the significant human exposure to this group of compounds, an important aspect is toxicology of the compounds and safety assessment of products. Silicones in general opinion are considered as a non-toxic substances, but there are some data about their negative effect on living organisms through the inhaled or oral application. However, the transdermal route has not been described in the literature as a possible alternative route of penetration. The aim of the study was to verify the possibility of penetration of the stratum corneum, further permeation into the deeper layers of the skin (epidermis and dermis) as well as to the fluid acceptor by VMS. Methods: Research methodology was developed based on the OECD and WHO guidelines. In ex-vivo study, the fluorescence microscope and ATR FT-IR spectroscopy was used. The Franz- type diffusion cells were used to application of the VMS on the sample of human skin (A=0.65 cm) for 24h. The stratum corneum at the application site was tape-stripped. After separation of epidermis, relevant dyes: fluorescein, sulforhodamine B, rhodamine B hexyl ester were put on and observations were carried in the microscope. To confirm the penetration and permeation of the cyclic or linear VMS and thus the presence of silicone in the individual layers of the skin, spectra ATR FT-IR of the sample after application of silicone and H2O (control sample) were recorded. The research included comparison of the intesity of bands in characteristic positions for silicones (1263 cm-1, 1052 cm-1 and 800 cm-1). Results: and Conclusions The results present that cyclic and linear VMS are able to overcome the barrier of the skin. Influence of them on damage of corneocytes of the stratum corneum was observed. This phenomenon was due to distinct disturbances in the lipid structure of the stratum corneum. The presence of cyclic and linear VMS were identified in the stratum corneum, epidermis as well as in the dermis by both fluorescence microscope and ATR FT-IR spectroscopy. This confirms that the cyclic and linear VMS can penetrate to stratum corneum and permeate through the human skin layers. Apart from this they cause changes in the structure of the skin. Results show to possible absorption into the blood and lymphathic vessels by the VMS with linear and cyclic structure.Keywords: low molecular methyl siloxanes, volatile methyl siloxanes, linear and cyclic siloxanes, skin penetration, skin permeation
Procedia PDF Downloads 3371219 The Biomechanical Assessment of Balance and Gait for Stroke Patients and the Implications in the Diagnosis and Rehabilitation
Authors: A. Alzahrani, G. Arnold, W. Wang
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Background: Stroke commonly occurs in middle-aged and elderly populations, and the diagnosis of early stroke is still difficult. Patients who have suffered a stroke have different balance and gait patterns from healthy people. Advanced techniques of motion analysis have been routinely used in the clinical assessment of cerebral palsy. However, so far, little research has been done on the direct diagnosis of early stroke patients using motion analysis. Objectives: The aim of this study was to investigate whether patients with stroke have different balance and gait from healthy people and which biomechanical parameters could be used to predict and diagnose potential patients who are at a potential risk to stroke. Methods: Thirteen patients with stroke were recruited as subjects whose gait and balance was analysed. Twenty normal subjects at the matched age participated in this study as a control group. All subjects’ gait and balance were collected using Vicon Nexus® to obtain the gait parameters, kinetic, and kinematic parameters of the hip, knee, and ankle joints in three planes of both limbs. Participants stood on force platforms to perform a single leg balance test. Then, they were asked to walk along a 10 m walkway at their comfortable speed. Participants performed 6 trials of single-leg balance for each side and 10 trials of walking. From the recorded trials, three good ones were analysed using the Vicon Plug-in-Gait model to obtain gait parameters, e.g., walking speed, cadence, stride length, and joint parameters, e.g., joint angle, force, moments, etc. Result: The temporal-spatial variables of Stroke subjects were compared with the healthy subjects; it was found that there was a significant difference (p < 0.05) between the groups. The step length, speed, cadence were lower in stroke subjects as compared to the healthy groups. The stroke patients group showed significantly decreased in gait speed (mean and SD: 0.85 ± 0.33 m/s), cadence ( 96.71 ± 16.14 step/min), and step length (0.509 ± 017 m) in compared to healthy people group whereas the gait speed was 1.2 ± 0.11 m/s, cadence 112 ± 8.33 step/min, and step length 0.648 ± 0.43 m. Moreover, it was observed that patients with stroke have significant differences in the ankle, hip, and knee joints’ kinematics in the sagittal and coronal planes. Also, the result showed that there was a significant difference between groups in the single-leg balance test, e.g., maintaining single-leg stance time in the stroke patients showed shorter duration (5.97 ± 6.36 s) in compared to healthy people group (14.36 ± 10.20 s). Conclusion: Our result showed that there are significantly differences between stroke patients and healthy subjects in the various aspects of gait analysis and balance test, as a consequences of these findings some of the biomechanical parameters such as joints kinematics, gait parameters, and single-leg stance balance test could be used in clinical practice to predict and diagnose potential patients who are at a high risk of further stroke.Keywords: gait analysis, kinetics, kinematics, single-leg stance, Stroke
Procedia PDF Downloads 1351218 Optimizing the Pair Carbon Xerogels-Electrolyte for High Performance Supercapacitors
Authors: Boriana Karamanova, Svetlana Veleva, Luybomir Soserov, Ana Arenillas, Francesco Lufrano, Antonia Stoyanova
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Supercapacitors have received a lot of research attention and are promising energy storage devices due to their high power and long cycle life. In order to developed an advanced device with significant capacity for storing charge and cheap carbon materials, efforts must focus not only on improving synthesis by controlling the morphology and pore size but also on improving electrode-electrolyte compatibility of the resulting systems. The present study examines the relationship between the surface chemistry of two activated carbon xerogels, the electrolyte type, and the electrochemical properties of supercapacitors. Activated carbon xerogels were prepared by varying the initial pH of the resorcinol-formaldehyde aqueous solution. The materials produced are physicochemical characterized by DTA/TGA, porous characterization, and SEM analysis. The carbon xerogel based electrodes were prepared by spreading over glass plate a slurry containing the carbon gel, graphite, and poly vinylidene difluoride (PVDF) binder. The layer formed was dried consecutively at different temperatures and then detached by water. After, the layer was dried again to improve its mechanical stability. The developed electrode materials and the Aquivion® E87-05S membrane (Solvay Specialty Polymers), socked in Na2SO4 as a polymer electrolyte, were used to assembly the solid-state supercapacitor. Symmetric supercapacitor cells composed by same electrodes and 1 M KOH electrolytes are also assembled and tested for comparison. The supercapacitor performances are verified by different electrochemical methods - cyclic voltammetry, galvanostatic charge/discharge measurements, electrochemical impedance spectroscopy, and long-term durability tests in neutral and alkaline electrolytes. Specific capacitances, energy, and power density, energy efficiencies, and durability were compared into studied supercapacitors. Ex-situ physicochemical analyses on the synthesized materials have also been performed, which provide information about chemical and structural changes in the electrode morphology during charge / discharge durability tests. They are discussed on the basis of electrode-electrolyte interaction. The obtained correlations could be of significance in order to design sustainable solid-state supercapacitors with high power and energy density. Acknowledgement: This research is funded by the Ministry of Education and Science of Bulgaria under the National Program "European Scientific Networks" (Agreement D01-286 / 07.10.2020, D01-78/30.03.2021). Authors gratefully acknowledge.Keywords: carbon xerogel, electrochemical tests, neutral and alkaline electrolytes, supercapacitors
Procedia PDF Downloads 1301217 Blunt Abdominal Trauma Management in Adult Patients: An Investigation on Safety of Discharging Patients with Normal Initial Findings
Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina
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Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST
Procedia PDF Downloads 3621216 The Effectiveness of Congressional Redistricting Commissions: A Comparative Approach Investigating the Ability of Commissions to Reduce Gerrymandering with the Wilcoxon Signed-Rank Test
Authors: Arvind Salem
