Search results for: Clinical test

Authors: May Khei Hu, Kevin Leong, Fu Siong Ng, Nicholas Peter

Abstract:

Introduction: Sympathetic stimulation has been recognised as a potent stimulus of arrhythmogenesis in various cardiac pathologies, possibly by augmenting dispersion of repolarisation. The effects of sympathetic stimulation in healthy subjects however remain unclear. It is, therefore, crucial to first establish the effects of physiological stress on dispersion of repolarisation in healthy subjects before understanding these effects in pathological cardiac conditions. We hypothesised that activation-recovery interval (ARI; which is a surrogate of action potential duration) and dispersion of repolarisation decrease on sympathetic stimulation. Methods: Eight patients aged 18-55 years with structurally normal hearts underwent head-up tilt test (HUTT) and exercise tolerance test (ETT) while wearing the electrocardiographic imaging (ECGi) vest. Patients later underwent CT scan and the epicardial potentials are reconstructed using the ECGi software. Activation and recovery times were determined from the acquired electrograms. ARI was calculated and later corrected using Bazett’s formula. Global and regional dispersion of repolarisation were determined from standard deviation of the corrected ARI (ARIc). One-way analysis of variance (ANOVA) and Wilcoxon test were used to evaluate statistical significance. Results: Global ARIc increased significantly [p<0.01] when patients were tilted upwards but decreased significantly after five minutes [p<0.01]. A subsequent post- hoc analysis revealed that the decrease in R-R was more substantial compared to the change in ARI, resulting in the observed increase in ARIc. Global ARIc decreased on peak exercise [p<0.01] but increased on recovery [p<0.01]. Global dispersion increased significantly on peak exercise [p<0.05] although there were no significant changes in regional dispersion. There were no significant changes in both global and regional dispersion during tilt. Conclusion: ARIc decreases upon sympathetic stimulation in healthy subjects. Global dispersion of repolarisation increases upon exercise although there were no changes in global or regional dispersion during orthostatic stress.

Keywords: dispersion of repolarisation, sympathetic stimulation, Head-up tilt test (HUTT), Exercise tolerance test (ETT), Electrocardiographic imaging (ECGi)

Procedia PDF Downloads 197

Authors: Hassan Almoslim

Abstract:

Background: The machine resistance training is an exercise that uses the equipment as loads to strengthen and condition the musculoskeletal system and improving muscle tone. The machine resistance training is easy to use, allow the individual to train with heavier weights without assistance, useful for beginners and elderly populations and specific muscle groups. Purpose: The purpose of this study was to examine the impact of nine weeks of machine resistance training on maximum strength among lean and normal weight male college students. Method: Thirty-six male college students aged between 19 and 21 years from King Fahd University of petroleum & minerals participated in the study. The subjects were divided into two an equal groups called Lean Group (LG, n = 18) and Normal Weight Group (NWG, n = 18). The subjects whose body mass index (BMI) is less than 18.5 kg / m2 is considered lean and who is between 18.5 to 24.9 kg / m2 is normal weight. Both groups performed machine resistance training nine weeks, twice per week for 40 min per training session. The strength measurements, chest press, leg press and abdomen exercises were performed before and after the training period. 1RM test was used to determine the maximum strength of all subjects. The training program consisted of several resistance machines such as leg press, abdomen, chest press, pulldown, seated row, calf raises, leg extension, leg curls and back extension. The data were analyzed using independent t-test (to compare mean differences) and paired t-test. The level of significance was set at 0.05. Results: No change was (P ˃ 0.05) observed in all body composition variables between groups after training. In chest press, the NWG recorded a significantly greater mean different value than the LG (19.33 ± 7.78 vs. 13.88 ± 5.77 kg, respectively, P ˂ 0.023). In leg press and abdomen exercises, both groups revealed similar mean different values (P ˃ 0.05). When the post-test was compared with the pre-test, the NWG showed significant increases in the chest press by 47% (from 41.16 ± 12.41 to 60.49 ± 11.58 kg, P ˂ 001), abdomen by 34% (from 45.46 ± 6.97 to 61.06 ± 6.45 kg, P ˂ 0.001) and leg press by 23.6% (from 85.27 ± 15.94 to 105.48 ± 21.59 kg, P ˂ 0.001). The LG also illustrated significant increases by 42.6% in the chest press (from 32.58 ± 7.36 to 46.47 ± 8.93 kg, P ˂ 0.001), the abdomen by 28.5% (from 38.50 ± 7.84 to 49.50 ± 7.88 kg, P ˂ 0.001) and the leg press by 30.8% (from 70.2 ± 20.57 to 92.01 ± 22.83 kg, P ˂ 0.001). Conclusion: It was concluded that the lean and the normal weight male college students can benefit from the machine resistance-training program remarkably.

Keywords: body composition, lean, machine resistance training, normal weight

Procedia PDF Downloads 356

Authors: Messaoudi Mohammed Amin

Abstract:

The reduction of available land resources and the increased cout associated with the use of hight quality materials have led to the need for local soils to be used in geotecgnical construction however, poor engineering properties of these soils pose difficulties for constructions project and need to be stabilized to improve their properties in oyher works unsuitable soils with low bearing capacity, high plasticity coupled with high insatbility are frequently encountered hense, there is a need to improve the physical and mechanical charateristics of these soils to make theme more suitable for construction this can be done by using different mechanical and chemical methods clayey soil stabilization has been practiced for quite sometime bu mixing additives, such us cement, lime and fly ash to the soil to increase its strength. The aim of this project is to study the effect of using lime, natural pozzolana or combination of both on the geotecgnical cherateristics of clayey soil. Test specimen were subjected to atterberg limits test, compaction test, box shear test and uncomfined compression test Lime or natural pozzolana was added to clayey soil at rangs of 0-8% and 0-20% respectively. In addition combinations of lime –natural pozzolana were added to clayey soil at the same ranges specimen were cured for 1-7, and 28 days after which they were tested for uncofined compression tests. Based on the experimental results, it was concluded that an important decrease of plasticity index was observed for thr samples stabilized with the combinition lime-natural pozzolana in addition, the use of the combination lime-natural pozzolana modifies the clayey soil classification according to casagrand plasiticity chart. Moreover, based on the favourable results of shear and compression strength obtained, it can be concluded that clayey soil can be successfuly stabilized by combined action of lime and natural pozzolana also this combination showed an appreciable improvement of the shear parameters. Finally, since natural pozzolana is much cheaper than lime ,the addition of natural pozzolana in lime soil mix may particulary become attractive and can result in cost reduction of construction.

