Search results for: trust recovery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2452

Search results for: trust recovery

862 Changing Left Ventricular Hypertrophy After Kidney Transplantation

Authors: Zohreh Rostami, Arezoo Khosravi, Mohammad Nikpoor Aghdam, Mahmood Salesi

Abstract:

Background: Cardiovascular mortality in chronic kidney disease (CKD) and end stage renal disease (ESRD) patients have a strong relationship with baseline or progressive left ventricular hypertrophy (LVH) meanwhile in hemodialysis patients 10% decrement in left ventricular mass was associated with 28% reduction in cardiovascular mortality risk. In consonance with these arguments, we designed a study to measure morphological and functional echocardiographic variations early after transplantation. Method: The patients with normal renal function underwent two advanced echocardiographic studies to examine the structural and functional changes in left ventricular mass before and 3-month after transplantation. Results: From a total of 23 participants 21(91.3%) presented with left ventricular hypertrophy, 60.9% in eccentric and 30.4% in concentric group. Diastolic dysfunction improved in concentric group after transplantation. Both in pre and post transplantation global longitudinal strain (GLS)- average in eccentric group was more than concentric (-17.45 ± 2.75 vs -14.3 ± 3.38 p=0.03) and (-18.08 ± 2.6 vs -16.1 ± 2.7 p= 0.04) respectively. Conclusion: Improvement and recovery of left ventricular function in concentric group was better and sooner than eccentric after kidney transplantation. Although fractional shortening and diastolic function and GLS-4C in pre-transplantation in concentric group was worse than eccentric, but therapeutic response to kidney transplantation in concentric was more and earlier than eccentric group.

Keywords: chronic kidney disease, end stage renal disease, left ventricular hypertrophy, global longitudinal strain

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861 Access of Small and Medium Enterprises to Finance in Rural Areas: Case of Indonesia and Thailand

Authors: N. Ikasari, T. Sumransat, U. Eko, R. Kusumastuti

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Small and medium enterprises (SMEs) are regarded as the engine for economic development, notwithstanding their continuous financing conundrum. In the case of developing countries, access to finance is a reflection of the effectiveness of government policy. The widely accepted perspective to assess small businesses’ access to finance is that of economic view. The existing body of literature presents access to finance in three dimensions; they are accessibility, eligibility and affordability. Within this perspective, the role of socio-cultural has not explored. This study is aimed at investigating the existence of any socio-cultural factors within access to finance issue in Asian countries where governance is enriched by countries’ values and beliefs. The significance of this study is the instigation of supplementary dimension to assess access to finance that eventually contributes to the development of micro-finance policy. Indonesia and Thailand are selected as cases in point, where distinction is drawn on the level of cultural diversity and micro-finance policy in respective country. A questionnaire is used to collect information related to the three dimensions of access to finance as well as to explore alternative financing reasoning to elaborate the issue from the demand side. Questionnaires are distributed to 60 small business owners operating in Indonesia and the same number in Thailand. In order to present a complete understanding on the matter at hand, interviews with banks are conducted to capture the perspective as presented by the supply side. Research findings show that small business owners and banks in Indonesia and Thailand are in agreement that access to finance is not deemed as an issue. However, trust issue that exists mutually between financing users and providers leads small business owners in Indonesia to look for alternative financing other than banks. The findings contribute to the refinement of micro-financing policy in Indonesia and Thailand.

Keywords: access to finance, Indonesia, small and medium enterprises, Thailand

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860 A Kinetic Study on Recovery of High-Purity Rutile TiO₂ Nanoparticles from Titanium Slag Using Sulfuric Acid under Sonochemical Procedure

Authors: Alireza Bahramian

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High-purity TiO₂ nanoparticles (NPs) with size ranging between 50 nm and 100 nm are synthesized from titanium slag through sulphate route under sonochemical procedure. The effect of dissolution parameters such as the sulfuric acid/slag weight ratio, caustic soda concentration, digestion temperature and time, and initial particle size of the dried slag on the extraction efficiency of TiO₂ and removal of iron are examined. By optimizing the digestion conditions, a rutile TiO₂ powder with surface area of 42 m²/g and mean pore diameter of 22.4 nm were prepared. A thermo-kinetic analysis showed that the digestion temperature has an important effect, while the acid/slag weight ratio and initial size of the slag has a moderate effect on the dissolution rate. The shrinking-core model including both chemical surface reaction and surface diffusion is used to describe the leaching process. A low value of activation energy, 38.12 kJ/mol, indicates the surface chemical reaction model is a rate-controlling step. The kinetic analysis suggested a first order reaction mechanism with respect to the acid concentrations.

Keywords: TiO₂ nanoparticles, titanium slag, dissolution rate, sonochemical method, thermo-kinetic study

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859 Analysis of an High Voltage Direct Current (HVDC) Connection Using a Real-Time Simulator Under Various Disturbances

Authors: Mankour Mohamed, Miloudi Mohamed

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A thorough and accurate simulation is necessary for the study of a High Voltage Direct Current (HVDC) link system during various types of disturbances, including internal faults on both converters, either on the rectifier or on the inverter, as well as external faults, such as AC or DC faults on both converter sides inside the DC link party. In this study, we examine how an HVDC inverter responds to three different types of failures, including faults at the inverter valve, system control faults, and single-phase-to-ground AC faults at the sending end of the inverter side. As this phenomenon represents the most frequent problem that may affect inverter valves, particularly those based on thyristor valves (LCC (line-Commutated converter)), it is more precise to explore which circumstance generates and raises the commutation failure on inverter valves. Because of the techniques used to accelerate the simulation, digital real-time simulators are now the most potent tools that provide simulation results. The real-time-lab RT-LAB platform HYPERSIM OP-5600 is used to implement the Simulation in the Loop (SIL) technique, which is used to validate the results. It is demonstrated how to recover from both the internal faults and the AC problem. The simulation findings show how crucial a role the control system plays in fault recovery.

