Search results for: clinical guidelines

Authors: Ipsita Biswas, Arnab Sarkar, Ashikur Rahaman, Gopeswar Mukherjee, Subhrangsu Chatterjee, Shamee Bhattacharjee, Deba Prasad Mandal

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One of the major reasons for the high mortality rate of lung cancer is the substantial delays in disease detection at late metastatic stages. It is of utmost importance to understand the detailed molecular signaling and detect the molecular markers that can be used for the early diagnosis of cancer. Several studies explored the emerging roles of long noncoding RNAs (lncRNAs) in various cancers as well as lung cancer. A long non-coding RNA LINC00273 was recently discovered to promote cancer cell migration and invasion, and its positive correlation with the pathological stages of metastasis may prove it to be a potential target for inhibiting cancer cell metastasis. Comparing real-time expression of LINC00273 in various human clinical cancer tissue samples with normal tissue samples revealed significantly higher expression in cancer tissues. This long intergenic noncoding RNA was found to be highly expressed in human liver tumor-initiating cells, human gastric adenocarcinoma AGS cell line, as well as human non-small cell lung cancer A549 cell line. SiRNA and shRNA-induced knockdown of LINC00273 in both in vitro and in vivo nude mice significantly subsided AGS and A549 cancer cell migration and invasion. LINC00273 knockdown also reduced TGF-β induced SNAIL, SLUG, VIMENTIN, ZEB1 expression, and metastasis in A549 cells. Plenty of reports have suggested the role of microRNAs of the miR200 family in reversing epithelial to mesenchymal transition (EMT) by inhibiting ZEB transcription factors. In this study, hsa-miR-200a-3p was predicted via IntaRNA-Freiburg RNA tools to be a potential target of LINC00273 with a negative free binding energy of −8.793 kcal/mol, and this interaction was verified as a confirmed target of LINC00273 by RNA pulldown, real-time PCR and luciferase assay. Mechanistically, LINC00273 accelerated TGF-β induced EMT by sponging hsa-miR-200a-3p which in turn liberated ZEB1 and promoted prometastatic functions in A549 cells in vitro as verified by real-time PCR and western blotting. The similar expression patterns of these EMT regulatory pathway molecules, viz. LINC00273, hsa-miR-200a-3p, ZEB1 and TGF-β, were also detected in various clinical samples like breast cancer tissues, oral cancer tissues, lung cancer tissues, etc. Overall, this LINC00273 mediated EMT regulatory signaling can serve as a potential therapeutic target for the prevention of lung cancer metastasis.

Keywords: epithelial to mesenchymal transition, long noncoding RNA, microRNA, non-small-cell lung carcinoma

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Authors: Mohammad Alqattan, Tala Alkhunani, Reema Al, Aldawish, Felwa Almurshard, Abdullah Alzahrani

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: Poland’s Syndrome is a congenital anomaly with two clinical features : unilateral agenesis of the pectoralis major and ipsilateral hand symbrachydactyly. Case presentation: We report a rare case of bilateral Poland’s syndrome with several unique features. Discussion: Poland’s syndrome is thought to be due to a vascular insult to the subclavian axis around the 6th week of gestation. Our patient has multiple rare and unique features of Poland’s syndrome. Conclusion: To our best knowledge, for the first time in the literature we associate Poland’s syndrome with cone-shaped epiphysis of the metacarpals of all fingers. Bilaterality, cleft hand deformity, and dextrocardia, were also rare features in our patient.

Keywords: Poland's syndrome, cleft hand deformity, bilaterality, dextrocardia, cone-shaped epiphysis

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Authors: Nadereh Sohrabi Shegefti, Siamak Samani

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Level of adjustment is the first index to check mental health. The aim of this study was developing a valid and reliable Multidimensional Adjustment Scale (MAS). The sample consisted of 150 college students. Multidimensional adjustment scale and Depression, Anxiety, and stress scale (DASS) were used in this study. Principle factor analysis, Pearson correlation coefficient, and Cornbach's Alpha were used to check the validity and reliability of the MAS. Principle component factor analysis showed a 5 factor solution for the MAS. Alpha coefficients for the MAS sub scales were ranged between .69 to .83. Test-retest reliability for MAS was .88 and the mean of sub scales- total score correlation was .88. All these indexes revealed an acceptable reliability and validity for the MAS. The MAS is a short assessment instrument with good acceptable psychometric properties to use in clinical filed.

Keywords: psychological adjustment, psychometric properties, validity, Pearson correlation

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Authors: Michael Olson

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The Accreditation Council for Graduate Medical Education (ACGME) in the U.S. has established core competencies and milestones for family physicians in residency training programs. These competencies are intended to guide preceptors as they work with physician trainees toward independent practice. This conceptual paper describes a framework for coaching trainees toward these milestones using motivational interviewing as an evidence-based approach. The main objective of applying the motivational interviewing framework to the residency training setting is to facilitate clinical behavior change that meets higher level competencies/rubric. This is a work in progress and there is no manuscript/paper prepared to date. A conceptual paper/framework will be completed by the conference deadline. This is based on a separate but related development of work we have completed and published elsewhere.

