Search results for: Criteria.

Authors: Mohammed Al-Zubaidi, Katherine Ong, Pravin Viswambaram, Steve McCombie, Oliver Oey, Jeremy Ong, Richard Gauci, Ronny Low, Dickon Hayne

Abstract:

Objective: Lymph node involvement along with distant metastasis in a patient with invasive bladder cancer determines the disease survival, therefeor, it is an essential determinant of the therapeutic management and outcome. This retrospective study aims to determine the accuracy of FDG PET scan in detecting lymphatic involvement and distant metastatic urothelial cancer compared to conventional CT staging. Method: A retrospective review of 76 patients with UC or BC who underwent surgery or confirmatory biopsy that was staged with both CT and 18F-FDG-PET (up to 8 weeks apart) between 2015 and 2020. Fifty-sevenpatients (75%) had formal pelvic LN dissection or biopsy of suspicious metastasis. 18F-FDG-PET reports for positive sites were qualitative depending on SUV Max. On the other hand, enlarged LN by RECIST criteria 1.1 (>10 mm) and other qualitative findings suggesting metastasis were considered positive in CT scan. Histopathological findings from surgical specimens or image-guided biopsies were considered the gold standard in comparison to imaging reports. 18F-FDG-avid or enlarged pelvic LNs with surgically proven nodal metastasis were considered true positives. Performance characteristics of 18F-FDG-PET and CT, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (PPV), were calculated. Results: Pelvic LN involvement was confirmed histologically in 10/57 (17.5%) patients. Sensitivity, specificity, PPV and NPV of CT for detecting pelvic LN metastases were 41.17% (95% CI:18-67%), 100% (95% CI:90-100%) 100% (95% CI:59-100%) and 78.26% (95% CI:64-89%) respectively. Sensitivity, specificity, PPV and NPV of 18F-FDG-PET for detecting pelvic LN metastases were 62.5% (95% CI:35-85%), 83.78% (95% CI:68-94%), 62.5% (95% CI:35-85%), and 83.78% (95% CI:68-94%) respectively. Pre-operative staging with 18F-FDG-PET identified the distant metastatic disease in 9/76 (11.8%) patients who were occult on CT. This retrospective study suggested that 18F-FDG-PET may be more sensitive than CT for detecting pelvic LN metastases. 7/76 (9.2%) patients avoided cystectomy due to 18F-FDG-PET diagnosed metastases that were not reported on CT. Conclusion: 18F-FDG-PET is more sensitive than CT for pelvic LN metastases, which can be used as the standard modality of bladder cancer staging, as it may change the treatment by detecting lymph node metastasis that was occult in CT. Further research involving randomised controlled trials comparing the diagnostic yield of 18F-FDG-PET and CT in detecting nodal and distant metastasis in UC or BC is warranted to confirm our findings.

Keywords: FDG PET, CT scan, urothelial cancer, bladder cancer

Procedia PDF Downloads 122

Authors: Maria Trimintziou, Michael Sakellariou, Prodromos Psarropoulos

Abstract:

Nowadays, the exploitation of hydrocarbons reserves in deep seas and oceans, in combination with the need to transport hydrocarbons among countries, has made the design, construction and operation of offshore pipelines very significant. Under this perspective, it is evident that many more offshore pipelines are expected to be constructed in the near future. Since offshore pipelines are usually crossing extended areas, they may face a variety of geohazards that impose substantial permanent ground deformations (PGDs) to the pipeline and potentially threaten its integrity. In case of a geohazard area, there exist three options to proceed. The first option is to avoid the problematic area through rerouting, which is usually regarded as an unfavorable solution due to its high cost. The second is to apply (if possible) mitigation/protection measures in order to eliminate the geohazard itself. Finally, the last appealing option is to allow the pipeline crossing through the geohazard area, provided that the pipeline will have been verified against the expected PGDs. In areas with moderate or high seismicity the design of an offshore pipeline is more demanding due to the earthquake-related geohazards, such as landslides, soil liquefaction phenomena, and active faults. It is worthy to mention that although worldwide there is a great experience in offshore geotechnics and pipeline design, the experience in seismic design of offshore pipelines is rather limited due to the fact that most of the pipelines have been constructed in non-seismic regions (e.g. North Sea, West Australia, Gulf of Mexico, etc.). The current study focuses on the seismic design of offshore pipelines against active faults. After an extensive literature review of the provisions of the seismic norms worldwide and of the available analytical methods, the study simulates numerically (through finite-element modeling and strain-based criteria) the distress of offshore pipelines subjected to PGDs induced by active seismic faults at the seabed. Factors, such as the geometrical properties of the fault, the mechanical properties of the ruptured soil formations, and the pipeline characteristics, are examined. After some interesting conclusions regarding the seismic vulnerability of offshore pipelines, potential cost-effective mitigation measures are proposed taking into account constructability issues.

Keywords: offhore pipelines, seismic design, active faults, permanent ground deformations (PGDs)

Procedia PDF Downloads 590

Authors: Simon B. N. Thompson

Abstract:

Early indicator of neurological disease has been proposed by the expanded Thompson Cortisol Hypothesis which suggests that yawning is linked to rises in cortisol levels. Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/

Keywords: cortisol, electromyography, neurology, yawning

Procedia PDF Downloads 590

Authors: Samira Mehrabi

Abstract:

Geriatric depression is a common late-life mental health disorder that increases morbidity and mortality. It has been shown that exercise is effective in alleviating symptoms of geriatric depression. However, inconsistencies across studies and lack of optimal dose-response of exercise for improving geriatric depression have made it challenging to draw solid conclusions on the effectiveness of exercise in late-life depression. Purpose: To further investigate the moderators of the effectiveness of exercise on geriatric depression across the current body of evidence. Methods: Based on the Arksey and O’Malley framework, an extensive search strategy was performed by exploring PubMed, Scopus, Sport Discus, PsycInfo, ERIC, and IBSS without limitations in the time frame. Eight systematic reviews with empirical results that evaluated the effect of exercise on depression among people aged ≥ 60 years were identified and their individual studies were screened for inclusion. One additional study was found through the hand searching of reference lists. After full-text screening and applying inclusion and exclusion criteria, 21 studies were retained for inclusion. Results: The review revealed high variability in characteristics of the exercise interventions and outcome measures. Sample characteristics, nature of comparators, main outcome assessment, and baseline severity of depression also varied notably. Mind-body and aerobic exercises were found to significantly reduce geriatric depression. However, results on the relationship between resistance training and improvements in geriatric depression were inconsistent, and results of the intensity-related antidepressant effects of exercise interventions were mixed. Extensive use of self-reported questionnaires for the main outcome assessment and lack of evidence on the relationship between depression severity and observed effects were of the other important highlights of the review. Conclusion: Several literature gaps were found regarding the potential effect modifiers of exercise and geriatric depression. While acknowledging the complexity of establishing recommendations on the exercise variables and geriatric depression, future studies are required to understand the interplay and threshold effect of exercise for treating geriatric depression.

