Search results for: time difference between fajr and new moon
19747 Efficacy and Safety of Probiotic Treatment in Patients with Liver Cirrhosis: A Systematic Review and Meta-Analysis
Authors: Samir Malhotra, Rajan K. Khandotra, Rakesh K. Dhiman, Neelam Chadha
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There is paucity of data about safety and efficacy of probiotic treatment on patient outcomes in cirrhosis. Specifically, it is important to know whether probiotics can improve mortality, hepatic encephalopathy (HE), number of hospitalizations, ammonia levels, quality of life, and adverse events. Probiotics may improve outcomes in patients with acute or chronic HE. However, it is also important to know whether probiotics can prevent development of HE, even in situations where patients do not have acute HE at the time of administration. It is also important to know if probiotics are useful as primary prophylaxis of HE. We aimed to conduct an updated systematic review and meta-analysis to evaluate the safety and efficacy of probiotics in patients with cirrhosis. We searched PubMed, Cochrane library, Embase, Scopus, SCI, Google Scholar, conference proceedings, and references of included studies till June 2017 to identify randomised clinical trials comparing probiotics with other treatments in cirrhotics. Data was analyzed using MedCalc. Probiotics had no effect on mortality but significantly reduced HE (14 trials, 1073 patients, OR 0.371; 95% CI 0.282 to 0.489). There was not enough data to conduct a meta-analysis on outcomes like hospitalizations and quality of life. The effect on plasma ammonia levels was not significant (SMD -0.429; 95%CI -1.034 – 0.177). There was no difference in adverse events. To conclude, although the included studies had a high risk of bias, the available evidence does suggest a beneficial effect on HE. Larger studies with longer periods of follow-up are needed to determine if probiotics can reduce all-cause mortality.Keywords: cirrhosis, hepatic encephalopathy, meta-analysis, probiotic
Procedia PDF Downloads 20119746 Queueing Modeling of M/G/1 Fault Tolerant System with Threshold Recovery and Imperfect Coverage
Authors: Madhu Jain, Rakesh Kumar Meena
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This paper investigates a finite M/G/1 fault tolerant multi-component machining system. The system incorporates the features such as standby support, threshold recovery and imperfect coverage make the study closer to real time systems. The performance prediction of M/G/1 fault tolerant system is carried out using recursive approach by treating remaining service time as a supplementary variable. The numerical results are presented to illustrate the computational tractability of analytical results by taking three different service time distributions viz. exponential, 3-stage Erlang and deterministic. Moreover, the cost function is constructed to determine the optimal choice of system descriptors to upgrading the system.Keywords: fault tolerant, machine repair, threshold recovery policy, imperfect coverage, supplementary variable technique
Procedia PDF Downloads 29319745 Of an 80 Gbps Passive Optical Network Using Time and Wavelength Division Multiplexing
Authors: Malik Muhammad Arslan, Muneeb Ullah, Dai Shihan, Faizan Khan, Xiaodong Yang
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Internet Service Providers are driving endless demands for higher bandwidth and data throughput as new services and applications require higher bandwidth. Users want immediate and accurate data delivery. This article focuses on converting old conventional networks into passive optical networks based on time division and wavelength division multiplexing. The main focus of this research is to use a hybrid of time-division multiplexing and wavelength-division multiplexing to improve network efficiency and performance. In this paper, we design an 80 Gbps Passive Optical Network (PON), which meets the need of the Next Generation PON Stage 2 (NGPON2) proposed in this paper. The hybrid of the Time and Wavelength division multiplexing (TWDM) is said to be the best solution for the implementation of NGPON2, according to Full-Service Access Network (FSAN). To co-exist with or replace the current PON technologies, many wavelengths of the TWDM can be implemented simultaneously. By utilizing 8 pairs of wavelengths that are multiplexed and then transmitted over optical fiber for 40 Kms and on the receiving side, they are distributed among 256 users, which shows that the solution is reliable for implementation with an acceptable data rate. From the results, it can be concluded that the overall performance, Quality Factor, and bandwidth of the network are increased, and the Bit Error rate is minimized by the integration of this approach.Keywords: bit error rate, fiber to the home, passive optical network, time and wavelength division multiplexing
Procedia PDF Downloads 7219744 Real Time Lidar and Radar High-Level Fusion for Obstacle Detection and Tracking with Evaluation on a Ground Truth
Authors: Hatem Hajri, Mohamed-Cherif Rahal
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Both Lidars and Radars are sensors for obstacle detection. While Lidars are very accurate on obstacles positions and less accurate on their velocities, Radars are more precise on obstacles velocities and less precise on their positions. Sensor fusion between Lidar and Radar aims at improving obstacle detection using advantages of the two sensors. The present paper proposes a real-time Lidar/Radar data fusion algorithm for obstacle detection and tracking based on the global nearest neighbour standard filter (GNN). This algorithm is implemented and embedded in an automative vehicle as a component generated by a real-time multisensor software. The benefits of data fusion comparing with the use of a single sensor are illustrated through several tracking scenarios (on a highway and on a bend) and using real-time kinematic sensors mounted on the ego and tracked vehicles as a ground truth.Keywords: ground truth, Hungarian algorithm, lidar Radar data fusion, global nearest neighbor filter
Procedia PDF Downloads 17419743 Learning Preference in Nursing Students at Boromarajonani College of Nursing Chon Buri
Authors: B. Wattanakul, G. Ngamwongwan, S. Ngamkham