Keywords: hypersim simulator, HVDC systems, mono-polar link, AC faults, misfiring faults

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858 Characteristics of Acute Poisoning in Emergency Departments: Multicenter Study in Korea

Authors: Hyuk-Hoon Kim, Young Gi Min

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Background: Acute poisoning is the common cause of morbidity and mortality. Characteristics of acute poisoning differ between countries. While other countries operate the database system for poisoning, Korea has not collected the database for acute poisoning. Distribution of incidence of acute poisoning depending on the types of materials have also not studied in Korea. Our aims are to evaluate the etiologic and demographic characteristics of acute poisoning cases and to obtain up-to-date information on acute poisonings. Method: We retrospectively recorded cases of acute poisoning from eight emergency departments of second level or university hospitals from different cities in Gyeonggi province in Korea from April 2006 and March 2015. The distributions of incidence of acute poisoning depending on the types of materials are mapped by geographic information system. Result: A total of 3,449 poisoned cases were analyzed. Mean estimated age of patients was 39.56 ± 22.40 years. Mean male to female ratio of patients was 1:1.4. Mean proportion of intentional poisoning was 57.9%. Common materials are benzodiazepine (16.6%), carbon monoxide (10.5%), pesticide (8.1%) and zolpidem (7.1%) Common route of exposure is ingestion (79.5%) and followed by inhalation (16.5%). Common treatment methods are gastric lavage (20%) and activated charcoal (30%). Most cases had uneventful recovery; 61.4% were treated as outpatients and 0.1% of the poisoning resulted in death in ER. Conclusion: Even though the cases enrolled in our study is not the overall cases of acute poisoning in Korea, our study could be the basis of countermeasures for analysis and prevention of acute poisoning in Korea.

Keywords: acute poisoning, emergency department, epidemiology, Korea

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857 Thermal Comfort in Office Rooms in a Historic Building with Modernized Heating, Ventilation and Air Conditioning Systems

Authors: Hossein Bakhtiari, Mathias Cehlin, Jan Akander

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Envelopes with low thermal performance is a common characteristic in many European historic buildings which leads to higher energy demand for heating and cooling as well as insufficient thermal comfort for the occupants. This paper presents the results of a study on the thermal comfort in the City Hall (Rådhuset) in Gävle, Sweden. This historic building is currently used as an office building. It is equipped with two relatively modern mechanical heat recovery ventilation systems with displacement ventilation supply devices in the offices. The district heating network heats the building via pre-heat supply air and radiators. Summer cooling comes from an electric heat pump that rejects heat into the exhaust ventilation air. A building management system controls HVAC equipment (heating, ventilation and air conditioning). The methodology is based on on-site measurements, data logging on the management system and evaluating the occupants’ perception of a summer and a winter period indoor environment using a standardized questionnaire. The main aim of the study is to investigate whether or not it is enough to have modernized HVAC systems to get adequate thermal comfort in a historic building with poor envelope performance used as an office building in Nordic climate conditions.

Keywords: historic buildings, on-site measurements, standardized questionnaire, thermal comfort

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856 Extracting Polyhydroxyalkanoates from Waste Sludge of Husbandry Industry Wastewater Treatment Plants

Authors: M. S. Lu, Y. P. Tsai, H. Shu, K. F. Chen, L. L. Lai

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This study used sodium hypochlorite/sodium dodecyl sulfate method to successfully extract polyhydroxyalkanoates (PHA) from the wasted sludge of a husbandry industry wastewater treatment plant. We investigated the optimum operational conditions of three key factors with respect to effectively extract PHAs from husbandry industry wastewater sludge, including the sodium hypochlorite concentration, liquid-solid ratio, and reaction time. The experimental results showed the optimum operational conditions for polyhydroxyalkanoate recovery as follows: (1) being digested by the sodium hypochlorite/sodium dodecyl sulfate solution with 15% (v/v) of hypochlorite concentration, (2) being operated at the condition of 1.25 mLmg-1 of liquid-solid ratio, and (3) being reacted for more than 60 min. Under these conditions, the content of the recovered PHAs was about 53.2±0.66 mgPHAs/gVSS, and the purity of the recovered PHAs was about 78.5±6.91 wt%. The recovered PHAs were further used to produce biodegradable plastics for decomposition test buried in soils. The decomposition test showed 66.5% of the biodegradable plastics produced in the study remained after being buried in soils for 49 days. The cost for extracting PHAs is about 10.3 US$/kgPHAs and is lower than those produced by pure culture methods (12-15 US$/kgPHAs).

Keywords: biodegradable plastic, biopolymers, polyhydroxyalkanoates (PHAs), waste sludge

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855 Parents, Carers and Young Persons’ Views Regarding Nursing ‘Workarounds’ Within Clinical Electronic Patient Record Systems

Authors: Patrick Nurse, Professor Neil Sebire, Polly Livermore

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The use of digital systems in healthcare is now highly prevalent. With further advancement of technology, these systems will become increasingly utilised within the healthcare sector. Therefore understanding how clinicians (for example, doctors, nurses) interact with technology and digital systems is critical to making care safer. Seven members from the Parent/Carers’ Research Advisory Group and the Young-Persons’ Research Group at a healthcare Trust in London and three staff members contributed to an engagement workshop to assess the impact of digital systems on the practice of nurses. The group also advised on the viability of a research study to investigate this further. A wide range of issues within digital system implementation in healthcare were raised, such as ‘workarounds’, system’s training, and upkeep and regulation of usage, which all emerged as early themes during the discussion. Further discussion focused on the subject of escalation of issues, ‘workarounds’, and problem solving. While challenging to implement, digital systems are hugely beneficial to healthcare providers. The workshop indicated that there is scope for investigation of the prevalence, nature, and escalation of ‘workarounds’, this was of key interest to the advisory group. An interesting concern of the group was their worry from a patient and parental perspective regarding how nurses might feel when needing to complete a ‘workaround’ during a busy shift. This is especially relevant if the reasons to complete the ‘workaround’ were outside the nurse’s control, driven by clinical need and urgency of care. This showed the level of insight that those using healthcare services have into the reality of workflows of those providing care. Additionally, it reflects the desire for patients and families to understand more about the administration and methodology of their care. Future study should be dedicated to understanding why nurses deploy ‘workarounds’, as well as their perspective and experience of them and subsequent escalation through leadership hierarchies

