Search results for: electronic continuum correction
459 Clinical Cases of Rare Types of 'Maturity Onset Diabetes of the Young' Diabetes
Authors: Alla Ovsyannikova, Oksana Rymar, Elena Shakhtshneider, Mikhail Voevoda
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In Siberia endocrinologists increasingly noted young patients with the course of diabetes mellitus differing from 1 and 2 types. Therefore we did a molecular genetic study for this group of patients to verify the monogenic forms of diabetes mellitus in them and researched the characteristics of this pathology. When confirming the monogenic form of diabetes, we performed a correction therapy for many patients (transfer from insulin to tablets), prevented specific complications, examined relatives and diagnosed their diabetes at the preclinical stage, revealed phenotypic characteristics of the pathology which led to the high significance of this work. Materials and Methods: We observed 5 patients (4 families). We diagnosed MODY (Maturity Onset Diabetes of the Young) during the molecular genetic testing (direct automatic sequencing). All patients had a full clinical examination, blood samples for biochemical research, determination of C-peptide and TSH, antibodies to b-cells, microalbuminuria, abdominal ultrasound, heart and thyroid ultrasound, examination of ophthalmologist. Results: We diagnosed 3 rare types of MODY: two women had MODY8, one man – MODY6 and man and his mother - MODY12. Patients with types 8 and 12 had clinical features. Age of onset hyperglycemia ranged from 26 to 34 years. In a patient with MODY6 fasting hyperglycemia was detected during a routine examination. Clinical symptoms, complications were not diagnosed. The patient observes a diet. In the first patient MODY8 was detected during first pregnancy, she had itchy skin and mostly postprandial hyperglycemia. Upon examination we determined glycated hemoglobin 7.5%, retinopathy, non-proliferative stage, peripheral neuropathy. She uses a basic bolus insulin therapy. The second patient with MODY8 also had clinical manifestations of hyperglycemia (pruritus, thirst), postprandial hyperglycemia and diabetic nephropathy, a stage of microalbuminuria. The patient was diagnosed autoimmune thyroiditis. She used inhibitors of DPP-4. The patient with MODY12 had an aggressive course. In the detection of hyperglycemia he had complaints of visual impairment, intense headaches, leg cramps. The patient had a history of childhood convulsive seizures of non-epileptic genesis, without organic pathology, which themselves were stopped at the age of 12 years. When we diagnosed diabetes a patient was 28 years, he had hypertriglyceridemia, atherosclerotic plaque in the carotid artery, proliferative retinopathy (lacerocoagulation). Diabetes and early myocardial infarction were observed in three cases in family. We prescribe therapy with sulfonylureas and SGLT-2 inhibitors with a positive effect. At the patient's mother diabetes began at a later age (30 years) and a less aggressive course was observed. She also has hypertriglyceridemia and uses oral hypoglycemic drugs. Conclusions: 1) When young patients with hyperglycemia have extrapancreatic pathologies and diabetic complications with a short duration of diabetes we can assume they have one of type of MODY diabetes. 2) In patients with monogenic forms of diabetes mellitus, the clinical manifestations of hyperglycemia in each succeeding generation are revealed at an earlier age. Research had increased our knowledge of the monogenic forms of diabetes. The reported study was supported by RSCF, research project No. 14-15-00496-P.Keywords: diabetes mellitus, MODY diabetes, monogenic forms, young patients
Procedia PDF Downloads 239458 Two-Way Reminder Systems to Support Activities of Daily Living for Adults with Cognitive Impairments: A Scoping Review
Authors: Julia Brudzinski, Ashley Croswell, Jade Mardin, Hannah Shilling, Jennifer Berg-Carnegie
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Adults with brain injuries and mental illnesses commonly experience cognitive impairments that interfere with their participation in activities of daily living (ADLs). Prior research states that electronic reminder systems can support adults with cognitive impairments; however, previous studies focus primarily on one-way reminder systems. Research on adults with chronic diseases reported that two-way reminder systems yield better health outcomes and disease self-management compared to one-way reminder systems. Literature was identified through systematically searching 7 databases and hand-searching relevant reference lists. Retrieved studies were independently screened and reviewed by at least two members of the research team. Data was extracted on study design, participant characteristics, intervention details, study objectives, outcome measures, and important results. 574 articles were screened and reviewed. Nine articles met all inclusion criteria and were included. The literature focused on three main areas: system feasibility (n=8), stakeholder satisfaction (n=6), and efficacy of the two-way reminder systems (n=6). Participants in eight of the studies had brain injuries, with participants in only one study having a mental illness (i.e., schizophrenia). Two-way reminder systems were used to support participation in a wide range of ADLs. The current literature on two-way reminder systems to support ADLs for adults with cognitive impairments focuses on feasibility, stakeholder satisfaction, and system efficacy. Future research should focus on addressing the barriers to accessing and implementing two-way reminder systems and identifying specific client characteristics that would benefit most from using these systems.Keywords: brain injury, digital health, occupational therapy, activities of daily living, two-way reminder systems
Procedia PDF Downloads 70457 A Hard Day's Night: Persistent Within-Individual Effects of Job Demands and the Role of Recovery Processes
Authors: Helen Pluut, Remus Ilies, Nikos Dimotakis, Maral Darouei
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This study aims to examine recovery from work as an important daily activity with implications for workplace behavior. Building on affective events theory and the stressor-detachment model as frameworks, this paper proposes and tests a comprehensive within-individual model that uncovers the role of recovery processes at home in linking workplace demands (e.g., workload) and stressors (e.g., workplace incivility) to next-day organizational citizenship behaviors (OCBs). Our sample consisted of 126 full-time employees in a large Midwestern University. For a period of 16 working days, these employees were asked to fill out 3 electronic surveys while at work. The first survey (sent out in the morning) measured self-reported sleep quality, recovery experiences the previous day at home, and momentary effect. The second survey (sent out close to the end of the workday) measured job demands and stressors as well as OCBs, while the third survey in the evening assessed job strain. Data were analyzed using Hierarchical Linear Modeling (HLM). Results indicated that job demands and stressors at work made it difficult to unwind properly at home and have a good night’s sleep, which had repercussions for next day’s morning effect, which, in turn, influenced OCBs. It can be concluded that processes of recovery are vital to an individual’s daily effective functioning and behavior at work, but recovery may become impaired after a hard day’s work. Thus, our study sheds light on the potentially persistent nature of strain experienced as a result of work and points to the importance of recovery processes to enable individuals to avoid such cross-day spillover. Our paper will discuss this implication for theory and practice as well as potential directions for future research.Keywords: affect, job demands, organizational citizenship behavior, recovery, strain
Procedia PDF Downloads 135456 Influence of UV Aging on the Mechanical Properties of Polycarbonate
Authors: S. Redjala, N. Ait Hocine, M. Gratton, N. Poirot, R. Ferhoum, S. Azem
