Search results for: control methods
5051 Heritage Tourism and the Changing Rural Landscape: Case Study of Cultural Landscape of Honghe Hani Rice Terraces
Authors: Yan Wang; Mathis Stock
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The World Heritage Site of Honghe Hani rice terrace, also a marginal rural region in Southern China, is undergoing rapid change because of urbanization and heritage tourism. Influenced by out-migration and changing ways of living in the urbanization process, the place sees a tendency of losing its rice terrace landscape, traditional housings and other forms of cultural traditions. However, heritage tourism tends to keep the past, valorize them for tourism purposes and diversifies rural livelihood strategies. The place stands at this development trajectories, where the same resources are subjected to different uses by different actors. The research seeks to answer the questions of how the site is transformed and co-constructed by different institutions, practices and actors, and the how heritage tourism affects local livelihood. The research aims to describe the transformation of villages, rice terraces, and cultural traditions, analyze the place-making process, and assess the role of heritage tourism in local livelihood transition. The research uses a mixed of methods including direct observation, participant observation, interviews; collects various data of images, words, narratives, and statistics, and analyze them qualitatively and qualitatively. Theoretically, it is hoped that the research would reexamine the concept of heritage, the world heritage practice from UNESCO, reveal the conflicts it entails in development and brings more thoughts from a functional perspective on heritage in relation to rural development. Practically, it is also anticipated that the research could access the linkage between heritage tourism and local livelihood, and generate concrete suggestions on how tourism could engage locals and improve their livelihood.Keywords: cultural landscape, Hani rice terraces, heritage tourism, livelihood strategy, place making, rural development, transformation
Procedia PDF Downloads 2355050 Clustering-Based Threshold Model for Condition Rating of Concrete Bridge Decks
Authors: M. Alsharqawi, T. Zayed, S. Abu Dabous
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To ensure safety and serviceability of bridge infrastructure, accurate condition assessment and rating methods are needed to provide basis for bridge Maintenance, Repair and Replacement (MRR) decisions. In North America, the common practices to assess condition of bridges are through visual inspection. These practices are limited to detect surface defects and external flaws. Further, the thresholds that define the severity of bridge deterioration are selected arbitrarily. The current research discusses the main deteriorations and defects identified during visual inspection and Non-Destructive Evaluation (NDE). NDE techniques are becoming popular in augmenting the visual examination during inspection to detect subsurface defects. Quality inspection data and accurate condition assessment and rating are the basis for determining appropriate MRR decisions. Thus, in this paper, a novel method for bridge condition assessment using the Quality Function Deployment (QFD) theory is utilized. The QFD model is designed to provide an integrated condition by evaluating both the surface and subsurface defects for concrete bridges. Moreover, an integrated condition rating index with four thresholds is developed based on the QFD condition assessment model and using K-means clustering technique. Twenty case studies are analyzed by applying the QFD model and implementing the developed rating index. The results from the analyzed case studies show that the proposed threshold model produces robust MRR recommendations consistent with decisions and recommendations made by bridge managers on these projects. The proposed method is expected to advance the state of the art of bridges condition assessment and rating.Keywords: concrete bridge decks, condition assessment and rating, quality function deployment, k-means clustering technique
Procedia PDF Downloads 2265049 Exhaled Breath Condensate in Lung Cancer: A Non-Invasive Sample for Easier Mutations Detection by Next Generation Sequencing
Authors: Omar Youssef, Aija Knuuttila, Paivi Piirilä, Virinder Sarhadi, Sakari Knuutila
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Exhaled breath condensate (EBC) is a unique sample that allows studying different genetic changes in lung carcinoma through a non-invasive way. With the aid of next generation sequencing (NGS) technology, analysis of genetic mutations has been more efficient with increased sensitivity for detection of genetic variants. In order to investigate the possibility of applying this method for cancer diagnostics, mutations in EBC DNA from lung cancer patients and healthy individuals were studied by using NGS. The key aim is to assess the feasibility of using this approach to detect clinically important mutations in EBC. EBC was collected from 20 healthy individuals and 9 lung cancer patients (four lung adenocarcinomas, four 8 squamous cell carcinoma, and one case of mesothelioma). Mutations in hotpot regions of 22 genes were studied by using Ampliseq Colon and Lung cancer panel and sequenced on Ion PGM. Results demonstrated that all nine patients showed a total of 19 cosmic mutations in APC, BRAF, EGFR, ERBB4, FBXW7, FGFR1, KRAS, MAP2K1, NRAS, PIK3CA, PTEN, RET, SMAD4, and TP53. In controls, 15 individuals showed 35 cosmic mutations in BRAF, CTNNB1, DDR2, EGFR, ERBB2, FBXW7, FGFR3, KRAS, MET, NOTCH1, NRAS, PIK3CA, PTEN, SMAD4, and TP53. Additionally, 45 novel mutations not reported previously were also seen in patients’ samples, and 106 novel mutations were seen in controls’ specimens. KRAS exon 2 mutations G12D was identified in one control specimen with mutant allele fraction of 6.8%, while KRAS G13D mutation seen in one patient sample showed mutant allele fraction of 17%. These findings illustrate that hotspot mutations are present in DNA from EBC of both cancer patients and healthy controls. As some of the cosmic mutations were seen in controls too, no firm conclusion can be drawn on the clinical importance of cosmic mutations in patients. Mutations reported in controls could represent early neoplastic changes or normal homeostatic process of apoptosis occurring in lung tissue to get rid of mutant cells. At the same time, mutations detected in patients might represent a non-invasive easily accessible way for early cancer detection. Follow up of individuals with important cancer mutations is necessary to clarify the significance of these mutations in both healthy individuals and cancer patients.Keywords: exhaled breath condensate, lung cancer, mutations, next generation sequencing
Procedia PDF Downloads 1795048 Passive Vibration Isolation Analysis and Optimization for Mechanical Systems
Authors: Ozan Yavuz Baytemir, Ender Cigeroglu, Gokhan Osman Ozgen
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Vibration is an important issue in the design of various components of aerospace, marine and vehicular applications. In order not to lose the components’ function and operational performance, vibration isolation design involving the optimum isolator properties selection and isolator positioning processes appear to be a critical study. Knowing the growing need for the vibration isolation system design, this paper aims to present two types of software capable of implementing modal analysis, response analysis for both random and harmonic types of excitations, static deflection analysis, Monte Carlo simulations in addition to study of parameter and location optimization for different types of isolation problem scenarios. Investigating the literature, there is no such study developing a software-based tool that is capable of implementing all those analysis, simulation and optimization studies in one platform simultaneously. In this paper, the theoretical system model is generated for a 6-DOF rigid body. The vibration isolation system of any mechanical structure is able to be optimized using hybrid method involving both global search and gradient-based methods. Defining the optimization design variables, different types of optimization scenarios are listed in detail. Being aware of the need for a user friendly vibration isolation problem solver, two types of graphical user interfaces (GUIs) are prepared and verified using a commercial finite element analysis program, Ansys Workbench 14.0. Using the analysis and optimization capabilities of those GUIs, a real application used in an air-platform is also presented as a case study at the end of the paper.Keywords: hybrid optimization, Monte Carlo simulation, multi-degree-of-freedom system, parameter optimization, location optimization, passive vibration isolation analysis
