Search results for: meta analysis

Authors: D. Chronopoulos, I. Antoniadis, V. Spitas, D. Koulocheris, V. Polenta

Abstract:

A concept of a simple linear oscillator, incorporating a negative stiffness element is demonstrated to exhibit extraordinary damping properties. This oscillator shares the same overall (static) stiffness, the same mass and the same damping element with a reference classical linear SDOF oscillator. However, it differs from the original SDOF oscillator by appropriately redistributing the component spring stiffness elements and by re-allocating the damping element. Despite the fact that the proposed oscillator incorporates a negative stiffness element, it is designed to be both statically and dynamically stable. Once such an oscillator is optimally designed, it is shown to exhibit an extraordinary apparent damping ratio, which is even several orders of magnitude higher than that of the original SDOF system, especially in cases where the original damping of the SDOF system is low. This damping behavior is not a result of a novel additional extraordinary energy dissipation mechanism, but a result of the phase difference between the positive and the negative stiffness elastic forces, which is in turn a consequence of the proper re-distribution of the stiffness and the damper elements. This fact ensures that an adequate level of elastic forces exists throughout the entire frequency range, able to counteract the inertial and the excitation forces. Next, Acoustic or Phononic Meta-materials are considered, in which one atom is replaced by the concept of the above simple linear oscillator. The results indicate that not only the damping of the meta-material verifies and exceeds the one expected from the so-called "meta-damping" behavior, but also that the band gap of the meta-material can be significantly increased.

Keywords: wave propagation, periodic structures, wave damping, mechanical engineering

Procedia PDF Downloads 340

Authors: Salam N. Abdo, Orien L. Tulp, George P. Einstein

Abstract:

The purpose of this exploratory study was to gather the insights into psoriasis etiology, treatment, and patient experience, for developing psoriasis and psoriatic arthritis diagnostic test. Data collection methods consisted of a comprehensive meta-analysis of relevant studies and psoriasis patient survey. Established meta-analysis guidelines were used for the selection and qualitative comparative analysis of psoriasis and psoriatic arthritis research studies. Only studies that clearly discussed psoriasis etiology, treatment, and patient experience were reviewed and analyzed, to establish a qualitative data base for the study. Using the insights gained from meta-analysis, an existing psoriasis patient survey was modified and administered to collect additional data as well as triangulate the results. The hypothesis is that specific types of psoriatic disease have specific etiology and pathophysiologic pattern. The following etiology categories were identified: bacterial, environmental/microbial, genetic, immune, infectious, trauma/stress, and viral. Additional results, obtained from meta-analysis and confirmed by patient survey, were the common age of onset (early to mid-20s) and type of psoriasis (plaque; mild; symmetrical; scalp, chest, and extremities, specifically elbows and knees). Almost 70% of patients reported no prescription drug use due to severe side effects and prohibitive cost. These results will guide the development of psoriasis and psoriatic arthritis diagnostic test. The significant number of medical publications classified psoriatic arthritis disease as inflammatory of an unknown etiology. Thus numerous meta-analyses struggle to report any meaningful conclusions since no definitive results have been reported to date. Therefore, return to the basics is an essential step to any future meaningful results. To date, medical literature supports the fact that psoriatic disease in its current classification could be misidentifying subcategories, which in turn hinders the success of studies conducted to date. Moreover, there has been an enormous commercial support to pursue various immune-modulation therapies, thus following a narrow hypothesis/mechanism of action that is yet to yield resolution of disease state. Recurrence and complications may be considered unacceptable in a significant number of these studies. The aim of the ongoing study is to focus on a narrow subgroup of patient population, as identified by this exploratory study via meta-analysis and patient survey, and conduct an exhaustive work up, aiming at mechanism of action and causality before proposing a cure or therapeutic modality. Remission in psoriasis has been achieved and documented in medical literature, such as immune-modulation, phototherapy, various over-the-counter agents, including salts and tar. However, there is no psoriasis and psoriatic arthritis diagnostic test to date, to guide the diagnosis and treatment of this debilitating and, thus far, incurable disease. Because psoriasis affects approximately 2% of population, the results of this study may affect the treatment and improve the quality of life of a significant number of psoriasis patients, potentially millions of patients in the United States alone and many more millions worldwide.

Keywords: biologics, early diagnosis, etiology, immune disease, immune modulation therapy, inflammation skin disorder, phototherapy, plaque psoriasis, psoriasis, psoriasis classification, psoriasis disease marker, psoriasis diagnostic test, psoriasis marker, psoriasis mechanism of action, psoriasis treatment, psoriatic arthritis, psoriatic disease, psoriatic disease marker, psoriatic patient experience, psoriatic patient quality of life, remission, salt therapy, targeted immune therapy

Procedia PDF Downloads 99

Authors: Justin-Herve Noubissi, Jean Claude Kamgang, Eric Ramat, Januarius Asongu, Christophe Cambier

Abstract:

The goal of our study is to analyse the impact of climatic factors in malaria transmission taking into account migration between Douala and Yaoundé, two cities of Cameroon country. We show how variations of climatic factors such as temperature and relative humidity affect the malaria spread. We propose a meta-population model of the dynamic transmission of malaria that evolves in space and time and that takes into account temperature and relative humidity and the migration between Douala and Yaoundé. We also integrate the variation of environmental factors as events also called mathematical impulsion that can disrupt the model evolution at any time. Our modelling has been done using the Discrete EVents System Specification (DEVS) formalism. Our implementation has been done on Virtual Laboratory Environment (VLE) that uses DEVS formalism and abstract simulators for coupling models by integrating the concept of DEVS.