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Exposure to different learning experiences contributes to changing in learning style. Addressing students’ learning preference could help teachers provide different learning activities that encourage the student to learn effectively. Purpose: The purpose of this descriptive study was to describe learning styles of nursing students at Boromarajonani College of Nursing Chon Buri. Sample: The purposive sample was 463 nursing students who were enrolled in a nursing program at different academic levels. The 16-item VARK questionnaire with 4 multiple choices was administered at one time data collection. Choices have consisted with modalities of Visual, Aural, Read/write, and Kinesthetic measured by VARK. Results: Majority of learning preference of students at different levels was visual and read/write learning preference. Almost 67% of students have a multimodal preference, which is visual learning preference associated with read/write or kinesthetic preference. At different academic levels, multimodalities are greater than single preference. Over 30% of students have one dominant learning preference, including visual preference, read/write preference and kinesthetic preference. Analysis of Variance (ANOVA) with Bonferroni adjustment revealed a significant difference between students based on their academic level (p < 0.001). Learning style of the first-grade nursing students differed from the second-grade nursing students (p < 0.001). While learning style of nursing students in the second-grade has significantly varied from the 1st, 3rd, and 4th grade (p < 0.001), learning preference of the 3rd grade has significantly differed from the 4th grade of nursing students (p > 0.05). Conclusions: Nursing students have varied learning styles based on their different academic levels. Learning preference is not fixed attributes. This should help nursing teachers assess the types of changes in students’ learning preferences while developing teaching plans to optimize students’ learning environment and achieve the needs of the courses and help students develop learning preference to meet the need of the course.Keywords: learning preference, VARK, learning style, nursing
Procedia PDF Downloads 35919742 Effect of Feed Supplement Optipartum C+ 200 (Alfa- Amylase and Beta-Glucanase) in In-Line Rumination Parameters
Authors: Ramūnas Antanaitis, Lina Anskienė, Robertas Stoškus
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This study was conducted during 2021.05.01 – 2021.08.31 at the Lithuanian University of health sciences and one Lithuanian dairy farm with 500 dairy cows (55.911381565736, 21.881321760608195). Average calving – 50 cows per month. Cows (n=20) in the treatment group (TG) were fed with feed supplement Optipartum C+ 200 (Enzymes: Alfa- Amylase 57 Units; Beta-Glucanase 107 Units) from 21 days before calving till 30 days after calving with feeding rate 200g/cow/day. Cows in the control group (CG) were fed a feed ration without feed supplement. Measurements started from 6 days before calving and continued till 21 days after calving. The following indicators were registered: with the RumiWatch System: Rumination time; Eating time; Drinking time; Rumination chews; Eating chews; Drinking gulps; Bolus; Chews per minute; Chews per bolus. With SmaXtec system - the temperature, pH of the contents of cows' reticulorumens and cows' activity. According to our results, we found that feeding of cows, from 21 days before calving to 30 days after calving, with a feed supplement with alfa- amylase and beta-glucanase (Optipartum C+ 200) (with dose 200g/cow/day) can produce an increase in: 9% rumination time and eating time, 19% drinking time, 11% rumination chews, 16% eating chews,13% number of boluses per rumination, 5% chews per minute and 16% chews per bolus. We found 1.28 % lower reiticulorumen pH and 0.64% lower reticulorumen temperature in cows fed with the supplement compared with control group cows. Also, cows feeding with enzymes were 8.80% more active.Keywords: Alfa-Amylase, Beta-Glucanase, cows, in-line, sensors
Procedia PDF Downloads 32819741 Theoretical Appraisal of Satisfactory Decision: Uncertainty, Evolutionary Ideas and Beliefs, Satisfactory Time Use
Authors: Okay Gunes
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Unsatisfactory experiences due to an information shortage regarding the future pay-offs of actual choices, yield satisficing decision-making. This research will examine, for the first time in the literature, the motivation behind suboptimal decisions due to uncertainty by subjecting Adam Smith’s and Jeremy Bentham’s assumptions about the nature of the actions that lead to satisficing behavior, in order to clarify the theoretical background of a “consumption-based satisfactory time” concept. The contribution of this paper with respect to the existing literature is threefold: Firstly, it is showed in this paper that Adam Smith’s uncertainty is related to the problem of the constancy of ideas and not related directly to beliefs. Secondly, possessions, as in Jeremy Bentham’s oeuvre, are assumed to be just as pleasing, as protecting and improving the actual or expected quality of life, so long as they reduce any displeasure due to the undesired outcomes of uncertainty. Finally, each consumption decision incurs its own satisfactory time period, owed to not feeling hungry, being healthy, not having transportation…etc. This reveals that the level of satisfaction is indeed a behavioral phenomenon where its value would depend on the simultaneous satisfaction derived from all activities.Keywords: decision-making, idea and belief, satisficing, uncertainty
Procedia PDF Downloads 28819740 Part Performance Improvement through Design Optimisation of Cooling Channels in the Injection Moulding Process
Authors: M. A. Alhubail, A. I. Alateyah, D. Alenezi, B. Aldousiri
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In this study conformal cooling channel (CCC) was employed to dissipate heat of, Polypropylene (PP) parts injected into the Stereolithography (SLA) insert to form tensile and flexural test specimens. The direct metal laser sintering (DMLS) process was used to fabricate a mould with optimised CCC, while optimum parameters of injection moulding were obtained using Optimal-D. The obtained results show that optimisation of the cooling channel layout using a DMLS mould has significantly shortened cycle time without sacrificing the part’s mechanical properties. By applying conformal cooling channels, the cooling time phase was reduced by 20 seconds, and also defected parts were eliminated.Keywords: optimum parameters, injection moulding, conformal cooling channels, cycle time
Procedia PDF Downloads 22919739 Analysis and Simulation of TM Fields in Waveguides with Arbitrary Cross-Section Shapes by Means of Evolutionary Equations of Time-Domain Electromagnetic Theory
Authors: Ömer Aktaş, Olga A. Suvorova, Oleg Tretyakov
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The boundary value problem on non-canonical and arbitrary shaped contour is solved with a numerically effective method called Analytical Regularization Method (ARM) to calculate propagation parameters. As a result of regularization, the equation of first kind is reduced to the infinite system of the linear algebraic equations of the second kind in the space of L2. This equation can be solved numerically for desired accuracy by using truncation method. The parameters as cut-off wavenumber and cut-off frequency are used in waveguide evolutionary equations of electromagnetic theory in time-domain to illustrate the real-valued TM fields with lossy and lossless media.Keywords: analytical regularization method, electromagnetic theory evolutionary equations of time-domain, TM Field
