Search results for: total quality management
1706 Outcome at the Extreme of Viability: A Single-Centre Experience
Authors: Antonia Harold-Barry, Eugene Dempsey
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Background: The objective is to examine the survival and outcome of infants born under 26 weeks gestation in an Irish tertiary maternity hospital from 2007-2016 and to describe the survival and neurodevelopmental outcomes of these extremely preterm infants. Method: The population is 132 infants born at 23, 24, and 25 weeks in Cork University Maternity Hospital from 2007 to 2016. Ethical approval was granted by the Cork Clinical Research Ethics Committee. Patient details were obtained from the Vermont Oxford and Badger Networks. Survival rates and Bayley scores were calculated to assess neurodevelopmental outcomes. Statistical analysis with SPSS included frequencies, distributions, and comparisons between data from 2007-2011 and 2012-2016. Results: Overall survival rate was 63%. Of the surviving babies, 61% had Bayley scores calculated. Survival stood at 39% for delivery at 23 weeks, 50% at 24 weeks, and 83% at 25 weeks. The 2012 to 2016 cohort has shown further increases in survival, with 50% of babies at 23 weeks, 58% at 24 weeks, and 89% at 25 weeks. Corresponding figures for 2007-2011 are 20%, 39%, and 75%. Gestational age and incidence of periventricular leukomalacia were statistically significant, with a p-value of 0.022. Gestational age and delivery room deaths had a p-value of 0.025, as did gestational age and birth weight. A comparison of the two cohorts (2007-2011 and 2012-2016) with the administration of antenatal steroids showed a statistically significant p-value of 0.044. Conclusion: There is less morbidity and mortality in infants born at 25 than at 23 or 24 weeks. Survival of extremely premature infants has increased significantly over the past ten years. Survival rates with normal neurodevelopmental outcomes are comparable with international standards and reflect positive changes in attitude and practices in neonatal intensive care. This study will inform parents about the potential outcomes of extreme prematurity and policy regarding the management of extreme prematurity.Keywords: extreme of viability, neurodevelopmental outcome, periventricular leukomalacia, prematurity
Procedia PDF Downloads 911705 Genome-Wide Analysis Identifies Locus Associated with Parathyroid Hormone Levels
Authors: Antonela Matana, Dubravka Brdar, Vesela Torlak, Marijana Popovic, Ivana Gunjaca, Ozren Polasek, Vesna Boraska Perica, Maja Barbalic, Ante Punda, Caroline Hayward, Tatijana Zemunik
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Parathyroid hormone (PTH) plays a critical role in the regulation of bone mineral metabolism and calcium homeostasis. Higher PTH levels are associated with heart failure, hypertension, coronary artery disease, cardiovascular mortality and poorer bone health. A twin study estimated that 60% of the variation in PTH concentrations is genetically determined. Only one GWAS of PTH concentration has been reported to date. Identified loci explained 4.5% of the variance in circulating PTH, suggesting that additional genetic variants remain undiscovered. Therefore, the aim of this study was to identify novel genetic variants associated with PTH levels in a general population. We have performed a GWAS meta-analysis on 2596 individuals originating from three Croatian cohorts: City of Split and the Islands of Korčula and Vis, within a large-scale project of “10,001 Dalmatians”. A total of 7 411 206 variants, imputed using the 1000 Genomes reference panel, with minor allele frequency ≥ 1% and Rsq ≥ 0.5 were analyzed for the association. GWAS within each data set was performed under an additive model, controlling for age, gender and relatedness. Meta-analysis was conducted using the inverse-variance fixed-effects method. Furthermore, to identify sex-specific effects, we have conducted GWAS meta-analyses analyzing males and females separately. In addition, we have performed biological pathway analysis. Four SNPs, representing one locus, reached genome-wide significance. The most significant SNP was rs11099476 on chromosome 4 (P=1.15x10-8), which explained 1.14 % of the variance in PTH. The SNP is located near the protein-coding gene RASGEF1B. Additionally, we detected suggestive association with SNPs, rs77178854 located on chromosome 2 in the DPP10 gene (P=2.46x10-7) and rs481121 located on chromosome 1 (P=3.58x10-7) near the GRIK1 gene. One of the top hits detected in the main meta-analysis, intron variant rs77178854 located within DPP10 gene, reached genome-wide significance in females (P=2.21x10-9). No single locus was identified in the meta-analysis in males. Fifteen biological pathways were functionally enriched at a P<0.01, including muscle contraction, ion homeostasis and cardiac conduction as the most significant pathways. RASGEF1B is the guanine nucleotide exchange factor, known to be associated with height, bone density, and hip. DPP10 encodes a membrane protein that is a member of the serine proteases family, which binds specific voltage-gated potassium channels and alters their expression and biophysical properties. In conclusion, we identified 2 novel loci associated with PTH levels in a general population, providing us with further insights into the genetics of this complex trait.Keywords: general population, genome-wide association analysis, parathyroid hormone, single nucleotide polymorphisms.
Procedia PDF Downloads 2281704 The Impact of Undocumented Migration on Human Security in Northern Nigeria
Authors: Targba Aondowase
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Undocumented migration along Nigeria’s boarder with Cameroon, Chad and Niger is a key issue in tackling the human security challenges in the region as the security situation cannot be contained without proper boarder control. The paper adopts migration systems theory which asserts that migration alters the social, cultural, economic, and institutional conditions at both the sending and receiving ends to explain the influence of unregistered migrants on institutional changes as it affects the security situation in Northern Nigeria. It was found that undocumented migration is majorly influenced by poverty, illegal trade, wars and asylum. The study also discovers that Nigerian boarders are porous with over 250 footpaths that link directly to Cameroon, Chad and Niger, making the proliferation of small arms and light weapons a transnational organized crime in the region. These porous borders are unmanned by security operatives with limited government presence in the boarder communities. The study also found that undocumented immigrants are easily integrated into the northern communities due to common religious beliefs and race where they carry out normal and civic functions without obstruction. The paper concluded that the level of undocumented migration in Northern Nigeria is high due to unmanned and porous borders. The paper therefore recommended that the security agencies should be strengthened through adequate funding, innovative technology, sound policies and proficient processes that will help protect the country’s borders. The National Populations Commission and the National Identity Management Commission should be strengthened to have a good data base of the country’s citizens and there should be international cooperation between the neighbouring countries to tackle illegal migration and illegal trade along the borders. The findings and recommendations of this paper will serve as a guide towards curtailing the impact of undocumented migration on human security in Northern Nigeria.Keywords: human security, impact, migration, undocumented
Procedia PDF Downloads 3361703 Enforcement against Illegal Logging: Issues and Challenges
Authors: Muhammad Nur Haniff Mohd Noor, Rokiah Kadir, Suriyani Muhamad
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Sustainable forest management and forest protection can be hampered by illegal logging. Illegal logging is not uncommon in many wood-producing countries. Hence, law enforcement, especially in timber-producing countries, is crucial in ensuring compliance with forestry related regulations, as well as confirming that all parties obey the rules and regulations prescribed by the authorities. However, enforcement officers are encountering various challenges and difficulties which have undermined the enforcement capacity and efficiency. The appropriate policy responses for these issues are important to resolve the problems in the long term and empowering enforcement capacity to meet future challenges of forest law enforcement. This paper is written according to extensive review of the articles and publications by The International Criminal Police Organization (INTERPOL), The International Tropical Timber Organization (ITTO), Chatham House and The Food and Agriculture Organization of the United Nations (FAO). Subsequently, various books and journal articles are reviewed to gain further insight towards enforcement issues and challenges. This paper identifies several issues which consist of (1) insufficient enforcement capacity and resources (2) lack of coordination between various enforcement agencies, (3) corruption in the government and private sectors and (4) unclear legal frameworks related to the forestry sector. Next, this paper discusses appropriate policy responses to address each enforcement challenges according to various publications. This includes specific reports concerning forest law enforcement published by international forestry-related organizations. Therefore, lack of resources, inadequate synchronization between agencies, corruption, and legal issues present challenges to enforcement officers in their daily routines. Recommendations regarding proper policy responses to overcome the issues are of great importance in assisting forest authorities in prioritizing their resources appropriately.Keywords: corruption, enforcement challenges, enforcement capacity, forest law enforcement, insufficient agency coordination, legislative ambiguity
