Search results for: option selection
1049 Safety and Feasibility of Distal Radial Balloon Aortic Valvuloplasty - The DR-BAV Study
Authors: Alexandru Achim, Tamás Szűcsborus, Viktor Sasi, Ferenc Nagy, Zoltán Jambrik, Attila Nemes, Albert Varga, Călin Homorodean, Olivier F. Bertrand, Zoltán Ruzsa
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Aim: Our study aimed to establish the safety and the technical success of distal radial access for balloon aortic valvuloplasty (DR-BAV). The secondary objective was to determine the effectiveness and appropriate role of DR-BAV within half year follow-up. Methods: Clinical and angiographic data from 32 consecutive patients with symptomatic aortic stenosis were evaluated in a prospective pilot single-center study. Between 2020 and 2021, the patients were treated utilizing dual distal radial access with 6-10F compatible balloons. The efficacy endpoint was divided into technical success (successful valvuloplasty balloon inflation at the aortic valve and absence of intra- or periprocedural major complications), hemodynamic success (a reduction of the mean invasive gradient >30%), and clinical success (an improvement of at least one clinical category in the NYHA classification). The safety endpoints were vascular complications (major and minor Valve Academic Research Consortium (VARC)-2 bleeding, diminished or lost arterial pulse or the presence of any pseudo-aneurysm or arteriovenous fistula during the clinical follow-up) and major adverse events, MAEs (the composite of death, stroke, myocardial infarction, and urgent major aortic valve replacement or implantation during the hospital stay and or at one-month follow-up). Results: 32 patients (40 % male, mean age 80 ± 8,5) with severe aortic valve stenosis were included in the study and 4 patients were excluded. Technical success was achieved in all patients (100%). Hemodynamic success was achieved in 30 patients (93,75%). Invasive max and mean gradients were reduced from 73±22 mm Hg and 49±22 mm Hg to 49±19 mm Hg and 20±13 mm Hg, respectively (p = <.001). Clinical success was achieved in 29 patients (90,6%). In total, no major adverse cardiac or cerebrovascular event nor vascular complications (according to VARC 2 criteria) occurred during the intervention. All-cause death at 6 months was 12%. Conclusion: According to our study, dual distal radial artery access is a safe and effective option for balloon aortic valvuloplasty in patients with severe aortic valve stenosis and can be performed in all patients with sufficient lumen diameter. Future randomized studies are warranted to investigate whether this technique is superior to other approaches.Keywords: mean invasive gradient, distal radial access for balloon aortic valvuloplasty (DR-BAV), aortic valve stenosis, pseudo-aneurysm, arteriovenous fistula, valve academic research consortium (VARC)-2
Procedia PDF Downloads 941048 A Fuzzy Hybrıd Decısıon Support System for Naval Base Place Selectıon in a Foreıgn Country
Authors: Latif Yanar, Muharrem Kaçan
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In this study, an Analytic Hierarchy Process and Analytic Network Process Decision Support System (DSS) model for determination of a navy base place in another country is proposed together with a decision support software (DESTEC 1.0) developed using C Sharp programming language. The proposed software also has the ability of performing the fuzzy models (Fuzzy AHP and Fuzzy ANP) of the proposed DSS to cope with the ambiguous and linguistic nature of the model. The AHP and ANP model, for a decision support for selecting the best place among the alternatives, including the criteria and alternatives, is developed and solved by the experts from Turkish Navy and Turkish academicians related to international relations branches of the universities in Turkey. Also, the questionnaires used for weighting of the criteria and the alternatives are filled by these experts.Some of our alternatives are: economic and political stability of the third country, the effect of another super power in that country, historical relations, security in that country, social facilities in the city in which the base will be built, the transportation security and difficulty from a main city that have an airport to the city will have the base etc. Over 20 criteria like these are determined which are categorized in social, political, economic and military aspects. As a result all the criteria and three alternatives are evaluated by different people who have background and experience to weight the criteria and alternatives as it must be in AHP and ANP evaluation system. The alternatives got their degrees all between 0 – 1 and the total is 1. At the end the DSS advices one of the alternatives as the best one to the decision maker according to the developed model and the evaluations of the experts.Keywords: analytic hierarchical process, analytic network process, fuzzy logic, naval base place selection, multiple criteria decision making
Procedia PDF Downloads 3911047 Comparing Pathogen Inhibition Effect of Different Preparations of Probiotic L. reuteri Strains
Authors: Tejinder Pal Singh, Ravinder Kumar Malik, Gurpreet Kaur
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Adhesion is key factor for colonization of the gastrointestinal tract and the ability of probiotic strains to inhibit pathogens. Therefore, the adhesion ability is considered as a suitable biomarker for the selection of potential probiotic. In the present study, eight probiotic Lactobacillus reuteri strains were evaluated as viable, LiCl treated or heat-killed forms and compared with probiotic reference strains (L. reuteri ATCC55730). All strains investigated were able to adhere to Caco-2 cells. All probiotic L. reuteri strains tested were able to inhibit and displace (P < 0.05) the adhesion of Escherichia coli ATCC25922, Salmonella typhi NCDC113, Listeria monocytogenes ATCC53135 and Enterococcus faecalis NCDC115. The probiotic strain L. reuteri LR6 showed the strongest adhesion and pathogen inhibition ability among the eight L. reuteri strains tested. In addition, the abilities to inhibit and to displace adhered pathogens depended on both the probiotic and the pathogen strains tested suggesting the involvement of various mechanisms. The adhesion and antagonistic potential of the probiotic strains were significantly decreased upon exposure to 5M LiCl, showing that surface molecules, proteinaceous in nature, are involved. The heat-killed forms of the probiotic L. reuteri strains also inhibited the attachment of selected pathogens to Caco-2 cells. In conclusion, in vitro assays showed that L. reuteri strains, as viable or heat-killed forms, are adherent to Caco-2 cell line model and are highly antagonistic to selected pathogens in which surface molecules, proteinaceous molecules in particular, plays an important role.Keywords: probiotics, Lactobacillus reuteri, adhesion, Caco-2 cells
Procedia PDF Downloads 2511046 Impact of Water Deficit and Nematode Infection Stress on Growth and Physiological Responses of Mungbean (Vigna radiata L.)