Procedia PDF Downloads 50119738 Communication of Expected Survival Time to Cancer Patients: How It Is Done and How It Should Be Done
Authors: Geir Kirkebøen
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Most patients with serious diagnoses want to know their prognosis, in particular their expected survival time. As part of the informed consent process, physicians are legally obligated to communicate such information to patients. However, there is no established (evidence based) ‘best practice’ for how to do this. The two questions explored in this study are: How do physicians communicate expected survival time to patients, and how should it be done? We explored the first, descriptive question in a study with Norwegian oncologists as participants. The study had a scenario and a survey part. In the scenario part, the doctors should imagine that a patient, recently diagnosed with a serious cancer diagnosis, has asked them: ‘How long can I expect to live with such a diagnosis? I want an honest answer from you!’ The doctors should assume that the diagnosis is certain, and that from an extensive recent study they had optimal statistical knowledge, described in detail as a right-skewed survival curve, about how long such patients with this kind of diagnosis could be expected to live. The main finding was that very few of the oncologists would explain to the patient the variation in survival time as described by the survival curve. The majority would not give the patient an answer at all. Of those who gave an answer, the typical answer was that survival time varies a lot, that it is hard to say in a specific case, that we will come back to it later etc. The survey part of the study clearly indicates that the main reason why the oncologists would not deliver the mortality prognosis was discomfort with its uncertainty. The scenario part of the study confirmed this finding. The majority of the oncologists explicitly used the uncertainty, the variation in survival time, as a reason to not give the patient an answer. Many studies show that patients want realistic information about their mortality prognosis, and that they should be given hope. The question then is how to communicate the uncertainty of the prognosis in a realistic and optimistic – hopeful – way. Based on psychological research, our hypothesis is that the best way to do this is by explicitly describing the variation in survival time, the (usually) right skewed survival curve of the prognosis, and emphasize to the patient the (small) possibility of being a ‘lucky outlier’. We tested this hypothesis in two scenario studies with lay people as participants. The data clearly show that people prefer to receive expected survival time as a median value together with explicit information about the survival curve’s right skewedness (e.g., concrete examples of ‘positive outliers’), and that communicating expected survival time this way not only provides people with hope, but also gives them a more realistic understanding compared with the typical way expected survival time is communicated. Our data indicate that it is not the existence of the uncertainty regarding the mortality prognosis that is the problem for patients, but how this uncertainty is, or is not, communicated and explained.Keywords: cancer patients, decision psychology, doctor-patient communication, mortality prognosis
Procedia PDF Downloads 33419737 Comparison of Donor Motivations in National Collegiate Athletic Association Division I vs Division II
Authors: Soojin Kim, Yongjae Kim
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Continuous economic downturn and ongoing budget cuts poses higher education with profound challenges which has a direct impact on the collegiate athletic programs. In response to the ever-changing landscape of the fiscal environment, universities seek to boost revenues, resorting to alternative sources of funding. In particular, athletic programs have become increasingly dependent on financial support from their alumni and boosters, which is how athletic departments attempt to offset budget shortfalls and make capital improvements. Although there currently exists three major divisions within National Collegiate Athletic Association (NCAA), the majority of the sport management studies on college sport tend to focus on Division I level. Particularly within the donor motivation literature, a plethora of donor motivation studies exist, but mainly on NCAA Division I athletic programs. Since each athletic department functions differently in a number of different dimensions, while institutional difference can also have a huge impact on athletic donor motivations, the current study attempts to fill this gap that exists in the literature. As such, the purpose of this study was to (I) reexamine the factor structure of the Athletic Donor motivation scale; and (II) identify the prominent athletic donor motives in a NCAA Division II athletic program. For the purpose of this study, a total of 232 actual donors were used for analysis. A confirmatory factor analysis (CFA) was employed to test construct validity, and the reliability of the scale was assessed using Composite Reliability. To identify the prominent motivational factors, the means and standard deviations were examined. Results of this study indicated that Vicarious Achievement, Philanthropy, and Commitment are the three primary motivational factors, while Tangible Benefits, was consistently found as an important motive in prior studies was found low. Such findings highlight the key difference and suggest different salient motivations exist that are specific to the context.Keywords: college athletics, donor, motivation, NCAA
Procedia PDF Downloads 14719736 A Simple Recursive Framework to Generate Gray Codes for Weak Orders in Constant Amortized Time
Authors: Marsden Jacques, Dennis Wong
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A weak order is a way to rank n objects where ties are allowed. In this talk, we present a recursive framework to generate Gray codes for weak orders. We then describe a simple algorithm based on the framework that generates 2-Gray codes for weak orders in constant amortized time per string. This framework can easily be modified to generate other Gray codes for weak orders. We provide an example on using the framework to generate the first Shift Gray code for weak orders, also in constant amortized time, where consecutive strings differ by a shift or a symbol change.Keywords: weak order, Cayley permutation, Gray code, shift Gray code
Procedia PDF Downloads 18119735 Relation of Mean Platelet Volume with Serum Paraoxonase-1 Activity and Brachial Artery Diameter and Intima Media Thickness in Diabetic Patients with Respect to Obesity and Diabetic Complications