Procedia PDF Downloads 1891702 A Qualitative Anthropological Analysis of Competing Health Perceptions in Chagas-Related Consultations in Non-Endemic Geneva
Authors: Marina Gold, Yves Jackson, David Parrat
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The high predominance of Latin American migrants in Geneva from countries where Chagas disease is endemic (Bolivia, Brazil, Argentina, Colombia) is increasing the incidence of chronic Chagas-related problems, especially cardiovascular complications. The precarious migratory status of what are mostly undocumented migrants complicates access to health and affects patients’ and doctors’ health perceptions regarding screening, treatment and monitoring of Chagas-related health concerns. This project results from a 3 year collaboration between the Geneva University Hospital and the NGO Mundo Sano to understand the following questions: 1) how do Latin American migrants perceive their health? 2) What do they understand from Chagas disease? 3) Are patients’ and doctors’ health perceptions similar or do they have competing agendas? This paper aims to present the results of a long-term study that interrogates health perceptions among Latin American migrants in Geneva. The first phase consisted in completing surveys at three community screening events (2016, 2017. 2018), and the results of these surveys reveal the subordination of the importance of health to that of having met economic family obligation. That is, health is important only when it becomes an impediment to economic gain. The contradictory result emerged that people are aware of the importance of health prevention in order to ensure long-term health, but they do not always have agency over their life-style habits (healthy food, regular exercise, emotional stability). The second phase of the research collected open-ended interviews with selected participants, in order to explore in more detail how Latin American migrants deal with Chagas in a different socio-political and economic context to that of endemic countries. These interviews (5 in total) reveal mixed methods of managing health: social networks, access to health care transnationally (in Geneva, Spain and back in their home country), and different valuations of health problems in each situation. The third phase consisted in observations of doctor-patient consultations and further extended interviews with patients to determine doctor/patient health perceptions around Chagas disease. This phase is ongoing, but it has yielded preliminarily observations regarding the expectations that patients’ have of doctors, and the understanding of doctors’ to patients’ complex situations. Positive and complementary health perceptions include patients’ feeling that doctors in Geneva are more understanding, more knowledgeable and less racist than those in their home country, who do not provide detailed information about Chagas or its treatment and discriminate against them for being indigenous or from poor rural areas, enabling a better communication between doctors and patients. Possible conflicting health perceptions include patients addressing their health concerns more holistically and encountering the specialist’s limitations to only treating one health concern, given time limitations and lack of competition with their colleagues (the general practitioner that referred the patient, for example). The implications of this study extend the case of Chagas disease in Geneva and is relevant for all chronic concerns and migratory contexts of precarity.Keywords: chagas disease, health perceptions, Latin American Migrants, non-endemic countries
Procedia PDF Downloads 1201701 Human Dental Pulp Stem Cells Attenuate Streptozotocin-Induced Parotid Gland Injury in Rats
Authors: Gehan ElAkabawy
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Background: Diabetes mellitus causes severe deteriorations of almost all the organs and systems of the body, as well as significant damage to the oral cavity. The oral changes are mainly related to salivary glands dysfunction characterized by hyposalivation and xerostomia, which significantly reduce diabetic patients’ quality of life. Human dental pulp stem cells represent a promising source for cell-based therapies, owing to their easy, minimally invasive surgical access, and high proliferative capacity. It was reported that the trophic support mediated by dental pulp stem cells can rescue the functional and structural alterations of damaged salivary glands. However, potential differentiation and paracrine effects of human dental pulp stem cells in diabetic-induced parotid gland damage have not been previously investigated. Our study aimed to investigate the therapeutic effects of intravenous transplantation of human dental pulp stem cells (hDPSCs) on parotid gland injury in a rat model of streptozotocin (STZ)-induced type 1 diabetes. Methods: Thirty Sprague-Dawley male rats were randomly categorised into three groups: control, diabetic (STZ), and transplanted (STZ+hDPSCs). hDPSCs or vehicle was injected into the tail vein 7 days after STZ injection. The fasting blood glucose levels were monitored weekly. A glucose tolerance test was performed, and the parotid gland weight, salivary flow rate, oxidative stress indices, parotid gland histology, and caspase-3, vascular endothelial growth factor (VEGF), and proliferating cell nuclear antigen (PCNA) expression in parotid tissues were assessed 28 days post-transplantation. Results: Transplantation of hDPSCs downregulated blood glucose, improved the salivary flow rate, and reduced oxidative stress. The cells migrated to, survived, and differentiated into acinar, ductal, and myoepithelial cells in the STZ-injured parotid gland. Moreover, they downregulated the expression of caspase-3 and upregulated the expression of VEGF and PCNA, likely exerting pro-angiogenetic and antiapoptotic effects and promoting endogenous regeneration. In addition, the transplanted cells enhanced the parotid nitric oxide (NO) -tetrahydrobiopterin (BH4) pathway. Conclusions: Our results show that hDPSCs can migrate to and survive within the STZ-injured parotid gland, where they prevent its functional and morphological damage by restoring normal glucose levels, differentiating into parotid cell populations, and stimulating paracrine-mediated regeneration. Thus, hDPSCs may have therapeutic potential in the treatment of diabetes-induced parotid gland injury.Keywords: dental pulp stem cells, diabetes, streptozotocin, parotid gland
Procedia PDF Downloads 1991700 Towards the Development of Islamic Accounting Standards for Baitulmal, Waqaf, and Zakat Transactions: Addressing Gaps for Enhanced Accountability
Authors: N. Farahin Ali, Naharriah Mohamed, Hafiz Majdi, Fathiyyah, Fadliana Saman
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This paper investigates the imperative for developing Islamic accounting standards tailored to Baitulmal, waqaf, and zakat transactions, with the goal of strengthening accountability and transparency in financial reporting. Current financial reporting frameworks in Malaysia—namely, the Malaysian Financial Reporting Standards (MFRS) and Malaysian Private Entities Reporting Standards (MPERS)—are designed predominantly for conventional financial transactions and fail to fully capture the Shariah-specific nature of these religious funds. The objective of this study is to critically examine the discrepancies between these conventional reporting standards and the requirements of Shariah-compliant financial transactions, specifically for Baitulmal, waqaf, and zakat. This research adopts a qualitative methodology, utilizing case studies from four different State Islamic Religious Councils to explore the current reporting practices. The findings reveal significant gaps between the conventional frameworks and the specific needs of Shariah-compliant accounting, leading to off-balance-sheet reporting of certain transactions and inconsistencies in financial disclosures across different states. These disparities undermine both the comparability and integrity of the financial reports, raising critical concerns regarding transparency and governance. The broader implications of this study underscore the necessity for a unified Islamic accounting standard that would align more closely with Shariah principles. Such a standard would not only enhance the disclosure and presentation of baitulmal, waqaf, and zakat transactions, but also improve decision-making processes, thereby fostering greater accountability and trust in the management of these Islamic funds. This paper advocates for a concerted effort to bridge the existing gap, ensuring that the distinctive characteristics of Islamic charitable funds are appropriately reflected in the financial reporting process.Keywords: islamic accounting, waqf, zakat, islamic finance
Procedia PDF Downloads 181699 The Contribution of Sanitation Practices to Marine Pollution and the Prevalence of Water-Borne Diseases in Prampram Coastal Area, Greater Accra-Ghana
Authors: Precious Roselyn Obuobi
