Search results for: crystal report
1283 Cervical Ectopic Pregnancy Case Report
Authors: Berrak Yildiz, Hinal Shah, Justine Fernandez, Nazje James, Anna Brown
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Cervical ectopic pregnancy, a rare type of ectopic pregnancies, is defined by blastocyst implantation within the cervical canal rather than the endometrium. Its rarity and potential for severe hemorrhage make cervical ectopic pregnancy a diagnostic and therapeutic challenge. A 39-year-old woman, G5P2022, with a history of two cesarean sections and two elective terminations, presented to the emergency department with vaginal bleeding and pelvic pain. Initial assessment showed a beta-hCG level of 2,853 mIU/mL, and transvaginal ultrasound revealed a small, irregular gestational sac at the level of the internal cervical os. Serial betahCG measurements over subsequent visits showed a declining trend, consistent with a nonviable pregnancy. The patient was ultimately treated with methotrexate at a dose of 50 mg/m² (total 100 mg), following which she reported no further symptoms. On follow-up, her beta-hCG level returned to the normal non-pregnant range, with no additional intervention needed. This case highlights the importance of early diagnosis in cervical ectopic pregnancy to avoid complications like hysterectomy. Methotrexate is an effective first-line treatment in hemodynamically stable patients, offering a conservative approach that can preserve fertility. The success in this patient underscores the role of prompt diagnosis and careful management in achieving resolution while minimizing invasive procedures.Keywords: beta-hCG, cervical, ectopic, methotrexate
Procedia PDF Downloads 111282 Carbon-Nanodots Modified Glassy Carbon Electrode for the Electroanalysis of Selenium in Water
Authors: Azeez O. Idris, Benjamin O. Orimolade, Potlako J. Mafa, Alex T. Kuvarega, Usisipho Feleni, Bhekie B. Mamba
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We report a simple and cheaper method for the electrochemical detection of Se(IV) using carbon nanodots (CNDTs) prepared from oat. The carbon nanodots were synthesised by green and facile approach and characterised using scanning electron microscopy, high-resolution transmission electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, and Raman spectroscopy. The CNDT was used to fabricate an electrochemical sensor for the quantification of Se(IV) in water. The modification of glassy carbon electrode (GCE) with carbon nanodots led to an increase in the electroactive surface area of the electrode, which enhances the redox current peak of [Fe(CN)₆]₃₋/₄‒ in comparison to the bare GCE. Using the square wave voltammetry, the detection limit and quantification limit of 0.05 and 0.167 ppb were obtained under the optimised parameters using deposition potential of -200 mV, 0.1 M HNO₃ electrolyte, electrodeposition time of 60 s, and pH 1. The results further revealed that the GCE-CNDT was not susceptible to many interfering cations except Cu(II) and Pb(II), and Fe(II). The sensor fabrication involves a one-step electrode modification and was used to detect Se(IV) in a real water sample, and the result obtained is in agreement with the inductively coupled plasma technique. Overall, the electrode offers a cheap, fast, and sensitive way of detecting selenium in environmental matrices.Keywords: carbon nanodots, square wave voltammetry, nanomaterials, selenium, sensor
Procedia PDF Downloads 911281 Determination of Activation Energy for Thermal Decomposition of Selected Soft Tissues Components
Authors: M. Ekiert, T. Uhl, A. Mlyniec
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Tendons are the biological soft tissue structures composed of collagen, proteoglycan, glycoproteins, water and cells of extracellular matrix (ECM). Tendons, which primary function is to transfer force generated by the muscles to the bones causing joints movement, are exposed to many micro and macro damages. In fact, tendons and ligaments trauma are one of the most numerous injuries of human musculoskeletal system, causing for many people (particularly for athletes and physically active people), recurring disorders, chronic pain or even inability of movement. The number of tendons reconstruction and transplantation procedures is increasing every year. Therefore, studies on soft tissues storage conditions (influencing i.e. tissue aging) seem to be an extremely important issue. In this study, an atomic-scale investigation on the kinetics of decomposition of two selected tendon components – collagen type I (which forms a 60-85% of a tendon dry mass) and elastin protein (which combine with ECM creates elastic fibers of connective tissues) is presented. A molecular model of collagen and elastin was developed based on crystal structure of triple-helical collagen-like 1QSU peptide and P15502 human elastin protein, respectively. Each model employed 4 linear strands collagen/elastin strands per unit cell, distributed in 2x2 matrix arrangement, placed in simulation box filled with water molecules. A decomposition phenomena was simulated with molecular dynamics (MD) method using ReaxFF force field and periodic boundary conditions. A set of NVT-MD runs was performed for 1000K temperature range in order to obtained temperature-depended rate of production of decomposition by-products. Based on calculated reaction rates activation energies and pre-exponential factors, required to formulate Arrhenius equations describing kinetics of decomposition of tested soft tissue components, were calculated. Moreover, by adjusting a model developed for collagen, system scalability and correct implementation of the periodic boundary conditions were evaluated. An obtained results provide a deeper insight into decomposition of selected tendon components. A developed methodology may also be easily transferred to other connective tissue elements and therefore might be used for further studies on soft tissues aging.Keywords: decomposition, molecular dynamics, soft tissue, tendons
Procedia PDF Downloads 2101280 Numerical Modelling and Soil-structure Interaction Analysis of Rigid Ballast-less and Flexible Ballast-based High-speed Rail Track-embankments Using Software
Authors: Tokirhusen Iqbalbhai Shaikh, M. V. Shah
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With an increase in travel demand and a reduction in travel time, high-speed rail (HSR) has been introduced in India. Simplified 3-D finite element modelling is necessary to predict the stability and deformation characteristics of railway embankments and soil structure interaction behaviour under high-speed design requirements for Indian soil conditions. The objective of this study is to analyse the rigid ballast-less and flexible ballast-based high speed rail track embankments for various critical conditions subjected to them, viz. static condition, moving train condition, sudden brake application, and derailment case, using software. The input parameters for the analysis are soil type, thickness of the relevant strata, unit weight, Young’s modulus, Poisson’s ratio, undrained cohesion, friction angle, dilatancy angle, modulus of subgrade reaction, design speed, and other anticipated, relevant data. Eurocode 1, IRS-004(D), IS 1343, IRS specifications, California high-speed rail technical specifications, and the NHSRCL feasibility report will be followed in this study.Keywords: soil structure interaction, high speed rail, numerical modelling, PLAXIS3D