Keywords: coaching, motivational interviewing, physicians, competencies

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Authors: Khabat Barkhordari

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Hepatitis delta virus (HDV) is a RNA virus that needs the function of hepatitis B virus (HBV) for its propagation and assembly. Infection by HDV can occur spontaneously with HBV infection and cause acute hepatitis or develop as secondary infection in HBV suffering patients. Based on genome sequence analysis, HDV has several genotypes which show broad geographic and diverse clinical features. The aim of current study is determine the molecular epidemiology of hepatitis delta virus genotype in patients with positive HBsAg among different ethnic groups of Iran. This systematic review study reviews the results of different studies which examined 2000 Iranian patients with HBV infection from 2010 to 2015. Among 2000 patients in this study, 16.75 % were containing anti-HDV antibody and HDV RNA was found in just 1.75% cases. All of positive cases also have genotype I.

Keywords: HDV, genotype, epidemiology, distribution

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Authors: Afaf Alharbi, Qianni Zhang

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The identification of malignant tissue in histopathological slides holds significant importance in both clinical settings and pathology research. This paper introduces a methodology aimed at automatically categorizing cancerous tissue through the utilization of a multiple-instance learning framework. This framework is specifically developed to acquire knowledge of the Bernoulli distribution of the bag label probability by employing neural networks. Furthermore, we put forward a neural network based permutation-invariant aggregation operator, equivalent to attention mechanisms, which is applied to the multi-instance learning network. Through empirical evaluation of an openly available colon cancer histopathology dataset, we provide evidence that our approach surpasses various conventional deep learning methods.

Keywords: attention multiple instance learning, MIL and transfer learning, histopathological slides, cancer tissue classification

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Authors: Harsh Thakkar, Ganesh Iyer

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In this paper, we survey various user-centered or context-based biomedical health information retrieval systems. We present and discuss the performance of systems submitted in CLEF eHealth 2014 Task 3 for this purpose. We classify and focus on comparing the two most prevalent retrieval models in biomedical information retrieval namely: Language Model (LM) and Vector Space Model (VSM). We also report on the effectiveness of using external medical resources and ontologies like MeSH, Metamap, UMLS, etc. We observed that the LM based retrieval systems outperform VSM based systems on various fronts. From the results we conclude that the state-of-art system scores for MAP was 0.4146, P@10 was 0.7560 and NDCG@10 was 0.7445, respectively. All of these score were reported by systems built on language modeling approaches.

Keywords: clinical document retrieval, concept-based information retrieval, query expansion, language models, vector space models

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Authors: Lissette Alejandra Lara, Mario Gomez, Jose Carlos Rodriguez

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ransnational corporations (TNCs) as units in which it is possible technology and knowledge transfer across borders and the potential for generating innovation and contributing in economic development both in home and host countries have been widely acknowledged in the foreign direct investment (FDI) literature. Particularly, the accelerated expansion of emerging countries TNCs in the last decades has guided an uprising research stream that measure the presence of reverse technology transfer, defined as the extent to which emerging countries’ TNCs use outward FDI in a host country through certain mechanisms to absorb and transfer knowledge thus improving its technological capabilities in the home country. The objective of this paper is to test empirically the presence of reverse technology transfer and its impact on the innovation capabilities in Mexican transnational corporations (MXTNCs) as a part of the emerging countries TNCs that have successfully entered to industrialized markets. Using a panel dataset of 22 MXTNCs over the period 1994-2015, the results of the econometric model demonstrate that the amount of Mexican outward FDI and the research and development (R&D) expenditure in host developed countries had a positive impact on the innovation capabilities at the firm and industry level. There is also evidence that management of acquired brands and the organizational structure of Mexican subsidiaries improved these capabilities. Implications for internationalization strategies of emerging countries corporations and future research guidelines are discussed.

Keywords: emerging countries, foreign direct investment, innovation capabilities, Mexican transnational corporations, reverse technology transfer

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Authors: Jacqueline Y. Thompson, Sam Watson, Lee Middleton, Karla Hemming