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Voters across the country are transferring the power of redistricting from the state legislatures to commissions to secure “fairer” districts by curbing the influence of gerrymandering on redistricting. Gerrymandering, intentionally drawing distorted districts to achieve political advantage, has become extremely prevalent, generating widespread voter dissatisfaction and resulting in states adopting commissions for redistricting. However, the efficacy of these commissions is dubious, with some arguing that they constitute a panacea for gerrymandering, while others contend that commissions have relatively little effect on gerrymandering. A result showing that commissions are effective would allay these fears, supplying ammunition for activists across the country to advocate for commissions in their state and reducing the influence of gerrymandering across the nation. However, a result against commissions may reaffirm doubts about commissions and pressure lawmakers to make improvements to commissions or even abandon the commission system entirely. Additionally, these commissions are publicly funded: so voters have a financial interest and responsibility to know if these commissions are effective. Currently, nine states place commissions in charge of redistricting, Arizona, California, Colorado, Michigan, Idaho, Montana, Washington, and New Jersey (Hawaii also has a commission but will be excluded for reasons mentioned later). This study compares the degree of gerrymandering in the 2022 election (“after”) to the election in which voters decided to adopt commissions (“before”). The before-election provides a valuable benchmark for assessing the efficacy of commissions since voters in those elections clearly found the districts to be unfair; therefore, comparing the current election to that one is a good way to determine if commissions have improved the situation. At the time Hawaii adopted commissions, it was merely a single at-large district, so it is before metrics could not be calculated, and it was excluded. This study will use three methods to quantify the degree of gerrymandering: the efficiency gap, the percentage of seats and the percentage of votes difference, and the mean-median difference. Each of these metrics has unique advantages and disadvantages, but together, they form a balanced approach to quantifying gerrymandering. The study uses a Wilcoxon Signed-Rank Test with a null hypothesis that the value of the metrics is greater than or equal to after the election than before and an alternative hypothesis that the value of these metrics is greater in the before the election than after using a 0.05 significance level and an expected difference of 0. Accepting the alternative hypothesis would constitute evidence that commissions reduce gerrymandering to a statistically significant degree. However, this study could not conclude that commissions are effective. The p values obtained for all three metrics (p=0.42 for the efficiency gap, p=0.94 for the percentage of seats and percentage of votes difference, and p=0.47 for the mean-median difference) were extremely high and far from the necessary value needed to conclude that commissions are effective. These results halt optimism about commissions and should spur serious discussion about the effectiveness of these commissions and ways to change them moving forward so that they can accomplish their goal of generating fairer districts.Keywords: commissions, elections, gerrymandering, redistricting
Procedia PDF Downloads 671215 Efficacy and Safety of Combination Therapy in Androgenetic Alopecia: Randomized Uncontrolled Evaluator, Blind Study
Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh
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Introduction: Early age of onset of baldness has marked psychological impact on personality. Combination therapies have better efficacy than monotherapy in androgenetic alopecia. Although medical, surgical treatment and cosmetic aids are available for treatment of pattern baldness, medical is first preferred the line of treatment. Although only 5% topical minoxidil is USFDA approved, 10% is available in India since 2007. Efficacy of tablet finasteride is well established in male pattern baldness. 5% topical minoxidil is effective and safe in female pattern baldness. There is a role of saw palmetto in regrowth of scalp hair. With this background research was undertaken to study efficacy and safety of topical minoxidil 10% + tab. Finesteride (1mg) + dermaroller in male pattern baldness and topical minoxidil 5% + cap. Saw palmetto (320 mg) + dermaroller in female pattern baldness. Methods and Materials: It was a randomized uncontrolled evaluator blind study consisting of total 21 patients, 15 of male pattern baldness and 6 of female pattern baldness within 20-35 yrs of age were enrolled. Male patients had Hamilton grade 2-4 MPB and females had Ludwig grade 2 FPB. Male patients were treated with Tab Finesteride 1mg once daily + 10% topical Minoxidil 1ml twice daily for 6 months. Female patients were treated with Cap. Saw palmetto 320 mg once daily + 5% topical Minoxidil twice daily for 6 months. In both male & female patients dermaroller therapy was used once in 10 days for 4 sittings followed by once in 15 days for next 5 months. Blood pressure and possible side effects were monitored in every follow up visits. Pre and post treatment photographs were taken. Assessment of hair growth was done at baseline and at the end of 6 months. Patients satisfactory grading scale and Physician assessment of hair growth scale were used to assessing the results. Trichoscan was done for assessment of hair-shaft diameter and density. Pre and post treatment photographs and Trichoscan hair growth analysis (by diameter and density) was done by physician (dermatologist) not directly involved in this study (evaluator blind). Result: This combination therapy showed moderate response in female pattern alopecia and good to excellent results in male pattern alopecia at the end of 6 months. During therapy none of the patients showed side effects like hypotension, headache and loss of libido, hirsuitism. Mild irritation due to crystal deposition was noted by 3 patients. Conclusion: Effective and early treatment using combination therapy with higher percent of Minoxidil for rapid hair growth is necessary in initial period since it will boost up the self-confidence in patients leading to better treatment compliance. Subsequent maintenance of hair growth can be done with lower concentration. No significant side effects with treatment are observed in both group of patients.Keywords: androgenetic alopecia, dermaroller, finasteride, minoxidil, saw palmetto
Procedia PDF Downloads 2431214 The Impact of the Virtual Learning Environment on Teacher's Pedagogy and Student's Learning in Primary School Setting
Authors: Noor Ashikin Omar
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The rapid growth and advancement in information and communication technology (ICT) at a global scene has greatly influenced and revolutionised interaction amongst society. The use of ICT has become second nature in managing everyday lives, particularly in the education environment. Traditional learning methods of using blackboards and chalks have been largely improved by the use of ICT devices such as interactive whiteboards and computers in school. This paper aims to explore the impacts of virtual learning environments (VLE) on teacher’s pedagogy and student’s learning in primary school settings. The research was conducted in two phases. Phase one of this study comprised a short interview with the school’s senior assistants to examine issues and challenges faced during planning and implementation of FrogVLE in their respective schools. Phase two involved a survey of a number of questionnaires directed to three major stakeholders; the teachers, students and parents. The survey intended to explore teacher’s and student’s perspective and attitude towards the use of VLE as a teaching and learning medium and as a learning experience as a whole. In addition, the survey from parents provided insights on how they feel towards the use of VLE for their child’s learning. Collectively, the two phases enable improved understanding and provided observations on factors that had affected the implementation of the VLE into primary schools. This study offers the voices of the students which were frequently omitted when addressing innovations as well as teachers who may not always be heard. It is also significant in addressing the importance of teacher’s pedagogy on students’ learning and its effects to enable more effective ICT integration with a student-centred approach. Finally, parental perceptions in the implementation of VLE in supporting their children’s learning have been implicated as having a bearing on educational achievement. The results indicate that the all three stakeholders were positive and highly supportive towards the use of VLE in schools. They were able to understand the benefits of moving towards the modern method of teaching using ICT and accept the change in the education system. However, factors such as condition of ICT facilities at schools and homes as well as inadequate professional development for the teachers in both ICT skills and management skills hindered exploitation of the VLE system in order to fully utilise its benefits. Social influences within different communities and cultures and costs of using the technology also has a significant impact. The findings of this study are important to the Malaysian Ministry of Education because it informs policy makers on the impact of the Virtual Learning Environment (VLE) on teacher’s pedagogy and learning of Malaysian primary school children. The information provided to policy makers allows them to make a sound judgement and enables an informed decision making.Keywords: attitudes towards virtual learning environment (VLE), parental perception, student's learning, teacher's pedagogy