Keywords: compartmental models, DEVS, discrete events, meta-population model, VLE

Procedia PDF Downloads 537

Authors: Shahlan Surat, Saemah Rahman, Saadiah Kummin

Abstract:

When teachers reflect and evaluate whether their teaching methods actually have an impact on students’ learning, they will adjust their practices accordingly. This inevitably improves their students’ learning and performance. The approach in meta-teaching can invigorate and create a passion for teaching. It thus helps to increase the commitment and love for the teaching profession. This study was conducted to determine the level of metacognitive thinking of teachers in the process of teaching and learning in the classroom. Metacognitive thinking teachers include the use of metacognitive knowledge which consists of different types of knowledge: declarative, procedural and conditional. The ability of the teachers to plan, monitor and evaluate the teaching process can also be determined. This study was conducted on 377 graduate teachers in Klang Valley, Malaysia. The stratified sampling method was selected for the purpose of this study. The metacognitive teaching inventory consisting of 24 items is called InKePMG (Teacher Indicators of Effectiveness Meta-Teaching). The results showed the level of mean is high for two components of metacognitive knowledge; declarative knowledge (mean = 4.16) and conditional (mean = 4.11) whereas, the mean of procedural knowledge is 4.00 (moderately high). Similarly, the level of knowledge in monitoring (mean = 4.11), evaluating (mean = 4.00) which indicate high score and planning (mean = 4.00) are moderately high score among teachers. In conclusion, this study shows that the planning and procedural knowledge is an important element in improving the quality of teachers teaching in the classroom. Thus, the researcher recommended that further studies should focus on training programs for teachers on metacognitive skills and also on developing creative thinking among teachers.

Keywords: metacognitive thinking skills, procedural knowledge, conditional knowledge, meta-teaching and regulation of cognitive

Procedia PDF Downloads 390

Authors: Merkineh Markos Lorato, Gedefaw Diress Alene

Abstract:

Introduction: Visual impairment is any condition of the eye or visual system that results in loss/reduction of visual functioning. It significantly influences the academic routine and social activities of children, and the effect is severe for low-income countries like Ethiopia. So, this study aimed to determine the pooled prevalence of visual impairment among school children in Ethiopia. Methods: Databases such as Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBASE, World Wide Web of Science, and Cochrane Library searched to retrieve eligible articles. In addition, Google Scholar and a reference list of the retrieved eligible articles were addressed. Studies that reported the prevalence of visual impairment were included to estimate the pooled prevalence. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and analysis was held using STATA 11 statistical software. I² was used to assess the heterogeneity. Because of considerable heterogeneity, a random effect meta-analysis model was used to estimate the pooled prevalence of visual impairment among school children in Ethiopia. Results: The result of 9 eligible studies showed that the pooled prevalence of visual impairment among school children in Ethiopia was 7.01% (95% CI: 5.46, 8.56%). In the subgroup analysis, the highest prevalence was reported in South Nations Nationalities and Tigray region together (7.99%; 3.63, 12.35), while the lowest prevalence was reported in Addis Ababa (5.73%; 3.93, 7.53). Conclusion: The prevalence of visual impairment among school children is significantly high in Ethiopia. If it is not detected and intervened early, it will cause a lifetime threat to visually impaired school children, so that school vision screening program plan and its implementation may cure the life quality of future generations in Ethiopia.

Keywords: visual impairment, school children, Ethiopia, prevalence

Procedia PDF Downloads 14

Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

Abstract:

Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

Procedia PDF Downloads 115

Authors: Monica Trifitriana, Rido Mulawarman

Abstract:

Introduction: Androgenetic alopecia (AGA) is a genetically predetermined disorder due to an excessive response to dihydrotestosterone (DHT). Currently, non-surgical treatment of androgenetic alopecia is more in demand by the patient. There are many non-surgical treatments, ranging from topical treatments oral medications, and procedure treatments. Objective: We aim to assess the latest evidence of the efficacy of non-surgical treatments of androgenetic alopecia in men in comparison to placebo for improving hair density, thickness, and growth. Method: We performed a comprehensive search on topics that assess non-surgical treatments of androgenetic alopecia in men from inception up until November 2021. Result: There were 24 studies out of a total of 2438 patients divided into five non-surgical treatment groups to assess the effectiveness of hair growth, namely: minoxidil 2% (MD: 8.11 hairs/cm²), minoxidil 5% (MD: 12.02 hairs/cm²), low-level laser light therapy/LLLT (MD: 12.35 hairs/cm²), finasteride 1mg (MD: 20.43 hairs/cm²), and Platelete-Rich Plasma/PRP with microneedling (MD: 26.33 hairs/cm²). All treatments had significant results for increasing hair growth, particularly in cases of androgenetic alopecia in men (P<0.00001). Conclusion: From the results, it was found that the five non-surgical treatment groups proved to be effective and significant for hair growth, particularly in cases of androgenetic alopecia in men. In order of the best non-surgical treatment for hair growth is starting from PRP with microneedling, Finasteride 1mg, LLLT, minoxidil 5%, to minoxidil 2%.

Keywords: androgenetic alopecia, non-surgical, men, meta-analysis, systematic review

Procedia PDF Downloads 137

Authors: Sofiane Bououden, Ilyes Boulkaibet

Abstract:

In terms of security of the information signal, the meta-heuristic Penguins Search Optimization Algorithm (PeSOA) is applied to synchronize chaotic encryption communications in the case of sensitive dependence on initial conditions in chaotic generator oscillator. The objective of this paper is the use of the PeSOA algorithm to exploring search space with random and iterative processes for synchronization of symmetric keys in both transmission and reception. Simulation results show the effectiveness of the PeSOA algorithm in generating symmetric keys of the encryption process and synchronizing.

Keywords: meta-heuristic, PeSOA, chaotic systems, encryption, synchronization optimization

Procedia PDF Downloads 175

Authors: Ibrahim Nadeem, Mohammed Rahman, Yasser Ad-Dab’Bagh, Mahmood Akhtar

Abstract:

Depression is one of the most prevalent mental illnesses and is often associated with various other medical disorders. In this review, we aim to evaluate existing systematic reviews that investigate the use of probiotics as a treatment for depressive symptoms. Five online databases were searched for relevant studies up to December 2017. Systematic reviews that included randomized controlled trials assessing the efficacy of probiotics in the treatment of depressive symptoms were included. Seven systematic reviews met the inclusion criteria. Three of these reviews conducted meta-analyses, out of which, two found probiotics to significantly improve depressive symptoms in the sample population. Two meta-analyses conducted subgroup analysis based on health status, and both found probiotics to significantly decrease depressive symptoms in patients with major depressive disorder, but only one review found it to significantly decrease in healthy patients. Another subgroup analysis was conducted based on age, and found probiotics to produce significant effects on subjects under the age of 60, but close to no effect on patients over the age of 65. Out of the four reviews that conducted qualitative analysis, three reviews concluded that probiotics have the potential to be used as a treatment. Due to the differences in clinical trials, a definitive effect of probiotics on depressive symptoms cannot be concluded. Nonetheless, probiotics seem to produce a significant therapeutic effect for subjects with pre-existing depressive symptoms. Further studies are warranted for definitive conclusions.

