Search results for: global health systems
1025 Serum Concentration of the CCL7 Chemokine in Diabetic Pregnant Women during Pregnancy until the Postpartum Period
Authors: Fernanda Piculo, Giovana Vesentini, Gabriela Marini, Debora Cristina Damasceno, Angelica Mercia Pascon Barbosa, Marilza Vieira Cunha Rudge
Abstract:
Introduction: Women with previous gestational diabetes mellitus (GDM) were significantly more likely to have urinary incontinence (UI) and pelvic floor muscle dysfunction compared to non-diabetic women two years after a cesarean section. Additional results demonstrated that induced diabetes causes detrimental effects on pregnant rat urethral muscle. These results indicate the need for exploration of the mechanistic role of a recovery factor in female UI. Chemokine ligand 7 (CCL7) was significantly over expressed in rat serum, urethral and vaginal tissues immediately following induction of stress UI in a rat model simulating birth trauma. CCL7 over expression has shown potency for stimulating targeted stem cell migration and provide a translational link (clinical measurement) which further provide opportunities for treatment. The aim of this study was to investigate the CCL7 levels profile in diabetic pregnant women with urinary incontinence during pregnancy over the first year postpartum. Methods: This study was conducted in the Perinatal Diabetes Research Center of the Botucatu Medical School/UNESP, and was approved by the Research Ethics Committee of the Institution (CAAE: 20639813.0.0000.5411). The diagnosis of GDM was established between 24th and 28th gestational weeks, by the 75 g-OGTT test according to ADA’s criteria. Urinary incontinence was defined according to the International Continence Society and the CCL7 levels was measured by ELISA (R&D Systems, Catalog Number DCC700). Two hundred twelve women were classified into four study groups: normoglycemic continent (NC), normoglycemic incontinent (NI), diabetic continent (DC) and diabetic incontinent (DI). They were evaluated at six-time-points: 12-18, 24-28 and 34-38 gestational weeks, 24-48 hours, 6 weeks and 6-12 months postpartum. Results: At 12-18 weeks, it was possible to consider only two groups, continent and incontinent, because at this early gestational period has not yet been the diagnosis of GDM. The group with GDM and UI (DI group) showed lower levels of CCL7 in all time points during pregnancy and postpartum, compared to normoglycemic groups (NC and NI), indicating that these women have not recovered from child birth induced UI during the 6-12 months postpartum compared to their controls, and that the progression of UI and/or lack of recovery throughout the first postpartum year can be related with lower levels of CCL7. Instead, serum CCL7 was significantly increased in the NC group. Taken together, these findings of overexpression of CCL7 in the NC group and decreased levels in the DI group, could confirm that diabetes delays the recovery from child birth induced UI, and that CCL7 could potentially be used as a serum marker of injury. Conclusion: This study demonstrates lower levels of CCL7 in the DI group during pregnancy and postpartum and suggests that the progression of UI in diabetic women and/or lack of recovery throughout the first postpartum year can be related with low levels of CCL7. This provides a translational potential where CCL7 measurement could be used as a surrogate for injury after delivery. Successful controlled CCL7 mediated stem cell homing to the lower urinary tract could one day introduce the potential for non-operative treatment or prevention of stress urinary incontinence.Keywords: CCL7, gestational diabetes, pregnancy, urinary incontinence
Procedia PDF Downloads 3381024 Scoring System for the Prognosis of Sepsis Patients in Intensive Care Units
Authors: Javier E. García-Gallo, Nelson J. Fonseca-Ruiz, John F. Duitama-Munoz
Abstract:
Sepsis is a syndrome that occurs with physiological and biochemical abnormalities induced by severe infection and carries a high mortality and morbidity, therefore the severity of its condition must be interpreted quickly. After patient admission in an intensive care unit (ICU), it is necessary to synthesize the large volume of information that is collected from patients in a value that represents the severity of their condition. Traditional severity of illness scores seeks to be applicable to all patient populations, and usually assess in-hospital mortality. However, the use of machine learning techniques and the data of a population that shares a common characteristic could lead to the development of customized mortality prediction scores with better performance. This study presents the development of a score for the one-year mortality prediction of the patients that are admitted to an ICU with a sepsis diagnosis. 5650 ICU admissions extracted from the MIMICIII database were evaluated, divided into two groups: 70% to develop the score and 30% to validate it. Comorbidities, demographics and clinical information of the first 24 hours after the ICU admission were used to develop a mortality prediction score. LASSO (least absolute shrinkage and selection operator) and SGB (Stochastic Gradient Boosting) variable importance methodologies were used to select the set of variables that make up the developed score; each of this variables was dichotomized and a cut-off point that divides the population into two groups with different mean mortalities was found; if the patient is in the group that presents a higher mortality a one is assigned to the particular variable, otherwise a zero is assigned. These binary variables are used in a logistic regression (LR) model, and its coefficients were rounded to the nearest integer. The resulting integers are the point values that make up the score when multiplied with each binary variables and summed. The one-year mortality probability was estimated using the score as the only variable in a LR model. Predictive power of the score, was evaluated using the 1695 admissions of the validation subset obtaining an area under the receiver operating characteristic curve of 0.7528, which outperforms the results obtained with Sequential Organ Failure Assessment (SOFA), Oxford Acute Severity of Illness Score (OASIS) and Simplified Acute Physiology Score II (SAPSII) scores on the same validation subset. Observed and predicted mortality rates within estimated probabilities deciles were compared graphically and found to be similar, indicating that the risk estimate obtained with the score is close to the observed mortality, it is also observed that the number of events (deaths) is indeed increasing as the outcome go from the decile with the lowest probabilities to the decile with the highest probabilities. Sepsis is a syndrome that carries a high mortality, 43.3% for the patients included in this study; therefore, tools that help clinicians to quickly and accurately predict a worse prognosis are needed. This work demonstrates the importance of customization of mortality prediction scores since the developed score provides better performance than traditional scoring systems.Keywords: intensive care, logistic regression model, mortality prediction, sepsis, severity of illness, stochastic gradient boosting
Procedia PDF Downloads 2221023 Outpatient Pelvic Nerve and Muscle Treatment Reduces Pain and Improves Functionality for Patients with Chronic Pelvic Pain and Erectile Dysfunction
Authors: Allyson Augusta Shrikhande, Alexa Rains, Tayyaba Ahmed, Marjorie Mamsaang, Rakhi Vyas, Janaki Natarajan, Erika Moody, Christian Reutter, Kimberlee Leishear, Yogita Tailor, Sandra Sandhu-Restaino, Lora Liu, Neha James, Rosemarie Filart
Abstract:
Characterized by consistent difficulty getting and keeping an erection firm enough for intercourse, Erectile Dysfunction may affect up to 15% of adult men. Although awareness and access to treatment have improved in recent years, many patients do not actively seek diagnosis or treatment due to the stigma surrounding this condition. Patients who do seek treatment are often dissatisfied by the efficacy of the medication. The condition inhibits patients’ quality of life by worsening mental health and relationships. The purpose of this study was to test the effectiveness of an outpatient neuromuscular treatment protocol in treating the symptoms of Chronic Pelvic Pain and Erectile Dysfunction, improving pain and function. 56 patients ages 20-79 presented to an outpatient clinic for treatment of pelvic pain and Erectile Dysfunction symptoms. These symptoms had persisted for an average of 4 years. All patients underwent external ultrasound-guided hydro-dissection technique targeted at pelvic peripheral nerves in combination with pelvic floor musculature trigger-point injections. To measure the effects of this treatment, a five question Erectile Dysfunction questionnaire was completed by each patient at their first visit to a clinic and three months after treatment began. Answers were summed for a total score of 5-25, with a higher score indicating optimal function. The average score before treatment was 14.125 (SD 5.411) (a=0.05; CI 12.708-15.542), which increased by 18% to an average of 16.625 (SD 6.423) (a=0.05; CI 14.943-18.307) after treatment (P=0.0004). Secondary outcome variables included a Visual Analogue Scale (VAS) to measure pelvic pain intensity and the Functional Pelvic Pain Scale (FPPS) to measure function across multiple areas. VAS scores reduced by 51% after three months. Before treatment, the mean VAS score was 5.87, and the posttreatment mean VAS score was 2.89. Pelvic pain functionality improved by 34% after three months. Pretreatment FPPS scores averaged at 7.48, decreasing to 4.91 after treatment. These results indicate that this unique treatment was very effective at relieving pain and increasing function for patients with Erectile Dysfunction.Keywords: chronic pelvic pain, erectile dysfunction, nonsurgical, outpatient, trigger point injections
Procedia PDF Downloads 891022 Adaptive Programming for Indigenous Early Learning: The Early Years Model
Authors: Rachel Buchanan, Rebecca LaRiviere
Abstract:
Context: The ongoing effects of colonialism continue to be experienced through paternalistic policies and funding processes that cause disjuncture between and across Indigenous early childhood programming on-reserve and in urban and Northern settings in Canada. While various educational organizations and social service providers have risen to address these challenges in the short, medium and long term, there continues to be a lack in nation-wide cohesive, culturally grounded, and meaningful early learning programming for Indigenous children in Canada. Indigenous-centered early learning programs tend to face one of two scaling dilemmas: their program goals are too prescriptive to enable the program to be meaningfully replicated in different cultural/ community settings, or their program goals are too broad to be meaningfully adapted to the unique cultural and contextual needs and desires of Indigenous communities (the “franchise approach”). There are over 600 First Nations communities in Canada representing more than 50 Nations and languages. Consequently, Indigenous early learning programming cannot be applied with a universal or “one size fits all” approach. Sustainable and comprehensive programming must be responsive to each community context, building upon existing strengths and assets to avoid program duplication and irrelevance. Thesis: Community-driven and culturally adapted early childhood programming is critical but cannot be achieved on a large scale within traditional program models that are constrained by prescriptive overarching program goals. Principles, rather than goals, are an effective way to navigate and evaluate complex and dynamic systems. Principles guide an intervention to be adaptable, flexible and scalable. The Martin Family Initiative (MFI) ’s Early Years program engages a principles-based approach to programming. As will be discussed in this paper, this approach enables the program to catalyze existing community-based strengths and organizational assets toward bridging gaps across and disjuncture between Indigenous early learning programs, as well as to scale programming in sustainable, context-responsive and dynamic ways. This paper argues that using a principles-driven and adaptive scaling approach, the Early Years model establishes important learnings for culturally adapted Indigenous early learning programming in Canada. Methodology: The Early Years has leveraged this approach to develop an array of programming with partner organizations and communities across the country. The Early Years began as a singular pilot project in one First Nation. In just three years, it has expanded to five different regions and community organizations. In each context, the program supports the partner organization through different means and to different ends, the extent to which is determined in partnership with each community-based organization: in some cases, this means supporting the organization to build home visiting programming from the ground-up; in others, it means offering organization-specific culturally adapted early learning resources to support the programming that already exists in communities. Principles underpin but do not define the practices of the program in each of these relationships. This paper will explore numerous examples of principles-based adaptability with the context of the Early Years, concluding that the program model offers theadaptability and dynamism necessary to respond to unique and ever-evolving community contexts and needs of Indigenous children today.Keywords: culturally adapted programming, indigenous early learning, principles-based approach, program scaling
Procedia PDF Downloads 1861021 Estimating the Ladder Angle and the Camera Position From a 2D Photograph Based on Applications of Projective Geometry and Matrix Analysis
Authors: Inigo Beckett
Abstract:
In forensic investigations, it is often the case that the most potentially useful recorded evidence derives from coincidental imagery, recorded immediately before or during an incident, and that during the incident (e.g. a ‘failure’ or fire event), the evidence is changed or destroyed. To an image analysis expert involved in photogrammetric analysis for Civil or Criminal Proceedings, traditional computer vision methods involving calibrated cameras is often not appropriate because image metadata cannot be relied upon. This paper presents an approach for resolving this problem, considering in particular and by way of a case study, the angle of a simple ladder shown in a photograph. The UK Health and Safety Executive (HSE) guidance document published in 2014 (INDG455) advises that a leaning ladder should be erected at 75 degrees to the horizontal axis. Personal injury cases can arise in the construction industry because a ladder is too steep or too shallow. Ad-hoc photographs of such ladders in their incident position provide a basis for analysis of their angle. This paper presents a direct approach for ascertaining the position of the camera and the angle of the ladder simultaneously from the photograph(s) by way of a workflow that encompasses a novel application of projective geometry and matrix analysis. Mathematical analysis shows that for a given pixel ratio of directly measured collinear points (i.e. features that lie on the same line segment) from the 2D digital photograph with respect to a given viewing point, we can constrain the 3D camera position to a surface of a sphere in the scene. Depending on what we know about the ladder, we can enforce another independent constraint on the possible camera positions which enables us to constrain the possible positions even further. Experiments were conducted using synthetic and real-world data. The synthetic data modeled a vertical plane with a ladder on a horizontally flat plane resting against a vertical wall. The real-world data was captured using an Apple iPhone 13 Pro and 3D laser scan survey data whereby a ladder was placed in a known location and angle to the vertical axis. For each case, we calculated camera positions and the ladder angles using this method and cross-compared them against their respective ‘true’ values.Keywords: image analysis, projective geometry, homography, photogrammetry, ladders, Forensics, Mathematical modeling, planar geometry, matrix analysis, collinear, cameras, photographs
Procedia PDF Downloads 521020 Modelling of Reactive Methodologies in Auto-Scaling Time-Sensitive Services With a MAPE-K Architecture
Authors: Óscar Muñoz Garrigós, José Manuel Bernabeu Aubán
Abstract:
Time-sensitive services are the base of the cloud services industry. Keeping low service saturation is essential for controlling response time. All auto-scalable services make use of reactive auto-scaling. However, reactive auto-scaling has few in-depth studies. This presentation shows a model for reactive auto-scaling methodologies with a MAPE-k architecture. Queuing theory can compute different properties of static services but lacks some parameters related to the transition between models. Our model uses queuing theory parameters to relate the transition between models. It associates MAPE-k related times, the sampling frequency, the cooldown period, the number of requests that an instance can handle per unit of time, the number of incoming requests at a time instant, and a function that describes the acceleration in the service's ability to handle more requests. This model is later used as a solution to horizontally auto-scale time-sensitive services composed of microservices, reevaluating the model’s parameters periodically to allocate resources. The solution requires limiting the acceleration of the growth in the number of incoming requests to keep a constrained response time. Business benefits determine such limits. The solution can add a dynamic number of instances and remains valid under different system sizes. The study includes performance recommendations to improve results according to the incoming load shape and business benefits. The exposed methodology is tested in a simulation. The simulator contains a load generator and a service composed of two microservices, where the frontend microservice depends on a backend microservice with a 1:1 request relation ratio. A common request takes 2.3 seconds to be computed by the service and is discarded if it takes more than 7 seconds. Both microservices contain a load balancer that assigns requests to the less loaded instance and preemptively discards requests if they are not finished in time to prevent resource saturation. When load decreases, instances with lower load are kept in the backlog where no more requests are assigned. If the load grows and an instance in the backlog is required, it returns to the running state, but if it finishes the computation of all requests and is no longer required, it is permanently deallocated. A few load patterns are required to represent the worst-case scenario for reactive systems: the following scenarios test response times, resource consumption and business costs. The first scenario is a burst-load scenario. All methodologies will discard requests if the rapidness of the burst is high enough. This scenario focuses on the number of discarded requests and the variance of the response time. The second scenario contains sudden load drops followed by bursts to observe how the methodology behaves when releasing resources that are lately required. The third scenario contains diverse growth accelerations in the number of incoming requests to observe how approaches that add a different number of instances can handle the load with less business cost. The exposed methodology is compared against a multiple threshold CPU methodology allocating/deallocating 10 or 20 instances, outperforming the competitor in all studied metrics.Keywords: reactive auto-scaling, auto-scaling, microservices, cloud computing
Procedia PDF Downloads 931019 Innovations in the Implementation of Preventive Strategies and Measuring Their Effectiveness Towards the Prevention of Harmful Incidents to People with Mental Disabilities who Receive Home and Community Based Services
Authors: Carlos V. Gonzalez
Abstract:
Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.Keywords: harm, patients, resilience, safety, mental illness, disability
Procedia PDF Downloads 4471018 Avoidance of Brittle Fracture in Bridge Bearings: Brittle Fracture Tests and Initial Crack Size
Authors: Natalie Hoyer
Abstract:
Bridges in both roadway and railway systems depend on bearings to ensure extended service life and functionality. These bearings enable proper load distribution from the superstructure to the substructure while permitting controlled movement of the superstructure. The design of bridge bearings, according to Eurocode DIN EN 1337 and the relevant sections of DIN EN 1993, increasingly requires the use of thick plates, especially for long-span bridges. However, these plate thicknesses exceed the limits specified in the national appendix of DIN EN 1993-2. Furthermore, compliance with DIN EN 1993-1-10 regulations regarding material toughness and through-thickness properties necessitates further modifications. Consequently, these standards cannot be directly applied to the selection of bearing materials without supplementary guidance and design rules. In this context, a recommendation was developed in 2011 to regulate the selection of appropriate steel grades for bearing components. Prior to the initiation of the research project underlying this contribution, this recommendation had only been available as a technical bulletin. Since July 2023, it has been integrated into guideline 804 of the German railway. However, recent findings indicate that certain bridge-bearing components are exposed to high fatigue loads, which necessitate consideration in structural design, material selection, and calculations. Therefore, the German Centre for Rail Traffic Research called a research project with the objective of defining a proposal to expand the current standards in order to implement a sufficient choice of steel material for bridge bearings to avoid brittle fracture, even for thick plates and components subjected to specific fatigue loads. The results obtained from theoretical considerations, such as finite element simulations and analytical calculations, are validated through large-scale component tests. Additionally, experimental observations are used to calibrate the calculation models and modify the input parameters of the design concept. Within the large-scale component tests, a brittle failure is artificially induced in a bearing component. For this purpose, an artificially generated initial defect is introduced at the previously defined hotspot into the specimen using spark erosion. Then, a dynamic load is applied until the crack initiation process occurs to achieve realistic conditions in the form of a sharp notch similar to a fatigue crack. This initiation process continues until the crack length reaches a predetermined size. Afterward, the actual test begins, which requires cooling the specimen with liquid nitrogen until a temperature is reached where brittle fracture failure is expected. In the next step, the component is subjected to a quasi-static tensile test until failure occurs in the form of a brittle failure. The proposed paper will present the latest research findings, including the results of the conducted component tests and the derived definition of the initial crack size in bridge bearings.Keywords: bridge bearings, brittle fracture, fatigue, initial crack size, large-scale tests