Authors: Areej A. Alzarqaa, Shahira S. Roushdy, Ali A. Alderfasi, Fahad A. AL-Yahya, Ahmed A. Dawaba
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The resistance of mungbean (Vigna radiata L. Wilczeck) and its physiological responses to drought stress was studied in a greenhouse pot experiment. A randomized complete block Design (RCBD) with factorial arrangement having three replications of each treatment was used. Treatments included three water deficit samples (80%, 40% and 20% of field capacity), two mungbean genotypes (Kawmay-1 and VC2010) and two root-knot nematode (Meloidogyne javanica) infection levels (infected and non-infected). Results showed that water deficit stress significantly hampered most of the studied parameters, except for the shoot water content, whereas genotypes showed highly significant differences for stomatal conductance, shoot dry weight and leaf area. Shoot water content was found to be non-significant in relation to chlorophyll b, shoot dry weight and leaf area, whereas highly significant but negatively correlated with chlorophyll a and stomatal conductance. However, all other possible correlations among studied parameters were found to be highly and positively significant. Results also showed that VC 2010 surpassed Kawmay-1 in most of studied characteristics. In the present study, genotypic variation was observed for these parameters and can be used as a basis for selection of the most promising variety under drought conditions.Keywords: drought stress, Meloidogyne javanica, mungbean, stomatal conductivity, leaf area, root-knot nematode, shoot water content
Procedia PDF Downloads 3721045 Improving Effectiveness of Students' Learning during Clinical Rotations at a Teaching Hospital in Rwanda
Authors: Nanyombi Lubimbi, Josette Niyokindi
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Background: As in many other developing countries in Africa, Rwanda suffers from a chronic shortage of skilled Health Care professionals including Clinical Instructors. This shortage negatively affects the clinical instruction quality therefore impacting student-learning outcomes. Due to poor clinical supervision, it is often noted that students have no structure or consistent guidance in their learning process. The Clinical Educators and the Rwandan counterparts identified the need to create a favorable environment for learning. Description: During orientation the expectations of the student learning process, collaboration of the clinical instructors with the nurses and Clinical Educators is outlined. The ward managers facilitate structured learning by helping the students identify a maximum of two patients using the school’s objectives to guide the appropriate selection of patients. Throughout the day, Clinical Educators with collaboration of Clinical Instructors when present conduct an ongoing assessment of learning and provide feedback to the students. Post-conference is provided once or twice a week to practice critical thinking skills of patient cases that they have been taking care of during the day. Lessons Learned: The students are found to be more confident with knowledge and skills gained during rotations. Clinical facility evaluations completed by students at the end of their rotations highlight the student’s satisfaction and recommendation for continuation of structured learning. Conclusion: Based on the satisfaction of both students and Clinical Instructors, we have identified need for structured learning during clinical rotations. We acknowledge that more evidence-based practice is necessary to effectively address the needs of nursing and midwifery students throughout the country.Keywords: Rwanda, clinical rotation, structured learning, critical thinking skills, post-conference
Procedia PDF Downloads 2391044 Evaluation of Newly Synthesized Steroid Derivatives Using In silico Molecular Descriptors and Chemometric Techniques
Authors: Milica Ž. Karadžić, Lidija R. Jevrić, Sanja Podunavac-Kuzmanović, Strahinja Z. Kovačević, Anamarija I. Mandić, Katarina Penov-Gaši, Andrea R. Nikolić, Aleksandar M. Oklješa
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This study considered selection of the in silico molecular descriptors and the models for newly synthesized steroid derivatives description and their characterization using chemometric techniques. Multiple linear regression (MLR) models were established and gave the best molecular descriptors for quantitative structure-retention relationship (QSRR) modeling of the retention of the investigated molecules. MLR models were without multicollinearity among the selected molecular descriptors according to the variance inflation factor (VIF) values. Used molecular descriptors were ranked using generalized pair correlation method (GPCM). In this method, the significant difference between independent variables can be noticed regardless almost equal correlation between dependent variable. Generated MLR models were statistically and cross-validated and the best models were kept. Models were ranked using sum of ranking differences (SRD) method. According to this method, the most consistent QSRR model can be found and similarity or dissimilarity between the models could be noticed. In this study, SRD was performed using average values of experimentally observed data as a golden standard. Chemometric analysis was conducted in order to characterize newly synthesized steroid derivatives for further investigation regarding their potential biological activity and further synthesis. This article is based upon work from COST Action (CM1105), supported by COST (European Cooperation in Science and Technology).Keywords: generalized pair correlation method, molecular descriptors, regression analysis, steroids, sum of ranking differences
Procedia PDF Downloads 3471043 Anti-Corruption, an Important Challenge for the Construction Industry!
Authors: Ahmed Stifi, Sascha Gentes, Fritz Gehbauer
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The construction industry is perhaps one of the oldest industry of the world. The ancient monuments like the egyptian pyramids, the temples of Greeks and Romans like Parthenon and Pantheon, the robust bridges, old Roman theatres, the citadels and many more are the best testament to that. The industry also has a symbiotic relationship with other . Some of the heavy engineering industry provide construction machineries, chemical industry develop innovative construction materials, finance sector provides fund solutions for complex construction projects and many more. Construction Industry is not only mammoth but also very complex in nature. Because of the complexity, construction industry is prone to various tribulations which may have the propensity to hamper its growth. The comparitive study of this industry with other depicts that it is associated with a state of tardiness and delay especially when we focus on the managerial aspects and the study of triple constraint (time, cost and scope). While some institutes says the complexity associated with it as a major reason, others like lean construction, refers to the wastes produced across the construction process as the prime reason. This paper introduces corruption as one of the prime factors for such delays.To support this many international reports and studies are available depicting that construction industry is one of the most corrupt sectors worldwide, and the corruption can take place throught the project cycle comprising project selection, planning, design, funding, pre-qualification, tendering, execution, operation and maintenance, and even through the reconstrction phase. It also happens in many forms such as bribe, fraud, extortion, collusion, embezzlement and conflict of interest and the self-sufficient. As a solution to cope the corruption in construction industry, the paper introduces the integrity as a key factor and build a new integrity framework to develop and implement an integrity management system for construction companies and construction projects.Keywords: corruption, construction industry, integrity, lean construction
Procedia PDF Downloads 3771042 Retrospective Analysis of Facial Skin Cancer Patients Treated in the Department of Oral and Maxillofacial Surgery Kiel
Authors: Abdullah Saeidi, Aydin Gülses, Christan Flörke