Keywords: exercise, geriatric depression, healthy aging, older adults, physical activity intervention, scoping review

Procedia PDF Downloads 107

Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

Abstract:

Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

Procedia PDF Downloads 79

Authors: Adrianna D. Hendricks

Abstract:

This paper examines the factors that contribute to the re-traumatization of victims of sex trafficking within the Canadian context. Sex trafficking occurring domestically in Canada is severely under-researched, stigmatized, and under-prosecuted, leading to the re-traumatization of victims by various levels of government. This is in part due to the Canadian criminal justice system unethically utilizing prostitution laws in cases of sex trafficking and partially due to the unaddressed stigmatization victims face within the justice system itself. Utilizing evidence from a current literature review, personal correspondence, and personal life experiences, this paper will demonstrate the need for victim involvement in policy reform. The current literature review was done through an academic database search using the terms: “Sex Trafficking, Exploitation, Canada”, with the limitation of articles written within the last 5 years and written within the Canadian context. Overall, from the results, only eight articles precisely matched the criteria. The current literature argues strongly and unanimously for more research and education of professionals who have close contact with high-risk populations (doctors, police officers, social workers, etc.) to protect both minors and adults from being sexually trafficked. Additionally, for women and girls who do not have Canadian citizenship, the fear of deportation becomes a barrier to disclosing exploitation experiences to professionals. There is a desperate need for more research done in tandem with survivors and victims to inform policymaking in a meaningful way. The researcher is a survivor of sex trafficking both as a youth and as an adult, giving the researcher a unique insight into the realities of the criminal justice system for victims of sex trafficking. There is a clear need for professionals in positions of power to be re-educated about the realities of sex-trafficking, and what it means for the victims. Congruent to the current research the author calls for: standardized professional training for people in healthcare, police officers, court officials, and victim services; with the additional layers of victim involvement in creation of professional education training, and victim involvement in research. Justice for victims/survivors can only be obtained if they have been consulted and believed. Without meaningful consultation with survivors, victims who are both minors and adults will continue to fall through the cracks in policy.

Keywords: Canadian policy, re-traumatization, sex-trafficking, stigmatization

Procedia PDF Downloads 69

Authors: Ana C. R. P. Ferreira, Adriano H. P. Pereira

Abstract:

Given the frequent variation of mineral properties throughout the Araxá pyrochlore deposit, even if a good homogenization work has been carried out before feeding the processing plants, an operation with quality and performance’s high variety standard is expected. These results could be improved and standardized if the blend composition parameters that most influence the processing route are determined, and then the types of raw materials are grouped by them, finally presenting a great reference with operational settings for each group. Associating the physical and chemical parameters of a unit operation through benchmarking or even an optimal reference of metallurgical recovery and product quality reflects in the reduction of the production costs, optimization of the mineral resource, and guarantee of greater stability in the subsequent processes of the production chain that uses the mineral of interest. Conducting a comprehensive exploratory data analysis to identify which characteristics of the ore are most relevant to the process route, associated with the use of Machine Learning algorithms for grouping the raw material (ore) and associating these with reference variables in the process’ benchmark is a reasonable alternative for the standardization and improvement of mineral processing units. Clustering methods through Decision Tree and K-Means were employed, associated with algorithms based on the theory of benchmarking, with criteria defined by the process team in order to reference the best adjustments for processing the ore piles of each cluster. A clean user interface was created to obtain the outputs of the created algorithm. The results were measured through the average time of adjustment and stabilization of the process after a new pile of homogenized ore enters the plant, as well as the average time needed to achieve the best processing result. Direct gains from the metallurgical recovery of the process were also measured. The results were promising, with a reduction in the adjustment time and stabilization when starting the processing of a new ore pile, as well as reaching the benchmark. Also noteworthy are the gains in metallurgical recovery, which reflect a significant saving in ore consumption and a consequent reduction in production costs, hence a more rational use of the tailings dams and life optimization of the mineral deposit.

Keywords: mineral clustering, machine learning, process optimization, pyrochlore processing

Procedia PDF Downloads 144

Authors: Chuang-Hung Lin, Cheng-Yuan Hsu, Jia-Yan Lin

Abstract:

It is an indispensible strategy to adopt greenery approach on architectural bases so as to improve ecological habitats, decrease heat-island effect, purify air quality, and relieve surface runoff as well as noise pollution, all of which are done in an attempt to achieve sustainable environment. How we can do with plant design to attain the best visual quality and ideal carbon dioxide fixation depends on whether or not we can appropriately make use of greenery according to the nature of architectural bases. To achieve the goal, it is a need that architects and landscape architects should be provided with sufficient local references. Current greenery studies focus mainly on the heat-island effect of urban with large scale. Most of the architects still rely on people with years of expertise regarding the adoption and disposition of plantation in connection with microclimate scale. Therefore, environmental design, which integrates science and aesthetics, requires fundamental research on landscape environment technology divided from building environment technology. By doing so, we can create mutual benefits between green building and the environment. This issue is extremely important for the greening design of the bases of green buildings in cities and various open spaces. The purpose of this study is to establish plant selection and allocation strategies under different building sunshade levels. Initially, with the shading of sunshine on the greening bases as the starting point, the effects of the shades produced by different building types on the greening strategies were analyzed. Then, by measuring the PAR( photosynthetic active radiation), the relative DLI( daily light integral) was calculated, while the DLI Map was established in order to evaluate the effects of the building shading on the established environmental greening, thereby serving as a reference for plant selection and allocation. The discussion results were to be applied in the evaluation of environment greening of greening buildings and establish the “right plant, right place” design strategy of multi-level ecological greening for application in urban design and landscape design development, as well as the greening criteria to feedback to the eco-city greening buildings.

Keywords: daily light integral, plant design, urban open space

Procedia PDF Downloads 511

Authors: Iman Farasat, Howard M. Salis

Abstract:

The CRISPR/Cas9 system has revolutionized genome engineering by enabling site-directed and high-throughput genome editing, genome insertion, and gene knockdowns in several species, including bacteria, yeast, flies, worms, and human cell lines. This technology has the potential to enable human gene therapy to treat genetic diseases and cancer at the molecular level; however, the current CRISPR/Cas9 system suffers from seemingly sporadic off-target genome mutagenesis that prevents its use in gene therapy. A comprehensive mechanistic model that explains how the CRISPR/Cas9 functions would enable the rational design of the guide-RNAs responsible for target site selection while minimizing unexpected genome mutagenesis. Here, we present the first quantitative model of the CRISPR/Cas9 genome mutagenesis system that predicts how guide-RNA sequences (crRNAs) control target site selection and cleavage activity. We used statistical thermodynamics and law of mass action to develop a five-step biophysical model of cas9 cleavage, and examined it in vivo and in vitro. To predict a crRNA's binding specificities and cleavage rates, we then compiled a nearest neighbor (NN) energy model that accounts for all possible base pairings and mismatches between the crRNA and the possible genomic DNA sites. These calculations correctly predicted crRNA specificity across 5518 sites. Our analysis reveals that cas9 activity and specificity are anti-correlated, and, the trade-off between them is the determining factor in performing an RNA-mediated cleavage with minimal off-targets. To find an optimal solution, we first created a scheme of safe-design criteria for Cas9 target selection by systematic analysis of available high throughput measurements. We then used our biophysical model to determine the optimal Cas9 expression levels and timing that maximizes on-target cleavage and minimizes off-target activity. We successfully applied this approach in bacterial and mammalian cell lines to reduce off-target activity to near background mutagenesis level while maintaining high on-target cleavage rate.