Authors: Pınar Karakaya, Meral Mert, Yildiz Okuturlar, Didem Acarer, Asuman Gedikbasi, Filiz Islim, Teslime Ayaz, Ozlem Soyluk, Ozlem Harmankaya, Abdulbaki Kumbasar
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Objective: To evaluate the relation of mean platelet volume (MPV) levels with serum paraoxonase-1 activity and brachial artery diameter and intima media thickness in diabetic patients with respect to obesity and diabetic complications. Methods: A total of 201 diabetic patients grouped with respect to obesity [obese (n=89) and non-obese (n=112) and diabetic complications [with (n=50) or without (n=150) microvascular complications and with (n=91) or without (n=108) macrovascular complications] groups were included. Data on demographic and lifestyle characteristics of patients, anthropometric measurements, diabetes related microvascular and macrovascular complications, serum levels for MPV, bBrachial artery diameter and intima media thickness (IMT) and serum paraoxonase and arylesterase activities were recorded. Correlation of MPV values to paraoxonase and arylesterase activities as well as to brachial artery diameter and IMT was evaluated in study groups. Results: Mean(SD) paraoxonase and arylesterase values were 119.8(37.5) U/L and 149.0(39.9) U/L, respectively in the overall population with no significant difference with respect to obesity and macrovascular diabetic complications, whereas significantly lower values for paraoxonase (107.5(30.7) vs. 123.9(38.8) U/L, p=0.007) and arylesterase (132.1(30.2) vs. 154.7(41.2) U/L, p=0.001) were noted in patients with than without diabetic microvascular complications. Mean(SD) MPV values were 9.10 (0.87) fL in the overall population with no significant difference with respect to obesity and diabetic complications. No significant correlation of MPV values to paraoxonase, arylesterase activities, to brachial artery diameter and IMT was noted in the overall study population as well as in study groups. Conclusion: In conclusion, our findings revealed a significant decrease I PON-1 activity in diabetic patients with microvascular rather than macrovascular complications, whereas regardless of obesity and diabetic complications, no increase in thrombogenic activity and no relation of thrombogenic activity with PON-1 activity and brachial artery diameter and IMK.Keywords: atherosclerosis, diabetes mellitus, microvascular complications, macrovascular complications, obesity, paraoxonase
Procedia PDF Downloads 35619734 Time-Domain Expressions for Bridge Self-Excited Aerodynamic Forces by Modified Particle Swarm Optimizer
Authors: Hao-Su Liu, Jun-Qing Lei
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This study introduces the theory of modified particle swarm optimizer and its application in time-domain expressions for bridge self-excited aerodynamic forces. Based on the indicial function expression and the rational function expression in time-domain expression for bridge self-excited aerodynamic forces, the characteristics of the two methods, i.e. the modified particle swarm optimizer and conventional search method, are compared in flutter derivatives’ fitting process. Theoretical analysis and numerical results indicate that adopting whether the indicial function expression or the rational function expression, the fitting flutter derivatives obtained by modified particle swarm optimizer have better goodness of fit with ones obtained from experiment. As to the flutter derivatives which have higher nonlinearity, the self-excited aerodynamic forces, using the flutter derivatives obtained through modified particle swarm optimizer fitting process, are much closer to the ones simulated by the experimental. The modified particle swarm optimizer was used to recognize the parameters of time-domain expressions for flutter derivatives of an actual long-span highway-railway truss bridge with double decks at the wind attack angle of 0°, -3° and +3°. It was found that this method could solve the bounded problems of attenuation coefficient effectively in conventional search method, and had the ability of searching in unboundedly area. Accordingly, this study provides a method for engineering industry to frequently and efficiently obtain the time-domain expressions for bridge self-excited aerodynamic forces.Keywords: time-domain expressions, bridge self-excited aerodynamic forces, modified particle swarm optimizer, long-span highway-railway truss bridge
Procedia PDF Downloads 31919733 Congestion Mitigation on an Urban Arterial through Infrastructure Intervention
Authors: Attiq Ur Rahman Dogar, Sohaib Ishaq
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Pakistan had experienced rapid motorization in the last decade. Due to the soft leasing schemes of banks and increase in average household income, even the middle class can now afford cars. The public transit system is inadequate and sparse. Due to these reasons, traffic demand on urban arterials has increased manifold. Poor urban transit planning and aging transportation systems have resulted in traffic congestion. The focus of this study is to improve traffic flow on a section of N-5 passing through the Rawalpindi downtown. Present efforts aim to carry out the analysis of traffic conditions on this section and to investigate the impact of traffic signal co-ordination on travel time. In addition to signal co-ordination, we also examined the effect of different infrastructure improvements on the travel time. After the economic analysis of alternatives and discussions, the improvement plan for Rawalpindi downtown urban arterial section is proposed for implementation.Keywords: signal coordination, infrastructure intervention, infrastructure improvement, cycle length, fuel consumption cost, travel time cost, economic analysis, travel time, Rawalpindi, Pakistan, traffic signals
Procedia PDF Downloads 31719732 Socioeconomic Burden of Life Long Disease: A Case of Diabetes Care in Bangladesh
Authors: Samira Humaira Habib