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Background: In Ghana, water-borne diseases remain a public health concern due to its impact. While marine pollution has been linked to outbreak of diseases especially in communities along the coast, associated risks such as oil spillage, marine debris, erosion, improper waste disposal and management practices persist. Objective: The study seeks to investigate sanitation practices that contribute to marine pollution in Prampram and the prevalence of selected water-borne diseases (diarrhea and typhoid fever). Method: This study used a descriptive cross-sectional design, employing the mix-method (qualitative and quantitative) approach. Twenty-two (22) participants were selected and semistructured questionnaire were administered to them. Additionally, interviews were conducted to collect more information. Further, an observation check-list was used to aid the data collection process. Secondary data comprising information on water-borne diseases in the district was acquired from the district health directorate to determine the prevalence of selected water-borne diseases in the community. Data Analysis: The qualitative data was analyzed using NVIVO® software by adapting the six steps thematic analysis by Braun and Clarke whiles STATA® version 16 was used to analyze the secondary data collected from the district health directorate. A descriptive statistic employed using mean, standard deviation, frequencies and proportions were used to summarize the results. Results: The results showed that open defecation and indiscriminate waste disposal were the main practices contributing to marine pollution in Prampram and its effect on public health. Conclusion: These findings have implications on public health and the environment, thus effort needs to be stepped up in educating the community on best sanitation practices.Keywords: environment, sanitation, marine pollution, water-borne diseases
Procedia PDF Downloads 781698 Strategies for Synchronizing Chocolate Conching Data Using Dynamic Time Warping
Authors: Fernanda A. P. Peres, Thiago N. Peres, Flavio S. Fogliatto, Michel J. Anzanello
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Batch processes are widely used in food industry and have an important role in the production of high added value products, such as chocolate. Process performance is usually described by variables that are monitored as the batch progresses. Data arising from these processes are likely to display a strong correlation-autocorrelation structure, and are usually monitored using control charts based on multiway principal components analysis (MPCA). Process control of a new batch is carried out comparing the trajectories of its relevant process variables with those in a reference set of batches that yielded products within specifications; it is clear that proper determination of the reference set is key for the success of a correct signalization of non-conforming batches in such quality control schemes. In chocolate manufacturing, misclassifications of non-conforming batches in the conching phase may lead to significant financial losses. In such context, the accuracy of process control grows in relevance. In addition to that, the main assumption in MPCA-based monitoring strategies is that all batches are synchronized in duration, both the new batch being monitored and those in the reference set. Such assumption is often not satisfied in chocolate manufacturing process. As a consequence, traditional techniques as MPCA-based charts are not suitable for process control and monitoring. To address that issue, the objective of this work is to compare the performance of three dynamic time warping (DTW) methods in the alignment and synchronization of chocolate conching process variables’ trajectories, aimed at properly determining the reference distribution for multivariate statistical process control. The power of classification of batches in two categories (conforming and non-conforming) was evaluated using the k-nearest neighbor (KNN) algorithm. Real data from a milk chocolate conching process was collected and the following variables were monitored over time: frequency of soybean lecithin dosage, rotation speed of the shovels, current of the main motor of the conche, and chocolate temperature. A set of 62 batches with durations between 495 and 1,170 minutes was considered; 53% of the batches were known to be conforming based on lab test results and experts’ evaluations. Results showed that all three DTW methods tested were able to align and synchronize the conching dataset. However, synchronized datasets obtained from these methods performed differently when inputted in the KNN classification algorithm. Kassidas, MacGregor and Taylor’s (named KMT) method was deemed the best DTW method for aligning and synchronizing a milk chocolate conching dataset, presenting 93.7% accuracy, 97.2% sensitivity and 90.3% specificity in batch classification, being considered the best option to determine the reference set for the milk chocolate dataset. Such method was recommended due to the lowest number of iterations required to achieve convergence and highest average accuracy in the testing portion using the KNN classification technique.Keywords: batch process monitoring, chocolate conching, dynamic time warping, reference set distribution, variable duration
Procedia PDF Downloads 1681697 Are Oral Health Conditions Associated with Children’s School Performance and School Attendance in the Kingdom of Bahrain - A Life Course Approach
Authors: Seham A. S. Mohamed, Sarah R. Baker, Christopher Deery, Mario V. Vettore
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Background: The link between oral health conditions and school performance and attendance remain unclear among Middle Eastern children. The association has been studied extensively in the Western region; however, several concerns have been raised regarding the reliability and validity of measures, low quality of studies, inadequate inclusion of potential confounders, and the lack of a conceptual framework. These limitations have meant that, to date, there has been no detailed understanding of the association or of the key social, clinical, behavioural and parental factors which may impact the association. Aim: To examine the association between oral health conditions and children’s school performance and attendance at Grade 2 in Muharraq city in the Kingdom of Bahrain using Heilmann et al.’s (2015) life course framework for oral health. Objectives: To (1) describe the prevalence of oral health conditions among 7-8 years old schoolchildren in the city of Muharraq; (2) analyse the social, biological, behavioural, and parental pathways that link early and current life exposures with children’s current oral health status; (3) examine the association between oral health conditions and school performance and attendance among schoolchildren; (4) explore the early and current life course social, biological, behavioural and parental factors associated with children’s school outcomes. Design: A time-ordered-cross-sectional study was conducted with 466 schoolchildren aged 7-8 years and their parents from Muharraq city in KoB. Data were collected through parents’ self-administered questionnaires, children’s face-face interviews, and dental clinical examinations. Outcome variables, including school performance and school attendance data, were obtained from the parents and school records. The data were analysed using structural equation modelling (SEM). Results: Dental caries, the consequence of dental caries (PUFA/pufa), and enamel developmental defects (EDD) prevalence were 93.4%, 25.7%, and 17.2%, respectively. The findings from the SEM showed that children born in families with high SES were less likely to suffer from dentine dental caries (β= -0.248) and more likely to earn high school performance (β= 0.136) at 7-8 years of age in Muharraq. From the current life course of children, the dental plaque was associated significantly and directly with enamel caries (β= 0.094), dentine caries (β= 0.364), treated teeth (filled or extracted because of dental caries) (β= 0.121), and indirectly associated with dental pain (β= 0.057). Further, dentine dental caries was associated significantly and directly with low school performance (β= -0.155). At the same time, the dental plaque was indirectly associated with low school performance via dental caries (β = −0.044). Conversely, treated teeth were associated directly with high school performance (β= 0.100). Notably, none of the OHCs, biological, SES, behavioural, or parental conditions was related to school attendance in children. Conclusion: The life course approach was adequate to examine the role of OHCs on children’s school performance and attendance. Birth and current (7-8-year-olds) social factors were significant predictors of poor OH and poor school performance.Keywords: dental caries, life course, Bahrain, school outcomes
Procedia PDF Downloads 1121696 Risk in the South African Sectional Title Industry: An Assurance Perspective
Authors: Leandi Steenkamp
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The sectional title industry has been a part of the property landscape in South Africa for almost half a century, and plays a significant role in addressing the housing problem in the country. Stakeholders such as owners and investors in sectional title property are in most cases not directly involved in the management thereof, and place reliance on the audited annual financial statements of bodies corporate for decision-making purposes. Although the industry seems to be highly regulated, the legislation regarding accounting and auditing of sectional title is vague and ambiguous. Furthermore, there are no industry-specific auditing and accounting standards to guide accounting and auditing practitioners in performing their work and industry financial benchmarks are not readily available. In addition, financial pressure on sectional title schemes is often very high due to the fact that some owners exercise unrealistic pressure to keep monthly levies as low as possible. All these factors have an impact on the business risk as well as audit risk of bodies corporate. Very little academic research has been undertaken on the sectional title industry in South Africa from an accounting and auditing perspective. The aim of this paper is threefold: Firstly, to discuss the findings of a literature review on uncertainties, ambiguity and confusing aspects in current legislation regarding the audit of a sectional title property that may cause or increase audit and business risk. Secondly, empirical findings of risk-related aspects from the results of interviews with three groups of body corporate role-players will be discussed. The role-players were body corporate trustee chairpersons, body corporate managing agents and accounting and auditing practitioners of bodies corporate. Specific reference will be made to business risk and audit risk. Thirdly, practical recommendations will be made on possibilities of closing the audit expectation gap, and further research opportunities in this regard will be discussed.Keywords: assurance, audit, audit risk, body corporate, corporate governance, sectional title