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Polycarbonate (PC) is a promising polymer with high transparency in the range of the visible spectrum and is used in various fields, for example medical, electronic, automotive. Its low weight, chemical inertia, high impact resistance and relatively low cost are of major importance. In recent decades, some materials such as metals and ceramics have been replaced by polymers because of their superior advantages. However, some characteristics of the polymers are highly modified under the effect of ultraviolet (UV) radiation and temperature. The changes induced in the material by such aging depend on the exposure time, the wavelength of the UV radiation and the temperature level. The UV energy is sufficient to break the chemical bonds leading to a cleavage of the molecular chains. This causes changes in the mechanical, thermal, optical and morphological properties of the material. The present work is focused on the study of the effects of aging under ultraviolet (UV) radiation and under different temperature values on the physical-chemical and mechanical properties of a PC. Thus, various investigations, such as FTIR and XRD analyses, SEM and optical microscopy observations, micro-hardness measurements and monotonic and cyclic tensile tests, were carried out on the PC in the initial state and after aging. Results have shown the impact of aging on the properties of the PC studied. In fact, the MEB highlighted changes in the superficial morphology of the material by the presence of cracks and material de-bonding in the form of debris. The FTIR spectra reveal an attenuation of the peaks like the hydroxyl (OH) groups located at 3520 cm-1. The XRD lines shift towards a larger angle, reaching a maximum of 3°. In addition, Vickers micro-hardness measurements show that aging affects the surface and the core of the material, which results in different mechanical behaviours under monotonic and cyclic tensile tests. This study pointed out effects of aging on the macroscopic properties of the PC studied, in relationship with its microstructural changes.Keywords: mechanical properties, physical-chemical properties, polycarbonate, UV aging, temperature aging
Procedia PDF Downloads 138455 The Uses of Photodynamic Therapy versus Anti-vascular Endothelial Growth Factor in the Management of Acute Central Serous Chorioretinopathy: Systematic Review and Meta-Analysis
Authors: Hadeel Seraj, Mohammed Khoshhal, Mustafa Alhamoud, Hassan Alhashim, Anas Alsaif, Amro Abukhashabah
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Central serous chorioretinopathy (CSCR) is an idiopathic retinal disease characterized by localized serous detachment of the neurosensory retina at the macula. To date, there is no high-quality evidence of recent updates on treating acute CSCR, focusing on photodynamic therapy (PDT) and anti-vascular endothelial growth factor (anti-VEGF). Hence, this review aims to systematically review the latest treatment strategies for acute CSCR. Methodology: The following electronic databases were used for a comprehensive and systematic literature review: MEDLINE, EMBASE, and Cochrane. In addition, we analyzed studies comparing PDT with placebo, anti-VEGF with placebo, or PDT with anti-VEGF in treating acute CSC eyes with no previous intervention. Results: Seven studies were included, with a total of 292 eyes. The overall positive results were significantly higher among patients who received PDT compared to control groups (OR = 7.96, 95% CI, 3.02 to 20.95, p < 0.001). The proportions of positive results were 81.0% and 97.1% among patients who received anti-VEGF and PDT, respectively, with no statistically significant differences between the groups. In addition, there were no significant differences between anti-VEGF and control groups. In contrast, PDT was significantly associated with lower recurrence odds than the control groups (OR = 0.12, 95% CI, 0.04 to 0.39, p = 0.042). Conclusion: According to our findings, PDT showed higher positive results than Anti-VEGF in acute CSCR. In addition, PDT was significantly associated with a lower recurrence rate than the control group. However, the analysis needs to be confirmed and updated by large-scale, well-designed RCTs.Keywords: central serous chorioretinopathy, Acute CSCR, photodynamic therapy, anti-vascular endothelial growth factor
Procedia PDF Downloads 72454 Delineation of Different Geological Interfaces Beneath the Bengal Basin: Spectrum Analysis and 2D Density Modeling of Gravity Data
Authors: Md. Afroz Ansari
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The Bengal basin is a spectacular example of a peripheral foreland basin formed by the convergence of the Indian plate beneath the Eurasian and Burmese plates. The basin is embraced on three sides; north, west and east by different fault-controlled tectonic features whereas released in the south where the rivers are drained into the Bay of Bengal. The Bengal basin in the eastern part of the Indian subcontinent constitutes the largest fluvio-deltaic to shallow marine sedimentary basin in the world today. This continental basin coupled with the offshore Bengal Fan under the Bay of Bengal forms the biggest sediment dispersal system. The continental basin is continuously receiving the sediments by the two major rivers Ganga and Brahmaputra (known as Jamuna in Bengal), and Meghna (emerging from the point of conflux of the Ganga and Brahmaputra) and large number of rain-fed, small tributaries originating from the eastern Indian Shield. The drained sediments are ultimately delivered into the Bengal fan. The significance of the present study is to delineate the variations in thicknesses of the sediments, different crustal structures, and the mantle lithosphere throughout the onshore-offshore Bengal basin. In the present study, the different crustal/geological units and the shallower mantle lithosphere were delineated by analyzing the Bouguer Gravity Anomaly (BGA) data along two long traverses South-North (running from Bengal fan cutting across the transition offshore-onshore of the Bengal basin and intersecting the Main Frontal Thrust of India-Himalaya collision zone in Sikkim-Bhutan Himalaya) and West-East (running from the Peninsular Indian Shield across the Bengal basin to the Chittagong–Tripura Fold Belt). The BGA map was derived from the analysis of topex data after incorporating Bouguer correction and all terrain corrections. The anomaly map was compared with the available ground gravity data in the western Bengal basin and the sub-continents of India for consistency of the data used. Initially, the anisotropy associated with the thicknesses of the different crustal units, crustal interfaces and moho boundary was estimated through spectral analysis of the gravity data with varying window size over the study area. The 2D density sections along the traverses were finalized after a number of iterations with the acceptable root mean square (RMS) errors. The estimated thicknesses of the different crustal units and dips of the Moho boundary along both the profiles are consistent with the earlier results. Further the results were encouraged by examining the earthquake database and focal mechanism solutions for better understanding the geodynamics. The earthquake data were taken from the catalogue of US Geological Survey, and the focal mechanism solutions were compiled from the Harvard Centroid Moment Tensor Catalogue. The concentrations of seismic events at different depth levels are not uncommon. The occurrences of earthquakes may be due to stress accumulation as a result of resistance from three sides.Keywords: anisotropy, interfaces, seismicity, spectrum analysis
Procedia PDF Downloads 262453 The Formation of Thin Copper Films on Graphite Surface Using Magnetron Sputtering Method
Authors: Zydrunas Kavaliauskas, Aleksandras Iljinas, Liutauras Marcinauskas, Mindaugas Milieska, Vitas Valincius
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The magnetron sputtering deposition method is often used to obtain thin film coatings. The main advantage of magnetron vaporization compared to other deposition methods is the high rate erosion of the cathode material (e.g., copper, aluminum, etc.) and the ability to operate under low-pressure conditions. The structure of the formed coatings depends on the working parameters of the magnetron deposition system, which is why it is possible to influence the properties of the growing film, such as morphology, crystal orientation, and dimensions, stresses, adhesion, etc. The properties of these coatings depend on the distance between the substrate and the magnetron surface, the vacuum depth, the gas used, etc. Using this deposition technology, substrates are most often placed near the anode. The magnetic trap of the magnetrons for localization of electrons in the cathode region is formed using a permanent magnet system that is on the side of the cathode. The scientific literature suggests that, after insertion of a small amount of copper into graphite, the electronic conductivity of graphite increase. The aim of this work is to create thin (up to 300 nm) layers on a graphite surface using a magnetron evaporation method, to investigate the formation peculiarities and microstructure of thin films, as well as the mechanism of copper diffusion into graphite inner layers at different thermal treatment temperatures. The electron scanning microscope was used to investigate the microrelief of the coating surface. The chemical composition is determined using the EDS method, which shows that, with an increase of the thermal treatment of the copper-carbon layer from 200 °C to 400 °C, the copper content is reduced from 8 to 4 % in atomic mass units. This is because the EDS method captures only the amount of copper on the graphite surface, while the temperature of the heat treatment increases part of the copper because of the diffusion processes penetrates into the inner layers of the graphite. The XRD method shows that the crystalline copper structure is not affected by thermal treatment.Keywords: carbon, coatings, copper, magnetron sputtering