Procedia PDF Downloads 5685047 The Effect of Taekwondo on Plantar Pressure Distribution and Arch Index
Authors: Maryam Kakavand, Samira Entezari, Sara Khoshjamalfekri, Raghad Mimar
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The objective of this study is 1) to compare elite female and beginner taekwondo players in terms of plantar pressure distribution, vertical ground reaction force, contact area, mean pressure, and right and left longitudinal arches, and 2) to compare preferred and non-preferred limbs among elite players. To the best of authors’ knowledge, as of yet, there is no information available about the plantar pressure distribution and arch index among taekwondo players. Material and Methods: An analytical-comparative research method is applied. Therefore seven elite athletes and eight novice athletes were selected. The emed-C50 platform was used to assess plantar pressure distribution, vertical ground reaction force, contact area, mean pressure of different areas, and planter longitudinal arch in a second step protocol. Independent t-test and dependent t-test were used at a level of 0.05 to compare the elites and beginners' right and left feet, and preferred and non-preferred limbs among elite athletes, respectively. Results: In comparing the right and left limbs of elite and beginner groups, findings indicate that there is only a significant difference in the mean pressure of the first metatarsal of the right foot. Findings also showed a significant difference in the contact area of the toes 3, 4, 5 regions between elites’ preferred and non-preferred limbs. However, no significant difference was found between the two groups’ right and left limbs and elites’ preferred and non-preferred limbs in terms of pressure distribution, vertical ground reaction force, and arch index. Conclusion: It seems that taekwondo exercises have affected pressure distribution patterns among advanced players causing some differences in their planter pressure distribution pattern when compared to that of beginners. Therefore, taekwondo exercises may be a factor contributing to asymmetry performance in preferred and non-preferred limbs.Keywords: planter pressure, arch index, taekwondo, elite
Procedia PDF Downloads 1605046 On the Other Side of Shining Mercury: In Silico Prediction of Cold Stabilizing Mutations in Serine Endopeptidase from Bacillus lentus
Authors: Debamitra Chakravorty, Pratap K. Parida
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Cold-adapted proteases enhance wash performance in low-temperature laundry resulting in a reduction in energy consumption and wear of textiles and are also used in the dehairing process in leather industries. Unfortunately, the possible drawbacks of using cold-adapted proteases are their instability at higher temperatures. Therefore, proteases with broad temperature stability are required. Unfortunately, wild-type cold-adapted proteases exhibit instability at higher temperatures and thus have low shelf lives. Therefore, attempts to engineer cold-adapted proteases by protein engineering were made previously by directed evolution and random mutagenesis. The lacuna is the time, capital, and labour involved to obtain these variants are very demanding and challenging. Therefore, rational engineering for cold stability without compromising an enzyme's optimum pH and temperature for activity is the current requirement. In this work, mutations were rationally designed with the aid of high throughput computational methodology of network analysis, evolutionary conservation scores, and molecular dynamics simulations for Savinase from Bacillus lentus with the intention of rendering the mutants cold stable without affecting their temperature and pH optimum for activity. Further, an attempt was made to incorporate a mutation in the most stable mutant rationally obtained by this method to introduce oxidative stability in the mutant. Such enzymes are desired in detergents with bleaching agents. In silico analysis by performing 300 ns molecular dynamics simulations at 5 different temperatures revealed that these three mutants were found to be better in cold stability compared to the wild type Savinase from Bacillus lentus. Conclusively, this work shows that cold adaptation without losing optimum temperature and pH stability and additionally stability from oxidative damage can be rationally designed by in silico enzyme engineering. The key findings of this work were first, the in silico data of H5 (cold stable savinase) used as a control in this work, corroborated with its reported wet lab temperature stability data. Secondly, three cold stable mutants of Savinase from Bacillus lentus were rationally identified. Lastly, a mutation which will stabilize savinase against oxidative damage was additionally identified.Keywords: cold stability, molecular dynamics simulations, protein engineering, rational design
Procedia PDF Downloads 1455045 A Study on the Impact of Covid-19 on Primary Healthcare Workers in Ekiti State, South-West Nigeria
Authors: Adeyinka Adeniran, Omowunmi Bakare, Esther Oluwole, Florence Chieme, Temitope Durojaiye, Modupe Akinyinka, Omobola Ojo, Babatunde Olujobi, Marcus Ilesanmi, Akintunde Ogunsakin
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Introduction: Globally, COVID-19 has greatly impacted the human race physically, socially, mentally, and economically. However, healthcare workers seemed to bear the greatest impact. The study, therefore, sought to assess the impact of COVID-19 on the primary healthcare workers in Ekiti, South-west Nigeria. Methods: The study was a cross-sectional descriptive study using a quantitative data collection method of 716 primary healthcare workers in Ekiti state. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate and multivariate analyses were conducted using a t-test, and the level of statistical significance was set at p<0.05. Results: Less than half (47.1%) of respondents were between 41-50 age group and a mean age of 44.4+6.4SD. A majority (89.4%) were female, and almost all (96.2%) were married. More than (90%) had ever heard of Coronavirus, and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on about (89.7%) of healthcare workers, with a mean score of 22+4.8. Conclusion: COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers, which reflected their psychological, physical, social, and economic well-being. Disease outbreaks are unlikely to disappear in the near future. Hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save lives.Keywords: Covid-19, health workforce, primary health care, health systems, depression
Procedia PDF Downloads 895044 Ameliorative Effect of Curcuma Longa against Arsenic Induced Reproductive Toxicity in Charles Foster Rats
Authors: Shazia Naheed Akhter, Rekha Kumari
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An estimated 70 million population are exposed to arsenic poisoning in India in recent times. Arsenic contamination in the groundwater has caused serious health hazards among the exposed population. In Bihar, the first district was Bhojpur, where arsenic causing health issues were reported in 2002. Presently, there are 18 districts that are reported arsenic poisoning in the groundwater. The exposed population is firstly diseased with various symptoms such as skin manifestations, loss of appetite, constipation, hormonal disorders, etc. The long duration exposure has led to cause infertility in the male subjects. The present study thus aims to develop the antidote against arsenic-induced male reproductive toxicity in animal models. The study was carried out on Charles Foster Rats after the approval from Institutional Animal Ethics Committee. A total of n=18 rats (12 weeks old) of an average weight of 160 ± 20 g were used for the study. The study group included n=6 control and n= 12 treated with sodium arsenite orally at the dose of 8mg/Kg b.w daily for 40 days. The n= 6 animals were dissected and the rest n=6 was administered orally with Curcuma longa rhizome ethanolic extract at the dose of 600mg/Kg b.w per day for 40 days. At the end of the entire experiment, all the animals were dissected out and their reproductive organs were taken out, especially epididymis for sperm counts, sperm motility, sperm mortality, sperm morphology. The blood samples were collected for the hormonal assay (testosterone and luteinizing hormone), as well as for hematological and biochemical analysis. The study showed a high magnitude of degeneration in the reproductive organs of the rats in the arsenic-treated group. There were degenerative fluctuations in the sperm counts, sperm motility, sperm mortality, sperm morphology and in the hormonal parameters, as well as in the hematological and biochemical parameters in the arsenic-treated rats. But, after the administration of Curcuma longa, there was significant amelioration in all these parameters. Therefore, the present study shows that Curcuma longa plays a vital role to combat arsenic-induced male reproductive toxicity.Keywords: sodium arsenite, Charles foster rats, ethanolic rhizome extract of curcuma longa, male reproductive toxicity, amelioration