Keywords: biophysical model, CRISPR, Cas9, genome editing

Procedia PDF Downloads 406

Authors: Katharina Kargel, Frederic Vobbe

Abstract:

Sexualized violence against children and adolescents using digital media poses particular challenges for practitioners with a focus on crisis intervention (social work, psychotherapy, law enforcement). The technical delimitation of violence increases the burden on those affected and increases the complexity of interdisciplinary cooperation. Urgently needed recommendations for practical action do not yet exist in Germany. Funded by the Federal Ministry of Education and Research, these recommendations for action are being developed in the HUMAN project together with science and practice. The presentation introduces the participatory approach of the HUMAN project. We discuss the application-oriented, casuistic approach of the project and present its results using the example of concrete case-based recommendations for Action. The participants will be presented with concrete prototypical case studies from the project, which will be used to illustrate quality criteria for crisis intervention in cases of sexualized violence using digital media. On the basis of case analyses, focus group interviews and interviews with victims of violence, we present the six central challenges of sexualized violence with the use of digital media, namely: • Diffusion (Ambiguities regarding the extent and significance of violence) , • Transcendence (Space and time independence of the dynamics of violence, omnipresence), • omnipresent anxiety (considering diffusion and transcendence), • being haunted (repeated confrontation with digital memories of violence or the perpetrator), • disparity (conflicts of interpretative power between those affected and the social environment) • simultaneity (of all other factors). We point out generalizable principles with which these challenges can be dealt with professionally. Dealing professionally with sexualized violence using digital media requires a stronger networking of professional actors. A clear distinction must be made between their own mission and the mission of the network partners. Those affected by violence must be shown options for crisis intervention in the context of the aid networks. The different competencies and the professional mission of the offers of help are to be made transparent. The necessity of technical possibilities for deleting abuse images beyond criminal prosecution will be discussed. Those affected are stabilized by multimodal strategies such as a combination of rational emotive therapy, legal support and technical assistance.

Keywords: sexualized violence, intervention, digital media, children and youth

Procedia PDF Downloads 237

Authors: Sylwia Sumińska, Łukasz Kapica, Grzegorz Szczepański

Abstract:

Introduction: Cognitive skills are a crucial part of everyday functioning. Cognitive skills include perception, attention, language, memory, executive functions, and higher cognitive skills. With the aging of societies, there is an increasing percentage of people whose cognitive skills decline. Cognitive skills affect work performance. The appropriate diagnosis of a worker’s cognitive skills reduces the risk of errors and accidents at work which is also important for senior workers. The study aimed to prepare new cognitive tests for adults aged 20-60 and assess the psychometric properties of the tests. The project responds to the need for reliable and accurate methods of assessing cognitive performance. Computer tests were developed to assess psychomotor performance, attention, and working memory. Method: Two hundred eighty people aged 20-60 will participate in the study in 4 age groups. Inclusion criteria for the study were: no subjective cognitive impairment, no history of severe head injuries, chronic diseases, psychiatric and neurological diseases. The research will be conducted from February - to June 2022. Cognitive tests: 1) Measurement of psychomotor performance: Reaction time, Reaction time with selective attention component; 2) Measurement of sustained attention: Visual search (dots), Visual search (numbers); 3) Measurement of working memory: Remembering words, Remembering letters. To assess the validity and the reliability subjects will perform the Vienna Test System, i.e., “Reaction Test” (reaction time), “Signal Detection” (sustained attention), “Corsi Block-Tapping Test” (working memory), and Perception and Attention Test (TUS), Colour Trails Test (CTT), Digit Span – subtest from The Wechsler Adult Intelligence Scale. Eighty people will be invited to a session after three months aimed to assess the consistency over time. Results: Due to ongoing research, the detailed results from 280 people will be shown at the conference separately in each age group. The results of correlation analysis with the Vienna Test System will be demonstrated as well.

Keywords: aging, attention, cognitive skills, cognitive tests, psychomotor performance, working memory

Procedia PDF Downloads 106

Authors: Rady A., Elsheshai A., Elsawy M., Nagui R.

Abstract:

Background and Aim: Metabolic syndrome affect around 20% of general population , authors have incriminated antipsychotics as serious risk factor that may provoke such derangement. The aim of our study is to assess metabolic syndrome in patients presenting psychotic features (delusions and hallucinations) whether schizophrenia or mood disorder and compare results in terms of drug naïf, on medication and healthy control. Subjects and Methods: The study recruited 40 schizophrenic patients, half of them drug naïf and the other half on antipsychotics, 40 patients with mood disorder with psychotic features, half of them drug naïf and the other half on medication, 20 healthy control. Exclusion criteria were put in order to exclude patients having already endocrine or metabolic disorders that my interfere with results obtain to minimize confusion bias. Metabolic syndrome assessed by measuring parameters including weight, body mass index, waist circumference, triglyceride level, HDL, fasting glucose, fasting insulin and insulin resistance Results: No difference was found when comparing drug naïf to those on medication in both schizophrenic and psychotic mood disorder arms, schizophrenic patients whether on medication or drug naïf should difference with control group for fasting glucose, schizophrenic patients on medication also showed difference in insulin resistance compared to control group. On the other hand, patients with psychotic mood disorder whether drug naïf or on medication showed difference from control group for fasting insulin level. Those on medication also differed from control for insulin resistance Conclusion: Our study didn’t reveal difference in metabolic syndrome among patients with psychotic features whether on medication or drug naïf. Only patients with Psychotic features on medication showed insulin resistance. Schizophrenic patients drug naïf or on medication tend to show higher fasting glucose while psychotic mood disorder whether drug naïf or on medication tend to show higher fasting insulin. This study suggest that presence of psychotic features themselves regardless being on medication or not carries a risk for insulin resistance and metabolic syndrome. Limitation: This study is limited by number of participants and larger numbers in future studies should be included in order to extrapolate results. Cohort longitudinal studies are needed in order to evaluate such hypothesis.

Keywords: schizophrenia, metabolic syndrome, psychosis, insulin, resistance

Procedia PDF Downloads 535

Authors: Risheka Suthantirakumar, Eilish Pearson, Jacqueline Woodman

Abstract:

Background: Previous research has found a variety of rates and reasons for choosing medically unindicated elective repeat cesarean section (ERCS). Understanding the frequency and reasoning of ERCS, especially when unwarranted, could help healthcare professionals better tailor their advice and service. Therefore, our study conducted meta-analyses and qualitative analyses to identify the reasons and rates worldwide for choosing this procedure over the trial of labor after cesarean (TOLAC), also referred to in published literature as vaginal birth after cesarean (VBAC). Methods: We conducted a systematic review of published literature available on PubMed, EMBASE, and science.gov and conducted a blinded peer review process to assess eligibility. Search terms were created in collaboration with experts in the field. An inclusion and exclusion criteria were established prior to reviewing the articles. Included studies were limited to those published in English due to author constraints, although no international boundaries were used in the search. No time limit for the search was used in order to portray changes over time. Results: Our qualitative analyses found five consistent themes across international studies, which were socioeconomic and cultural differences, previous cesarean experience, perceptions of risk with vaginal birth, patients’ perceptions of future benefits, and medical advice and information. Our meta-analyses found variable rates of ERCS across international borders and within national populations. The average rate across all studies was 44% (CI 95% 36-51). Discussion: The studies included in our qualitative analysis demonstrated similar repetitive themes, which give validity to the findings across the studies included. We consider the rate variation across and within national populations to be partially a result of differing inclusion and eligibility assessment between different studies and argue that a proforma be utilized for future research to be comparable.