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Skin cancer of the face region is the most common type of malignancy and surgical excision is the preferred approach. However, the clinical long term results reported in the literature are still controversial. Objectives: To describe; 1. Demographical characteristics 2. Affected site, distribution and TNM classification regarding tumor type 3. Surgical aspects • Surgical removal: excision principles, safety margins, the need for secondary resection, primary reconstruction/ defect closure, anesthesia protocol, duration of hospital stay (if any) • Secondary intervention for defect closure/reconstruction: Flap technique, anesthesia protocol, duration of hospital stay (if any), postoperative wound management etc. 4. Tumor recurrences 5. Clinical outcomes 6. Studying the possible therapy approach throw Biostatistical relation and correlation between multiple Histological, diagnostics and clinical Faktors. following surgical ablation of the skin cancer of the head and neck region. Methods: Selection and statistical analysis of medical records of patients who had admitted to the Department of Oral and Maxillofacial Surgery, Universitätsklinikum Schleswig Holstein, Campus Kiel during the period of 2015-2019 will be retrospectively evaluated. Data will be collected via ORBIS Information-Management-System (ORBIS AG, Saarbrücken, Germany).Keywords: non melanoma skin cancer, face skin cancer, skin reconstruction, non melanoma skin cancer recurrence, non melanoma skin cancer metastases
Procedia PDF Downloads 1061041 Task Scheduling and Resource Allocation in Cloud-based on AHP Method
Authors: Zahra Ahmadi, Fazlollah Adibnia
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Scheduling of tasks and the optimal allocation of resources in the cloud are based on the dynamic nature of tasks and the heterogeneity of resources. Applications that are based on the scientific workflow are among the most widely used applications in this field, which are characterized by high processing power and storage capacity. In order to increase their efficiency, it is necessary to plan the tasks properly and select the best virtual machine in the cloud. The goals of the system are effective factors in scheduling tasks and resource selection, which depend on various criteria such as time, cost, current workload and processing power. Multi-criteria decision-making methods are a good choice in this field. In this research, a new method of work planning and resource allocation in a heterogeneous environment based on the modified AHP algorithm is proposed. In this method, the scheduling of input tasks is based on two criteria of execution time and size. Resource allocation is also a combination of the AHP algorithm and the first-input method of the first client. Resource prioritization is done with the criteria of main memory size, processor speed and bandwidth. What is considered in this system to modify the AHP algorithm Linear Max-Min and Linear Max normalization methods are the best choice for the mentioned algorithm, which have a great impact on the ranking. The simulation results show a decrease in the average response time, return time and execution time of input tasks in the proposed method compared to similar methods (basic methods).Keywords: hierarchical analytical process, work prioritization, normalization, heterogeneous resource allocation, scientific workflow
Procedia PDF Downloads 1451040 Design and Manufacture of a Hybrid Gearbox Reducer System
Authors: Ahmed Mozamel, Kemal Yildizli
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Due to mechanical energy losses and a competitive of minimizing these losses and increases the machine efficiency, the need for contactless gearing system has raised. In this work, one stage of mechanical planetary gear transmission system integrated with one stage of magnetic planetary gear system is designed as a two-stage hybrid gearbox system. The permanent magnets internal energy in the form of the magnetic field is used to create meshing between contactless magnetic rotors in order to provide self-system protection against overloading and decrease the mechanical loss of the transmission system by eliminating the friction losses. Classical methods, such as analytical, tabular method and the theory of elasticity are used to calculate the planetary gear design parameters. The finite element method (ANSYS Maxwell) is used to predict the behaviors of a magnetic gearing system. The concentric magnetic gearing system has been modeled and analyzed by using 2D finite element method (ANSYS Maxwell). In addition to that, design and manufacturing processes of prototype components (a planetary gear, concentric magnetic gear, shafts and the bearings selection) of a gearbox system are investigated. The output force, the output moment, the output power and efficiency of the hybrid gearbox system are experimentally evaluated. The viability of applying a magnetic force to transmit mechanical power through a non-contact gearing system is presented. The experimental test results show that the system is capable to operate continuously within the range of speed from 400 rpm to 3000 rpm with the reduction ratio of 2:1 and maximum efficiency of 91%.Keywords: hybrid gearbox, mechanical gearboxes, magnetic gears, magnetic torque
Procedia PDF Downloads 1521039 Content Analysis of ‘Junk Food’ Content in Children’s TV Programmes: A Comparison of UK Broadcast TV and Video-On-Demand Services
Authors: Shreesh Sinha, Alexander B. Barker, Megan Parkin, Emma Wilson, Rachael L. Murray
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Background and Objectives: Exposure to HFSS imagery is associated with the consumption of foods high in fat, sugar or salt (HFSS), and subsequently obesity, among young people. We report and compare the results of two content analyses, one of two popular terrestrial children's television channels in the UK and the other of a selection of children's programmes available on video-on-demand (VOD) streaming sites. Methods: Content analysis of three days' worth of programmes (including advertisements) on two popular children's television channels broadcast on UK television (CBeebies and Milkshake) as well as a sample of 40 highest-rated children's programmes available on the VOD platforms, Netflix and Amazon Prime, using 1-minute interval coding. Results: HFSS content was seen in 181 broadcasts (36%) and in 417 intervals (13%) on terrestrial television, 'Milkshake' had a significantly higher proportion of programmes/adverts which contained HFSS content than 'CBeebies'. In VOD platforms, HFSS content was seen in 82 episodes (72% of the total number of episodes), across 459 intervals (19% of the total number of intervals), with no significant difference in the proportion of programmes containing HFSS content between Netflix and Amazon Prime. Conclusions: This study demonstrates that HFSS content is common in both popular UK children's television channels and children's programmes on VOD services. Since previous research has shown that HFSS content in the media has an effect on HFSS consumption, children's television programmes broadcast either on TV or VOD services are likely to have an effect on HFSS consumption in children, and legislative opportunities to prevent this exposure are being missed.Keywords: public health, junk food, children's TV, HFSS
Procedia PDF Downloads 1021038 A 7 Dimensional-Quantitative Structure-Activity Relationship Approach Combining Quantum Mechanics Based Grid and Solvation Models to Predict Hotspots and Kinetic Properties of Mutated Enzymes: An Enzyme Engineering Perspective
Authors: R. Pravin Kumar, L. Roopa
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Enzymes are molecular machines used in various industries such as pharmaceuticals, cosmetics, food and animal feed, paper and leather processing, biofuel, and etc. Nevertheless, this has been possible only by the breath-taking efforts of the chemists and biologists to evolve/engineer these mysterious biomolecules to work the needful. Main agenda of this enzyme engineering project is to derive screening and selection tools to obtain focused libraries of enzyme variants with desired qualities. The methodologies for this research include the well-established directed evolution, rational redesign and relatively less established yet much faster and accurate insilico methods. This concept was initiated as a Receptor Rependent-4Dimensional Quantitative Structure Activity Relationship (RD-4D-QSAR) to predict kinetic properties of enzymes and extended here to study transaminase by a 7D QSAR approach. Induced-fit scenarios were explored using Quantum Mechanics/Molecular Mechanics (QM/MM) simulations which were then placed in a grid that stores interactions energies derived from QM parameters (QMgrid). In this study, the mutated enzymes were immersed completely inside the QMgrid and this was combined with solvation models to predict descriptors. After statistical screening of descriptors, QSAR models showed > 90% specificity and > 85% sensitivity towards the experimental activity. Mapping descriptors on the enzyme structure revealed hotspots important to enhance the enantioselectivity of the enzyme.Keywords: QMgrid, QM/MM simulations, RD-4D-QSAR, transaminase