Procedia PDF Downloads 2305043 Influence of Distribution of Body Fat on Cholesterol Non-HDL and Its Effect on Kidney Filtration
Authors: Magdalena B. Kaziuk, Waldemar Kosiba
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Background: In the XXI century we have to deal with the epidemic of obesity which is important risk factor for the cardiovascular and kidney diseases. Lipo proteins are directly involved in the atherosclerotic process. Non-high-density lipo protein (non-HDL) began following widespread recognition of its superiority over LDL as a measurement of vascular event risk. Non-HDL includes residual risk which persists in patients after achieved recommended level of LDL. Materials and Methods: The study covered 111 patients (52 females, 59 males, age 51,91±14 years), hospitalized on the intern department. Body composition was assessed using the bioimpendance method and anthropometric measurements. Physical activity data were collected during the interview. The nutritional status and the obesity type were determined with the Waist to Height Ratio and the Waist to Hip Ratio. A function of the kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using MDRD formula. Non-HDL was calculated as a difference between concentration of the Total and HDL cholesterol. Results: 10% of patients were found to be underweight; 23.9 % had correct body weight; 15,08 % had overweight, while the remaining group had obesity: 51,02 %. People with the android shape have higher non-HDL cholesterol versus with the gynoid shape (p=0.003). The higher was non-HDL, the lower eGFR had studied subjects (p < 0.001). Significant correlation was found between high non-HDL and incorrect dietary habits in patients avoiding eating vegetables, fruits and having low physical activity (p < 0.005). Conclusions: Android type of figure raises the residual risk of the heart disease associated with higher levels of non-HDL. Increasing physical activity in these patients reduces the level of non-HDL. Non-HDL seems to be the best predictor among all cholesterol measures for the cardiovascular events and worsening eGFR.Keywords: obesity, non-HDL cholesterol, glomerular filtration rate, lifestyle
Procedia PDF Downloads 3765042 Factors Affecting M-Government Deployment and Adoption
Authors: Saif Obaid Alkaabi, Nabil Ayad
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Governments constantly seek to offer faster, more secure, efficient and effective services for their citizens. Recent changes and developments to communication services and technologies, mainly due the Internet, have led to immense improvements in the way governments of advanced countries carry out their interior operations Therefore, advances in e-government services have been broadly adopted and used in various developed countries, as well as being adapted to developing countries. The implementation of advances depends on the utilization of the most innovative structures of data techniques, mainly in web dependent applications, to enhance the main functions of governments. These functions, in turn, have spread to mobile and wireless techniques, generating a new advanced direction called m-government. This paper discusses a selection of available m-government applications and several business modules and frameworks in various fields. Practically, the m-government models, techniques and methods have become the improved version of e-government. M-government offers the potential for applications which will work better, providing citizens with services utilizing mobile communication and data models incorporating several government entities. Developing countries can benefit greatly from this innovation due to the fact that a large percentage of their population is young and can adapt to new technology and to the fact that mobile computing devices are more affordable. The use of models of mobile transactions encourages effective participation through the use of mobile portals by businesses, various organizations, and individual citizens. Although the application of m-government has great potential, it does have major limitations. The limitations include: the implementation of wireless networks and relative communications, the encouragement of mobile diffusion, the administration of complicated tasks concerning the protection of security (including the ability to offer privacy for information), and the management of the legal issues concerning mobile applications and the utilization of services.Keywords: e-government, m-government, system dependability, system security, trust
Procedia PDF Downloads 3865041 Transformation of the Institutionality of International Cooperation in Ecuador from 2007 to 2017: 2017: A Case of State Identity Affirmation through Role Performance
Authors: Natalia Carolina Encalada Castillo
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As part of an intended radical policy change compared to former administrations in Ecuador, the transformation of the institutionality of international cooperation during the period of President Rafael Correa was considered as a key element for the construction of the state of 'Good Living'. This intention led to several regulatory changes in the reception of cooperation for development, and even the departure of some foreign cooperation agencies. Moreover, Ecuador launched the initiative to become a donor of cooperation towards other developing countries through the ‘South-South Cooperation’ approach. All these changes were institutionalized through the Ecuadorian System of International Cooperation as a new framework to establish rules and policies that guarantee a sovereign management of foreign aid. Therefore, this research project has been guided by two questions: What were the factors that motivated the transformation of the institutionality of international cooperation in Ecuador from 2007 to 2017? and, what were the implications of this transformation in terms of the international role of the country? This paper seeks to answer these questions through Role Theory within a Constructivist meta-theoretical perspective, considering that in this case, changes at the institutional level in the field of cooperation, responded not only to material motivations but also to interests built on the basis of a specific state identity. The latter was only possible to affirm through specific roles such as ‘sovereign recipient of cooperation’ as well as ‘donor of international cooperation’. However, the performance of these roles was problematic as they were not easily accepted by the other actors in the international arena or in the domestic level. In terms of methodology, these dynamics are analyzed in a qualitative way mainly through interpretive analysis of the discourse of high-level decision-makers from Ecuador and other cooperation actors. Complementary to this, document-based research of relevant information as well as interviews have been conducted. Finally, it is concluded that even if material factors such as infrastructure needs, trade and investment interests, as well as reinforcement of state control and monitoring of cooperation flows, motivated the institutional transformation of international cooperation in Ecuador; the essential basis of these changes was the search for a new identity for the country to be projected in the international arena. This identity started to be built but continues to be unstable. Therefore, it is important to potentiate the achievements of the new international cooperation policies, and review their weaknesses, so that non-reimbursable cooperation funds received as well as ‘South-South cooperation’ actions, contribute effectively to national objectives.Keywords: Ecuador, international cooperation, Role Theory, state identity
Procedia PDF Downloads 2205040 Benefits of Occupational Therapy for Children with Intellectual Disabilities in the Aspects of Vocational Activities and Instrumental Activities of Daily Life
Authors: Shakhawath Hossain, Tazkia Tahsin