Keywords: elective cesarean section, VBAC, TOLAC, maternal choice

Procedia PDF Downloads 111

Authors: Daniel Wachira

Abstract:

The study aims to determine factors contributing to increasing rates of DFU among DM patients attending clinics in Nyahururu County referral hospital, Lakipia County. The study objectives include;- To determine the demographic factors contributing to increased rates of DFU among DM patients, determining the sociocultural factors that contribute to increased rates of DFU among DM patients and determining the health facility factors contributing to increased rates of DFU among DM patients attending DM clinic at Nyahururu county referral hospital, Laikipia County. This study will adopt a descriptive cross-sectional study design. It involves the collection of data at a one-time point without follow-up. This method is fast and inexpensive, there is no loss to follow up as the data is collected at one time point and associations between variables can be determined. The study population includes all DM patients with or without DFU. The sampling technique that will be used is the probability sampling method, a simple random method of sampling will be used. The study will employ the use of questionnaires to collect the required information. Questionnaires will be a research administered questionnaires. The questionnaire developed was done in consultation with other research experts (supervisor) to ensure reliability. The questionnaire designed will be pre-tested by hand delivering them to a sample 10% of the sample size at J.M Kariuki Memorial hospital, Nyandarua county and thereafter collecting them dully filled followed by refining of errors to ensure it is valid for collection of data relevant for this study. Refining of errors on the questionnaires to ensure it was valid for collection of data relevant for this study. Data collection will begin after the approval of the project. Questionnaires will be administered only to the participants who met the selection criteria by the researcher and those who agreed to participate in the study to collect key information with regard to the objectives of the study. The study's authority will be obtained from the National Commission of Science and Technology and Innovation. Permission will also be obtained from the Nyahururu County referral hospital administration staff. The purpose of the study will be explained to the respondents in order to secure informed consent, and no names will be written on the questionnaires. All the information will be treated with maximum confidentiality by not disclosing who the respondent was and the information.

Keywords: diabetes, foot ulcer, social factors, hospital factors

Procedia PDF Downloads 23

Authors: Lisa Chandler, Alistair Ward

Abstract:

A significant component of design pedagogy is the need to foster design thinking in various contexts and to support students in understanding links between educational exercises and their potential application in professional design practice. It is also important that educators provide opportunities for students to engage with new technologies and encourage them to imagine applying their design skills for a range of outcomes. Problem solving is central to design so it is also essential that students understand that there can be multiple solutions to a design brief, and are supported in undertaking creative experimentation to generate imaginative outcomes. This paper presents a case study examining some innovative approaches to addressing these elements of design pedagogy. It investigates the effectiveness of the Immerse Lab, a three wall projection room at the University of the Sunshine Coast, Australia, as a learning context for design practice, for generating ideas and for supporting learning involving the comparative display of design outcomes. The project required first year design students to create a simple graphic design derived from an ordinary object and to incorporate specific design criteria. Utilizing custom-designed software, the students’ solutions were projected together onto the Immerse walls to create a large-scale, immersive grid of images, which was used to compare and contrast various responses to the same problem. The software also enabled individual student designs to be transformed, multiplied and enlarged in multiple ways and prompted discussions around the applicability of the designs in real world contexts. Teams of students interacted with their projected designs, brainstorming imaginative applications for their outcomes. Analysis of 77 anonymous student surveys revealed that the majority of students found: learning in the Immerse Lab to be beneficial; comparative review more effective than in standard tutorial rooms; that the activity generated new ideas; it encouraged students to think differently about their designs; it inspired students to develop their existing designs or create new ones. The project demonstrates that curricula involving immersive spaces can be effective in supporting engaging and relevant design pedagogy and might be utilized in other disciplinary areas.

Keywords: design pedagogy, immersive education, technology-enhanced learning, visualization

Procedia PDF Downloads 259

Authors: Sung Hyun Kim

Abstract:

Introduction: Sleep disturbance is common in children with developmental disorders (D.D.). Sleep disturbance has a variety of negative effects, such as behavior problems, medical problems, and even developmental problems in children with D.D. However, to our best knowledge, there has been no proper treatment for sleep disorders in children with D.D. Therefore, we conduct this study to know the positive effects of intensive rehabilitation therapy in children with D.D. on the degree of sleep disturbance. Method: We prospectively recruited 22 patients with a diagnosis of D.D. during the period of January 2022 through May 2022. The inclusion criteria were as follows: 1) a patient who would participate in the intensive rehabilitation therapy of our institution; 2) the age participant under 18 years at the time of assessment; 3) a child who has consented to participate in the study by signing the consent form by the legal guardian. We investigated the clinical characteristics of participants by the medical record, including sex, age, underlying diagnosis of D.D., and Gross Motor Function Measures (GMFM). Before starting the intensive rehabilitation therapy, we conducted a Sleep disturbance scale for children (SDSC). It contains 26 questions about children’s sleep, and those questions are grouped into six subscales, such as Disorders of initiating and maintaining sleep (DIMS), Sleep Breathing Disorders(SBD), Disorders of arousal(DOA), Sleep-Wake Transition Disorders(SWTD), Disorders of excessive somnolence(DOES) and Sleep Hyperhydrosis(SHY). We used the t-score, which was calculated by comparing the scores of normal children. Twenty two patients received 8 weeks of intensive rehabilitation, including daily physical and occupational therapy. After that, we did follow up with SDSC. The comparison between SDSC before and after intensive rehabilitation was calculated using the paired t-test, and P< 0.05 was considered statistically significant. Results: Demographic data and clinical characteristics of 22 patients are enrolled. Patients were 4.03 ± 2.91 years old, and of the total 22 patients, 14 (64%) were male, and 8 (36%) were female. Twelve patients(45%) were diagnosed with Cerebral palsy(C.P.), and the mean value of participants’ GMFM was 47.82 ± 20.60. Each mean value of SDSC’s subscales was also calculated. DIMS was 62.36 ± 13.72, SBD was 54.18 ± 8.39, DOA was 49.59 ± 7.01, SWTD was 58.95 ± 9.20, DOES was 53.09 ± 15.15, SHY was 52.14 ± 8.82, and the total was 59.86 ± 13.18. These values suggest that children with D.D. have sleep disorders. After 8 weeks of intensive rehabilitation treatment, the score of DIMS showed improvement(p=0.016), but not the other subscale and total score of SDSC. Conclusion: This result showed that intensive rehabilitation could be helpful to patients of D.D. with sleep disorders. Especially intensive rehabilitation therapy itself can be a meaningful treatment in inducing and maintaining sleep.

