Search results for: clinical characteristic
3206 Scope of Lasers in Periodontics
Authors: Atmaja Patel
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Since the development of lasers in 1951, the first medical application was reported by Goldman in 1962. In 1960, T.H. Maiman produced the first Ruby laser and was used in cardiovascular surgery by McGuff in 1963. After a long time of investigations and new developments in laser technology first clinical applications were performed by Choy and Ginsburg in 1983. Introduction of the first true dental laser was in 1989. This paper is to highlight the various treatments and prevention of periodontal diseases. Lasers have become more predictable and effective form of treatment for periodontal diseases. The advantages of lasers include reduced use of anaesthesia, coagulation that yields a dry surgical field and hence better visibility, reduced need of sutures, minimal swelling and scarring, less pain and medication, faster healing and increased patient acceptance.Keywords: lasers, periodontal surgery, diode laser, healing
Procedia PDF Downloads 3213205 Precocious Puberty Due to an Autonomous Ovarian Cyst in a 3-Year-Old Girl: Case Report
Authors: Aleksandra Chałupnik, Zuzanna Chilimoniuk, Joanna Borowik, Aleksandra Borkowska, Anna Torres
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Background: Precocious puberty is the occurrence of secondary sexual characteristics in girls before the age of 8. The diverse etiology of premature puberty is crucial to determine whether it is true precocious puberty, depending on the activation of the hypothalamic-pituitary-gonadal axis, or pseudo-precocious, which is independent of the activation of this axis. Whatever the cause, premature action of the sex hormones leads to the common symptoms of various forms of puberty. These include the development of sexual characteristics, acne, acceleration of growth rate and acceleration of skeletal maturation. Due to the possible genetic basis of the disorders, an interdisciplinary search for the cause is needed. Case report: The case report concerns a patient of a pediatric gynecology clinic who, at the age of two years, developed advanced thelarhe (M3) and started recurrent vaginal bleeding. In August 2019, gonadotropin suppression initially and after LHRH stimulation and high estradiol levels were reported at the Endocrinology Department. Imaging examinations showed a cyst in the right ovary projection. The bone age was six years. The entire clinical picture indicated pseudo- (peripheral) precocious in the course of ovarian autonomic cyst. In the follow-up ultrasound performed in September, the image of the cyst was stationary and normalization of estradiol levels and clinical symptoms was noted. In December 2019, cyst regression and normal gonadotropin and estradiol concentrations were found. In June 2020, white mucus tinged with blood on the underwear, without any other disturbing symptoms, was observed for several days. Two consecutive USG examinations carried out in the same month confirmed the change in the right ovary, the diameter of which was 25 mm with a very high level of estradiol. Germinal tumor markers were normal. On the Tanner scale, the patient scored M2P1. The labia and hymen had puberty features. The correct vaginal entrance was visible. Another active vaginal bleeding occurred in the first week of July 2020. The considered laparoscopic treatment was abandoned due to the lack of oncological indications. Treatment with Tamoxifen was recommended in July 2020. In the initiating period of treatment, no maturation progression, and even reduction of symptoms, no acceleration of growth and a marked reduction in the size of the cysts were noted. There was no bleeding. After the size of the cyst and hormonal activity increased again, the treatment was changed to Anastrozole, the effect of which led to a reduction in the size of the cyst. Conclusions: The entire clinical picture indicates alleged (peripheral) puberty. Premature puberty in girls, which is manifested as enlarged mammary glands with high levels of estrogens secreted by autonomic ovarian cysts and prepubertal levels of gonadotropins, may indicate McCune-Albright syndrome. Vaginal bleeding may also occur in this syndrome. Cancellation of surgical treatment of the cyst made it impossible to perform a molecular test that would allow to confirm the diagnosis. Taking into account the fact that cysts are often one of the first symptoms of McCune-Albrigt syndrome, it is important to remember about multidisciplinary care for the patient and careful search for skin and bone changes or other hormonal disorders.Keywords: McCune Albrigth's syndrome, ovarian cyst, pediatric gynaecology, precocious puberty
Procedia PDF Downloads 1933204 Physical Properties and Elastic Studies of Fluoroaluminate Glasses Based on Alkali
Authors: C. Benhamideche
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Fluoroaluminate glasses have been reported as the earliest heavy metal fluoride glasses. By comparison with flurozirconate glasses, they offer a set of similar optical features, but also some differences in their elastic and chemical properties. In practice they have been less developed because their stability against devitrification is smaller than that of the most stable fluoroziconates. The purpose of this study was to investigate glass formation in systems AlF3-YF3-PbF2-MgF2-MF2 (M= Li, Na, K). Synthesis was implemented at room atmosphere using the ammonium fluoride processing. After fining, the liquid was into a preheated brass mold, then annealed below the glass transition temperature for several hours. The samples were polished for optical measurements. Glass formation has been investigated in a systematic way, using pseudo ternary systems in order to allow parameters to vary at the same time. We have chosen the most stable glass compositions for the determination of the physical properties. These properties including characteristic temperatures, density and proprieties elastic. Glass stability increases in multicomponent glasses. Bulk samples have been prepared for physical characterization. These glasses have a potential interest for passive optical fibers because they are less sensitive to water attack than ZBLAN glass, mechanically stronger. It is expected they could have a larger damage threshold for laser power transmission.Keywords: fluoride glass, aluminium fluoride, thermal properties, density, proprieties elastic