Procedia PDF Downloads 1101279 Covid Encephalopathy and New-Onset Seizures in the Context of a Prior Brain Abnormality: A Case Report
Authors: Omar Sorour, Michael Leahy, Thomas Irvine, Vladimir Koren
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Introduction: Covid encephalitis is a rare yet dangerous complication, particularly affecting the older and immunocompromised. Symptoms range from confusion to delirium, coma, and seizures. Although neurological manifestations have become more well-characterized in COVID patients, little is known about whether priorneurological abnormalities may predispose patients to COVID encephalopathy. Case Description: A 73 y.o. male with a CT and MRI-confirmed stable, prior 9 mm cavernoma in the right frontal lobe and no past history of seizures was hospitalized with generalized weakness, abdominal pain, nausea, and shortness of breath with subsequent COVID pneumonia. Three days after the initial presentation, the patient developed a spontaneous generalized tonic-clonic seizure consistent with presumed COVID encephalitis, along with somnolence and confusion. A day later, the patient had two other seizure episodes. Follow-up EEG suggested an inter-ictal epileptic focus with sharp waves corresponding to roughly the same location as the patient’s pre-existing cavernoma. The patient’s seizures stopped shortly thereafter, while his encephalopathy continued for days. Conclusion: We illustrate that a pre-existing anatomic cortical abnormality may act as a potential nidus for new-onset seizure activity in the context of suggested COVID encephalopathy. Future studies may further demonstrate that manifestations of COVIDencephalopathy in certain patients may be more predictable than initially assumed.Keywords: cavernoma, covid, encephalopathy, seizures
Procedia PDF Downloads 1711278 Disaster Mitigation from an Analysis of a Condemned Building Erected over Collapsible Clay Soil in Brazil
Authors: Marcelo Jesus Kato Avila, Joao Da Costa Pantoja
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Differential settlement of foundations is a serious pathology in buildings that put at risk lives and property. A common reason for the occurrence of this specific pathology in central Brazil is the presence of collapsible clay, a typical soil in the region. In this study, the foundation of a condemned building erected above this soil is analyzed. The aim is to prevent problems in new constructions, to predict which buildings may be subjected to damages, and to make possible a more precise treatment in less advanced differential settlements observed in the buildings of the vicinity, which includes a hospital, a Military School, an indoor sporting arena, the Police Academy, and the Military Police Headquarters. The methodology consists of visual inspection, photographic report of the main pathologies, analysis of the existing foundations, determination of the soil properties, the study of the cracking level and assessment of structural failure risk of the building. The findings show that the presence of water weaken the soil structure on which the foundation rest, being the main cause of the pathologic settlement, indicating that even in a one store building it was necessary to consider deeper digging, other categories of foundations, and more elaborated and detailed foundation plans when the soil presents this behavior.Keywords: building cracks, collapsible clay, differential settlement, structural failure risk
Procedia PDF Downloads 2551277 On a Transient Magnetohydrodynamics Heat Transfer Within Radiative Porous Channel Due to Convective Boundary Condition
Authors: Bashiru Abdullahi, Isah Bala Yabo, Ibrahim Yakubu Seini
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In this paper, the steady/transient MHD heat transfer within radiative porous channel due to convective boundary conditions is considered. The solution of the steady-state and that of the transient version were conveyed by Perturbation and Finite difference methods respectively. The heat transfer mechanism of the present work ascertains the influence of Biot number〖(B〗_i1), magnetizing parameter (M), radiation parameter(R), temperature difference, suction/injection(S) Grashof number (Gr) and time (t) on velocity (u), temperature(θ), skin friction(τ), and Nusselt number (Nu). The results established were discussed with the help of a line graph. It was found that the velocity, temperature, and skin friction decay with increasing suction/injection and magnetizing parameters while the Nusselt number upsurges with suction/injection at y = 0 and falls at y =1. The steady-state solution was in perfect agreement with the transient version for a significant value of time t. It is interesting to report that the Biot number has a cogent influence consequently, as its values upsurge the result of the present work slant the extended literature.Keywords: heat transfer, thermal radiation, porous channel, MHD, transient, convective boundary condition
Procedia PDF Downloads 1211276 Tuning of Indirect Exchange Coupling in FePt/Al₂O₃/Fe₃Pt System
Authors: Rajan Goyal, S. Lamba, S. Annapoorni
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The indirect exchange coupled system consists of two ferromagnetic layers separated by non-magnetic spacer layer. The type of exchange coupling may be either ferro or anti-ferro depending on the thickness of the spacer layer. In the present work, the strength of exchange coupling in FePt/Al₂O₃/Fe₃Pt has been investigated by varying the thickness of the spacer layer Al₂O₃. The FePt/Al₂O₃/Fe₃Pt trilayer structure is fabricated on Si <100> single crystal substrate using sputtering technique. The thickness of FePt and Fe₃Pt is fixed at 60 nm and 2 nm respectively. The thickness of spacer layer Al₂O₃ was varied from 0 to 16 nm. The normalized hysteresis loops recorded at room temperature both in the in-plane and out of plane configuration reveals that the orientation of easy axis lies along the plane of the film. It is observed that the hysteresis loop for ts=0 nm does not exhibit any knee around H=0 indicating that the hard FePt layer and soft Fe₃Pt layer are strongly exchange coupled. However, the insertion of Al₂O₃ spacer layer of thickness ts = 0.7 nm results in appearance of a minor knee around H=0 suggesting the weakening of exchange coupling between FePt and Fe₃Pt. The disappearance of knee in hysteresis loop with further increase in thickness of the spacer layer up to 8 nm predicts the co-existence of ferromagnetic (FM) and antiferromagnetic (AFM) exchange interaction between FePt and Fe₃Pt. In addition to this, the out of plane hysteresis loop