Keywords: depression, gut-brain axis, gut microbiota, probiotic, psychobiotic

Procedia PDF Downloads 119

Authors: Lebeza Alemu Tenaw, Fei Wan Ngai

Abstract:

Background: Postpartum depression is the most common mental health disorder that occurs after childbirth, and it is more prevalent among teenage mothers compared to adults. Although there is emerging evidence suggesting psychosocial interventions can decrease postpartum depression, there are no consistent findings regarding the effectiveness of these interventions, especially for teenage mothers. The current review aimed to investigate the effectiveness of psychosocial interventions in preventing postpartum depression among teenage mothers. Methods: The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) manual was implemented to select articles from online databases. The articles were searched using the Population, Intervention, Control, and Outcome (PICO) model. The quality of the articles was assessed using the Cochrane Collaboration Risk of Bias assessment tool. The statistical analyses were performed using Stata 17, and the effect size was estimated using the standard mean difference score of depression between the intervention and control groups. Heterogeneity between the studies was assessed through the I2 statistic and Q statistic, while the publication bias was evaluated using the asymmetry of the funnel plot and Egger's test. Results: In this systematic review, a total of nine articles were included. While psychosocial interventions demonstrated in reducing the risk of postpartum depression compared to usual maternal care, it is important to note that the mean difference score of depression was significant in only three of the included studies. The overall meta-analysis finding revealed that psychosocial interventions were effective in preventing postpartum depression, with a pooled effect size of -0.5 (95% CI: -0.95, -0.06) during the final time postpartum depression assessment. The heterogeneity level was found to be substantial, with an I2 value of 82.3%. However, no publication bias was observed. Conclusion: The review findings suggest that psychosocial interventions initiated during the late antenatal and early postnatal periods effectively prevent postpartum depression. The interventions were found to be more beneficial during the first three months of the postpartum period. However, this review also highlighted that there is a scarcity of interventional studies conducted in low-income countries, indicating the need for further studies in diverse communities.

Keywords: teenage pregnancy, postpartum depression, review

Procedia PDF Downloads 31

Authors: Xu Feifei

Abstract:

The prevalence of COVID-19 currently is the biggest challenge to improving people's quality of life. Its impact on the health-related quality of life (HRQoL) is highly uncertain and has not been summarized so far. The aim of the present systematic review was to assess and provide an up-to-date analysis of the impact of the COVID-19 pandemic on the HRQoL of participants who have been infected, have not been infected but isolated, frontline, with different diseases, and the general population. Therefore, an electronic search of the literature in PubMed databases was performed from 2019 to July 2022 (without date restriction). PRISMA guideline methodology was employed, and data regarding the HRQoL were extracted from eligible studies. Articles were included if they met the following inclusion criteria: (a) reports on the data collection of the health state utility values (HSUVs) related to COVID-19 from 2019 to 2021; (b) English language and peer-reviewed journals; and (c) original HSUV data; (d) using EQ-5D tool to quantify the HRQoL. To identify studies that reported the effects on COVID-19, data on the proportion of overall HSUVs of participants who had the outcome were collected and analyzed using a one-group meta-analysis. As a result, thirty-two studies fulfilled the inclusion criteria and, therefore, were included in the systematic review. A total of 45295 participants and provided 219 means of HSUVs during COVID-19 were included in this systematic review. The range of utility is from 0.224 to 1. The study included participants from Europe (n=16), North America (n=4), Asia (n=10), South America (n=1), and Africa (n=1). Twelve articles showed that the HRQoL of the participants who have been infected with COVID-19 (range of overall HSUVs from 0.6125 to 0.863). Two studies reported the population of frontline workers (the range of overall HSUVs from 0.82 to 0.93). Seven of the articles researched the participants who had not been infected with COVID-19 but suffered from morbidities during the pandemic (range of overall HSUVs from 0.5 to 0.96). Thirteen studies showed that the HRQoL of the respondents who have not been infected with COVID-19 and without any morbidities (range of overall HSUVs from 0.64 to 0.964). Moreover, eighteen articles reported the outcomes of overall HSUVs during the COVID-19 pandemic in different population groups. The estimate of overall HSUVs of direct COVID-19 experience population (n=1333) was 0.751 (95% CI 0.670 - 0.832, I2 = 98.64%); the estimate of frontline population (n=610) was 0.906 ((95% CI 0.854 – 0.957, I2 = 98.61%); participants with different disease (n=132) were 0.768 (95% CI 0.515 - 1.021, I2= 99.26%); general population without infection history (n=29,892) was 0.825 (95% CI 0.766 - 0.885, I2 =99.69%). Conclusively, taking into account these results, this systematic review might confirm that COVID-19 has a negative impact on the HRQoL of the infected population and illness population. It provides practical value for cost-effectiveness model analysis of health states related to COVID-19.

Keywords: COVID-19, health-related quality of life, meta-analysis, systematic review, utility value

Procedia PDF Downloads 63

Authors: Ladda Her, Juntip Kanjanasilp, Ratree Sawangjit, Nathorn Chaiyakunapruk

Abstract:

Cough is the common symptom of the respiratory tract infections or non-infections; the duration of cough indicates a classification and severity of disease. Herbal medicines can be used as the alternative to drugs for relief of cough symptoms from acute and chronic disease. Eucalyptus was used for reducing cough with evidences suggesting it has an active role in reduction of airway inflammation. The present study aims to evaluate efficacy and safety of eucalyptus for relief of cough symptom in respiratory disease. Method: The Cochrane Library, MEDLINE (PubMed), Scopus, CINAHL, Springer, Science direct, ProQuest, and THAILIS databases. From its inception until 01/02/2019 for randomized control trials. We follow for the efficacy and safety of eucalyptus for reducing cough. Methodological quality was evaluated by using the Cochrane risk of bias tool; two reviewers in our team screened eligibility and extracted data. Result: Six studies were included for the review and five studies were included in the meta-analysis, there were 1.911 persons including children (n: 1) and adult (n: 5) studies; for study in children and adult were between 1 and 80 years old, respectively. Eucalyptus was used as mono herb (n: 2) and in combination with other herbs form (n: 4). All of the studies with eucalyptus were compared for efficacy and safety with placebo or standard treatment, Eucalyptus dosage form in studies included capsules, spray, and syrup. Heterogeneity was 32.44 used random effect model (I² = 1.2%, χ² = 1.01; P-value = 0.314). The efficacy of eucalyptus was showed a reduced cough symptom statistically significant (n = 402, RR: 1.40, 95%CI [1.19, 1.65], P-value < 0.0001) when compared with placebo. Adverse events (AEs) were reported mild to moderate intensity with mostly gastrointestinal symptom. The methodological quality of the included trials was overall poor. Conclusion: Eucalyptus appears to be beneficial and safe for relieving in respiratory diseases focus on cough frequency. The evidence was inconclusive due to limited quality trial. Well-designed trials for evaluating the effectiveness in humans, the effectiveness for reducing cough symptom in human is needed. Eucalyptus had safety as monotherapy or in combination with other herbs.

Keywords: cough, eucalyptus, cineole, herbal medicine, systematic review, meta-analysis

Procedia PDF Downloads 133

Authors: Desta Brhanu Gebrehiwot

Abstract:

The purpose of this review was to analyze the overall or combined effect of scholarly studies conducted on the impacts of Food for work (FFW) and Productive Safety Net Program (PSNP) on farm households’ livelihood (agricultural investment on the adoption of fertilizer, food security, livestock holding, nutrition and its’ disincentive effect) in Ethiopia. In addition, to make a critical assessment of the internal and external validity of the existing studies, the review also indicates the possibility to redesign the program. The method of selecting eligible studies for review was PICOS (Participants, Intervention, Comparison, Outcomes, and Settings) framework. The method of analysis was the fixed effects model under Meta-Analysis. The findings of this systematic review confirm the overall or combined positive significant impact of PSNP on fertilizer adoption (combined point estimate=0.015, standard error=0.005, variance=0.000, lower limit 0.004 up to the upper limit=0.026, z-value=2.726, and p-value=0.006). And the program had a significant positive impact on the child nutrition of rural households and had no significant disincentive effect. However, the program had no significant impact on livestock holdings. Thus, PSNP is important for households whose livelihood depends on rain-fed agriculture and are exposed to rainfall shocks. Thus, better to integrate the program into the national agricultural policy. In addition, most of the studies suggested that PSNP needs more attention to the design and targeting issued in order to be effective and efficient in social protection.

Keywords: meta-analysis, fixed effect model, PSNP, rural-livelihood, Ethiopia

Procedia PDF Downloads 47

Authors: Getenet Dessie, Jinhu Li, Son Nghiem, Tinh Doan

Abstract:

Background: Concerns regarding malnutrition have evolved from focusing solely on single forms to addressing the simultaneous occurrence of multiple types, commonly referred to as the double or triple burden of malnutrition. Nevertheless, data concerning the concurrent occurrence of various types of malnutrition are scarce. Therefore, this systematic review and meta-analysis aims to assess the pooled prevalence of the double burden of malnutrition among children under five in Sub-Saharan Africa and other least-developed countries (LDCs). Methods: Electronic, web-based searches were conducted from January 15 to June 28, 2023, across several databases, including PubMed, Embase, Google Scholar, and the World Health Organization's Hinari portal, as well as other search engines, to identify primary studies published up to June 28, 2023. Laboratory-based cross-sectional studies on children under the age of five were included. Two independent authors assessed the risk of bias and the quality of the identified articles. The primary outcomes of this study were micronutrient deficiencies and the comorbidity of stunting and anemia, as well as wasting and anemia. The random-effects model was utilized for analysis. The association of identified variables with the various forms of malnutrition was also assessed using adjusted odds ratios (AOR) with a 95% confidence interval (CI). This review was registered in PROSPERO with the reference number CRD42023409483. Findings: The electronic search generated 6,087 articles, 93 of which matched the inclusion criteria for the final meta-analysis. Micronutrient deficiencies were prevalent among children under five in Sub-Saharan Africa and other LDCs, with rates ranging from 16.63% among 25,169 participants for vitamin A deficiency to 50.90% among 3,936 participants for iodine deficiency. Iron deficiency anemia affected 20.56% of the 63,121 participants. The combined prevalence of wasting anemia and stunting anemia was 5.41% among 64,709 participants and 19.98% among 66,016 participants, respectively. Both stunting and vitamin A supplementation were associated with vitamin A and iron deficiencies, with adjusted odds ratios (AOR) of 1.54 (95% CI: 1.01, 2.37) and 1.37 (95% CI: 1.21, 1.55), respectively. Interpretation: The prevalence of the double burden of malnutrition among children under the age of five was notably high in Sub-Saharan Africa and other LDCs. These findings indicate a need for increased attention and a focus on understanding the factors influencing this double burden of malnutrition.

Keywords: children, Sub-Saharan Africa, least developed countries, double burden of malnutrition, systematic review, meta-analysis

Procedia PDF Downloads 57

Authors: Emmanuel Uba, Lily Chimuanya, Maryam Tar

Abstract:

Orthographic engineering is no longer the preserve of the Short Messaging Service (SMS), which is characterised by limited space. Such stylistic creativity or deviation is fast creeping into real-time messaging, popularly known as Instant Messaging (IM), despite the large number of characters allowed. This occurs at various linguistic levels: phonology, morphology, syntax, etc. Nigerians are not immune to this linguistic stylisation. This study investigates the phonological and meta-phonological conventions of the messages sent and received via WhatsApp by Nigerian graduates. This is ontological study of 250 instant messages collected from 98 graduates from different ethnic groups in Nigeria. The selection and analysis of the messages are based on figure and ground principle. The results reveal the use of accent stylisation, phoneme substitution, blending, consonantisation (a specialised form of deletion targeting vowels), numerophony (using a figure/number, usually 1-10, to represent a word or syllable that has the same sound) and phonetic respelling in the IMs sent by Nigerians. The study confirms the existence of linguistic creativity.