Procedia PDF Downloads 2021213 Metamorphosis of Caste: An Examination of the Transformation of Caste from a Material to Ideological Phenomenon in Sri Lanka
Authors: Pradeep Peiris, Hasini Lecamwasam
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The fluid, ambiguous, and often elusive existence of caste among the Sinhalese in Sri Lanka has inspired many scholarly endeavours. Originally, Sinhalese caste was organized according to the occupational functions assigned to various groups in society. Hence cultivators came to be known as Goyigama, washers Dobi, drummers Berava, smiths Navandanna and so on. During pre-colonial times the specialized services of various groups were deployed to build water reservoirs, cultivate the land, and/or sustain the Buddhist order by material means. However, as to how and why caste prevails today in Sinhalese society when labour is in ideal terms free to move where it wants, or in other words, occupation is no longer strictly determined or restricted by birth, is a question worth exploring. Hence this paper explores how, and perhaps more interestingly why, when the nexus between traditional occupations and caste status is fast disappearing, caste itself has managed to survive and continues to be salient in politics in Sri Lanka. In answer to this larger question, the paper looks at caste from three perspectives: 1) Buddhism, whose ethical project provides a justification of social stratifications that transcends economic bases 2) Capitalism that has reactivated and reproduced archaic relations in a process of 'accumulation by subordination', not only by reinforcing the marginality of peripheral caste groups, but also by exploiting caste divisions to hinder any realization of class interests and 3) Democracy whose supposed equalizing effect expected through its ‘one man–one vote’ approach has been subverted precisely by itself, whereby the aggregate ultimately comes down to how many such votes each ‘group’ in society has. This study draws from field work carried out in Dedigama (in the District of Kegalle, Central Province) and Kelaniya (in the District of Colombo, Western Province) in Sri Lanka over three years. The choice of field locations was encouraged by the need to capture rural and urban dynamics related to caste since caste is more apparently manifest in rural areas whose material conditions partially warrant its prevalence, whereas in urban areas it exists mostly in the ideological terrain. In building its analysis, the study has employed a combination of objectivist and subjectivist approaches to capture the material and ideological existence of caste and caste politics in Sinhalese society. Therefore, methods such as in-depth interviews, observation, and collection of demographical and interpretive data from secondary sources were used for this study. The paper has been situated in a critical theoretical framework of social inquiry in an attempt to question dominant assumptions regarding such meta-labels as ‘Capitalism’ and ‘Democracy’, and also the supposed emancipatory function of religion (focusing on Buddhism).Keywords: Buddhism, capitalism, caste, democracy, Sri Lanka
Procedia PDF Downloads 1311212 The Effects of a Hippotherapy Simulator in Children with Cerebral Palsy: A Pilot Study
Authors: Canan Gunay Yazici, Zubeyir Sarı, Devrim Tarakci
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Background: Hippotherapy considered as global techniques used in rehabilitation of children with cerebral palsy as it improved gait pattern, balance, postural control, balance and gross motor skills development but it encounters some problems (such as the excess of the cost of horses' care, nutrition, housing). Hippotherapy simulator is being developed in recent years to overcome these problems. These devices aim to create the effects of hippotherapy made with a real horse on patients by simulating the movements of a real horse. Objectives: To evaluate the efficacy of hippotherapy simulator on gross motor functions, sitting postural control and dynamic balance of children with cerebral palsy (CP). Methods: Fourteen children with CP, aged 6–15 years, seven with a diagnosis of spastic hemiplegia, five of diplegia, two of triplegia, Gross Motor Function Classification System level I-III. The Horse Riding Simulator (HRS), including four-speed program (warm-up, level 1-2-3), was used for hippotherapy simulator. Firstly, each child received Neurodevelopmental Therapy (NDT; 45min twice weekly eight weeks). Subsequently, the same children completed HRS+NDT (30min and 15min respectively, twice weekly eight weeks). Children were assessed pre-treatment, at the end of 8th and 16th week. Gross motor function, sitting postural control, dynamic sitting and standing balance were evaluated by Gross Motor Function Measure-88 (GMFM-88, Dimension B, D, E and Total Score), Trunk Impairment Scale (TIS), Pedalo® Sensamove Balance Test and Pediatric Balance Scale (PBS) respectively. Unit of Scientific Research Project of Marmara University supported our study. Results: All measured variables were a significant increase compared to baseline values after both intervention (NDT and HRS+NDT), except for dynamic sitting balance evaluated by Pedalo®. Especially HRS+NDT, increase in the measured variables was considerably higher than NDT. After NDT, the Total scores of GMFM-88 (mean baseline 62,2 ± 23,5; mean NDT: 66,6 ± 22,2; p < 0,05), TIS (10,4 ± 3,4; 12,1 ± 3; p < 0,05), PBS (37,4 ± 14,6; 39,6 ± 12,9; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 92,3 ± 5,2; p > 0,05) and Pedalo® standing balance points (80,2 ± 10,8; 82,5 ± 11,5; p < 0,05) increased by 7,1%, 2%, 3,9%, 5,2% and 6 % respectively. After HRS+NDT treatment, the total scores of GMFM-88 (mean baseline: 62,2 ± 23,5; mean HRS+NDT: 71,6 ± 21,4; p < 0,05), TIS (10,4 ± 3,4; 15,6 ± 2,9; p < 0,05), PBS (37,4 ± 14,6; 42,5 ± 12; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 93,8 ± 3,7; p > 0,05) and standing balance points (80,2 ± 10,8; 86,2 ± 5,6; p < 0,05) increased by 15,2%, 6%, 7,3%, 6,4%, and 11,9%, respectively, compared to the initial values. Conclusion: Neurodevelopmental therapy provided significant improvements in gross motor functions, sitting postural control, sitting and standing balance of children with CP. When the hippotherapy simulator added to the treatment program, it was observed that these functions were further developed (especially with gross motor functions and dynamic balance). As a result, this pilot study showed that the hippotherapy simulator could be a useful alternative to neurodevelopmental therapy for the improvement of gross motor function, sitting postural control and dynamic balance of children with CP.Keywords: balance, cerebral palsy, hippotherapy, rehabilitation
Procedia PDF Downloads 1361211 Excess Body Fat as a Store Toxin Affecting the Glomerular Filtration and Excretory Function of the Liver in Patients after Renal Transplantation
Authors: Magdalena B. Kaziuk, Waldemar Kosiba, Marek J. Kuzniewski
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Introduction: Adipose tissue is a typical place for storage water-insoluble toxins in the body. It's connective tissue, where the intercellular substance consist of fat, which level in people with low physical activity should be 18-25% for women and 13-18% for men. Due to the fat distribution in the body we distinquish two types of obesity: android (visceral, abdominal) and gynoidal (gluteal-femoral, peripheral). Abdominal obesity increases the risk of complications of the cardiovascular system diseases, and impaired renal and liver function. Through the influence on disorders of metabolism, lipid metabolism, diabetes and hypertension, leading to emergence of the metabolic syndrome. So thus, obesity will especially overload kidney function in patients after transplantation. Aim: An attempt was made to estimate the impact of amount fat tissue on transplanted kidney function and excretory function of the liver in patients after Ktx. Material and Methods: The study included 108 patients (50 females, 58 male, age 46.5 +/- 12.9 years) with active kidney transplant after more than 3 months from the transplantation. An analysis of body composition was done by using electrical bioimpedance (BIA) and anthropometric measurements. Estimated basal metabolic rate (BMR), muscle mass, total body water content and the amount of body fat. Information about physical activity were obtained during clinical examination. Nutritional status, and type of obesity were determined by using indicators: Waist to Height Ratio (WHR) and Waist to Hip Ratio (WHR). Excretory functions of the transplanted kidney was rated by calculating the estimated renal glomerular filtration rate (eGFR) using the MDRD formula. Liver function was rated by total bilirubin and alanine aminotransferase levels ALT concentration in serum. In our patients haemolitic uremic syndrome (HUS) was excluded. Results: In 19.44% of patients had underweight, 22.37% of the respondents were with normal weight, 11.11% had overweight, and the rest were with obese (49.08%). People with android stature have a lower eGFR compared with those with the gynoidal stature (p = 0.004). All patients with obesity had higher amount of body fat from a few to several percent. The higher amount of body fat percentage, the lower eGFR had patients (p <0.001). Elevated ALT levels significantly correlated with a high fat content (p <0.02). Conclusion: Increased amount of body fat, particularly in the case of android obesity can be a predictor of kidney and liver damage. Due to that obese patients should have more frequent control of diagnostic functions of these organs and the intensive dietary proceedings, pharmacological and regular physical activity adapted to the current physical condition of patients after transplantation.Keywords: obesity, body fat, kidney transplantation, glomerular filtration rate, liver function