Procedia PDF Downloads 1371037 Indenyl and Allyl Palladates: Synthesis, Bonding, and Anticancer Activity
Authors: T. Scattolin, E. Cavarzerani, F. Visentin, F. Rizzolio
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Organopalladium compounds have recently attracted attention for their high stability even under physiological conditions and, above all, for their remarkable in vitro cytotoxicity towards cisplatin-resistant cell lines. Among the organopalladium derivatives, those bearing at least one N-heterocyclic carbene ligand (NHC) and the Pd(II)-η³-allyl fragment have exhibited IC₅₀ values in the micro and sub-micromolar range towards several cancer cell lines in vitro and in some cases selectivity towards cancerous vs. non-tumorigenic cells. Herein, a selection of allyl and indenyl palladates were synthesized using a solvent-free method consisting of grinding the corresponding palladium precursors with different saturated and unsaturated azolium salts. All compounds have been fully characterized by NMR, XRD and elemental analyses. The intramolecular H, Cl interaction has been elucidated and quantified using the Voronoi Deformation Density scheme. Most of the complexes showed excellent cytotoxicity towards ovarian cancer cell lines, with I₅₀ values comparable to or even lower than cisplatin. Interestingly, the potent anticancer activity was also confirmed in a high-serous ovarian cancer (HGSOC) patient-derived tumoroid, with a clear superiority of this class of compounds over classical platinum-based agents. Finally, preliminary enzyme inhibition studies of the synthesized palladate complexes against the model TrxR show that the compounds have high activity comparable to or even higher than auranofin and classical Au(I) NHC complexes. Based on such promising data, further in vitro and in vivo experiments and in-depth mechanistic studies are ongoing in our laboratories.Keywords: anticancer activity, palladium complexes, organoids, indenyl and allyl ligands
Procedia PDF Downloads 941036 Nonparametric Truncated Spline Regression Model on the Data of Human Development Index in Indonesia
Authors: Kornelius Ronald Demu, Dewi Retno Sari Saputro, Purnami Widyaningsih
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Human Development Index (HDI) is a standard measurement for a country's human development. Several factors may have influenced it, such as life expectancy, gross domestic product (GDP) based on the province's annual expenditure, the number of poor people, and the percentage of an illiterate people. The scatter plot between HDI and the influenced factors show that the plot does not follow a specific pattern or form. Therefore, the HDI's data in Indonesia can be applied with a nonparametric regression model. The estimation of the regression curve in the nonparametric regression model is flexible because it follows the shape of the data pattern. One of the nonparametric regression's method is a truncated spline. Truncated spline regression is one of the nonparametric approach, which is a modification of the segmented polynomial functions. The estimator of a truncated spline regression model was affected by the selection of the optimal knots point. Knot points is a focus point of spline truncated functions. The optimal knots point was determined by the minimum value of generalized cross validation (GCV). In this article were applied the data of Human Development Index with a truncated spline nonparametric regression model. The results of this research were obtained the best-truncated spline regression model to the HDI's data in Indonesia with the combination of optimal knots point 5-5-5-4. Life expectancy and the percentage of an illiterate people were the significant factors depend to the HDI in Indonesia. The coefficient of determination is 94.54%. This means the regression model is good enough to applied on the data of HDI in Indonesia.Keywords: generalized cross validation (GCV), Human Development Index (HDI), knots point, nonparametric regression, truncated spline
Procedia PDF Downloads 3391035 Setting Uncertainty Conditions Using Singular Values for Repetitive Control in State Feedback
Authors: Muhammad A. Alsubaie, Mubarak K. H. Alhajri, Tarek S. Altowaim
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A repetitive controller designed to accommodate periodic disturbances via state feedback is discussed. Periodic disturbances can be represented by a time delay model in a positive feedback loop acting on system output. A direct use of the small gain theorem solves the periodic disturbances problem via 1) isolating the delay model, 2) finding the overall system representation around the delay model and 3) designing a feedback controller that assures overall system stability and tracking error convergence. This paper addresses uncertainty conditions for the repetitive controller designed in state feedback in either past error feedforward or current error feedback using singular values. The uncertainty investigation is based on the overall system found and the stability condition associated with it; depending on the scheme used, to set an upper/lower limit weighting parameter. This creates a region that should not be exceeded in selecting the weighting parameter which in turns assures performance improvement against system uncertainty. Repetitive control problem can be described in lifted form. This allows the usage of singular values principle in setting the range for the weighting parameter selection. The Simulation results obtained show a tracking error convergence against dynamic system perturbation if the weighting parameter chosen is within the range obtained. Simulation results also show the advantage of weighting parameter usage compared to the case where it is omitted.Keywords: model mismatch, repetitive control, singular values, state feedback
Procedia PDF Downloads 1551034 Feature Selection of Personal Authentication Based on EEG Signal for K-Means Cluster Analysis Using Silhouettes Score
Authors: Jianfeng Hu
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Personal authentication based on electroencephalography (EEG) signals is one of the important field for the biometric technology. More and more researchers have used EEG signals as data source for biometric. However, there are some disadvantages for biometrics based on EEG signals. The proposed method employs entropy measures for feature extraction from EEG signals. Four type of entropies measures, sample entropy (SE), fuzzy entropy (FE), approximate entropy (AE) and spectral entropy (PE), were deployed as feature set. In a silhouettes calculation, the distance from each data point in a cluster to all another point within the same cluster and to all other data points in the closest cluster are determined. Thus silhouettes provide a measure of how well a data point was classified when it was assigned to a cluster and the separation between them. This feature renders silhouettes potentially well suited for assessing cluster quality in personal authentication methods. In this study, “silhouettes scores” was used for assessing the cluster quality of k-means clustering algorithm is well suited for comparing the performance of each EEG dataset. The main goals of this study are: (1) to represent each target as a tuple of multiple feature sets, (2) to assign a suitable measure to each feature set, (3) to combine different feature sets, (4) to determine the optimal feature weighting. Using precision/recall evaluations, the effectiveness of feature weighting in clustering was analyzed. EEG data from 22 subjects were collected. Results showed that: (1) It is possible to use fewer electrodes (3-4) for personal authentication. (2) There was the difference between each electrode for personal authentication (p<0.01). (3) There is no significant difference for authentication performance among feature sets (except feature PE). Conclusion: The combination of k-means clustering algorithm and silhouette approach proved to be an accurate method for personal authentication based on EEG signals.Keywords: personal authentication, K-mean clustering, electroencephalogram, EEG, silhouettes
Procedia PDF Downloads 2851033 Dealing with the Spaces: Ultra Conservative Approach from Childhood to Adulthood