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Introduction: The odds ratio (estimated via logistic regression) is a well-established and common approach for estimating covariate-adjusted binary treatment effects when comparing a treatment and control group with dichotomous outcomes. Its popularity is primarily because of its stability and robustness to model misspecification. However, the situation is different for the relative risk and risk difference, which are arguably easier to interpret and better suited to specific designs such as non-inferiority studies. So far, there is no equivalent, widely acceptable approach to estimate an adjusted relative risk and risk difference when conducting clinical trials. This is partly due to the lack of a comprehensive evaluation of available candidate methods. Methods/Approach: A simulation study is designed to evaluate the performance of relevant candidate methods to estimate relative risks to represent conditional and marginal estimation approaches. We consider the log-binomial, generalised linear models (GLM) with iteratively weighted least-squares (IWLS) and model-based standard errors (SE); log-binomial GLM with convex optimisation and model-based SEs; log-binomial GLM with convex optimisation and permutation tests; modified-Poisson GLM IWLS and robust SEs; log-binomial generalised estimation equations (GEE) and robust SEs; marginal standardisation and delta method SEs; and marginal standardisation and permutation test SEs. Independent and identically distributed datasets are simulated from a randomised controlled trial to evaluate these candidate methods. Simulations are replicated 10000 times for each scenario across all possible combinations of sample sizes (200, 1000, and 5000), outcomes (10%, 50%, and 80%), and covariates (ranging from -0.05 to 0.7) representing weak, moderate or strong relationships. Treatment effects (ranging from 0, -0.5, 1; on the log-scale) will consider null (H0) and alternative (H1) hypotheses to evaluate coverage and power in realistic scenarios. Performance measures (bias, mean square error (MSE), relative efficiency, and convergence rates) are evaluated across scenarios covering a range of sample sizes, event rates, covariate prognostic strength, and model misspecifications. Potential Results, Relevance & Impact: There are several methods for estimating unadjusted and adjusted relative risks. However, it is unclear which method(s) is the most efficient, preserves type-I error rate, is robust to model misspecification, or is the most powerful when adjusting for non-prognostic and prognostic covariates. GEE estimations may be biased when the outcome distributions are not from marginal binary data. Also, it seems that marginal standardisation and convex optimisation may perform better than GLM IWLS log-binomial.

Keywords: binary outcomes, statistical methods, clinical trials, simulation study

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Authors: Gianna Zou

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Propensity score matching (PSM), introduced by Paul R. Rosenbaum and Donald Rubin in 1983, is a popular statistical matching technique which tries to estimate the treatment effects by taking into account covariates that could impact the efficacy of study medication in clinical trials. PSM can be used to reduce the bias due to confounding variables. However, PSM assumes that the response values are normally distributed. In some cases, this assumption may not be held. In this paper, a machine learning method - Bayesian Additive Regression Tree (BART), is used as a more robust method of matching. BART can work well when models are misspecified since it can be used to model heterogeneous treatment effects. Moreover, it has the capability to handle non-linear main effects and multiway interactions. In this research, a BART Matching Method (BMM) is proposed to provide a more reliable matching method over PSM. By comparing the analysis results from PSM and BMM, BMM can perform well and has better prediction capability when the response values are not normally distributed.

Keywords: BART, Bayesian, matching, regression

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Authors: Shramana Mondal

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As a city is growing in population, sprawl, and complexity, use of public spaces increases variably and thus ensuring safety for the people becomes an utmost priority. While active monitoring measures may be necessary in some places, urban design can play a major role in devising self-policing and encourage active public life. This paper aims to explore the various spatial and psychological reasons for the occurrence of crime and the role of ‘urban design’ to address this issue. In this research, the principles of urban design are examined, as well as projected on actual site by addressing the issue with urban design principles. In this review the sociological, psychological, typological and morphological factors are addressed which affect the safety of a space and the possible framing guidelines, controls and urban design strategies are explored to address a safe neighborhood. On the basis of statistical survey, the residential and street network of Malviya Nagar in Delhi is chosen as the area of demonstration. The programs inhibit a safe neighborhood and a movement network that are addressed based on the four principles of natural surveillance, territoriality, community building, and connectivity. The paper concludes with a discussion of the urban design as an effective tool by creating an intense active zone with mixed use feature to ensure throughout activity and also ensuring safe pedestrian zone by introducing sense of community feeling and territoriality thus achieving active, useful and public friendly space.

Keywords: crime, public life, safety, urban design

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Authors: M A. Habit, S. A. Syed-Sahil, A. Bahari

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Abstract—Laser cutting is a method of manufacturing process that uses laser in order to cut materials. It provides and ensures extreme accuracy which has a clean cut effect, CO2 laser dominate this application due to their good- quality beam combined with high output power. It comes with a small scale and it has a limitation in cutting sizes of materials, therefore it is more appropriate for custom- made products. The same laser cutting machine is also capable in cutting fine material such as fine silk, cotton, leather, polyester, etc. Lack of explorations and knowledge besides being unaware about this technology had caused many of the designers not to use this laser cutting method in their collections. The objectives of this study are: 1) To identify the potential of laser cutting technique in Custom-Made Garments for men’s casual wear: 2) To experiment the laser cutting technique in custom made garments: 3) To offer guidelines and formula for men’s custom- made casualwear designs with aesthetic value. In order to achieve the objectives, this research has been conducted by using mixed methods which are interviews with two (2) local experts in the apparel manufacturing industries and interviews via telephone with five (5) local respondents who are local emerging fashion designers, the questionnaires were distributed to one hundred (100) respondents around Klang Valley, in order to gain the information about their understanding and awareness regarding laser cutting technology. The experiment was conducted by using natural and man- made fibers. As a conclusion, all of the objectives had been achieved in producing custom-made men’s casualwear and with the production of these attires it will help to educate and enhance the innovation in fine technology. Therefore, there will be a good linkage and collaboration between the design experts and the manufacturing companies.