Keywords: figure and ground principle, instant messaging, linguistic stylisation, meta-phonology

Procedia PDF Downloads 371

Authors: Rami Hashish, Manon Limousis-Gayda, Caitlin McCleery

Abstract:

Introduction: Mild traumatic brain injuries, also referred to as concussions, represent an increasing burden to society. Due to limited objective diagnostic measures, concussions are diagnosed by assessing subjective symptoms, often leading to disputes to their presence. Common biomechanical measures associated with concussion are high linear and/or angular acceleration to the head. With regards to linear acceleration, approximately 80g’s has previously been shown to equate with a 50% probability of concussion. Motor vehicle collisions (MVCs) are a leading cause of concussion, due to high head accelerations experienced. The change in velocity (delta-V) of a vehicle in an MVC is an established metric for impact severity. As acceleration is the rate of delta-V with respect to time, the purpose of this paper is to determine the relation between delta-V (and occupant parameters) with linear head acceleration. Methods: A meta-analysis was conducted for manuscripts collected using the following keywords: head acceleration, concussion, brain injury, head kinematics, delta-V, change in velocity, motor vehicle collision, and rear-end. Ultimately, 280 studies were surveyed, 14 of which fulfilled the inclusion criteria as studies investigating the human response to impacts, reporting head acceleration, and delta-V of the occupant’s vehicle. Statistical analysis was conducted with SPSS and R. The best fit line analysis allowed for an initial understanding of the relation between head acceleration and delta-V. To further investigate the effect of occupant parameters on head acceleration, a quadratic model and a full linear mixed model was developed. Results: From the 14 selected studies, 139 crashes were analyzed with head accelerations and delta-V values ranging from 0.6 to 17.2g and 1.3 to 11.1 km/h, respectively. Initial analysis indicated that the best line of fit (Model 1) was defined as Head Acceleration = 0.465

Keywords: acceleration, brain injury, change in velocity, Delta-V, TBI

Procedia PDF Downloads 209

Authors: Trevor R. Higgins

Abstract:

To speed/enhance recovery from sport, cold water immersion (CWI) and contrast water therapy (CWT) have become common practice within the high-level team sport. Initially, research into CWI and CWT protocols and recovery was sparse; athletes relied solely upon an anecdotal support. However, an increase into recovery research has occurred. A number of reviews have subsequently been conducted to clarify scientific evidence. However, as the nature of physiological stress and training status of participants will impact on results, an opportunity existed to narrow the focus to a more exacting review evaluating hydrotherapy for recovery in a team sport. A Boolean logic [AND] keyword search of databases was conducted: SPORTDiscus; AMED; CINAHL; MEDLINE. Data was extracted and the standardized mean differences were calculated with 95% CI. The analysis of pooled data was conducted using a random-effect model, with Heterogeneity assessed using I2. 23 peer reviewed papers (n=606) met the criteria. Meta-analyses results indicated CWI was likely beneficial for recovery at 24h (Countermovement Jump (CMJ): p= 0.05, CI -0.004 to 0.578; All-out sprint: p=0.02, -0.056 to 0.801; DOMS: p=0.08, CI -0.092 to 1.936) and at 72h (accumulated sprinting: p=0.07, CI -0.062 to 1.209; DOMS: p=0.09, CI -0.121 to 1.555) following team sport. Whereas CWT was likely beneficial for recovery at 1h (CMJ: p= 0.07, CI -0.004 to 0.863) and at 48h (fatigue: p=0.04, CI 0.013 to 0.942) following team sport. Athlete’s perceptions of muscle soreness and fatigue are enhanced with CWI and/or CWT, however even though CWI and CWT were beneficial in attenuating decrements in neuromuscular performance 24 hours following team sport, indications are those benefits were no longer Sydney evident 48 hours following team sport.

Keywords: cold water immersion, contrast water therapy, recovery, team sport

Procedia PDF Downloads 488

Authors: Adriana C. Panayi, Riaz A. Agha, Brady A. Sieber, Dennis P. Orgill

Abstract:

Background: Increased rates of both breast cancer and obesity have resulted in more women seeking breast reconstruction. These women may be at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who have undergone breast reconstruction following mastectomy. Methods: Cochrane, PUBMED and EMBASE electronic databases were screened and data was extracted from included studies. The clinical outcomes assessed were surgical complications, medical complications, length of postoperative hospital stay, reoperation rate and patient satisfaction. Results: 33 studies met the inclusion criteria for the review and 29 provided enough data to be included in the meta-analysis (71368 patients, 20061 of which were obese). Obese women were 2.3 times more likely to experience surgical complications (95 percent CI 2.19 to 2.39; P < 0.00001), 2.8 times more likely to have medical complications (95 percent CI 2.41 to 3.26; P < 0.00001) and had a 1.9 times higher risk of reoperation (95 percent CI 1.75 to 2.07; P < 0.00001). The most common complication, wound dehiscence, was 2.5 times more likely in obese women (95 percent CI 1.80 to 3.52; P < 0.00001). Sensitivity analysis confirmed that obese women were more likely to experience surgical complications (RR 2.36, 95% CI 2.22–2.52; P < 0.00001). Conclusions: This study provides evidence that obesity increases the risk of complications in both implant and autologous reconstruction. Additional prospective and observational studies are needed to determine if weight reduction prior to reconstruction reduces the perioperative risks associated with obesity.

Keywords: autologous reconstruction, breast cancer, breast reconstruction, literature review, obesity, oncology, prosthetic reconstruction

Procedia PDF Downloads 284

Authors: Frieda Amitai

Abstract:

The field of Translation Studies includes both descriptive and applied aspects, one of which is developing curricula. Within this topic there are theories dealing with curricula aimed at translator training, and theories meant to explore teaching translation as means through which awareness to language is developed in order to enhance language knowledge. An example of the latter is a unique study program in Israeli high schools – Teaching Translation Skills Program (TTSP). This study program has been taught in Israel for more than two decades and is aimed at raising students' meta-linguistic awareness as well as their language proficiency in both source language and target language in order to enable them become better language learners. The objective of the current research was to examine whether the goals of this program are achieved – increase in students' metalinguistic awareness and language proficiency. A follow-up case study was aimed at examining the level of proficiency which would develop most by this way of teaching English. The study was conducted in two stages – before and after participating in the program. 400 subjects took part in the first stage, and 100 took part in the second. In both parts of the study, participants were given the same five tasks in both Hebrew and English in addition to a questionnaire, in which they were asked about their own knowledge of Hebrew and in comparison to that of their peers. Their teachers were asked about the success of the program and about the methodology they use in class. Findings show significant change in the level of meta-linguistic awareness of the students as well as their language proficiency. A comparison between their answers before and after the program shows that their meta-linguistic awareness increased, as did their ability to recognize linguistic mistakes. These findings serve as strong evidence for the positive effect such study program has on the development of meta-linguistic awareness and linguistic knowledge. The follow-up case study tests the change among weaker language learners.