Procedia PDF Downloads 2433203 Accurate HLA Typing at High-Digit Resolution from NGS Data
Authors: Yazhi Huang, Jing Yang, Dingge Ying, Yan Zhang, Vorasuk Shotelersuk, Nattiya Hirankarn, Pak Chung Sham, Yu Lung Lau, Wanling Yang
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Human leukocyte antigen (HLA) typing from next generation sequencing (NGS) data has the potential for applications in clinical laboratories and population genetic studies. Here we introduce a novel technique for HLA typing from NGS data based on read-mapping using a comprehensive reference panel containing all known HLA alleles and de novo assembly of the gene-specific short reads. An accurate HLA typing at high-digit resolution was achieved when it was tested on publicly available NGS data, outperforming other newly-developed tools such as HLAminer and PHLAT.Keywords: human leukocyte antigens, next generation sequencing, whole exome sequencing, HLA typing
Procedia PDF Downloads 6693202 Approaches to Diagnosis of Ectopic Solid Organs in the Abdominopelvic Cavity
Authors: Van-Ngoc-Cuong Le, Ngoc-Quy Le
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Approaches to the diagnosis of ectopic solid organs in the abdominopelvic cavity include Accessory liver lobe, Accessory spleens (ectopic splenic tissue), Wandering spleen, Ectopic pancreatic tissue, Ectopic kidney (Pancake kidney), Cryptorchidism (undescended testis, ectopic testis), Ectopic endometriosis. The application of diagnostic imaging techniques, of which magnetic resonance imaging is the most important, includes a clinical case study and reports. Ectopic organs and tumors are easy to confuse. This is a concern, as well as practical challenges encountered and solutions adopted in the fields of Image Analysis.Keywords: ectopic, accessory, wandering, tumor
Procedia PDF Downloads 133201 Prevalence of Rituximab Efficacy Over Immunosuppressants in Therapy of Systemic Sclerosis
Authors: Liudmila Garzanova, Lidia Ananyeva, Olga Koneva, Olga Ovsyannikova, Oxana Desinova, Mayya Starovoytova, Rushana Shayahmetova, Anna Khelkovskaya-Sergeeva
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Abstract Objectives. Rituximab (RTX) shown a positive effect in the treatment of systemic sclerosis (SSc). But there is still not enough data on comparing the effectiveness of RTX with immunosuppressants (IS). The aim of our study was to compare changes of lung function and skin score in SSc between two groups of patients (pts) - on RXT therapy (prescribed after ineffectiveness of previous therapy with IS) and on therapy with IS only. Methods. This study included 103 pts received RTX as an addition to previous therapy (group 1) and 65 pts received therapy with IS and prednisolone (group 2). The mean follow-up period was 12.6±10.7months. In group 1 the mean age was 47±12.9 years, female – 88 pts (84%), the diffuse cutaneous subset of the disease had 55 pts (53%). The mean disease duration was 6.2±5.5 years. 82% pts had interstitial lung disease (ILD) and 92% were positive for ANA, 67% of them were positive for antitopoisomerase-1. All pts received prednisolone at a dose of 11.3±4.5 mg/day, IS at inclusion received 47% of them. The cumulative mean dose of RTX was 1.7±0.6 g. In group 2 the mean age was 50.8±13.8 years, female-53 pts (82%), the diffuse cutaneous subset of the disease had 44 pts (68%). The mean disease duration was 8.8±7.7 years. 81% pts had ILD and 88% were positive for ANA, 58% of them were positive for antitopoisomerase-1. All pts received prednisolone at a dose of 8.69±4.28 mg/day, IS received 57% of them. Cyclophosphamide (CP) received 45% of pts. The cumulative mean dose of CP was 10.2±15.1g. D-penicillamine received 30% of pts. Other pts was on mycophenolate mofetil or methotrexate therapy in single cases. The pts of the compared groups did not differ in the main demographic and clinical parameters. The results are presented as delta (Δ) - difference between the baseline parameter and follow up point. Results. In group 1 there was an improvement of all outcome parameters: increased of forced vital capacity, % predicted - ΔFVC=4% (p=0.0004); Diffusing capacity for carbon monoxide, % predicted remained stable (ΔDLCO=0.1%); improvement of the Rodnan skin score-ΔmRss=3.4 (p=0.001); decrease of Activity index (EScSG-AI) - ΔActivity index=1.7 (p=0.001). In group 2 the changes was insignificant: ΔFVC=-2.3%, ΔmRss=0.87, ΔActivity index=0.3. But there was a significant decrease of DLCO: ΔDLCO=-5.1% (p=0.001). Conclusion. The results of our study confirm the data on the positive effect of RTX in complex therapy in pts with SSc (decrease of skin induration, increase of FVC, stabilization of DLCO). Meantime, pts on IS and prednisolone therapy shown the worsening of lung function and insignificant changes of other clinical parameters. RTX could be considered as a more effective option in complex treatment of SSc in comparison with IS therapyKeywords: immunosuppressants, interstitial lung disease, systemic sclerosis, rituximab
Procedia PDF Downloads 863200 Development of PSS/E Dynamic Model for Controlling Battery Output to Improve Frequency Stability in Power Systems
Authors: Dae-Hee Son, Soon-Ryul Nam