Procedia PDF Downloads 2691695 Epidemiological Patterns of Pediatric Fever of Unknown Origin
Authors: Arup Dutta, Badrul Alam, Sayed M. Wazed, Taslima Newaz, Srobonti Dutta
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Background: In today's world, with modern science and contemporary technology, a lot of diseases may be quickly identified and ruled out, but children's fever of unknown origin (FUO) still presents diagnostic difficulties in clinical settings. Any fever that reaches 38 °C and lasts for more than seven days without a known cause is now classified as a fever of unknown origin (FUO). Despite tremendous progress in the medical sector, fever of unknown origin, or FOU, persists as a major health issue and a major contributor to morbidity and mortality, particularly in children, and its spectrum is sometimes unpredictable. The etiology is influenced by geographic location, age, socioeconomic level, frequency of antibiotic resistance, and genetic vulnerability. Since there are currently no known diagnostic algorithms, doctors are forced to evaluate each patient one at a time with extreme caution. A persistent fever poses difficulties for both the patient and the doctor. This prospective observational study was carried out in a Bangladeshi tertiary care hospital from June 2018 to May 2019 with the goal of identifying the epidemiological patterns of fever of unknown origin in pediatric patients. Methods: It was a hospital-based prospective observational study carried out on 106 children (between 2 months and 12 years) with prolonged fever of >38.0 °C lasting for more than 7 days without a clear source. Children with additional chronic diseases or known immunodeficiency problems were not allowed. Clinical practices that helped determine the definitive etiology were assessed. Initial testing included a complete blood count, a routine urine examination, PBF, a chest X-ray, CRP measurement, blood cultures, serology, and additional pertinent investigations. The analysis focused mostly on the etiological results. The standard program SPSS 21 was used to analyze all of the study data. Findings: A total of 106 patients identified as having FUO were assessed, with over half (57.5%) being female and the majority (40.6%) falling within the 1 to 3-year age range. The study categorized the etiological outcomes into five groups: infections, malignancies, connective tissue conditions, miscellaneous, and undiagnosed. In the group that was being studied, infections were found to be the main cause in 44.3% of cases. Undiagnosed cases came in at 31.1%, cancers at 10.4%, other causes at 8.5%, and connective tissue disorders at 4.7%. Hepato-splenomegaly was seen in people with enteric fever, malaria, acute lymphoid leukemia, lymphoma, and hepatic abscesses, either by itself or in combination with other conditions. About 53% of people who were not diagnosed also had hepato-splenomegaly at the same time. Conclusion: Infections are the primary cause of PUO (pyrexia of unknown origin) in children, with undiagnosed cases being the second most common cause. An incremental approach is beneficial in the process of diagnosing a condition. Non-invasive examinations are used to diagnose infections and connective tissue disorders, while invasive investigations are used to diagnose cancer and other ailments. According to this study, the prevalence of undiagnosed diseases is still remarkable, so extensive historical analysis and physical examinations are necessary in order to provide a precise diagnosis.Keywords: children, diagnostic challenges, fever of unknown origin, pediatric fever, undiagnosed diseases
Procedia PDF Downloads 311694 Dyadic Video Evidence on How Emotions in Parent Verbal Bids Affect Child Compliance in a British Sample
Authors: Iris Sirirada Pattara-Angkoon, Rory Devine, Anja Lindberg, Wendy Browne, Sarah Foley, Gabrielle McHarg, Claire Hughes
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Introduction: The “Terrible Twos” is a phrase used to describe toddlers 18-30 months old. It characterizes a transition from high dependency to their caregivers in infancy to more autonomy and mastery of the body and environment. Toddlers at this age may also show more willfulness and stubbornness that could predict a future trajectory leading to conduct disorders. Thus, an important goal for this age group is to promote responsiveness to their caregivers (i.e., compliance). Existing literature tends to focus on praise to increase desirable child behavior. However, this relationship is not always straightforward as some studies have found no or negative association between praise and child compliance. Research suggests positive emotions and affection showed through body language (e.g., smiles) and actions (e.g., hugs, kisses) along with positive parent-child relationship can strengthen the praise and child compliance association. Nonetheless, few studies have examined the influences of positive emotionality within the speech. This is important as implementing verbal positive emotionality is easier than physical adjustments. The literature also tends not to include fathers in the study sample as mothers were traditionally the primary caregiver. However, as child-caring duties are increasing shared equally between mothers and fathers, it is important to include fathers within the study as studies have frequently found differences between female and male caregiver characteristics. Thus, the study will address the literary gap in two ways: 1. explore the influences of positive emotionality in parental speech and 2. include an equal sample of mothers and fathers. Positive emotionality is expected to positively correlate with and predict child compliance. Methodology: This study analyzed toddlers (18-24 months) in their dyadic interactions with mothers and fathers. A Duplo (block) task was used where parents had to work with their children to build the Duplo according to the given photo for four minutes. Then, they would be told to clean up the blocks. Parental positive emotionality in different speech types (e.g., bids, praises, affirmations) and child compliance were measured. Results: The study found that mothers (M = 28.92, SD = 12.01) were significantly more likely than fathers (M = 23.01, SD = 12.28) to use positive verbal emotionality in their speech, t(105) = 4.35, p< .001. High positive emotionality in bids during Duplo task and Clean Up was positively correlated with more child compliance in each task, r(273) = .35, p< .001 and r(264) = .58, p< .001, respectively. Overall, parental positive emotionality in speech significantly predicted child compliance, F(6, 218) = 13.33, p< .001, R² = .27) with emotionality in verbal bids (t = 6.20, p< .001) and affirmations (t = 3.12, p = .002) being significant predictors. Conclusion: Positive verbal emotions may be useful for increasing compliance in toddlers. This can be beneficial for compliance interventions as well as to the parent-child relationship quality through reduction of conflict and child defiance. As this study is correlational in nature, it will be important for future research to test the directional influence of positive emotionality within speech.Keywords: child temperament, compliance, positive emotion, toddler, verbal bids
Procedia PDF Downloads 1851693 Rural Sanitation in India: Special Context in the State of Odisa
Authors: Monalisha Ghosh, Asit Mohanty
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The lack of sanitation increases living costs, decreases spend on education and nutrition, lowers income earning potential, and threatens safety and welfare. This is especially true for rural India. Only 32% of rural households have their own toilets and that less than half of Indian households have a toilet at home. Of the estimated billion people in the world who defecate in the open, more than half reside in rural India. It is empirically established that poor sanitation leads to high infant mortality rate and low income generation in rural India. In India, 1,600 children die every day before reaching their fifth birthday and 24% of girls drop out of school as the lack of basic sanitation. Above all, lack of sanitation is not a symptom of poverty but a major contributing factor. According to census 2011, 67.3% of the rural households in the country still did not have access to sanitation facilities. India’s sanitation deficit leads to losses worth roughly 6% of its gross domestic product (GDP) according to World Bank estimates by raising the disease burden in the country. The dropout rate for girl child is thirty percent in schools in rural areas because of lack of sanitation facilities for girl students. The productivity loss per skilled labors during a year is calculated at Rs.44, 160 in Odisha. The performance of the state of Odisha has not been satisfactory in improving sanitation facilities. The biggest challenge is triggering behavior change in vast section of rural population regarding need to use toilets. Another major challenge is funding and implementation for improvement of sanitation facility. In an environment of constrained economic resources, Public Private Partnership in form of performance based management or maintenance contract will be all the more relevant to improve the sanitation status in rural sector.Keywords: rural sanitation, infant mortality rate, income, granger causality, pooled OLS method test public private partnership