Keywords: comparison, metalinguistic awareness, language learning, translation skills

Procedia PDF Downloads 339

Authors: Rihab Hentati, Younes Boujelbene

Abstract:

Nowadays we realize more and more than the value of a company is not only a function of its means of production but depends essentially on the managerial aptitude and orientation to implement the material and human means for generating profitability. Indeed, a productive R&D activity, a good strategy, and innovation are originally supplementary benefits that increase the value of the business. Is this ‘value-added’ closely linked to innovation? The purpose of our research is to Meta-analyze the results of 56 empirical studies in order to explain the overall effect of innovation on performance of small and medium-sized enterprises. In order to justify the differences in the results, we look for the moderating factors that may affect the innovation-performance relationship. We find a positive and significant relationship between innovation and performance in small and medium-sized enterprises. The results also note a positive relationship between entrepreneurial orientation, research and development (R&D), and performance in SMEs. In addition, innovation has a strong impact on performance measured both with accounting and market index. The originality of the article is based on a rigorous synthesis, based on several statistical tools, of an important subject of research in finance.

Keywords: innovation, performance, entrepreneurial orientation, meta-analysis, moderator variables

Procedia PDF Downloads 263

Authors: Guilherme Baldo Carlos

Abstract:

The flexible job-shop scheduling problem (FJSP) is an NP-hard combinatorial optimization problem, which can be applied to model several applications in a wide array of industries. This problem will have its importance increase due to the shift in the production mode that modern society is going through. The demands are increasing and for products personalized and customized. This work aims to apply a meta-heuristic called a genetic algorithm (GA) to solve this problem. A GA is a meta-heuristic inspired by the natural selection of Charles Darwin; it produces a population of individuals (solutions) and selects, mutates, and mates the individuals through generations in order to find a good solution for the problem. The results found indicate that the GA is suitable for FJSP solving.

Keywords: genetic algorithm, evolutionary algorithm, scheduling, flexible job-shop scheduling

Procedia PDF Downloads 126

Authors: Fangfang Wang, Tianjing Wang, Leyi Fu, Feng Yun, Ningning Xie, Jue Zhou, Fan Qu

Abstract:

Background: Ferroptosis, a recently discovered form of programmed cell death characterized by iron-dependent lipid peroxidation, may be linked to polycystic ovary syndrome (PCOS). Diseases marked by iron overload have been correlated with ferroptosis. Coincidently, investigations have revealed anomalies in iron metabolism among women with PCOS; however, there were inconsistencies in the evidence. Objective and Rationale: This review aimed to comprehensively explore the potential relationship between ferroptosis and PCOS by investigating the differences in iron metabolism among women with PCOS in comparison to a control group. Additionally, a narrative synthesis was provided on the past research status regarding the association between PCOS and ferroptosis. Methods: A systematic search of the literature was performed using PubMed, Embase, Web of Science from inception up to December 2022. Search terms relating to assisted PCOS, ferroptosis, and iron metabolism were used. PRISMA guidance was followed. RevMan 5.4 was utilized for conducting the meta-analysis, wherein the investigated outcomes included iron status (ferritin, iron, transferrin saturation) and a systemic iron-regulatory hormone (hepcidin). A narrative synthesis was performed to explore the correlation between PCOS and ferroptosis. Results: In the meta-analysis comprising a total of 16 studies, significant differences in serum ferritin levels between the PCOS group and the control group were observed (15 studies, standardized mean difference (SMD): 0.41, 95% CI: 0.22 to 0.59, P<0.01). This indicates elevated serum ferritin levels in PCOS patients compared to women without PCOS. The transferrin saturation in PCOS patients was significantly higher than that in the control group (3 studies, mean difference (MD): 4.39, 95% CI: 1.67 to 7.11, P<0.01). Regarding serum iron (6 studies, SMD: 0.05, 95% CI: -0.24 to 0.33, P=0.75) and serum hepcidin (4 studies, SMD: -0.44, 95% CI: -1.41 to 0.52, P=0.37), no statistically significant differences were observed between the PCOS group and the control group. Other studies have found that ferroptosis is involved in the occurrence and development of PCOS, offering valuable insights for guiding potential treatment measures and prognosis evaluation of PCOS. In addition, ferroptosis is involved in the miscarriage of PCOS-like rats; thus, controlling ferroptosis might improve pregnancy outcomes in PCOS. Conclusions: The observation of a significant elevation in serum ferritin and transferrin saturation levels in women with PCOS may suggest an underlying disturbance in iron metabolism, potentially inducing the activation of ferroptosis. Further research is imperative to elucidate the underlying pathophysiology, providing insights for potential preventive measures and therapeutic strategies. Limitation: There are some limitations as follows: First, due to limited extractable information, we excluded purely abstract publications and non-English publications. Second, the majority of original articles were case-control studies, making it difficult to determine the causal relationship between iron metabolism abnormalities and the onset of PCOS. Third, there is substantial heterogeneity in the definition of PCOS.