Procedia PDF Downloads 451017 Effects of Roasting as Preservative Method on Food Value of the Runner Groundnuts, Arachis hypogaea
Authors: M. Y. Maila, H. P. Makhubele
Abstract:
Roasting is one of the oldest preservation method used in foods such as nuts and seeds. It is a process by which heat is applied to dry foodstuffs without the use of oil or water as a carrier. Groundnut seeds, also known as peanuts when sun dried or roasted, are among the oldest oil crops that are mostly consumed as a snack, after roasting in many parts of South Africa. However, roasting can denature proteins, destroy amino acids, decrease nutritive value and induce undesirable chemical changes in the final product. The aim of this study, therefore, was to evaluate the effect of various roasting times on the food value of the runner groundnut seeds. A constant temperature of 160 °C and various time-intervals (20, 30, 40, 50 and 60 min) were used for roasting groundnut seeds in an oven. Roasted groundnut seeds were then cooled and milled to flour. The milled sundried, raw groundnuts served as reference. The proximate analysis (moisture, energy and crude fats) was performed and the results were determined using standard methods. The antioxidant content was determined using HPLC. Mineral (cobalt, chromium, silicon and iron) contents were determined by first digesting the ash of sundried and roasted seed samples in 3M Hydrochloric acid and then determined by Atomic Absorption Spectrometry. All results were subjected to ANOVA through SAS software. Relative to the reference, roasting time significantly (p ≤ 0.05) reduced moisture (71%–88%), energy (74%) and crude fat (5%–64%) of the runner groundnut seeds, whereas the antioxidant content was significantly (p ≤ 0.05) increased (35%–72%) with increasing roasting time. Similarly, the tested mineral contents of the roasted runner groundnut seeds were also significantly (p ≤ 0.05) reduced at all roasting times: cobalt (21%–83%), chromium (48%–106%) and silicon (58%–77%). However, the iron content was significantly (p ≤ 0.05) unaffected. Generally, the tested runner groundnut seeds had higher food value in the raw state than in the roasted state, except for the antioxidant content. Moisture is a critical factor affecting the shelf life, texture and flavor of the final product. Loss of moisture ensures prolonged shelf life, which contribute to the stability of the roasted peanuts. Also, increased antioxidant content in roasted groundnuts is essential in other health-promoting compounds. In conclusion, the overall reduction in the proximate and mineral contents of the runner groundnuts seeds due to roasting is sufficient to suggest influences of roasting time on the food value of the final product and shelf life.Keywords: dry roasting, legume, oil source, peanuts
Procedia PDF Downloads 2871016 Out of the Closet: Transgressive Representations of Queer Intimacy in Filipino Mainstream Media
Authors: Darel Magramo
Abstract:
This study argues that media representations of queer intimacies can be transgressive. Representations of queerness in local and international media can be a reflection of the culture where the media product belongs to and these representations can be peculiar and intolerable to different communities. Since these representations of queerness in any media product are rare and unacceptable it can be seen as transgressive in a way that it goes beyond the norms of a particular community and violates the common perceptions about gender and sexuality. Examining media representations of the queer community in a predominantly Catholic country means breaking the religious belief, principles, and stereotypes about homosexuality and same-sex relationship. Using a mainstream media and gender theory this study examined whether and how one particular Filipino mainstream media representation of queer intimacies can enact such transgression. Over the past years Original Pinoy Music (Original Filipino Music) or OPM has produced chart-topping and controversial hit songs which includes: This guy is in love with you pare (pare refers to a guy or men) released in 2002: Nagmahal ako ng bakla (I fell in love with a gay) released in 2009: and lastly Pare mahal mo raw ako (Man, you love me?) released in 2014. By examining these songs, this study outlines tropes on how OPM songs present transgression in queer intimacy including the image of love for money only to gaiety and satisfaction which presents how an openly gay man makes a cisgender man falls in love for him by satisfying him through his humorous antics, this is one way of showing transgression in queer relationship in Philippine context by going beyond the common stereotype of a cisgender man falling in love to a gay man for his wealth to falling in love genuinely because of gaiety and satisfaction in the relationship. This study also identifies how media created a new way of presenting gay and homosexual relationship - from the stereotypes of gays having illnesses and mental health problems, mainstream media continues to present that queer relationship is not all about love and sexual desire but also it promotes acceptance and love towards people in the community. A queer relationship does not only revolve in the idea of having a same-sex relationship but the idea that queer relationship is also between friends and other people of the community by manifesting acceptance and love. Amidst the conservative culture of the Philippines, mainstream media continues to progress and develop ways on how to present gender and sexuality in different media products. These representations create a transgressive way of showing acceptance and understanding towards identities particularly homosexuality and queer relationships.Keywords: gender studies, homosexuality, media representations, queer intimacy
Procedia PDF Downloads 1601015 Improving the Detection of Depression in Sri Lanka: Cross-Sectional Study Evaluating the Efficacy of a 2-Question Screen for Depression
Authors: Prasad Urvashi, Wynn Yezarni, Williams Shehan, Ravindran Arun
Abstract:
Introduction: Primary health services are often the first point of contact that patients with mental illness have with the healthcare system. A number of tools have been developed to increase detection of depression in the context of primary care. However, one challenge amongst many includes utilizing these tools within the limited primary care consultation timeframe. Therefore, short questionnaires that screen for depression that are just as effective as more comprehensive diagnostic tools may be beneficial in improving detection rates of patients visiting a primary care setting. Objective: To develop and determine the sensitivity and specificity of a 2-Question Questionnaire (2-QQ) to screen for depression in in a suburban primary care clinic in Ragama, Sri Lanka. The purpose is to develop a short screening tool for depression that is culturally adapted in order to increase the detection of depression in the Sri Lankan patient population. Methods: This was a cross-sectional study involving two steps. Step one: verbal administration of 2-QQ to patients by their primary care physician. Step two: completion of the Peradeniya Depression Scale, a validated diagnostic tool for depression, the patient after their consultation with the primary care physician. The results from the PDS were then correlated to the results from the 2-QQ for each patient to determine sensitivity and specificity of the 2-QQ. Results: A score of 1/+ on the 2-QQ was most sensitive but least specific. Thus, setting the threshold at this level is effective for correctly identifying depressed patients, but also inaccurately captures patients who are not depressed. A score of 6 on the 2-QQ was most specific but least sensitive. Setting the threshold at this level is effective for correctly identifying patients without depression, but not very effective at capturing patients with depression. Discussion: In the context of primary care, it may be worthwhile setting the 2-QQ screen at a lower threshold for positivity (such as a score of 1 or above). This would generate a high test sensitivity and thus capture the majority of patients that have depression. On the other hand, by setting a low threshold for positivity, patients who do not have depression but score higher than 1 on the 2-QQ will also be falsely identified as testing positive for depression. However, the benefits of identifying patients who present with depression may outweigh the harms of falsely identifying a non-depressed patient. It is our hope that the 2-QQ will serve as a quick primary screen for depression in the primary care setting and serve as a catalyst to identify and treat individuals with depression.Keywords: depression, primary care, screening tool, Sri Lanka
Procedia PDF Downloads 2571014 Effects of the Affordable Care Act On Preventive Care Disparities
Authors: Cagdas Agirdas
Abstract:
Background: The Affordable Care Act (ACA) requires non-grandfathered private insurance plans, starting with plan years on or after September 23rd, 2010, to provide certain preventive care services without any cost sharing in the form of deductibles, copayments or co-insurance. This requirement may affect racial and ethnic disparities in preventive care as it provides the largest copay reduction in preventive care. Objectives: We ask whether the ACA’s free preventive care benefits are associated with a reduction in racial and ethnic disparities in the utilization of four preventive services: cholesterol screenings, colonoscopies, mammograms, and pap smears. Methods: We use a data set of over 6,000 individuals from the 2009, 2010, and 2013 Medical Expenditure Panel Surveys (MEPS). We restrict our data set only to individuals who are old enough to be eligible for each preventive service. Our difference-in-differences logistic regression model classifies privately-insured Hispanics, African Americans, and Asians as the treatment groups and 2013 as the after-policy year. Our control group consists of non-Hispanic whites on Medicaid as this program already covered preventive care services for free or at a low cost before the ACA. Results: After controlling for income, education, marital status, preferred interview language, self-reported health status, employment, having a usual source of care, age and gender, we find that the ACA is associated with increases in the probability of the median, privately-insured Hispanic person to get a colonoscopy by 3.6% and a mammogram by 3.1%, compared to a non-Hispanic white person on Medicaid. Similarly, we find that the median, privately-insured African American person’s probability of receiving these two preventive services improved by 2.3% and 2.4% compared to a non-Hispanic white person on Medicaid. We do not find any significant improvements for any racial or ethnic group for cholesterol screenings or pap smears. Furthermore, our results do not indicate any significant changes for Asians compared to non-Hispanic whites in utilizing the four preventive services. These reductions in racial/ethnic disparities are robust to reconfigurations of time periods, previous diagnosis, and residential status. Conclusions: Early effects of the ACA’s provision of free preventive care are significant for Hispanics and African Americans. Further research is needed for the later years as more individuals became aware of these benefits.Keywords: preventive care, Affordable Care Act, cost sharing, racial disparities