Procedia PDF Downloads 4241692 Kinetic Rate Comparison of Methane Catalytic Combustion of Palladium Catalysts Impregnated onto ɤ-Alumina and Bio-Char
Authors: Noor S. Nasri, Eric C. A. Tatt, Usman D. Hamza, Jibril Mohammed, Husna M. Zain
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Climate change has becoming a global environmental issue that may trigger irreversible changes in the environment with catastrophic consequences for human, animals and plants on our planet. Methane, carbon dioxide and nitrous oxide are the greenhouse gases (GHG) and as the main factor that significantly contributes to the global warming. Mainly carbon dioxide be produced and released to atmosphere by thermal industrial and power generation sectors. Methane is dominant component of natural gas releases significant of thermal heat, and the gaseous pollutants when homogeneous thermal combustion takes place at high temperature. Heterogeneous catalytic Combustion (HCC) principle is promising technologies towards environmental friendly energy production should be developed to ensure higher yields with lower pollutants gaseous emissions and perform complete combustion oxidation at moderate temperature condition as comparing to homogeneous high thermal combustion. Hence the principle has become a very interesting alternative total oxidation for the treatment of pollutants gaseous emission especially NOX product formation. Noble metals are dispersed on a support-porous HCC such as γ- Al2O3, TiO2 and ThO2 to increase thermal stability of catalyst and to increase to effectiveness of catalytic combustion. Support-porous HCC material to be selected based on factors of the surface area, porosity, thermal stability, thermal conductivity, reactivity with reactants or products, chemical stability, catalytic activity, and catalyst life. γ- Al2O3 with high catalytic activity and can last longer life of catalyst, is commonly used as the support for Pd catalyst at low temperatures. Sustainable and renewable support-material of bio-mass char was derived from agro-industrial waste material and used to compare with those the conventional support-porous material. The abundant of biomass wastes generated in palm oil industries is one potential source to convert the wastes into sustainable material as replacement of support material for catalysts. Objective of this study was to compare the kinetic rate of reaction the combustion of methane on Palladium (Pd) based catalyst with Al2O3 support and bio-char (Bc) support derived from shell kernel. The 2wt% Pd was prepared using incipient wetness impregnation method and the HCC performance was accomplished using tubular quartz reactor with gas mixture ratio of 3% methane and 97% air. Material characterization was determined using TGA, SEM, and BET surface area. The methane porous-HCC conversion was carried out by online gas analyzer connected to the reactor that performed porous-HCC. BET surface area for prepared 2 wt% Pd/Bc is smaller than prepared 2wt% Pd/ Al2O3 due to its low porosity between particles. The order of catalyst activity based on kinetic rate on reaction of catalysts in low temperature is prepared 2wt% Pd/Bc > calcined 2wt% Pd/ Al2O3 > prepared 2wt% Pd/ Al2O3 > calcined 2wt% Pd/Bc. Hence the usage of agro-industrial bio-mass waste material can enhance the sustainability principle.Keywords: catalytic-combustion, environmental, support-bio-char material, sustainable and renewable material
Procedia PDF Downloads 3931691 Analysis of the Factors of Local Acceptance of Wind Power Generation Facilities
Authors: Hyunjoo Park, Taehyun Kim, Taehyun Kim
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The government that declared 'de-nuclearization' pushes up renewable energy policies such as solar power and wind power as an alternative to nuclear power generation. However, local residents who are concerned about the development and natural disasters have been hit by opposition, and related businesses around the country are experiencing difficulties. There is also a voice saying that installing a large wind power generator will cause landslides, low frequencies and noise, which will have a bad influence. Renewal is only a harmful and disgusting facility for the residents. In this way, it is expected that extreme social conflicts will occur in the decision making process related to the locally unwanted land-use (LULU). The government's efforts to solve this problem have been steadily progressing, but the systematic methodology for bringing in active participation and opinion gathering of the residents has not yet been established except for the simple opinion poll or referendum. Therefore, it is time to identify the factors that concern the local residents about the wind power generation facilities, and to find ways to make policy decision-making possible. In this study, we analyze the perception of people about offshore and onshore wind power facilities through questionnaires or interviews, and examine quantitative and qualitative precedent studies to analyze them. In addition, the study evaluates what factors affect the local acceptance of wind power facilities. As a result of the factor analysis of the questionnaire items, factors affecting the residents' acceptance of the wind power facility were extracted from four factors such as environmental, economic, risk, social, and management factor. The study also found that the influence of the determinants of local acceptance on the regional acceptability differs according to the demographic characteristics such as gender and income level. This study will contribute to minimizing the conflict on the installation of wind power facilities through communication among the local residents.Keywords: factor analysis, local acceptance, locally unwanted land-use, LULU, wind power generation facilities
Procedia PDF Downloads 1571690 Risks beyond Cyber in IoT Infrastructure and Services
Authors: Mattias Bergstrom
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Significance of the Study: This research will provide new insights into the risks with digital embedded infrastructure. Through this research, we will analyze each risk and its potential negation strategies, especially for AI and autonomous automation. Moreover, the analysis that is presented in this paper will convey valuable information for future research that can create more stable, secure, and efficient autonomous systems. To learn and understand the risks, a large IoT system was envisioned, and risks with hardware, tampering, and cyberattacks were collected, researched, and evaluated to create a comprehensive understanding of the potential risks. Potential solutions have then been evaluated on an open source IoT hardware setup. This list shows the identified passive and active risks evaluated in the research. Passive Risks: (1) Hardware failures- Critical Systems relying on high rate data and data quality are growing; SCADA systems for infrastructure are good examples of such systems. (2) Hardware delivers erroneous data- Sensors break, and when they do so, they don’t always go silent; they can keep going, just that the data they deliver is garbage, and if that data is not filtered out, it becomes disruptive noise in the system. (3) Bad Hardware injection- Erroneous generated sensor data can be pumped into a system by malicious actors with the intent to create disruptive noise in critical systems. (4) Data gravity- The weight of the data collected will affect Data-Mobility. (5) Cost inhibitors- Running services that need huge centralized computing is cost inhibiting. Large complex AI can be extremely expensive to run. Active Risks: Denial of Service- It is one of the most simple attacks, where an attacker just overloads the system with bogus requests so that valid requests disappear in the noise. Malware- Malware can be anything from simple viruses to complex botnets created with specific goals, where the creator is stealing computer power and bandwidth from you to attack someone else. Ransomware- It is a kind of malware, but it is so different in its implementation that it is worth its own mention. The goal with these pieces of software is to encrypt your system so that it can only be unlocked with a key that is held for ransom. DNS spoofing- By spoofing DNS calls, valid requests and data dumps can be sent to bad destinations, where the data can be extracted for extortion or to corrupt and re-inject into a running system creating a data echo noise loop. After testing multiple potential solutions. We found that the most prominent solution to these risks was to use a Peer 2 Peer consensus algorithm over a blockchain to validate the data and behavior of the devices (sensors, storage, and computing) in the system. By the devices autonomously policing themselves for deviant behavior, all risks listed above can be negated. In conclusion, an Internet middleware that provides these features would be an easy and secure solution to any future autonomous IoT deployments. As it provides separation from the open Internet, at the same time, it is accessible over the blockchain keys.Keywords: IoT, security, infrastructure, SCADA, blockchain, AI
Procedia PDF Downloads 1081689 Increased Stability of Rubber-Modified Asphalt Mixtures to Swelling, Expansion and Rebound Effect during Post-Compaction
Authors: Fernando Martinez Soto, Gaetano Di Mino