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The power system frequency falls when disturbance such as rapid increase of system load or loss of a generating unit occurs in power systems. Especially, increase in the number of renewable generating units has a bad influence on the power system because of loss of generating unit depending on the circumstance. Conventional technologies use frequency droop control battery output for the frequency regulation and balance between supply and demand. If power is supplied using the fast output characteristic of the battery, power system stability can be further more improved. To improve the power system stability, we propose battery output control using ROCOF (Rate of Change of Frequency) in this paper. The bigger the power difference between the supply and the demand, the bigger the ROCOF drops. Battery output is controlled proportionally to the magnitude of the ROCOF, allowing for faster response to power imbalances. To simulate the control method of battery output system, we develop the user defined model using PSS/E and confirm that power system stability is improved by comparing with frequency droop control.Keywords: PSS/E user defined model, power deviation, frequency droop control, ROCOF (rate of change of frequency)
Procedia PDF Downloads 4173199 Did Nature of Job Matters - Impact of Perceived Job Autonomy on Turnover Intention in Sales and Marketing Managers: Moderating Effect of Procedural and Distributive Justice
Authors: Muhammad Babar Shahzad
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The purpose of our study is to investigate the relationship between perceived job autonomy and turnover intention in sales & marketing staff. Perceived job autonomy is considered one of most studied dimension of Job Characteristic Model. But still there is a confusion in scholars about predictive role of perceived job autonomy in turnover intention. In line of more complex research on this relation, we investigated the relationship between perceived job autonomy and turnover intention. Did nature of job have any impact on this relationship. On the call of different authors we take interactive effect of perceived job autonomy and procedural justice on turnover intention. Predictive role of distributive justice to employee outcomes is not deniable. But predictive role of distributive justice will be prone in different contextual influences. Interactive role of distributive justice and perceived job autonomy is also not tested before. We collected date from 279 marketing and sales managers working in financial institution, FMCG industries, Pharamesutical Industry & Bank. Strong and direct negative relation was found in perceived job autonomy, distributive justice & procedural justice on turnover intention. Distributive and procedural justice is also amplifying the negative relationship of perceived job autonomy and turnover intention. Limitation and future direction for research is also discussed.Keywords: perceived job autonomy, turnover intention, procedural justice, distributive job
Procedia PDF Downloads 5133198 An Approach to Apply Kernel Density Estimation Tool for Crash Prone Location Identification
Authors: Kazi Md. Shifun Newaz, S. Miaji, Shahnewaz Hazanat-E-Rabbi
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In this study, the kernel density estimation tool has been used to identify most crash prone locations in a national highway of Bangladesh. Like other developing countries, in Bangladesh road traffic crashes (RTC) have now become a great social alarm and the situation is deteriorating day by day. Today’s black spot identification process is not based on modern technical tools and most of the cases provide wrong output. In this situation, characteristic analysis and black spot identification by spatial analysis would be an effective and low cost approach in ensuring road safety. The methodology of this study incorporates a framework on the basis of spatial-temporal study to identify most RTC occurrence locations. In this study, a very important and economic corridor like Dhaka to Sylhet highway has been chosen to apply the method. This research proposes that KDE method for identification of Hazardous Road Location (HRL) could be used for all other National highways in Bangladesh and also for other developing countries. Some recommendations have been suggested for policy maker to reduce RTC in Dhaka-Sylhet especially in black spots.Keywords: hazardous road location (HRL), crash, GIS, kernel density
Procedia PDF Downloads 3153197 Experimental Investigation on the Mechanical Behaviour of Three-Leaf Masonry Walls under In-Plane Loading
Authors: Osama Amer, Yaser Abdel-Aty, Mohamed Abd El Hady
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The present paper illustrates an experimental approach to provide understanding of the mechanical behavior and failure mechanisms of different typologies of unreinforced three-leaf masonry walls of historical Islamic architectural heritage in Egypt. The main objective of this study is to investigate the propagation of possible cracking, ultimate load, deformations and failure mechanisms. Experimental data on interface-shear and compression tests on large scale three-leaf masonry wallets are provided. The wallets were built basically of Egyptian limestone and modified lime mortar. External wallets were built of stone blocks while the inner leaf was built of rubble limestone. Different loading conditions and dimensions of core layer for two types of collar joints (with and without shear keys) are considered in the tests. Mechanical properties of the constituent materials of masonry were tested and a database of characteristic properties was created. The results of the experiments will highlight the properties, force-displacement curves, stress distribution of multiple-leaf masonry walls contributing to the derivation of rational design rules and validation of numerical models.Keywords: masonry, three-leaf walls, mechanical behavior, testing, architectural heritage
Procedia PDF Downloads 2943196 A Rare Case Report of Non-Langerhans Cell Cutaneous Histiocytosis in a 6-Month Old Infant
Authors: Apoorva D. R.