Keywords: clay, soil stabilization, natural pozzolana, atterberg limits, compaction, compressive strength shear strength, curing

Procedia PDF Downloads 301

Authors: Chijioke Okafor, Malik Maaza, Touhami Mokrani

Abstract:

Proton exchange membrane, PEM was developed and tested for potential application in fuel cell. Nafion was electrospun to nanofiber network with the aid of poly(ethylene oxide), PEO, as a carrier polymer. The matrix polymer was crosslinked with Norland Optical Adhesive 63 under UV after compacting and annealing. The welded nanofiber mat was characterized for morphology, proton conductivity, and methanol permeability, then tested in a single cell test station. The results of the fabricated nanofiber membrane showed a proton conductivity of 0.1 S/cm at 25 oC and higher fiber volume fraction; methanol permeability of 3.6x10^-6 cm2/s and power density of 96.1 and 81.2 mW/cm2 for 5M and 1M methanol concentration respectively.

Keywords: fuel cell, nafion, nanofiber, permeability

Procedia PDF Downloads 482

Authors: Jeanne Phyre Lagare, Kirstin Rhys Pueblos

Abstract:

This study was conducted to evaluate the possible anthelmintic activities of the decoction and the nonpolar constituents of the aerial part of Ruellia tuberosa Linn. against Eudrilus eugeniae or African Night Crawler earthworms as test organism which are of anatomic and physiological resemblance to the intestinal roundworm parasites of human beings. The in vitro anthelmintic assay of each extract was done by determining the time of paralysis and death of the test organisms at three concentrations (3, 25, 50 mg/mL). The hexane-soluble extract (RTH) showed better results compared to the decoction (RTD) at all concentrations employed. All the fractions of RTH showed significantly higher anthelmintic activities (111.43, 48.19, and 62.3 minutes, respectively) compared to their mother extract (164.56 minutes) at 3-mg/mL concentration. Moreover, RTH5 showed a comparable activity with the positive control mebendazole at 3-mg/mL concentration. Remarkably, fraction RTH4 exhibited the best anthelmintic activity at 3-mg/mL concentration for it showed the strongest anthelmintic activity than the rest of the test solutions tested. The study demonstrated the promising anthelmintic activity of the nonpolar constituent of the ethanolic extract of R. tuberosa Linn.

Keywords: anthelmintic activity, Eudrillus eugenia, mebendazole, Ruellia tuberosa Linn

Procedia PDF Downloads 201

Authors: Venencia Albert, Arulselvi Subramanian, Hara Prasad Pati, Asok K. Mukhophadhyay

Abstract:

Acute traumatic coagulopathy in an endogenous dysregulation of the intrinsic coagulation system in response to the injury, associated with three-fold risk of poor outcome, and is more amenable to corrective interventions, subsequent to early identification and management. Multiple definitions for stratification of the patients' risk for early acute coagulopathy have been proposed, with considerable variations in the defining criteria, including several trauma-scoring systems based on prehospital data. We aimed to develop a clinically relevant definition for acute coagulopathy of trauma based on conventional coagulation assays and to assess its efficacy in comparison to recently established prehospital prediction models. Methodology: Retrospective data of all trauma patients (n = 490) presented to our level I trauma center, in 2014, was extracted. Receiver operating characteristic curve analysis was done to establish cut-offs for conventional coagulation assays for identification of patients with acute traumatic coagulopathy was done. Prospectively data of (n = 100) adult trauma patients was collected and cohort was stratified by the established definition and classified as "coagulopathic" or "non-coagulopathic" and correlated with the Prediction of acute coagulopathy of trauma score and Trauma-Induced Coagulopathy Clinical Score for identifying trauma coagulopathy and subsequent risk for mortality. Results: Data of 490 trauma patients (average age 31.85±9.04; 86.7% males) was extracted. 53.3% had head injury, 26.6% had fractures, 7.5% had chest and abdominal injury. Acute traumatic coagulopathy was defined as international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s. Of the 100 adult trauma patients (average age 36.5±14.2; 94% males), 63% had early coagulopathy based on our conventional coagulation assay definition. Overall prediction of acute coagulopathy of trauma score was 118.7±58.5 and trauma-induced coagulopathy clinical score was 3(0-8). Both the scores were higher in coagulopathic than non-coagulopathic patients (prediction of acute coagulopathy of trauma score 123.2±8.3 vs. 110.9±6.8, p-value = 0.31; trauma-induced coagulopathy clinical score 4(3-8) vs. 3(0-8), p-value = 0.89), but not statistically significant. Overall mortality was 41%. Mortality rate was significantly higher in coagulopathic than non-coagulopathic patients (75.5% vs. 54.2%, p-value = 0.04). High prediction of acute coagulopathy of trauma score also significantly associated with mortality (134.2±9.95 vs. 107.8±6.82, p-value = 0.02), whereas trauma-induced coagulopathy clinical score did not vary be survivors and non-survivors. Conclusion: Early coagulopathy was seen in 63% of trauma patients, which was significantly associated with mortality. Acute traumatic coagulopathy defined by conventional coagulation assays (international normalized ratio ≥ 1.19; prothrombin time ≥ 15.5 s; activated partial thromboplastin time ≥ 29 s) demonstrated good ability to identify coagulopathy and subsequent mortality, in comparison to the prehospital parameter-based scoring systems. Prediction of acute coagulopathy of trauma score may be more suited for predicting mortality rather than early coagulopathy. In emergency trauma situations, where immediate corrective measures need to be taken, complex multivariable scoring algorithms may cause delay, whereas coagulation parameters and conventional coagulation tests will give highly specific results.