Keywords: sleep disorder, developmental delay, intensive rehabilitation therapy, cerebral palsy

Procedia PDF Downloads 87

Authors: Maria Medeiros, Suren Surenthiran, Abitha Muralithar, Soushma Seeburuth, Mohammed Mohammed

Abstract:

Introduction: Appendicitis is the most common surgical emergency globally and can have devastating consequences. Diagnostic imaging in acute appendicitis has become increasingly common in aiding the diagnosis of acute appendicitis. Computerized tomography (CT) and ultrasound (US) are the most commonly used imaging modalities for diagnosing acute appendicitis. Pre-operative imaging has contributed to a reduction of negative appendicectomy rates from between 10-29% to 5%. Literature report CT scan has a diagnostic sensitivity of 94% in acute appendicitis. This clinical audit was conducted to establish if the CT scan's diagnostic yield for acute appendicitis matches the literature. CT scan has a high sensitivity and specificity for diagnosing acute appendicitis and its use can result in a lower negative appendicectomy rate. The aim of this study is to compare the pre-operative imaging findings from CT scans to the histopathology results post-operatively and establish the accuracy of CT scans in aiding the diagnosis of acute appendicitis. Methods: This was a retrospective study focusing on adult presentations to the general surgery department in a district general hospital in central London with an impression of acute appendicitis. We analyzed all patients from July 2022 to December 2022 who underwent a CT scan preceding appendicectomy. Pre-operative CT findings and post-operative histopathology findings were compared to establish the efficacy of CT scans in diagnosing acute appendicitis. Our results were also cross-referenced with pre-existing literature. Data was collected and anonymized using CERNER and analyzed in Microsoft Excel. Exclusion criteria: Children, age <16. Results: 65 patients had CT scans in which the report stated acute appendicitis. Of those 65 patients, 62 patients underwent diagnostic laparoscopies. 100% of patients who underwent an appendicectomy with a pre-operative CT scan showing acute appendicitis had acute appendicitis in histopathology analysis. 3 of the 65 patients who had a CT scan showing appendicitis received conservative treatment. Conclusion: CT scans positive for acute appendicitis had 100% sensitivity and a positive predictive value, which matches published research studies (sensitivity of 94%). The use of CT scans in the diagnostic work-up for acute appendicitis can be extremely helpful in a) confirming the diagnosis and b) reducing the rates of negative appendicectomies and consequently reducing unnecessary operative-associated risks for patients, reducing costs and reducing pressure on emergency theatre lists.

Keywords: acute apendicitis, CT scan, general surgery, imaging

Procedia PDF Downloads 94

Authors: Cherres Sara, Cajas Diego

Abstract:

This paper explores how EFL teachers understand the process of Lesson Study in Ecuadorian schools and the challenges and opportunities that it brings to the improvement of their teaching practice. Using a narrative research methodology, this study presents the results of the application of the four steps of Lesson Study carried out by seven teachers in four different schools located in the Southern part of Ecuador during four months. Before starting the implementation of the lesson study, 30 teachers were trained on this model. This training was opened to EFL teachers working in public and private schools without any charge. The criteria to select these teachers were first, to be minimum a one-year in-service teacher, second, to have a b2 level of English, and third, to be able to commit to follow the course guidelines. After the course, seven teachers decided to continue with the implementation of the Lesson Study in their respective institutions. During the implementation of the Lesson Study, data was collected through observations, in-depth interviews and teachers’ planning meetings; and analyzed using a thematic analysis. The results of this study are presented using the lenses of seven EFL teachers that explained the challenges and opportunities that the implementation of Lesson Study conveyed. The challenges identified were the limited capacity of reflection and recognition of the activities that required improvement after the class, limited capacity to provide truthful peer feedback, teachers wrong notions about their performance in their classes, difficulties to follow a collaborative lesson plan; and, the disconnection between class activities and the class content. The opportunities identified were teachers’ predisposition to collaborate, teachers’ disposition to attend professional development courses, their commitment to work extra hours in planning meetings, their openness and their desired to be observed in their classes; and, their willingness to share class materials and knowledge. On the other hand, the results show that there is a disconnection between teachers’ knowledge of ELT and its proper application in class (from theory to practice). There are also, rigid institutional conceptions of teaching that do not allow teaching innovations. The authors concluded that there is a disconnection between teachers’ knowledge of ELT and its proper application in class (from theory to practice). There are also, rigid institutional conceptions of teaching that do not allow teaching innovations for example: excessive institutional paperwork and activities that are not connected to the development of students’ competences.

Keywords: ELT, lesson study, teachers’ professional development, teachers’ collaboration

Procedia PDF Downloads 71

Authors: Flavia Magliacani

Abstract:

The urbanization of the last decades and its resulting urban growth entail problems both for environmental and economic sustainability. From this perspective, sustainable settlement development requires a horizontal decrease in the existing urban structure in order to enhance its greater concentration. Hence, new stratifications of the city fabric and architectural strategies ensuring high-density settlement models are possible solutions. However, although increasing housing density is necessary, it is not sufficient. Guaranteeing the quality of living is, indeed, equally essential. In order to meet this objective, many other factors come to light, namely the relationship between private and public spaces, the proximity to services, the accessibility of public transport, the local lifestyle habits, and the social needs. Therefore, how to safeguard both quality and density in human habitats? The present paper attempts to answer the previous main research question by addressing several sub-questions: Which architectural types meet the dual need for urban density and housing quality? Which project criteria should be taken into consideration by good design practices? What principles are desirable for future planning? The research will analyse different architectural responses adopted in four European cities: Paris, Lion, Rotterdam, and Amsterdam. In particular, it will develop a qualitative and comparative study of two specific architectural solutions which integrate housing density and quality living. On the one hand, the so-called 'self-contained city' model, on the other hand, the French 'Habitat Dense Individualisé' one. The structure of the paper will be as follows: the first part will develop a qualitative evaluation of some case studies, emblematic examples of the two above said architectural models. The second part will focus on the comparison among the chosen case studies. Finally, some conclusions will be drawn. The methodological approach, therefore, combines qualitative and comparative research. Parameters will be defined in order to highlight potential and criticality of each model in light of an interdisciplinary view. In conclusion, the present paper aims at shading light on design approaches which ensure a right balance between density and quality of the urban living in contemporary European cities.

Keywords: density, future design, housing quality, human habitat

Procedia PDF Downloads 108

Authors: Yusuf Yilmaz, Gamze Gediz Ilis

Abstract:

Gas Nitrogen where has a boiling point of -189.52oC at atmospheric pressure widely used in the industry. Nitrogen that used in the industry should be transported in liquid form to the plant area. Ambient air vaporizer (AAV) generally used for vaporization of cryogenic gases such as liquid nitrogen (LN2), liquid oxygen (LOX), liquid natural gas (LNG), and liquid argon (LAR) etc. AAV is a group of star-shaped fin vaporizer. The design and the effect of the shape of fins of the vaporizer is one of the most important criteria for the performance of the vaporizer. In this study, the performance of AAV working with liquid nitrogen was analyzed numerically in a star-shaped aluminum finned pipe. The numerical analysis is performed in order to investigate the heat capacity of the vaporizer per meter pipe length. By this way, the vaporizer capacity can be predicted for the industrial applications. In order to achieve the validation of the numerical solution, the experimental setup is constructed. The setup includes a liquid nitrogen tank with a pressure of 9 bar. The star-shaped aluminum finned tube vaporizer is connected to the LN2 tank. The inlet and the outlet pressure and temperatures of the LN2 of the vaporizer are measured. The mass flow rate of the LN2 is also measured and collected. The comparison of the numerical solution is performed by these measured data. The ambient conditions of the experiment are given as boundary conditions to the numerical model. The surface tension and contact angle have a significant effect on the boiling of liquid nitrogen. Average heat transfer coefficient including convective and nucleated boiling components should be obtained for liquid nitrogen saturated flow boiling in the finned tube. Fluent CFD module is used to simulate the numerical solution. The turbulent k-ε model is taken to simulate the liquid nitrogen flow. The phase change is simulated by using the evaporation-condensation approach used with user-defined functions (UDF). The comparison of the numerical and experimental results will be shared in this study. Besides, the performance capacity of the star-shaped finned pipe vaporizer will be calculated in this study. Based on this numerical analysis, the performance of the vaporizer per unit length can be predicted for the industrial applications and the suitable pipe length of the vaporizer can be found for the special cases.