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INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.Keywords: histiocytosis, non langerhans cell, case report, fatal, rare
Procedia PDF Downloads 923195 Enhancement Effect of Superparamagnetic Iron Oxide Nanoparticle-Based MRI Contrast Agent at Different Concentrations and Magnetic Field Strengths
Authors: Bimali Sanjeevani Weerakoon, Toshiaki Osuga, Takehisa Konishi
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Magnetic Resonance Imaging Contrast Agents (MRI-CM) are significant in the clinical and biological imaging as they have the ability to alter the normal tissue contrast, thereby affecting the signal intensity to enhance the visibility and detectability of images. Superparamagnetic Iron Oxide (SPIO) nanoparticles, coated with dextran or carboxydextran are currently available for clinical MR imaging of the liver. Most SPIO contrast agents are T2 shortening agents and Resovist (Ferucarbotran) is one of a clinically tested, organ-specific, SPIO agent which has a low molecular carboxydextran coating. The enhancement effect of Resovist depends on its relaxivity which in turn depends on factors like magnetic field strength, concentrations, nanoparticle properties, pH and temperature. Therefore, this study was conducted to investigate the impact of field strength and different contrast concentrations on enhancement effects of Resovist. The study explored the MRI signal intensity of Resovist in the physiological range of plasma from T2-weighted spin echo sequence at three magnetic field strengths: 0.47 T (r1=15, r2=101), 1.5 T (r1=7.4, r2=95), and 3 T (r1=3.3, r2=160) and the range of contrast concentrations by a mathematical simulation. Relaxivities of r1 and r2 (L mmol-1 Sec-1) were obtained from a previous study and the selected concentrations were 0.05, 0.06, 0.07, 0.08, 0.09, 0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.0, 2.0, and 3.0 mmol/L. T2-weighted images were simulated using TR/TE ratio as 2000 ms /100 ms. According to the reference literature, with increasing magnetic field strengths, the r1 relaxivity tends to decrease while the r2 did not show any systematic relationship with the selected field strengths. In parallel, this study results revealed that the signal intensity of Resovist at lower concentrations tends to increase than the higher concentrations. The highest reported signal intensity was observed in the low field strength of 0.47 T. The maximum signal intensities for 0.47 T, 1.5 T and 3 T were found at the concentration levels of 0.05, 0.06 and 0.05 mmol/L, respectively. Furthermore, it was revealed that, the concentrations higher than the above, the signal intensity was decreased exponentially. An inverse relationship can be found between the field strength and T2 relaxation time, whereas, the field strength was increased, T2 relaxation time was decreased accordingly. However, resulted T2 relaxation time was not significantly different between 0.47 T and 1.5 T in this study. Moreover, a linear correlation of transverse relaxation rates (1/T2, s–1) with the concentrations of Resovist can be observed. According to these results, it can conclude that the concentration of SPIO nanoparticle contrast agents and the field strengths of MRI are two important parameters which can affect the signal intensity of T2-weighted SE sequence. Therefore, when MR imaging those two parameters should be considered prudently.Keywords: Concentration, resovist, field strength, relaxivity, signal intensity
Procedia PDF Downloads 3523194 Fuzzy Inference System for Determining Collision Risk of Ship in Madura Strait Using Automatic Identification System
Authors: Emmy Pratiwi, Ketut B. Artana, A. A. B. Dinariyana
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Madura Strait is considered as one of the busiest shipping channels in Indonesia. High vessel traffic density in Madura Strait gives serious threat due to navigational safety in this area, i.e. ship collision. This study is necessary as an attempt to enhance the safety of marine traffic. Fuzzy inference system (FIS) is proposed to calculate risk collision of ships. Collision risk is evaluated based on ship domain, Distance to Closest Point of Approach (DCPA), and Time to Closest Point of Approach (TCPA). Data were collected by utilizing Automatic Identification System (AIS). This study considers several ships’ domain models to give the characteristic of marine traffic in the waterways. Each encounter in the ship domain is analyzed to obtain the level of collision risk. Risk level of ships, as the result in this study, can be used as guidance to avoid the accident, providing brief description about safety traffic in Madura Strait and improving the navigational safety in the area.Keywords: automatic identification system, collision risk, DCPA, fuzzy inference system, TCPA
Procedia PDF Downloads 5513193 Triangular Geometric Feature for Offline Signature Verification
Authors: Zuraidasahana Zulkarnain, Mohd Shafry Mohd Rahim, Nor Anita Fairos Ismail, Mohd Azhar M. Arsad
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Handwritten signature is accepted widely as a biometric characteristic for personal authentication. The use of appropriate features plays an important role in determining accuracy of signature verification; therefore, this paper presents a feature based on the geometrical concept. To achieve the aim, triangle attributes are exploited to design a new feature since the triangle possesses orientation, angle and transformation that would improve accuracy. The proposed feature uses triangulation geometric set comprising of sides, angles and perimeter of a triangle which is derived from the center of gravity of a signature image. For classification purpose, Euclidean classifier along with Voting-based classifier is used to verify the tendency of forgery signature. This classification process is experimented using triangular geometric feature and selected global features. Based on an experiment that was validated using Grupo de Senales 960 (GPDS-960) signature database, the proposed triangular geometric feature achieves a lower Average Error Rates (AER) value with a percentage of 34% as compared to 43% of the selected global feature. As a conclusion, the proposed triangular geometric feature proves to be a more reliable feature for accurate signature verification.Keywords: biometrics, euclidean classifier, features extraction, offline signature verification, voting-based classifier