Keywords: trauma, coagulopathy, prediction, model

Procedia PDF Downloads 176

Authors: Neda Valizadeh, Mani Mofidi, Sama Haghighi, Ali Hashemaghaee, Soudabeh Shafiee Ardestani

Abstract:

Background: There are many systems and parameters to evaluate trauma patients in the emergency department. Most of these evaluations are to distinguish patients with worse conditions so that the care systems have a better prediction of condition for a better care-giving. The purpose of this study is to determine the relationship between axillary body temperature and mortality in patients hospitalized in the intensive care unit (ICU) with multiple traumas and with other clinical and para-clinical factors. Methods: All patients between 16 and 75 years old with multiple traumas who were admitted into Emergency Department then hospitalized in the ICU were included in our study. An axillary temperature in the first and the second day of admission, Glasgow cola scale (GCS), systolic blood pressure, Serum glucose levels, and white blood cell counts of all patients at the admission day were recorded and their relationship with mortality were analyzed by SPSS software with suitable statistical tests. Results: Axillary body temperatures in the first and second day were statistically lower in expired traumatic patients (p=0.001 and p<0,001 respectively). Patients with lower GCS had a significantly lower first-day temperature and a significantly higher mortality. (p=0.006 and p=0.006 respectively). Furthermore, the first-day axillary temperature was significantly lower in patients with a lower first-day systolic blood pressure (p=0.014). Conclusion: Our results showed that lower axillary body temperature in the first day is associated with higher mortality, lower GCS, and lower systolic blood pressure. Thus, this could be used as a predictor of mortality in evaluation of traumatic patients in emergency settings.

Keywords: fever, trauma, mortality, emergency

Procedia PDF Downloads 376

Authors: Maria E. V. Amarante, Carolina L. Cerdeira, Julia V. Cortes, Fiorita G. L. Mundim

Abstract:

Basal cell carcinoma (BCC) is the most prevalent type of skin cancer in humans. It arises from the basal cells of the epidermis and cutaneous appendages. The role of sunlight exposure as a risk factor for BCC is very well defined due to its power to influence genetic mutations, in addition to having a suppressor effect on the skin immune system. Despite showing low metastasis and mortality rates, the tumor is locally infiltrative, aggressive, and destructive. Considering the high prevalence rate of this carcinoma and the importance of early detection, a retrospective study was carried out in order to correlate the clinical data available on BBC, characterize it epidemiologically, and thus enable effective prevention measures for the population. Data on the period from January 2015 to December 2019 were collected from the medical records of patients registered at one pathology service located in the southeast region of Brazil, known as SVO, which delivers skin biopsy results. The study was aimed at correlating the variables, sex, age, and subtypes found. Data analysis was performed using the chi-square test at a nominal significance level of 5% in order to verify the independence between the variables of interest. Fisher's exact test was applied in cases where the absolute frequency in the cells of the contingency table was less than or equal to five. The statistical analysis was performed using the R® software. Ninety-three basal cell carcinoma were analyzed, and its frequency in the 31-to 45-year-old age group was 5.8 times higher in men than in women, whereas, from 46 to 59 years, the frequency was found 2.4 times higher in women than in men. Between the ages of 46 to 59 years, it should be noted that the sclerodermiform subtype appears more than the solid one, with a difference of 7.26 percentage points. Reversely, the solid form appears more frequently in individuals aged 60 years or more, with a difference of 8.57 percentage points. Among women, the frequency of the solid subtype was 9.93 percentage points higher than the sclerodermiform frequency. In males, the same percentage difference is observed, but sclerodermiform is the most prevalent subtype. It is concluded in this study that, in general, there is a predominance of basal cell carcinoma in females and in individuals aged 60 years and over, which demonstrates the tendency of this tumor. However, when rarely found in younger individuals, the male gender prevailed. The most prevalent subtype was the solid one. It is worth mentioning that the sclerodermiform subtype, which is more aggressive, was seen more frequently in males and in the 46-to 59-year-old range.

Keywords: basal cell carcinoma, epidemiology, sclerodermiform basal cell carcinoma, skin cancer, solar radiation, solid basal cell carcinoma

Procedia PDF Downloads 139

Authors: Hafsa Qabool, Rashna Sukhia, Mubassar Fida

Abstract:

Introduction: Success of orthodontic mechanotherapy is highly dependent upon patient cooperation and compliance throughout the duration of treatment. This study was conducted to assess the cooperation and compliance of adult orthodontic patients during the leveling and alignment, space closure/molar correction, and finishing stages of tooth movement. Materials and Methods: Patient cooperation and compliance among three stages of orthodontic treatment were assessed using the Orthodontic Patient Cooperation Scale (OPCS) and Clinical Compliance Evaluation (CCE) form. A sample size of 38 was calculated for each stage of treatment; therefore, 114 subjects were included in the study. Shapiro-Wilk test identified that the data were normally distributed. One way ANOVA was used to evaluate the percentage cooperation and compliance among the three stages. Pair-wise comparisons between the three stages were performed using Post-hoc Tukey. Results: Statistically significant difference was seen for scores of patient compliance using CCE (p = 0.01); however, the results of the OPCS showed a non-significant difference for patient cooperation (p = 0.16) among the three stages of treatment. Post-hoc analysis showed significant differences (p = 0.01) in patient cooperation and compliance between space closure and the finishing stage. Highly significant (p < 0.001) decline in oral hygiene was found with the progression of orthodontic treatment. Conclusions: Improvement in the cooperation and compliance levels for adult orthodontic patients was observed during space closure & molar correction stage, which then showed a decline as treatment progressed. Oral hygiene was progressively compromised as orthodontic treatment progressed.