Keywords: liquid nitrogen, numerical modeling, two-phase flow, cryogenics

Procedia PDF Downloads 120

Authors: Z. Wang, F. Pashaei Kamali, J. A. Posada Duque, P. Osseweijer

Abstract:

Globally, the aviation sector is seeking for sustainable solutions to comply with the pressure to reduce greenhouse gas emissions. Jet fuels derived from biomass are generally perceived as a sustainable alternative compared with their fossil counterparts. However, the establishment of jet biofuels supply chains will have impacts on environment, economy, and society. While existing studies predominantly evaluated environmental impacts and techno-economic feasibility of jet biofuels, very few studies took the social / socioeconomic aspect into consideration. Therefore, this study aims to provide a focused evaluation of social sustainability for aviation biofuels with a supply chain perspective. Three potential jet biofuel supply chains based on different feedstocks, i.e. sugarcane, eucalyptus, and macauba were analyzed in the context of Brazil. The assessment of social sustainability is performed with a process-based approach combined with input-output analysis. Over the supply chains, a set of social sustainability issues including employment, working condition (occupational accident and wage level), labour right, education, equity, social development (GDP and trade balance) and food security were evaluated in a (semi)quantitative manner. The selection of these social issues is based on two criteria: (1) the issues are highly relevant and important to jet biofuel production; (2) methodologies are available for assessing these issues. The results show that the three jet biofuel supply chains lead to a differentiated level of social effects. The sugarcane-based supply chain creates the highest number of jobs whereas the biggest contributor of GDP turns out to be the macauba-based supply chain. In comparison, the eucalyptus-based supply chain stands out regarding working condition. It is also worth noting that biojet fuel supply chain with high level of social benefits could result in high level of social concerns (such as occupational accident, violation of labour right and trade imbalance). Further research is suggested to investigate the possible interactions between different social issues. In addition, the exploration of a wider range of social effects is needed to expand the comprehension of social sustainability for biofuel supply chains.

Keywords: biobased supply chain, jet biofuel, social assessment, social sustainability, socio-economic impacts

Procedia PDF Downloads 266

Authors: David Adade-Boateng, Benard Fei Baffoe, Colin A. Booth, Michael A. Fullen

Abstract:

Remediation of diesel fuel, oil and grease in contaminated soils obtained from a mine site in Ghana are explored using rhizoremediation technology with different levels of nutrient amendments (i.e. N (nitrogen) in Compost (0.2, 0.5 and 0.8%), Urea (0.2, 0.5 and 0.8%) and Topsoil (0.2, 0.5 and 0.8%)) for a native species. A Ghanaian native grass species, Paspalum spp. from the Poaceae family, indicative across Sub-Saharan Africa, was selected following the development of essential and desirable growth criteria. Vegetative parts of the species were subjected to ten treatments in a Randomized Complete Block Design (RCBD) in three replicates. The plant-associated microbial community was examined in Paspalum spp. An assessment of the influence of Paspalum spp on the abundance and activity of micro-organisms in the rhizosphere revealed a build-up of microbial communities over a three month period. This was assessed using the MPN method, which showed rhizospheric samples from the treatments were significantly different (P <0.05). Multiple comparisons showed how microbial populations built-up in the rhizosphere for the different treatments. Treatments G (0.2% compost), H (0.5% compost) and I (0.8% compost) performed significantly better done other treatments, while treatments D (0.2% topsoil) and F (0.8% topsoil) were insignificant. Furthermore, treatment A (0.2% urea), B (0.5% urea), C (0.8% urea) and E (0.5% topsoil) also performed the same. Residual diesel and oil concentrations (as total petroleum hydrocarbons, TPH and oil and grease) were measured using infra-red spectroscopy and gravimetric methods, respectively. The presence of single species successfully enhanced the removal of hydrocarbons from soil. Paspalum spp. subjected to compost levels (0.5% and 0.8%) and topsoil levels (0.5% and 0.8%) showed significantly lower residual hydrocarbon concentrations compared to those treated with Urea. A strong relationship (p<0.001) between the abundance of hydrocarbon degrading micro-organisms in the rhizosphere and hydrocarbon biodegradation was demonstrated for rhizospheric samples with treatment G (0.2% compost), H (0.5% compost) and I (0.8% compost) (P <0.001). The same level of amendment with 0.8% compost (N-level) can improve the application effectiveness. These findings have wide-reaching implications for the environmental management of soils contaminated by hydrocarbons in Sub-Saharan Africa. However, it is necessary to further investigate the in situ rhizoremediation potential of Paspalum spp. at the field scale.

Keywords: rhizoremediation, microbial population, rhizospheric sample, treatments

Procedia PDF Downloads 328

Authors: Solomon Okorley

Abstract:

With the emergence of artificial intelligence, a proposition that has been made with increasing conviction is the need to assign legal personhood to robots. A major problem that arises when dealing with robots is the issue of liability: who do it hold liable when a robot causes harm? The suggestion to assign legal personality to robots has been made to aid in the assignment of liability. This paper contends that it is premature to assign legal personhood to robots. The paper employed the doctrinal and comparative research methodology. The paper first discusses the various theories that underpin the granting of legal personhood to juridical personalities to ascertain whether these theories can aid in the proposition to assign legal personhood to robots. These theories include fiction theory, aggregate theory, realist theory, and organism theory. Except for the aggregate theory, the fiction theory, the realist theory and the organism theory provide a good foundation to the proposal for legal personhood to be assigned to robots. The paper considers whether robots should be assigned legal personhood from a jurisprudential approach. The legal positivists assert that no metaphysical presuppositions are needed to determine who could be a legal person: the sole deciding factor is the engagement in legal relations and this prerequisite could be fulfilled by robots. However, rationalists, religionists and naturalists assert that the satisfaction of the metaphysical criteria is the basis of legal personality and since robots do not possess this feature, they cannot be assigned legal personhood. This differing perspective shows that the jurisprudential school of thought to which one belongs influences the decision whether to assign legal personhood to robots. The paper makes arguments for and against the assigning of legal personhood to robots. Assigning legal personhood to robots is necessary for the assigning of liability; and since robots are independent in their operation, they should be assigned legal personhood. However, it is argued that the degree of autonomy is insufficient. Robots do not understand legal obligations; they do not have a will of their own and the purported autonomy that they possess is an ‘imputed autonomy’. A crucial question to be asked is ‘whether it is desirable to confer legal personhood on robots’ and not ‘whether legal personhood should be assigned to robots’. This is due to the subjective nature of the responses to such a question as well as the peculiarities of countries in response to this question. The main argument in support of assigning legal personhood to robots is to aid in assigning liability. However, it is argued conferring legal personhood on robots is not the only way to deal with liability issues. Since any of the stakeholders involved with the robot system can be held liable for an accident, it is not desirable to assign legal personhood to robot. It is forecasted that in the epoch of strong artificial intelligence, granting robots legal personhood is plausible; however, in the current era, it is premature.