Procedia PDF Downloads 3813192 Effects of Rice Husk Ash on the Properties of Scrap Tyre Steel Fiber Reinforced High Performance Concrete (RHA-STSFRHAC)
Authors: Isyaka Abdulkadir, Egbe-Ngu Ntui Ogork
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This research aims to investigate the effect of Rice Husk Ash (RHA) on Scrap Tyre Steel Fiber Reinforced High Performance Concrete (STSFRHPC). RHA was obtained by control burning of rice husk in a kiln to a temperature of 650-700oC and when cooled sieved through 75µm sieve and characterized. The effect of RHA were investigated on grade 50 STSFRHPC of 1:1.28:1.92 with water cement ratio of 0.39 at additions of Scrap Tyre Steel Fiber (STSF) of 1.5% by volume of concrete and partial replacement of cement with RHA at percentages of 0, 5, 10, 15 and 20. The fresh concrete was tested for slump while the hardened concrete was tested for compressive and splitting tensile strengths respectively at curing ages of 3, 7, 28 and 56 days in accordance with standard procedure. Results of RHA-STSFRHPC indicated a reduction in slump and compressive strength with increase in RHA content, while splitting tensile strength increased with RHA replacement up to 10% and reduction in strength above 10% RHA content. The 28 days compressive strength of RHA-STSFRHPC with up to 10% RHA attained the desired characteristic strength of 50N/mm2 and therefore up to 10% RHA is considered as the optimum replacement dosage in STSFRHPC-RHA.Keywords: compressive strength, high performance concrete, rice husk ash, scrap tyre steel fibers
Procedia PDF Downloads 3403191 Stress Analysis of Water Wall Tubes of a Coal-fired Boiler during Soot Blowing Operation
Authors: Pratch Kittipongpattana, Thongchai Fongsamootr
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This research aimed to study the influences of a soot blowing operation and geometrical variables to the stress characteristic of water wall tubes located in soot blowing areas which caused the boilers of Mae Moh power plant to lose their generation hour. The research method is divided into 2 parts (a) measuring the strain on water wall tubes by using 3-element rosette strain gages orientation during a full capacity plant operation and in periods of soot blowing operations (b) creating a finite element model in order to calculate stresses on tubes and validating the model by using experimental data in a steady state plant operation. Then, the geometrical variables in the model were changed to study stresses on the tubes. The results revealed that the stress was not affected by the soot blowing process and the finite element model gave the results 1.24% errors from the experiment. The geometrical variables influenced the stress, with the most optimum tubes design in this research reduced the average stress from the present design 31.28%.Keywords: boiler water wall tube, finite element, stress analysis, strain gage rosette
Procedia PDF Downloads 3923190 Development of Trigger Tool to Identify Adverse Drug Events From Warfarin Administered to Patient Admitted in Medical Wards of Chumphae Hospital
Authors: Puntarikorn Rungrattanakasin
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Objectives: To develop the trigger tool to warn about the risk of bleeding as an adverse event from warfarin drug usage during admission in Medical Wards of Chumphae Hospital. Methods: A retrospective study was performed by reviewing the medical records for the patients admitted between June 1st,2020- May 31st, 2021. ADEs were evaluated by Naranjo’s algorithm. The international normalized ratio (INR) and events of bleeding during admissions were collected. Statistical analyses, including Chi-square test and Reciever Operating Characteristic (ROC) curve for optimal INR threshold, were used for the study. Results: Among the 139 admissions, the INR range was found to vary between 0.86-14.91, there was a total of 15 bleeding events, out of which 9 were mild, and 6 were severe. The occurrence of bleeding started whenever the INR was greater than 2.5 and reached the statistical significance (p <0.05), which was in concordance with the ROC curve and yielded 100 % sensitivity and 60% specificity in the detection of a bleeding event. In this regard, the INR greater than 2.5 was considered to be an optimal threshold to alert promptly for bleeding tendency. Conclusions: The INR value of greater than 2.5 (>2.5) would be an appropriate trigger tool to warn of the risk of bleeding for patients taking warfarin in Chumphae Hospital.Keywords: trigger tool, warfarin, risk of bleeding, medical wards
Procedia PDF Downloads 1493189 Walking Cadence to Attain a Minimum of Moderate Aerobic Intensity in People at Risk of Cardiovascular Diseases
Authors: Fagner O. Serrano, Danielle R. Bouchard, Todd A. Duhame
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Walking cadence (steps/min) is an effective way to prescribe exercise so an individual can reach a moderate intensity, which is recommended to optimize health benefits. To our knowledge, there is no study on the required walking cadence to reach a moderate intensity for people that present chronic conditions or risk factors for chronic conditions such as Cardiovascular Diseases (CVD). The objectives of this study were: 1- to identify the walking cadence needed for people at risk of CVD to a reach moderate intensity, and 2- to develop and test an equation using clinical variables to help professionals working with individuals at risk of CVD to estimate the walking cadence needed to reach moderate intensity. Ninety-one people presenting a minimum of two risk factors for CVD completed a medically supervised graded exercise test to assess maximum oxygen consumption at the first visit. The last visit consisted of recording walking