Keywords: patient compliance, adult orthodontics, orthodontic motivation, orthodontic patient adherence

Procedia PDF Downloads 168

Authors: O. E. Okafor, L. U. S. Ezeanyika, C. G. Nkwonta, C. J. Okonkwo

Abstract:

The effect of processing on plasma lipid profile and atherogenic indices of rats fed Artocarpus heterophyllus seed diets at different concentrations were investigated. Fifty five rats were used for this study, they were divided into eleven groups of five rats each (one control group and ten test groups), the test groups were fed raw, boiled, roasted, fermented, and soaked diets at 10 % and 40% concentrations. The study lasted for thirty five days. The diets led to significant decrease (p < 0.05) in plasma cholesterol and triacylglycerol of rats fed 10% and 40% concentrations of the diets, and a significant increase (p < 0.05) in high density lipoprotein (HDL) levels at 40% concentrations of the test diets. The diets also produced decrease in low density lipoprotein (LDL), very low density lipoprotein (VLDL), cardiac risk ratio (CRR), atherogenic index of plasma (AIP) and atherogenic coefficient (AC) at 40% concentrations except the soaked group that showed slight elevation of LDL, CRR, AC and AIP at 40% concentration. Artocarpus heterophyllus seeds could be beneficial to health because of its ability to increase plasma HDL and reduce plasma LDL, VLDL, cholesterol, triglycerides and atherogenic indices at higher diet concentration.

Keywords: artocarpus heterophyllus, atherogenic indices, concentrations, lipid profile

Procedia PDF Downloads 302

Authors: Vassilis C. Moulianitis, Evgenios Scourboutis, Ilias Katsanis, Paraskevas Papanikos, Nikolas Zacharopoulos

Abstract:

This paper presents the conceptual design of an automated biomethane potential measurement system. First, the design specifications for the BMP system and the basic components of the system will be presented. Three concepts that meet the design specifications will be presented. The basic characteristics of each concept will be analyzed in detail. The concepts will be evaluated using a set of design criteria that includes flexibility, cost, size, complexity, aesthetics, and accessibility in order to determine the best solution. The evaluation will be based on the discrete Choquet integral.

Keywords: automated biomethane test, conceptual mechatronics design, concept evaluation, Choquet integral

Procedia PDF Downloads 94

Authors: Mark McGuire, Eric Shannon, John Parmigiani

Abstract:

Timber harvesting increasingly involves mechanized equipment. This has increased the efficiency of harvesting, but has also introduced worker-safety concerns. One such concern arises from the use of harvesters. During operation, harvesters subject saw chain to large dynamic mechanical stresses. These stresses can, under certain conditions, cause the saw chain to fracture. The high speed of harvester saw chain can cause the resulting open chain loop to fracture a second time due to the dynamic loads placed upon it as it travels through space. If a second fracture occurs, it can result in a projectile consisting of one-to-several chain links. This projectile is referred to as a chain shot. It has speeds similar to a bullet but typically has greater mass and is a significant safety concern. Numerous examples exist of chain shots penetrating bullet-proof barriers and causing severe injury and death. Improved harvester-cab barriers can help prevent injury however a comprehensive scientific understanding of chain shot is required to consistently reduce or prevent it. Obtaining this understanding requires a test machine with the capability to cause chain shot to occur under carefully controlled conditions and accurately measure the response. Worldwide few such test machine exist. Those that do focus on validating the ability of barriers to withstand a chain shot impact rather than obtaining a scientific understanding of the chain shot event itself. The purpose of this paper is to describe the design, fabrication, and use of a test machine capable of a comprehensive scientific investigation of chain shot. The capabilities of this machine are to test all commercially-available saw chains and bars at chain tensions and speeds meeting and exceeding those typically encountered in harvester use and accurately measure the corresponding key technical parameters. The test machine was constructed inside of a standard shipping container. This provides space for both an operator station and a test chamber. In order to contain the chain shot under any possible test conditions, the test chamber was lined with a base layer of AR500 steel followed by an overlay of HDPE. To accommodate varying bar orientations and fracture-initiation sites, the entire saw chain drive unit and bar mounting system is modular and capable of being located anywhere in the test chamber. The drive unit consists of a high-speed electric motor with a flywheel. Standard Ponsse harvester head components are used to bar mounting and chain tensioning. Chain lubrication is provided by a separate peristaltic pump. Chain fracture is initiated through ISO standard 11837. Measure parameters include shaft speed, motor vibration, bearing temperatures, motor temperature, motor current draw, hydraulic fluid pressure, chain force at fracture, and high-speed camera images. Results show that the machine is capable of consistently causing chain shot. Measurement output shows fracture location and the force associated with fracture as a function of saw chain speed and tension. Use of this machine will result in a scientific understanding of chain shot and consequently improved products and greater harvester operator safety.

Keywords: chain shot, safety, testing, timber harvesters

Procedia PDF Downloads 152

Authors: O. I. Papagianni, P. Potsaki, K. Almpounioti, D. Chatzicharalampous, A. Voutsa, O. Katira, A. Michalaki, H. C. Karantonis, A. E. Koutelidakis

Abstract:

High intakes of carbohydrates and fats have been associated with an increased risk of chronic diseases due to the role of postprandial oxidative stress. This pilot nutritional intervention aimed to examine the acute effect of consuming two different types of breadsticks prepared from durum wheat flour mixtures differing in total phenolic content on postprandial inflammatory and oxidant responses in healthy volunteers. A cross-over, controlled, and single-blind clinical trial was designed, and two isocaloric high-fat and high-carbohydrate meals were tested. Serum total, HDL- and LDL-cholesterol, triglycerides, glucose, CRP, uric acid, plasma total antioxidant capacity, and antiplatelet activity were determined in fasting and 30, 60, and 120 min after consumption. The results showed a better postprandial HDL-cholesterol and total antioxidant activity response in the intervention group. The choice of durum wheat flours with higher phenolic content and antioxidant activity is presented as promising for human health, and clinical studies will expand to draw safer conclusions.