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The application of rubber into bituminous mixtures requires attention and care during mixing and compaction. Rubber modifies the properties because it reacts in the internal structure of bitumen at high temperatures changing the performance of the mixture (interaction process of solvents with binder-rubber aggregate). The main change is the increasing of the viscosity and elasticity of the binder due to the larger sizes of the rubber particles by dry process but, this positive effect is counteracted by short mixing times, compared to wet technology, and due to the transport processes, curing time and post-compaction of the mixtures. Therefore, negative effects as swelling of rubber particles, rebounding effect of the specimens and thermal changes by different expansion of the structure inside the mixtures, can change the mechanical properties of the rubberized blends. Based on the dry technology, different asphalt-rubber binders using devulcanized or natural rubber (truck and bus tread rubber), have served to demonstrate these effects and how to solve them into two dense-gap graded rubber modified asphalt concrete mixes (RUMAC) to enhance the stability, workability and durability of the compacted samples by Superpave gyratory compactor method. This paper specifies the procedures developed in the Department of Civil Engineering of the University of Palermo during September 2016 to March 2017, for characterizing the post-compaction and mix-stability of the one conventional mixture (hot mix asphalt without rubber) and two gap-graded rubberized asphalt mixes according granulometry for rail sub-ballast layers with nominal size of Ø22.4mm of aggregates according European standard. Thus, the main purpose of this laboratory research is the application of ambient ground rubber from scrap tires processed at conventional temperature (20ºC) inside hot bituminous mixtures (160-220ºC) as a substitute for 1.5%, 2% and 3% by weight of the total aggregates (3.2%, 4.2% and, 6.2% respectively by volumetric part of the limestone aggregates of bulk density equal to 2.81g/cm³) considered, not as a part of the asphalt binder. The reference bituminous mixture was designed with 4% of binder and ± 3% of air voids, manufactured for a conventional bitumen B50/70 at 160ºC-145ºC mix-compaction temperatures to guarantee the workability of the mixes. The proportions of rubber proposed are #60-40% for mixtures with 1.5 to 2% of rubber and, #20-80% for mixture with 3% of rubber (as example, a 60% of Ø0.4-2mm and 40% of Ø2-4mm). The temperature of the asphalt cement is between 160-180 ºC for mixing and 145-160 ºC for compaction, according to the optimal values for viscosity using Brookfield viscometer and 'ring and ball' - penetration tests. These crumb rubber particles act as a rubber-aggregate into the mixture, varying sizes between 0.4mm to 2mm in a first fraction, and 2-4mm as second proportion. Ambient ground rubber with a specific gravity of 1.154g/cm³ is used. The rubber is free of loose fabric, wire, and other contaminants. It was found optimal results in real beams and cylindrical specimens with each HMA mixture reducing the swelling effect. Different factors as temperature, particle sizes of rubber, number of cycles and pressures of compaction that affect the interaction process are explained.Keywords: crumb-rubber, gyratory compactor, rebounding effect, superpave mix-design, swelling, sub-ballast railway
Procedia PDF Downloads 2441688 Effects of Culture Conditions on the Adhesion of Yeast Candida spp. and Pichia spp. to Stainless Steel with Different Polishing and Their Control
Authors: Ružica Tomičić, Zorica Tomičić, Peter Raspor
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An abundant growth of unwanted yeasts in food processing plants can lead to problems in quality and safety with significant financial losses. Candida and Pichia are the genera mainly involved in spoilage of products in the food and beverage industry. These contaminating microorganisms can form biofilms on food contact surfaces, being difficult to eradicate, increasing the probability of microbial survival and further dissemination during food processing. It is well known that biofilms are more resistant to antimicrobial agents compared to planktonic cells and this makes them difficult to eliminate. Among the strategies used to overcome resistance to antifungal drugs and preservatives, the use of natural substances such as plant extracts has shown particular promise, and many natural substances have been found to exhibit antifungal properties. This study aimed to investigated the impact of growth medium (Malt Extract broth (MEB) or Yeast Peptone Dextrose (YPD) broth) and temperatures (7°C, 37°C, 43°C for Candida strains and 7°C, 27°C, 32°C for Pichia strains) on the adhesion of Candida spp. and Pichia spp. to stainless steel (AISI 304) discs with different degrees of surface roughness (Ra = 25.20 – 961.9 nm), a material commonly used in the food industry. We also evaluated the antifungal and antiadhesion activity of plant extracts such as Humulus lupulus, Alpinia katsumadai and Evodia rutaecarpa against C. albicans, C glabrata and P. membranifaciens and investigated whether these plant extracts can interfere with biofilm formation. The adhesion was assessed by the crystal violet staining method, while the broth microdilution method CLSI M27-A3 was used to determine the minimum inhibitory concentration (MIC) of plant extracts. Our results indicated that the nutrient content of the medium significantly influenced the amount of adhered cells of the tested yeasts. The growth medium which resulted in a higher adhesion of C. albicans and C. glabrata was MEB, while for C. parapsilosis and C. krusei was YPD. In the case of P. pijperi and P. membranifaciens, YPD broth was more effective in promoting adhesion than MEB. Regarding the effect of temperature, C. albicans strain adhered to stainless steel surfaces in significantly higher level at a temperature of 43°C, while on the other hand C. glabrata, C. parapsilosis and C. krusei showed a different behavior with significantly higher adhesion at 37°C than at 7°C and 43°C. Further, the adherence ability of Pichia strains was highest at 27°C. Based on the MIC values, all plant extracts exerted significant antifungal effects with MIC values ranged from 100 to 400 μg/mL. It was observed that biofilm of C. glabrata were more resistance to plant extracts as compared to C. albicans. However, extracts of A. katsumadai and E. rutaecarpa promoted the growth and development of the preformed biofilm of P. membranifaciens. Thus, the knowledge of how these microorganisms adhere and which factors affect this phenomenon is of great importance in order to avoid their colonization on food contact surfaces.Keywords: adhesion, Candida spp., Pichia spp., plant extracts
Procedia PDF Downloads 1971687 Paper-Like and Battery Free Sensor Patches for Wound Monitoring
Authors: Xiaodi Su, Xin Ting Zheng, Laura Sutarlie, Nur Asinah binte Mohamed Salleh, Yong Yu
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Wound healing is a dynamic process with multiple phases. Rapid profiling and quantitative characterization of inflammation and infection remain challenging. We have developed paper-like battery-free multiplexed sensors for holistic wound assessment via quantitative detection of multiple inflammation and infection markers. In one of the designs, the sensor patch consists of a wax-printed paper panel with five colorimetric sensor channels arranged in a pattern resembling a five-petaled flower (denoted as a ‘Petal’ sensor). The five sensors are for temperature, pH, trimethylamine, uric acid, and moisture. The sensor patch is sandwiched between a top transparent silicone layer and a bottom adhesive wound contact layer. In the second design, a palm-like-shaped paper strip is fabricated by a paper-cutter printer (denoted as ‘Palm’ sensor). This sensor strip carries five sensor regions connected by a stem sampling entrance that enables rapid colorimetric detection of multiple bacteria metabolites (aldehyde, lactate, moisture, trimethylamine, tryptophan) from wound exudate. For both the “\’ Petal’ and ‘Palm’ sensors, color images can be captured by a mobile phone. According to the color changes, one can quantify the concentration of the biomarkers and then determine wound healing status and identify/quantify bacterial species in infected wounds. The ‘Petal’ and ‘Palm’ sensors are validated with in-situ animal and ex-situ skin wound models, respectively. These sensors have the potential for integration with wound dressing to allow early warning of adverse events without frequent removal of the plasters. Such in-situ and early detection of non-healing condition can trigger immediate clinical intervention to facilitate wound care management.Keywords: wound infection, colorimetric sensor, paper fluidic sensor, wound care
Procedia PDF Downloads 831686 The Effect of Metabolites of Fusarium solani on the Activity of the PR-Proteins (Chitinase, β-1,3-Glucanase and Peroxidases) of Potato Tubers
Authors: A. K. Tursunova, O. V. Chebonenko, A. Zh. Amirkulova, A. O. Abaildayev, O. A. Sapko, Y. M. Dyo, A. Sh. Utarbaeva