Procedia PDF Downloads 4541210 Dietary Flaxseed Decreases Central Blood Pressure and the Concentrations of Plasma Oxylipins Associated with Hypertension in Patients with Peripheral Arterial Disease
Authors: Stephanie PB Caligiuri, Harold M Aukema, Delfin Rodriguez-Leyva, Amir Ravandi, Randy Guzman, Grant N. Pierce
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Background: Hypertension leads to cardiac and cerebral events and therefore is the leading risk factor attributed to death in the world. Oxylipins may be mediators in these events as they can regulate vascular tone and inflammation. Oxylipins are derived from fatty acids. Dietary flaxseed is rich in the n3 fatty acid, alpha-linolenic acid, and, therefore, may have the ability to change the substrate profile of oxylipins. As a result, this could alter blood pressure. Methods: A randomized, double-blinded, controlled clinical trial, the Flax-PAD trial, was used to assess the impact of dietary flaxseed on blood pressure (BP), and to also assess the relationship of plasma oxylipins to BP in 81 patients with peripheral arterial disease (PAD). Patients with PAD were chosen for the clinical trial as they are at an increased risk for hypertension and cardiac and cerebral events. Thirty grams of ground flaxseed were added to food products to consume on a daily basis for 6 months. The control food products contained wheat germ, wheat bran, and mixed dietary oils instead of flaxseed. Central BP, which is more significantly associated to organ damage, cardiac, and cerebral events versus brachial BP, was measured by pulse wave analysis at baseline and 6 months. A plasma profile of 43 oxylipins was generated using solid phase extraction, HPLC-MS/MS, and stable isotope dilution quantitation. Results: At baseline, the central BP (systolic/diastolic) in the placebo and flaxseed group were, 131/73 ± 2.5/1.4 mmHg and 128/71 ± 2.6/1.4 mmHg, respectively. After 6 months of intervention, the flaxseed group exhibited a decrease in blood pressure of 4.0/1.0 mmHg. The 6 month central BP in the placebo and flaxseed groups were, 132/74 ± 2.9/1.8 mmHg and 124/70 ± 2.6/1.6 mmHg (P<0.05). Correlation and logistic regression analyses between central blood pressure and oxylipins were performed. Significant associations were observed between central blood pressure and 17 oxylipins, primarily produced from arachidonic acid. Every 1 nM increase in 16-hydroxyeicosatetraenoic acid (HETE) increased the odds of having high central systolic BP by 15-fold, of having high central diastolic BP by 6-fold and of having high central mean arterial pressure by 15-fold. In addition, every 1 nM increase in 5,6-dihydroxyeicosatrienoic acid (DHET) and 11,12-DHET increased the odds of having high central mean arterial pressure by 45- and 18-fold, respectively. Flaxseed induced a significant decrease in these as well as 4 other vasoconstrictive oxylipins. Conclusion: Dietary flaxseed significantly lowered blood pressure in patients with PAD and hypertension. Plasma oxylipins were strongly associated with central blood pressure and may have mediated the flaxseed-induced decrease in blood pressure.Keywords: hypertension, flaxseed, oxylipins, peripheral arterial disease
Procedia PDF Downloads 4601209 Comparing the Knee Kinetics and Kinematics during Non-Steady Movements in Recovered Anterior Cruciate Ligament Injured Badminton Players against an Uninjured Cohort: Case-Control Study
Authors: Anuj Pathare, Aleksandra Birn-Jeffery
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Background: The Anterior Cruciate Ligament(ACL) helps stabilize the knee joint minimizing tibial anterior translation. Anterior Cruciate Ligament (ACL) injury is common in racquet sports and often occurs due to sudden acceleration, deceleration or changes of direction. This mechanism in badminton most commonly occurs during landing after an overhead stroke. Knee biomechanics during dynamic movements such as walking, running and stair negotiation, do not return to normal for more than a year after an ACL reconstruction. This change in the biomechanics may lead to re-injury whilst performing non-steady movements during sports, where these injuries are most prevalent. Aims: To compare if the knee kinetics and kinematics in ACL injury recovered athletes return to the same level as those from an uninjured cohort during standard movements used for clinical assessment and badminton shots. Objectives: The objectives of the study were to determine: Knee valgus during the single leg squat, vertical drop jump, net shot and drop shot; Degree of internal or external rotation during the single leg squat, vertical drop jump, net shot and drop shot; Maximum knee flexion during the single leg squat, vertical drop jump and net shot. Methods: This case-control study included 14 participants with three ACL injury recovered athletes and 11 uninjured participants. The participants performed various functional tasks including vertical drop jump, single leg squat; the forehand net shot and the forehand drop shot. The data was analysed using the two-way ANOVA test, and the reliability of the data was evaluated using the Intra Class Coefficient. Results: The data showed a significant decrease in the range of knee rotation in ACL injured participants as compared to the uninjured cohort (F₇,₅₅₆=2.37; p=0.021). There was also a decrease in the maximum knee flexion angles and an increase in knee valgus angles in ACL injured participants although they were not statistically significant. Conclusion: There was a significant decrease in the knee rotation angles in the ACL injured participants which could be a potential cause for re-injury in these athletes in the future. Although the results for decrease in maximum knee flexion angles and increase in knee valgus angles were not significant, this may be due to a limited sample of ACL injured participants; there is potential for it to be identified as a variable of interest in the rehabilitation of ACL injuries. These changes in the knee biomechanics could be vital in the rehabilitation of ACL injured athletes in the future, and an inclusion of sports based tasks, e.g., Net shot along with standard protocol movements for ACL assessment would provide a better measure of the rehabilitation of the athlete.Keywords: ACL, biomechanics, knee injury, racquet sport
Procedia PDF Downloads 1681208 Bio-Medical Equipment Technicians: Crucial Workforce to Improve Quality of Health Services in Rural Remote Hospitals in Nepal
Authors: C. M. Sapkota, B. P. Sapkota
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Background: Continuous developments in science and technology are increasing the availability of thousands of medical devices – all of which should be of good quality and used appropriately to address global health challenges. It is obvious that bio medical devices are becoming ever more indispensable in health service delivery and among the key workforce responsible for their design, development, regulation, evaluation and training in their use: biomedical technician (BMET) is the crucial. As a pivotal member of health workforce, biomedical technicians are an essential component of the quality health service delivery mechanism supporting the attainment of the Sustainable Development Goals. Methods: The study was based on cross sectional descriptive design. Indicators measuring the quality of health services were assessed in Mechi Zonal Hospital (MZH) and Sagarmatha Zonal Hospital (SZH). Indicators were calculated based on the data about hospital utilization and performance of 2018 available in Medical record section of both hospitals. MZH had employed the BMET during 2018 but SZH had no BMET in 2018.Focus Group Discussion with health workers in both hospitals was conducted to validate the hospital records. Client exit interview was conducted to assess the level of client satisfaction in both the hospitals. Results: In MZH there was round the clock availability and utilization of Radio diagnostics equipment, Laboratory equipment. Operation Theater was functional throughout the year. Bed Occupancy rate in MZH was 97% but in SZH it was only 63%.In SZH, OT was functional only 54% of the days in 2018. CT scan machine was just installed but not functional. Computerized X-Ray in SZH was functional only in 72% of the days. Level of client satisfaction was 87% in MZH but was just 43% in SZH. MZH performed all (256) the Caesarean Sections but SZH performed only 36% of 210 Caesarean Sections in 2018. In annual performance ranking of Government Hospitals, MZH was placed in 1st rank while as SZH was placed in 19th rank out of 32 referral hospitals nationwide in 2018. Conclusion: Biomedical technicians are the crucial member of the human resource for health team with the pivotal role. Trained and qualified BMET professionals are required within health-care systems in order to design, evaluate, regulate, acquire, maintain, manage and train on safe medical technologies. Applying knowledge of engineering and technology to health-care systems to ensure availability, affordability, accessibility, acceptability and utilization of the safer, higher quality, effective, appropriate and socially acceptable bio medical technology to populations for preventive, promotive, curative, rehabilitative and palliative care across all levels of the health service delivery.Keywords: biomedical equipment technicians, BMET, human resources for health, HRH, quality health service, rural hospitals