Authors: Maryam Firouzmandi, Moosa Miri
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Common reasons for early tooth loss are trauma, extraction due to caries or periodontal disease and congenital missing. The remaining space after tooth loss may cause functional and esthetic problems. Therefore restorative dentists should attempt to manage these spaces using conservative methods. The goal is to restore the lost esthetic and function, prevent phonetic, self-esteem and personality problems and tongue habits. Preserving alveolar bone is also of great importance during the growth stage. Purpose: When deciding about the management of the missing tooth, space implants are contradicted until the completion of dentoalveolar development. Even in adulthood, due to systemic or periodontal problems or biological and economic issues, the implant might not be indicated. In this article, the alternative conservative restorative methods of space maintenance are going to be discussed. Essix retainers are made chair-side as easy as forming a custom bleaching tray with some modifications. They are esthetically acceptable and not expensive. These temporaries provide support for the lips but could not be used during function. Mini-screw-supported temporaries are another option for maintaining the space, especially after orthodontic treatment when there is a time lag between the termination of orthodontic treatment and definitive restoration. Two techniques will be presented for this kind of restoration: Denture tooth pontic or a composite crown. The benefits are alveolar bone preservation, Physiologic pressure on the alveolar ridge to increase its density and even can be retained until the completion of the definitive treatment. Bonded fixed partial denture includes Maryland bridge, fiber-reinforced composite bridge, resin-bonded bridge, and ceramic bonded bridge. These types of bridges are recommended to be used after a pubertal growth spurt and a recent meta-analysis considered their clinical success similar to conventional FDPs and implant-supported crowns. However, they have several advantages that are going to be discussed by presenting some clinical examples. Practical instruction on how to construct an FRC bridge and a novel chair-side Maryland bridge will be given by means of clinical cases. Clinical relevance: minimally invasive options should always be considered and destruction of healthy enamel and dentin during the preparation phase should be avoided as much as possible.Keywords: tooth missing, fiber-reinforced composite, Maryland, Essix retainers, screw-retained restoration
Procedia PDF Downloads 1981032 Isolation and Characterization of Bio-surfactant Producing Alcaligenes sp YLA1 and Its Diesel Degradation Potentials
Authors: Abdulrahman Abdulhamid Arabo, Raji Arabi Bamanga, Mujiburrahman Fadilu, Musa Abubakar, Fatima Abdullahi Shehu, Hafeez Muhammad Yakasai, Nasiru Abdullahi
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The aim of this study was to isolate and identify biosurfactant-producing and diesel alkanes degrading bacteria. For this reason, bacteria isolated from the diesel-contaminated site were screened for their potential to produce biosurfactants and degrade diesel alkanes. Primary selection of diesel degraders was carried out by using the conventional enrichment culture technique, where 12 bacterial strains were isolated based on their ability to grow on minimal media supplemented with diesel as the sole carbon source, which was followed by qualitative screening methods for potential biosurfactant production. Isolate B11 was the only candidate that showed positive signs for drop collapse, foaming, hemolytic test, oil displacement of more than 22 ± 0.05 mm, and emulsification (E24) of 14 ± 0.30%. The effect of various culture parameters (incubation time, diesel concentration, nitrogen source, pH and temperature) on the biodegradation of diesel was evaluated. The optimum incubation time was confirmed to be 120 days for isolate B11, and the optimum PH was confirmed as 8.0 for the isolate; similarly, the optimum temperature was confirmed as 35oC. In addition, diesel oil was used as the sole carbon source for the isolates. The favorable diesel concentration was 12.5 % (v/v) for the isolate. The isolate has shown degradative ability towards Tridecane (C13), dodecane, 2, 6, 10-trimethyl- (C15), Tetradecane (C14), 2,6,10-Trimethyltridecane (C16), Pentadecane (C15). It degraded between 0.27% - 9.65% of individual diesel oil alkanes. The strain has exhibited the potential of degrading diesel oil n-alkanes and was identified as Alcaligenes species strain B11 (MZ027604) using the 16S rRNA. Sequencing.Keywords: diesel oil, biosurfactant, Alcaligenes sp, biodegradation
Procedia PDF Downloads 1111031 The Effectiveness of a Six-Week Yoga Intervention on Body Awareness, Warnings of Relapse, and Emotion Regulation among Incarcerated Females
Authors: James Beauchemin
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Introduction: The incarceration of people with mental illness and substance use disorders is a major public health issue, with social, clinical, and economic implications. Yoga participation has been associated with numerous psychological benefits; however, there is a paucity of research examining impacts of yoga with incarcerated populations. The purpose of this study was to evaluate effectiveness of a six-week yoga intervention on several mental health-related variables, including emotion regulation, body awareness, and warnings of substance relapse among incarcerated females. Methods: This study utilized a pre-post, three-arm design, with participants assigned to intervention, therapeutic community, or general population groups. A between-groups analysis of covariance (ANCOVA) was conducted across groups to assess intervention effectiveness using the Difficulties in Emotion Regulation Scale (DERS), Scale of Body Connection (SBC), and Warnings of Relapse (AWARE) Questionnaire. Results: ANCOVA results for warnings of relapse (AWARE) revealed significant between-group differences F(2, 80) = 7.15, p = .001; np2 = .152), with significant pairwise comparisons between the intervention group and both the therapeutic community (p = .001) and the general population (p = .005) groups. Similarly, significant differences were found for emotional regulation (DERS) F(2, 83) = 10.521, p = .000; np2 = .278). Pairwise comparisons indicated a significant difference between the intervention and general population (p = .01). Finally, significant differences between the intervention and control groups were found for body awareness (SBC) F(2, 84) = 3.69, p = .029; np2 = .081). Between-group differences were clarified via pairwise comparisons, indicating significant differences between the intervention group and both the therapeutic community (p = .028) and general population groups (p = .020). Implications: Study results suggest that yoga may be an effective addition to integrative mental health and substance use treatment for incarcerated women, and contributes to increasing evidence that holistic interventions may be an important component for treatment with this population. Specifically, given the prevalence of mental health and substance use disorders, findings revealed that changes in body awareness and emotion regulation may be particularly beneficial for incarcerated populations with substance use challenges as a result of yoga participation. From a systemic perspective, this proactive approach may have long-term implications for both physical and psychological well-being for the incarcerated population as a whole, thereby decreasing the need for traditional treatment. By integrating a more holistic, salutogenic model that emphasizes prevention, interventions like yoga may work to improve the wellness of this population, while providing an alternative or complementary treatment option for those with current symptoms.Keywords: yoga, mental health, incarceration, wellness
Procedia PDF Downloads 1381030 The Bacteriocin Produced by Lactic Acid Bacteria as an Antibacterial of Sub Clinic Mastitis on Dairy Cows
Authors: Nenny Harijani, Dhandy Koesoemo Wardhana