Keywords: custom-made, fashion, laser cut, men’s wear

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Authors: Vabya Kumar Pandit, Mudit Mittal, N. Prahlad Rao, Ramnath Babu

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TeamIndus is the only Indian team competing for the Google Lunar XPRIZE(GLXP). The GLXP is a global competition to challenge the private entities to soft land a rover on the moon, travel minimum 500 meters and transmit high definition images and videos to Earth. Towards this goal, the TeamIndus strategy is to design and developed lunar lander that will deliver a rover onto the surface of the moon which will accomplish GLXP mission objectives. This paper showcases the various system level noise control techniques adopted by Electrical Distribution System (EDS), to achieve the required Electromagnetic Compatibility (EMC) of the spacecraft. The design guidelines followed to control Electromagnetic Interference by proper electronic package design, grounding, shielding, filtering, and cable routing within the stipulated mass budget, are explained. The paper also deals with the challenges of achieving Electromagnetic Cleanliness in presence of various Commercial Off-The-Shelf (COTS) and In-House developed components. The methods of minimizing Electrostatic Discharge (ESD) by identifying the potential noise sources, susceptible areas for charge accumulation and the methodology to prevent arcing inside spacecraft are explained. The paper then provides the EMC requirements matrix derived from the mission requirements to meet the overall Electromagnetic compatibility of the Spacecraft.

Keywords: electromagnetic compatibility, electrostatic discharge, electrical distribution systems, grounding schemes, light weight harnessing

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Authors: Samira B. R. Prado, Paulo R. Melfi, Beatriz T. Minguzzi, João P. Fabi

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Fruit softening is the main change that occurs during papaya (Carica papaya L.) ripening. It is characterized by the depolymerization of cell wall polysaccharides, especially the pectic fractions, which causes cell wall disassembling. However, it is uncertain how the modification of the two main pectin polysaccharides fractions (water-soluble – WSF, and oxalate-soluble fractions - OSF) accounts for fruit softening. The aim of this work was to correlate molecular weight changes of WSF and OSF with the gene expression of pectin-solubilizing enzymes (pectinases) during papaya ripening. Papaya fruits obtained from a producer were harvest and storage under specific conditions. The fruits were divided in five groups according to days after harvesting. Cell walls from all groups of papaya pulp were isolated and fractionated (WSF and OSF). Expression profiles of pectinase genes were achieved according to the MIQE guidelines (Minimum Information for publication of Quantitative real-time PCR Experiments). The results showed an increased yield and a decreased molecular weight throughout ripening for WSF and OSF. Gene expression data support that papaya softening is achieved by polygalacturonases (PGs) up-regulation, in which their actions might have been facilitated by the constant action of pectinesterases (PMEs). Moreover, BGAL1 gene was up-regulated during ripening with a simultaneous galactose release, suggesting that galactosidases (GALs) could also account for pulp softening. The data suggest that a solubilization of galacturonans and a depolymerization of cell wall components were caused mainly by the action of PGs and GALs.

Keywords: carica papaya, fruit ripening, galactosidases, plant cell wall, polygalacturonases

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Authors: Eun-Chan Kim, Jeong-Hwan Oh, Seung-Guk Lee

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Billions of tones of ballast water including various aquatic organisms are being carried around the world by ships. When the ballast water is discharged into new environments, some aquatic organisms discharged with ballast water may become invasive and severely disrupt the native ecology. Thus, International Maritime Organization (IMO) adopted the Ballast Water Management Convention in 2004. Regulation A-4 of the convention states that a government in waters under their jurisdiction may grant exemptions to any requirements to ballast water management, but only when they are granted to a ship or ships on a voyage or voyages between specified ports or locations, or to a ship which operates exclusively between specified ports or locations. In order to grant exemptions, risk assessment should be conducted based on the guidelines for risk assessment developed by the IMO. For the risk assessment, it is essential to collect the relevant information and establish a database system. This paper studies the database system for ballast water risk assessment. This database consists of the shipping database, ballast water database, port environment database and species database. The shipping database has been established based on the data collected from the port management information system of Korea Government. For the ballast water database, ballast water discharge has only been estimated by the loading/unloading of the cargoes as the convention has not come into effect yet. The port environment database and species database are being established based on the reference documents, and existing and newly collected monitoring data. This database system has been approved to be a useful system, capable of appropriately analyzing the risk assessment in the all ports of Korea.