Procedia PDF Downloads 281452 Numerical Investigation of 3D Printed Pin Fin Heat Sinks for Automotive Inverter Cooling Application
Authors: Alexander Kospach, Fabian Benezeder, Jürgen Abraham
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E-mobility poses new challenges for inverters (e.g., higher switching frequencies) in terms of thermal behavior and thermal management. Due to even higher switching frequencies, thermal losses become greater, and the cooling of critical components (like insulated gate bipolar transistor and diodes) comes into focus. New manufacturing methods, such as 3D printing, enable completely new pin-fin structures that can handle higher waste heat to meet the new thermal requirements. Based on the geometrical specifications of the industrial partner regarding the manufacturing possibilities for 3D printing, different and completely new pin-fin structures were numerically investigated for their hydraulic and thermal behavior in fundamental studies assuming an indirect liquid cooling. For the 3D computational fluid dynamics (CFD) thermal simulations OpenFOAM was used, which has as numerical method the finite volume method for solving the conjugate heat transfer problem. A steady-state solver for turbulent fluid flow and solid heat conduction with conjugate heat transfer between solid and fluid regions was used for the simulations. In total, up to fifty pinfin structures and arrangements, some of them completely new, were numerically investigated. On the basis of the results of the principal investigations, the best two pin-fin structures and arrangements for the complete module cooling of an automotive inverter were numerically investigated and compared. There are clear differences in the maximum temperatures for the critical components, such as IGTBs and diodes. In summary, it was shown that 3D pin fin structures can significantly contribute to the improvement of heat transfer and cooling of an automotive inverter. This enables in the future smaller cooling designs and a better lifetime of automotive inverter modules. The new pin fin structures and arrangements can also be applied to other cooling applications where 3D printing can be used.Keywords: pin fin heat sink optimization, 3D printed pin fins, CFD simulation, power electronic cooling, thermal management
Procedia PDF Downloads 94451 Influence of Magnetic Field on Microstructure and Properties of Copper-Silver Composites
Authors: Engang Wang
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The Cu-alloy composites are a kind of high-strength and high-conductivity Cu-based alloys, which have excellent mechanical and electrical properties and is widely used in electronic, electrical, machinery industrial fields. However, the solidification microstructure of the composites, such as the primary or second dendrite arm spacing, have important rule to its tensile strength and conductivity, and that is affected by its fabricating method. In this paper, two kinds of directional solidification methods; the exothermic powder method (EP method) and liquid metal cooling method (LMC method), were used to fabricate the Cu-alloy composites with applied different magnetic fields to investigate their influence on the solidifying microstructure of Cu-alloy, and further the fabricated Cu-alloy composites was drawn to wires to investigate the influence of fabricating method and magnetic fields on the drawing microstructure of fiber-reinforced Cu-alloy composites and its properties. The experiment of Cu-Ag alloy under directional solidification and horizontal magnetic fields with different processing parameters show that: 1) For the Cu-Ag alloy with EP method, the dendrite is directionally developed in the cooling copper mould and the solidifying microstructure is effectively refined by applying horizontal magnetic fields. 2) For the Cu-Ag alloy with LMC method, the primary dendrite arm spacing is decreased and the content of Ag in the dendrite increases as increasing the drawing velocity of solidification. 3) The dendrite is refined and the content of Ag in the dendrite increases as increasing the magnetic flux intensity; meanwhile, the growth direction of dendrite is also affected by magnetic field. The research results of Cu-Ag alloy in situ composites by drawing deforming process show that the micro-hardness of alloy is higher by decreasing dendrite arm spacing. When the dendrite growth orientation is consistent with the axial of the samples. the conductivity of the composites increases with the second dendrite arm spacing increases. However, its conductivity reduces with the applied magnetic fields owing to disrupting the dendrite growth orientation.Keywords: Cu-Ag composite, magnetic field, microstructure, solidification
Procedia PDF Downloads 208450 The Effect of Satisfaction with the Internet on Online Shopping Attitude With TAM Approach Controlled By Gender
Authors: Velly Anatasia
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In the last few decades extensive research has been conducted into information technology (IT) adoption, testing a series of factors considered to be essential for improved diffusion. Some studies analyze IT characteristics such as usefulness, ease of use and/or security, others focus on the emotions and experiences of users and a third group attempts to determine the importance of socioeconomic user characteristics such as gender, educational level and income. The situation is similar regarding e-commerce, where the majority of studies have taken for granted the importance of including these variables when studying e-commerce adoption, as these were believed to explain or forecast who buys or who will buy on the internet. Nowadays, the internet has become a marketplace suitable for all ages and incomes and both genders and thus the prejudices linked to the advisability of selling certain products should be revised. The objective of this study is to test whether the socioeconomic characteristics of experienced e-shoppers such as gender rally moderate the effect of their perceptions of online shopping behavior. Current development of the online environment and the experience acquired by individuals from previous e-purchases can attenuate or even nullify the effect of these characteristics. The individuals analyzed are experienced e-shoppers i.e. individuals who often make purchases on the internet. The Technology Acceptance Model (TAM) was broadened to include previous use of the internet and perceived self-efficacy. The perceptions and behavior of e-shoppers are based on their own experiences. The information obtained will be tested using questionnaires which were distributed and self-administered to respondent accustomed using internet. The causal model is estimated using structural equation modeling techniques (SEM), followed by tests of the moderating effect of socioeconomic variables on perceptions and online shopping behavior. The expected findings of this study indicated that gender moderate neither the influence of previous use of the internet nor the perceptions of e-commerce. In short, they do not condition the behavior of the experienced e-shopper.Keywords: Internet shopping, age groups, gender, income, electronic commerce
Procedia PDF Downloads 326449 A Continuous Real-Time Analytic for Predicting Instability in Acute Care Rapid Response Team Activations
Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward
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A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.Keywords: critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team
Procedia PDF Downloads 140448 Minimal Invasive Esophagectomy for Esophageal Cancer: An Institutional Review From a Dedicated Centre of Pakistan
Authors: Nighat Bakhtiar, Ali Raza Khan, Shahid Khan Khattak, Aamir Ali Syed