Keywords: polycystic ovary syndrome, ferroptosis, iron metabolism, systematic review and meta-analysis

Procedia PDF Downloads 32

Authors: E. H. Walsh, J. McMahon, M. P. Herring

Abstract:

Post-primary school-based suicide prevention (PSSP) is a valuable avenue to reduce suicidal behaviours in adolescents. The aims of this meta-analysis and meta-regression were 1) to quantify the effect of PSSP interventions on adolescent suicide ideation (SI) and suicide attempts (SA), and 2) to explore how intervention effects may vary based on important contextual and intervention factors. This study provides further support to the benefits of PSSP by demonstrating lower suicide outcomes in over 30,000 adolescents following PSSP and mental health interventions and tentatively suggests that intervention effectiveness may potentially vary based on intervention factors. The protocol for this study is registered on PROSPERO (ID=CRD42020168883). Population, intervention, comparison, outcomes, and study design (PICOs) defined eligible studies as cluster randomised studies (n=12) containing PSSP and measuring suicide outcomes. Aggregate electronic database EBSCO host, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched. Cochrane bias tools for cluster randomised studies demonstrated that half of the studies were rated as low risk of bias. The Egger’s Regression Test adapted for multi-level modelling indicated that publication bias was not an issue (all ps > .05). Crude and corresponding adjusted pooled log odds ratios (OR) were computed using the Metafor package in R, yielding 12 SA and 19 SI effects. Multi-level random-effects models accounting for dependencies of effects from the same study revealed that in crude models, compared to controls, interventions were significantly associated with 13% (OR=0.87, 95% confidence interval (CI), [0.78,0.96], Q18 =15.41, p=0.63) and 34% (OR=0.66, 95%CI [0.47,0.91], Q10=16.31, p=0.13) lower odds of SI and SA, respectively. Adjusted models showed similar odds reductions of 15% (OR=0.85, 95%CI[0.75,0.95], Q18=10.04, p=0.93) and 28% (OR=0.72, 95%CI[0.59,0.87], Q10=10.46, p=0.49) for SI and SA, respectively. Within-cluster heterogeneity ranged from no heterogeneity to low heterogeneity for SA across crude and adjusted models (0-9%). No heterogeneity was identified for SI across crude and adjusted models (0%). Pre-specified univariate moderator analyses were not significant for SA (all ps < 0.05). Variations in average pooled SA odds reductions across categories of various intervention characteristics were observed (all ps < 0.05), which preliminarily suggests that the effectiveness of interventions may potentially vary across intervention factors. These findings have practical implications for researchers, clinicians, educators, and decision-makers. Further investigation of important logical, theoretical, and empirical moderators on PSSP intervention effectiveness is recommended to establish how and when PSSP interventions best reduce adolescent suicidal behaviour.

Keywords: adolescents, contextual factors, post-primary school-based suicide prevention, suicide ideation, suicide attempts

Procedia PDF Downloads 83

Authors: Saeed Pourhassan, Nastaran Maghbouli

Abstract:

Statement of the problem: The relationship between obesity and cardiovascular diseases has been studied widely(1). The distribution of fat tissue gained attention in relation to cardiovascular risk factors during lang-time research (2). American College of Cardiology/American Heart Association (ACC/AHA) is widely and the most reliable tool to be used as a cardiovascular risk (CVR) assessment tool(3). This study aimed to determine which anthropometric index is better in discrimination of high CVR patients from low risks using ACC/AHA score in addition to finding the best index as a CVR predictor among both genders in different races and countries. Methodology & theoretical orientation: The literature in PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched by two independent investigators using the keywords "anthropometric indices," "cardiovascular risk," and "obesity." The search strategy was limited to studies published prior to Jan 2022 as full-texts in the English language. Studies using ACC/AHA risk assessment tool as CVR and those consisted at least 2 anthropometric indices (ancient ones and novel ones) are included. Study characteristics and data were extracted. The relative risks were pooled with the use of the random-effect model. Analysis was repeated in subgroups. Findings: Pooled relative risk for 7 studies with 16,348 participants were 1.56 (1.35-1.72) for BMI, 1.67(1.36-1.83) for WC [waist circumference], 1.72 (1.54-1.89) for WHR [waist-to-hip ratio], 1.60 (1.44-1.78) for WHtR [waist-to-height ratio], 1.61 (1.37-1.82) for ABSI [A body shape index] and 1.63 (1.32-1.89) for CI [Conicity index]. Considering gender, WC among females and WHR among men gained the highest RR. The heterogeneity of studies was moderate (α²: 56%), which was not decreased by subgroup analysis. Some indices such as VAI and LAP were evaluated just in one study. Conclusion & significance: This meta-analysis showed WHR could predict CVR better in comparison to BMI or WHtR. Some new indices like CI and ABSI are less accurate than WHR and WC. Among women, WC seems to be a better choice to predict cardiovascular disease risk.

Keywords: obesity, cardiovascular disease, risk assessment, anthropometric indices

Procedia PDF Downloads 84

Authors: R. Alothaim, T. Mishra

Abstract:

Different researchers have reviewed the gender wage gap since early days between women and men to point out their difference to help bring about equality in production among them. Many fingers have been pointed out towards culture and religion as one of the major factors contributing to the gender wage gap throughout the years passed. Recent research has been done to give out equalization to this gap between men and women. The gender wage gap has raised serious concerns among nations and societies. Additionally, data, methodology and time periods have been affected by the gender wage gap, thus needing special decision making to help in the meta-study in the provision of quantitative review. Quality indicators have played a crucial role towards the education through stressing on enough consideration to help give a solution of equality and worth in the research study. The different research reviewed have given enough evidence and impact to point out that the major causes of this gender wage gap has resulted due to culture. On the other pedestal, religion may play a role to the issues of gender wage gap but with more emphasis on culture playing the bigger part. Furthermore, social status of individual has contributed to the wage gap difference between men and women. Labor market has played a vital role in empowering women, leading to the lower rate of the raw wage difference in the recent years.

Keywords: culture, gender wage gap, social, religion

Procedia PDF Downloads 98

Authors: Chia-Chen Hsieh, Fei-Hsiu Hsiao

Abstract:

Objective: To examine the effects of supportive care interventions on depressive symptoms in patients with lung cancer. Methods: The databases of Cochrane Central Register of Controlled Trials (CENTRAL), Ovid EMBASE, PubMed, and Chinese Electronic Periodical Services (CEPS) were searched from their inception until September 2015. We included the studies with randomized controlled trial design that compared standard care with supportive care interventions using psychotherapeutic or exercises approach. The standardized mean differences (SMD) (Cohen’s d) were calculated to estimate the treatment effects. The Cochrane Risk of Bias Tool was used for quality assessment and subgroup analysis was conducted to identify possible sources of heterogeneity. Results: A total of 1472 patients with lung cancer were identified. Compared with standard care, the overall effects of all supportive care interventions significantly reduced depressive symptoms (SMD = -0.74 with 95% CI = -1.07 to -0.41), and the effect was maintained at the 4th, 8th, and 12th weeks of follow-up. Either psychotherapy combined with psychoeducation or exercise alone produced significant improvements in depressive symptoms, while psychoeducation alone did not. The greater improvements in depressive symptoms occurred in lung cancer patients with severe depressive symptoms at baseline, total duration of interventions of less than ten weeks, and intervention provided through face-to-face delivery. Conclusions: Psychotherapy combined with psychoeducation can help patients manage the causes of depressive symptoms, including both symptom distress and psychological trauma due to lung cancer. Exercise can target the impaired respiratory function that is a cause of depressive symptoms in lung cancer patients.