Keywords: patient engagement/involvement, workarounds, medication-administration, digital systems

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854 Economic Viability of Using Guar Gum as a Viscofier in Water Based Drilling Fluids

Authors: Devesh Motwani, Amey Kashyap

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Interest in cost effective drilling has increased substantially in the past years. Economics associated with drilling fluids is needed to be considered seriously for lesser cost per foot in planning and drilling of a wellbore and the various environmental concerns imposed by international communities related with the constituents of the drilling fluid. Viscofier such as Guar Gum is a high molecular weight polysaccharide from Guar plants, is used to increase viscosity in water-based and brine-based drilling fluids thus enabling more efficient cleaning of the bore. Other applications of this Viscofier are to reduce fluid loss by giving a better colloidal solution, decrease fluid friction and so minimising power requirements and used in hydraulic fracturing to increase the recovery of oil and gas. Guar gum is also used as a surfactant, synthetic polymer and defoamer. This paper presents experimental results to verifying the properties of guar gum as a viscofier and filtrate retainer as well as observing the impact of different quantities of guar gum and Carboxymethyl cellulose (CMC) in a standard sample of water based bentonite mud solution. This is in attempt to make a drilling fluid which contains half of the quantity of drilling mud used and yet is equally viscous to the standardised mud sample. Thus we can see that mud economics will be greatly affected by this approach. However guar gum is thermally stable till 60-65°C thus limited to be used in drilling shallow wells and for a wider thermal range, suitable chrome free additives are required.

Keywords: economics, guargum, viscofier, CMC, thermal stability

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853 Scanning Electron Microscopy of the Erythrocytes of Channa punctatus (Bloch) Exposed to Mercuric Chloride

Authors: Shweta Maheshwari, Anish Dua

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Hematological changes reflect the adverse effects of heavy metals on fish. Hematology is a valuable tool to evaluate pathological condition of the fish. It helps in diagnosing the structural and functional status of fish exposed to toxicants. Morphological alteration in erythrocytes due to environmental stress can be studied through ultra-structural analysis. The aim of the present study was to assess the toxicity of mercuric chloride on red blood cells of an air breathing fish, Channa punctatus. Fish were subjected to chronic experiments using three sublethal concentration of mercuric chloride (0.020mg/L, 0.027mg/L, 0.040mg/L) for a period of 15, 30 and 60 days. Exposed fish of all the three concentrations were subjected to a recovery period of 30 days. A control was maintained in tap water simultaneously. For SEM analysis, blood from caudal vein of fish was taken and examined at an accelerating voltage of 20kV. Scanning electron micrographs revealed elliptical shaped erythrocytes of control fish. Alterations in the erythrocyte morphology such as presence of spherocytes, membrane internalization, crenation of membrane and development of lobopodial projections were observed in the exposed fish. The study revealed that ultra-structural analysis appears to be a sensitive method to evaluate the toxicity of various toxicants to fish.

Keywords: Channa punctatus, erythrocytes, mercuric chloride, scanning electron microscopy

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852 The Family, Tradition and Change in Africa: The Perspective of Postcolonial African Fiction

Authors: Ayobami Kehinde

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The literary representations of the family, tradition and change in African literature offer an immense, and as yet little theorised area of literary scholarship. Therefore, this paper explores the nexus among the family, tradition and change in five purposively selected post-colonial African fiction: Chimamanda Adichie’s Purple Hibiscus, Wale Okediran’s Tenants of the House, J. M. Coetzee’s In the Heart of the Country, Tsitsi Dangrembga’s Nervous Condition and Meja Mwangi’s Striving for the Wind. The methodology centres on analysing, questioning, undermining and celebrating the family and its contemporary vicissitudes as depicted in the texts. This is with a view to exploring the postcolonial novel with references to concepts developed by major theorists in the field of postcolonial studies, including Frantz Fanon, Edward Said, Gayatri Spivak, Homi Bhabha, Kwame Appiah and Achille Mbembe. It is revealed that in spite of the fact that the family is a vital institution, the primary social unit in any community, an agent of acculturation and the first focus of development, independence and growth, the texts reflect a diversity of problems confronting the family unit in Africa. These include the multiple problems of disrupted family lives, enforced family separation, political and personal violence with the domestic environment. It is concluded that the post-colonial African novel is a quintessential weapon to analyse the continent, opening up to the reader the specific expressions and experiences of human lives and their wider contexts. Therefore, the post-colonial African novel is a primary socio-cultural indicator representing an immense variety of lived realities in the continent. The study, therefore, suggests a concerted concern with the preservation of traditional family structures and other related aspects, such as cultural values, spirituality, gender roles and mutual trust.

Keywords: family, African fiction, postcolonialism, African tradition, domestic dissonance

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851 Telemedicine for Telerehabilitation in Areas Affected by Social Conflicts in Colombia

Authors: Lilia Edit Aparicio Pico, Paulo Cesar Coronado Sánchez, Roberto Ferro Escobar