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Introduction: Chemoradiation followed by resection has been the standard therapy for resectable (cT1-4aN0-3M0) esophageal carcinoma. The optimal surgical approach remains a matter of debate. Therefore, the purpose of this study was to share our experiences of minimal invasive esophagectomies concerning morbidity, mortality and oncological quality. This study aims to enlighten the world about the surgical outcomes after minimally invasive esophagectomy at Shaukat Khanum Hospital Lahore. Objective: The purpose of this study is to review an institutional experience of Surgical outcomes of Minimal Invasive esophagectomies for esophageal cancer. Methodology: This retrospective study was performed after ethical approval at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) Pakistan. Patients who underwent Minimal Invasive esophagectomies for esophageal cancer from March 2018 to March 2023 were selected. Data was collected through the human information system (HIS) electronic database of SKMCH&RC. Data was described using mean and median with minimum and maximum values for quantitative variables. For categorical variables, a number of observations and percentages were reported. Results: A total of 621 patients were included in the study, with the mean age of the patient was 39 years, ranging between 18-58 years. Mean Body Mass Index of patients was 21.2.1±4.1. Neo-adjuvant chemoradiotherapy was given to all patients. The mean operative time was 210.36 ± 64.51 minutes, and the mean blood loss was 121 milliliters. There was one mortality in 90 days, while the mean postoperative hospital stay was 6.58 days with a 4.64 standard deviation. The anastomotic leak rate was 4.2%. Chyle leak was observed in 12 patients. Conclusion: The minimal invasive technique is a safe approach for esophageal cancers, with minimal complications and fast recovery.Keywords: minimal invasive, esophagectomy, laparscopic, cancer
Procedia PDF Downloads 64447 Job Stress Among the Nurses of the Emergency Department of Selected Saudi Hospital
Authors: Mahmoud Abdel Hameed Shahin
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Job demands that are incompatible with an employee's skills, resources, or needs cause unpleasant emotional and physical reactions known as job stress. Nurses offer care in hospital emergency rooms all around the world, and since they operate in such a dynamic and unpredictable setting, they are constantly under pressure. It has been discovered that job stress has harmful impacts on nurses' health as well as their capacity to handle the demands of their jobs. The purpose of this study was to evaluate the level of job stress experienced by the emergency department nurses at King Fahad Specialist Hospital in Buraidah City, Saudi Arabia. In October 2021, a cross-sectional descriptive study was conducted. 80 nurses were conveniently selected for the study, the bulk of them worked at King Fahad Specialist Hospital's emergency department. An electronic questionnaire with a sociodemographic data sheet and a job stress scale was given to the participating nurses after ethical approval was received from the Ministry of Health's representative bodies. Using SPSS Version 26, both descriptive and inferential statistics were employed to analyze and tabulate the acquired data. According to the findings, the factors that contributed to the most job stress in the clinical setting were having an excessive amount of work to do and working under arbitrary deadlines, whereas the factors that contributed to the least stress were receiving the proper recognition or rewards for good work. In the emergency room of King Fahad Specialist Hospital, nurses had a moderate level of stress (M=3.32 ± 0.567/5). Based on their experience, emergency nurses' levels of job stress varied greatly, with nurses with less than a year of experience notably experiencing the lowest levels of job stress. The amount of job stress did not differ significantly based on the emergency nurses' age, nationality, gender, marital status, position, or level of education. The causes and impact of stress on emergency nurses should be identified and alleviated by hospitals through the implementation of interventional programs.Keywords: emergency nurses, job pressure, Qassim, Saudi Arabia, job stress
Procedia PDF Downloads 179446 Challenges in Implementing the Inculcation of Noble Values During Teaching by Primary Schools Teachers in Peninsular Malaysia
Authors: Mohamad Khairi Haji Othman, Mohd Zailani Mohd Yusoff, Rozalina Khalid
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The inculcation of noble values in teaching and learning is very important, especially to build students with good characters and values. Therefore, the purpose of this research is to identify the challenges of implementing the inculcation of noble values in teaching in primary schools. This study was conducted at four North Zone Peninsular Malaysia schools. This study was used a qualitative approach in the form of case studies. The qualitative approach aims at gaining meaning and a deep understanding of the phenomenon studied from the perspectives of the study participants and not intended to make the generalization. The sample in this study consists of eight teachers who teach in four types of schools that have been chosen purposively. The method of data collection is through semi-structured interviews used in this study. The comparative method is continuously used in this study to analyze the primary data collected. The study found that the main challenges faced by teachers were students' problems and class control so that teachers felt difficult to the inculcation of noble values in teaching. In addition, the language challenge is difficult for students to understand. Similarly, peers are also challenging because students are more easily influenced by friends rather than listening to teachers' instructions. The last challenge was the influence of technology and mass media electronic more widespread. The findings suggest that teachers need to innovate in order to assist the school in inculcating religious and moral education towards the students. The school through guidance and counseling teachers can also plan some activities that are appropriate to the student's present condition. Through this study, teachers and the school should work together to develop the values of students in line with the needs of the National Education Philosophy that wishes to produce intelligent, emotional, spiritual, intellectual and social human capital.Keywords: challenges, implementation, inculcation, noble values
Procedia PDF Downloads 181445 Extent of Knowledge, Preparedness and Perception on Telemedicine among Family Medicine Resident Physicians in Different Training Institutions in Cebu City, PH during COVID-19 Pandemic
Authors: Kristine Joy Y. Sumanga, Clarissa Mae D. Derecho
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Telemedicine is providing health care services using electronic means at a distance, including the diagnosis, treatment, and prevention of diseases as well as the research and evaluation and education of health care providers. The role of telemedicine in this time of the COVID-19 pandemic is vital, especially in the practice of medicine. General Objective: To determine the extent of knowledge, preparedness and perception of telemedicine among Family Medicine Resident Physicians in different training institutions in Cebu City during the Coronavirus Disease 19 pandemic. Methods: A descriptive, cross-sectional survey research study was conducted in four hospital training institutions in Cebu City. A total of 41 respondents gave their consent and were given the online survey questionnaire pertaining to the extent of knowledge, preparedness and perceptions on telemedicine, including respondents’ demographic data and problems encountered in Telemedicine. Results: Out of the 41 respondents, 56.10% were young adults (26 to 30 years old), mostly females (70.73%), single (68.29%), first-year residents (43.90%), employed at a government hospital (70.73%) and are in the traditional residency pathway (82.93%). On relevant experience, 82.93% experienced telemedicine during residency, with 100% on follow-up consultations, and 95% were consulted due to infections. Respondents’ extent of knowledge was average, while the extent of preparedness and perception were great. Problems with low connectivity (80.48%) were noted by most of the respondents. Conclusion: Resident physicians moderately understood the information about telemedicine but with a great extent of preparedness and perception. They are always prepared for telemedicine modality because they are fully aware of its existence and need in the delivery of health care services among their patients at the time of the pandemic. Challenges to low connectivity and handling patients’ data privacy were the major concerns met by the resident physicians in the use of telemedicine.Keywords: telemedicine, knowledge, preparedness, perception, family medicine, residents, COVID 19
Procedia PDF Downloads 72444 Minimally Invasive versus Conventional Sternotomy for Aortic Valve Replacement: A Systematic Review and Meta-Analysis
Authors: Ahmed Shaboub, Yusuf Jasim Althawadi, Shadi Alaa Abdelaal, Mohamed Hussein Abdalla, Hatem Amr Elzahaby, Mohamed Mohamed, Hazem S. Ghaith, Ahmed Negida