Procedia PDF Downloads 1531013 Preparedness Level of European Cultural Institutions and Catering Establishments Within the Sanitary and Epidemiological Dimension During the COVID-19 Pandemic
Authors: Magdalena Barbara Kaziuk
Abstract:
Introduction: In December 2019, the first case of an acute infectious disease of the respiratory system caused by the SARS-CoV-2 virus was recorded in Wuhan in Central China. On March 11, 2020, the World Health Organization restrictions, among others, in the travel industry. Aim: The aim of the study was the assessment of the preparedness of European cultural institutions and catering establishments within the sanitary and epidemiological dimension during the COVID-19 pandemic by Polish tourists and their sense of safety in selected destinations. Material and methods: The study involved 300 Polish tourists (125 females, 175 males, age 46.5+/-12.9 years) who traveled during the COVID-19 pandemic to Southern European countries. 5 most popular travel destinations were selected: Italy, Austria, Greece, Croatia, and Mediterranean islands. The tourists assessed cultural institutions and catering establishments with the use of a proprietary questionnaire which concerned the preparedness regarding the sanitary and epidemiological requirements and the tourists' sense of safety. The number of respondents was deliberate - 60 persons per each country. Results: The more stringent sanitary regimes, the higher the sense of safety in the study group of females aged 45-50 (p<0.005), while the more stringent sanitary and epidemiological issues are implemented, the shorter the stay (p<0.001). Less stringent restrictions resulted in increased sense of freedom and mental rest in the group of studied males (p<0.005). Conclusions: The respondents' opinions revealed that the highest level of safety with regard to sanitary and epidemiological requirements (masks covering mouth and nose worn by both personnel and society, the necessity to present the COVID passport, the possibility to disinfect hands) was observed in Austria and Italy, while shorter length of the stay in these countries resulted from high prices, particularly in catering establishments. According to the respondents, less stringent restrictions, among others lack of the necessity to own the COVID passport, were linked to Croatia and Mediterranean islands. The sense of safety was satisfying, while the sense of freedom and mental rest was high. declared a string of COVID-19 cases a pandemic. Most countries implemented numerous sanitary and epidemiologicalKeywords: sanitary and epidemiological regimes, tourist facilities, COVID-19 pandemic, sense of safety
Procedia PDF Downloads 1241012 DSF Elements in High-Rise Timber Buildings
Authors: Miroslav Premrov, Andrej Štrukelj, Erika Kozem Šilih
Abstract:
The utilization of prefabricated timber-wall elements with double glazing, called as double-skin façade element (DSF), represents an innovative structural approach in the context of new high-rise timber construction, simultaneously combining sustainable solutions with improved energy efficiency and living quality. In addition to the minimum energy needs of buildings, the design of modern buildings is also increasingly focused on the optimal indoor comfort, in particular on sufficient natural light indoors. An optimally energy-designed building with an optimal layout of glazed areas around the building envelope represents a great potential in modern timber construction. Usually, all these transparent façade elements, because of energy benefits, are primary asymmetrical oriented and if they are considered as non-resisting against a horizontal load impact, a strong torsion effects in the building can appear. The problem of structural stability against a strong horizontal load impact of such modern timber buildings especially increase in a case of high-rise structures where additional bracing elements have to be used. In such a case, special diagonal bracing systems or other bracing solutions with common timber wall elements have to be incorporated into the structure of the building to satisfy all prescribed resisting requirements given by the standards. However, all such structural solutions are usually not environmentally friendly and also not contribute to an improved living comfort, or they are not accepted by the architects at all. Consequently, it is a special need to develop innovative load-bearing timber-glass wall elements which are in the same time environmentally friendly, can increase internal comfort in the building, but are also load-bearing. The new developed load-bearing DSF elements can be a good answer on all these requirements. Timber-glass façade elements DSF wall elements consist of two transparent layers, thermal-insulated three-layered glass pane on the internal side and an additional single-layered glass pane on the external side of the wall. The both panes are separated by an air channel which can be of any dimensions and can have a significant influence on the thermal insulation or acoustic response of such a wall element. Most already published studies on DSF elements primarily deal only with energy and LCA solutions and do not address any structural problems. In previous studies according to experimental analysis and mathematical modeling it was already presented a possible benefit of such load-bearing DSF elements, especially comparing with previously developed load-bearing single-skin timber wall elements, but they were not applicate yet in any high-rise timber structure. Therefore, in the presented study specially selected 10-storey prefabricated timber building constructed in a cross-laminated timber (CLT) structural wall system is analyzed using the developed DSF elements in a sense to increase a structural lateral stability of the whole building. The results evidently highlight the importance the load-bearing DSF elements, as their incorporation can have a significant impact on the overall behavior of the structure through their influence on the stiffness properties. Taking these considerations into account is crucial to ensure compliance with seismic design codes and to improve the structural resilience of high-rise timber buildings.Keywords: glass, high-rise buildings, numerical analysis, timber
Procedia PDF Downloads 461011 A High-Throughput Enzyme Screening Method Using Broadband Coherent Anti-stokes Raman Spectroscopy
Authors: Ruolan Zhang, Ryo Imai, Naoko Senda, Tomoyuki Sakai
Abstract:
Enzymes have attracted increasing attentions in industrial manufacturing for their applicability in catalyzing complex chemical reactions under mild conditions. Directed evolution has become a powerful approach to optimize enzymes and exploit their full potentials under the circumstance of insufficient structure-function knowledge. With the incorporation of cell-free synthetic biotechnology, rapid enzyme synthesis can be realized because no cloning procedure such as transfection is needed. Its open environment also enables direct enzyme measurement. These properties of cell-free biotechnology lead to excellent throughput of enzymes generation. However, the capabilities of current screening methods have limitations. Fluorescence-based assay needs applicable fluorescent label, and the reliability of acquired enzymatic activity is influenced by fluorescent label’s binding affinity and photostability. To acquire the natural activity of an enzyme, another method is to combine pre-screening step and high-performance liquid chromatography (HPLC) measurement. But its throughput is limited by necessary time investment. Hundreds of variants are selected from libraries, and their enzymatic activities are then identified one by one by HPLC. The turn-around-time is 30 minutes for one sample by HPLC, which limits the acquirable enzyme improvement within reasonable time. To achieve the real high-throughput enzyme screening, i.e., obtain reliable enzyme improvement within reasonable time, a widely applicable high-throughput measurement of enzymatic reactions is highly demanded. Here, a high-throughput screening method using broadband coherent anti-Stokes Raman spectroscopy (CARS) was proposed. CARS is one of coherent Raman spectroscopy, which can identify label-free chemical components specifically from their inherent molecular vibration. These characteristic vibrational signals are generated from different vibrational modes of chemical bonds. With the broadband CARS, chemicals in one sample can be identified from their signals in one broadband CARS spectrum. Moreover, it can magnify the signal levels to several orders of magnitude greater than spontaneous Raman systems, and therefore has the potential to evaluate chemical's concentration rapidly. As a demonstration of screening with CARS, alcohol dehydrogenase, which converts ethanol and nicotinamide adenine dinucleotide oxidized form (NAD+) to acetaldehyde and nicotinamide adenine dinucleotide reduced form (NADH), was used. The signal of NADH at 1660 cm⁻¹, which is generated from nicotinamide in NADH, was utilized to measure the concentration of it. The evaluation time for CARS signal of NADH was determined to be as short as 0.33 seconds while having a system sensitivity of 2.5 mM. The time course of alcohol dehydrogenase reaction was successfully measured from increasing signal intensity of NADH. This measurement result of CARS was consistent with the result of a conventional method, UV-Vis. CARS is expected to have application in high-throughput enzyme screening and realize more reliable enzyme improvement within reasonable time.Keywords: Coherent Anti-Stokes Raman Spectroscopy, CARS, directed evolution, enzyme screening, Raman spectroscopy
Procedia PDF Downloads 1411010 Magnetic Solid-Phase Separation of Uranium from Aqueous Solution Using High Capacity Diethylenetriamine Tethered Magnetic Adsorbents
Authors: Amesh P, Suneesh A S, Venkatesan K A
Abstract:
The magnetic solid-phase extraction is a relatively new method among the other solid-phase extraction techniques for the separating of metal ions from aqueous solutions, such as mine water and groundwater, contaminated wastes, etc. However, the bare magnetic particles (Fe3O4) exhibit poor selectivity due to the absence of target-specific functional groups for sequestering the metal ions. The selectivity of these magnetic particles can be remarkably improved by covalently tethering the task-specific ligands on magnetic surfaces. The magnetic particles offer a number of advantages such as quick phase separation aided by the external magnetic field. As a result, the solid adsorbent can be prepared with the particle size ranging from a few micrometers to the nanometer, which again offers the advantages such as enhanced kinetics of extraction, higher extraction capacity, etc. Conventionally, the magnetite (Fe3O4) particles were prepared by the hydrolysis and co-precipitation of ferrous and ferric salts in aqueous ammonia solution. Since the covalent linking of task-specific functionalities on Fe3O4 was difficult, and it is also susceptible to redox reaction in the presence of acid or alkali, it is necessary to modify the surface of Fe3O4 by silica coating. This silica coating is usually carried out by hydrolysis and condensation of tetraethyl orthosilicate over the surface of magnetite to yield a thin layer of silica-coated magnetite particles. Since the silica-coated magnetite particles amenable for further surface modification, it can be reacted with task-specific functional groups to obtain the functionalized magnetic particles. The surface area exhibited by such magnetic particles usually falls in the range of 50 to 150 m2.g-1, which offer advantage such as quick phase separation, as compared to the other solid-phase extraction systems. In addition, the magnetic (Fe3O4) particles covalently linked on mesoporous silica matrix (MCM-41) and task-specific ligands offer further advantages in terms of extraction kinetics, high stability, longer reusable cycles, and metal extraction capacity, due to the large surface area, ample porosity and enhanced number of functional groups per unit area on these adsorbents. In view of this, the present paper deals with the synthesis of uranium specific diethylenetriamine ligand (DETA) ligand anchored on silica-coated magnetite (Fe-DETA) as well as on magnetic mesoporous silica (MCM-Fe-DETA) and studies on the extraction of uranium from aqueous solution spiked with uranium to mimic the mine water or groundwater contaminated with uranium. The synthesized solid-phase adsorbents were characterized by FT-IR, Raman, TG-DTA, XRD, and SEM. The extraction behavior of uranium on the solid-phase was studied under several conditions like the effect of pH, initial concentration of uranium, rate of extraction and its variation with pH and initial concentration of uranium, effect of interference ions like CO32-, Na+, Fe+2, Ni+2, and Cr+3, etc. The maximum extraction capacity of 233 mg.g-1 was obtained for Fe-DETA, and a huge capacity of 1047 mg.g-1 was obtained for MCM-Fe-DETA. The mechanism of extraction, speciation of uranium, extraction studies, reusability, and the other results obtained in the present study suggests Fe-DETA and MCM-Fe-DETA are the potential candidates for the extraction of uranium from mine water, and groundwater.Keywords: diethylenetriamine, magnetic mesoporous silica, magnetic solid-phase extraction, uranium extraction, wastewater treatment
Procedia PDF Downloads 1681009 Developing Optical Sensors with Application of Cancer Detection by Elastic Light Scattering Spectroscopy
Authors: May Fadheel Estephan, Richard Perks
Abstract:
Context: Cancer is a serious health concern that affects millions of people worldwide. Early detection and treatment are essential for improving patient outcomes. However, current methods for cancer detection have limitations, such as low sensitivity and specificity. Research Aim: The aim of this study was to develop an optical sensor for cancer detection using elastic light scattering spectroscopy (ELSS). ELSS is a noninvasive optical technique that can be used to characterize the size and concentration of particles in a solution. Methodology: An optical probe was fabricated with a 100-μm-diameter core and a 132-μm centre-to-centre separation. The probe was used to measure the ELSS spectra of polystyrene spheres with diameters of 2, 0.8, and 0.413 μm. The spectra were then analysed to determine the size and concentration of the spheres. Findings: The results showed that the optical probe was able to differentiate between the three different sizes of polystyrene spheres. The probe was also able to detect the presence of polystyrene spheres in suspension concentrations as low as 0.01%. Theoretical Importance: The results of this study demonstrate the potential of ELSS for cancer detection. ELSS is a noninvasive technique that can be used to characterize the size and concentration of cells in a tissue sample. This information can be used to identify cancer cells and assess the stage of the disease. Data Collection: The data for this study were collected by measuring the ELSS spectra of polystyrene spheres with different diameters. The spectra were collected using a spectrometer and a computer. Analysis Procedures: The ELSS spectra were analysed using a software program to determine the size and concentration of the spheres. The software program used a mathematical algorithm to fit the spectra to a theoretical model. Question Addressed: The question addressed by this study was whether ELSS could be used to detect cancer cells. The results of the study showed that ELSS could be used to differentiate between different sizes of cells, suggesting that it could be used to detect cancer cells. Conclusion: The findings of this research show the utility of ELSS in the early identification of cancer. ELSS is a noninvasive method for characterizing the number and size of cells in a tissue sample. To determine cancer cells and determine the disease's stage, this information can be employed. Further research is needed to evaluate the clinical performance of ELSS for cancer detection.Keywords: elastic light scattering spectroscopy, polystyrene spheres in suspension, optical probe, fibre optics
Procedia PDF Downloads 821008 An Interactive User-Oriented Approach to Optimizing Public Space Lighting
Authors: Tamar Trop, Boris Portnov
Abstract:
Public Space Lighting (PSL) of outdoor urban areas promotes comfort, defines spaces and neighborhood identities, enhances perceived safety and security, and contributes to residential satisfaction and wellbeing. However, if excessive or misdirected, PSL leads to unnecessary energy waste and increased greenhouse gas emissions, poses a non-negligible threat to the nocturnal environment, and may become a potential health hazard. At present, PSL is designed according to international, regional, and national standards, which consolidate best practice. Yet, knowledge regarding the optimal light characteristics needed for creating a perception of personal comfort and safety in densely populated residential areas, and the factors associated with this perception, is still scarce. The presented study suggests a paradigm shift in designing PSL towards a user-centered approach, which incorporates pedestrians' perspectives into the process. The study is an ongoing joint research project between China and Israel Ministries of Science and Technology. Its main objectives are to reveal inhabitants' perceptions of and preferences for PSL in different densely populated neighborhoods in China and Israel, and to develop a model that links instrumentally measured parameters of PSL (e.g., intensity, spectra and glare) with its perceived comfort and quality, while controlling for three groups of attributes: locational, temporal, and individual. To investigate measured and perceived PSL, the study employed various research methods and data collection tools, developed a location-based mobile application, and used multiple data sources, such as satellite multi-spectral night-time light imagery, census statistics, and detailed planning schemes. One of the study’s preliminary findings is that higher sense of safety in the investigated neighborhoods is not associated with higher levels of light intensity. This implies potential for energy saving in brightly illuminated residential areas. Study findings might contribute to the design of a smart and adaptive PSL strategy that enhances pedestrians’ perceived safety and comfort while reducing light pollution and energy consumption.Keywords: energy efficiency, light pollution, public space lighting, PSL, safety perceptions
Procedia PDF Downloads 1341007 Gut Microbiota in Patients with Opioid Use Disorder: A 12-week Follow up Study
Authors: Sheng-Yu Lee
Abstract:
Aim: Opioid use disorder is often characterized by repetitive drug-seeking and drug-taking behaviors with severe public health consequences. Animal model showed that opioid-induced perturbations in the gut microbiota causally relate to neuroinflammation, deficits in reward responding, and opioid tolerance, possibly due to changes in gut microbiota. Therefore, we propose that the dysbiosis of gut microbiota can be associated with pathogenesis of opioid dependence. In this current study, we explored the differences in gut microbiota between patients and normal controls and in patients before and after initiation of methadone treatment program for 12 weeks. Methods: Patients with opioid use disorder between 20 and 65 years were recruited from the methadone maintenance outpatient clinic in 2 medical centers in the Southern Taiwan. Healthy controls without any family history of major psychiatric disorders (schizophrenia, bipolar disorder and major depressive disorder) were recruited from the community. After initial screening, 15 patients with opioid use disorder joined the study for initial evaluation (Week 0), 12 of them completed the 12-week follow-up while receiving methadone treatment and ceased heroin use (Week 12). Fecal samples were collected from the patients at baseline and the end of 12th week. A one-time fecal sample was collected from the healthy controls. The microbiota of fecal samples were investigated using 16S rRNA V3V4 amplicon sequencing, followed by bioinformatics and statistical analyses. Results: We found no significant differences in species diversity in opioid dependent patients between Week 0 and Week 12, nor compared between patients at both points and controls. For beta diversity, using principal component analysis, we found no significant differences between patients at Week 0 and Week 12, however, both patient groups showed significant differences compared to control (P=0.011). Furthermore, the linear discriminant analysis effect size (LEfSe) analysis was used to identify differentially enriched bacteria between opioid use patients and healthy controls. Compared to controls, the relative abundance of Lactobacillaceae Lactobacillus (L. Lactobacillus), Megasphaera Megasphaerahexanoica (M. Megasphaerahexanoica) and Caecibacter Caecibactermassiliensis (C Caecibactermassiliensis) were increased in patients at Week 0, while Coriobacteriales Atopobiaceae (C. Atopobiaceae), Acidaminococcus Acidaminococcusintestini (A. Acidaminococcusintestini) and Tractidigestivibacter Tractidigestivibacterscatoligenes (T. Tractidigestivibacterscatoligenes) were increased in patients at Week 12. Conclusion: In conclusion, we suggest that the gut microbiome community maybe linked to opioid use disorder, such differences may not be altered even after 12-week of cessation of opioid use.Keywords: opioid use disorder, gut microbiota, methadone treatment, follow up study
Procedia PDF Downloads 1061006 Syngas From Polypropylene Gasification in a Fluidized Bed
Authors: Sergio Rapagnà, Alessandro Antonio Papa, Armando Vitale, Andre Di Carlo
Abstract:
In recent years the world population has enormously increased the use of plastic products for their living needs, in particular for transporting and storing consumer goods such as food and beverage. Plastics are widely used in the automotive industry, in construction of electronic equipment, clothing and home furnishings. Over the last 70 years, the annual production of plastic products has increased from 2 million tons to 460 million tons. About 20% of the last quantity is mismanaged as waste. The consequence of this mismanagement is the release of plastic waste into the terrestrial and marine environments which represents a danger to human health and the ecosystem. Recycling all plastics is difficult because they are often made with mixtures of polymers that are incompatible with each other and contain different additives. The products obtained are always of lower quality and after two/three recycling cycles they must be eliminated either by thermal treatment to produce heat or disposed of in landfill. An alternative to these current solutions is to obtain a mixture of gases rich in H₂, CO and CO₂ suitable for being profitably used for the production of chemicals with consequent savings fossil sources. Obtaining a hydrogen-rich syngas can be achieved by gasification process using the fluidized bed reactor, in presence of steam as the fluidization medium. The fluidized bed reactor allows the gasification process of plastics to be carried out at a constant temperature and allows the use of different plastics with different compositions and different grain sizes. Furthermore, during the gasification process the use of steam increase the gasification of char produced by the first pyrolysis/devolatilization process of the plastic particles. The bed inventory can be made with particles having catalytic properties such as olivine, capable to catalyse the steam reforming reactions of heavy hydrocarbons normally called tars, with a consequent increase in the quantity of gases produced. The plant is composed of a fluidized bed reactor made of AISI 310 steel, having an internal diameter of 0.1 m, containing 3 kg of olivine particles as a bed inventory. The reactor is externally heated by an oven up to 1000 °C. The hot producer gases that exit the reactor, after being cooled, are quantified using a mass flow meter. Gas analyzers are present to measure instantly the volumetric composition of H₂, CO, CO₂, CH₄ and NH₃. At the conference, the results obtained from the continuous gasification of polypropylene (PP) particles in a steam atmosphere at temperatures of 840-860 °C will be presented.Keywords: gasification, fluidized bed, hydrogen, olivine, polypropyle
Procedia PDF Downloads 271005 Carotenoid Bioaccessibility: Effects of Food Matrix and Excipient Foods
Authors: Birgul Hizlar, Sibel Karakaya
Abstract:
Recently, increasing attention has been given to carotenoid bioaccessibility and bioavailability in the field of nutrition research. As a consequence of their lipophilic nature and their specific localization in plant-based tissues, carotenoid bioaccessibility and bioavailability is generally quite low in raw fruits and vegetables, since carotenoids need to be released from the cellular matrix and incorporated in the lipid fraction during digestion before being absorbed. Today’s approach related to improving the bioaccessibility is to design food matrix. Recently, the newest approach, excipient food, has been introduced to improve the bioavailability of orally administered bioactive compounds. The main idea is combining food and another food (the excipient food) whose composition and/or structure is specifically designed for improving health benefits. In this study, effects of food processing, food matrix and the addition of excipient foods on the carotenoid bioaccessibility of carrots were determined. Different excipient foods (olive oil, lemon juice and whey curd) and different food matrices (grating, boiling and mashing) were used. Total carotenoid contents of the grated, boiled and mashed carrots were 57.23, 51.11 and 62.10 μg/g respectively. No significant differences among these values indicated that these treatments had no effect on the release of carotenoids from the food matrix. Contrary to, changes in the food matrix, especially mashing caused significant increase in the carotenoid bioaccessibility. Although the carotenoid bioaccessibility was 10.76% in grated carrots, this value was 18.19% in mashed carrots (p<0.05). Addition of olive oil and lemon juice as excipients into the grated carrots caused 1.23 times and 1.67 times increase in the carotenoid content and the carotenoid bioaccessibility respectively. However, addition of the excipient foods in the boiled carrot samples did not influence the release of carotenoid from the food matrix. Whereas, up to 1.9 fold increase in the carotenoid bioaccessibility was determined by the addition of the excipient foods into the boiled carrots. The bioaccessibility increased from 14.20% to 27.12% by the addition of olive oil, lemon juice and whey curd. The highest carotenoid content among mashed carrots was found in the mashed carrots incorporated with olive oil and lemon juice. This combination also caused a significant increase in the carotenoid bioaccessibility from 18.19% to 29.94% (p<0.05). When compared the results related with the effect of the treatments on the carotenoid bioaccessibility, mashed carrots containing olive oil, lemon juice and whey curd had the highest carotenoid bioaccessibility. The increase in the bioaccessibility was approximately 81% when compared to grated and mashed samples containing olive oil, lemon juice and whey curd. In conclusion, these results demonstrated that the food matrix and addition of the excipient foods had a significant effect on the carotenoid content and the carotenoid bioaccessibility.Keywords: carrot, carotenoids, excipient foods, food matrix
Procedia PDF Downloads 4571004 Persistence of Ready Mix (Chlorpyriphos 50% + Cypermethrin 5%), Cypermethrin and Chlorpyriphos in Soil under Okra Fruits
Authors: Samriti Wadhwa, Beena Kumari
Abstract:
Background and Significance: Residue levels of ready mix (chlorpyriphos 50% and cypermethrin 5%), cypermethrin and chlorpyriphos individually in sandy loam soil under okra fruits (Variety, Varsha Uphar) were determined; a field experiment was conducted at Research Farm of Department of Entomology of Chaudhary Charan Singh Haryana Agriculture University, Hisar, Haryana, India. Persistence behavior of cypermethrin and chlorpyriphos was studied following application of a pre-mix formulation of insecticides viz. Action-505EC, chlorpyriphos (Radar 20 EC) and cypermethrin (Cyperkill 10 EC) at the recommended dose and double the recommended dose along with control at fruiting stage. Pesticide application also leads to decline in soil acarine fauna which is instrumental in the breakdown of the litter because of which minerals are released into the soil. So, by this study, one can evaluate the safety of pesticides for the soil health. Methodology: Action-505EC (chlorpyriphos 50% and cypermethrin 5%) at 275 g a .i. ha⁻¹ (single dose) and 550 g a. i. ha⁻¹ (double dose), chlorpyriphos (Radar 20 EC) at 200 g a. i. ha⁻¹ (single dose) and 400 g a. i. ha⁻¹ (double dose) and cypermethrin (Cyperkill 10 EC) at 50 g a. i. ha⁻¹ (single dose) and 100 g a. i. ha⁻¹ (double dose) were applied at the fruiting stage on okra crop. Samples of soils from okra field were collected periodically at 0 (1h after spray), 1, 3, 5, 7, 10, 15 days and at harvest after application as well of control soil sample. After air drying, adsorbing through Florisil and activated charcoal and eluting with hexane: acetone (9:1) then residues in soils were estimated by a gas chromatograph equipped with a capillary column and electron capture detector. Results: No persistence of cypermethrin in ready-mix in soil under okra fruits at single and double dose was observed. In case of chlorpyriphos in ready-mix, average initial deposits on 0 (1 h after treatment) day was 0.015 mg kg⁻¹ and 0.036 mg kg⁻¹ which persisted up to 5 days and up to 7 days for single and double dose, respectively. After that residues reached below a detectable level of 0.010 mg kg⁻¹. Experimental studies on cypermethrin individually revealed that average initial deposits on 0 (1 h after treatment) were 0.008 mg kg⁻¹ and 0.012 mg kg⁻¹ which persisted up to 3 days and 5 days for single and double dose, respectively after that residues reached to below detectable level. The initial deposits of chlorpyriphos individually in soil were found to be 0.055 mg kg⁻¹ and 0.113 mg kg⁻¹ which persisted up to 7 days and 10 days at a lower dose and higher dose, respectively after that residues reached to below determination level. Conclusion: In soil under okra crop, only individual cypermethrin in both the doses persisted whereas no persistence of cypermethrin in ready-mix was observed. Persistence of chlorpyriphos individually is more as compared to chlorpyriphos in ready-mix in both the doses. Overall, the persistence of chlorpyriphos in soil under okra crop is more than cypermethrin.Keywords: chlorpyriphos, cypermethrin, okra, ready mix, soil
Procedia PDF Downloads 1631003 Assessment of Ecosystem Readiness for Adoption of Circularity: A Multi-Case Study Analysis of Textile Supply Chain in Pakistan
Authors: Azhar Naila, Steuer Benjamin
Abstract:
Over-exploitation of resources and the burden on natural systems have provoked worldwide concerns about the potential resource as well as supply risks in the future. It has been estimated that the consumption of materials and resources will double by 2060, substantially mounting the amount of waste and emissions produced by individuals, organizations, and businesses, which necessitates sustainable technological innovations to address the problem. Therefore, there is a need to design products and services purposefully for material resource efficiency. This directs us toward the conceptualization and implementation of the ‘Circular Economy (CE),’ which has gained considerable attention among policymakers, researchers, and businesses in the past decade. A large amount of literature focuses on the concept of CE. However, contextual empirical research on the need to embrace CE in an emerging economy like Pakistan is still scarce, where the traditional economic model of take-make-dispose is quite common. Textile exports account for approximately 61% of Pakistan's total exports, and the industry provides employment for about 40% of the country's total industrial workforce. The industry provides job opportunities to above 10 million farmers, with cotton as the main crop of Pakistan. Consumers, companies, as well as the government have explored very limited CE potential in the country. This gap has motivated us to carry out the present study. The study is based on a mixed method approach, for which key informant interviews have been conducted to get insight into the present situation of the ecosystem readiness for the adoption of CE in 20 textile manufacturing industries. The subject study has been conducted on the following areas i) the level of understanding of the CE concept among key stakeholders in the textile manufacturing industry ii) Companies are pushing boundaries to invest in circularity-based initiatives, exploring the depths of risk-taking iii) the current national policy framework support the adoption of CE. Qualitative assessment has been undertaken using MAXQDA to analyze the data received after the key informant interviews. The data has been transcribed and coded for further analysis. The results show that most of the key stakeholders have a clear understanding of the concept, whereas few consider it to be only relevant to the end-of-life treatment of waste generated from the industry. Non-governmental organizations have been observed to be key players in creating awareness among the manufacturing industries. Maximum companies have shown their consent to invest in initiatives related to the adoption of CE. Whereas a few consider themselves far behind the race due to a lack of financial resources and support from responsible institutions. Mostly, the industries have an ambitious vision for integrating CE into the company’s policy but seem not to be ready to take any significant steps to nurture a culture for experimentation. However, the government is not playing any vital role in the transition towards CE; rather, they have been busy with the state’s uncertain political situation. Presently, Pakistan does not have any policy framework that supports the transition towards CE. Acknowledging the present landscape a well-informed CE transition is immediately required.Keywords: circular economy, textile supply chain, textile manufacturing industries, resource efficiency, ecosystem readiness, multi-case study analysis