Keywords: autonomy, legal personhood, premature, jurisprudential

Procedia PDF Downloads 70

Authors: Adhithy Menon E., Biju C. A.

Abstract:

In the 1960s, the concept of preserving heritage monuments was first introduced. During the 1990s, the concept of cultural landscapes gained importance, highlighting the importance of culture and heritage. Throughout this paper, we examine the second category of the cultural landscape, which is an organically evolving landscape as it represents a web of tangible, intangible, and ecological heritage and the ways in which they can be rejuvenated. Cultural landscapes in various regions, such as the Chettinad Village clusters, are in serious decline, which is identified through the Heritage Passport program of this area (2007). For this reason, it is necessary to conduct a detailed analysis of the factors that contribute to this degradation to ensure its protection in the future. An analysis of the cultural landscape of the Chettinad Village clusters and its impact on the community is presented in this paper. The paper follows the first objective, which is to understand cultural landscapes and their different criteria and categories. It is preceded by the study of various methods for protecting cultural landscapes. To identify a core area of intervention based on the parameters of Cultural Landscapes and Community Based Tourism, a study and analysis of the regional context of Chettinad village clusters considering tourism development must first be conducted. Lastly, planning interventions for integrating community-based tourism in Chettinad villages for the purpose of rejuvenating the cultural landscapes of the villages as well as their communities. The major findings include the importance of the local community in protecting cultural landscapes. The parameters identified to have an impact on Chettinad Village clusters are a community (community well-being, local maintenance, and enhancement, demand, alternative income for community, public participation, awareness), tourism (location and physical access, journey time, tourist attractions), integrity (natural factors, natural disasters, demolition of structures, deterioration of materials) authenticity (sense of place, living elements, building techniques, artistic expression, religious context) disaster management (natural disasters) and environmental impact (pollution). This area can be restored to its former glory and preserved as part of the cultural landscape for future generations by focusing on and addressing these parameters within the identified core area of the Chettinad Villages cluster (Kanadukathan TP, Kothamangalam, Kottaiyur, Athangudi, Karikudi, and Palathur).

Keywords: Chettinad village clusters, community, cultural landscapes, organically evolved.

Procedia PDF Downloads 83

Authors: Michael Howard

Abstract:

The growing popularity of electric vehicles in the United States requires an ever-expanding infrastructure of commercial DC fast charging stations. The U.S. Department of Energy estimates 33,355 publicly available DC fast charging stations as of September 2023. In 2017, 115,370 gasoline stations were operating in the United States, much more ubiquitous than DC fast chargers. Range anxiety is an important impediment to the adoption of electric vehicles and is even more relevant in underserved regions in the country. The peer-to-peer energy marketplace helps fill the demand by allowing private home and small business owners to rent their 240 Volt, level-2 charging facilities. The existing, publicly accessible outlets are wrapped with a Cloud-connected microcontroller managing security and charging sessions. These microcontrollers act as Edge devices communicating with a Cloud message broker, while both buyer and seller users interact with the framework via a web-based user interface. The database storage used by the marketplace framework is a key component in both the cost of development and the performance that contributes to the user experience. A traditional storage solution is the SQL database. The architecture and query language have been in existence since the 1970s and are well understood and documented. The Structured Query Language supported by the query engine provides fine granularity with user query conditions. However, difficulty in scaling across multiple nodes and cost of its server-based compute have resulted in a trend in the last 20 years towards other NoSQL, serverless approaches. In this study, we evaluate the NoSQL vs. SQL solutions through a comparison of Google Cloud Firestore and Cloud SQL MySQL offerings. The comparison pits Google's serverless, document-model, non-relational, NoSQL against the server-base, table-model, relational, SQL service. The evaluation is based on query latency, flexibility/scalability, and cost criteria. Through benchmarking and analysis of the architecture, we determine whether Firestore can support the energy marketplace storage needs and if the introduction of a GraphQL middleware layer can overcome its deficiencies.

Keywords: non-relational, relational, MySQL, mitigate, Firestore, SQL, NoSQL, serverless, database, GraphQL

Procedia PDF Downloads 63

Authors: Noman Shahzad, Amyn Pardhan, Hasnain Zafar

Abstract:

Introduction: Though short term survival advantage of damage control laparotomy in management of critically ill trauma patients is established, there is little known about the long-term quality of life of these patients. Facial closure rate after damage control laparotomy is reported to be 20-70 percent. Abdominal wall reconstruction in those who failed to achieve facial closure is challenging and can potentially affect quality of life of these patients. Methodology: We conducted retrospective matched cohort study. Adult patients who underwent damage control laparotomy from Jan 2007 till Jun 2013 were identified through medical record. Patients who had concomitant disabling brain injury or limb injuries requiring amputation were excluded. Age, gender and presentation time matched non exposure group of patients who underwent laparotomy for trauma but no damage control were identified for each damage control laparotomy patient. Quality of life assessment was done via telephonic interview at least one year after the operation, using Urdu version of EuroQol Group Quality of Life (QOL) questionnaire EQ5D after permission. Wilcoxon signed rank test was used to compare QOL scores and McNemar test was used to compare individual parameters of QOL questionnaire. Study was approved by institutional ethical review committee. Results: Out of 32 patients who underwent damage control laparotomy during study period, 20 fulfilled the selection criteria for which 20 matched controls were selected. Median age of patients (IQ Range) was 33 (26-40) years. Facial closure rate in damage control laparotomy group was 40% (8/20). One third of those who did not achieve facial closure (4/12) underwent abdominal wall reconstruction. Self-reported QOL score of damage control laparotomy patients was significantly worse than non-damage control group (p = 0.032). There was no statistically significant difference in two groups regarding individual QOL measures. Significantly, more patients in damage control group were requiring use of abdominal binder, and more patients in damage control group had to either change their job or had limitations in continuing previous job. Our study was not adequately powered to detect factors responsible for worse QOL in damage control group. Conclusion: Quality of life of damage control patients is worse than their age and gender matched patients who underwent trauma laparotomy but not damage control. Adequately powered studies need to be conducted to explore factors responsible for this finding for potential improvement.

Keywords: damage control laparotomy, laparostomy, quality of life

Procedia PDF Downloads 280

Authors: May Newisar, Richard Kingston, Philip Black

Abstract:

Heritage-led regeneration developments have been considered as one of the cornerstones of the economic and social revival of historic towns and cities in the UK. However, this approach has proved its deficiency within the development of Liverpool World Heritage site. This is due to the conflict between sustaining the tangible and intangible values as well as achieving the aimed economic developments. Accordingly, the development of such areas is influenced by a top-down approach which considers heritage as consumable experience and urban regeneration as the economic development for it. This neglects the heritage sites characteristics and values as well as the design criteria for public open spaces that overlap with the heritage sites. Currently, knowledge regarding the relationship between the physical built environment of the heritage sites including the intangible values and the design development of the public open spaces is limited. Public open spaces have been studied from different perspectives such as increasing walkability, a source of social cohesion, provide a good quality of life as well as understanding users’ perception. While heritage sites have been discussed heavily on how to maintain the physical environment, understanding the courses of threats and how to be protected. In addition to users’ experiences and motivations of visiting such areas. Furthermore, new approaches tried to overcome the gap such as the historic urban landscape approach. This approach is focusing on the entire human environment with all its tangible and intangible qualities. However, this research aims to understand the relationship between the heritage sites and public open spaces and how the overlap of the design and development of both could be used as a quality to enhance the heritage sites and improve users’ experience. A meaning-making approach will be used in order to understand and articulate how the development of Liverpool World Heritage site and its value could influence and shape the design of public open space Pier Head in order to attract a different level of tourists to be used as a tool for economic development. Consequently, this will help in bridging the gap between the planning and conservation areas’ policies through an understanding of how flexible is the system in order to adopt alternative approaches for the design and development strategies for those areas.