Keywords: ballast water, IMO, risk assessment, shipping, environment, species

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Authors: Basavaraj Kabade, K. T. Nagaraja, Swathi Ramanathan, A. Veeraragavan, P. S. Reashma

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Deteriorating quality of the pedestrian environment and the increasing risk of pedestrian crashes are major concerns for most of the cities in India. The recent shift in the priority to motorized transport and the abating condition of existing pedestrian facilities can be considered as prime reasons for the increasing pedestrian related crashes in India. Bengaluru City – the IT capital hub of the nation is not much different from this. The increase in number of pedestrian crashes in Bengaluru reflects the same. To resolve this issue and to ensure safe, sustainable and pedestrian friendly sidewalks, Govt. of Karnataka, India has implemented newfangled pedestrian sidewalks popularized programme named Tender S.U.R.E. (Specifications for Urban Road Execution) projects. Tender SURE adopts unique urban street design guidelines where the pedestrians are given prime preference. The present study presents an assessment of the quality and performance of the pedestrian side walk and the walkability index of the newly built pedestrian friendly sidewalks. Various physical and environmental factors affecting pedestrian safety are identified and studied in detail. The pedestrian mobility is quantified through Pedestrian Level of Service (PLoS) and the pedestrian walking comfort is measured by calculating the Walkability Index (WI). It is observed that the new initiatives taken in reference to improving pedestrian safety have succeeded in Bengaluru by attaining a level of Service of ‘A’ and with a good WI score.

Keywords: pedestrian safety, pedestrian level of service (PLoS), Right of Way (RoW), Tender S.U.R.E (Specifications for Urban Road Execution), walkability index (WI), walkway facilities

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Authors: Amar Ghelani

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People with auditory verbal hallucinations (AVH) who seek support from mental health services commonly report feeling unheard and invalidated in their interactions with social workers and psychiatric professionals. Current mental health training and clinical approaches have proven to be inadequate in addressing the complex nature of voice hearing. Childhood trauma is a key factor in the development of AVH and can render people more vulnerable to hearing both supportive and/or disturbing voices. Lived experiences of racism, poverty, and immigration are also associated with development of what is broadly classified as psychosis. Despite evidence affirming the influence of environmental factors on voice hearing, the Western biomedical system typically conceptualizes this experience as a symptom of genetically-based mental illnesses which requires diagnosis and treatment. Overemphasis on psychiatric medications, referrals, and directive approaches to people’s problems has shifted clinical interventions away from assessing and addressing problems directly related to AVH. The Maastricht approach offers voice hearers and mental health workers an alternative and respectful starting point for understanding and coping with voices. The approach was developed by voice hearers in partnership with mental health professionals and entails an innovative method to assess and create meaning from voice hearing and related life stressors. The objectives of the approach are to help people who hear voices: (1) understand the problems and/or people the voices may represent in their history, and (2) cope with distress and find solutions to related problems. The Maastricht approach has also been found to help voice hearers integrate emotional conflicts, reduce avoidance or fear associated with AVH, improve therapeutic relationships, and increase a sense of control over internal experiences. The proposed oral presentation will be guided by a recovery-oriented theoretical framework which suggests healing from psychological wounds occurs through social connections and community support systems. The presentation will start with a brainstorming exercise to identify participants pre-existing knowledge of the subject matter. This will lead into a literature review on the relations between trauma, intersectionality, and AVH. An overview of the Maastricht approach and review of research related to its therapeutic risks and benefits will follow. Participants will learn trauma-informed coping skills and questions which can help voice hearers make meaning from their experiences. The presentation will conclude with a review of resources and learning opportunities where participants can expand their knowledge of the Hearing Voices Movement and Maastricht approach.

Keywords: Maastricht interview, recovery, therapeutic assessment, voice hearing

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Authors: Amnon Shirizly, Ohad Dolev

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In recent years, the implementation and use of Metal Additive Manufacturing (AM) parts increase. As a result, the demand for bigger parts rises along with the desire to reduce it’s the production cost. Generally, in powder bed Additive Manufacturing technology the part size is limited by the machine build volume. In order to overcome this limitation, the parts can be built in one or more machine operations and mechanically joint or weld them together. An alternative option could be a production of wrought part and built on it the AM structure (mainly to reduce costs). In both cases, the mechanical properties of the interface have to be defined and recognized. In the current study, the authors introduce guidelines on how to examine the interface between wrought alloy and powder-bed AM. The mechanical and metallurgical properties of the Ti6Al4V materials (wrought alloy and powder-bed AM) and their hybrid interface were examined. The mechanical properties gain from tensile test bars in the built direction and fracture toughness samples in various orientations. The hybrid specimens were built onto a wrought Ti6Al4V start-plate. The standard fracture toughness (CT25 samples) and hybrid tensile specimens' were heat treated and milled as a post process to final diminutions. In this Study, the mechanical tensile tests and fracture toughness properties supported by metallurgical observation will be introduced and discussed. It will show that the hybrid approach of utilizing powder bed AM onto wrought material expanding the current limitation of the future manufacturing technology.