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The aim of this study is to know the bacteriocin as antimicrobial activity produced by Lactic Acid Bacteria (LAB) as Antibacterial of Sub Clinic Mastitis on Dairy Cows. The antimicrobial is produced by LAB which isolates from cattle intestine can inhibit the growth Staphylococcus aureus, Steptocococcus agalactiae an Escherichia coli which were caused by dairy cattle subclinical mastitis. The failure of this bacteria growth was indicated by the formation of a clear zone surrounding the colonies on Brain Heart Infusion Agar plate. The bacteriocin was produced by Lactic Acid Bacteria (LAB) as antimicrobial, which could inhibit the growth of indicator bacteria Staphylococcus aureus, S.aglactiae and E.coli. This study was also developed bacteriocin to be used as a therapeutic of subclinical mastitis on dairy cows. The method used in this study was isolation, selection and identification of LAB using Mann Rogosa Sharp Medium, followed by characterization of the bacteriocin produced by LAB. The result of the study showed that bacteriocin isolated from beef cattle’s intestine could inhibit the growth Staphylococcus aureus, S. agalactiae, an Escherichia coli, which was indicated by clear zone surrounding the colonies on Brain Heart Infusion Agar plate. Characteristics of bacteriocin were heat-stable exposed to 80 0C for 30 minutes and 100 ⁰C for 15 minutes and inactivated by proteolytic enzymes such as trypsin. This approach has suggested the development of bacteriocin as a therapeutic agent for subclinical mastitis in dairy cattle.Keywords: lactic acid bacteria, bacteriocin, staphylococcus aureus, S. agalactiae, E. coli, sub
Procedia PDF Downloads 1341029 Critical Literacy and Multiliteracies in the English Language Teaching at Federal Institute of Mato Grosso, Rondonópolis Campus
Authors: Jordana Lenhardt
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This paperwork aims to promote a reflection on the critical literacy and multiliteracies concepts in the English language teaching, under an emancipatory perspective, in the English language classroom at the Federal Institute of Mato Grosso (IFMT), Rondonópolis Campus. Some Authors place the relationship between the world conscience and the self-conscience in a direct reason, compromising one to the other, and others defend that emancipatory teaching practice must be connected in all the spheres of the social context; with this paperwork, we intend to analyze students’ interactions with the English language, in order to verify if they demonstrate critical conscience about language and the world around them. The study is still at a preliminary level and is grounded in discourse critical analysis and systemic-functional linguistics. We understand that text is irremediable, linked to a context, and that the linguistic selection made by the speaker builds social representations. This research foresees the analysis of some students’ speeches in an interview about their classes at the Federal Institute in the city of Rondonópolis and the methodology being used on them. Discourse critical analysis explains that, through the awareness of the language uses, learners can become more conscious of the coercions in their own language practices, the possibilities of risks, and the costs of the individual or collective challenges, to engage themselves in emancipatory linguistic practice. The critical language conscience contributes, on the other hand, to make students more aware of the practices in which they are involved, as producers and consumers of texts, of the social forces, ideologies, and power relations, their effects on the identities and social relations, as well as the discourse role in the social and cultural processes.Keywords: multiliteracies, critical literacy, emancipation, social transformation
Procedia PDF Downloads 1011028 Optimization of Springback Prediction in U-Channel Process Using Response Surface Methodology
Authors: Muhamad Sani Buang, Shahrul Azam Abdullah, Juri Saedon
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There is not much effective guideline on development of design parameters selection on springback for advanced high strength steel sheet metal in U-channel process during cold forming process. This paper presents the development of predictive model for springback in U-channel process on advanced high strength steel sheet employing Response Surface Methodology (RSM). The experimental was performed on dual phase steel sheet, DP590 in U-channel forming process while design of experiment (DoE) approach was used to investigates the effects of four factors namely blank holder force (BHF), clearance (C) and punch travel (Tp) and rolling direction (R) were used as input parameters using two level values by applying Full Factorial design (24). From a statistical analysis of variant (ANOVA), result showed that blank holder force (BHF), clearance (C) and punch travel (Tp) displayed significant effect on springback of flange angle (β2) and wall opening angle (β1), while rolling direction (R) factor is insignificant. The significant parameters are optimized in order to reduce the springback behavior using Central Composite Design (CCD) in RSM and the optimum parameters were determined. A regression model for springback was developed. The effect of individual parameters and their response was also evaluated. The results obtained from optimum model are in agreement with the experimental valuesKeywords: advance high strength steel, u-channel process, springback, design of experiment, optimization, response surface methodology (rsm)
Procedia PDF Downloads 5411027 Analyzing Transit Network Design versus Urban Dispersion
Authors: Hugo Badia
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This research answers which is the most suitable transit network structure to serve specific demand requirements in an increasing urban dispersion process. Two main approaches of network design are found in the literature. On the one hand, a traditional answer, widespread in our cities, that develops a high number of lines to connect most of origin-destination pairs by direct trips; an approach based on the idea that users averse to transfers. On the other hand, some authors advocate an alternative design characterized by simple networks where transfer is essential to complete most of trips. To answer which of them is the best option, we use a two-step methodology. First, by means of an analytical model, three basic network structures are compared: a radial scheme, starting point for the other two structures, a direct trip-based network, and a transfer-based one, which represent the two alternative transit network designs. The model optimizes the network configuration with regard to the total cost for each structure. For a scenario of dispersion, the best alternative is the structure with the minimum cost. This dispersion degree is defined in a simple way considering that only a central area attracts all trips. If this area is small, we have a high concentrated mobility pattern; if this area is too large, the city is highly decentralized. In this first step, we can determine the area of applicability for each structure in function to that urban dispersion degree. The analytical results show that a radial structure is suitable when the demand is so centralized, however, when this demand starts to scatter, new transit lines should be implemented to avoid transfers. If the urban dispersion advances, the introduction of more lines is no longer a good alternative, in this case, the best solution is a change of structure, from direct trips to a network based on transfers. The area of applicability of each network strategy is not constant, it depends on the characteristics of demand, city and transport technology. In the second step, we translate analytical results to a real case study by the relationship between the parameters of dispersion of the model and direct measures of dispersion in a real city. Two dimensions of the urban sprawl process are considered: concentration, defined by Gini coefficient, and centralization by area based centralization index. Once it is estimated the real dispersion degree, we are able to identify in which area of applicability the city is located. In summary, from a strategic point of view, we can obtain with this methodology which is the best network design approach for a city, comparing the theoretical results with the real dispersion degree.Keywords: analytical network design model, network structure, public transport, urban dispersion
Procedia PDF Downloads 2301026 Interface between Personal Values and Social Entrepreneurship in Social Projects That Develop Sports Practice
Authors: Leticia Lengler, Jefferson Oliveira, Vania Estivalete, Jordana Marques Kneipp