Procedia PDF Downloads 1211207 The Adaptive Role of Negative Emotions in Optimal Functioning
Authors: Brianne Nichols, John A. Parkinson
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Positive Psychology has provided a rich understanding of the beneficial effects of positive emotions in relation to optimal functioning, and research has been devoted to promote states of positive feeling and thinking. While this is a worthwhile pursuit, positive emotions are not useful in all contexts - some situations may require the individual to make use of their negative emotions to reach a desired end state. To account for the potential value of a wider range of emotional experiences that are common to the human condition, Positive Psychology needs to expand its horizons and investigate how individuals achieve positive outcomes using varied means. The current research seeks to understand the positive psychology of fear of failure (FF), which is a commonly experienced negative emotion relevant to most life domains. On the one hand, this emotion has been linked with avoidance motivation and self-handicap behaviours, on the other; FF has been shown to act as a drive to move the individual forward. To fully capture the depth of this highly subjective emotional experience and understand the circumstances under which FF may be adaptive, this study adopted a mixed methods design using SenseMaker; a web-based tool that combines the richness of narratives with the objectivity of numerical data. Two hundred participants consisting mostly of undergraduate university students shared a story of a time in the recent past when they feared failure of achieving a valued goal. To avoid researcher bias in the interpretation of narratives, participants self-signified their stories in a tagging system that was based on researchers’ aim to explore the role of past failures, the cognitive, emotional and behavioural profile of individuals high and low in FF, and the relationship between these factors. In addition, the role of perceived personal control and self-esteem were investigated in relation to FF using self-report questionnaires. Results from quantitative analyses indicated that individuals with high levels of FF, compared to low, were strongly influenced by past failures and preoccupied with their thoughts and emotions relating to the fear. This group also reported an unwillingness to accept their internal experiences, which in turn was associated with withdrawal from goal pursuit. Furthermore, self-esteem was found to mediate the relationship between perceived control and FF, suggesting that self-esteem, with or without control beliefs, may have the potential to buffer against high FF. It is hoped that the insights provided by the current study will inspire future research to explore the ways in which ‘acceptance’ may help individuals keep moving towards a goal despite the presence of FF, and whether cultivating a non-contingent self-esteem is the key to resilience in the face of failures.Keywords: fear of failure, goal-pursuit, negative emotions, optimal functioning, resilience
Procedia PDF Downloads 1891206 Therapeutic Challenges in Treatment of Adults Bacterial Meningitis Cases
Authors: Sadie Namani, Lindita Ajazaj, Arjeta Zogaj, Vera Berisha, Bahrije Halili, Luljeta Hasani, Ajete Aliu
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Background: The outcome of bacterial meningitis is strongly related to the resistance of bacterial pathogens to the initial antimicrobial therapy. The objective of the study was to analyze the initial antimicrobial therapy, the resistance of meningeal pathogens and the outcome of adults bacterial meningitis cases. Materials/methods: This prospective study enrolled 46 adults older than 16 years of age, treated for bacterial meningitis during the years 2009 and 2010 at the infectious diseases clinic in Prishtinë. Patients are categorized into specific age groups: > 16-26 years of age (10 patients), > 26-60 years of age (25 patients) and > 60 years of age (11 patients). All p-values < 0.05 were considered statistically significant. Data were analyzed using Stata 7.1 and SPSS 13. Results: During the two year study period 46 patients (28 males) were treated for bacterial meningitis. 33 patients (72%) had a confirmed bacterial etiology; 13 meningococci, 11 pneumococci, 7 gram-negative bacilli (Ps. aeruginosa 2, Proteus sp. 2, Acinetobacter sp. 2 and Klebsiella sp. 1 case) and 2 staphylococci isolates were found. Neurological complications developed in 17 patients (37%) and the overall mortality rate was 13% (6 deaths). Neurological complications observed were: cerebral abscess (7/46; 15.2%), cerebral edema (4/46; 8.7%); haemiparesis (3/46; 6.5%); recurrent seizures (2/46; 4.3%), and single cases of thrombosis sinus cavernosus, facial nerve palsy and decerebration (1/46; 2.1%). The most common meningeal pathogens were meningococcus in the youngest age group, gram negative-bacilli in second age group and pneumococcus in eldery age group. Initial single-agent antibiotic therapy (ceftriaxone) was used in 17 patients (37%): in 60% of patients in the youngest age group and in 44% of cases in the second age group. 29 patients (63%) were treated with initial dual-agent antibiotic therapy; ceftriaxone in combination with vancomycin or ampicillin. Ceftriaxone and ampicillin were the most commonly used antibiotics for the initial empirical therapy in adults > 50 years of age. All adults > 60 years of age were treated with the initial dual-agent antibiotic therapy as in this age group was recorded the highest mortality rate (M=27%) and adverse outcome (64%). Resistance of pathogens to antimicrobics was recorded in cases caused by gram-negative bacilli and was associated with greater risk for developing neurological complications (p=0.09). None of the gram-negative bacilli were resistant to carbapenems; all were resistant to ampicillin while 5/7 isolates were resistant to cefalosporins. Resistance of meningococci and pneumococci to beta-lactams was not recorded. There were no statistical differences in the occurrence of neurological complications (p > 0.05), resistance of meningeal pathogens to antimicrobics (p > 0.05) and the inital antimicrobial therapy (one vs. two antibiotics) concerning group-ages in adults. Conclusions: The initial antibiotic therapy with ceftriaxone alone or in combination with vancomycin or ampicillin did not cover cases caused by gram-negative bacilli.Keywords: adults, bacterial meningitis, outcomes, therapy
Procedia PDF Downloads 1661205 Analyzing Temperature and Pressure Performance of a Natural Air-Circulation System
Authors: Emma S. Bowers
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Perturbations in global environments and temperatures have heightened the urgency of creating cost-efficient, energy-neutral building techniques. Structural responses to this thermal crisis have included designs (including those of the building standard PassivHaus) with airtightness, window placement, insulation, solar orientation, shading, and heat-exchange ventilators as potential solutions or interventions. Limitations in the predictability of the circulation of cooled air through the ambient temperature gradients throughout a structure are one of the major obstacles facing these enhanced building methods. A diverse range of air-cooling devices utilizing varying technologies is implemented around the world. Many of them worsen the problem of climate change by consuming energy. Using natural ventilation principles of air buoyancy and density to circulate fresh air throughout a building with no energy input can combat these obstacles. A unique prototype of an energy-neutral air-circulation system was constructed in order to investigate potential temperature and pressure gradients related to the stack effect (updraft of air through a building due to changes in air pressure). The stack effect principle maintains that since warmer air rises, it will leave an area of low pressure that cooler air will rush in to fill. The result is that warmer air will be expelled from the top of the building as cooler air is directed through the bottom, creating an updraft. Stack effect can be amplified by cooling the air near the bottom of a building and heating the air near the top. Using readily available, mostly recyclable or biodegradable materials, an insulated building module was constructed. A tri-part construction model was utilized: a subterranean earth-tube heat exchanger constructed of PVC pipe and placed in a horizontally oriented trench, an insulated, airtight cube aboveground to represent a building, and a solar chimney (painted black to increase heat in the out-going air). Pressure and temperature sensors were placed at four different heights within the module as well as outside, and data was collected for a period of 21 days. The air pressures and temperatures over the course of the experiment were compared and averaged. The promise of this design is that it represents a novel approach which directly addresses the obstacles of air flow and expense, using the physical principle of stack effect to draw a continuous supply of fresh air through the structure, using low-cost and readily available materials (and zero manufactured energy). This design serves as a model for novel approaches to creating temperature controlled buildings using zero energy and opens the door for future research into the effects of increasing module scale, increasing length and depth of the earth tube, and shading the building. (Model can be provided).Keywords: air circulation, PassivHaus, stack effect, thermal gradient