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Fusarium solani and its variants cause root and stem rot of plants. Dry rot is the most common disease of potato tubers during storage. The causative agents of fusariosis in contact with plants behave as antagonists, growth stimulants or parasites. The diversity of host-parasite relationships is explained by the parasite’s ability to produce a wide spectrum of biologically active compounds including toxins, enzymes, oligosaccharides, antibiotic substances, enniatins and gibberellins. Many of these metabolites contribute to the creation of compatible relations; others behave as elicitors, inducing various protective responses in plants. An important part of the strategy for developing plant resistance against pathogens is the activation of protein synthesis to produce protective ‘pathogenesis-related’ proteins. The family of PR-proteins known to confer the most protective response is chitinases (EC 3.2.1.14, Cht) and β-1,3-glucanases (EC 3.2.1.39, Glu). PR-proteins also include a large multigene family of peroxidases (EC 1.11.1.7, Pod), and increased activity of Pod and expression of the Pod genes leads to the development of resistance to a broad class of pathogens. Despite intensive research on the role of PR-proteins, the question of their participation in the mechanisms of formation of the F.solani–S.tuberosum pathosуstem is not sufficiently studied. Our aim was to investigate the effect of different classes of F. solani metabolites on the activity of chitinase, β-1,3-glucanases and peroxidases in tubers of Solanum tuberosum. Metabolite culture filtrate (CF) and cytoplasmic components were fractionated by extraction of the mycelium with organic solvents, salting out techniques, dialysis, column chromatography and ultrafiltration. Protein, lipid, carbohydrate and polyphenolic fractions of fungal metabolites were derived. Using enzymatic hydrolysis we obtained oligo glycans from fungal cell walls with different molecular weights. The activity of the metabolites was tested using potato tuber discs (d = 16mm, h = 5mm). The activity of PR-proteins of tubers was analyzed in a time course of 2–24 hours. The involvement of the analysed metabolites in the modulation of both early non-specific and late related to pathogenesis reactions was demonstrated. The most effective inducer was isolated from the CF (fraction of total phenolic compounds including naphtazarins). Induction of PR-activity by this fraction was: chitinase - 340-360%, glucanase - 435-450%, soluble forms of peroxidase - 400-560%, related forms of peroxidase - 215-237%. High-inducing activity was observed by the chloroform and acetonitrile extracts of the mycelium (induction of chitinase and glucanase activity was 176-240%, of soluble and bound forms of peroxidase - 190-400%). The fraction of oligo glycans mycelium cell walls of 1.2 kDa induced chitinase and β-1,3-glucanase to 239-320%; soluble forms and related peroxidase to 198-426%. Oligo glycans cell walls of 5-10 kDa had a weak suppressor effect - chitinase (21-25%) and glucanase (25-28%) activity; had no effect on soluble forms of peroxidase, but induced to 250-270% activity related forms. The CF polysaccharides of 8.5 kDa and 3.1 kDa inhibited synchronously the glucanase and chitinase specific response in step (after 24 hours at 42-50%) and the step response induced nonspecific peroxidase activity: soluble forms 4.8 -5.2 times, associated forms 1.4-1.6 times.Keywords: fusarium solani, PR-proteins, peroxidase, solanum tuberosum
Procedia PDF Downloads 2051685 From Acute Abdomen to Hormonal Crisis: Case Report on a Long-Delayed Sheehan's Syndrome Diagnosis
Authors: Maham Leeza Adil, Mahrukh Alvi, Muhammad Osman
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Introduction: Sheehan's syndrome (SS) is a rare cause of hypopituitarism resulting from postpartum hemorrhage and pituitary necrosis. It remains an underdiagnosed condition, especially in developing countries, due to poor obstetric care and home deliveries. This case report highlights the significance of recognizing atypical presentations of SS, such as pancytopenia, to aid in early diagnosis and management. Case Presentation: A 40-year-old female presented with acute abdomen symptoms and was initially diagnosed with acalculous cholecystitis. However, a detailed history revealed a history of postpartum hemorrhage 18 years prior, leading to a provisional diagnosis of SS. Further investigations confirmed panhypopituitarism, including hypothyroidism, hypocortisolism, and hypogonadism. Notably, the patient also exhibited pancytopenia, a rarely reported hematological manifestation of SS. Discussion: SS often presents with nonspecific symptoms, leading to delayed or missed diagnoses. In this case, the patient's initial presentation of acute abdomen symptoms was attributed to secondary adrenal insufficiency due to panhypopituitarism. The presence of pancytopenia, along with hyponatremia, further complicated the clinical picture. Hormone replacement therapy led to a remarkable improvement in the patient's condition, emphasizing the importance of early diagnosis and intervention. Conclusion: SS is a common cause of panhypopituitarism in developing countries, but its atypical presentations, such as pancytopenia, are rare and often overlooked. This case highlights the need for increased awareness among clinicians to consider SS in patients with unexplained hematological abnormalities, particularly in regions with high rates of postpartum hemorrhage. Early recognition and appropriate hormone replacement therapy can significantly improve patients' outcomes and prevent long-term complications associated with this underdiagnosed syndrome.Keywords: Sheehan syndrome, panhypopituitarism, pancytopenia, delayed diagnosis
Procedia PDF Downloads 241684 The Enquiry of Food Culture Products, Practices and Perspectives: An Action Research on Teaching and Learning Food Culture from International Food Documentary Films
Authors: Tsuiping Chen
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It has always been an international consensus that food forms a big part of any culture since the old times. However, this idea has not been globally concretized until the announcement of including food or cuisine as intangible cultural heritage by UNESCO in 2010. This announcement strengthens the value of food culture, which is getting more and more notice by every country. Although Taiwan is not one of the members of the United Nations, we cannot detach ourselves from this important global trend, especially when we have a lot of culinary students expected to join the world culinary job market. These students should have been well educated with the knowledge of world food culture to make them have the sensibility and perspectives for the occurring global food issues before joining the culinary jobs. Under the premise of the above concern, the researcher and also the instructor took on action research with one class of students in the 'Food Culture' course watching, discussing, and analyzing 12 culinary documentary films selected from one decade’s (2007-2016) of Berlin Culinary Cinema in one semester of class hours. In addition, after class, the students separated themselves into six groups and joined 12 times of one-hour-long focus group discussion on the 12 films conducted by the researcher. Furthermore, during the semester, the students submitted their reflection reports on each film to the university e-portfolio system. All the focus discussions and reflection reports were recorded and collected for further analysis by the researcher and one invited film researcher. Glaser and Strauss’ Grounded Theory (1967) constant comparison method was employed to analyze the collected data. Finally, the findings' results were audited by all participants of the research. All the participants and the researchers created 200 items of food culture products, 74 items of food culture practices, and 50 items of food culture perspectives from the action research journey through watching culinary documentaries. The journey did broaden students’ points of view on world food culture and enhance their capability on perspective construction for food culture. Four aspects of significant findings were demonstrated. First, learning food culture through watching Berlin culinary films helps students link themselves to the happening global food issues such as food security, food poverty, and food sovereignty, which direct them to rethink how people should grow, share and consume food. Second, watching different categories of documentary food films enhances students’ strong sense of responsibility for ensuring healthy lives and promoting well-being for all people in every corner of the world. Third, watching these documentary films encourages students to think if the culinary education they have accepted in this island is inclusive and the importance of quality education, which can promote lifelong learning. Last but not least, the journey of the culinary documentary film watching in the 'Food Culture' course inspires students to take pride in their profession. It is hoped the model of teaching food culture with culinary documentary films will inspire more food culture educators, researchers, and the culinary curriculum designers.Keywords: food culture, action research, culinary documentary films, food culture products, practices, perspectives
Procedia PDF Downloads 1131683 The Clash between Environmental and Heritage Laws: An Australian Case Study
Authors: Andrew R. Beatty
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The exploitation of Australia’s vast mineral wealth is regulated by a matrix of planning, environment and heritage legislation, and despite the desire for a ‘balance’ between economic, environmental and heritage values, Aboriginal objects and places are often detrimentally impacted by mining approvals. The Australian experience is not novel. There are other cases of clashes between the rights of traditional landowners and businesses seeking to exploit mineral or other resources on or beneath those lands, including in the United States, Canada, and Brazil. How one reconciles the rights of traditional owners with those of resource companies is an ongoing legal problem of general interest. In Australia, planning and environmental approvals for resource projects are ordinarily issued by State or Territory governments. Federal legislation such as the Aboriginal and Torres Strait Islander Heritage Protection Act 1984 (Cth) is intended to act as a safety net when State or Territory legislation is incapable of protecting Indigenous objects or places in the context of approvals for resource projects. This paper will analyse the context and effectiveness of legislation enacted to protect Indigenous heritage in the planning process. In particular, the paper will analyse how the statutory objects of such legislation need to be weighed against the statutory objects of competing legislation designed to facilitate and control resource exploitation. Using a current claim in the Federal Court of Australia for the protection of a culturally significant landscape as a case study, this paper will examine the challenges faced in ascribing value to cultural heritage within the wider context of environmental and planning laws. Our findings will reveal that there is an inherent difficulty in defining and weighing competing economic, environmental and heritage considerations. An alternative framework will be proposed to guide regulators towards making decisions that result in better protection of Indigenous heritage in the context of resource management.Keywords: environmental law, heritage law, indigenous rights, mining