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Objectives: We aimed to compare the safety and outcomes of the minimally invasive approaches versus conventional sternotomy procedures for aortic valve replacement. Methods: We conducted a PRISMA-compliant systematic review and meta-analysis. We ran an electronic search of PubMed, Cochrane CENTRAL, Scopus, and Web of Science to identify the relevant published studies. Data were extracted and pooled as standardized mean difference (SMD) or risk ratio (RR) using StataMP version 17 for macOS. Results: Forty-one studies with a total of 15,065 patients were included in this meta-analysis (minimally invasive approaches n=7231 vs. conventional sternotomy n=7834). The pooled effect size showed that minimally invasive approaches had lower mortality rate (RR 0.76, 95%CI [0.59 to 0.99]), intensive care unit and hospital stays (SMD -0.16 and -0.31, respectively), ventilation time (SMD -0.26, 95%CI [-0.38 to -0.15]), 24-h chest tube drainage (SMD -1.03, 95%CI [-1.53 to -0.53]), RBCs transfusion (RR 0.81, 95%CI [0.70 to 0.93]), wound infection (RR 0.66, 95%CI [0.47 to 0.92]) and acute renal failure (RR 0.65, 95%CI [0.46 to 0.93]). However, minimally invasive approaches had longer operative time, cross-clamp, and bypass times (SMD 0.47, 95%CI [0.22 to 0.72], SMD 0.27, 95%CI [0.07 to 0.48], and SMD 0.37, 95%CI [0.20 to 0.45], respectively). There were no differences between the two groups in blood loss, endocarditis, cardiac tamponade, stroke, arrhythmias, pneumonia, pneumothorax, bleeding reoperation, tracheostomy, hemodialysis, or myocardial infarction (all P>0.05). Conclusion: Current evidence showed higher safety and better operative outcomes with minimally invasive aortic valve replacement compared to the conventional approach. Future RCTs with long-term follow-ups are recommended.Keywords: aortic replacement, minimally invasive, sternotomy, mini-sternotomy, aortic valve, meta analysis
Procedia PDF Downloads 113443 A Systematic Review of the Methodological and Reporting Quality of Case Series in Surgery
Authors: Riaz A. Agha, Alexander J. Fowler, Seon-Young Lee, Buket Gundogan, Katharine Whitehurst, Harkiran K. Sagoo, Kyung Jin Lee Jeong, Douglas G. Altman, Dennis P. Orgill
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Introduction: Case Series are an important and common study type. Currently, no guideline exists for reporting case series and there is evidence of key data being missed from such reports. We propose to develop a reporting guideline for case series using a methodologically robust technique. The first step in this process is a systematic review of literature relevant to the reporting deficiencies of case series. Methods: A systematic review of methodological and reporting quality in surgical case series was performed. The electronic search strategy was developed by an information specialist and included MEDLINE, EMBASE, Cochrane Methods Register, Science Citation index and Conference Proceedings Citation index, from the start of indexing until 5th November 2014. Independent screening, eligibility assessments and data extraction was performed. Included articles were analyzed for five areas of deficiency: failure to use standardized definitions missing or selective data transparency or incomplete reporting whether alternate study designs were considered. Results: The database searching identified 2,205 records. Through the process of screening and eligibility assessments, 92 articles met inclusion criteria. Frequency of methodological and reporting issues identified was a failure to use standardized definitions (57%), missing or selective data (66%), transparency, or incomplete reporting (70%), whether alternate study designs were considered (11%) and other issues (52%). Conclusion: The methodological and reporting quality of surgical case series needs improvement. Our data shows that clear evidence-based guidelines for the conduct and reporting of a case series may be useful to those planning or conducting them.Keywords: case series, reporting quality, surgery, systematic review
Procedia PDF Downloads 353442 Elaboration of Sustainable Luminescence Material Based on Rare Earth Complexes for Solar Energy Conversion
Authors: Othmane Essahili, Mohamed Ilsouk, Carine Duhayon, Omar Moudam
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Due to their excellent and promising properties, a great deal of attention has recently been devoted to luminescent materials, particularly those utilizing rare earth elements. These materials play an essential role in low-cost energy conversion technology applications, such as luminescent solar concentrators (LSCs). They also have potential applications in Agri-PV systems and smart building windows. Luminescent materials based on europium (III) complexes are known for their high luminescence efficiency, long fluorescence lifetimes, and sharp emission bands. However, they present certain drawbacks related to their limited absorption capacity due to the forbidden 4f-4f electronic transitions. To address these drawbacks, using β-diketonate ligands as sensitizers appears as a promising solution to enhance luminescence intensity through the antenna effect, where the ligand's excited energy is transferred to the europium ions. In this study, we synthesized β-diketonate-based europium complexes with phenanthroline derivatives, modified with various methyl groups, to examine their effects on the complexes' stability in poly(methyl methacrylate) (PMMA) films. Our findings reveal that these complexes exhibit remarkable red emission and high photoluminescence quantum yield. Stability tests under different conditions for 1200 hours showed that complexes with a higher number of methyl substitutions offer improved photoluminescent stability and resistance to degradation, particularly in outdoor settings. This research underscores the potential of chemically tuned phenanthroline ligands in developing stable, efficient luminescent materials for future optoelectronic devices, including efficient and durable LSCs.Keywords: luminescent materials, photochemistry, luminescent solar concentrators, β-diketonate-based europium complexes
Procedia PDF Downloads 54441 Performance and Limitations of Likelihood Based Information Criteria and Leave-One-Out Cross-Validation Approximation Methods
Authors: M. A. C. S. Sampath Fernando, James M. Curran, Renate Meyer
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Model assessment, in the Bayesian context, involves evaluation of the goodness-of-fit and the comparison of several alternative candidate models for predictive accuracy and improvements. In posterior predictive checks, the data simulated under the fitted model is compared with the actual data. Predictive model accuracy is estimated using information criteria such as the Akaike information criterion (AIC), the Bayesian information criterion (BIC), the Deviance information criterion (DIC), and the Watanabe-Akaike information criterion (WAIC). The goal of an information criterion is to obtain an unbiased measure of out-of-sample prediction error. Since posterior checks use the data twice; once for model estimation and once for testing, a bias correction which penalises the model complexity is incorporated in these criteria. Cross-validation (CV) is another method used for examining out-of-sample prediction accuracy. Leave-one-out cross-validation (LOO-CV) is the most computationally expensive variant among the other CV methods, as it fits as many models as the number of observations. Importance sampling (IS), truncated importance sampling (TIS) and Pareto-smoothed importance sampling (PSIS) are generally used as approximations to the exact LOO-CV and utilise the existing MCMC results avoiding expensive computational issues. The reciprocals of the predictive densities calculated over posterior draws for each observation are treated as the raw importance weights. These are in turn used to calculate the approximate LOO-CV of the observation as a weighted average of posterior densities. In IS-LOO, the raw weights are directly used. In contrast, the larger weights are replaced by their modified truncated weights in calculating TIS-LOO and PSIS-LOO. Although, information criteria and LOO-CV are unable to reflect the goodness-of-fit in absolute sense, the differences can be used to measure the relative performance of the models of interest. However, the use of these measures is only valid under specific circumstances. This study has developed 11 models using normal, log-normal, gamma, and student’s t distributions to improve the PCR stutter prediction with forensic data. These models are comprised of four with profile-wide variances, four with locus specific variances, and three which are two-component mixture models. The mean stutter ratio in each model is modeled as a locus specific simple linear regression against a feature of the alleles under study known as the longest uninterrupted sequence (LUS). The use of AIC, BIC, DIC, and WAIC in model comparison has some practical limitations. Even though, IS-LOO, TIS-LOO, and PSIS-LOO are considered to be approximations of the exact LOO-CV, the study observed some drastic deviations in the results. However, there are some interesting relationships among the logarithms of pointwise predictive densities (lppd) calculated under WAIC and the LOO approximation methods. The estimated overall lppd is a relative measure that reflects the overall goodness-of-fit of the model. Parallel log-likelihood profiles for the models conditional on equal posterior variances in lppds were observed. This study illustrates the limitations of the information criteria in practical model comparison problems. In addition, the relationships among LOO-CV approximation methods and WAIC with their limitations are discussed. Finally, useful recommendations that may help in practical model comparisons with these methods are provided.Keywords: cross-validation, importance sampling, information criteria, predictive accuracy