also shows an asymmetry around H=0. The exchange field Hex = (Hc↑-HC↓)/2, where Hc↑ and Hc↓ are the coercivity estimated from lower and upper branch of hysteresis loop, increases from ~ 150 Oe to ~ 700 Oe respectively. This behavior may be attributed to the uncompensated moments in the hard FePt layer and soft Fe₃Pt layer at the interface. A better insight into the variation in indirect exchange coupling has been investigated using recoil curves. It is observed that the almost closed recoil curves are obtained for ts= 0 nm up to a reverse field of ~ 5 kOe. On the other hand, the appearance of appreciable open recoil curves at lower reverse field ~ 4 kOe for ts = 0.7 nm indicates that uncoupled soft phase undergoes irreversible magnetization reversal at lower reverse field suggesting the weakening of exchange coupling. The openness of recoil curves decreases with increase in thickness of the spacer layer up to 8 nm. This behavior may be attributed to the competition between FM and AFM exchange interactions. The FM exchange coupling between FePt and Fe₃Pt due to porous nature of Al₂O₃ decreases much slower than the weak AFM coupling due to interaction between Fe ions of FePt and Fe₃Pt via O ions of Al₂O₃. The hysteresis loop has been simulated using Monte Carlo based on Metropolis algorithm to investigate the variation in strength of exchange coupling in FePt/Al₂O₃/Fe₃Pt trilayer system.Keywords: indirect exchange coupling, MH loop, Monte Carlo simulation, recoil curve
Procedia PDF Downloads 1901275 The Experience of Applying Multi-Sensory Stimulation ICU for Arousing a Patient with Traumatic Brain Injury in Intensive Care
Authors: Hsiao-Wen Tsai
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Motor vehicle accident is the first cause of head injury in the world; severe head injury cases may cause conscious disturbance and death. This is a report about a case of a young adult patient suffering from motor vehicle accident leading to severe head injury who passed through three time surgical procedures, and his mother (who is the informal caregiver). This case was followed from 28th January to 15th February 2011 by using Gordon’s 11 functional health patterns. Patient’s cognitive-perceptual and self-perception-self-concept patterns were altered. Anxiety was also noted on his informal caregiver due to patients’ condition. During the intensive care period, maintaining patient’s vital signs and cerebral perfusion pressure were essential to avoid secondary neuronal injury. Multi-sensory stimulation, caring accompanying, supporting, listening and encouraging patient’s family involved in patient care were very important to reduce informal caregiver anxiety. Finally, the patient consciousness improved from GCS 4 to GCS 11 before discharging from ICU. Patient’s primary informal caregiver, his mother, also showed anxiety improvement. This is was successful case with traumatic brain injury recovered from coma.Keywords: anxiety, multi-sensory stimulation, reduce intracranial adaptive capacity, traumatic brain injury
Procedia PDF Downloads 2671274 Cardiopulmonary Disease in Bipolar Disorder Patient with History of SJS: Evidence Based Case Report
Authors: Zuhrotun Ulya, Muchammad Syamsulhadi, Debree Septiawan
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Patients with bipolar disorder are three times more likely to suffer cardiovascular disorders than the general population, which will influence their level of morbidity and rate of mortality. Bipolar disorder also affects the pulmonary system. The choice of long term-monotherapy and other combinative therapies have clinical impacts on patients. This study investigates the case of a woman who has been suffering from bipolar disorder for 16 years, and who has a history of Steven Johnson Syndrome. At present she is suffering also from cardiovascular and pulmonary disorder. An analysis of the results of this study suggests that there is a relationship between cardiovascular disorder, drug therapies, Steven Johnson Syndrome and mood stabilizer obtained from the PubMed, Cochrane, Medline, and ProQuest (publications between 2005 and 2015). Combination therapy with mood stabilizer is recommended for patients who do not have side effect histories from these drugs. The replacement drugs and combinations may be applied, especially for those with bipolar disorders, and the combination between atypical antipsychotic groups and mood stabilizers is often made. Clinicians, however, should be careful with the patients’ physical and metabolic changes, especially those who have experienced long-term therapy and who showed a history of Steven Johnson Syndrome (for which clinicians probably prescribed one type of medicine).Keywords: cardiopulmonary disease, bipolar disorder, SJS, therapy
Procedia PDF Downloads 4311273 Variation of Hedonic Capacity of People According to Age and Its Correlation with Chronotype
Authors: T. Hojageldiyev, Y. Bolmammedov
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Increasing evidence suggests late chronotype individuals are at increased risk of developing psychopathological conditions. Our previously conducted study aimed to know the distribution of chronotypes according to age revealed that evening-types reaching a peak at age 14. While there is growing number of studies evaluating associations between chronotype and affective symptoms, to our best knowledge there are no studies addressing the issue of prevalence of anhedonia according to age groups of people. The sample included 545 healthy students between 13-21 years old from secondary schools and universities of Turkmenistan. Self-report 14 item Snaith-Hamilton Pleasure Scale (SHAPS) was used to assess hedonic tone of students. SHAPS score of 3 or higher indicates the criteria for the anhedonia. According to similarity of hedonic capacity participants divided into three age groups. Group I (age 13-14-15) includes 206 students (92 female), group II (age 16-17) includes 256 students (111 female) and group III (age 18-19-20-21) includes 83 (37 female). Statistical analysis was performed using Microsoft Excel 2013 and GraphPad Prism 7.0 programs. According to results average SHAPS scores of group I is 1.93 ± 1.94, group II 1.08 ± 1.43 and group III 1.29 ± 1.62. Students with anhedonia in group I consisted 30.5%, in group II 13,2% and in group III 12.04%. There are no gender differences. According to questionnaire results, higher prevalence of anhedonia is at the age between 13-15 than other age groups, and hedonic capacity increases as the age of students increases (p < 0.05). As a result, distribution of evening-types according to age correlates with hedonic capacity which is evening-types tends to have lower hedonic capacity.Keywords: anhedonia, age, chronotype, hedonic capacity
Procedia PDF Downloads 1611272 Inhibitory Impacts of Fulvic Acid-Coated Iron Oxide Nano Particles on the Amyloid Fibril Aggregations
Authors: Dalia Jomehpour, Sara Sheikhlary, Esmaeil Heydari, Mohammad Hossien Majles Ara