Keywords: additive manufacturing, hybrid, fracture-toughness, powder bed

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Authors: Rachel Ashwell, Sally Millett

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Introduction: Adequate post-operative pain relief is a key priority in the delivery of caesarean sections. This improves patient experience, reduces morbidity and enables optimal mother-infant interaction. Recommendations outlined in the NICE guidelines for caesarean section (CS) include offering peri-operative intrathecal/epidural diamorphine and post-operative opioid analgesics; offering non-steroidal anti-inflammatory drugs (NSAIDs) unless contraindicated and taking hourly observations for 12 hours following intrathecal diamorphine. Method: This audit assessed the provision of post-CS analgesia in 29 women over a two-week period. Indicators used were the use of intrathecal/epidural opioids, use of post-operative opioids and NSAIDs, frequency of observations and patient satisfaction with pain management on post-operative days 1 and 2. Results: All women received intrathecal/epidural diamorphine, 97% were prescribed post-operative opioids and all were prescribed NSAIDs unless contraindicated. Hourly observations were not maintained for 12 hours following intrathecal diamorphine. 97% of women were satisfied with their pain management on post-operative day 1 whereas only 75% were satisfied on day 2. Discussion: This service meets the proposed standards for the provision of post-operative analgesia, achieving high levels of patient satisfaction 1 day after CS. However, patient satisfaction levels are significantly lower on post-operative day 2, which may be due to reduced frequency of observations. The lack of an official audit standard for patient satisfaction on postoperative day 2 may result in reduced incentive to prioritise pain management at this stage.

Keywords: Caesarean section, analgesia, postoperative care, patient satisfaction

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Authors: M. A. I Perera, C. R. Wijesinghe, A. R. Weerasinghe

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his study was conducted to review and identify the unsupervised techniques that can be employed to analyze gene expression data in order to identify better subtypes of tumors. Identifying subtypes of cancer help in improving the efficacy and reducing the toxicity of the treatments by identifying clues to find target therapeutics. Process of gene expression data analysis described under three steps as preprocessing, clustering, and cluster validation. Feature selection is important since the genomic data are high dimensional with a large number of features compared to samples. Hierarchical clustering and K Means are often used in the analysis of gene expression data. There are several cluster validation techniques used in validating the clusters. Heatmaps are an effective external validation method that allows comparing the identified classes with clinical variables and visual analysis of the classes.

Keywords: cancer subtypes, gene expression data analysis, clustering, cluster validation

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Authors: Pedro Gomes, Luís Sá Castelo, António Lopes, Marta Maio, Pedro Mota, Adélia Avelar, António Marques Dias

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Introduction: Total Knee Arthroplasty (TKA) has contributed to improvement of patient`s quality of life, although it has been associated with some complications including component loosening and polyethylene wear. To prevent these complications various fixation techniques have been employed. Hybrid TKA with cemented tibial and cementless femoral components have shown favourable outcomes, although it still lack of consensus in the literature. Objectives: To evaluate the clinical and radiographic results of hybrid versus cemented TKA with an average 5 years follow-up and analyse the survival rates. Methods: A retrospective study of 125 TKAs performed in 92 patients at our institution, between 2006 to 2008, with a minimum follow-up of 2 years. The same prosthesis was used in all knees. Hybrid TKA fixation was performed in 96 knees, with a mean follow-up of 4,8±1,7 years (range, 2–8,3 years) and 29 TKAs received fully cemented fixation with a mean follow-up of 4,9±1,9 years (range, 2-8,3 years). Selection for hybrid fixation was nonrandomized and based on femoral component fit. The Oxford Knee Score (OKS 0-48) was evaluated for clinical assessment and Knee Society Roentgenographic Evaluation Scoring System was used for radiographic outcome. The survival rate was calculated using the Kaplan-Meier method, with failures defined as revision of either the tibial or femoral component for aseptic failures and all-causes (aseptic and infection). Analysis of survivorship data was performed using the log-rank test. SPSS (v22) was the computer program used for statistical analysis. Results: The hybrid group consisted of 72 females (75%) and 24 males (25%), with mean age 64±7 years (range, 50-78 years). The preoperative diagnosis was osteoarthritis (OA) in 94 knees (98%), rheumatoid arthritis (RA) in 1 knee (1%) and Posttraumatic arthritis (PTA) in 1 Knee (1%). The fully cemented group consisted of 23 females (79%) and 6 males (21%), with mean age 65±7 years (range, 47-78 years). The preoperative diagnosis was OA in 27 knees (93%), PTA in 2 knees (7%). The Oxford Knee Scores were similar between the 2 groups (hybrid 40,3±2,8 versus cemented 40,2±3). The percentage of radiolucencies seen on the femoral side was slightly higher in the cemented group 20,7% than the hybrid group 11,5% p0.223. In the cemented group there were significantly more Zone 4 radiolucencies compared to the hybrid group (13,8% versus 2,1% p0,026). Revisions for all causes were performed in 4 of the 96 hybrid TKAs (4,2%) and 1 of the 29 cemented TKAs (3,5%). The reason for revision was aseptic loosening in 3 hybrid TKAs and 1 of the cemented TKAs. Revision was performed for infection in 1 hybrid TKA. The hybrid group demonstrated a 7 years survival rate of 93% for all-cause failures and 94% for aseptic loosening. No significant difference in survivorship was seen between the groups for all-cause failures or aseptic failures. Conclusions: Hybrid TKA yields similar intermediate-term results and survival rates as fully cemented total knee arthroplasty and remains a viable option in knee joint replacement surgery.