Procedia PDF Downloads 385440 Hierarchical Manganese and Nickel Selenide based Ultra-efficient Electrode Material for All-Solid-State Asymmetric Supercapacitors with Extended Energy Efficacy
Authors: Siddhant Srivastav, Soumyaranjan Mishra, Sumanta Kumar Meher
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Researchers are attempting to develop extremely efficient electrochemical energy storage technologies as a result of the phenomenal advancement of portable electronic devices. Because of their improved electrical conductivity and narrower band gap, transition metal selenide-based nanostructures have piqued the interest of many researchers in this field. Based on this concept, we present a simple anion exchange hydrothermal synthesis method for synthesizing manganese and nickel based selenide (Mn/NiSe2) nanostructure for use in all-solid-state asymmetric supercapacitors. According to the comprehensive physicochemical characterizations, the material has lowly crystalline properties, a distinct porous microstructure, and a significant bonding contact between the metal and the selenium. The electrochemical investigations of the Mn/NiSe2 electrode material revealed supercapacitive charge discharge properties, excellent electro-kinetic reversibility, and minimal charge transfer resistance (Rct). Furthermore, the all-solid-state asymmetric supercapacitor device assembled using Mn/NiSe2 as positive electrode, nitrogen doped reduced graphene oxide (N-rGO) as negative electrode, and PVA-KOH gel as electrolyte/separator exhibit good redox behaviour, excellent charge-discharge properties with negligible voltage (IR) drop, and lower impedance characteristics. The solid state asymmetric supercapacitor device (Mn/NiSe2||N-rGO) demonstrated the power density of ultra-capacitors and the energy density of rechargeable batteries. Conclusively, the Mn/NiSe2 has been proposed as a potential outstanding electrode material for the next generation of all-solid-state asymmetric supercapacitors.Keywords: anion exchange, asymmetric supercapacitor, supercapacitive charge-discharge, voltage drop
Procedia PDF Downloads 98439 2.4 GHz 0.13µM Multi Biased Cascode Power Amplifier for ISM Band Wireless Applications
Authors: Udayan Patankar, Shashwati Bhagat, Vilas Nitneware, Ants Koel
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An ISM band power amplifier is a type of electronic amplifier used to convert a low-power radio-frequency signal into a larger signal of significant power, typically used for driving the antenna of a transmitter. Due to drastic changes in telecommunication generations may lead to the requirements of improvements. Rapid changes in communication lead to the wide implementation of WLAN technology for its excellent characteristics, such as high transmission speed, long communication distance, and high reliability. Many applications such as WLAN, Bluetooth, and ZigBee, etc. were evolved with 2.4GHz to 5 GHz ISM Band, in which the power amplifier (PA) is a key building block of RF transmitters. There are many manufacturing processes available to manufacture a power amplifier for desired power output, but the major problem they have faced is about the power it consumed for its proper working, as many of them are fabricated on the GaN HEMT, Bi COMS process. In this paper we present a CMOS Base two stage cascode design of power amplifier working on 2.4GHz ISM frequency band. To lower the costs and allow full integration of a complete System-on-Chip (SoC) we have chosen 0.13µm low power CMOS technology for design. While designing a power amplifier, it is a real task to achieve higher power efficiency with minimum resources. This design showcase the Multi biased Cascode methodology to implement a two-stage CMOS power amplifier using ADS and LTSpice simulating tool. Main source is maximum of 2.4V which is internally distributed into different biasing point VB driving and VB driven as required for distinct stages of two stage RF power amplifier. It shows maximum power added efficiency near about 70.195% whereas its Power added efficiency calculated at 1 dB compression point is 44.669 %. Biased MOSFET is used to reduce total dc current as this circuit is designed for different wireless applications comes under 2.4GHz ISM Band.Keywords: RFIC, PAE, RF CMOS, impedance matching
Procedia PDF Downloads 217438 Efficacy of Celecoxib Adjunct Treatment on Bipolar Disorder: Systematic Review and Meta-Analysis
Authors: Daniela V. Bavaresco, Tamy Colonetti, Antonio Jose Grande, Francesc Colom, Joao Quevedo, Samira S. Valvassori, Maria Ines da Rosa
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Objective: Performed a systematic review and meta-analysis to evaluated the potential effect of the cyclo-oxygenases (Cox)-2 inhibitor Celecoxib adjunct treatment in Bipolar Disorder (BD), through of randomized controlled trials. Method: A search of the electronic databases was proceeded, on MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Biomed Central, Web of Science, IBECS, LILACS, PsycINFO (American Psychological Association), Congress Abstracts, and Grey literature (Google Scholar and the British Library) for studies published from January 1990 to February 2018. A search strategy was developed using the terms: 'Bipolar disorder' or 'Bipolar mania' or 'Bipolar depression' or 'Bipolar mixed' or 'Bipolar euthymic' and 'Celecoxib' or 'Cyclooxygenase-2 inhibitors' or 'Cox-2 inhibitors' as text words and Medical Subject Headings (i.e., MeSH and EMTREE) and searched. The therapeutic effects of adjunctive treatment with Celecoxib were analyzed, it was possible to carry out a meta-analysis of three studies included in the systematic review. The meta-analysis was performed including the final results of the Young Mania Rating Scale (YMRS) at the end of randomized controlled trials (RCT). Results: Three primary studies were included in the systematic review, with a total of 121 patients. The meta-analysis had significant effect in the YMRS scores from patients with BD who used Celecoxib adjuvant treatment in comparison to placebo. The weighted mean difference was 5.54 (95%CI=3.26-7.82); p < 0.001; I2 =0%). Conclusion: The systematic review suggests that adjuvant treatment with Celecoxib improves the response of major treatments in patients with BD when compared with adjuvant placebo treatment.Keywords: bipolar disorder, Cox-2 inhibitors, Celecoxib, systematic review, meta-analysis
Procedia PDF Downloads 484437 The Implications of Technological Advancements on the Constitutional Principles of Contract Law
Authors: Laura Çami (Vorpsi), Xhon Skënderi