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Introduction/Background: Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. Vocational education is a multi-professional approach that is provided to individuals of working age with health-related impairments, limitations, or restrictions with work functioning and whose primary aim is to optimize work participation. Instrumental Activities of Daily Living activities to support daily life within the home and community. Like as community mobility, financial management, meal preparation, and clean-up, shopping. Material and Method: Electronic searches of Medline, PubMed, Google scholar, OT Seeker literature using the key terms of intellectual disability, vocational rehabilitation, instrumental activities of daily living and Occupational Therapy, as well as a thorough manual search for relevant literature. Results: There were 13 articles, all qualitative and quantitative, which are included in this review. All studies were mixed methods in design. To take the Occupational Therapy services, there is a significant improvement in their children's various areas like as sensory issues, cognitive abilities, perceptual skills, visual, motor planning, and group therapy. After taking the vocational and instrumental activities of daily living training children with intellectual disabilities to participate in their daily activities and work as an employee different company or organizations. Conclusion: The persons with intellectual disability are an integral part of our society who deserves social support and opportunities like other human beings. From the result section of the project papers, it is found that the significant benefits of Occupational Therapy services in the aspects of vocational and instrumental activities of daily living.Keywords: occupational therapy, daily living activities, intellectual disabilities, instrumental ADL
Procedia PDF Downloads 1325039 Community Pharmacist's Perceptions, Attitude and Role in Oral Health Promotion and Diseases Prevention
Authors: Bushra Alghamdi, Alla Alsharif, Hamzah Aljohani, Saba Kassim
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Introduction: Collaborative work has always been acknowledged as a fundamental concept in delivering oral health care. Aim: This study aimed to assess the perception and attitude of pharmacists in oral health promotion and to determine the confident levels of pharmacists in delivering advice on oral health problems. Methods: An observational cross-sectional survey, using self-administered anonymous questionnaires, was conducted between March and April 2017. The study recruited a convenience sample of registered community pharmacists who were working in local private pharmaceutical stores in the urban area of Madinah, Kingdom of Saudi Arabia (KSA). A preliminary descriptive analysis was performed. Results: Thirty-five pharmacists have completed the surveys. All participants were males, with a mean age of 35.5 ( ± 6.92) years. Eighty-six percent of the participants reported that pharmacists should have a role in oral health promotion. Eighty percent have reported adequate level of confident when giving advice on most of the common oral health problems that include; oral health related risk behaviors such as tobacco cessation (46%), bleeding gums (63%) and sensitive teeth (60%). However, higher percentages of pharmacists have reported low confident levels when giving advice in relation to specific domain of dentistry, such as lost dental fillings (57%), loose crowns (60%), trauma to teeth (40%), denture-related problems (51%) and oral cancer (6.9%). Conclusion: Community pharmacists recognized their potential role in promoting oral health in KSA. Community pharmacists had varying levels of ability and confidence to offer support for oral health. The study highlighted that inner professional collaboration between pharmacists and dental care healthcare should be enhanced.Keywords: community, oral health, promotion, pharmacist
Procedia PDF Downloads 2035038 Management of Nutritional Strategies in Prevention of Autism Before and During Pregnancy
Authors: Maryam Ghavam Sadri, Kimia Moiniafshari
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Objectives: Autism is a neuro-developmental disorder that has negative effects on verbal, mental and behavioral development. Studies have shown the role of a maternal dietary pattern before and during pregnancy. The relation of exerting of nutritional management programs in prevention of Autism has been approved. This review article has been made to investigate the role of nutritional management strategies before and during pregnancy in the prevention of Autism. Methods: This review study was accomplished by using the keywords related to the topic, 67 articles were found (2000-2015) and finally 20 article with criteria such as including maternal lifestyle, nutritional deficiencies and Autism prevention were selected. Results: Maternal dietary pattern and health before and during pregnancy have important roles in the incidence of Autism. Studies have suggested that high dietary fat intake and obesity can increase the risk of Autism in offspring. Maternal metabolic condition specially gestational diabetes (GDM) (p-value < 0.04) and folate deficiency (p-value = 0.04) is associated with risk of Autism. Studies have shown that folate intake in mothers with autistic children is less than mothers who have typically developing children (TYP) (p-value<0.01). As folate is an essential micronutrient for fetus mental development, consumption of average 600 mcg/day especially in P1 phase of pregnancy results in significant reduction in incidence of Autism (OR:1.53, 95%CI=0.42-0.92, p-value = 0.02). furthermore, essential fatty acid deficiency especially omega-3 fatty acid increases the rate of Autism and consumption of supplements and food sources of omega-3 can decrease the risk of Autism up to 34% (RR=1.53, 95%CI=1-2.32). Conclusion: regards to nutritional deficiency and maternal metabolic condition before and during pregnancy in prevalence of Autism, carrying out the appropriate nutritional strategies such as well-timed folate supplementation before pregnancy and healthy lifestyle adherence for prevention of metabolic syndrome (GDM) seems to help Autism prevention.Keywords: autism, autism prevention, dietary inadequacy, maternal lifestyle
Procedia PDF Downloads 3615037 Analysis of Constraints and Opportunities in Dairy Production in Botswana
Authors: Som Pal Baliyan
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Dairy enterprise has been a major source of employment and income generation in most of the economies worldwide. Botswana government has also identified dairy as one of the agricultural sectors towards diversification of the mineral dependent economy of the country. The huge gap between local demand and supply of milk and milk products indicated that there are not only constraints but also; opportunities exist in this sub sector of agriculture. Therefore, this study was an attempt to identify constraints and opportunities in dairy production industry in Botswana. The possible ways to mitigate the constraints were also identified. The findings should assist the stakeholders especially, policy makers in the formulation of effective policies for the growth of dairy sector in the country. This quantitative study adopted a survey research design. A final survey followed by a pilot survey was conducted for data collection. The purpose of the pilot survey was to collect basic information on the nature and extent of the constraints, opportunities and ways to mitigate the constraints in dairy production. Based on the information from pilot survey, a four point Likert’s scale type questionnaire was constructed, validated and tested for its reliability. The data for the final survey were collected from purposively selected twenty five dairy farms. The descriptive statistical tools were employed to analyze data. Among the twelve constraints identified; high feed costs, feed shortage and availability, lack of technical support, lack of skilled manpower, high prevalence of pests and diseases and, lack of dairy related technologies were the six major constraints in dairy production. Grain feed production, roughage feed production, manufacturing of dairy feed, establishment of milk processing industry and, development of transportation systems were the five major opportunities among the eight opportunities identified. Increasing production of animal feed locally, increasing roughage feed production locally, provision of subsidy on animal feed, easy access to sufficient financial support, training of the farmers and, effective control of pests and diseases were identified as the six major ways to mitigate the constraints. It was recommended that the identified constraints and opportunities as well as the ways to mitigate the constraints need to be carefully considered by the stakeholders especially, policy makers during the formulation and implementation of the policies for the development of dairy sector in Botswana.Keywords: dairy enterprise, milk production, opportunities, production constraints
Procedia PDF Downloads 4135036 An Attempt of Cost Analysis of Heart Failure Patients at Cardiology Department at Kasr Al Aini Hospitals: A Micro-Costing Study from Social Perspective
Authors: Eman Elsebaie, A. Sedrak, R. Ziada