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In this study, we report fulvic acid-coated iron oxide nanoparticles of 10.7 ± 2.7 nm size, which serve to inhibit amyloid fibrillation formation. Although the effect of fulvic acid on tau fibrils was investigated, to our best knowledge, its inhibitory impacts on amyloid aggregation formation have been assessed neither in-vitro nor in-vivo. On the other hand, iron oxide nanoparticles exhibit anti-amyloid activity on their own. This study investigates the inhibitory effect of fulvic acid coated iron oxide nanoparticles on amyloid aggregations formed from the commonly used in-vitro model, lysozyme from chicken egg white. FESEM, XRD, and FTIR characterization confirmed that fulvic acid was coated onto the surface of the nanoparticles. The inhibitory effects of the fulvic acid coated iron oxide nanoparticles were verified by Thioflavin T assay, circular dichroism (CD), and FESEM analysis. Furthermore, the toxicity of the nanoparticles on the neuroblastoma SH-SY5Y human cell line was assessed through an MTT assay. Our results indicate that fulvic acid coated iron oxide nanoparticles can efficiently inhibit the formation of amyloid aggregations while exhibiting negligible in-vitro toxicity; thus, they can be used as anti-amyloid agents in the development of the potential drug for neurodegenerative diseases.Keywords: Alzheimer’s disease, fulvic acid coated iron oxide nanoparticles, fulvic acid, amyloid inhibitor, polyphenols
Procedia PDF Downloads 1121271 English and Information and Communication Technology: Zones of Exclusion in Education in Low-Income Countries
Authors: Ram A. Giri, Amna Bedri, Abdou Niane
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Exclusion in education on the basis of language in multilingual contexts operates at multiple levels. Learners of diverse ethnolinguistic backgrounds are often expected to learn through English and are pushed further down the learning ladder if they also have to access education through Information and Communication Technology (ICT). The paper explores marginalized children’s lived experiences in accessing technology and English in four low-income countries in Africa and Asia. Based on the findings of the first phase of a multinational qualitative research study, we report on the factors or barriers that affect children’s access, opportunities and motivation for learning through technology and English. ICT and English - the language of ICT and education - can enhance learning and can even be essential. However, these two important keys to education can also function as barriers to accessing quality education, and therefore as zones of exclusion. This paper looks into how marginalized children (aged 13-15) engage in learning through ICT and English and to what extent the restrictive access and opportunities contribute to the widening of the already existing gap in education. By applying the conceptual frameworks of “access and accessibility of learning” and “zones of exclusion,” the paper elucidates how the barriers prevent children’s effective engagement with learning and addresses such questions as to how marginalized children access technology and English for learning; whether the children value English, and what their motivation and opportunity to learn it are. In addition, the paper will point out policy and pedagogic implications.Keywords: exclusion, inclusion, inclusive education, marginalization
Procedia PDF Downloads 2301270 Assessing the Role of Failed-ADR in Civil Litigation
Authors: Masood Ahmed
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There is a plethora of literature (including judicial and extra-judicial comments) concerning the virtues of alternative dispute resolution processes within the English civil justice system. Lord Woolf in his Access to Justice Report ushered in a new pro-ADR philosophy and this was reinforced by Sir Rupert Jackson in his review of civil litigation costs. More recently, Briggs LJ, in his review of the Chancery Court, reiterated the significant role played by ADR and the need for better integration of ADR processes within the Chancery Court. His Lordship also noted that ADR which had failed to produce a settlement (i.e. a failed-ADR) continued to play a significant role in contributing to a ‘substantial narrowing of the issues or increased focus on the key issues’ which were ‘capable of assisting both the parties and the court in the economical determination of the dispute at trial.’ With the assistance of empirical data, this paper investigates the nature of failed-ADR and, in particular, assesses the effectiveness of failed-ADR processes as a tool in: (a) narrowing the legal and/or factual issues which may assist the courts in more effective and efficient case management of the dispute; (b) assisting the parties in the future settlement of the matter. This paper will also measure the effectiveness of failed-ADR by considering the views and experiences of legal practitioners who have engaged in failed-ADR.Keywords: English civil justice system, alternative dispute resolution processes, civil court process, empirical data from legal profession regarding failed ADR
Procedia PDF Downloads 4661269 Feeling Ambivalence Towards Values
Authors: Aysheh Maslemani, Ruth Mayo, Greg Maio, Ariel Knafo-Noam
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Values are abstract ideals that serve as guiding principles in one's life. As inherently positive and desirable concepts, values are seen as motivators for actions and behaviors. However, research has largely ignored the possibility that values may elicit negative feelings despite being explicitly important to us. In the current study, we aim to examine this possibility. Four hundred participants over 18 years(M=41.6, SD=13.7, Female=178) from the UK completed a questionnaire in which they were asked to indicate their level of positive/negative feelings towards a comprehensive list of values and then report the importance of these values to them. The results support our argument by showing that people can have negative feelings towards their values and that people can feel both positive and negative emotions towards their values simultaneously, which means feeling ambivalence. We ran a mixed-effect model with ambivalence, value type, and their interaction as fixed effects, with by subject random intercept and by subject random slope for ambivalence. The results reveal that values that elicit less ambivalence predicted higher ratings for value importance. This research contributes to the field of values on multiple levels. Theoretically, it will uncover new insights about values, such as the existence of negative emotions towards them and the presence of ambivalence towards values. These findings may inspire future studies to explore the effects of ambivalence on people's well-being, behaviors, cognition, and their affect. We discuss the findings and consider their implications for understanding the social psychological mechanisms underpinning value ambivalence.Keywords: emotion, social cognition, values., ambivalence