cadence using a foot pod Garmin FR-60 and a Polar heart rate monitor, aiming to get participants to reach 40% of their maximal oxygen consumption using a portable metabolic cart on an indoor flat surface. The equation to predict the walking cadence needed to reach moderate intensity in this sample was developed as follows: The sample was randomly split in half and the equation was developed with one half of the participants, and validated using the other half. Body mass index, height, stride length, leg height, body weight, fitness level (VO2max), and self-selected cadence (over 200 meters) were measured using objective measured. Mean walking cadence to reach moderate intensity for people age 64.3 ± 10.3 years old at risk of CVD was 115.8 10.3 steps per minute. Body mass index, height, body weight, fitness level, and self-selected cadence were associated with walking cadence at moderate intensity when evaluated in bivariate analyses (r ranging from 0.22 to 0.52; all P values ≤0.05). Using linear regression analysis including all clinical variables associated in the bivariate analyses, body weight was the significant predictor of walking cadence for reaching a moderate intensity (ß=0.24; P=.018) explaining 13% of walking cadence to reach moderate intensity. The regression model created was Y = 134.4-0.24 X body weight (kg).Our findings suggest that people presenting two or more risk factors for CVD are reaching moderate intensity while walking at a cadence above the one officially recommended (116 steps per minute vs. 100 steps per minute) for healthy adults.Keywords: cardiovascular disease, moderate intensity, older adults, walking cadence
Procedia PDF Downloads 4443188 Numerical and Experimental Studies on the Characteristic of the Air Distribution in the Wind-Box of a Circulating Fluidized Bed Boiler
Authors: Xiaozhou Liu, Guangyu Zhu, Yu Zhang, Hongwei Wu
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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 1783187 Data Science-Based Key Factor Analysis and Risk Prediction of Diabetic
Authors: Fei Gao, Rodolfo C. Raga Jr.
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This research proposal will ascertain the major risk factors for diabetes and to design a predictive model for risk assessment. The project aims to improve diabetes early detection and management by utilizing data science techniques, which may improve patient outcomes and healthcare efficiency. The phase relation values of each attribute were used to analyze and choose the attributes that might influence the examiner's survival probability using Diabetes Health Indicators Dataset from Kaggle’s data as the research data. We compare and evaluate eight machine learning algorithms. Our investigation begins with comprehensive data preprocessing, including feature engineering and dimensionality reduction, aimed at enhancing data quality. The dataset, comprising health indicators and medical data, serves as a foundation for training and testing these algorithms. A rigorous cross-validation process is applied, and we assess their performance using five key metrics like accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC-ROC). After analyzing the data characteristics, investigate their impact on the likelihood of diabetes and develop corresponding risk indicators.Keywords: diabetes, risk factors, predictive model, risk assessment, data science techniques, early detection, data analysis, Kaggle
Procedia PDF Downloads 793186 Analysis of Vibratory Signals Based on Local Mean Decomposition (LMD) for Rolling Bearing Fault Diagnosis
Authors: Toufik Bensana, Medkour Mihoub, Slimane Mekhilef
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The use of vibration analysis has been established as the most common and reliable method of analysis in the field of condition monitoring and diagnostics of rotating machinery. Rolling bearings cover a broad range of rotary machines and plays a crucial role in the modern manufacturing industry. Unfortunately, the vibration signals collected from a faulty bearing are generally nonstationary, nonlinear and with strong noise interference, so it is essential to obtain the fault features correctly. In this paper, a novel numerical analysis method based on local mean decomposition (LMD) is proposed. LMD decompose the signal into a series of product functions (PFs), each of which is the product of an envelope signal and a purely frequency modulated FM signal. The envelope of a PF is the instantaneous amplitude (IA), and the derivative of the unwrapped phase of a purely flat frequency demodulated (FM) signal is the IF. After that, the fault characteristic frequency of the roller bearing can be extracted by performing spectrum analysis to the instantaneous amplitude of PF component containing dominant fault information. The results show the effectiveness of the proposed technique in fault detection and diagnosis of rolling element bearing.Keywords: fault diagnosis, rolling element bearing, local mean decomposition, condition monitoring
Procedia PDF Downloads 3923185 A Look into Surgical Site Infections: Impact of Collective Interventions
Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff
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Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement
Procedia PDF Downloads 4833184 Universal Screening for GBS and Efficacy of GBS Intrapartum Antibiotic Prophylaxis [IAP] an Al Rahba Experience
Authors: Ritu Nambiar, Shazia Tariq, Sumaira Jamil, Farida Munawar, Imelda Israell
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GBS has emerged as a leading cause of neonatal infections worldwide and clinical trials have demonstrated that giving IAP was effective in reducing early onset GBS (EOGBS) disease of the newborn. There is no available data on the prevalence of GBS in the UAE, therefore, a retrospective chart analysis of our parturients were done to look at our prevalence. The aim of this study is: 1. To study the prevalence of GBS colonization of parturients at al Rahba Hospital following universal screening between 35-37 week. 2. To look at efficacy of GBS intrapartum antibiotic prophylaxis by NICU admission for EO GBS disease of the newborn. 1) The prevalence of GBS in our patient population is 24.15%. 2) Incidence of EO GBS disease of the newborn was 0.6%.Keywords: GBS Screening, universal intrapartum antibiotic prophylaxis, parturients, newborn