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This paper presents the implementation of telemedicine services for physiotherapy, occupational therapy, and speech therapy rehabilitation, utilizing telebroadcasting of audiovisual content to enhance comprehensive patient recovery in rural areas of San Vicente del Caguán municipality, characterized by high levels of social conflict in Colombia. The region faces challenges such as dysfunctional problems, physical rehabilitation needs, and a high prevalence of hearing diseases, leading to neglect and substandard health services. Limited access to healthcare due to communication barriers and transportation difficulties exacerbates these issues. To address these challenges, a research initiative was undertaken to leverage information and communication technologies (ICTs) to improve healthcare quality and accessibility for this vulnerable population. The primary objective was to develop a tele-rehabilitation system to provide asynchronous online therapies and teleconsultation services for patient follow-up during the recovery process. The project comprises two components: Communication systems and human development. A technological component involving the establishment of a wireless network connecting rural centers and the development of a mobile application for video-based therapy delivery. Communications systems will be provided by a radio link that utilizes internet provided by the Colombian government, located in the municipality of San Vicente del Caguán to connect two rural centers (Pozos and Tres Esquinas) and a mobile application for managing videos for asynchronous broadcasting in sidewalks and patients' homes. This component constitutes an operational model integrating information and telecommunications technologies. The second component involves pedagogical and human development. The primary focus is on the patient, where performance indicators and the efficiency of therapy support were evaluated for the assessment and monitoring of telerehabilitation results in physical, occupational, and speech therapy. They wanted to implement a wireless network to ensure audiovisual content transmission for tele-rehabilitation, design audiovisual content for tele-rehabilitation based on services provided by the ESE Hospital San Rafael in physiotherapy, occupational therapy, and speech therapy, develop a software application for fixed and mobile devices enabling access to tele-rehabilitation audiovisual content for healthcare personnel and patients and finally to evaluate the technological solution's contribution to the ESE Hospital San Rafael community. The research comprised four phases: wireless network implementation, audiovisual content design, software application development, and evaluation of the technological solution's impact. Key findings include the successful implementation of virtual teletherapy, both synchronously and asynchronously, and the assessment of technological performance indicators, patient evolution, timeliness, acceptance, and service quality of tele-rehabilitation therapies. The study demonstrated improved service coverage, increased care supply, enhanced access to timely therapies for patients, and positive acceptance of teletherapy modalities. Additionally, the project generated new knowledge for potential replication in other regions and proposed strategies for short- and medium-term improvement of service quality and care indicators

Keywords: e-health, medical informatics, telemedicine, telerehabilitation, virtual therapy

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850 A Study of Effectiveness of Topical Grapeseed Oil for Reducing Wrinkles on Periorbital Areas in Asian People in Thailand

Authors: Cherish Romina Prajitno, Sunisa Thaichinda

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One indicator of facial aging is wrinkles. Not only that, but wrinkles are a key indicator in our world of facial aesthetics. Wrinkles occur where fault lines develop in aging skin. Nowadays, people are more motivated to keep up their appealing and young appearance. Many individuals are seeking a fast recovery time for their aesthetic procedures and are interested in non-invasive techniques that have a proven track record for successful outcomes. The purpose of this study is to see the efficacy of 100% (pure) grapeseed oil for reducing periorbital wrinkles. This study used the split-face, double-blind method, and this treatment was administered for three months at random to fifteen patients, with the grapeseed oil at one side of the face and the other side with the placebo. The main outcome measure was determined by conducting a comparative analysis of the participants' wrinkle results during each visit using the VIsioscan® VC98. Additionally, we evaluated the skin's elasticity and barrier function using the Cutometer® MP 530 and Tewameter® TM300. Furthermore, we administered a satisfaction score questionnaire to the patients in the 12th week. The findings of the study indicate that grapeseed oil exhibited a noteworthy effect in diminishing the appearance of wrinkles in the periorbital region, enhancing the viscoelastic properties of the periorbital skin, and improving the functionality of the skin barrier in the periorbital area.

Keywords: periorbital wrinkles, pure grapeseed oil, split-face method

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849 Assessment of the Socio-Economic Impacts of Natural Hazards along the Mediterranean Coastal Zone of Egypt

Authors: Islam Abou El-Magd, Elham Ali, Ali Amasha

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Earthquakes strike without warning and cause widespread damage to social and economic infrastructures and creating life losses. These can neither be predicted nor prevented in terms of their magnitude, place, and time of occurrence. It is a global phenomenon that creates nearly 18% of life losses and nearly 35% of economic damage. The coastal zone of Egypt is considered low to medium risk, however, there is a record of high magnitude earthquakes that created Tsunami in the past. The northern coastal zone of Egypt is under the force of tension shear zones of African and European plates that have considerable earthquakes with variable degrees. This research studied the earthquakes in the last 65 years in the Mediterranean Basin in relation to the geotectonic shear zones. 85% of these earthquakes are in the marine that might create Tsunami. Aegean and Anatolia shear zones are the highest contributors of the earthquakes with nearly 37% and 36% respectively. However the least one is the Arabia zone with 1%, and Africa is about 26%. The research proposed three scenarios for the socioeconomic hazards, earthquakes with Tsunami that will destroy one fifth of the economic infrastructures with unpredictable life losses. The estimated cost of recovery of such losses is nearly 400B USD. The second scenario is earthquake without Tsunami that will impact the major urban and infrastructures. The last scenario is tidal gauges events that threaten the low-lying areas particularly the eastern side which has major land subsidence.

Keywords: natural hazards, earthquakes, tusnami, Nile delta, Egypt

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848 Tornado Disaster Impacts and Management: Learning from the 2016 Tornado Catastrophe in Jiangsu Province, China

Authors: Huicong Jia, Donghua Pan

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As a key component of disaster reduction management, disaster emergency relief and reconstruction is an important process. Based on disaster system theory, this study analyzed the Jiangsu tornado from the formation mechanism of disasters, through to the economic losses, loss of life, and social infrastructure losses along the tornado disaster chain. The study then assessed the emergency relief and reconstruction efforts, based on an analytic hierarchy process method. The results were as follows: (1) An unstable weather system was the root cause of the tornado. The potentially hazardous local environment, acting in concert with the terrain and the river network, was able to gather energy from the unstable atmosphere. The wind belt passed through a densely populated district, with vulnerable infrastructure and other hazard-prone elements, which led to an accumulative disaster situation and the triggering of a catastrophe. (2) The tornado was accompanied by a hailstorm, which is an important triggering factor for a tornado catastrophe chain reaction. (3) The evaluation index (EI) of the emergency relief and reconstruction effect for the ‘‘6.23’’ tornado disaster in Yancheng was 91.5. Compared to other relief work in areas affected by disasters of the same magnitude, there was a more successful response than has previously been experienced. The results provide new insights for studies of disaster systems and the recovery measures in response to tornado catastrophe in China.