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The context of social, economic and environmental transformations has driven innumerable changes in the organizational environment, influencing the social interactions that occur in this scenario. In this sense, social entrepreneurship emerges as a unique opportunity to challenge, question, rethink certain concepts and traditional theories widely discussed in relation to entrepreneurship. Therefore, the interest in studying personal values has been based on the idea that they might be predictors of the behavior of individuals. As an attempt to relate personal values with the characteristics of social entrepreneurs, this study aims to investigate the salient values and the social entrepreneurship perceptions that occur in two social projects responsible for developing sports skills among the students. For purposes of analysis, it is intended to consider: (i) a description of both Social Projects and their respective institutions, considering their history and relevance in the context; (ii) analysis of the personal values of the idealizers and teachers responsible for the projects, (iii) identification of the characteristics of social entrepreneurship manifested in the two projects, and (iv) discussion of similarities and disparities of the categories identified among the participants of the projects. Therefore, this study will carry a qualitative analysis from the interviews with 10 participants of each social project (named Projeto Remar/ASENA and Projeto Mãos Dadas/JUDÔ SANTA MARIA): 2 projects coordinators, 2 students, 2 parents of students, 2 physical education internships and 2 businessmen who stablished a partnership with each project. The data collection will be done through semi-structured interviews that are going to last around 30 minutes each, being recorded, transcribed and later analyzed, through the categorical analysis. The option for categorical analysis is supported by the fact that it is the best alternative when one wants to study values, opinions, attitudes and beliefs, through qualitative ones. In the present research, the pre-analysis phase consisted of an organization of the material collected during the research with Remar and Mãos Dadas Project, and a dynamic reading of this material, seeking to identify the characteristics of social entrepreneurship and values addressed in the study. In the analytical description phase, a more in-depth analysis of the material collected in the research will be carried out. The third phase, referred to as referential interpretation or treatment of results obtained will allow to verify the homogeneity and the heterogeneity among the participants' perceptions of the projects. Some preliminary results coming from the first interviews revealed the projects are guided by values such as cooperation, respect, well-being and nature preservation. These values are linked to the social entrepreneurship perception of the projects managers, who established their activities in behalf of the local community.Keywords: personal values, social entrepreneurship, social projects, sports participants
Procedia PDF Downloads 3651025 The Relationships among Self-Efficacy, Critical Thinking and Communication Skills Ability in Oncology Nurses for Cancer Immunotherapy in Taiwan
Authors: Yun-Hsiang Lee
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Cancer is the main cause of death worldwide. With advances in medical technology, immunotherapy, which is a newly developed advanced treatment, is currently a crucial cancer treatment option. For better quality cancer care, the ability to communicate and critical thinking plays a central role in clinical oncology settings. However, few studies have explored the impact of communication skills on immunotherapy-related issues and their related factors. This study was to (i) explore the current status of communication skill ability for immunotherapy-related issues, self-efficacy for immunotherapy-related care, and critical thinking ability; and (ii) identify factors related to communication skill ability. This is a cross-sectional study. Oncology nurses were recruited from the Taiwan Oncology Nursing Society, in which nurses came from different hospitals distributed across four major geographic regions (North, Center, South, East) of Taiwan. A total of 123 oncology nurses participated in this study. A set of questionnaires were used for collecting data. Communication skill ability for immunotherapy issues, self-efficacy for immunotherapy-related care, critical thinking ability, and background information were assessed in this survey. Independent T-test and one-way ANOVA were used to examine different levels of communication skill ability based on nurses having done oncology courses (yes vs. no) and education years (< 1 year, 1-3 years, and > 3 years), respectively. Spearman correlation was conducted to understand the relationships between communication skill ability and other variables. Among the 123 oncology nurses in the current study, the majority of them were female (98.4%), and most of them were employed at a hospital in the North (46.8%) of Taiwan. Most of them possessed a university degree (78.9%) and had at least 3 years of prior work experience (71.7%). Forty-three of the oncology nurses indicated in the survey that they had not received oncology nurses-related training. Those oncology nurses reported moderate to high levels of communication skill ability for immunotherapy issues (mean=4.24, SD=0.7, range 1-5). Nurses reported moderate levels of self-efficacy for immunotherapy-related care (mean=5.20, SD=1.98, range 0-10) and also had high levels of critical thinking ability (mean=4.76, SD=0.60, range 1-6). Oncology nurses who had received oncology training courses had significantly better communication skill ability than those who had not received oncology training. Oncology nurses who had higher work experience (1-3 years, or > 3 years) had significantly higher levels of communication skill ability for immunotherapy-related issues than those with lower work experience (<1 year). When those nurses reported better communication skill ability, they also had significantly better self-efficacy (r=.42, p<.01) and better critical thinking ability (r=.47, p<.01). Taken altogether, courses designed to improve communication skill ability for immunotherapy-related issues can make a significant impact in clinical settings. Communication skill ability for oncology nurses is the major factor associated with self-efficacy and critical thinking, especially for those with lower work experience (< 1 year).Keywords: communication skills, critical thinking, immunotherapy, oncology nurses, self-efficacy
Procedia PDF Downloads 1051024 Variants of Fat Mass Obesity Associated rs 9939609 Associated with Obesity and Eating Behavior in Adolescent of Minangkabau Ethnic
Authors: Susmiati, Ingrid S. Surono, Jamsari, Nur Indrawati Lipoeto
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There are two contradicting opinions on the relationship between fat mass obesity associated (FTO) rs 9939609 variants and obesity on various ethnics and races. The first opinion agrees that there is an association between the two variables, yet another one disagree. Minangkabau ethnic had a different dietary pattern with other ethnics in Indonesia. They had higher fat and low fiber intakes compared to the other ethnics groups. There is little research in genetic factors that influence eating behavior (food preference or food selection). The objective of this study was to investigate the association between FTO rs 9939609 variants with obesity and eating behavior in adolescent girls of Minangkabau Ethnic. The research design was case control study. A total of 275 adolescent girls aged 12-15 years old (130 obese and 145 normal) were randomly chosen from four districts at West Sumatera (Padang, Padang Pariaman, Padang Panjang and Tanah Datar). Genetic variants of FTO rs 9939609 were analyzed with Tetra-primer Amplification Refractory Mutation System-Polimerase Chain Reaction (AMRS PCR), eating behavior were gathered using eating habits questionnaire, and Body Mass Index (BMI) was calculated according to BMI Z-score (WHO). The result showed that genetic variants of FTO rs 9939609 (TT, TA and AA genotype) had associated with obesity (p = 0,013), whereas subject with An Allele was significantly associated with obesity (odds ratio 1,62 [95% confidential interval, 1,00-2,60]). Subjects with An Allele carrier reported a higher consumption of fried food (p < 0.05) as compared to TT genotypes carriers. There is no association between genetic variants and meal frequency, fruit and fiber intakes p > 0.05. The genetic variants of FTO rs 9939609 are associated with obesity and eating behavior in adolescent of Minangkabau Ethics.Keywords: FTO rs9939609, obesity, eating behavior, adolescents