Procedia PDF Downloads 1521204 A Therapeutic Approach for Bromhidrosis with Glycopyrrolate 2% Cream: Clinical Study of 20 Patients
Authors: Vasiliki Markantoni, Eftychia Platsidaki, Georgios Chaidemenos, Georgios Kontochristopoulos
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Introduction: Bromhidrosis, also known as osmidrosis, is a common distressing condition with a significant negative effect on patient’s quality of life. Its etiology is multifactorial. It usually affects axilla, genital skin, breasts and soles, areas where apocrine glands are mostly distributed. Therapeutic treatments include topical antibacterial agents, antiperspirants and neuromuscular blocker agents-toxins. In this study, we aimed to evaluate the efficacy and possible complications of topical glycopyrrolate, an anticholinergic agent, for treatment of bromhidrosis. Glycopyrrolate, applied topically as a cream, solution or spray at concentrations between 0,5% and 4%, has been successfully used to treat different forms of focal hyperhidrosis. Materials and Methods: Twenty patients, six males and fourteen females, meeting the criteria for bromhidrosis were treated with topical glycopyrrolate for two months. The average age was 36. Eleven patients had bromhidrosis located to the axillae, four to the soles, four to both axillae and soles and one to the genital folds. Glycopyrrolate was applied topically as a cream at concentration 2%, formulated in Fitalite. During the first month, patients were using the cream every night and thereafter twice daily. The degree of malodor was assessed subjectively by patients and scaled averagely as ‘none’, ‘mild’, ‘moderate’, and ‘severe’ with corresponding scores of 0, 1, 2, and 3, respectively. The modified Dermatology Life Quality Index (DLQI) was used to assess the quality of life. The clinical efficacy was graded by the patient scale of excellent, good, fair and poor. In the end, patients were given the power to evaluate whether they were totally satisfied with, partially satisfied or unsatisfied and possible side effects during the treatment were recorded. Results: All patients were satisfied at the end of the treatment. No patient defined the response as no improvement. The subjectively assessed score level of bromhidrosis was remarkably improved after the first month of treatment and improved slightly more after the second month. DLQI score was also improved to all patients. Adverse effects were reported in 2 patients. In the first case, topical irritation was reported. This was classed as mild (erythema and desquamation), appeared during the second month of treatment and was treated with low-potency topical corticosteroids. In the second case, mydriasis was reported, that recovered without specific treatment, as soon as we insisted to the importance of careful hygiene after cream application so as not to contaminate the periocular skin or ocular surface. Conclusions: Dermatologists often encounter patients with bromhidrosis, therefore should be aware of treatment options. To the best of our knowledge, this is the first study to evaluate the use of topical glycopyrrolate as a therapeutic approach for bromhidrosis. Our findings suggest that topical glycopyrrolate has an excellent safety profile and demonstrate encouraging results for the management of this distressful condition.Keywords: Bromhidrosis, glycopyrrolate, topical treatment, osmidrosis
Procedia PDF Downloads 1601203 Investigation of Fluid-Structure-Seabed Interaction of Gravity Anchor Under Scour, and Anchor Transportation and Installation (T&I)
Authors: Vinay Kumar Vanjakula, Frank Adam
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The generation of electricity through wind power is one of the leading renewable energy generation methods. Due to abundant higher wind speeds far away from shore, the construction of offshore wind turbines began in the last decades. However, the installation of offshore foundation-based (monopiles) wind turbines in deep waters are often associated with technical and financial challenges. To overcome such challenges, the concept of floating wind turbines is expanded as the basis of the oil and gas industry. For such a floating system, stabilization in harsh conditions is a challenging task. For that, a robust heavy-weight gravity anchor is needed. Transportation of such anchor requires a heavy vessel that increases the cost. To lower the cost, the gravity anchor is designed with ballast chambers that allow the anchor to float while towing and filled with water when lowering to the planned seabed location. The presence of such a large structure may influence the flow field around it. The changes in the flow field include, formation of vortices, turbulence generation, waves or currents flow breaking and pressure differentials around the seabed sediment. These changes influence the installation process. Also, after installation and under operating conditions, the flow around the anchor may allow the local seabed sediment to be carried off and results in Scour (erosion). These are a threat to the structure's stability. In recent decades, rapid developments of research work and the knowledge of scouring on fixed structures (bridges and monopiles) in rivers and oceans have been carried out, and very limited research work on scouring around a bluff-shaped gravity anchor. The objective of this study involves the application of different numerical models to simulate the anchor towing under waves and calm water conditions. Anchor lowering involves the investigation of anchor movements at certain water depths under wave/current. The motions of anchor drift, heave, and pitch is of special focus. The further study involves anchor scour, where the anchor is installed in the seabed; the flow of underwater current around the anchor induces vortices mainly at the front and corners that develop soil erosion. The study of scouring on a submerged gravity anchor is an interesting research question since the flow not only passes around the anchor but also over the structure that forms different flow vortices. The achieved results and the numerical model will be a basis for the development of other designs and concepts for marine structures. The Computational Fluid Dynamics (CFD) numerical model will build in OpenFOAM and other similar software.Keywords: anchor lowering, anchor towing, gravity anchor, computational fluid dynamics, scour
Procedia PDF Downloads 1601202 Mapping Intertidal Changes Using Polarimetry and Interferometry Techniques
Authors: Khalid Omari, Rene Chenier, Enrique Blondel, Ryan Ahola
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Northern Canadian coasts have vulnerable and very dynamic intertidal zones with very high tides occurring in several areas. The impact of climate change presents challenges not only for maintaining this biodiversity but also for navigation safety adaptation due to the high sediment mobility in these coastal areas. Thus, frequent mapping of shorelines and intertidal changes is of high importance. To help in quantifying the changes in these fragile ecosystems, remote sensing provides practical monitoring tools at local and regional scales. Traditional methods based on high-resolution optical sensors are often used to map intertidal areas by benefiting of the spectral response contrast of intertidal classes in visible, near and mid-infrared bands. Tidal areas are highly reflective in visible bands mainly because of the presence of fine sand deposits. However, getting a cloud-free optical data that coincide with low tides in intertidal zones in northern regions is very difficult. Alternatively, the all-weather capability and daylight-independence of the microwave remote sensing using synthetic aperture radar (SAR) can offer valuable geophysical parameters with a high frequency revisit over intertidal zones. Multi-polarization SAR parameters have been used successfully in mapping intertidal zones using incoherence target decomposition. Moreover, the crustal displacements caused by ocean tide loading may reach several centimeters that can be detected and quantified across differential interferometric synthetic aperture radar (DInSAR). Soil moisture change has a significant impact on both the coherence and the backscatter. For instance, increases in the backscatter intensity associated with low coherence is an indicator for abrupt surface changes. In this research, we present primary results obtained following our investigation of the potential of the fully polarimetric Radarsat-2 data for mapping an inter-tidal zone located on Tasiujaq on the south-west shore of Ungava Bay, Quebec. Using the repeat pass cycle of Radarsat-2, multiple seasonal fine quad (FQ14W) images are acquired over the site between 2016 and 2018. Only 8 images corresponding to low tide conditions are selected and used to build an interferometric stack of data. The observed displacements along the line of sight generated using HH and VV polarization are compared with the changes noticed using the Freeman Durden polarimetric decomposition and Touzi degree of polarization extrema. Results show the consistency of both approaches in their ability to monitor the changes in intertidal zones.Keywords: SAR, degree of polarization, DInSAR, Freeman-Durden, polarimetry, Radarsat-2
Procedia PDF Downloads 1311201 Arthroscopic Superior Capsular Reconstruction Using the Long Head of the Biceps Tendon (LHBT)
Authors: Ho Sy Nam, Tang Ha Nam Anh