Keywords: China, disaster system, emergency relief, tornado catastrophe

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847 Effects of Length of Time of Fasting upon Subjective and Objective Variables When Controlling Sleep, Food and Fluid Intakes

Authors: H. Alabed, K. Abuzayan. L. Fgie, K. Zarug

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Ramadan requires individuals to abstain from food and fluid intake between sunrise and sunset; physiological considerations predict that poorer mood, physical performance and mental performance will result. In addition, any difficulties will be worsened because preparations for fasting and recovery from it often mean that nocturnal sleep is decreased in length, and this independently affects mood and performance. A difficulty of interpretation in many studies is that the observed changes could be due to fasting but also to the decreased length of sleep and altered food and fluid intakes before and after the daytime fasting. These factors were separated in this study, which took place over three separate days and compared the effects of different durations of fasting (4, 8 or 16h) upon a wide variety of measures (including subjective and objective assessments of performance, body composition, dehydration and responses to a short bout of exercise) - but with an unchanged amount of nocturnal sleep, controlled supper the previous evening, controlled intakes at breakfast and daytime naps not being allowed. Many of the negative effects of fasting observed in previous studies were present in this experiment also. These findings indicate that fasting was responsible for many of the changes previously observed, though some effect of sleep loss, particularly if occurring on successive days (as would occur in Ramadan) cannot be excluded.

Keywords: drinking, eating, mental performance, physical performance, social activity, blood, sleepiness

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846 Identifying the True Extend of Glioblastoma Based on Preoperative FLAIR Images

Authors: B. Shukir, L. Szivos, D. Kis, P. Barzo

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Glioblastoma is the most malignant brain tumor. In general, the survival rate varies between (14-18) months. Glioblastoma consists a solid and infiltrative part. The standard therapeutic management of glioblastoma is maximum safe resection followed by chemo-radiotherapy. It’s hypothesized that the pretumoral hyperintense region in fluid attenuated inversion recovery (FLAIR) images includes both vasogenic edema and infiltrated tumor cells. In our study, we aimed to define the sensitivity and specificity of hyperintense FLAIR images preoperatively to examine how well it can define the true extent of glioblastoma. (16) glioblastoma patients included in this study. Hyperintense FLAIR region were delineated preoperatively as tumor mask. The infiltrative part of glioblastoma considered the regions where the tumor recurred on the follow up MRI. The recurrence on the CE-T1 images was marked as the recurrence masks. According to (AAL3) and (JHU white matter labels) atlas, the brain divided into cortical and subcortical regions respectively. For calculating specificity and sensitivity, the FLAIR and the recurrence masks overlapped counting how many regions affected by both . The average sensitivity and specificity was 83% and 85% respectively. Individually, the sensitivity and specificity varied between (31-100)%, and (100-58)% respectively. These results suggest that despite FLAIR being as an effective radiologic imaging tool its prognostic value remains controversial and probabilistic tractography remain more reliable available method for identifying the true extent of glioblastoma.

Keywords: brain tumors, glioblastoma, MRI, FLAIR

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845 Managing Subretinal Bleeds with Intravitreal Aflibercept

Authors: Prachi Abhishek Dave, Abhishek Dave

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Purpose: The purpose of this study is to elucidate the role of intravitreal injection Aflibercept in managing complex cases of Wet Age Related Macular Degeneration (ARMD) and the gratifying visual recovery experienced with a minimally invasive procedure. Methods: A 73-year-old gentleman presented with a drop in vision in the left eye for 25 days. On examination, his best corrected visual acuity (BCVA) in the Right eye (OD) was 6/60, and finger counting close to face in the Left eye (OS). On multimodal imaging, he was diagnosed to have a scarred Wet ARMD in OD and an active Wet ARMD with a large subretinal bleed secondary to Wet ARMD in OS. Treatment management options included monotherapy with an Injection Aflibercept or an intravitreal gas injection with tPA followed by Injection Aflibercept. Considering his one-eyed status, the patient decided to go for Aflibercept monotherapy. Results: After 3 monthly injections of injection Aflibercept, the subretinal bleed reduced, the subretinal fluid resolved, and his vision in OS improved to 6/9. He is on a regular follow-up and has not needed any further injections in OS and he maintains 6/9 vision. Conclusions: Conventional treatment guidelines for a large subretinal bleed dictate the use of gas followed by intravitreal Injection Aflibercept. However, gas has its own limitations of causing a rise in intraocular pressure and a transient loss of vision, which is particularly troublesome in one-eyed patients. Injection Aflibercept offers a much safer, less invasive, and elegant treatment option for such patients with equally good or even better visual outcomes.

Keywords: wet ARMD, subretinal bleed, intravitreal injections, aflibercept, EYELEA, intravitreal gas

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844 Relationship Financing: A Process of Interpretative Phenomenological Analysis

Authors: Y. Fandja, O. Colot, M. Croquet

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Small and medium-sized firms (SMEs) face difficulties in accessing bank credit. Bank credit is actually the main source of external financing for SMEs. In general, SMEs are risky businesses because of the potential opacity maintained by the leader in the management of affairs, the agency conflicts between business owners and third-party funders and the potential opportunism of the leader due to the incompleteness of the contracts. These elements accentuate the problems of information asymmetries between SMEs and bankers leading to capital rationing. Moreover, the last economic crisis reinforced this rationing of capital. However, a long-term relationship between SMEs and their bank would enable the latter to accumulate a set of relevant information allowing the reduction of information asymmetry and, consequently, the reduction of credit rationing. The objective of this research is to investigate the lived experience of SMEs loan officers in their relationships with their clients in order to understand how these relationships can affect the financing structure of these SMEs. To carry out this research, an Interpretative Phenomenological Analysis is implemented. This approach is part of the constructivist paradigm and refers to the subjective narratives of the individual rather than to an objective description of the facts. The role of the researcher is to explore the lived experience of the interviewees and to try to understand the meaning they give to this experience. Currently, several sixty-minute semi-structured interviews with loan officers for SMEs have been conducted. The analysis of the content of these interviews brought out three main themes. First, the relationship between the credit officer and the company manager is complex because the credit officer is not aware of establishing a personal relationship with his client. Second; the emotional involvement in the bank financing decision is present and third, the trust in the relationship between the credit officer and his client is very important. The originality of this research is to use the interpretative phenomenological analysis more specific to psychology and sociology in order to approach in a different way the problem of the financing of SMEs through their particular relations with the bankers.