Procedia PDF Downloads 671268 Feeling Ambivalence Towards Yours Values
Authors: Aysheh Maslemani, Ruth Mayo, Greg Maio, Ariel Knafo-Noam
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Values are abstract ideals that serve as guiding principles in one's life. As inherently positive and desirable concepts, values are seen as motivators for actions and behaviors. However, research has largely ignored the possibility that values may elicit negative feelings despite being explicitly important to us. In the current study we aim to examine this possibility. Four hundred participants over 18 years(M=41.6,SD=13.7,Female=178) from the UK completed a questionnaire in which they were asked to indicate their level of positive/negative feelings towards a comprehensive list of values and then report the importance of these values to them. The results support our argument by showing that people can have negative feelings towards their values and that people can feel both positive and negative emotions towards their values simultaneously, which means feeling ambivalence. We ran a mixed-effect model with ambivalence, value type, and their interaction as fixed effects, with by subject random intercept, and by subject random slope for ambivalence. The results reveal that values that elicit less ambivalence predicted higher ratings for value importance. This research contributes to the field of values on multiple levels. Theoretically, it will uncover new insights about values, such as the existence of negative emotions towards them, the presence of ambivalence towards values. These findings may inspire future studies to explore the effects of ambivalence on people's well-being, behaviors, cognition, and their affect. We discuss the findings and consider their implications for understanding the social psychological mechanisms underpinning value ambivalence.Keywords: ambivalence, emotion, social cognition, values
Procedia PDF Downloads 671267 Addressing Primary Care Clinician Burnout in a Value Based Care Setting During the COVID-19 Pandemic
Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar
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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement
Procedia PDF Downloads 821266 Understanding Climate Change with Chinese Elderly: Knowledge, Attitudes and Practices on Climate Change in East China
Authors: Pelin Kinay, Andy P. Morse, Elmer V. Villanueva, Karyn Morrissey, Philip L Staddon, Shanzheng Zhang, Jingjing Liu
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The present study aims to evaluate the climate change and health related knowledge, attitudes and practices (KAP) of the elderly population (60 years plus) in Hefei and Suzhou cities of China (n=300). This cross-sectional study includes 150 participants in each city. Data regarding demographic characteristics, KAP, and climate change perceptions were collected using a semi-structured questionnaire. When asked about the potential impacts of climate change over 79% of participants stated that climate change affected their lifestyle. Participants were most concerned about storms (51.7%), food shortage (33.3%) and drought (26%). The main health risks cited included water contamination (32%), air pollution related diseases (38.3%) and lung disease (43%). Finally, a majority (68.3%) did not report receiving government assistance on climate change issues. Logistic regression models were used to analyse the data in order to understand the links between socio-demographical factors and KAP of the participants. These findings provide insights for potential adaptation strategies targeting the elderly. It is recommended that government should take responsibility in creating awareness strategies to improve the coping capacity of elderly in China to climate change and its health impacts and develop climate change adaptation strategies.Keywords: China, climate change, elderly, KAP
Procedia PDF Downloads 2681265 Indoor Air Pollution: A Major Threat to Human Health
Authors: Pooja Rawat, Rakhi Tyagi
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Globally, almost 3 billion people rely on biomass (wood, charcoal, dung and crop residues) and coal as their primary source of domestic energy. Cooking and heating with solid fuels on open fire give rise to major pollutants. Women are primarily affected by these pollutants as they spend most of their time in the house. The WHO World Health Report 2002 estimates that indoor air pollution (IAP) is responsible for 2.7% of the loss of disability adjusted life years (DALYs) worldwide and 3.7% in high mortality developing countries. Indoor air pollution has the potential to not only impact health, but also impact the general economic well-being of the household. Exposure to high level of household pollution lead to acute and chronic respiratory conditions (e.g.: pneumonia, chronic obstructive pulmonary disease, lung cancer and cataract). There has been many strategies for reducing IAP like subsidize cleaner fuel technologies, for example use of kerosene rather than traditional biomass fuels. Another example is development, promotion of 'improved cooking stoves'. India, likely ranks second- distributing over 12 million improved stoves in the first seven years of a national program to develop. IAP should be reduced by understanding the welfare effects of reducing IAP within households and to understanding the most cost effective way to reduce it.Keywords: open fire, indoor pollution, lung diseases, indoor air pollution
Procedia PDF Downloads 2981264 Genetic Approach to Target Putative PKS Genes Involved in Ochratoxin a Biosynthesis within Aspergillus Section Nigri, As a Main Cause of Human Nephropathy
Authors: Sabah Ben Fredj Melki, Yves Brygoo, Ahmed Mliki
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A 700 pb PCR-derived DNA fragment was isolated from Aspergillus carbonarius, Aspergillus niger, and Aspergillus tubingensis using degenerated primers (LC1-LC2c) and two newly designed primer pairs (KSLB-LC6) for Aspergillus niger and (AFl1F-LC2) for Aspergillus tubingensis developed for the acyl transferase (AT) and the KS domains of fungal PKSs. DNA from the most of black Aspergillus species currently recognized was tested. Herein, we report on the identification and characterisation of a part of the novel putative OTA-polyketide synthase gene in A. carbonarius “ACPks”, A. niger “ANPks” and A. tubingenis “ATPks”. The sequences were aligned and analyzed using phylogenetic methods. Primers used in this study showed general applicability and other Aspergillus species belonging to section Nigri were successfully amplified especially in A. niger and A. tubingenis. The predicted amino acid sequences “ACPks” displayed 66 to 81% similarities to different polyketide synthase genes while “ANPks” similarities varied from 68 to 71% and “ATPks” were from 81 to 97%. The AT and the KS domains appeared to be specific for a particular type of fungal PKSs and were related to PKSs involved in different mycotoxin biosynthesis pathways, including ochratoxin A. The sequences presented in this work have a high utility for the discovery of novel fungal PKS gene clusters.Keywords: Pks genes, OTA Biosynthesis, Aspergillus Nigri, sequence analysis