Keywords: historic urban landscape, environmental psychology, urban governance, identity

Procedia PDF Downloads 132

Authors: Libing Zhu, Waichung Chen, Kwaicing Lo, Lei Li

Abstract:

Background: Tian Jiu Therapy (a medicinal vesiculation therapy according to traditional Chinese medicine theory) in San Fu Days (the three hottest days in a year is calculated by the Chinese ancient calendar) is widely used by patients with chronic asthma in China although from modern medicine perspective there is insufficient evidence of its effectiveness and safety issues. We investigated the efficacy and safety of Tian Jiu Therapy compared with placebo in patients with chronic asthma. Methods: Patients with chronic asthma were randomly assigned to Tian Jiu treatment group (n=165), placebo control group (n=158). Registered Chinese Medicine practitioners, in Orthopedics-Traumatology, Acupuncture, and Tui-na Clinical Centre for Teaching and Research, School of Chinese Medicine, The University of Hong Kong, administered Tian Jiu Therapy and placebo treatment in 3 times over 2 months. Patients completed questionnaires and lung function test before treatment and after treatment, 3, 6, 9, and 11 months, respectively. The primary outcome was the no of asthma-related sub-healthy symptoms and the percentage of patients with twenty-three symptoms. Results: 451 patients were recruited totally, 111 patients refused or did not participate according the appointment time and 17 did not meet the inclusion criteria. Consequently, 323 of eligible patients were enrolled. There was nothing difference between Tian Jiu Therapy group and placebo control group at the end of all treatments neither primary nor secondary outcomes. While Tian Jiu Therapy as compared with placebo significantly reduced the percentage of participants who are susceptible waken up by asthma symptoms from 27% to 14% at 2nd follow-up (P < 0.05). Similarly, Tian Jiu Therapy significantly reduced the proportion of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow-up (P < 0.05). Additionally, Tian Jiu Therapy significantly reduced the level of asthma, the proportion of participants who don’t need to processed during asthma attack increased from 6% to 15% at 1st follow-up and 0% to 7% at 3rd follow-up (P < 0.05). Improvements also occurred with Tian Jiu Therapy group, it reduced the proportion of participants who were spontaneously sweating at 3rd follow up and diarrhea after intake of oily food at 4th follow-up (P < 0.05). Conclusion: When added to a regimen of foundational therapy for chronic asthma participants, Tian Jiu Therapy further reduced the need for medications to control asthma, improved the quality of participants’ life, and significantly reduced the level of asthma. What is more, this benefit seems to have an accumulative effect over time was in accordance with the TCM theory of 'winter disease is being cured in summer'.

Keywords: asthma, Tian Jiu Therapy, San Fu Days, triaditional Chinese medicine, clinical trial

Procedia PDF Downloads 314

Authors: Sammar Zain Allam

Abstract:

Smart Growth, intelligent cities, and healthy cities cited by WHO world health organization; they all call for clean air and minimizing air pollutants considering human health. Air quality is a thriving matter to achieve ecological cities; towards sustainable environmental development of urban fabric design. Selection criteria depends on the strategic location of our area as it is located at the entry of the city of Alexandria from its agricultural road. Besides, it represents the city center for retail, business, and educational amenities. Our study is analyzing readings of definite factors affecting air quality in a centric area in Alexandria. Our readings will be compared to standard measures of carbon dioxide, carbon monoxide, suspended particles, and air velocity or air flow. Carbon emissions are pondered in our study, in addition to suspended particles and the air velocity or air flow. Carbon dioxide and carbon monoxide crystalize the main elements to necessitate environmental and sustainable studies with the appearance of global warming and the glass house effect. Nevertheless, particulate matters are increasing causing breath issues especially to children and elder people; still threatening future generations to meet their own needs; sustainable development definition. Analysis of carbon dioxide, carbon monoxide, suspended particles together with air velocity or air flow has taken place in our area of study to manifest the relationship between these elements and the urban fabric design and land use distribution. For conclusion, dense urban fabric affecting air flow, and thus result in the concentration of air pollutants in certain zones. The appearance of open space with green areas allow the fading of air pollutants and help in their absorption. Along with dense urban fabric, high rise buildings trap air carriers which contribute to high readings of our elements. Also, street design may facilitate the circulation of air which helps carrying these pollutant away and distribute it to a wider space which decreases its harms and effects.

Keywords: carbon emissions, air quality measurements, arteries air quality, airflow or air velocity, particulate matter, clean air, urban density

Procedia PDF Downloads 427

Authors: Mahnaz Seyedoshohadaee

Abstract:

Background and Aims: Hospitalization of one of the family members in the hospital, especially in the emergency department, causes anxiety and psychological problems in family members and others. The way nurses interact with patients and their companions can play an important role in controlling and managing their anxiety. This study aims to determine the relationship between the anxiety of family members of patients referring to emergency departments and their views on the communication skills of nurses. Materials and Methods: The current research was a descriptive-correlation cross-sectional study on 263 family members of patients referred to the department. The emergency of two selected medical training centers affiliated with Iran University of Medical Sciences was performed. The samples were selected continuously in 2018 based on the inclusion criteria. Information was collected using the Health Communication Questionnaire (HCCQ) and Beck Anxiety Questionnaire (BAI). To analyze the data, Pearson's correlation coefficient, independent t-tests, analysis of variance, and Kruskal-Wallis were used at a significance level of 0.05. The data was analyzed using SPSS version 16 statistical software. Results: The mean score of communication skills of emergency department nurses from the point of view of patients' companions was at a low level (74.36 with a standard deviation of 3.7). 3.75% of patients' companions had anxiety at a mild level. There was no statistically significant correlation between the anxieties of the patient's companions. The anxiety of the patient's companions had a statistically significant relationship with the educational level (P=0.039), economic status (P=0.033), and family relationship with the patient (P=0.001). Also, the average anxiety score in children was significantly higher than that of patients' wives (P=0.008). The triage level of the patient also had a statistically significant relationship with the anxiety of the patient's companions (P>0.001). Conclusion: Most of the family members of the patients referred to the emergency room experienced mild anxiety. Also, from their point of view, the communication skills of emergency nurses were at a weak level. Despite the fact that there was no statistically significant relationship between the patient's family member's anxiety and their opinion about nurses' communication skills in this study, it seems that the weak communication skills of nurses from the patient's family member's point of view need special attention. The results of the present study can provide the necessary grounds for planning to improve the communication skills of nurses and also control the anxiety of patient caregivers through in-service training or other incentive mechanisms.

Keywords: anxiety, family, emergency department, communication skills, nurse

Procedia PDF Downloads 59