Keywords: financing structure, interpretative phenomenological analysis, relationship financing, SME

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843 Role of Physiotherapist: How Their Job and Working Area Could Be Known

Authors: Juan Pablo Hervas-Perez, Jesus Guodemar-Perez, Montserrat Ruiz-Lopez, Elena Sonsoles Rodriguez-Lopez, Noemi Mayoral-Gonzalo, Eduardo Cimadevilla Fernandez-Pola, Mario Caballero-Corella

Abstract:

Physiotherapy is a healthcare discipline that covers many fields of action within the recovery and prevention of health. Some are well known, but others, such as working with newborns and premature children are not so. Physical therapist functions are well defined, but the impression of the population is that there are other professionals who can develop them, and a large part are unknown. Objective: To evaluate the level of knowledge of the sample on the role of the physiotherapist in general, and more specifically in the neonatal intensive care (NICU) units, and estimate your level of notions on the development centered care (DCC). Method: A descriptive, transversal, observational and prospective study developed on a 125 participants' sample. Results: From the sample studied, 87.2% had already had contact with physiotherapy previously. An 80.9% believed that the physiotherapist intervention was decisive for the cure, and 84.0% would recommend physiotherapy treatment to others. Of the total surveyed, 98.0% felt that the physiotherapist is who should run the physiotherapeutic treatments, but shares with other professions 71.0% of votes. The field's best-known work is rehabilitation (94.0%); Neonatology is on the 4th place (66.0% of votes). Conclusions: Many areas of work of physical therapy are unknown to a big part of the population, including the own health workers. Less than half of the sample meets the DCC, and only 58% of the interviewed physiotherapists know them.

Keywords: functions of physiotherapist, neonatal intensive care, physiotherapy, prematurity

Procedia PDF Downloads 309
842 Characterization of Biosurfactants Produced by Bacteria Degrading Gasoline

Authors: Ikram Kamal, Mohamed Blaghen

Abstract:

Biosurfactants are amphiphilic biological compounds consisting of hydrophobic and hydrophilic domains produced extracellularly or as part of the cell membrane by a variety of yeast, bacteria and filamentous fungi. Biosurfactant applications in the environmental industries are promising due to their biodegradability, low toxicity, and effectiveness in enhancing biodegradation and solubilization of low solubility compounds. Currently, the main application is for enhancement of oil recovery and hydrocarbon bioremediation due to their biodegradability and low critical micelle concentration (CMC). The use of biosurfactants has also been proposed for various industrial applications, such as in food additives, cosmetics, detergent formulations and in combinations with enzymes for wastewater treatment. In this study, we have investigated the potential of bacterial strains: Mannheimia haemolytica, Burkholderia cepacia and Serratia ficaria were collected aseptically from the lagoon Marchika (water and soil) in Nador, Morocco; for the production of biosurfactants. This study also aimed to optimize the biosurfactant production process by changing the variables that influence the type and amount of biosurfactant produced by these microorganisms such as: carbon sources and also other physical and chemical parameters such as temperature and pH. Emulsification index, methylene blue test, and thin layer chromatography (TLC) revealed the ability of strains used in this study to produce compounds that could emulsify gasoline. In addition, a GC/MS was used to separate and identify different biosurfactants purified.

Keywords: biosurfactants, Mannheimia haemolytica, biodegradability, Burkholderia cepacia, Serratia ficaria

Procedia PDF Downloads 243
841 Nursing Experience of Providing Nursing Care to a Lung Transplantation Patient by Applying the Self-Efficacy Theory

Authors: Hsin-Yi Huang

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This study mainly discussed the disease-induced and surgery-induced physical, psychological, and spiritual issues faced by a patient who suffered from emphysema and respiratory failure and had underwent a right-lung transplantation surgery. Nursing care was provided from May 21 to May 29. Based on the observations, interviews, physical examinations, and evaluations that were carried out using Roy’s adaptation model, the following nursing issues were identified: risk of infection, lack of knowledge, and anxiety. Active care was provided and a good nursing relationship with the patient and the patient’s family was established. The four strategies of Bandura’s self-efficacy theory (self-transcendence, vicarious experience, verbal persuasion, and biofeedback) were employed. Instructions for the appropriate rehabilitation exercises were given, immunosuppressant concentration was monitored, and special measures were taken to prevent infection. The patient was encouraged to express feelings and was provided with sufficient information to alleviate anxiety. With assistance from nursing personnel and the medical team, the patient was successfully discharged from the hospital and thereafter embarked on the path of postoperative recovery. The patient learned about the importance of home self-care and regular follow-up outpatient visits, and patient management was implemented for discharge preparation services. This nursing case study may serve as a reference to nurses managing similar cases in future.