Keywords: breadsticks, durum wheat flours, postprandial inflammation, postprandial oxidative stress, ex vivo antiplatelet activity

Procedia PDF Downloads 77

Authors: Xiaozhou Liu, Guangyu Zhu, Yu Zhang, Hongwei Wu

Abstract:

The wind-box is one of the important components of a Circulating Fluidized Bed (CFB) boiler. The uniformity of air flow in the wind-box of is very important for highly efficient operation of the CFB boiler. Non-uniform air flow distribution within the wind-box can reduce the boiler's thermal efficiency, leading to higher energy consumptions. An effective measure to solve this problem is to install an air flow distributing device in the wind-box. In order to validate the effectiveness of the air flow distributing device, visual and velocity distribution uniformity experiments have been carried out under five different test conditions by using a 1:64 scale model of a 220t/hr CFB boiler. It has been shown that the z component of flow velocity remains almost the same at control cross-sections of the wind-box, with a maximum variation of less than 10%. Moreover, the same methodology has been carried out to a full-scale 220t/hr CFB boiler. The hot test results depict that the thermal efficiency of the boiler has increased from 85.71% to 88.34% when tested with an air flow distributing device in place, which is equivalent to a saving of 5,000 tons of coal per year. The economic benefits of this energy-saving technology have been shown to be very significant, which clearly demonstrates that the technology is worth applying and popularizing.

Keywords: circulating fluidized bed, CFB, wind-box, air flow distributing device, visual experiment, velocity distribution uniformity experiment, hot test

Procedia PDF Downloads 176

Authors: Anmol Patel

Abstract:

Cardiopulmonary resuscitation is medical intervention which should be considered for all inpatients; with a patient centred approach, open communication and accurate documentation of clinical decisions. National enquiries have shown that in a significant number of cases CPR was attempted when it was considered inappropriate. In these circumstances attempting to prevent a natural death and subjecting a patient to trauma at the end of life would deprive them of a dignified death. Anticipatory “do not attempt CPR (DNACPR)” decisions aim to prevent this for those considered appropriate. As a legal document, these forms are required to be completed accurately and thoroughly. The aim of this study was to evaluate the difference in quality of DNACPR forms completed using electronic versus paper formats. A retrospective review of DNACPR forms and related documentation was completed in two District General Hospitals in South-East England, one of which uses electronic forms, while the other uses paper red forms. 50 completed forms from each hospital were analysed to assess for legibility, and quality of completion of all subsections of the form, including communications with family, relatives and the Multidisciplinary team. The hospital using paper forms showed a 40-44% rate of completion of sections relating to communication with patients and family, compared to 70% with the hospital using electronic forms. Similar trends were observed with other sections of the form. Conclusion: This study suggests that the implementation of electronic DNACPR forms significantly improves clinical practice and promotes better open communication with patients, family and the MDT.

Keywords: DNACPR, resuscitation, DNAR, patient communication

Procedia PDF Downloads 78

Authors: Kuan-Jen Lai, Fang-Yi Lin, Shang-Rong Huang, Yun-Zheng Zeng, Po-Chieh Hsu, Jay Wu

Abstract:

The normalized glandular dose (DgN) estimates the energy deposition of mammography in clinical practice. The Monte Carlo simulations frequently use uniformly mixed phantom for calculating the conversion factor. However, breast tissues are not uniformly distributed, leading to errors of conversion factor estimation. This study constructed a three-layer phantom to estimated more accurate of normalized glandular dose. In this study, MCNP code (Monte Carlo N-Particles code) was used to create the geometric structure. We simulated three types of target/filter combinations (Mo/Mo, Mo/Rh, Rh/Rh), six voltages (25 ~ 35 kVp), six HVL parameters and nine breast phantom thicknesses (2 ~ 10 cm) for the three-layer mammographic phantom. The conversion factor for 25%, 50% and 75% glandularity was calculated. The error of conversion factors compared with the results of the American College of Radiology (ACR) was within 6%. For Rh/Rh, the difference was within 9%. The difference between the 50% average glandularity and the uniform phantom was 7.1% ~ -6.7% for the Mo/Mo combination, voltage of 27 kVp, half value layer of 0.34 mmAl, and breast thickness of 4 cm. According to the simulation results, the regression analysis found that the three-layer mammographic phantom at 0% ~ 100% glandularity can be used to accurately calculate the conversion factors. The difference in glandular tissue distribution leads to errors of conversion factor calculation. The three-layer mammographic phantom can provide accurate estimates of glandular dose in clinical practice.

Keywords: Monte Carlo simulation, mammography, normalized glandular dose, glandularity

Procedia PDF Downloads 189

Authors: Rubaiat S. Ahmed, Jemer Garrido, Sergey M. Motov

Abstract:

Clinical informatics (CI) enables the transformation of data into a systematic organization that improves the quality of care and the generation of positive health outcomes.Innovative technology through informatics that compiles accurate data on analgesic utilization in the emergency department can enhance pain management in this important clinical setting. We aim to establish a simplified reporting system through CI to examine and assess the analgesic prescribing practices in the EDthrough executing a U.S. federal grant project on opioid reduction initiatives. Queried data points of interest from a level-one trauma ED’s electronic medical records were used to create data sets and develop informational/visual reporting dashboards (on Microsoft Excel and Google Sheets) concerning analgesic usage across several pre-defined parameters and performance metrics using CI. The data was then qualitatively analyzed to evaluate ED analgesic prescribing trends by departmental clinicians and leadership. During a 12-month reporting period (Dec. 1, 2020 – Nov. 30, 2021) for the ongoing project, about 41% of all ED patient visits (N = 91,747) were for pain conditions, of which 81.6% received analgesics in the ED and at discharge (D/C). Of those treated with analgesics, 24.3% received opioids compared to 75.7% receiving opioid alternatives in the ED and at D/C, including non-pharmacological modalities. Demographics showed among patients receiving analgesics, 56.7% were aged between 18-64, 51.8% were male, 51.7% were white, and 66.2% had government funded health insurance. Ninety-one percent of all opioids prescribed were in the ED, with intravenous (IV) morphine, IV fentanyl, and morphine sulfate immediate release (MSIR) tablets accounting for 88.0% of ED dispensed opioids. With 9.3% of all opioids prescribed at D/C, MSIR was dispensed 72.1% of the time. Hydrocodone, oxycodone, and tramadol usage to only 10-15% of the time, and hydromorphone at 0%. Of opioid alternatives, non-steroidal anti-inflammatory drugs were utilized 60.3% of the time, 23.5% with local anesthetics and ultrasound-guided nerve blocks, and 7.9% with acetaminophen as the primary non-opioid drug categories prescribed by ED providers. Non-pharmacological analgesia included virtual reality and other modalities. An average of 18.5 ED opioid orders and 1.9 opioid D/C prescriptions per 102.4 daily ED patient visits was observed for the period. Compared to other specialties within our institution, 2.0% of opioid D/C prescriptions are given by ED providers, compared to the national average of 4.8%. Opioid alternatives accounted for 69.7% and 30.3% usage, versus 90.7% and 9.3% for opioids in the ED and D/C, respectively.There is a pressing need for concise, relevant, and reliable clinical data on analgesic utilization for ED providers and leadership to evaluate prescribing practices and make data-driven decisions. Basic computer software can be used to create effective visual reporting dashboards with indicators that convey relevant and timely information in an easy-to-digest manner. We accurately examined our ED's analgesic prescribing practices using CI through dashboard reporting. Such reporting tools can quickly identify key performance indicators and prioritize data to enhance pain management and promote safe prescribing practices in the emergency setting.