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Introduction: In the recent decades, heart failure (HF) has become one of the most prevalent cardio-vascular disease (CVDs), especially in the elderly and the main cause of hospitalization in Egypt cardiology departments. By 2030, the prevalence of HF is expected to increase by 25%. Total direct costs will increase to $818 billion, and the total indirect cost in terms of lost productivity is close to $275 billion. The current study was conducted to estimate the economic costs of services delivered for heart failure patients at the cardiology department in Cairo University Hospitals (CUHs). Aim: To gain an understanding of the cost of heart failure disease and its main drivers aiming to minimize associated health care costs. Subjects and Methods: Economic cost analysis study was conducted for a prospective group of all cases of HF admitted to the cardiology department in CUHs from end of March till end of April 2016 and another retrospective randomized sample from patients with HF, during the first 3 months of 2016 to measure estimated average cost per patient per day. Results: The mean age of the prospective group was 48.6 ± 17.16 years versus 52.3 ± 11.5 years for the retrospective group. The median (IQR) of Length of stay was 15 (15) days in the prospective group versus 9 (16) days in the retrospective group. The average HF inpatient cost/day in the cardiology department during April 2016 was 362.32 (255.5) L.E. versus 391.2(255.9) L.E. during January and February 2016. Conclusion: Up to 70% of expenditure in the management of HF is related to hospital admission. The average cost of such an admission was 5540.03 (IQR=7507.8) L.E. and 4687.4 (IQR=7818.8) L.E. with the average cost per day estimated at 362.32 (IQR=255.5) L.E. and 386.2(IQR=255.9) L.E. in prospective and retrospective groups respectively.Keywords: health care cost, heart failure, hospitalization, inpatient
Procedia PDF Downloads 2465035 Subsurface Exploration for Soil Geotechnical Properties and its Implications for Infrastructure Design and Construction in Victoria Island, Lagos, Nigeria
Authors: Sunday Oladele, Joseph Oluwagbeja Simeon
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Subsurface exploration, integrating methods of geotechnics and geophysics, of a planned construction site in the coastal city of Lagos, Nigeria has been carried out with the aim of characterizing the soil properties and their implication for the proposed infrastructural development. Six Standard Penetration Tests (SPT), fourteen Dutch Cone Penetrometer Tests (DCPT) and 2D Electrical Resistivity Imaging employing Dipole-dipole and Pole-dipole arrays were implemented on the site. The topsoil (0 - 4m) consists of highly compacted sandy lateritic clay(10 to 5595Ωm) to 1.25m in some parts and dense sand in other parts to 5.50m depth. This topsoil was characterized as a material of very high shear strength (≤ 150kg/m2) and allowable bearing pressure value of 54kN/m2 to 85kN/m2 and a safety factor of 2.5. Soft amorphous peat/peaty clay (0.1 to 11.4Ωm), 3-6m thick, underlays the lateritic clay to about 18m depth. Grey, medium dense to very dense sand (0.37 to 2387Ωm) with occasional gravels underlies the peaty clay down to 30m depth. Within this layer, the freshwater bearing zones are characterized by high resistivity response (83 to 2387Ωm), while the clayey sand/saline water intruded sand produced subdued resistivity output (0.37 to 40Ωm). The overall ground-bearing pressure for the proposed structure would be 225kN/m2. Bored/cast-in-place pile at 18.00m depth with any of these diameters and respective safe working loads 600mm/1,140KN, 800mm/2,010KN and 1000mm/3,150KN is recommended for the proposed multi-story structure.Keywords: subsurface exploration, Geotechnical properties, resistivity imaging, pile
Procedia PDF Downloads 995034 Screening Maize for Compatibility with F. Oxysporum to Enhance Striga asiatica (L.) Kuntze Resistance
Authors: Admire Isaac Tichafa Shayanowako, Mark Laing, Hussein Shimelis
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Striga asiatica is among the leading abiotic constraints to maize production under small-holder farming communities in southern African. However, confirmed sources of resistance to the parasitic weed are still limited. Conventional breeding programmes have been progressing slowly due to the complex nature of the inheritance of Striga resistance, hence there is a need for more innovative approaches. This study aimed to achieve partial resistance as well as to breed for compatibility with Fusarium oxysporum fsp strigae, a soil fungus that is highly specific in its pathogenicity. The agar gel and paper roll assays in conjunction with a glass house pot trial were done to select genotypes based on their potential to stimulate germination of Striga and to test the efficacy of Fusarium oxysporum as a biocontrol agent. Results from agar gel assays showed a moderate to high potential in the release of Strigalactones among the 33 OPVs. Maximum Striga germination distances from the host root of 1.38 cm and up to 46% germination were observed in most of the populations. Considerable resistance was observed in a landrace ‘8lines’ which had the least Striga germination percentage (19%) with a maximum distance of 0.93 cm compared to the resistant check Z-DPLO-DTC1 that had 23% germination at a distance of 1.4cm. The number of fusarium colony forming units significantly deferred (P < 0.05) amongst the genotypes growing between germination papers. The number of crown roots, length of primary root and fresh weight of shoot and roots were highly correlated with concentration of fusarium macrospore counts. Pot trials showed significant differences between the fusarium coated and the uncoated treatments in terms of plant height, leaf counts, anthesis-silks intervals, Striga counts, Striga damage rating and Striga vigour. Striga emergence counts and Striga flowers were low in fusarium treated pots. Plants in fusarium treated pots had non-significant differences in height with the control treatment. This suggests that foxy 2 reduces the impact of Striga damage severity. Variability within fusarium treated genotypes with respect to traits under evaluation indicates the varying degree of compatibility with the biocontrol.Keywords: maize, Striga asiaitca, resistance, compatibility, F. oxysporum
Procedia PDF Downloads 2585033 Hydrogeochemical Investigation of Lead-Zinc Deposits in Oshiri and Ishiagu Areas, South Eastern Nigeria
Authors: Christian Ogubuchi Ede, Moses Oghenenyoreme Eyankware
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This study assessed the concentration of heavy metals (HMs) in soil, rock, mine dump pile, and water from Oshiri and Ishiagu areas of Ebonyi State. Investigations on mobile fraction equally evaluated the geochemical condition of different HM using UV spectrophotometer for Mineralized and unmineralized rocks, dumps, and soil, while AAS was used in determining the geochemical nature of the water system. Analysis revealed very high pollution of Cd mostly in Ishiagu (Ihetutu and Amaonye) active mine zones and with subordinates enrichments of Pb, Cu, As, and Zn in Amagu and Umungbala. Oshiri recorded sparingly moderate to high contamination of Cd and Mn but out rightly high anthropogenic input. Observation showed that most of the contamination conditions were unbearable while at the control but decrease with increasing distance from the mine vicinity. The potential heavy metal risk of the environments was evaluated using the risk factors such as enrichment factor, index of Geoacumulation, Contamination Factor, and Effect Range Median. Cadmium and Zn showed moderate to extreme contamination using Geoaccumulation Index (Igeo) while Pb, Cd, and As indicated moderate to strong pollution using the Effect Range Median. Results, when compared with the allowable limits and standards, showed the concentration of the metals in the following order Cd>Zn>Pb>As>Cu>Ni (rocks), Cd>As>Pb>Zn>Cu>Ni (soil) while Cd>Zn>As>Pb> Cu (for mine dump pile. High concentrations of Zn and As were recorded more in mine pond and salt line/drain channels along active mine zones, it heightened its threat during the rainy period as it settles into river course, living behind full-scale contaminations to inhabitants depending on it for domestic uses. Pb and Cu with moderate pollution were recorded in surface/stream water source as its mobility were relatively low. Results from Ishiagu Crush rock sites and Fedeco metallurgical and auto workshop where groundwater contamination was seen infiltrating some of the wells points gave rise to values that were 4 times high than the allowable limits. Some of these metal concentrations according to WHO (2015) if left unmitigated pose adverse effects to the soil and human community.Keywords: water, geo-accumulation, heavy metals, mine and Nigeria.