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Diabetes has profound effects on individuals and their families. If diabetes is not well monitored and managed, then it leads to long-term complications and a large and growing cost to the health care system. Prevalence and socioeconomic burden of diabetes and relative return of investment for the elimination or the reduction of the burden are much more important regarding its cost burden. Various studies regarding the socioeconomic cost burden of diabetes are well explored in developed countries but almost absent in developing countries like Bangladesh. The main objective of the study is to estimate the total socioeconomic burden of diabetes. It is a prospective longitudinal follow up study which is analytical in nature. Primary and secondary data are collected from patients who are undergoing treatment for diabetes at the out-patient department of Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine & Metabolic Disorders (BIRDEM). Of the 2115 diabetic subjects, females constitute around 50.35% of the study subject, and the rest are male (49.65%). Among the subjects, 1323 are controlled, and 792 are uncontrolled diabetes. Cost analysis of 2115 diabetic patients shows that the total cost of diabetes management and treatment is US$ 903018 with an average of US$ 426.95 per patient. In direct cost, the investigation and medical treatment at hospital along with investigation constitute most of the cost in diabetes. The average cost of a hospital is US$ 311.79, which indicates an alarming warn for diabetic patients. The indirect cost shows that cost of productivity loss (US$ 51110.1) is higher among the all indirect item. All constitute total indirect cost as US$ 69215.7. The incremental cost of intensive management of uncontrolled diabetes is US$ 101.54 per patient and event-free time gained in this group is 0.55 years and the life years gain is 1.19 years. The incremental cost per event-free year gained is US$ 198.12. The incremental cost of intensive management of the controlled group is US$ 89.54 per patient and event-free time gained is 0.68 years, and the life year gain is 1.12 years. The incremental cost per event-free year gained is US$ 223.34. The EuroQoL difference between the groups is found to be 64.04. The cost-effective ratio is found to be US$ 1.64 cost per effect in case of controlled diabetes and US$ 1.69 cost per effect in case of uncontrolled diabetes. So management of diabetes is much more cost-effective. Cost of young type 1 diabetic patient showed upper socioeconomic class, and with the increase of the duration of diabetes, the cost increased also. The dietary pattern showed macronutrients intake and cost are significantly higher in the uncontrolled group than their counterparts. Proper management and control of diabetes can decrease the cost of care for the long term.Keywords: cost, cost-effective, chronic diseases, diabetes care, burden, Bangladesh
Procedia PDF Downloads 14719731 Comparison of Medical Students Evaluation by Serious Games and Clinical Case-Multiple Choice Questions
Authors: Chamtouri I., Kechida M.
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Background: Evaluation has a prominent role in medical education and graduation. This evaluation has usually done in face-to-face, by written or oral questions. Simulation is increasingly taking a part as a method of evaluation. Due to the Covid-19 pandemic, which disrupted face-to-face evaluation, simulation using serious games (SG) is emerging in the field of training and assessment of medical students. The aim of our study is to compare the results of the evaluation of medical students by virtual simulation by online serious games versus clinical case-multiple choice questions (MCQ) and to assess the degree of satisfaction from these two evaluation methods. Methods: Medical students from the same study level were voluntarily participated in this study. Groupe 1 had an evaluation by SG dealing with “diagnosis and management of ST-segment elevationmyocardialinfarction (STEMI)alreadyprepared on the website www.Mediactiv.com. Groupe 2 were evaluated by clinical case-MCQ having thes same topic as SG. Results of the two groups were compared. Satisfaction questionnaire was filled by the two groups. Satisfaction degree was compared between the two groups. Results. In this study, 64 medical students (G1:31 and G2: 33) were enrolled. Obtaining complete notes in the "questioning" and "clinical examination" parts is significantly more important in-group 1 compared to group 2. No significant difference detected between the two groups in terms of “ECG interpretation” and “diagnosis of STEMI” parts. A greater number of students of group 1 obtained the full note compared to group 2 in “the initial treatment part” (54.8% vs. 39.4%; p = 0.04). Thirty learners (96.8%) in-group 1 obtained a total score ≥ 50% versus 69.7% in-group 2 (p = 0.004). The full score of 100% was obtained in three learners in-group1, while no student scored 100% in-group2 (p = 0.027). Medical evaluation using SG was reported as more innovative, fun, and realistic compared to evaluation by clinical case-MCQ. No significant difference detected between the two methods in terms of stress. Conclusion: Simulation by SG can be considered as an innovative and effective method in evaluating medical students with a higher degree of satisfaction.Keywords: evaluation, serious games, medical students, satisfaction
Procedia PDF Downloads 14219730 The Efficacy of Pre-Hospital Packed Red Blood Cells in the Treatment of Severe Trauma: A Retrospective, Matched, Cohort Study
Authors: Ryan Adams
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Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine
Procedia PDF Downloads 39419729 Effect of Preconception Picture-Based Nutrition Education on Knowledge and Adherence to Iron-Folic Acid Supplementation Among Women Planning to Be Pregnant in Ethiopia
Authors: Anteneh Berhane Yeyi, Tefera Belachew
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Any woman who could become pregnant is at risk of having a baby with neural tube defects (NTDs). A spontaneous aborted women with immediately preceding pregnancy may have an increased risk of develop NTDs. Ethiopia has one of the highest rates of micronutrient deficiencies, including folate and iron deficiency. Currently, in Ethiopia, NTDs is emerged as a public health concern. Even if Ethiopia, has implement different strategies for reducing maternal and neonatal mortality and morbidity, there is no room in the health care system and lack of integration for preventing the risk of NTDs for those women who aborted spontaneously and women who discontinue long acting contraception to become pregnant. The purpose of this study was to evaluate the effect of preconception picture-based nutrition education on knowledge and adherence to iron-folic acid supplement (IFAS) intake to reduce the risk of developing neural tube defects (NTDs) and iron deficiency anemia (IDA) among women who had a planned to pregnancy in Ethiopia, a country with a high burden of NTDs. Methodology: This study was conducted in Eastern Ethiopia. A double blinded parallel randomized controlled trial design was employed among women in the age group of 18-45 years who requested to interrupt modern contraceptive who have an intention to be pregnant and women with spontaneous abortion who refused to take a contraceptive. The interventional arm (n=122) received a preconception picture-based nutrition education with iron-folic acid supplement, and the control arm (n=122) received only preconception IFAS. In this study male partners were participated. Result: After three months of intervention the proportion of adherence to IFAS was 23% (n=56). With regard to adherence within the groups, 42.6% (n=52) in the intervention group and 3.3% (n=4) in the control group and the intervention group were significantly higher than in