Keywords: clinical informatics, dashboards, emergency department, health informatics, healthcare informatics, medical informatics, opioids, pain management, technology

Procedia PDF Downloads 144

Authors: Noora Al Muftah, Reda Rawi, Richard Thompson, Halima Bensmail

Abstract:

Clinical responses to anticancer therapies are often restricted to a subset of patients. In some cases, mutated cancer genes are potent biomarkers of response to targeted agents. There is an urgent need to identify biomarkers that predict which patients with are most likely to respond to treatment. Systematic efforts to correlate tumor mutational data with biologic dependencies may facilitate the translation of somatic mutation catalogs into meaningful biomarkers for patient stratification. To identify genomic features associated with drug sensitivity and uncover new biomarkers of sensitivity and resistance to cancer therapeutics, we have screened and integrated a panel of several hundred cancer cell lines from different databases, mutation, DNA copy number, and gene expression data for hundreds of cell lines with their responses to targeted and cytotoxic therapies with drugs under clinical and preclinical investigation. We found mutated cancer genes were associated with cellular response to most currently available Glioma cancer drugs and some frequently mutated genes were associated with sensitivity to a broad range of therapeutic agents. By linking drug activity to the functional complexity of cancer genomes, systematic pharmacogenomic profiling in cancer cell lines provides a powerful biomarker discovery platform to guide rational cancer therapeutic strategies.

Keywords: cancer, gene network, Lasso, penalized regression, P-values, unbiased estimator

Procedia PDF Downloads 409

Authors: Musa Galadima Toro

Abstract:

The study focused on the impact of teaching critical reading strategies on students’ performance in English and communication skills at the college of education Azare Bauchi state, Nigeria. It adopted a pre-test, post-test experimental group design. A sample of two hundred and forty (240) students was randomly selected from four departments within the school. The students were randomized into two groups: experimental and control groups. The experimental group was taught critical reading strategies as a form of treatment, while the control group involved in normal reading comprehension exercises. The findings of the study showed a significant difference in the performance of students who were taught critical reading strategies at the post- test level. Recommendations based on the findings of the study were proffered such as placing more emphasis on teaching critical reading strategies in order to improve students’ creative thinking skills and also encouraging students to read articles in science and humanities to improve their reading skills among others.

Keywords: English, communication skill, critical reading, strategies

Procedia PDF Downloads 272

Authors: Ahmad Hashim, Thariq Khan Azizuddin Khan, Zulakbal Abd Karim, Nohazira Abdul Karim

Abstract:

This research aims to obtain the validity and reliability of a survey instrument to evaluate the values, attitudes, and professionalism of sports science students, from the Faculty of Sports Science and Coaching, Universiti Pendidikan Sultan Idris (UPSI). It is a survey which is divided into two components namely first; moral, self-esteem, proactive, self-reliant and voluntary and second; ethics and professionalism. Development of the survey instrument is based on the Malaysian Education Development Plan, Higher Education Malaysia. There are 50 items prepared based on the five-point Likert scale which were tested at the pilot test level. It involved 212 research subjects selected based on random sampling. In addition, the research method applied is in the form of pre-experimental one group pre-test-post-test. Results of the analysis showed that overall field expert validity is r = .89, while the Cronbach alpha reliability correlation value of outdoor education instrument evaluation survey is r = .85. Next, this survey was tested again for construct validity using the factor analysis method for statistical analysis which would validate each item tested was supposed to be in the right component. From the analysis, results show that Bartlett's test is significant p < .05 and Kaiser-Meyer-Olkin index range is r = .87. The result showed 39 survey items are produced out of 50 items of the survey based on this factor analysis method. Research has shown that the survey instrument developed is valid and reliable to be used for the Faculty of Sports Sciences and Coaching, UPSI.

Keywords: values, attitudes, professionalism, ethics, professionalism

Procedia PDF Downloads 191

Authors: Fetah Eren, Ismail Sahin, Ismail Celik, Ahmet Oguz Akturk

Abstract:

The aim of this study is to discover secondary school students’ perceptions related to information technologies and the connections between concepts in their cognitive structures. A word association test consisting of six concepts related to information technologies is used to collect data from 244 secondary school students. Concept maps that present students’ cognitive structures are drawn with the help of frequency data. Data are analyzed and interpreted according to the connections obtained as a result of the concept maps. It is determined students associate most with these concepts—computer, Internet, and communication of the given concepts, and associate least with these concepts—computer-assisted education and information technologies. These results show the concepts, Internet, communication, and computer, are an important part of students’ cognitive structures. In addition, students mostly answer computer, phone, game, Internet and Facebook as the key concepts. These answers show students regard information technologies as a means for entertainment and free time activity, not as a means for education.