Procedia PDF Downloads 1755032 Research on the Feasibility of Evaluating Low-Temperature Cracking Performance of Asphalt Mixture Using Fracture Energy
Authors: Tao Yang, Yongli Zhao
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Low-temperature cracking is one of the major challenges for asphalt pavement in the cold region. Fracture energy could determine from various test methods, which is a commonly used parameter to evaluate the low-temperature cracking resistance of asphalt mixture. However, the feasibility of evaluating the low-temperature cracking performance of asphalt mixture using fracture energy is not investigated comprehensively. This paper aims to verify whether fracture energy is an appropriate parameter to evaluate the low-temperature cracking performance. To achieve this goal, this paper compared the test results of thermal stress restrained specimen test (TSRST) and semi-circular bending test (SCB) of asphalt mixture with different types of aggregate, TSRST and indirect tensile test (IDT) of asphalt mixture with different additives, and single-edge notched beam test (SENB) and TSRST of asphalt mixture with different asphalt. Finally, the correlation between in-suit cracking performance and fracture energy was surveyed. The experimental results showed the evaluation result of critical cracking temperature and fracture energy are not always consistent; the in-suit cracking performance is also not correlated well with fracture energy. These results indicated that it is not feasible to evaluate low-temperature performance by fracture energy. Then, the composition of fracture energy of TSRST, SCB, disk-shaped compact tension test (DCT), three-point bending test (3PB) and IDT was analyzed. The result showed: the area of thermal stress versus temperature curve is the multiple of fracture energy and could be used to represent fracture energy of TSRST, as the multiple is nearly equal among different asphalt mixtures for a specific specimen; the fracture energy, determined from TSRST, SCB, DCT, 3PB, SENB and IDT, is mainly the surface energy that forms the fracture face; fracture energy is inappropriate to evaluate the low-temperature cracking performance of asphalt mixture, as the relaxation/viscous performance is not considered; if the fracture energy was used, it is recommended to combine this parameter with an index characterizing the relaxation or creep performance of asphalt mixture.Keywords: asphalt pavement, cold region, critical cracking temperature, fracture energy, low-temperature cracking
Procedia PDF Downloads 1945031 A Decision-Support Tool for Humanitarian Distribution Planners in the Face of Congestion at Security Checkpoints: A Real-World Case Study
Authors: Mohanad Rezeq, Tarik Aouam, Frederik Gailly
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In times of armed conflicts, various security checkpoints are placed by authorities to control the flow of merchandise into and within areas of conflict. The flow of humanitarian trucks that is added to the regular flow of commercial trucks, together with the complex security procedures, creates congestion and long waiting times at the security checkpoints. This causes distribution costs to increase and shortages of relief aid to the affected people to occur. Our research proposes a decision-support tool to assist planners and policymakers in building efficient plans for the distribution of relief aid, taking into account congestion at security checkpoints. The proposed tool is built around a multi-item humanitarian distribution planning model based on multi-phase design science methodology that has as its objective to minimize distribution and back ordering costs subject to capacity constraints that reflect congestion effects using nonlinear clearing functions. Using the 2014 Gaza War as a case study, we illustrate the application of the proposed tool, model the underlying relief-aid humanitarian supply chain, estimate clearing functions at different security checkpoints, and conduct computational experiments. The decision support tool generated a shipment plan that was compared to two benchmarks in terms of total distribution cost, average lead time and work in progress (WIP) at security checkpoints, and average inventory and backorders at distribution centers. The first benchmark is the shipment plan generated by the fixed capacity model, and the second is the actual shipment plan implemented by the planners during the armed conflict. According to our findings, modeling and optimizing supply chain flows reduce total distribution costs, average truck wait times at security checkpoints, and average backorders when compared to the executed plan and the fixed-capacity model. Finally, scenario analysis concludes that increasing capacity at security checkpoints can lower total operations costs by reducing the average lead time.Keywords: humanitarian distribution planning, relief-aid distribution, congestion, clearing functions
Procedia PDF Downloads 855030 Impact of Intelligent Transportation System on Planning, Operation and Safety of Urban Corridor
Authors: Sourabh Jain, S. S. Jain
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Intelligent transportation system (ITS) is the application of technologies for developing a user–friendly transportation system to extend the safety and efficiency of urban transportation systems in developing countries. These systems involve vehicles, drivers, passengers, road operators, managers of transport services; all interacting with each other and the surroundings to boost the security and capacity of road systems. The goal of urban corridor management using ITS in road transport is to achieve improvements in mobility, safety, and the productivity of the transportation system within the available facilities through the integrated application of advanced monitoring, communications, computer, display, and control process technologies, both in the vehicle and on the road. Intelligent transportation system is a product of the revolution in information and communications technologies that is the hallmark of the digital age. The basic ITS technology is oriented on three main directions: communications, information, integration. Information acquisition (collection), processing, integration, and sorting are the basic activities of ITS. In the paper, attempts have been made to present the endeavor that was made to interpret and evaluate the performance of the 27.4 Km long study corridor having eight intersections and four flyovers. The corridor consisting of six lanes as well as eight lanes divided road network. Two categories of data have been collected such as traffic data (traffic volume, spot speed, delay) and road characteristics data (no. of lanes, lane width, bus stops, mid-block sections, intersections, flyovers). The instruments used for collecting the data were video camera, stop watch, radar gun, and mobile GPS (GPS tracker lite). From the analysis, the performance interpretations incorporated were the identification of peak and off-peak hours, congestion and level of service (LOS) at midblock sections and delay followed by plotting the speed contours. The paper proposed the urban corridor management strategies based on sensors integrated into both vehicles and on the roads that those have to be efficiently executable, cost-effective, and familiar to road users. It will be useful to reduce congestion, fuel consumption, and pollution so as to provide comfort, safety, and efficiency to the users.Keywords: ITS strategies, congestion, planning, mobility, safety
Procedia PDF Downloads 1825029 Prognostic Impact of Pre-transplant Ferritinemia: A Survival Analysis Among Allograft Patients
Authors: Mekni Sabrine, Nouira Mariem