Procedia PDF Downloads 521002 Political Communication in Twitter Interactions between Government, News Media and Citizens in Mexico
Authors: Jorge Cortés, Alejandra Martínez, Carlos Pérez, Anaid Simón
Abstract:
The presence of government, news media, and general citizenry in social media allows considering interactions between them as a form of political communication (i.e. the public exchange of contradictory discourses about politics). Twitter’s asymmetrical following model (users can follow, mention or reply to other users that do not follow them) could foster alternative democratic practices and have an impact on Mexican political culture, which has been marked by a lack of direct communication channels between these actors. The research aim is to assess Twitter’s role in political communication practices through the analysis of interaction dynamics between government, news media, and citizens by extracting and visualizing data from Twitter’s API to observe general behavior patterns. The hypothesis is that regardless the fact that Twitter’s features enable direct and horizontal interactions between actors, users repeat traditional dynamics of interaction, without taking full advantage of the possibilities of this medium. Through an interdisciplinary team including Communication Strategies, Information Design, and Interaction Systems, the activity on Twitter generated by the controversy over the presence of Uber in Mexico City was analysed; an issue of public interest, involving aspects such as public opinion, economic interests and a legal dimension. This research includes techniques from social network analysis (SNA), a methodological approach focused on the comprehension of the relationships between actors through the visual representation and measurement of network characteristics. The analysis of the Uber event comprised data extraction, data categorization, corpus construction, corpus visualization and analysis. On the recovery stage TAGS, a Google Sheet template, was used to extract tweets that included the hashtags #UberSeQueda and #UberSeVa, posts containing the string Uber and tweets directed to @uber_mx. Using scripts written in Python, the data was filtered, discarding tweets with no interaction (replies, retweets or mentions) and locations outside of México. Considerations regarding bots and the omission of anecdotal posts were also taken into account. The utility of graphs to observe interactions of political communication in general was confirmed by the analysis of visualizations generated with programs such as Gephi and NodeXL. However, some aspects require improvements to obtain more useful visual representations for this type of research. For example, link¬crossings complicates following the direction of an interaction forcing users to manipulate the graph to see it clearly. It was concluded that some practices prevalent in political communication in Mexico are replicated in Twitter. Media actors tend to group together instead of interact with others. The political system tends to tweet as an advertising strategy rather than to generate dialogue. However, some actors were identified as bridges establishing communication between the three spheres, generating a more democratic exercise and taking advantage of Twitter’s possibilities. Although interactions in Twitter could become an alternative to political communication, this potential depends on the intentions of the participants and to what extent they are aiming for collaborative and direct communications. Further research is needed to get a deeper understanding on the political behavior of Twitter users and the possibilities of SNA for its analysis.Keywords: interaction, political communication, social network analysis, Twitter
Procedia PDF Downloads 2211001 Economics of Precision Mechanization in Wine and Table Grape Production
Authors: Dean A. McCorkle, Ed W. Hellman, Rebekka M. Dudensing, Dan D. Hanselka
Abstract:
The motivation for this study centers on the labor- and cost-intensive nature of wine and table grape production in the U.S., and the potential opportunities for precision mechanization using robotics to augment those production tasks that are labor-intensive. The objectives of this study are to evaluate the economic viability of grape production in five U.S. states under current operating conditions, identify common production challenges and tasks that could be augmented with new technology, and quantify a maximum price for new technology that growers would be able to pay. Wine and table grape production is primed for precision mechanization technology as it faces a variety of production and labor issues. Methodology: Using a grower panel process, this project includes the development of a representative wine grape vineyard in five states and a representative table grape vineyard in California. The panels provided production, budget, and financial-related information that are typical for vineyards in their area. Labor costs for various production tasks are of particular interest. Using the data from the representative budget, 10-year projected financial statements have been developed for the representative vineyard and evaluated using a stochastic simulation model approach. Labor costs for selected vineyard production tasks were evaluated for the potential of new precision mechanization technology being developed. These tasks were selected based on a variety of factors, including input from the panel members, and the extent to which the development of new technology was deemed to be feasible. The net present value (NPV) of the labor cost over seven years for each production task was derived. This allowed for the calculation of a maximum price for new technology whereby the NPV of labor costs would equal the NPV of purchasing, owning, and operating new technology. Expected Results: The results from the stochastic model will show the projected financial health of each representative vineyard over the 2015-2024 timeframe. Investigators have developed a preliminary list of production tasks that have the potential for precision mechanization. For each task, the labor requirements, labor costs, and the maximum price for new technology will be presented and discussed. Together, these results will allow technology developers to focus and prioritize their research and development efforts for wine and table grape vineyards, and suggest opportunities to strengthen vineyard profitability and long-term viability using precision mechanization.Keywords: net present value, robotic technology, stochastic simulation, wine and table grapes
Procedia PDF Downloads 2601000 A Hardware-in-the-loop Simulation for the Development of Advanced Control System Design for a Spinal Joint Wear Simulator
Authors: Kaushikk Iyer, Richard M Hall, David Keeling
Abstract:
Hardware-in-the-loop (HIL) simulation is an advanced technique for developing and testing complex real-time control systems. This paper presents the benefits of HIL simulation and how it can be implemented and used effectively to develop, test, and validate advanced control algorithms used in a spinal joint Wear simulator for the Tribological testing of spinal disc prostheses. spinal wear simulator is technologically the most advanced machine currently employed For the in-vitro testing of newly developed spinal Discimplants. However, the existing control techniques, such as a simple position control Does not allow the simulator to test non-sinusoidal waveforms. Thus, there is a need for better and advanced control methods that can be developed and tested Rigorouslybut safely before deploying it into the real simulator. A benchtop HILsetupis was created for experimentation, controller verification, and validation purposes, allowing different control strategies to be tested rapidly in a safe environment. The HIL simulation aspect in this setup attempts to replicate similar spinal motion and loading conditions. The spinal joint wear simulator containsa four-Barlinkpowered by electromechanical actuators. LabVIEW software is used to design a kinematic model of the spinal wear Simulator to Validatehow each link contributes towards the final motion of the implant under test. As a result, the implant articulates with an angular motion specified in the international standards, ISO-18192-1, that define fixed, simplified, and sinusoid motion and load profiles for wear testing of cervical disc implants. Using a PID controller, a velocity-based position control algorithm was developed to interface with the benchtop setup that performs HIL simulation. In addition to PID, a fuzzy logic controller (FLC) was also developed that acts as a supervisory controller. FLC provides intelligence to the PID controller by By automatically tuning the controller for profiles that vary in amplitude, shape, and frequency. This combination of the fuzzy-PID controller is novel to the wear testing application for spinal simulators and demonstrated superior performance against PIDwhen tested for a spectrum of frequency. Kaushikk Iyer is a Ph.D. Student at the University of Leeds and an employee at Key Engineering Solutions, Leeds, United Kingdom, (e-mail: [email protected], phone: +44 740 541 5502). Richard M Hall is with the University of Leeds, the United Kingdom as a professor in the Mechanical Engineering Department (e-mail: [email protected]). David Keeling is the managing director of Key Engineering Solutions, Leeds, United Kingdom (e-mail: [email protected]). Results obtained are successfully validated against the load and motion tolerances specified by the ISO18192-1 standard and fall within limits, that is, ±0.5° at the maxima and minima of the motion and ±2 % of the complete cycle for phasing. The simulation results prove the efficacy of the test setup using HIL simulation to verify and validate the accuracy and robustness of the prospective controller before its deployment into the spinal wear simulator. This method of testing controllers enables a wide range of possibilities to test advanced control algorithms that can potentially test even profiles of patients performing various dailyliving activities.Keywords: Fuzzy-PID controller, hardware-in-the-loop (HIL), real-time simulation, spinal wear simulator
Procedia PDF Downloads 171999 Impact of Pedagogical Techniques on the Teaching of Sports Sciences
Authors: Muhammad Saleem
Abstract:
Background: The teaching of sports sciences encompasses a broad spectrum of disciplines, including biomechanics, physiology, psychology, and coaching. Effective pedagogical techniques are crucial in imparting both theoretical knowledge and practical skills necessary for students to excel in the field. The impact of these techniques on students’ learning outcomes, engagement, and professional preparedness remains a vital area of study. Objective: This study aims to evaluate the effectiveness of various pedagogical techniques used in the teaching of sports sciences. It seeks to identify which methods most significantly enhance student learning, retention, engagement, and practical application of knowledge. Methods: A mixed-methods approach was employed, including both quantitative and qualitative analyses. The study involved a comparative analysis of traditional lecture-based teaching, experiential learning, problem-based learning (PBL), and technology-enhanced learning (TEL). Data were collected through surveys, interviews, and academic performance assessments from students enrolled in sports sciences programs at multiple universities. Statistical analysis was used to evaluate academic performance, while thematic analysis was applied to qualitative data to capture student experiences and perceptions. Results: The findings indicate that experiential learning and PBL significantly improve students' understanding and retention of complex sports science concepts compared to traditional lectures. TEL was found to enhance engagement and provide students with flexible learning opportunities, but its impact on deep learning varied depending on the quality of the digital resources. Overall, a combination of experiential learning, PBL, and TEL was identified as the most effective pedagogical approach, leading to higher student satisfaction and better preparedness for real-world applications. Conclusion: The study underscores the importance of adopting diverse and student-centered pedagogical techniques in the teaching of sports sciences. While traditional lectures remain useful for foundational knowledge, integrating experiential learning, PBL, and TEL can substantially improve student outcomes. These findings suggest that educators should consider a blended approach to pedagogy to maximize the effectiveness of sports science education.Keywords: sport sciences, pedagogical techniques, health and physical education, problem-based learning, student engagement
Procedia PDF Downloads 26998 A Framework for Automated Nuclear Waste Classification
Authors: Seonaid Hume, Gordon Dobie, Graeme West
Abstract:
Detecting and localizing radioactive sources is a necessity for safe and secure decommissioning of nuclear facilities. An important aspect for the management of the sort-and-segregation process is establishing the spatial distributions and quantities of the waste radionuclides, their type, corresponding activity, and ultimately classification for disposal. The data received from surveys directly informs decommissioning plans, on-site incident management strategies, the approach needed for a new cell, as well as protecting the workforce and the public. Manual classification of nuclear waste from a nuclear cell is time-consuming, expensive, and requires significant expertise to make the classification judgment call. Also, in-cell decommissioning is still in its relative infancy, and few techniques are well-developed. As with any repetitive and routine tasks, there is the opportunity to improve the task of classifying nuclear waste using autonomous systems. Hence, this paper proposes a new framework for the automatic classification of nuclear waste. This framework consists of five main stages; 3D spatial mapping and object detection, object classification, radiological mapping, source localisation based on gathered evidence and finally, waste classification. The first stage of the framework, 3D visual mapping, involves object detection from point cloud data. A review of related applications in other industries is provided, and recommendations for approaches for waste classification are made. Object detection focusses initially on cylindrical objects since pipework is significant in nuclear cells and indeed any industrial site. The approach can be extended to other commonly occurring primitives such as spheres and cubes. This is in preparation of stage two, characterizing the point cloud data and estimating the dimensions, material, degradation, and mass of the objects detected in order to feature match them to an inventory of possible items found in that nuclear cell. Many items in nuclear cells are one-offs, have limited or poor drawings available, or have been modified since installation, and have complex interiors, which often and inadvertently pose difficulties when accessing certain zones and identifying waste remotely. Hence, this may require expert input to feature match objects. The third stage, radiological mapping, is similar in order to facilitate the characterization of the nuclear cell in terms of radiation fields, including the type of radiation, activity, and location within the nuclear cell. The fourth stage of the framework takes the visual map for stage 1, the object characterization from stage 2, and radiation map from stage 3 and fuses them together, providing a more detailed scene of the nuclear cell by identifying the location of radioactive materials in three dimensions. The last stage involves combining the evidence from the fused data sets to reveal the classification of the waste in Bq/kg, thus enabling better decision making and monitoring for in-cell decommissioning. The presentation of the framework is supported by representative case study data drawn from an application in decommissioning from a UK nuclear facility. This framework utilises recent advancements of the detection and mapping capabilities of complex radiation fields in three dimensions to make the process of classifying nuclear waste faster, more reliable, cost-effective and safer.Keywords: nuclear decommissioning, radiation detection, object detection, waste classification
Procedia PDF Downloads 200997 Effect of Automatic Self Transcending Meditation on Perceived Stress and Sleep Quality in Adults
Authors: Divya Kanchibhotla, Shashank Kulkarni, Shweta Singh
Abstract:
Chronic stress and sleep quality reduces mental health and increases the risk of developing depression and anxiety as well. There is increasing evidence for the utility of meditation as an adjunct clinical intervention for conditions like depression and anxiety. The present study is an attempt to explore the impact of Sahaj Samadhi Meditation (SSM), a category of Automatic Self Transcending Meditation (ASTM), on perceived stress and sleep quality in adults. The study design was a single group pre-post assessment. Perceived Stress Scale (PSS) and the Pittsburgh Sleep Quality Index (PSQI) were used in this study. Fifty-two participants filled PSS, and 60 participants filled PSQI at the beginning of the program (day 0), after two weeks (day 16) and at two months (day 60). Significant pre-post differences for the perceived stress level on Day 0 - Day 16 (p < 0.01; Cohen's d = 0.46) and Day 0 - Day 60 (p < 0.01; Cohen's d = 0.76) clearly demonstrated that by practicing SSM, participants experienced reduction in the perceived stress. The effect size of the intervention observed on the 16th day of assessment was small to medium, but on the 60th day, a medium to large effect size of the intervention was observed. In addition to this, significant pre-post differences for the sleep quality on Day 0 - Day 16 and Day 0 - Day 60 (p < 0.05) clearly demonstrated that by practicing SSM, participants experienced improvement in the sleep quality. Compared with Day 0 assessment, participants demonstrated significant improvement in the quality of sleep on Day 16 and Day 60. The effect size of the intervention observed on the 16th day of assessment was small, but on the 60th day, a small to medium effect size of the intervention was observed. In the current study we found out that after practicing SSM for two months, participants reported a reduction in the perceived stress, they felt that they are more confident about their ability to handle personal problems, were able to cope with all the things that they had to do, felt that they were on top of the things, and felt less angered. Participants also reported that their overall sleep quality improved; they took less time to fall asleep; they had less disturbances in sleep and less daytime dysfunction due to sleep deprivation. The present study provides clear evidence of the efficacy and safety of non-pharmacological interventions such as SSM in reducing stress and improving sleep quality. Thus, ASTM may be considered a useful intervention to reduce psychological distress in healthy, non-clinical populations, and it can be an alternative remedy for treating poor sleep among individuals and decreasing the use of harmful sedatives.Keywords: automatic self transcending meditation, Sahaj Samadhi meditation, sleep, stress
Procedia PDF Downloads 136996 Functional Outcome of Speech, Voice and Swallowing Following Excision of Glomus Jugulare Tumor
Authors: B. S. Premalatha, Kausalya Sahani
Abstract:
Background: Glomus jugulare tumors arise within the jugular foramen and are commonly seen in females particularly on the left side. Surgical excision of the tumor may cause lower cranial nerve deficits. Cranial nerve involvement produces hoarseness of voice, slurred speech, and dysphagia along with other physical symptoms, thereby affecting the quality of life of individuals. Though oncological clearance is mainly emphasized on while treating these individuals, little importance is given to their communication, voice and swallowing problems, which play a crucial part in daily functioning. Objective: To examine the functions of voice, speech and swallowing outcomes of the subjects, following excision of glomus jugulare tumor. Methods: Two female subjects aged 56 and 62 years had come with a complaint of change in voice, inability to swallow and reduced clarity of speech following surgery for left glomus jugulare tumor were participants of the study. Their surgical information revealed multiple cranial nerve palsies involving the left facial, left superior and recurrent branches of the vagus nerve, left pharyngeal, left soft palate, left hypoglossal and vestibular nerves. Functional outcomes of voice, speech and swallowing were evaluated by perceptual and objective assessment procedures. Assessment included the examination of oral structures and functions, dysarthria by Frenchey dysarthria assessment, cranial nerve functions and swallowing functions. MDVP and Dr. Speech software were used to evaluate acoustic parameters of voice and quality of voice respectively. Results: The study revealed that both the subjects, subsequent to excision of glomus jugulare tumor, showed a varied picture of affected oral structure and functions, articulation, voice and swallowing functions. The cranial nerve assessment showed impairment of the vagus, hypoglossal, facial and glossopharyngeal nerves. Voice examination indicated vocal cord paralysis associated with breathy quality of voice, weak voluntary cough, reduced pitch and loudness range, and poor respiratory support. Perturbation parameters as jitter, shimmer were affected along with s/z ratio indicative of voice fold pathology. Reduced MPD(Maximum Phonation Duration) of vowels indicated that disturbed coordination between respiratory and laryngeal systems. Hypernasality was found to be a prominent feature which reduced speech intelligibility. Imprecise articulation was seen in both the subjects as the hypoglossal nerve was affected following surgery. Injury to vagus, hypoglossal, gloss pharyngeal and facial nerves disturbed the function of swallowing. All the phases of swallow were affected. Aspiration was observed before and during the swallow, confirming the oropharyngeal dysphagia. All the subsystems were affected as per Frenchey Dysarthria Assessment signifying the diagnosis of flaccid dysarthria. Conclusion: There is an observable communication and swallowing difficulty seen following excision of glomus jugulare tumor. Even with complete resection, extensive rehabilitation may be necessary due to significant lower cranial nerve dysfunction. The finding of the present study stresses the need for involvement of as speech and swallowing therapist for pre-operative counseling and assessment of functional outcomes.Keywords: functional outcome, glomus jugulare tumor excision, multiple cranial nerve impairment, speech and swallowing
Procedia PDF Downloads 252