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In today's rapidly evolving technological landscape, the traditional principles of contract law are facing significant challenges. The emergence of new technologies, such as electronic signatures, smart contracts, and online dispute resolution mechanisms, is transforming the way contracts are formed, interpreted, and enforced. This paper examines the implications of these technological advancements on the constitutional principles of contract law. One of the fundamental principles of contract law is freedom of contract, which ensures that parties have the autonomy to negotiate and enter into contracts as they see fit. However, the use of technology in the contracting process has the potential to disrupt this principle. For example, online platforms and marketplaces often offer standard-form contracts, which may not reflect the specific needs or interests of individual parties. This raises questions about the equality of bargaining power between parties and the extent to which parties are truly free to negotiate the terms of their contracts. Another important principle of contract law is the requirement of consideration, which requires that each party receives something of value in exchange for their promise. The use of digital assets, such as cryptocurrencies, has created new challenges in determining what constitutes valuable consideration in a contract. Due to the ambiguity in this area, disagreements about the legality and enforceability of such contracts may arise. Furthermore, the use of technology in dispute resolution mechanisms, such as online arbitration and mediation, may raise concerns about due process and access to justice. The use of algorithms and artificial intelligence to determine the outcome of disputes may also raise questions about the impartiality and fairness of the process. Finally, it should be noted that there are many different and complex effects of technical improvements on the fundamental constitutional foundations of contract law. As technology continues to evolve, it will be important for policymakers and legal practitioners to consider the potential impacts on contract law and to ensure that the principles of fairness, equality, and access to justice are preserved in the contracting process.Keywords: technological advancements, constitutional principles, contract law, smart contracts, online dispute resolution, freedom of contract
Procedia PDF Downloads 124436 The Effectiveness of Zinc Supplementation in Taste Disorder Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Boshra Mozaffar, Arash Ardavani, Iskandar Idris
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Food taste and flavor affect food choice and acceptance, which are essential to maintain good health and quality of life. Reduced circulating zinc levels have been shown to adversely affect taste which can result in reduced appetite, weight loss and psychological problems, but the efficacy of Zinc supplementation to treat disorders of taste remains unclear. In this systematic review and meta-analysis, we aimed to examine the efficacy of zinc supplementation in the treatment of taste disorders. We searched four electronic bibliographical databases; Ovid MEDLINE, Ovid Embase, Ovid AMAD and PubMed. Article bibliographies were also searched, which yielded additional relevant studies. To facilitate the collection and identification of all available and relevant articles published before 7 December 2020, there were no restrictions on the publication date. We performed a systematic review and meta-analysis according to the PRISMA Statement. This review was registered at PROSPERO and given the identification number CRD42021228461. In total, we included 12 randomized controlled trials with 938 subjects. Intervention includes zinc (sulfate, gluconate, picolinate, polaprezinc and acetate); the pooled results of the meta-analysis indicate that improvements in taste disorder occurred more frequently in the intervention group compared to the control group (RR = 1.8; 95% CI:1.27 -2.57, p=0.009). The doses are equivalent to 17 mg- 86.7 mg of elemental zin for three to six months. Zinc supplementation is an effective treatment for taste disorders in patients with zinc deficiency or idiopathic taste disorders when given in high doses ranging from 68–86.7 mg/d for up to three months. However, we did not find sufficient evidence to determine the effectiveness of zinc supplementation in patients with taste disorders induced by chronic renal failure.Keywords: taste change, taste disorder, zinc, zinc sulfate or Zn, deficiency, supplementation.
Procedia PDF Downloads 260435 The Universal Cultural Associations in the Conceptual Metaphors Used in the Headlines of Arab News and Saudi Gazette Newspapers: A Critical Cognitive Study
Authors: Hind Hassan Arruwaite
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Conceptual metaphor is a cognitive semantic tool that provides access to people's conceptual systems. The correlation in the human conceptual system surpasses limited time and specific cultures. The universal associations provide universal schemas that organize people's conceptualization of the world. The study aims to explore how the cultural associations used in conceptual metaphors create commonalities and harmony between people of the world. In the research methodology, the researcher implemented Critical Metaphor Analysis, Metaphor Candidate Identification and Metaphor Identification Procedure models to deliver qualitative and descriptive findings. The semantic tension was the key criterion in identifying metaphorically used words in the headlines. The research materials are the oil trade conceptual metaphors used in the headlines of Arab News and Saudi Gazette Newspapers. The data will be uploaded to the self-constructed corpus to examine electronic lists for identifying conceptual metaphors. The study investigates the types of conceptual metaphors used in the headlines of the newspapers, the cultural associations identified in the conceptual metaphors, and whether the identified cultural associations in conceptual metaphors create universal conceptual schemas. The study aligned with previous seminal works on conceptual metaphor theory in emphasizing the distinctive power of conceptual metaphors in exposing the cultural associations that unify people's perceptions. The correlation of people conceptualization provides universal schemas that involve elements of human sensorimotor experiences. The study contributes to exposing the shared cultural associations that ensure the commonality of all humankind's thinking mechanism.Keywords: critical discourse analysis, critical metaphor analysis, conceptual metaphor theory, primary and specific metaphors, corpus-driven approach, universal associations, image schema, sensorimotor experience, oil trade
Procedia PDF Downloads 196434 Maternal Mental Health and Patient Reported Outcomes: Identifying At-Risk Pregnant and Postpartum Patients
Authors: Jennifer Reese, Josh Biber, Howard Weeks, Rachel Hess
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Aim: The Edinburgh Postnatal Depression Screen (EPDS) is a mental health screening for pregnant women that has been widely used over the last 30 years. This screen is typically given in clinic on paper to patients throughout pregnancy and postpartum. The screen helps identify patients who may be at risk for pregnancy related depression or postpartum depression. In early 2016, University of Utah Health implemented an electronic version of the EPDS as well as the PROMIS Depression v1.0 instrument for all pregnant and postpartum patients. We asked patients both instruments to understand coverage of patients identified as at risk for each instrument. Methods: The EPDS is currently administered as part of our PRO template for pregnant and postpartum women. We also administer the PROMIS Depression as part of a standard PRO assessment to all patients. Patients are asked to complete an assessment no more often than every eight weeks. PRO assessments are either completed at home or in clinic with a tablet computer. Patients with a PROMIS score of ≥ 65 or a EPDS score of ≥ 10 were identified as at risk for depression Results: From April 2016 to April 2017, 1,330 unique patients were screened at University of Utah Health in OBGYN clinics with both the EPDS and PROMIS depression instrument on the same day. There were 28 (2.1%) patients were identified as at risk for depression using the PROMIS depression screen, while 262 (19.7%) patients were identified as at risk for postpartum depression using the EPDS screen. Overall, 27 (2%) patients were identified as at risk on both instruments. Conclusion: The EPDS identified a higher percent (19.7%) of patients at risk for depression when compared to the PROMIS depression (2.1%). Ninety-six percent of patients who screened positive on the PROMIS depression screen also screened positive on the EPDS screen. Mental health is an important component to a patient’s overall wellbeing. We want to ensure all patients, particularly pregnant or post-partum women, receive screening and treatment when necessary. A combination of screenings may be necessary to provide the overall best care for patients and to identify the highest percentage of patients at risk.Keywords: patient reported outcomes, mental health, maternal, depression
Procedia PDF Downloads 363433 Satisfaction of Distance Education University Students with the Use of Audio Media as a Medium of Instruction: The Case of Mountains of the Moon University in Uganda
Authors: Mark Kaahwa, Chang Zhu, Moses Muhumuza