Keywords: word association test, cognitive structure, information technology, secondary school

Procedia PDF Downloads 413

Authors: Liu Ziyu, Gao Yongfeng, Li Muhua, Zhao Jiahao, Meng Song

Abstract:

The effect of thermal shock on the operation of micro electromechanical systems (MEMS) were examined. All MEMS device were tested before and after three different conditions of thermal shock (from -55℃ to 85℃, from -65℃ to 125℃, from -65℃ to 200℃). The micro lens showed no changes after thermal shock, which shows that the design of the micro lens can be well adapted to the application environment in the space. The design of the micro mirror can be well adapted to the space application environment. The micro-magnetometer, RF MEMS switch and the micro accelerometer exhibited degradation and parameter drift after thermal shock, potential mechanical was proposed.

Keywords: MEMS, thermal shock test, reliability, space environment

Procedia PDF Downloads 590

Authors: M. Sumida, S. Morita

Abstract:

In this research, the effect of unsteady flows acting on road vehicles was experimentally investigated, using an advanced and recently introduced wind tunnel. The aims of this study were to extract the characteristics of fluid forces acting on road vehicles under unsteady wind conditions and obtain new information on drag forces in a practical on-road test. We applied pulsating wind as a representative example of the atmospheric fluctuations that vehicles encounter on the road. That is, we considered the case where the vehicles are moving at constant speed in the air, with large wind oscillations. The experimental tests were performed on the Ahmed-type test model, which is a simplified vehicle model. This model was chosen because of its simplicity and the data accumulated under steady wind conditions. The experiments were carried out with a time-averaged Reynolds number of Re = 4.16x10⁵ and a pulsation period of T = 1.5 s, with amplitude of η = 0.235. Unsteady fluid forces of drag and lift were obtained utilizing a multi-component load cell. It was observed that the unsteady aerodynamic forces differ significantly from those under steady wind conditions. They exhibit a phase shift and an enhanced response to the wind oscillations. Furthermore, their behavior depends on the slant angle of the rear shape of the model.

Keywords: Ahmed body, automotive aerodynamics, unsteady wind, wind tunnel test

Procedia PDF Downloads 293

Authors: Ryan Dale B. Elnar

Abstract:

This study developed a multidimensional need assessment scale for college students called The University of Mindanao Needs Assessment Scale (UMNAS). Although there are context-specific instruments measuring the needs of clinical and non-clinical samples, literature reveals no standardized scales to measure the needs of the college students thus a four-phase item development process was initiated to support its content validity. Comprising seven broad facets namely spiritual-moral, intrapersonal, socio-personal, psycho-emotional, cognitive, physical and sexual, a pyramid model of college needs was deconstructed through FGD sample to support the literature review. Using various construct validity procedures, the model was further tested using a total of 881 Filipino college samples. The result of the study revealed evidences of the reliability and validity of the UMNAS. The reliability indices range from .929-.933. Exploratory and confirmatory factor analyses revealed a one-factor-six-dimensional instrument to measure the needs of the college students. Using multivariate regression analysis, year level and course are found predictors of students’ needs. Content analysis attested the usefulness of the instrument to diagnose students’ personal and academic issues and concerns in conjunction with other measures. The norming process includes 1728 students from the different colleges of the University of Mindanao. Further validation is recommended to establish a national norm for the instrument.

Keywords: needs assessment scale, validity, factor analysis, college students

Procedia PDF Downloads 442

Authors: P. H. Mfengwana, S. S. Mashele, L. Verschaeve, R. Anthonissen, I. T. Manduna

Abstract:

Gunnera perpensa is traditionally used mostly by women for the treatment of different gynaecological related conditions due to its proven uterine contractility effects. The uses of this plant include menstrual pain relief, treatment of infertility and promotion of easy labour. However, even though this plant species has been reported to possess numerous medicinal properties, to author’s best knowledge, its safety has not been investigated. Thus, this study was aimed at investigating the genotoxicity and antigenotoxicity of Gunnera perpensa aqueous, methanol and dichloromethane extracts. The in vitro toxicity of the plant extracts was assessed with the neutral red uptake (NRU) test. Genotoxic and antigenotoxic properties of Gunnera perpensa were investigated using high-throughput assays: bacterial Vitotox test and the alkaline comet assay with and without S9 activation on human C3A cells. Ethyl Methanesulfonate (EMS) and 4-nitroquinoline-oxide (4-NQO) were used as positive controls, respectively. All extracts showed toxicity in a dose-dependent manner; however, that does not mean they were all genotoxic. Methanol extract did show genotoxicity with S9 (metabolism) only at the highest concentration of 500 µg/ml due to increased DNA damage observed, however, no genotoxicity was observed from other concentrations. Therefore, the results show that Gunnera perpensa extracts are genotoxic and not safe for human use.

Keywords: antigenotoxicity, comet test, genotoxicity, Gunnera perpensa, vitotox assay

Procedia PDF Downloads 134

Authors: Masome Moeni, Roya Abedizadeh, Elham Aram, Hamid Sadeghi-Abandansari, Davood Sabour, Robert Menzel, Ali Hassanpour

Abstract:

Significant number of studies and preclinical research in formulation of cancer nano-pharmaceutics have led to an improvement in cancer care. Nonetheless, the antineoplastic agents have ‘failed to live up to its promise’ since their clinical performance is moderately low. For almost ninety years, iron oxide nanoparticles (IONPS) have managed to keep its reputation in clinical application due to their low toxicity, versatility and multi-modal capabilities. Drug Administration approved utilization of IONPs for diagnosis of cancer as contrast media in magnetic resonance imaging, as heat mediator in magnetic hyperthermia and for the treatment of iron deficiency. Furthermore, IONPs have high drug-loading capacity, which makes them good candidates as therapeutic agent transporters. There are yet challenges to overcome for successful clinical application of IONPs, including stability of drug and poor delivery, which might lead to (i) drug resistance, (ii) shorter blood circulation time, and (iii) rapid elimination and adverse side effects from the system. In this study, highly stable and super paramagnetic IONPs were prepared for efficient and targeted drug delivery in cancer treatment. The synthesis procedure was briefly involved the production of IONPs via co-precipitation followed by coating with tetraethyl orthosilicate and 3-aminopropylethoxysilane and grafting with folic acid for stability targeted purposes and controlled drug release. Physiochemical and morphological properties of modified IONPs were characterised using different analytical techniques. The resultant IONPs exhibited clusters of 10 nm spherical shape crystals with less than 100 nm size suitable for drug delivery. The functionalized IONP showed mesoporous features, high stability, dispersibility and crystallinity. Subsequently, the functionalized IONPs were successfully loaded with oxaliplatin, a chemotherapeutic agent, for a controlled drug release in an actively targeting cancer cells. FT-IR observations confirmed presence of oxaliplatin functional groups, while ICP-MS results verified the drug loading was ~ 1.3%.