Keywords: hybrid, survival rate, total knee arthroplasty, orthopaedic surgery

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Authors: Alissa Settembrino

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Improvisation, one of the most expressive qualities of the performing arts, has allowed for entire compositions to be created through descargas. A topic relatively understudied, these combo-inspired jam sessions originated in Cuba and intrigued jazz musicians in the United States to experiment with their improvisation after the Cool Jazz era. Through the exploration of prominent improvisation-based Cuban dance styles, the crucial jazz musicians that contributed to the progression of the descarga movement and comparing such facets to that of jazz in the United States, this paper offers a critical comparative analysis to suggest how the descarga influenced American jazz. This paper specifically focuses on harmonic construction, form and rhythmic qualities, as well as how these recorded jam sessions started to change the way people listened to and enjoyed this style of music. Examining the harmonic intricacies of descargas offers the likelihood of having influenced the construction of the blues scale in American jazz. Since these recorded jam sessions originally stemmed from Cuban dance styles (the cumbia, guaracha, rumba, etc.), descarga compositions changed the way musicians structured their improvisation to meet recording guidelines as well as their audiences’ listening needs. The ways in which the descarga inspired harmonic and rhythmic change led to the movement’s influence on the jazz culture as it progressed from Cuba to New York during the 1950s. Exploring the descarga provides insight into a movement that is not commonly studied and encourages further discussion about how certain aspects of Latin American culture have influenced the United States socially and creatively.

Keywords: descarga, harmony, improvisation, jam session, jazz

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Authors: Anna Jeon, Seung-Ho Han, Je-Hun Lee

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The aim of this study was to determine the location and distribution pattern of neurovascular structures superior and inferior to the clavicle by detailed dissection. Fifteen adult non-embalmed cadavers with a mean age of 71.5 years were studied. For measurements, the most prominent point of the sternal end of the clavicle (SEC) on anterior view and the most prominent point of the acromial end of the clavicle (AEC) were identified before dissection. A line connecting the SEC and AEC was used as a reference line. The surrounding neurovascular structures were investigated. The supraclavicular nerve was densely distributed at 71.73% on the reference line. Branches of the thoracoacromial artery were located at 76.92%. Branches of subclavian vein were evenly distributed at all sections. The subclavian vein and artery and brachial plexus were located from 31.3% to 57.5%. That area needs caution because major neurovascular structures run underneath the clavicle.

Keywords: clavicle, ORIF, neurovascular structure, anatomical study

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Authors: Sandra Landy

Abstract:

Traumatic experiences in youth are a major risk factor for future suicidality. With suicide steadily increasing over the last 20 years as one of the top three leading causes of death in children and adolescents, it is essential to examine the aspects of trauma that contribute to suicidality. A quantitative secondary data analysis of a prospective, multicenter 24-month observational study of youth who have experienced traumatic experiences was utilized to determine the relationship between bullying and suicide attempts, cyberbullying and suicide attempts, and number of traumas and suicide attempts. Data was analyzed with the Spearman-rank correlation test to determine the relationships. Findings supported past research establishing a relationship between bulling, including cyberbullying, and suicide attempts, as well as increasing number of traumatic experiences and suicide attempts. Further large scale studies may be beneficial to support these findings.

Keywords: adolescent(s), suicide, trauma, bullying, cyberbullying

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Authors: Nassim Salmi

Abstract:

Postoperative mobilization is an important part of fundamental care. Increased mobilization has a positive effect on recovery, but immobilization is still a challenge in postoperative care. Aims: To report how the establishment of a national nursing database was used to measure postoperative mobilization in patients undergoing surgery for ovarian cancer. Mobilization was defined as at least 3 hours out of bed on postoperative day 1, with the goal set at achieving this in 60% of patients. Clinical nurses on 4400 patients with ovarian cancer performed data entry. Findings: 46.7% of patients met the goal for mobilization on the first postoperative day, but variations in duration and type of mobilization were observed. Of those mobilized, 51.8% had been walking in the hallway. A national nursing database creates opportunities to optimize fundamental care. By comparing nursing data with oncological, surgical, and pathology data, it became possible to study mobilization in relation to cancer stage, comorbidity, treatment, and extent of surgery.