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Background and aim: Allogeneic hematopoietic stem cell transplantation is a curative treatment for several hematological diseases; however, it has a non-negligible morbidity and mortality depending on several prognostic factors, including pre-transplant hyperferritinemia. The aim of our study was to estimate the impact of hyperferritinemia on survivals and on the occurrence of post-transplant complications. Methods: It was a longitudinal study conducted over 8 years and including all patients who had a first allograft. The impact of pretransplant hyperferritinemia (ferritinemia ≥1500) on survivals was studied using the Kaplan Meier method and the COX model for uni- and multivariate analysis. The Khi-deux test and binary logistic regression were used to study the association between pretransplant ferritinemia and post-transplant complications. Results: One hundred forty patients were included with an average age of 26.6 years and a sex ratio (M/F)=1.4. Hyperferritinemia was found in 33% of patients. It had no significant impact on either overall survival (p=0.9) or event -free survival (p=0.6). In multivariate analysis, only the type of disease was independently associated with overall survival (p=0.04) and event-free survival (p=0.002). For post-allograft complications: The occurrence of early documented infections was independently associated with pretransplant hyperferritinemia (p=0.02) and the presence of acute graft versus host disease( GVHD) (p<10-3). The occurrence of acute GVHD was associated with early documented infection (p=0.002) and Cytomegalovirus reactivation (p<10-3). The occurrence of chronic GVHD was associated with the presence of Cytomegalovirus reactivation (p=0.006) and graft source (p=0.009). Conclusion: Our study showed the significant impact of pre-transplant hyperferritinemia on the occurrence of early infections but not on survivals. Early and more accurate assessment iron overload by other tests such as liver magnetic resonance imaging with initiation of chelating treatment could prevent the occurrence of such complications after transplantation.Keywords: allogeneic, transplants, ferritin, survival
Procedia PDF Downloads 705028 Evaluating the Feasibility of Chemical Dermal Exposure Assessment Model
Authors: P. S. Hsi, Y. F. Wang, Y. F. Ho, P. C. Hung
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The aim of the present study was to explore the dermal exposure assessment model of chemicals that have been developed abroad and to evaluate the feasibility of chemical dermal exposure assessment model for manufacturing industry in Taiwan. We conducted and analyzed six semi-quantitative risk management tools, including UK - Control of substances hazardous to health ( COSHH ) Europe – Risk assessment of occupational dermal exposure ( RISKOFDERM ), Netherlands - Dose related effect assessment model ( DREAM ), Netherlands – Stoffenmanager ( STOFFEN ), Nicaragua-Dermal exposure ranking method ( DERM ) and USA / Canada - Public Health Engineering Department ( PHED ). Five types of manufacturing industry were selected to evaluate. The Monte Carlo simulation was used to analyze the sensitivity of each factor, and the correlation between the assessment results of each semi-quantitative model and the exposure factors used in the model was analyzed to understand the important evaluation indicators of the dermal exposure assessment model. To assess the effectiveness of the semi-quantitative assessment models, this study also conduct quantitative dermal exposure results using prediction model and verify the correlation via Pearson's test. Results show that COSHH was unable to determine the strength of its decision factor because the results evaluated at all industries belong to the same risk level. In the DERM model, it can be found that the transmission process, the exposed area, and the clothing protection factor are all positively correlated. In the STOFFEN model, the fugitive, operation, near-field concentrations, the far-field concentration, and the operating time and frequency have a positive correlation. There is a positive correlation between skin exposure, work relative time, and working environment in the DREAM model. In the RISKOFDERM model, the actual exposure situation and exposure time have a positive correlation. We also found high correlation with the DERM and RISKOFDERM models, with coefficient coefficients of 0.92 and 0.93 (p<0.05), respectively. The STOFFEN and DREAM models have poor correlation, the coefficients are 0.24 and 0.29 (p>0.05), respectively. According to the results, both the DERM and RISKOFDERM models are suitable for performance in these selected manufacturing industries. However, considering the small sample size evaluated in this study, more categories of industries should be evaluated to reduce its uncertainty and enhance its applicability in the future.Keywords: dermal exposure, risk management, quantitative estimation, feasibility evaluation
Procedia PDF Downloads 1735027 Effective Strategies Migrants Adopted to Improve Food Security in a Regional Area of Australia
Authors: Joanne Sin Wei Yeoh, Quynh Lê, Daniel R. Terry, Rosa Mc Manamey
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Food security is a global issue and one of the concerns in Australia, particularly in regional and rural areas. Despite Australia’s current ability to produce enough food to feed more than its current population, evidence has been accumulating over the last decade to demonstrate many Australians struggle to feed themselves, including immigrants from cultural and linguistically diverse (CALD) backgrounds. This study aims to identify the acculturation strategies used by migrants to enhance their approach to food security in Tasmania. The study employed a mixed methods approach that used both questionnaires and semi-structured interviews with migrants living in Tasmania. Descriptive and inferential statistics was used to analyse data collected from questionnaire, whereas, thematic analysis was employed to analyse the interview data. Migrants (n=301) completed the questionnaire with a response rate of 50.2% and 33 follow-up interviews were conducted. We found that majority of the migrants (70.0%) replaced food ingredients and went without the food they could not buy from shops with similar ingredients. Support and advice from friends were effective ways to improve their food access. Additionally, length of stays in Tasmania and region of origin were significantly associated with the ways migrants dealing with food security. The interview results revealed that migrants managed to adapt to the new food culture by using different acculturation strategies, including access food ingredients from other country; adjusting or adapting; home gardening and access to technology. In addition, social and cultural capitals were also treated as vital roles in improving migrants’ food security. To summarize, migrants employed different strategies for food security while acculturating into the new environment. Our findings could become the guidelines for migrants and relevant government or private sectors that address food security.Keywords: food security, migrants, strategies, inferential statistics
Procedia PDF Downloads 5315026 Experimental and Modal Determination of the State-Space Model Parameters of a Uni-Axial Shaker System for Virtual Vibration Testing
Authors: Jonathan Martino, Kristof Harri
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In some cases, the increase in computing resources makes simulation methods more affordable. The increase in processing speed also allows real time analysis or even more rapid tests analysis offering a real tool for test prediction and design process optimization. Vibration tests are no exception to this trend. The so called ‘Virtual Vibration Testing’ offers solution among others to study the influence of specific loads, to better anticipate the boundary conditions between the exciter and the structure under test, to study the influence of small changes in the structure under test, etc. This article will first present a virtual vibration test modeling with a main focus on the shaker model and will afterwards present the experimental parameters determination. The classical way of modeling a shaker is to consider the shaker as a simple mechanical structure augmented by an electrical circuit that makes the shaker move. The shaker is modeled as a two or three degrees of freedom lumped parameters model while the electrical circuit takes the coil impedance and the dynamic back-electromagnetic force into account. The establishment of the equations of this model, describing the dynamics of the shaker, is presented in this article and is strongly related to the internal physical quantities of the shaker. Those quantities will be reduced into global parameters which will be estimated through experiments. Different experiments will be carried out in order to design an easy and practical method for the identification of the shaker parameters leading to a fully functional shaker model. An experimental modal analysis will also be carried out to extract the modal parameters of the shaker and to combine them with the electrical measurements. Finally, this article will conclude with an experimental validation of the model.Keywords: lumped parameters model, shaker modeling, shaker parameters, state-space, virtual vibration