Procedia PDF Downloads 731263 Quantification of Polychlorinated Biphenyls (PCBs) in Soil Samples of Electrical Power Substations from Different Cities in Nigeria
Authors: Omasan Urhie Urhie, Adenipekun C. O, Eke W., Ogwu K., Erinle K. O
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Polychlorinated Biphenyls (PCBs) are Persistent organic pollutants (POPs) that are very toxic; they possess ability to accumulate in soil and in human tissues hence resulting in health issues like birth defect, reproductive disorder and cancer. The air is polluted by PCBs through volatilization and dispersion; they also contaminate soil and sediments and are not easily degraded. Soil samples were collected from a depth of 0-15 cm from three substations (Warri, Ughelli and Ibadan) of Power Holding Company of Nigeria (PHCN) where old transformers were dumped in Nigeria. Extraction and cleanup of soil samples were conducted using Accelerated Solvent Extraction (ASE) with Pressurized Liquid extraction (PLE). The concentration of PCBs was determined using gsas chromatography/mass spectrometry (GC/MS). Mean total PCB concentrations in the soil samples increased in the order Ughelli ˂ Ibadan˂ Warri, 2.457757ppm Ughelli substation 4.198926ppm, for Ibadan substation and 14.05065ppm at Warri substation. In the Warri samples, PCB-167 was the most abundant at about 30% (4.28086ppm) followed by PCB-157 at about 20% (2.77871), of the total PCB concentrations (14.05065ppm). Of the total PCBs in the Ughelli and Ibadan samples, PCB-156 was the most abundant at about 44% and 40%, respectively. This study provides a baseline report on the presence of PCBs in the vicinity of abandoned electrical power facilities in different cities in Nigeria.Keywords: polychlorintated biphenyls, persistent organic pollutants, soil, transformer
Procedia PDF Downloads 1401262 Quantum Sieving for Hydrogen Isotope Separation
Authors: Hyunchul Oh
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One of the challenges in modern separation science and technology is the separation of hydrogen isotopes mixtures since D2 and H2 consist of almost identical size, shape and thermodynamic properties. Recently, quantum sieving of isotopes by confinement in narrow space has been proposed as an alternative technique. Despite many theoretical suggestions, however, it has been difficult to discover a feasible microporous material up to now. Among various porous materials, the novel class of microporous framework materials (COFs, ZIFs and MOFs) is considered as a promising material class for isotope sieving due to ultra-high porosity and uniform pore size which can be tailored. Hence, we investigate experimentally the fundamental correlation between D2/H2 molar ratio and pore size at optimized operating conditions by using different ultramicroporous frameworks. The D2/H2 molar ratio is strongly depending on pore size, pressure and temperature. An experimentally determined optimum pore diameter for quantum sieving lies between 3.0 and 3.4 Å which can be an important guideline for designing and developing feasible microporous frameworks for isotope separation. Afterwards, we report a novel strategy for efficient hydrogen isotope separation at technologically relevant operating pressure through the development of quantum sieving exploited by the pore aperture engineering. The strategy involves installation of flexible components in the pores of the framework to tune the pore surface.Keywords: gas adsorption, hydrogen isotope, metal organic frameworks(MOFs), quantum sieving
Procedia PDF Downloads 2651261 Electronic and Optical Properties of YNi4Si-Type DyNi4Si Compound: A Full Potential Study
Authors: Dinesh Kumar Maurya, Sapan Mohan Saini
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A theoretical formalism to calculate the structural, electronic and optical properties of orthorhombic crystals from first principle calculations is described. This is applied first time to new YNi4Si-type DyNi4Si compound. Calculations are performed using full-potential augmented plane wave (FPLAPW) method in the framework of density functional theory (DFT). The Coulomb corrected local-spin density approximation (LSDA+U) in the self-interaction correction (SIC) has been used for exchange-correlation potential. Our optimized results of lattice parameters show good agreement to the previously reported experimental study. Analysis of the calculated band structure of DyNi4Si compound demonstrates their metallic character. We found Ni-3d states mainly contribute to density of states from -5.0 eV to the Fermi level while the Dy-f states peak stands tall in comparison to the small contributions made by the Ni-d and R-d states above Fermi level, which is consistent with experiment, in DNi4Si compound. Our calculated optical conductivity compares well with the experimental data and the results are analyzed in the light of band-to-band transitions. We also report the frequency-dependent refractive index n(ω) and the extinction coefficient k(ω) of the compound.Keywords: band structure, density of states, optical properties, LSDA+U approximation, YNi4Si- type DyNi4Si compound
Procedia PDF Downloads 3491260 A Comparison of Anger State and Trait Anger Among Adolescents with and without Visual Impairment
Authors: Sehmus Aslan, Sibel Karacaoglu, Cengiz Sevgin, Ummuhan Bas Aslan
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Objective: Anger expression style is an important moderator of the effects on the person and person’s environment. Anger and anger expression have become important constructs in identifying individuals at high risk for psychological difficulties. To our knowledge, there is no information about anger and anger expression of adolescents with visual impairment. The aim of this study was to compare anger and anger expression among adolescents with and without visual impairment. Methods: Thirty-eight adolescents with visual impairment (18 female, 20 male) and 44 adolescents without visual impairment (22 female, 24 male), in totally 84 adolescents aged between 12 to 15 years, participated in the study. Anger and anger expression of the participants assessed with The State-Trait Anger Scale (STAS). STAS, a self-report questionnaire, is designed to measure the experience and expression of anger. STAS has four subtitles including continuous anger, anger in, anger out and anger control. Reliability and validity of the STAS have been well established among adolescents. Mann-Whitney U Test was used for statistical analysis. Results: No significant differences were found in the scores of continuous anger and anger out between adolescents with and without visual impairment (p < 0.05). On the other hand, there were differences in scores of anger control and anger in between adolescents with and without visual impairment (p>0.05). The score of anger control in adolescents with visual impairment were higher compared with adolescents without visual impairment. Meanwhile, the adolescents with visual impairment had lower score for anger in compared with adolescents without visual impairment. Conclusions: The results of this study suggest that there is no difference in anger level among adolescents with and without visual impairment meanwhile there is difference in anger expression.Keywords: adolescent, anger, impaired, visual