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Background: Rotator cuff tears are a common problem in the aging population. The prevalence of massive rotator cuff tears varies in some studies from 10% to 40%. Of irreparable rotator cuff tears (IRCTs), which are mostly associated with massive tear size, 79% are estimated to have recurrent tears after surgical repair. Recent studies have shown that superior capsule reconstruction (SCR) in massive rotator cuff tears can be an efficient technique with optimistic clinical scores and preservation of stable glenohumeral stability. Superior capsule reconstruction techniques most commonly use either fascia lata autograft or dermal allograft, both of which have their own benefits and drawbacks (such as the potential for donor site issues, allergic reactions, and high cost). We propose a simple technique for superior capsule reconstruction that involves using the long head of the biceps tendon as a local autograft; therefore, the comorbidities related to graft harvesting are eliminated. The long head of the biceps tendon proximal portion is relocated to the footprint and secured as the SCR, serving to both stabilize the glenohumeral joint and maintain vascular supply to aid healing. Objective: The purpose of this study is to assess the clinical outcomes of patients with large to massive RCTs treated by SCR using LHBT. Materials and methods: A study was performed of consecutive patients with large to massive RCTs who were treated by SCR using LHBT between January 2022 and December 2022. We use one double-loaded suture anchor to secure the long head of the biceps to the middle of the footprint. Two more anchors are used to repair the rotator cuff using a single-row technique, which is placed anteriorly and posteriorly on the lateral side of the previously transposed LHBT. Results: The 3 men and 5 women had an average age of 61.25 years (range 48 to 76 years) at the time of surgery. The average follow-up was 8.2 months (6 to 10 months) after surgery. The average preoperative ASES was 45.8, and the average postoperative ASES was 85.83. The average postoperative UCLA score was 29.12. VAS score was improved from 5.9 to 1.12. The mean preoperative ROM of forward flexion and external rotation of the shoulder was 720 ± 160 and 280 ± 80, respectively. The mean postoperative ROM of forward flexion and external rotation were 1310 ± 220 and 630 ± 60, respectively. There were no cases of progression of osteoarthritis or rotator cuff muscle atrophy. Conclusion: SCR using LHBT is considered a treatment option for patients with large or massive RC tears. It can restore superior glenohumeral stability and function of the shoulder joint and can be an effective procedure for selected patients, helping to avoid progression to cuff tear arthropathy.Keywords: superior capsule reconstruction, large or massive rotator cuff tears, the long head of the biceps, stabilize the glenohumeral joint
Procedia PDF Downloads 711200 Acute Neurophysiological Responses to Resistance Training; Evidence of a Shortened Super Compensation Cycle and Early Neural Adaptations
Authors: Christopher Latella, Ashlee M. Hendy, Dan Vander Westhuizen, Wei-Peng Teo
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Introduction: Neural adaptations following resistance training interventions have been widely investigated, however the evidence regarding the mechanisms of early adaptation are less clear. Understanding neural responses from an acute resistance training session is pivotal in the prescription of frequency, intensity and volume in applied strength and conditioning practice. Therefore the primary aim of this study was to investigate the time course of neurophysiological mechanisms post training against current super compensation theory, and secondly, to examine whether these responses reflect neural adaptations observed with resistance training interventions. Methods: Participants (N=14) completed a randomised, counterbalanced crossover study comparing; control, strength and hypertrophy conditions. The strength condition involved 3 x 5RM leg extensions with 3min recovery, while the hypertrophy condition involved 3 x 12 RM with 60s recovery. Transcranial magnetic stimulation (TMS) and peripheral nerve stimulation were used to measure excitability of the central and peripheral neural pathways, and maximal voluntary contraction (MVC) to quantify strength changes. Measures were taken pre, immediately post, 10, 20 and 30 mins and 1, 2, 6, 24, 48, 72 and 96 hrs following training. Results: Significant decreases were observed at post, 10, 20, 30 min, 1 and 2 hrs for both training groups compared to control group for force, (p <.05), maximal compound wave; (p < .005), silent period; (p < .05). A significant increase in corticospinal excitability; (p < .005) was observed for both groups. Corticospinal excitability between strength and hypertrophy groups was near significance, with a large effect (η2= .202). All measures returned to baseline within 6 hrs post training. Discussion: Neurophysiological mechanisms appear to be significantly altered in the period 2 hrs post training, returning to homeostasis by 6 hrs. The evidence suggests that the time course of neural recovery post resistance training occurs 18-40 hours shorter than previous super compensation models. Strength and hypertrophy protocols showed similar response profiles with current findings suggesting greater post training corticospinal drive from hypertrophy training, despite previous evidence that strength training requires greater neural input. The increase in corticospinal drive and decrease inl inhibition appear to be a compensatory mechanism for decreases in peripheral nerve excitability and maximal voluntary force output. The changes in corticospinal excitability and inhibition are akin to adaptive processes observed with training interventions of 4 wks or longer. It appears that the 2 hr recovery period post training is the most influential for priming further neural adaptations with resistance training. Secondly, the frequency of prescribed resistance sessions can be scheduled closer than previous super compensation theory for optimal strength gains.Keywords: neural responses, resistance training, super compensation, transcranial magnetic stimulation
Procedia PDF Downloads 2791199 Forum Shopping in Biotechnology Law: Understanding Conflict of Laws in Protecting GMO-Based Inventions as Part of a Patent Portfolio in the Greater China Region
Authors: Eugene C. Lim
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This paper seeks to examine the extent to which ‘forum shopping’ is available to patent filers seeking protection of GMO (genetically modified organisms)-based inventions in Hong Kong. Under Hong Kong’s current re-registration system for standard patents, an inventor must first seek patent protection from one of three Designated Patent Offices (DPO) – those of the People’s Republic of China (PRC), the Europe Union (EU) (designating the UK), or the United Kingdom (UK). The ‘designated patent’ can then be re-registered by the successful patentee in Hong Kong. Interestingly, however, the EU and the PRC do not adopt a harmonized approach toward the patenting of GMOs, and there are discrepancies in their interpretation of the phrase ‘animal or plant variety’. In view of these divergences, the ability to effectively manage ‘conflict of law’ issues is an important priority for multinational biotechnology firms with a patent portfolio in the Greater China region. Generally speaking, both the EU and the PRC exclude ‘animal and plant varieties’ from the scope of patentable subject matter. However, in the EU, Article 4(2) of the Biotechnology Directive allows a genetically modified plant or animal to be patented if its ‘technical feasibility is not limited to a specific variety’. This principle has allowed for certain ‘transgenic’ mammals, such as the ‘Harvard Oncomouse’, to be the subject of a successful patent grant in the EU. There is no corresponding provision on ‘technical feasibility’ in the patent legislation of the PRC. Although the PRC has a sui generis system for protecting plant varieties, its patent legislation allows the patenting of non-biological methods for producing transgenic organisms, not the ‘organisms’ themselves. This might lead to a situation where an inventor can obtain patent protection in Hong Kong over transgenic life forms through the re-registration of a patent from a more ‘biotech-friendly’ DPO, even though the subject matter in question might not be patentable per se in the PRC. Through a comparative doctrinal analysis of legislative provisions, cases and court interpretations, this paper argues that differences in the protection afforded to GMOs do not generally prejudice the ability of global MNCs to obtain patent protection in Hong Kong. Corporations which are able to first obtain patents for GMO-based inventions in Europe can generally use their European patent as the basis for re-registration in Hong Kong, even if such protection might not be available in the PRC itself. However, the more restrictive approach to GMO-based patents adopted in the PRC would be more acutely felt by enterprises and inventors based in mainland China. The broader scope of protection offered to GMO-based patents in Europe might not be available in Hong Kong to mainland Chinese patentees under the current re-registration model for standard patents, unless they have the resources to apply for patent protection as well from another (European) DPO as the basis for re-registration.Keywords: biotechnology, forum shopping, genetically modified organisms (GMOs), greater China region, patent portfolio