Keywords: anxiety, lung transplantation, Roy's adaptation model, self-efficacy theory

Procedia PDF Downloads 135
840 The Myth of Mohini and Ardhanarishvara: A Queer Reading

Authors: Anindita Roy

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This paper offers a queer reading of the myth of Mohini and Ardhanarishvara in Indian mythology to explore the transformative capacity of gender performativity with a view to focusing on the notion of female and male as harmonious contributors in culture and nature. The qualitative study of these two narratives ponders on the issues of dualism in Indian mythology. These myths approach different queer experiences in different ways - the first, an incarnation of Vishnu into Mohini by body swapping and the latter, the myth of Ardhanarishvara in which one sacred body upholds two different biological identities together- male and female. Emphasizing on the transformation of sex, the present paper re-reads how these queer-transformations can become transformative in the society. The study is explained in three parts. The first one focuses on the two select myths to explore the idea of gender as performance and the concept of queer ecofeminism where nature/culture, heterosexuality/queer female/male dualism exist in a paradigm. The second segment analyzes whether these myths destabilize or promote the access of queer and the experience of ‘other’ in the society and resistance against domination. The third section inquires to rethink the whole world about the value and hierarchy of men over women, heterosexuality over queer, culture over nature to call for a recovery of the female/male, nature/culture principles as complementary. What the paper intends to investigate is if and how gender transformations in religious myths have the capacity to transform personal and social notions and practices of different hierarchies.

Keywords: dualism, Indian myth, queer, transformativity

Procedia PDF Downloads 157
839 Effects of Length of Time of Fasting Upon Subjective and Objective Variables When Prior Sleep and Food and Fluid Intakes Have Been Controlled

Authors: H. Alabed, K. Abuzayan, J. Ezarrugh, S. Ali, M. Touba

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Ramadan requires individuals to abstain from food and fluid intake between sunrise and sunset, Physiological considerations predict that poorer mood, Physical performance and mental performance will result. In addition, Any difficulties will be worsened because preparations for fasting and recovery from it often mean that nocturnal sleep is decreased in length and this independently affects mood and performance. A difficulty of interpretation in many studies is that the observed changes could be due to fasting but also to the decreased length of sleep and altered food and fluid intakes before and after the daytime fasting. These factors were separated in this study, Which took place over three separate days and compared the effects of different durations of fasting (4, 8 or 16 h) upon a wide variety of measures (including subjective and objective assessments of performance, body composition, Dehydration and responses to a short bout of exercise) but with an unchanged amount of nocturnal sleep, Controlled supper the previous evening, Controlled intakes at breakfast and daytime naps not being allowed. Many of the negative effects of fasting observed in previous studies were present in this experiment also. These findings indicate that fasting was responsible for many of the changes previously observed, Though some effect of sleep loss, Particularly if occurring on successive days (as would occur in Ramadan) cannot be excluded.

Keywords: Drinking, eating, mental performance, physical performance, social activity, blood, sleepiness

Procedia PDF Downloads 297
838 Biosorption of Metal Ions from Sarcheshmeh Acid Mine Drainage by Immobilized Bacillus thuringiensis in a Fixed-Bed Column

Authors: V. Khosravi, F. D. Ardejani, A. Aryafar, M. Sedighi

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Heavy metals have a damaging impact for the environment, animals and humans due to their extreme toxicity and removing them from wastewaters is a very important and interesting task in the field of water pollution control. Biosorption is a relatively new method for treatment of wastewaters and recovery of heavy metals. In this study, a continuous fixed bed study was carried out by using Bacillus thuringiensis as a biosorbent for the removal of Cu and Mn ions from Sarcheshmeh Acid Mine Drainage (AMD). The effect of operating parameters such as flow rate and bed height on the sorption characteristics of B. thuringiensis was investigated at pH 6.0 for each metal ion. The experimental results showed that the breakthrough time decreased with increasing flow rate and decreasing bed height. The data also indicated that the equilibrium uptake of both metals increased with decreasing flow rate and increasing bed height. BDST, Thomas, and Yoon–Nelson models were applied to experimental data to predict the breakthrough curves. All models were found suitable for describing the whole dynamic behavior of the column with respect to flow rate and bed height. In order to regenerate the adsorbent, an elution step was carried out with 1 M HCl and five adsorption-desorption cycles were carried out in continuous manner.

Keywords: acid mine drainage, bacillus thuringiensis, biosorption, cu and mn ions, fixed bed

Procedia PDF Downloads 388
837 The Role of Vitamin D Supplementation in Augmenting IFN-γ Production in Response to Mycobacterium Tuberculosis Infection: A Randomized Controlled Trial

Authors: Muhammad Imran Hussain, Ramisha Ibtisam, Tayyaba Fatima, Huba Khalid, Ayesha Aziz, Khansa, Adan Sitara, Anam Shahzad, Aymen Jabeen

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Vitamin D supports the immune system fight TB by inhibiting Interferon-gamma (IFN-γ) and lowering host inflammation. The purpose of the research was to see if giving the vitamin D supplements to TB patients affected their prognosis. A randomized placebo control study of 200 TB patients was performed among which 106 received 400,000 IU of injectable vitamin D3 and 94 received placebo for 2 doses. Assessment was carried out at the end of every month for 3 months. IFN-γ responses to whole blood stimulation generated by the Mycobacterium tuberculosis sonicate (MTBs) antigen and early secreted and T cell activated 6 kDa (ESAT6) were assessed at 0 and 12 weeks. The statistical analysis used descriptive statistics (mean and standard deviation), Friedman's test and Fisher's test. The vitamin D group gained significantly more weight (+3.90 pounds) and had less persistent lung disease on imaging (1.33 zones vs. 1.84 zones). They also had a 50% decrease in cavity size. Additionally, patients with low baseline serum concentrations of 25-(OH)D had a significant increase in MTB-induced IFN-γ production after taking vitamin D supplements. Vitamin D administration in large amounts can hasten the recovery of TB patients. The findings point is a therapeutically useful activity of Vitamin D's in the management for tuberculosis.