Keywords: cancer treatment, chemotherapeutic agent, drug delivery, iron oxide, multi-functional nanoparticle

Procedia PDF Downloads 83

Authors: Ayami Umemura

Abstract:

The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

Procedia PDF Downloads 88

Authors: Amin Davoudi

Abstract:

Aim: New approaches have been introduced to improve soft tissue indices of the dental implants. This systematic review aimed to investigate the effect of computer-aided design and computer-assisted manufacture (CAD/CAM) zirconia (Zr) implant abutments on periodontal aspects. Materials and Methods: Five electronic databases were searched thoroughly based on prior defined MeSH and non-MeSH keywords. Clinical studies were collected via hand searches in English language journals up to September 2020. Interproximal papilla stability, papilla recession, pink and white esthetic score (PES, WES), bone and gingival margin levels, color, and contour of soft tissue were reviewed. Results: The initial literature search yielded 412 articles. After the evaluation of abstracts and full texts, six studies were eligible to be screened. The study design of the included studies was a prospective cohort (n=3) and randomized clinical trial (n=3). The outcome was found to be significantly better for Zr than titanium abutments, however, the studies did not show significant differences between stock and CAD/CAM abutments. Conclusion: Papilla fill, WES, PES, and the distance from the contact point to dental crest bone of adjacent tooth and inter-tooth–implant distance were not significantly different between Zr CAD/CAM and Zr stock abutments. However, soft tissue stability and recession index were better in Zr CAD/CAM abutments.

Keywords: zirconia, CADCAM, periodental, implant

Procedia PDF Downloads 101

Authors: Amani M. Al-Hussan

Abstract:

The current study aimed to explore the effects of science teaching strategies course (CURR422) on developing academic self efficacy and motivation towards teaching it in female primary classroom teachers in College of Education in Princess Nora Bint AbdulRahman University. The study sample consisted (48) female student teachers. To achieve the study aims, the researcher designed two instruments: Academic Self Efficacy Scale & Motivation towards Teaching Science Scale while maintaining the validity and reliability of these instruments.. Several statistical procedures were conducted i.e. Independent Sample T-test, Eta Square, Cohen D effect size. The results reveal that there were statistically significant differences between means of pre and post test for the sample in favor of post test. For academic self efficacy scale, Eta square was 0.99 and the effect size was 27.26. While for the motivation towards teaching science scale, Eta was 0.99 and the effect size was 51.72. These results indicated high effects of independent variable on the dependent variable.

Keywords: academic self efficiency, achievement, motivation, primary classroom teacher, science teaching strategies course, evaluation

Procedia PDF Downloads 499

Authors: Gema M. Rodado, Jose M. Olavarrieta

Abstract:

Hydrogen fuel cell technologies have experienced a great boost in the last decades, significantly increasing the production of these devices for both stationary and portable (mainly automotive) applications; these are influenced by two main factors: environmental pollution and energy shortage. A fuel cell is an electrochemical device that converts chemical energy directly into electricity by using hydrogen and oxygen gases as reactive components and obtaining water and heat as byproducts of the chemical reaction. Fuel cells, specifically those of Proton Exchange Membrane (PEM) technology, are considered an alternative to internal combustion engines, mainly because of the low emissions they produce (almost zero), high efficiency and low operating temperatures (< 373 K). The introduction and use of fuel cells in the automotive market requires the development of standardized and validated procedures to test and evaluate their performance in different environmental conditions including vibrations and freeze-thaw cycles. These situations of vibration and extremely low/high temperatures can affect the physical integrity or even the excellent operation or performance of the fuel cell stack placed in a vehicle in circulation or in different climatic conditions. The main objective of this work is the development and validation of vibration and freeze-thaw cycling test procedures for fuel cell stacks that can be used in a vehicle in order to consolidate their safety, performance, and durability. In this context, different experimental tests were carried out at the facilities of the National Hydrogen Centre (CNH2). The experimental equipment used was: A vibration platform (shaker) for vibration test analysis on fuel cells in three axes directions with different vibration profiles. A walk-in climatic chamber to test the starting, operating, and stopping behavior of fuel cells under defined extreme conditions. A test station designed and developed by the CNH2 to test and characterize PEM fuel cell stacks up to 10 kWe. A 5 kWe PEM fuel cell stack in off-operation mode was used to carry out two independent experimental procedures. On the one hand, the fuel cell was subjected to a sinusoidal vibration test on the shaker in the three axes directions. It was defined by acceleration and amplitudes in the frequency range of 7 to 200 Hz for a total of three hours in each direction. On the other hand, the climatic chamber was used to simulate freeze-thaw cycles by defining a temperature range between +313 K and -243 K with an average relative humidity of 50% and a recommended ramp up and rump down of 1 K/min. The polarization curve and gas leakage rate were determined before and after the vibration and freeze-thaw tests at the fuel cell stack test station to evaluate the robustness of the stack. The results were very similar, which indicates that the tests did not affect the fuel cell stack structure and performance. The proposed procedures were verified and can be used as an initial point to perform other tests with different fuel cells.

Keywords: climatic chamber, freeze-thaw cycles, PEM fuel cell, shaker, vibration tests

Procedia PDF Downloads 117