control group. In the intervention group the proportion of adherence to IFAS intake among participants increased by 40.1% and there were statistically difference (P<0.0001). The difference in difference between the two groups of adherence to IFAS intake was 37.6% and there were a statistical significance (P<0.0001). Level of knowledge between the groups did differ before and after intervention (P= 0.87 Vs P<0.0001). The overall the mean change in knowledge Mean (+SE) between group was 0.9 (+3.04 SE) and there were significant differences between two groups (P<0.001). Conclusion: In general this intervention is effective toward adherence to IFAS and a critical milestone to improve maternal health and reduce the neonate mortality due to NTDs and other advert effect of pregnancy and birth outcomes. This intervention is very short, simple, and cost effective and has potential for adaptation, feasible development to large-scale implementation in the existing health care system. Furthermore, this type of interventional approach has the potential to reduce the country's ANC program dropout rates and increase male partner’s participation on reproductive health.Keywords: NTDs, IFAS, WRA, Ethiopia
Procedia PDF Downloads 3719728 Adaptive Data Approximations Codec (ADAC) for AI/ML-based Cyber-Physical Systems
Authors: Yong-Kyu Jung
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The fast growth in information technology has led to de-mands to access/process data. CPSs heavily depend on the time of hardware/software operations and communication over the network (i.e., real-time/parallel operations in CPSs (e.g., autonomous vehicles). Since data processing is an im-portant means to overcome the issue confronting data management, reducing the gap between the technological-growth and the data-complexity and channel-bandwidth. An adaptive perpetual data approximation method is intro-duced to manage the actual entropy of the digital spectrum. An ADAC implemented as an accelerator and/or apps for servers/smart-connected devices adaptively rescales digital contents (avg.62.8%), data processing/access time/energy, encryption/decryption overheads in AI/ML applications (facial ID/recognition).Keywords: adaptive codec, AI, ML, HPC, cyber-physical, cybersecurity
Procedia PDF Downloads 8019727 Self-Selected Intensity and Discounting Rates of Exercise in Comparison with Food and Money in Healthy Adults
Authors: Tamam Albelwi, Robert Rogers, Hans-Peter Kubis
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Background: Exercise is widely acknowledged as a highly important health behavior, which reduces risks related to lifestyle diseases like type 2 diabetes, cardiovascular disease. However, exercise adherence is low in high-risk groups and sedentary lifestyle is more the norm than the exception. Expressed reasons for exercise participation are often based on delayed outcomes related to health threats and benefits but also enjoyment. Whether exercise is perceived as rewarding is well established in animal literature but the evidence is sparse in humans. Additionally, the question how stable any reward is perceived with time delays is an important question influencing decision-making (in favor or against a behavior). For the modality exercise, this has not been examined before. We, therefore, investigated the discounting of pre-established self-selected exercise compared with established rewards of food and money with a computer-based discounting paradigm. We hypothesized that exercise will be discounted like an established reward (food and money); however, we expect that the discounting rate is similar to a consumable reward like food. Additionally, we expected that individuals’ characteristics like preferred intensity, physical activity and body characteristics are associated with discount rates. Methods: 71 participants took part in four sessions. The sessions were designed to let participants select their preferred exercise intensity on a treadmill. Participants were asked to adjust their speed for optimizing pleasantness over an exercise period of up to 30 minutes, heart rate and pleasantness rating was measured. In further sessions, the established exercise intensity was modified and tested on perceptual validity. In the last exercise session rates of perceived exertion was measured on the preferred intensity level. Furthermore, participants filled in questionnaires related to physical activity, mood, craving, and impulsivity and answered choice questions on a bespoke computer task to establish discounting rates of their preferred exercise (kex), their favorite food (kfood) and a value-matching amount of money (kmoney). Results: Participants self-selected preferred speed was 5.5±2.24 km/h, at a heart rate of 120.7±23.5, and perceived exertion scale of 10.13±2.06. This shows that participants preferred a light exercise intensity with low to moderate cardiovascular strain based on perceived pleasantness. Computer assessment of discounting rates revealed that exercise was quickly discounted like a consumable reward, no significant difference between kfood and kex (kfood =0.322±0.263; kex=0.223±0.203). However, kmoney (kmoney=0.080±0.02) was significantly lower than the rates of exercise and food. Moreover, significant associations were found between preferred speed and kex (r=-0.302) and between physical activity levels and preferred speed (r=0.324). Outcomes show that participants perceived and discounted self-selected exercise like an established reward (food and money) but was discounted more like consumable rewards. Moreover, exercise discounting was quicker in individuals who preferred lower speeds, being less physically active. This may show that in a choice conflict between exercise and food the delay of exercise (because of distance) might disadvantage exercise as the chosen behavior particular in sedentary people. Conclusion: exercise can be perceived as a reward and is discounted quickly in time like food. Pleasant exercise experience is connected to low to moderate cardiovascular and perceptual strain.Keywords: delay discounting, exercise, temporal discounting, time perspective
Procedia PDF Downloads 27219726 The Role Support Groups Play in Decreasing Depression and PTSD in Cancer Survivors: A Literature Review
Authors: Julianne Macmullen