Procedia PDF Downloads 2745025 Comparison of Mcgrath, Pentax, and Macintosh Laryngoscope in Normal and Cervical Immobilized Manikin by Novices
Authors: Jong Yeop Kim, In Kyong Yi, Hyun Jeong Kwak, Sook Young Lee, Sung Yong Park
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Background: Several video laryngoscopes (VLs) were used to facilitate tracheal intubation in the normal and potentially difficult airway, especially by novice personnel. The aim of this study was to compare tracheal intubation performance regarding the time to intubation, glottic view, difficulty, and dental click, by a novice using McGrath VL, Pentax Airway Scope (AWS) and Macintosh laryngoscope in normal and cervical immobilized manikin models. Methods: Thirty-five anesthesia nurses without previous intubation experience were recruited. The participants performed endotracheal intubation in a manikin model at two simulated neck positions (normal and fixed neck via cervical immobilization), using three different devices (McGrath VL, Pentax AWS, and Macintosh direct laryngoscope) at three times each. Performance parameters included intubation time, success rate of intubation, Cormack Lehane laryngoscope grading, dental click, and subjective difficulty score. Results: Intubation time and success rate at the first attempt were not significantly different between the 3 groups in normal airway manikin. In the cervical immobilized manikin, the intubation time was shorter (p = 0.012) and the success rate with the first attempt was significantly higher (p < 0.001) when using McGrath VL and Pentax AWS compared with Macintosh laryngoscope. Both VLs showed less difficulty score (p < 0.001) and more Cormack Lehane grade I (p < 0.001). The incidence of dental clicks was higher with McGrath VL than Macintosh laryngoscope in the normal and cervical immobilized airway (p = 0.005, p < 0.001, respectively). Conclusion: McGrath VL and Pentax AWS resulted in shorter intubation time, higher first attempt success rate, compared with Macintosh laryngoscope by a novice intubator in a cervical immobilized manikin model. McGrath VL could be reduced the risk of dental injury compared with Macintosh laryngoscope in this scenario.Keywords: intubation, manikin, novice, videolaryngoscope
Procedia PDF Downloads 1625024 Decision Making in Medicine and Treatment Strategies
Authors: Kamran Yazdanbakhsh, Somayeh Mahmoudi
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Three reasons make good use of the decision theory in medicine: 1. Increased medical knowledge and their complexity makes it difficult treatment information effectively without resorting to sophisticated analytical methods, especially when it comes to detecting errors and identify opportunities for treatment from databases of large size. 2. There is a wide geographic variability of medical practice. In a context where medical costs are, at least in part, by the patient, these changes raise doubts about the relevance of the choices made by physicians. These differences are generally attributed to differences in estimates of probabilities of success of treatment involved, and differing assessments of the results on success or failure. Without explicit criteria for decision, it is difficult to identify precisely the sources of these variations in treatment. 3. Beyond the principle of informed consent, patients need to be involved in decision-making. For this, the decision process should be explained and broken down. A decision problem is to select the best option among a set of choices. The problem is what is meant by "best option ", or know what criteria guide the choice. The purpose of decision theory is to answer this question. The systematic use of decision models allows us to better understand the differences in medical practices, and facilitates the search for consensus. About this, there are three types of situations: situations certain, risky situations, and uncertain situations: 1. In certain situations, the consequence of each decision are certain. 2. In risky situations, every decision can have several consequences, the probability of each of these consequences is known. 3. In uncertain situations, each decision can have several consequences, the probability is not known. Our aim in this article is to show how decision theory can usefully be mobilized to meet the needs of physicians. The decision theory can make decisions more transparent: first, by clarifying the data systematically considered the problem and secondly by asking a few basic principles should guide the choice. Once the problem and clarified the decision theory provides operational tools to represent the available information and determine patient preferences, and thus assist the patient and doctor in their choices.Keywords: decision making, medicine, treatment strategies, patient
Procedia PDF Downloads 5815023 Microalgae Hydrothermal Liquefaction Process Optimization and Comprehension to Produce High Quality Biofuel
Authors: Lucie Matricon, Anne Roubaud, Geert Haarlemmer, Christophe Geantet
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Introduction: This case discusses the management of two floor of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. Case Report: A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Discussion: Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk, and second primary cancer development.Keywords: microalgae, biofuels, hydrothermal liquefaction, biomass
Procedia PDF Downloads 1375022 MiR-200a/ZEB1 Pathway in Liver Fibrogenesis of Biliary Atresia
Authors: Hai-Ying Liu, Yi-Hao Chen, Shu-Yin Pang, Feng-Hua Wang, Xiao-Fang Peng, Li-Yuan Yang, Zheng-Rong Chen, Yi Chen, Bing Zhu
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Objective: Biliary atresia (BA) is characterized by progressive liver fibrosis. Epithelial-mesenchymal transition (EMT) has been implicated as a key mechanism in the pathogenesis of organ fibrosis. MiR-200a has been shown to repress EMT. We aim to explore the role of miR-200a in the fibrogenesis of BA. Methods: We obtained the plasma samples and liver samples from patients with BA or controls to examine the role of miR-200a. Histological liver fibrosis was assessed using the Ishak fibrosis scores. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was performed to detect the expression of miR-200a in plasma. We also evaluated the expression of miR-200a in liver tissues using tyramide signal amplification fluorescence in situ hybridization (TSA-FISH). The expression of EMT related proteins zinc finger E-box-binding homeobox 1 (ZEB1), E-cadherin and α-smooth muscle actin (α-SMA) in the liver sections were detected by immunohistochemical staining. Results: We found that the expression of miR-200a was both elevated in the plasma and liver tissues from BA patients compared with the controls. The hepatic expression of ZEB1 and α-SMA were markedly increased in the liver sections from BA patients compared to the controls, whereas E-cadherin was downregulated in the BA group. Simultaneously, we noted that the hepatic expression of miR-200a, E-cadherin and α-SMA were upregulated with the progression of liver fibrosis in the BA group, while ZEB1 was downregulated with the progression of liver fibrosis in BA patients. Conclusion: These findings suggest EMT has a critical effect on the fibrotic process of BA, and the interaction between miR-200a and ZEB1 may regulate EMT and eventually influence liver fibrogenesis of BA.Keywords: biliary atresia, liver fibrosis, MicroRNA, epithelial-mesenchymal transition, zinc finger E-box-binding homeobox 1
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