Procedia PDF Downloads 1731023 Engineering of Filtration Systems in Egyptian Cement Plants: Industrial Case Study
Authors: Mohamed. A. Saad
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The paper represents a case study regarding the conversion of Electro-Static Precipitators (ESP`s) into Fabric Filters (FF). Seven cement production companies were established in Egypt during the period 1927 to 1980 and 6 new companies were established to cope with the increasing cement demand in 1980's. The cement production market shares in Egypt indicate that there are six multinational companies in the local market, they are interested in the environmental conditions improving and so decided to achieve emission reduction project. The experimental work in the present study is divided into two main parts: (I) Measuring Efficiency of Filter Fabrics with detailed description of a designed apparatus. The paper also reveals the factors that should be optimized in order to assist problem diagnosis, solving and increasing the life of bag filters. (II) Methods to mitigate dust emissions in Egyptian cement plants with a special focus on converting the Electrostatic Precipitators (ESP`s) into Fabric Filters (FF) using the same ESP casing, bottom hoppers, dust transportation system, and ESP ductwork. Only the fan system for the higher pressure drop with the fabric filter was replaced. The proper selection of bag material was a prime factor with regard to gas composition, temperature and particle size. Fiberglass with PTFE membrane coated bags was selected. This fabric is rated for a continuous temperature of 250 C and a surge temperature of 280C. The dust emission recorded was less than 20 mg/m3 from the production line fitted with fabric filters which is super compared with the ESP`s working lines stack.Keywords: Engineering Electrostatic Precipitator, filtration, dust collectors, cement
Procedia PDF Downloads 2531022 Randomized, Controlled Blind Study Comparing Sacroiliac Intra-Articular Steroid Injection to Radiofrequency Denervation for Management of Sacroiliac Joint Pain
Authors: Ossama Salman
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Background and objective: Sacroiliac joint pain is a common cause for chronic axial low back pain, with up to 20% prevalence rate. To date, no effective long-term treatment intervention has been embarked on yet. The aim of our study was to compare steroid block to radiofrequency ablation for SIJ pain conditions. Methods: A randomized, blind, study was conducted in 30 patients with sacroiliac joint pain. Fifteen patients received radiofrequency denervation of L4-5 primary dorsal rami and S1-3 lateral sacral branch, and 15 patients received steroid under fluoroscopy. Those in the steroid group who did not respond to steroid injections were offered to cross over to get radiofrequency ablation. Results: At 1-, 3- and 6-months post-intervention, 73%, 60% and 53% of patients, respectively, gained ≥ 50 % pain relief in the radiofrequency (RF) ablation group. In the steroid group, at one month post intervention follow up, only 20% gained ≥ 50 % pain relief, but failed to show any improvement at 3 months and 6 months follow up. Conclusions: Radiofrequency ablation at L4 and L5 primary dorsal rami and S1-3 lateral sacral branch may provide effective and longer pain relief compared to the classic intra-articular steroid injection, in properly selected patients with suspected sacroiliac joint pain. Larger studies are called for to confirm our results and lay out the optimal patient selection and treatment parameters for this poorly comprehended disorder.Keywords: lateral branch denervation, LBD, radio frequency, RF, sacroiliac joint, SIJ, visual analogue scale, VAS
Procedia PDF Downloads 2191021 Perceptions of Climate Change Risk to Forest Ecosystems: A Case Study of Patale Community Forestry User Group, Nepal
Authors: N. R. P Withana, E. Auch
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The purpose of this study was to investigate perceptions of climate change risk to forest ecosystems and forest-based communities as well as perceived effectiveness of adaptation strategies for climate change as well as challenges for adaptation. Data was gathered using a pre-tested semi-structured questionnaire. Simple random selection technique was applied. For the majority of issues, the responses were obtained on multi-point Likert scales, and the scores provided were, in turn, used to estimate the means and other useful estimates. A composite knowledge index developed using correct responses to a set of self-rated statements were used to evaluate the issues. The mean of the knowledge index was 0.64. Also all respondents recorded values of the knowledge index above 0.25. Increase forest fire was perceived by respondents as the greatest risk to forest eco-system. Decrease access to water supplies was perceived as the greatest risk to livelihoods of forest based communities. The most effective adaptation strategy relevant to climate change risks to forest eco-systems and forest based communities livelihoods in Kathmandu valley in Nepal as perceived by the respondents was reforestation and afforestation. As well, lack of public awareness was perceived as the major limitation for climate change adaptation. However, perceived risks as well as effective adaptation strategies showed an inconsistent association with knowledge indicators and social-cultural variables. The results provide useful information to any party who involve with climate change issues in Nepal, since such attempts would be more effective once the people’s perceptions on these aspects are taken into account.Keywords: climate change, risk perceptions, forest ecosystems, forest-based communities
Procedia PDF Downloads 3981020 The Risk of Bleeding in Knee or Shoulder Injections in Patients on Warfarin Treatment
Authors: Muhammad Yasir Tarar
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Background: Intraarticular steroid injections are an effective option in alleviating the symptoms of conditions like osteoarthritis, rheumatoid arthritis, crystal arthropathy, and rotator cuff tendinopathy. Most of these injections are conducted in the elderly who are on polypharmacy, including anticoagulants at times. Up to 6% of patients aged 80-84 years have been reported to be taking Warfarin. The literature availability on safety quotient for patients undergoing intraarticular injections on Warfarin is scarce. It has remained debatable over the years which approach is safe for these patients. Continuing warfarin has a theoretical bleeding risk, and stopping it can lead to even severe life-threatening thromboembolic events in high-risk patients. Objectives: To evaluate the risk of bleeding complications in patients on warfarin undergoing intraarticular injections or arthrocentesis. Study Design & Methods: A literature search of MEDLINE (1946 to present), EMBASE (1974 to present), and Cochrane CENTRAL (1988 to present) databases were conducted using any combination of the keywords, Injection, Knee, Shoulder, Joint, Intraarticular, arthrocentesis, Warfarin, and Anticoagulation in November 2020 for articles published in any language with no publication year limit. The study inclusion criteria included reporting on the rate of bleeding complications following injection of the knee or shoulder in patients on warfarin treatment. Randomized control trials and prospective and retrospective study designs were included. An electronic standardized Performa for data extraction was made. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) the methodology was used. The articles were appraised using the methodological index for nonrandomized studies. The Cochrane Risk of Bias Tool used to assess the risk of bias in included RCTs and the MINORS tool for assessment of bias in observational studies. Results: The search of databases resulted in a total of 852 articles. Relevant articles as per the inclusion criteria were shortlisted, 7 articles deemed suitable to be include. A total of 1033 joints sample size was undertaken with specified knee and shoulder joints of a total of 820. Only 6 joints had bleeding complications, 5 early bleeding at the time of injection or aspiration, and one late bleeding complication with INR of 5, additionally, 2 patients complained of bruising, 3 of pain, and 1 managed for infection. Conclusions: The results of the metanalysis show that it is relatively safe to perform intraarticular injections in patients on Warfarin regardless of the INR range.Keywords: arthrocentesis, warfarin, bleeding, injection
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