Procedia PDF Downloads 4023183 Breath Ethanol Imaging System Using Real Time Biochemical Luminescence for Evaluation of Alcohol Metabolic Capacity
Authors: Xin Wang, Munkbayar Munkhjargal, Kumiko Miyajima, Takahiro Arakawa, Kohji Mitsubayashi
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The measurement of gaseous ethanol plays an important role of evaluation of alcohol metabolic capacity in clinical and forensic analysis. A 2-dimensional visualization system for gaseous ethanol was constructed and tested in visualization of breath and transdermal alcohol. We demonstrated breath ethanol measurement using developed high-sensitive visualization system. The concentration of breath ethanol calculated with the imaging signal was significantly different between the volunteer subjects of ALDH2 (+) and (-).Keywords: breath ethanol, ethnaol imaging, biochemical luminescence, alcohol metabolism
Procedia PDF Downloads 3543182 The Impact of Autism on Children Behavior
Authors: Marina Wagdy Nageeb Eskander
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A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills
Procedia PDF Downloads 613181 Biobased Polyurethane Derived from Transesterified Castor Oil: Synthesis and Charecterization
Authors: Sonalee Das, Smita Mohanty, S. K. Nayak
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Recent years has witnessed the increasing demand for natural resources and products in polyurethane synthesis because of global warming, sustainable development and oil crisis. For this purpose, different plant oils such as soybean oil, castor oil and linseed oil are extensively used. Moreover, the isocyanate used for the synthesis of polyurethane is derived from petroleum resources. In this present work attempts have been made for the successful synthesis of biobased isocyanate from castor oil with partially biobased isocyanate in presence of catalyst dibutyltin dilaurate (DBTDL). The goal of the present study was to investigate the thermal, mechanical, morphological and chemical properties of the synthesized polyurethane in terms of castor oil modification. The transesterified polyol shows broad and higher hydroxyl value as compared to castor oil which was confirmed by FTIR studies. The FTIR studies also revealed the successful synthesis of bio based polyurethane by showing characteristic peaks at 3300cm-1, 1715cm-1 and 1532cm-1 respectively. The TGA results showed three step degradation mechanism for the synthesized polyurethane from modified and unmodified castor oil. However, the modified polyurethane exhibited higher degradation temperature as compared to unmodified one. The mechanical properties also demonstrated higher tensile strength for modified polyurethane as compared to unmodified one.Keywords: castor oil, partially biobased Isocyanate, polyurethane synthesis, FTIR
Procedia PDF Downloads 3543180 The Clinical Effectiveness of Off-The-Shelf Foot Orthoses on the Dynamics of Gait in Patients with Early Rheumatoid Arthritis
Authors: Vicki Cameron
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Background: Rheumatoid Arthritis (RA) typically effects the feet and about 20% of patients present initially with foot and ankle symptoms. Custom moulded foot orthoses (FO) in the management of foot and ankle problems in RA is well documented in the literature. Off-the-shelf FO are thought to provide an effective alternative to custom moulded FO in patients with RA, however they are not evidence based. Objectives: To determine the effects of off-the-shelf FO on; 1. quality of life (QOL) 2. walking speed 4. peak plantar pressure in the forefoot (PPPft) Methods: Thirty-five patients (six male and 29 female) participated in the study from 11/2006 to 07/2008. The age of the patients ranged from 26 to 80 years (mean 52.4 years; standard deviation [SD] 13.3 years). A repeated measures design was used, with patients presenting at baseline, three months and six months. Patients were tested walking barefoot, shod and shod with FO. The type of orthoses used was the Slimflex Plastic ® (Algeos). The Leeds Foot Impact Scale (LFIS) was used to investigate QOL. The Vicon 612 motion analysis system was used to determine the effect of FO on walking speed. The F-scan walkway and in-shoe systems provided information of the effect on PPPft. Ethical approval was obtained on 07/2006. Data was analysed using SPSS version 15.0. Results/Discussion: The LFIS data was analysed with a repeated measures ANOVA. There was a significant improvement in the LFIS score with the use of the FO over the six months (p<0.01). A significant increase in walking speed with the orthoses was observed (p<0.01). Peak plantar pressure in the forefoot was reduced with the FO, as shown by a non-parametric Friedman’s test (chi-square = 55.314, df=2, p<0.05). Conclusion: The results show that off-the-shelf FO are effective in managing foot problems in patients with RA. Patients reported an improved QOL with the orthoses, and further objective measurements were quantified to provide a rationale for this change. Patients demonstrated an increased walking speed, which has been shown to be associated with reduced pain. The FO decreased PPPft which have been reported as a site of pain and ulceration in patients with RA. Salient Clinical Points: Off-the-shelf FO offer an effective alternative to custom moulded FO, and can be dispensed at the chair side. This is crucial in the management of foot problems associated with RA as early intervention is advocated due to the chronic and progressive nature of the disease.Keywords: podiatry, rheumatoid arthritis, foot orthoses, gait analysis
Procedia PDF Downloads 2613179 The Effect of Autism Attitudes and Laws and Restrictions
Authors: Eva Maged Hosni Sadek