Keywords: supportive care intervention, depressive symptoms, lung cancer, meta-analysis

Procedia PDF Downloads 280

Authors: Dimitrios Ntardas, Alexandros Tzanetos, Georgios Dounias

Abstract:

High Voltage Substations (HVS) are the intermediate step between production of power and successfully transmitting it to clients, making them one of the most important checkpoints in power grids. Nowadays - renewable resources and consequently distributed generation are growing fast, the construction of HVS is of high importance both in terms of quality and time completion so that new energy producers can quickly and safely intergrade in power grids. The resources needed, such as machines and workers, should be carefully allocated so that the construction of a HVS is completed on time, with the lowest possible cost (e.g. not spending additional cost that were not taken into consideration, because of project delays), but in the highest quality. In addition, there are milestones and several checkpoints to be precisely achieved during construction to ensure the cost and timeline control and to ensure that the percentage of governmental funding will be granted. The management of such a demanding project is a NP-hard problem that consists of prerequisite constraints and resource limits for each task of the project. In this work, a hybrid meta-heuristic method is implemented to solve this problem. Meta-heuristics have been proven to be quite useful when dealing with high-dimensional constraint optimization problems. Hybridization of them results in boost of their performance.

Keywords: hybrid meta-heuristic methods, substation construction, resource allocation, time-cost efficiency

Procedia PDF Downloads 132

Authors: Simin Shahvazi, Sepideh Soltani, Seyed Mehdi Ahmadi, Russell J. De Souza, Amin Salehi-Abargouei

Abstract:

Background and Objectives: Vitamin D has received attention for its potential to disrupt cancer processes such as attenuating cell proliferation and exacerbating differentiation and apoptosis. However, whether there exists a role for vitamin D in the treatment of prostate cancer specifically remains controversial. We systematically review the literature to assess whether supplementation with vitamin D influences PSA response and overall survival in patients with prostate cancer. Methods: We searched PubMed, Scopus, ISI Web of Science and Google scholar from inception through up to 10 September 2017 for both before-and-after and randomized trials that evaluated the effect of vitamin D supplementation on the prostate specific antigen (PSA) response rate in participants with prostate cancer. The DerSimonian and Laird, inverse-weighted random-effects model was used to pool effect estimates from the studies. Heterogeneity and potential publication bias were evaluated. Subgroup analyses were also performed. Results: Twenty-two studies (16 before-after and 6 randomized controlled trials) were found and included in meta-analysis. The analysis on controlled clinical trials revealed that PSA change from baseline [weighted mean difference (WMD) = -1.66 ng/ml, 95%CI: -0.69, 0.36, P= 0.543)], PSA response (RR=1.18, 95%CI: 0.97, 1.45, P=0.104) and mortality rate (risk ratio (RR) = 1.05, 95% CI: 0.81-1.36; P=0.713) was not significantly different between vitamin D supplementation and placebo groups. Single arm trials revealed that vitamin D supplementation had had a modest effect on PSA response rate: 19% of those enrolled had at least a 50% reduction in PSA by the end of treatment (95% CI: 7% to 31%; p=0.002). Conclusion: We found that vitamin D modestly increases the PSA response rate in single arm studies. No effect on serum PSA levels, PSA response and mortality was seen in randomized controlled clinical trials. It does not seem patients with prostate cancer benefit from vitamin D supplementation.

Keywords: mortality, prostatic neoplasms, PSA response, vitamin D

Procedia PDF Downloads 178

Authors: Yang Chen, Lili Fu

Abstract:

Promoting urban regeneration in existing areas has been elevated to a national strategy in China. In this context, because of the multidimensional sustainable effect through the intensive use of land, mixed-use development has become an important objective for high-quality urban regeneration in the inner city. However, in the long period of time since China's reform and opening up, the "unbalanced phenomenon" of mixed-use development in China's inner cities has been very serious. On the one hand, the excessive focus on certain individual spaces has led to an increase in the level of mixed-use development in some areas, substantially ahead of others, resulting in a growing gap between different parts of the inner city; On the other hand, the excessive focus on a one-dimensional element of the spatial organization of mixed-use development, such as the enhancement of functional mix or spatial capacity, has led to a lagging phenomenon or neglect in the construction of other dimensional elements, such as pedestrian permeability, green environmental quality, social inclusion, etc. This phenomenon is particularly evident in the central area of the inner city, and it clearly runs counter to the need for sustainable development in China's new era. Therefore, a rational qualitative and quantitative analysis of the "unbalanced phenomenon" will help to identify the problem and provide a basis for the formulation of relevant optimization plans in the future. This paper builds a dynamic evaluation method of mixed-use development based on a meta-dimensional model and then uses spatial evolution analysis and spatial consistency analysis with ArcGIS software to reveal the "unbalanced phenomenon " in over the past 40 years of the central city area in Nanjing, a China’s typical city facing regeneration. This study result finds that, compared to the increase in functional mix and capacity, the dimensions of residential space mix, public service facility mix, pedestrian permeability, and greenness in Nanjing's city central area showed different degrees of lagging improvement, and the unbalanced development problems in each part of the city center are different, so the governance and planning plan for future mixed-use development needs to fully address these problems. The research methodology of this paper provides a tool for comprehensive dynamic identification of mixed-use development level’s change, and the results deepen the knowledge of the evolution of mixed-use development patterns in China’s inner cities and provide a reference basis for future regeneration practices.

Keywords: mixed-use development, unbalanced phenomenon, the meta-dimensional model, over the past 40 years of Nanjing, China

Procedia PDF Downloads 81

Authors: Ramanen Sugunesegran, Michael L. Williams

Abstract:

Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.

Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair

Procedia PDF Downloads 64