Keywords: tuberculosis, vitamin D, interferon gamma, protein, infection

Procedia PDF Downloads 34
836 Energy Efficient Clustering with Reliable and Load-Balanced Multipath Routing for Wireless Sensor Networks

Authors: Alamgir Naushad, Ghulam Abbas, Shehzad Ali Shah, Ziaul Haq Abbas

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Unlike conventional networks, it is particularly challenging to manage resources efficiently in Wireless Sensor Networks (WSNs) due to their inherent characteristics, such as dynamic network topology and limited bandwidth and battery power. To ensure energy efficiency, this paper presents a routing protocol for WSNs, namely, Enhanced Hybrid Multipath Routing (EHMR), which employs hierarchical clustering and proposes a next hop selection mechanism between nodes according to a maximum residual energy metric together with a minimum hop count. Load-balancing of data traffic over multiple paths is achieved for a better packet delivery ratio and low latency rate. Reliability is ensured in terms of higher data rate and lower end-to-end delay. EHMR also enhances the fast-failure recovery mechanism to recover a failed path. Simulation results demonstrate that EHMR achieves a higher packet delivery ratio, reduced energy consumption per-packet delivery, lower end-to-end latency, and reduced effect of data rate on packet delivery ratio when compared with eminent WSN routing protocols.

Keywords: energy efficiency, load-balancing, hierarchical clustering, multipath routing, wireless sensor networks

Procedia PDF Downloads 60
835 The Impacts of an Adapted Literature Circle Model on Reading Comprehension, Engagement, and Cooperation in an EFL Reading Course

Authors: Tiantian Feng

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There is a dearth of research on the literary circle as a teaching strategy in English as a Foreign Language (EFL) classes in Chinese colleges and universities and even fewer empirical studies on its impacts. In this one-quarter, design-based project, the researcher aims to increase students’ engagement, cooperation, and, on top of that, reading comprehension performance by utilizing a researcher-developed, adapted reading circle model in an EFL reading course at a Chinese college. The model also integrated team-based learning and portfolio assessment, with an emphasis on the specialization of individual responsibilities, contributions, and outcomes in reading projects, with the goal of addressing current issues in EFL classes at Chinese colleges, such as passive learning, test orientation, ineffective and uncooperative teamwork, and lack of dynamics. In this quasi-experimental research, two groups of students enrolled in the course were invited to participate in four in-class team projects, with the intervention class following the adapted literature circle model and team members rotating as Leader, Coordinator, Brain trust, and Reporter. The researcher/instructor used a sequential explanatory mixed-methods approach to quantitatively analyze the final grades for the pre-and post-tests, as well as individual scores for team projects and will code students' artifacts in the next step, with the results to be reported in a subsequent paper(s). Initial analysis showed that both groups saw an increase in final grades, but the intervention group enjoyed a more significant boost, suggesting that the adapted reading circle model is effective in improving students’ reading comprehension performance. This research not only closes the empirical research gap of literature circles in college EFL classes in China but also adds to the pool of effective ways to optimize reading comprehension performance and class performance in college EFL classes.

Keywords: literature circle, EFL teaching, college english reading, reading comprehension

Procedia PDF Downloads 83
834 Enhancement of Dune Sand from the Western Erg (Algeria) in the Formulation of New Concrete

Authors: Ahmed Tafraoui, Gilles Escadeillas, Thierry Vidal

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The southern Algeria is known for its huge sand dunes that cover part of its territory (Sahara). This sand has features that allow a glimpse of a recovery in the construction field in the form of Ultra High Performance Concrete (UHPC). This type of concrete using a large amount of silica fume, ultra fine addition that gives very high performance but is also relatively rare and expensive. Replacing it with another addition to equivalent properties, such as metakaolin, can also be considered. The objective of this study is to both enhance the sand dunes of Erg south west western Algeria but also reduce manufacturing costs of Ultra High Performance Concrete to incorporating metakaolin to instead of silica fume. Performances to determine mechanical performance are instantaneous, compression and bending. Initially, we characterized the Algerian sand dune. Then, we have to find a formulation of UHPC, adequate in terms of implementation and to replace silica fume by metakaolin. Finally, we studied the actual value of the sand dune. Concrete obtained have very high mechanical performance, up to a compressive strength of 250 MPa, a tensile strength of 45 MPa by bending with the method of heat treatment. This study shows that the enhancement of dune sand studied is quite possible in UHPC, and in particular UHPC bundles and the replacement of silica fume by metakaolin do not alter the properties of these concretes.

Keywords: Ultra High Performance Concrete, sand dune, formulations, silica fume, metakaolin, strength

Procedia PDF Downloads 456
833 Improving Subjective Bias Detection Using Bidirectional Encoder Representations from Transformers and Bidirectional Long Short-Term Memory

Authors: Ebipatei Victoria Tunyan, T. A. Cao, Cheol Young Ock

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Detecting subjectively biased statements is a vital task. This is because this kind of bias, when present in the text or other forms of information dissemination media such as news, social media, scientific texts, and encyclopedias, can weaken trust in the information and stir conflicts amongst consumers. Subjective bias detection is also critical for many Natural Language Processing (NLP) tasks like sentiment analysis, opinion identification, and bias neutralization. Having a system that can adequately detect subjectivity in text will boost research in the above-mentioned areas significantly. It can also come in handy for platforms like Wikipedia, where the use of neutral language is of importance. The goal of this work is to identify the subjectively biased language in text on a sentence level. With machine learning, we can solve complex AI problems, making it a good fit for the problem of subjective bias detection. A key step in this approach is to train a classifier based on BERT (Bidirectional Encoder Representations from Transformers) as upstream model. BERT by itself can be used as a classifier; however, in this study, we use BERT as data preprocessor as well as an embedding generator for a Bi-LSTM (Bidirectional Long Short-Term Memory) network incorporated with attention mechanism. This approach produces a deeper and better classifier. We evaluate the effectiveness of our model using the Wiki Neutrality Corpus (WNC), which was compiled from Wikipedia edits that removed various biased instances from sentences as a benchmark dataset, with which we also compare our model to existing approaches. Experimental analysis indicates an improved performance, as our model achieved state-of-the-art accuracy in detecting subjective bias. This study focuses on the English language, but the model can be fine-tuned to accommodate other languages.

Keywords: subjective bias detection, machine learning, BERT–BiLSTM–Attention, text classification, natural language processing

Procedia PDF Downloads 111