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A descriptive statistical analysis of the data showed that the most important factor evoking negative attitudes among teachers is student behavior. have been presented as useful models for understanding the risk factors and protective factors associated with the emergence of autistic traits. Although these "syndrome" forms of autism reach clinical thresholds, they appear to be distinctly different from the idiopathic or "non-syndrome" autism phenotype. Most teachers reported that kindergartens did not prepare them for the educational needs of children with autism, particularly in relation to non-verbal skills. The study is important and points the way for improving teacher inclusion education in Thailand. Inclusive education for students with autism is still in its infancy in Thailand. Although the number of autistic children in schools has increased significantly since the Thai government introduced the Education Regulations for Persons with Disabilities Act in 2008, there is a general lack of services for autistic students and their families. This quantitative study used the Teaching Skills and Readiness Scale for Students with Autism (APTSAS) to test the attitudes and readiness of 110 elementary school teachers when teaching students with autism in general education classrooms. To uncover the true nature of these co morbidities, it is necessary to expand the definition of autism to include the cognitive features of the disorder, and then apply this expanded conceptualization to examine patterns of autistic syndromes. This study used various established eye-tracking paradigms to assess the visual and attention performance of children with DS and FXS who meet the autism thresholds defined in the Social Communication Questionnaire. To study whether the autistic profiles of these children are associated with visual orientation difficulties ("sticky attention"), decreased social attention, and increased visual search performance, all of which are hallmarks of the idiopathic autistic child phenotype. Data will be collected from children with DS and FXS, aged 6 to 10 years, and two control groups matched for age and intellectual ability (i.e., children with idiopathic autism).In order to enable a comparison of visual attention profiles, cross-sectional analyzes of developmental trajectories are carried out. Significant differences in the visual-attentive processes underlying the presentation of autism in children with FXS and DS have been suggested, supporting the concept of syndrome specificity. The study provides insights into the complex heterogeneity associated with autism syndrome symptoms and autism itself, with clinical implications for the utility of autism intervention programs in DS and FXS populations.Keywords: attitude, autism, teachers, sports activities, movement skills, motor skills
Procedia PDF Downloads 613178 ‘Groupitizing’ – A Key Factor in Math Learning Disabilities
Authors: Michal Wolk, Bat-Sheva Hadad, Orly Rubinsten
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Objective: The visuospatial perception system process that allows us to decompose and recompose small quantities into a whole is often called “groupitizing.” Previous studies have been found that adults use groupitizing processes in quantity estimation tasks and link this ability of subgroups recognition to arithmetic proficiency. This pilot study examined if adults with math difficulties benefit from visuospatial grouping cues when asked to estimate the quantity of a given set. It also compared the tipping point in which a significant improvement occurs in adults with typical development compared to adults with math difficulties. Method: In this pilot research, we recruited adults with low arithmetic abilities and matched controls. Participants were asked to estimate the quantity of a given set. Different grouping cues were displayed (space, color, or none) with different visual configurations (different quantities-different shapes, same quantities- different shapes, same quantities- same shapes). Results: Both groups showed significant performance improvement when grouping cues appeared. However, adults with low arithmetic abilities benefited from the grouping cues already in very small quantities as four. Conclusion: impaired perceptual groupitizing abilities may be a characteristic of low arithmetic abilities.Keywords: groupitizing, math learning disability, quantity estimation, visual perception system
Procedia PDF Downloads 2063177 Nature of a Supercritical Mesophase
Authors: Hamza Javar Magnier, Leslie V. Woodcock
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It has been reported that at temperatures above the critical there is no “continuity of liquid and gas”, as originally hypothesized by van der Waals. Rather, both gas and liquid phases, with characteristic properties as such, extend to supercritical temperatures. Each phase is bounded by the locus of a percolation transition, i.e. a higher-order thermodynamic phase change associated with percolation of gas clusters in a large void, or liquid interstitial vacancies in a large cluster. Between these two-phase bounds, it is reported there exists a mesophase that resembles an otherwise homogeneous dispersion of gas micro-bubbles in liquid (foam) and a dispersion of liquid micro-droplets in gas (mist). Such a colloidal-like state of a pure one-component fluid represents a hitherto unchartered equilibrium state of matter besides pure solid, liquid or gas. Here we provide compelling evidence, from molecular dynamics (MD) simulations, for the existence of this supercritical mesophase and its colloidal nature. We report preliminary results of computer simulations for a model fluid using a simplistic representation of atoms or molecules, i.e. a hard-core repulsion with an attraction so short that the atoms are referred to as “adhesive spheres”. Molecular clusters, and hence percolation transitions, are unambiguously defined. Graphics of color-coded clusters show colloidal characteristics of the supercritical mesophase.Keywords: critical phenomena, mesophase, supercritical, square-well, critical parameters
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