Keywords: postoperative care, gynecology, nursing documentation, database

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Authors: Kunthida Kulprateepunya, Napat Boontiam, Bunthita Phuasa, Chatsuda Kankayant, Bantoeng Polsawat, Sumran Poontong

Abstract:

Frailty is the thin line between good health and illness. The syndrome is more common in the elderly who transition from strong to weak. (Vulnerability). Fragility can prevent and promote healthy recovery before it goes into disability. This research and development aim to analyze the situation analysis of frailty of the elderly, develop a program, and evaluate the effect of a health promotion program to prevent and solve the problem of frailty among the elderly. The research consisted of 3 phases: 1) analysis of the frailty situation, 2) development of a model, 3) evaluation of the effectiveness of the model. Samples were 328, 122 elderlies using the multi-stage random sampling method. The research instrument was a frailty questionnaire use of the five symptoms, the main characteristics were muscle weakness, slow walking, low physical activity. Fatigue and unintentional weight loss, criteria frailty use more than or equal to three or more symptoms are frailty. Data were analyzed by descriptive and t-test dependent test statistics. The findings showed three parts. First, frailty in the elderly was 23.05 percentage and 56.70% pre-frailty. Second, it was development of a health promotion program to prevent and solve the problem of frailty the elderly with a combination of Nine-Square Exercise, Elastic Band Exercise, Elastic Coconut Shell. Third, evaluation of the effectiveness of the model by comparison of the elderly's get up and go test, the average time before using the program was 14.42 and after using the program was 8.57. It was statistically significant at the .05 level. In conclusion, the findings can used to develop guidelines to promote the health of the frailty elderly.

Keywords: elderly, fragile, nine-square exercise, elastic coconut shell

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Authors: A. Benaiche

Abstract:

In the current situation, the automobile has become the main means of locomotion. It allows traveling long distances, encouraging urban sprawl. To counteract this trend, the train is often proposed as an alternative to the car. Simultaneously, the favoring of urban development around public transport nodes such as railway stations is one of the main issues of the coordination between urban planning and transportation and the keystone of the sustainable urban development implementation. In this context, this paper focuses on the study of the spatial structuring dynamics around the railway. Specifically, it is a question of studying the demographic dynamics in rail corridors of Nantes, Angers and Le Mans (Western France) basing on the radiation of railway stations. Consequently, the methodology is concentrated on the knowledge of demographic weight and gains of these corridors, the index of urban intensity and the mobility behaviors (workers’ travels, scholars' travels, modal practices of travels). The perimeter considered to define the rail corridors includes the communes of urban area which have a railway station and communes with an access time to the railway station is less than fifteen minutes by car (time specified by the Regional Transport Scheme of Travelers). The main tools used are the statistical data from the census of population, the basis of detailed tables and databases on mobility flows. The study reveals that the population is not tightened along rail corridors and train use is minimal despite the presence of a nearby railway station. These results lead to propose guidelines to make the train, a real vector of mobility across the rail corridors.

Keywords: coordination between urban planning and transportation, rail corridors, railway stations, travels

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Authors: Kingkan Chumjamras

Abstract:

There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

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Authors: Khairi El Battawy, Monika Skalicki

Abstract:

The present investigation has been done on pure Egyptian Arabian mares that reared in private horse studs. Fifty non-pregnant mares were selected and examined to classify them as either being reproductively healthy or subfertile mares including clinical endometritis, early embryonic death, granulosa cell tumor, repeat breeder (post-breeding endometritis), and anoestrus mares. The purpose of the study was to assess oxidative/antioxidant biochemical metabolites, lipogram, trace elements and reproductive hormones throughout reproductive conditions in mares during regular estrous, anestrum, early pregnancy, granulose cell tumor, ovulation failure, and endometritis. Results showed intensification of the free radical-dependent process in the blood of infertile mare, especially mares with endometritis. Ultrasonography as a diagnostic tool diagnosis of endometritis in mares was an important step as it revealed much information concerning infertility problem.

Keywords: endometritis, ovulation, oxidative, mare

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Authors: Dereje Ferede, Solomon Negash

Abstract:

Artificial Intelligence (AI) is a key enabler and driver to transform and revolutionize the healthcare industries. However, utilizing AI and achieving these benefits is challenging for different sectors in wide-ranging, more difficult for developing economy healthcare. Due to this, real-world clinical execution and implementation of AI have not yet aged. We believe that examining the determinants is key to addressing these challenges. Furthermore, the literature does not yet particularize determinants of AI capabilities and ways of empowering the healthcare ecosystem to develop AI capabilities in a developing economy. Thus, this study aims to position AI as a digital transformation weapon for the healthcare ecosystem by examining AI capability determinants and providing insights on better empowering the healthcare industry to develop AI capabilities. To do so, we base on the technology-organization-environment (TOE) model and will apply a mixed research approach. We will conclude with recommendations based on findings for future practitioners and researchers.

Keywords: artificial intelligence, capability, digital transformation, developing economies, healthcare

Procedia PDF Downloads 242