Procedia PDF Downloads 4141259 Analysis of Ancient and Present Lightning Protection Systems of Large Heritage Stupas in Sri Lanka
Authors: J.R.S.S. Kumara, M.A.R.M. Fernando, S.Venkatesh, D.K. Jayaratne
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Protection of heritage monuments against lightning has become extremely important as far as their historical values are concerned. When such structures are large and tall, the risk of lightning initiated from both cloud and ground can be high. This paper presents a lightning risk analysis of three giant stupas in Anuradhapura era (fourth century BC onwards) in Sri Lanka. The three stupas are Jethawaaramaya (269-296 AD), Abayagiriya (88-76 BC) and Ruwanweliseya (161-137 BC), the third, fifth and seventh largest ancient structures in the world. These stupas are solid brick structures consisting of a base, a near hemispherical dome and a conical spire on the top. The ancient stupas constructed with a dielectric crystal on the top and connected to the ground through a conducting material, was considered as the hypothesis for their original lightning protection technique. However, at present, all three stupas are protected with Franklin rod type air termination systems located on top of the spire. First, a risk analysis was carried out according to IEC 62305 by considering the isokeraunic level of the area and the height of the stupas. Then the standard protective angle method and rolling sphere method were used to locate the possible touching points on the surface of the stupas. The study was extended to estimate the critical current which could strike on the unprotected areas of the stupas. The equations proposed by (Uman 2001) and (Cooray2007) were used to find the striking distances. A modified version of rolling sphere method was also applied to see the effects of upward leaders. All these studies were carried out for two scenarios: with original (i.e. ancient) lightning protection system and with present (i.e. new) air termination system. The field distribution on the surface of the stupa in the presence of a downward leader was obtained using finite element based commercial software COMSOL Multiphysics for further investigations of lightning risks. The obtained results were analyzed and compared each other to evaluate the performance of ancient and new lightning protection methods and identify suitable methods to design lightning protection systems for stupas. According to IEC standards, all three stupas with new and ancient lightning protection system has Level IV protection as per protection angle method. However according to rolling sphere method applied with Uman’s equation protection level is III. The same method applied with Cooray’s equation always shows a high risk with respect to Uman’s equation. It was found that there is a risk of lightning strikes on the dome and square chamber of the stupa, and the corresponding critical current values were different with respect to the equations used in the rolling sphere method and modified rolling sphere method.Keywords: Stupa, heritage, lightning protection, rolling sphere method, protection level
Procedia PDF Downloads 2521258 Investigation of the Effects of Monoamine Oxidase Levels on the 20S Proteasome
Authors: Bhavini Patel, Aslihan Ugun-Klusek, Ellen Billet
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The two main contributing factors to familial and idiopathic form of Parkinson’s disease (PD) are oxidative stress and altered proteolysis. Monoamine oxidase-A (MAO-A) plays a significant role in redox homeostasis by producing reactive oxygen species (ROS) via deamination of for example, dopamine. The ROS generated induces chemical modification of proteins resulting in altered biological function. The ubiquitin-proteasome system, which consists of three different types or proteolytic activity, namely “chymotrypsin-like” activity (CLA), “trypsin-like” activity (TLA) and “post acidic-like” activity (PLA), is responsible for the degradation of ubiquitinated proteins. Defects in UPS are known to be strongly correlated to PD. Herein, the effect of ROS generated by MAO-A on proteasome activity and the effects of proteasome inhibition on MAO-A protein levels in WT, mock and MAO-A overexpressed (MAO-A+) SHSY5Y neuroblastoma cell lines were investigated. The data in this study report increased proteolytic activity when MAO-A protein levels are significantly increased, in particular CLA and PLA. Additionally, 20S proteasome inhibition induced a decrease in MAO-A levels in WT and mock cells in comparison to MAO-A+ cells in which 20S proteasome inhibition induced increased MAO-A levels to be further increased at 48 hours of inhibition. This study supports the fact that MAO-A could be a potential pharmaceutical target for neuronal protection as data suggests that endogenous MAO-A levels may be essential for modulating cell death and survival.Keywords: monoamine oxidase, neurodegeneration, Parkinson's disease, proteasome
Procedia PDF Downloads 1351257 Preventing Violent Extremism through Augmenting Community Resilience and Empowering Community Members in Swat
Authors: Dr. Muhammad Idris Idris, Dr. Said Saeed Saeed
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Terrorism is the chronic issue of the hour. It is the disciplined practice of vicious activities like assassinating, slaughtering, mutilating, and frightening of the innocents to attain religious, fiscal, and political goals and to question the authority of the government. Leaders of the world promised to transform the planet by empowering community members and building community resilience (CR) against terrorism. This study concentrates to explore building community resilience against terrorism and empowering community members and implement strategies for strengthening community resilience. For data collection a mixed methods methodology will be used. Means, STD deviation, Pearson correlation, and thematic analysis will be employed to analyze the gathered data. The findings of the study will be interpreted and recommendations will be furnished accordingly. Study results will be disseminated to all concerned through conferences and seminar sessions. It is predicted that after the completion, the project team will be in a robust position to start writing the report that concentrates on strengthening community resilience, which is the crucial goal of this project. The publication will contribute effectively to all stakeholders and society, particularly to the lower rungs of social order. Moreover, it is expected that this project will contribute to future research in the domain of community resilience. This project will also reveal the remarkable potential of archival research on community resilience.Keywords: Violent Extremism, community Role, community resilience, community empowerment, Leadership role