Procedia PDF Downloads 3241198 Stability Study of Hydrogel Based on Sodium Alginate/Poly (Vinyl Alcohol) with Aloe Vera Extract for Wound Dressing Application
Authors: Klaudia Pluta, Katarzyna Bialik-Wąs, Dagmara Malina, Mateusz Barczewski
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Hydrogel networks, due to their unique properties, are highly attractive materials for wound dressing. The three-dimensional structure of hydrogels provides tissues with optimal moisture, which supports the wound healing process. Moreover, a characteristic feature of hydrogels is their absorption properties which allow for the absorption of wound exudates. For the fabrication of biomedical hydrogels, a combination of natural polymers ensuring biocompatibility and synthetic ones that provide adequate mechanical strength are often used. Sodium alginate (SA) is one of the polymers widely used in wound dressing materials because it exhibits excellent biocompatibility and biodegradability. However, due to poor strength properties, often alginate-based hydrogel materials are enhanced by the addition of another polymer such as poly(vinyl alcohol) (PVA). This paper is concentrated on the preparation methods of sodium alginate/polyvinyl alcohol hydrogel system incorporating Aloe vera extract and glycerin for wound healing material with particular focus on the role of their composition on structure, thermal properties, and stability. Briefly, the hydrogel preparation is based on the chemical cross-linking method using poly(ethylene glycol) diacrylate (PEGDA, Mn = 700 g/mol) as a crosslinking agent and ammonium persulfate as an initiator. In vitro degradation tests of SA/PVA/AV hydrogels were carried out in Phosphate-Buffered Saline (pH – 7.4) as well as in distilled water. Hydrogel samples were firstly cut into half-gram pieces (in triplicate) and immersed in immersion fluid. Then, all specimens were incubated at 37°C and then the pH and conductivity values were measurements at time intervals. The post-incubation fluids were analyzed using SEC/GPC to check the content of oligomers. The separation was carried out at 35°C on a poly(hydroxy methacrylate) column (dimensions 300 x 8 mm). 0.1M NaCl solution, whose flow rate was 0.65 ml/min, was used as the mobile phase. Three injections with a volume of 50 µl were made for each sample. The thermogravimetric data of the prepared hydrogels were collected using a Netzsch TG 209 F1 Libra apparatus. The samples with masses of about 10 mg were weighed separately in Al2O3 crucibles and then were heated from 30°C to 900°C with a scanning rate of 10 °C∙min−1 under a nitrogen atmosphere. Based on the conducted research, a fast and simple method was developed to produce potential wound dressing material containing sodium alginate, poly(vinyl alcohol) and Aloe vera extract. As a result, transparent and flexible SA/PVA/AV hydrogels were obtained. The degradation experiments indicated that most of the samples immersed in PBS as well as in distilled water were not degraded throughout the whole incubation time.Keywords: hydrogels, wound dressings, sodium alginate, poly(vinyl alcohol)
Procedia PDF Downloads 1561197 Displaying Compostela: Literature, Tourism and Cultural Representation, a Cartographic Approach
Authors: Fernando Cabo Aseguinolaza, Víctor Bouzas Blanco, Alberto Martí Ezpeleta
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Santiago de Compostela became a stable object of literary representation during the period between 1840 and 1915, approximately. This study offers a partial cartographical look at this process, suggesting that a cultural space like Compostela’s becoming an object of literary representation paralleled the first stages of its becoming a tourist destination. We use maps as a method of analysis to show the interaction between a corpus of novels and the emerging tradition of tourist guides on Compostela during the selected period. Often, the novels constitute ways to present a city to the outside, marking it for the gaze of others, as guidebooks do. That leads us to examine the ways of constructing and rendering communicable the local in other contexts. For that matter, we should also acknowledge the fact that a good number of the narratives in the corpus evoke the representation of the city through the figure of one who comes from elsewhere: a traveler, a student or a professor. The guidebooks coincide in this with the emerging fiction, of which the mimesis of a city is a key characteristic. The local cannot define itself except through a process of symbolic negotiation, in which recognition and self-recognition play important roles. Cartography shows some of the forms that these processes of symbolic representation take through the treatment of space. The research uses GIS to find significant models of representation. We used the program ArcGIS for the mapping, defining the databases starting from an adapted version of the methodology applied by Barbara Piatti and Lorenz Hurni’s team at the University of Zurich. First, we designed maps that emphasize the peripheral position of Compostela from a historical and institutional perspective using elements found in the texts of our corpus (novels and tourist guides). Second, other maps delve into the parallels between recurring techniques in the fictional texts and characteristic devices of the guidebooks (sketching itineraries and the selection of zones and indexicalization), like a foreigner’s visit guided by someone who knows the city or the description of one’s first entrance into the city’s premises. Last, we offer a cartography that demonstrates the connection between the best known of the novels in our corpus (Alejandro Pérez Lugín’s 1915 novel La casa de la Troya) and the first attempt to create package tourist tours with Galicia as a destination, in a joint venture of Galician and British business owners, in the years immediately preceding the Great War. Literary cartography becomes a crucial instrument for digging deeply into the methods of cultural production of places. Through maps, the interaction between discursive forms seemingly so far removed from each other as novels and tourist guides becomes obvious and suggests the need to go deeper into a complex process through which a city like Compostela becomes visible on the contemporary cultural horizon.Keywords: compostela, literary geography, literary cartography, tourism
Procedia PDF Downloads 3871196 Determinants of Quality of Life in Patients with Atypical Prarkinsonian Syndromes: 1-Year Follow-Up Study
Authors: Tatjana Pekmezovic, Milica Jecmenica-Lukic, Igor Petrovic, Vladimir Kostic
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Background: A group of atypical parkinsonian syndromes (APS) includes a variety of rare neurodegenerative disorders characterized by reduced life expectancy, increasing disability, and considerable impact on health-related quality of life (HRQoL). Aim: In this study we wanted to answer two questions: a) which demographic and clinical factors are main contributors of HRQoL in our cohort of patients with APS, and b) how does quality of life of these patients change over 1-year follow-up period. Patients and Methods: We conducted a prospective cohort study in hospital settings. The initial study comprised all consecutive patients who were referred to the Department of Movement Disorders, Clinic of Neurology, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade (Serbia), from January 31, 2000 to July 31, 2013, with the initial diagnoses of ‘Parkinson’s disease’, ‘parkinsonism’, ‘atypical parkinsonism’ and ‘parkinsonism plus’ during the first 8 months from the appearance of first symptom(s). The patients were afterwards regularly followed in 4-6 month intervals and eventually the diagnoses were established for 46 patients fulfilling the criteria for clinically probable progressive supranuclear palsy (PSP) and 36 patients for probable multiple system atrophy (MSA). The health-related quality of life was assessed by using the SF-36 questionnaire (Serbian translation). Hierarchical multiple regression analysis was conducted to identify predictors of composite scores of SF-36. The importance of changes in quality of life scores of patients with APS between baseline and follow-up time-point were quantified using Wilcoxon Signed Ranks Test. The magnitude of any differences for the quality of life changes was calculated as an effect size (ES). Results: The final models of hierarchical regression analysis showed that apathy measured by the Apathy evaluation scale (AES) score accounted for 59% of the variance in the Physical Health Composite Score of SF-36 and 14% of the variance in the Mental Health Composite Score of SF-36 (p<0.01). The changes in HRQoL were assessed in 52 patients with APS who completed 1-year follow-up period. The analysis of magnitude for changes in HRQoL during one-year follow-up period have shown sustained medium ES (0.50-0.79) for both Physical and Mental health composite scores, total quality of life as well as for the Physical Health, Vitality, Role Emotional and Social Functioning. Conclusion: This study provides insight into new potential predictors of HRQoL and its changes over time in patients with APS. Additionally, identification of both prognostic markers of a poor HRQoL and magnitude of its changes should be considered when developing comprehensive treatment-related strategies and health care programs aimed at improving HRQoL and well-being in patients with APS.Keywords: atypical parkinsonian syndromes, follow-up study, quality of life, APS
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