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Due to advances in technology and early detection and treatment of cancer, many cancer patients are surviving longer than five years post-diagnosis. Most cancer patients suffer from depression, anxiety, and post-traumatic stress disorder (PTSD) at some point during diagnosis, treatment, and survivorship. A subgroup of patients will continue to suffer from depression and PTSD and require early intervention. Support groups provide patients with the emotional and informational support they require while also giving survivors a sense of community, friendship, and purpose. This type of support is recognized by researchers to improve the quality of life while also decreasing depression and PTSD symptoms. The gaps in the literature include cultural diversity, minorities, and support groups involving cancer types other than breast cancer. Another gap in the literature includes the perceptions of cancer patients as well as longitudinal studies to determine the relationships between support groups and decreased depression and PTSD rates over time. Future research is required to fill the gaps in the literature mentioned previously. Future research is also needed to analyze the difference in age groups and different types of support groups such as professionally-led, peer-led, and online. Implications for practice involve providers assessing for the symptoms of depression and PTSD in order to offer prompt treatment and support services to those patients. In conclusion, social support by way of support groups improves the quality of life, gives survivors a sense of purpose to help others while also gaining the support they need, and reduces the rate of depressive episodes related to PTSD.Keywords: cancer survivor, survivorship, post-traumatic stress disorder (PTSD), depression, support groups
Procedia PDF Downloads 17819725 Impact of Global Warming on the Total Flood Duration and Flood Recession Time in the Meghna Basin Using Hydrodynamic Modelling
Authors: Karan Gupta
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The floods cause huge loos each year, and their impact gets manifold with the increase of total duration of flood as well as recession time. Moreover, floods have increased in recent years due to climate change in floodplains. In the context of global climate change, the agreement in Paris convention (2015) stated to keep the increase in global average temperature well below 2°C and keep it at the limit of 1.5°C. Thus, this study investigates the impact of increasing temperature on the stage, discharge as well as total flood duration and recession time in the Meghna River basin in Bangladesh. This study considers the 100-year return period flood flows in the Meghna river under the specific warming levels (SWLs) of 1.5°C, 2°C, and 4°C. The results showed that the rate of increase of duration of flood is nearly 50% lesser at ∆T = 1.5°C as compared to ∆T = 2°C, whereas the rate of increase of duration of recession is 75% lower at ∆T = 1.5°C as compared to ∆T = 2°C. Understanding the change of total duration of flood as well as recession time of the flood gives a better insight to effectively plan for flood mitigation measures.Keywords: flood, climate change, Paris convention, Bangladesh, inundation duration, recession duration
Procedia PDF Downloads 14219724 Inventory Control for Purchased Part under Long Lead Time and Uncertain Demand: MRP vs Demand-Driven MRP Approach
Authors: M. J. Shofa, A. Hidayatno, O. M. Armand
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MRP as a production control system is appropriate for the deterministic environment. Unfortunately, most production systems such as customer demands are stochastic. Demand-Driven MRP (DDMRP) is a new approach for inventory control system, and it deals with demand uncertainty. The objective of this paper is to compare the MRP and DDMRP work for a long lead time and uncertain demand in terms of on-hand inventory levels. The evaluation is conducted through a discrete event simulation using purchased part data from an automotive company. The result is MRP gives 50,759 pcs / day while DDMRP gives 34,835 pcs / day (reduce 32%), it means DDMRP is more effective inventory control than MRP in terms of on-hand inventory levels.Keywords: Demand-Driven MRP, long lead time, MRP, uncertain demand
Procedia PDF Downloads 30119723 Endoscopic Pituitary Surgery: Learning Curve and Nasal Quality of Life
Authors: Martin Dupuy, Solange Grunenwald, Pierre-Louis Colombo, Laurence Mahieu, Pomone Richard, Philippe Bartoli
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Endonasal endoscopic trans-sphenoidal surgery for pituitary tumours has become a mainstay of treatment over the last two decades. Although it is generally accepted that there is no significant difference between endoscopic versus microscopic approach for surgical outcomes (endocrine and ophthalmologic status), nasal morbidity seems to the benefit of endoscopic procedures. Minimally invasive endoscopic surgery needs an operative learning curve to achieve surgeon’s efficiency. This learning curve is now well known for surgical outcomes and complications rate, however, few data are available for nasal morbidity. The aim of our series is to document operative experience and nasal quality of life after (NQOL) endoscopic trans-sphenoidal surgery. The prospective pituitary surgical cohort consisted of 525 consecutives patients referred to our Skull Base Diseases Department. Endoscopic procedures were performed by a single neurosurgeon using an uninostril approach. NQOL was evaluated using the Sino-Nasal Test (SNOT-22), the Anterior Base Nasal Inventory (ASBNI) and the Skull Base Inventory Score (SBIS). Data were collected before surgery during hospital stay and 3 months after the surgery. The seventy first patients were compared to the latest 70 patients. There was no significant difference between comparison score before versus after surgery for SNOT-22, ASBNI and SBIS during the single surgeon’s learning curve. Our series demonstrates that in our institution there is no statistically significant learning curve for NQOL after uninostril endoscopic pituitary surgery. A careful progression through sinonasal structures with very limited mucosal incision is associated with minimal morbidity and preserves nasal function. Conservative and minimal invasive approach could be achieved early during learning curve.Keywords: pituitary surgery, quality of life, minimal invasive surgery, learning curve, pituitary tumours, skull base surgery, endoscopic surgery
Procedia PDF Downloads 12419722 A Fuzzy Control System for Reducing Urban Stormwater Runoff by a Stormwater Storage Tank
Authors: Pingping Zhang, Yanpeng Cai, Jianlong Wang
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Stormwater storage tank (SST) is a popular low impact development technology for reducing stormwater runoff in the construction of sponge city. At present, it is difficult to perform the automatic control of SST for reducing peak flow. In this paper, fuzzy control was introduced into the peak control of SST to improve the efficiency of reducing stormwater runoff. Firstly, the design of SST was investigated. A catchment area and a return period were assumed, a SST model was manufactured, and then the storage capacity of the SST was verified. Secondly, the control parameters of the SST based on reducing stormwater runoff were analyzed, and a schematic diagram of real-time control (RTC) system based on peak control SST was established. Finally, fuzzy control system of a double input (flow and water level) and double output (inlet and outlet valve) was designed. The results showed that 1) under the different return periods (one year, three years, five years), the SST had the effect of delayed peak control and storage by increasing the detention time, 2) rainfall, pipeline flow, the influent time and the water level in the SST could be used as RTC parameters, and 3) the response curves of flow velocity and water level fluctuated very little and reached equilibrium in a short time. The combination of online monitoring and fuzzy control was feasible to control the SST automatically. This paper provides a theoretical reference for reducing stormwater runoff and improving the operation efficiency of SST.Keywords: stormwater runoff, stormwater storage tank, real-time control, fuzzy control