Procedia PDF Downloads 1451256 The Antagonistic/Synergistic Effect of Probiotic Yeast Saccharomyces boulardii on Candida glabrata Adhesion
Authors: Zorica Tomičić, Ružica Tomičić, Peter Raspor
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Growing resistance of pathogenic yeast Candida glabrata to many classes of antifungal drugs has stimulated efforts to discover new agents to combat a rising number of invasive C. glabrata infections, which deserves a great deal of concern due to the high mortality rate in immunocompromised populations. One promising strategy is the use of probiotic microorganisms, which, when administered in adequate amounts, confers a health benefit. A selected number of probiotic organisms, Saccharomyces boulardii among them, have been tested as potential biotherapeutic agents. The aim of this study was to investigate the effect of the probiotic yeast S. boulardii on the adhesion of clinical isolates of C. glabrata at different temperatures, pH values, and in the presence of three clinically important antifungal drugs, such as fluconazole, itraconazole and amphotericin B. The method used to assess adhesion was crystal violet staining. The selection of antimycotics concentrations used in the adhesion assay was based on minimum inhibitory concentrations (MICs) obtained by the preliminarily performed microdilution modification of the Reference method for broth dilution antifungal susceptibility testing of yeast (Clinical and Laboratory Standards Institute (CLSI), standard M27-A2). the results showed that despite the nonadhesiveness of S. boulardii cells, probiotic yeast significantly suppressed the adhesion of C. glabrata strains. Besides, at specific strain ratios, a slight stimulatory effect was observed in some C. glabrata strains, which highlights the importance of strain specificity and opens up further research interests. When environmental conditions are considered, temperature and pH significantly influenced co-culture adhesion of C. glabrata and S. boulardii. The adhesion of C. glabrata strains was relatively equally reduced over all tested temperature range (28°C, 37°C, 39°C and 42°C) in the presence of S. boulardii cells, while the adhesion of a few C. glabrata strains were significantly stimulated at 28°C and suppressed at 42°C. Further, the adhesion was highly dependent on pH, with the highest adherence at pH 4 and lowest at pH 8.5. It was observed that S. boulardii did not manage to suppress the adhesion of C. glabrata strains at high pH. Antimycotics on the other hand showed a greater impact, since S. boulardii failed to affect co-culture adhesion at higher antimycotics concentrations. As expected, exposure to various concentrations of amphotericin B significantly reduced the adherence ability of C.glabrata strains both in a single culture and co-culture with S. boulardii. Therefore, it can be speculated that S. boulardii could substitute the effect of antimycotics in a range concentrations and with specific type of strains. This would certainly change the view on the treatment of yeast infections in the future.Keywords: adhesion, antimycotics, candida glabrata, saccharomyces boulardii
Procedia PDF Downloads 681255 Rapid Evidence Remote Acquisition in High-Availability Server and Storage System for Digital Forensic to Unravel Academic Crime
Authors: Bagus Hanindhito, Fariz Azmi Pratama, Ulfah Nadiya
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Nowadays, digital system including, but not limited to, computer and internet have penetrated the education system widely. Critical information such as students’ academic records is stored in a server off- or on-campus. Although several countermeasures have been taken to protect the vital resources from outsider attack, the defense from insiders threat is not getting serious attention. At the end of 2017, a security incident that involved academic information system in one of the most respected universities in Indonesia affected not only the reputation of the institution and its academia but also academic integrity in Indonesia. In this paper, we will explain our efforts in investigating this security incident where we have implemented a novel rapid evidence remote acquisition method in high-availability server and storage system thus our data collection efforts do not disrupt the academic information system and can be conducted remotely minutes after incident report has been received. The acquired evidence is analyzed during digital forensic by constructing the model of the system in an isolated environment which allows multiple investigators to work together. In the end, the suspect is identified as a student (insider), and the investigation result is used by prosecutors to charge the suspect as an academic crime.Keywords: academic information system, academic crime, digital forensic, high-availability server and storage, rapid evidence remote acquisition, security incident
Procedia PDF Downloads 1521254 The Characteristics of the Chairman of Board of Directors That Are Associated with Better Levels of Performance
Authors: Abilio Pires Zacarias
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Analyzing company boards of directors is a relevant and timely topic. As the representative of shareholders, the board is the most senior management body of this type of company. Therefore, ascertaining the best kind of candidates to nominate, namely the most appropriate characteristics for leading the board to achieve better levels of performance, is certainly of great interest. The companies selected for this study were the 1,000 largest non-financial companies and the 100 largest financial companies in Portugal according to the Instituto Nacional de Estatística for 2010. The information stemmed from a questionnaire addressed to the person in charge of daily company management and then processed through STATA 17 with the multivariate analysis of variables - MANOVA. The study may correspondingly report that the vast majority of boards in the sample operate a dual leadership structure. By in terms of its prevalence, unitary leadership represents only a minority. Agency theory and stewardship theory postulate different characteristics for the ideal chairman but neither receive confirmation from our results. On the other hand, our findings do validate the behavioral theory of firms (BToF), concluding that experience is associated with organizational performance. This study is also relevant due to its analysis of companies not listed on the financial markets not only because of their weighting in the economy but also because they remain only very poorly studied in this field and thus also correspondingly contributing to deepening the literature.Keywords: agency theory, behavioral theory of the firm, board of directors, corporate governance, stewardship theory
Procedia PDF Downloads 181