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This study investigates the satisfaction of distance education university students (DEUS) with the use of audio media as a medium of instruction. Studying students’ satisfaction is vital because it shows whether learners are comfortable with a certain instructional strategy or not. Although previous studies have investigated the use of audio media, the satisfaction of students with an instructional strategy that combines radio teaching and podcasts as an independent teaching strategy has not been fully investigated. In this study, all lectures were delivered through the radio and students had no direct contact with their instructors. No modules or any other material in form of text were given to the students. They instead, revised the taught content by listening to podcasts saved on their mobile electronic gadgets. Prior to data collection, DEUS received orientation through workshops on how to use audio media in distance education. To achieve objectives of the study, a survey, naturalistic observations and face-to-face interviews were used to collect data from a sample of 211 undergraduate and graduate students. Findings indicate that there was no statistically significant difference in the levels of satisfaction between male and female students. The results from post hoc analysis show that there is a statistically significant difference in the levels of satisfaction regarding the use of audio media between diploma and graduate students. Diploma students are more satisfied compared to their graduate counterparts. T-test results reveal that there was no statistically significant difference in the general satisfaction with audio media between rural and urban-based students. And ANOVA results indicate that there is no statistically significant difference in the levels of satisfaction with the use of audio media across age groups. Furthermore, results from observations and interviews reveal that DEUS found learning using audio media a pleasurable medium of instruction. This is an indication that audio media can be considered as an instructional strategy on its own merit.Keywords: audio media, distance education, distance education university students, medium of instruction, satisfaction
Procedia PDF Downloads 111432 An Approach to Automate the Modeling of Life Cycle Inventory Data: Case Study on Electrical and Electronic Equipment Products
Authors: Axelle Bertrand, Tom Bauer, Carole Charbuillet, Martin Bonte, Marie Voyer, Nicolas Perry
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The complexity of Life Cycle Assessment (LCA) can be identified as the ultimate obstacle to massification. Due to these obstacles, the diffusion of eco-design and LCA methods in the manufacturing sectors could be impossible. This article addresses the research question: How to adapt the LCA method to generalize it massively and improve its performance? This paper aims to develop an approach for automating LCA in order to carry out assessments on a massive scale. To answer this, we proceeded in three steps: First, an analysis of the literature to identify existing automation methods. Given the constraints of large-scale manual processing, it was necessary to define a new approach, drawing inspiration from certain methods and combining them with new ideas and improvements. In a second part, our development of automated construction is presented (reconciliation and implementation of data). Finally, the LCA case study of a conduit is presented to demonstrate the feature-based approach offered by the developed tool. A computerized environment supports effective and efficient decision-making related to materials and processes, facilitating the process of data mapping and hence product modeling. This method is also able to complete the LCA process on its own within minutes. Thus, the calculations and the LCA report are automatically generated. The tool developed has shown that automation by code is a viable solution to meet LCA's massification objectives. It has major advantages over the traditional LCA method and overcomes the complexity of LCA. Indeed, the case study demonstrated the time savings associated with this methodology and, therefore, the opportunity to increase the number of LCA reports generated and, therefore, to meet regulatory requirements. Moreover, this approach also presents the potential of the proposed method for a wide range of applications.Keywords: automation, EEE, life cycle assessment, life cycle inventory, massively
Procedia PDF Downloads 82431 Comparison of Deep Brain Stimulation Targets in Parkinson's Disease: A Systematic Review
Authors: Hushyar Azari
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Aim and background: Deep brain stimulation (DBS) is regarded as an important therapeutic choice for Parkinson's disease (PD). The two most common targets for DBS are the subthalamic nucleus (STN) and globus pallidus (GPi). This review was conducted to compare the clinical effectiveness of these two targets. Methods: A systematic literature search in electronic databases: Embase, Cochrane Library and PubMed were restricted to English language publications 2010 to 2021. Specified MeSH terms were searched in all databases. Studies which evaluated the Unified Parkinson's Disease Rating Scale (UPDRS) III were selected by meeting the following criteria: (1) compared both GPi and STN DBS; (2) had at least three months follow-up period; (3)at least five participants in each group; (4)conducted after 2010. Study quality assessment was performed using the Modified Jadad Scale. Results: 3577 potentially relevant articles were identified, of these, 3569 were excluded based on title and abstract, duplicate and unsuitable article removal. Eight articles satisfied the inclusion criteria and were scrutinized (458 PD patients). According to Modified Jadad Scale, the majority of included studies had low evidence quality which was a limitation of this review. 5 studies reported no statistically significant between-group difference for improvements in UPDRS ш scores. At the same time, there were some results in terms of pain, action tremor, rigidity, and urinary symptoms, which indicated that STN DBS might be a better choice. Regarding the adverse effects, GPi was superior. Conclusion: It is clear that other larger randomized clinical trials with longer follow-up periods and control groups are needed to decide which target is more efficient for deep brain stimulation in Parkinson’s disease and imposes fewer adverse effects on the patients. Meanwhile, STN seems more reasonable according to the results of this systematic review.Keywords: brain stimulation, globus pallidus, Parkinson's disease, subthalamic nucleus
Procedia PDF Downloads 176430 Social Media as a Tool for Medication Adherence and Personal Health Management
Authors: Huang Wei-Chi, Li Wei, Yu Tien-Chieh
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Medication adherence is crucial for treatment success. Adherence problem is common in patients with polypharmacy, especially in the geriatric population who are vulnerable to multiple chronic conditions but averagely less knowledgeable about diseases and medications. In order to help patients take medications appropriately and enhance the understanding of diseases or medications, a Line official account named e-Pharmacist was designed. The line is a popular freeware app with the highest penetration rate (95.7%) in Taiwan. The interface of e-Pharmacist is user-friendly for easy-to-read and convenient operating. Differ from other medication adherence apps, users just added e-Pharmacist as a LINE friend without installing any more apps and the drug lists were automatically downloaded from the personal electronic medical records with security permission. Over and above medication reminder, several additional capabilities were set up and engaged in the platform of e-Pharmacist including prescription refill reservation, laboratory examination consultation, medical appointment registration, and “Daily Health Log” where patients can record and track data of blood pressure/blood sugar and daily meals for self-health management as well as can share the important information to clinical professionals when seeking medical help. Additionally, a Line chatbot was utilized to provide tailored medicine information for the individual user. From July 2020 to March 2022, around 3000 patients added e-pharmacist as Line friends. Every day more than 1500 patients receive messages from e-pharmacist to notify them to take medicine. Thanks to the e-pharmacist alert system and Chatbot, the low-compliance patients (defined by Program on Adherence to Medication, PAM) significantly dropped from 36% to 6%, whereas the high-compliance patients dramatically increased from 13% to 77%. The user satisfaction is 98%. In brief, an e-pharmacist is not only a medication reminder but also a tailored personal assistant with value-added service for health management.Keywords: e-pharmacist, self-health management, medication reminder, value-added service
Procedia PDF Downloads 148