Procedia PDF Downloads 20419721 The Difference of Serum Tnf-α Levels between Patients Schizophrenic Male with Smoking and Healthy Control
Authors: Rona Hanani Simamora, Bahagia Loebis, M. Surya Husada
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Background: The exact cause of schizophrenia is not known, although several etiology theories have been proposed for the disease, including immune dysfunction or autoimmune mechanisms. Cytokines including Tnf-α has an important role in the pathophysiology of schizophrenia and the effects of pharmacological treatment with antipsychotics. Nicotine is widespread effects on the brain, immune system and cytokine levels. Smoking among schizophrenic patients could play a role in the altered cytokine profiles of schizophrenia such as Tnf-α. Aims: To determine differences of serum Tnf-α levels between schizophrenic patients with smoking in male and healthy control. Methods: This study was a comparative analytic study, divided into two groups: 1) group of male schizophrenic patients with smoking (n1=30) with inclusion criteria were patients who have been diagnosed schizophrenic based PPDGJ-III, 20-60 years old, male, smoking, chronic schizophrenic patients in the stable phase and willing to participate this study. Exclusion criteria were having other mental disorders and comorbidity with other medical illnesses. 2) healthy control group (n2=30) with inclusion criteria were 20-60 years old, male, smoking, willing to participate this study. Exclusion criteria were having mental disorder, a family history of psychiatric disorders, the other medical illnesses, a history of alcohol and other substances abuse (except caffeine and nicotine). Serum Tnf-α were analyzed using the Quantikine HS Human Tnf –α Immunoassay. Results: Serum Tnf-α level measure in patient schizophrenia male with smoking and compared with the healthy control subjects. Tnf-α levels were significantly higher in patients schizophrenic male with smoking (25,79±27,96) to healthy control subjects (2,74±2,19), by using the Mann Whitney U test showed a statistically significant difference was observed for serum Tnf-α level (p < 0,001). Conclusions: Schizophrenia is a highly heterogeneous disorder, and this study shows an increase Tnf-α as pro-inflammation cytokines in schizophrenics. These results suggest an immune abnormalities may be involved in the etiology and pathophysiology of schizophrenia.Keywords: male, schizophrenic, smoking, Tnf Alpha
Procedia PDF Downloads 25019720 Data-Mining Approach to Analyzing Industrial Process Information for Real-Time Monitoring
Authors: Seung-Lock Seo
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This work presents a data-mining empirical monitoring scheme for industrial processes with partially unbalanced data. Measurement data of good operations are relatively easy to gather, but in unusual special events or faults it is generally difficult to collect process information or almost impossible to analyze some noisy data of industrial processes. At this time some noise filtering techniques can be used to enhance process monitoring performance in a real-time basis. In addition, pre-processing of raw process data is helpful to eliminate unwanted variation of industrial process data. In this work, the performance of various monitoring schemes was tested and demonstrated for discrete batch process data. It showed that the monitoring performance was improved significantly in terms of monitoring success rate of given process faults.Keywords: data mining, process data, monitoring, safety, industrial processes
Procedia PDF Downloads 40119719 Memory Types in Hemodialysis (HD) Patients; A Study Based on Hemodialysis Duration, Zahedan: South East of Iran
Authors: Behnoush Sabayan, Ali Alidadi, Saeid Ebarhimi, N. M. Bakhshani
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Hemodialysis (HD) patients are at a high risk of atherosclerotic and vascular disease; also little information is available for the HD impact on brain structure of these patients. We studied the brain abnormalities in HD patients. The aim of this study was to investigate the effect of long term HD on brain structure of HD patients. Non-contrast MRI was used to evaluate imaging findings. Our study included 80 HD patients of whom 39 had less than six months of HD and 41 patients had a history of HD more than six months. The population had a mean age of 51.60 years old and 27.5% were female. According to study, HD patients who have been hemodialyzed for a long time (median time of HD was up to 4 years) had small vessel ischemia than the HD patients who underwent HD for a shorter term, which the median time was 3 to 5 months. Most of the small vessel ischemia was located in pre-ventricular, subcortical and white matter (1.33± .471, 1.23± .420 and 1.39±.490). However, the other brain damages like: central pons abnormality, global brain atrophy, thinning of corpus callosum and frontal lobe atrophy were found (P<0.01). The present study demonstrated that HD patients who were under HD for a longer time had small vessel ischemia and we conclude that this small vessel ischemia might be a causative mechanism of brain atrophy in chronic hemodialysis patients. However, additional researches are needed in this area.Keywords: Hemodialysis Patients, Duration of Hemodialysis, MRI, Zahedan
Procedia PDF Downloads 21419718 A Generalized Weighted Loss for Support Vextor Classification and Multilayer Perceptron
Authors: Filippo Portera
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Usually standard algorithms employ a loss where each error is the mere absolute difference between the true value and the prediction, in case of a regression task. In the present, we present several error weighting schemes that are a generalization of the consolidated routine. We study both a binary classification model for Support Vextor Classification and a regression net for Multylayer Perceptron. Results proves that the error is never worse than the standard procedure and several times it is better.Keywords: loss, binary-classification, MLP, weights, regression
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