Procedia PDF Downloads 981682 Whey Protein in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Authors: Zyrah Lou R. Samar, Genecarlo Liwanag
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Type 2 Diabetes Mellitus is the more prevalent type, caused by a combination of insulin resistance and inadequate insulin response to hyperglycemia1. Aside from pharmacologic interventions, medical nutrition therapy is an integral part of the management of patients with Type 2 Diabetes Mellitus. Whey protein, which is one of the best protein sources, has been investigated for its applicability in improving glycemic control in patients with Type 2 Diabetes Mellitus. This systematic review and meta-analysis was conducted to measure the magnitude of the effect of whey protein on glycemic control in type 2 diabetes mellitus. The aim of this review is to evaluate the efficacy and safety of whey protein in patients with type 2 diabetes mellitus. Methods: A systematic electronic search for studies in the PubMed and Cochrane Collaboration database was done. Included in this review were randomized controlled trials of whey protein enrolling patients with type 2 diabetes mellitus. Three reviewers independently searched, assessed, and extracted data from the individual studies. Results: A systematic literature search on online databases such as Cochrane Central Registry, PubMed, and Herdin Plus was conducted in April to September 2021 to identify eligible studies. The search yielded 21 randomized controlled trials after removing duplicates. Only 5 articles were included after reviewing the full text, which met the criteria for selection. Conclusion: Whey protein supplementation significantly reduced fasting blood glucose. However, it did not reduce post-prandial blood glucose, HbA1c level, and weight when compared with the placebo. There has been a considerate heterogeneity across all studies, which may have contributed/confounded its effects. A larger sample size and better inclusion, and a more specific study may be included in the future reviews.Keywords: whey protein, diabetes, nutrition, fasting blood sugar, postprandial glucose, HbA1c, weight reduction
Procedia PDF Downloads 1111681 Women's Perceptions of Zika Virus Prevention Recommendations: A Tale of Two Cities within Fortaleza, Brazil
Authors: Jeni Stolow, Lina Moses, Carl Kendall
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Zika virus (ZIKV) reemerged as a global threat in 2015 with Brazil at its epicenter. Brazilians have a long history of combatting Aedes aegypti mosquitos as it is a common vector for dengue, chikungunya, and yellow fever. As a response to the epidemic, public health authorities promoted ZIKV prevention behaviors such as mosquito bite prevention, reproductive counseling for women who are pregnant or contemplating pregnancy, pregnancy avoidance, and condom use. Most prevention efforts from Brazil focused on the mosquito vector- utilizing recycled dengue approaches without acknowledging the context in which women were able to adhere to these prevention messages. This study used qualitative methods to explore how women in Fortaleza, Brazil perceive ZIKV, the Brazilian authorities’ ZIKV prevention recommendations, and the feasibility of adhering to these recommendations. A core study aim was to look at how women perceive their physical, social, and natural environment as it impacts women’s ability to adhere to ZIKV prevention behaviors. A Rapid Anthropological Assessment (RAA) containing observations, informational interviews, and semi-structured in-depth interviews were utilized for data collection. The study utilized Grounded Theory as the systematic inductive method of analyzing the data collected. Interviews were conducted with 35 women of reproductive age (15-39 years old), who primarily utilize the public health system. It was found that women’s self-identified economic class was associated with how strongly women felt they could prevent ZIKV. All women interviewed technically belong to the C-class, the middle economic class. Although all members of the same economic class, there was a divide amongst participants as to who perceived themselves as higher C-class versus lower C-class. How women saw their economic status was dictated by how they perceived their physical, social, and natural environment. Women further associated their environment and their economic class to their likelihood of contracting ZIKV, their options for preventing ZIKV, their ability to prevent ZIKV, and their willingness to attempt to prevent ZIKV. Women’s perceived economic status was found to relate to their structural environment (housing quality, sewage, and locations to supplies), social environment (family and peer norms), and natural environment (wetland areas, natural mosquito breeding sites, and cyclical nature of vectors). Findings from this study suggest that women’s perceived environment and economic status impact their perceived feasibility and desire to attempt behaviors to prevent ZIKV. Although ZIKV has depleted from epidemic to endemic status, it is suggested that the virus will return as cyclical outbreaks like that seen with similar arboviruses such as dengue and chikungunya. As the next ZIKV epidemic approaches it is essential to understand how women perceive themselves, their abilities, and their environments to best aid the prevention of ZIKV.Keywords: Aedes aegypti, environment, prevention, qualitative, zika
Procedia PDF Downloads 1341680 Evaluating the Effectiveness of Mesotherapy and Topical 2% Minoxidil for Androgenic Alopecia in Females, Using Topical 2% Minoxidil as a Common Treatment
Authors: Hamed Delrobai Ghoochan Atigh
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Androgenic alopecia (AGA) is a common form of hair loss, impacting approximately 50% of females, which leads to reduced self-esteem and quality of life. It causes progressive follicular miniaturization in genetically predisposed individuals. Mesotherapy -- a minimally invasive procedure, topical 2% minoxidil, and oral finasteride have emerged as popular treatment options in the realm of cosmetics. However, the efficacy of mesotherapy compared to other options remains unclear. This study aims to assess the effectiveness of mesotherapy when it is added to topical 2% minoxidil treatment on female androgenic alopecia. Mesotherapy, also known as intradermotherapy, is a technique that entails administering multiple intradermal injections of a carefully composed mixture of compounds in low doses, applied at various points in close proximity to or directly over the affected areas. This study involves a randomized controlled trial with 100 female participants diagnosed with androgenic alopecia. The subjects were randomly assigned to two groups: Group A used topical 2% minoxidil twice daily and took Finastride oral tablet. For Group B, 10 mesotherapy sessions were added to the prior treatment. The injections were administered every week in the first month of treatment, every two weeks in the second month, and after that the injections were applied monthly for four consecutive months. The response assessment was made at baseline, the 4th session, and finally after 6 months when the treatment was complete. Clinical photographs, 7-point Likert scale patient self-evaluation, and 7-point Likert scale assessment tool were used to measure the effectiveness of the treatment. During this evaluation, a significant and visible improvement in hair density and thickness was observed. The study demonstrated a significant increase in treatment efficacy in Group B compared to Group A post-treatment, with no adverse effects. Based on the findings, it appears that mesotherapy offers a significant improvement in female AGA over minoxidil. Hair loss was stopped in Group B after one month and improvement in density and thickness of hair was observed after the third month. The findings from this study provide valuable insights into the efficacy of mesotherapy in treating female androgenic alopecia. Our evaluation offers a detailed assessment of hair growth parameters, enabling a better understanding of the treatments' effectiveness. The potential of this promising technique is significantly enhanced when carried out in a medical facility, guided by appropriate indications and skillful execution. An interesting observation in our study is that in areas where the hair had turned grey, the newly regrown hair does not retain its original grey color; instead, it becomes darker. The results contribute to evidence-based decision-making in dermatological practice and offer different insights into the treatment of female pattern hair loss.Keywords: androgenic alopecia, female hair loss, mesotherapy, topical 2% minoxidil
Procedia PDF Downloads 1041679 Effect of Electric Arc Furnace Coarse Slag Aggregate And Ground Granulated Blast Furnace Slag on Mechanical and Durability Properties of Roller Compacted Concrete Pavement
Authors: Amiya Kumar Thakur, Dinesh Ganvir, Prem Pal Bansal
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Industrial by product utilization has been encouraged due to environment and economic factors. Since electric arc furnace slag aggregate is a by-product of steel industry and its storage is a major concern hence it can be used as a replacement of natural aggregate as its physical and mechanical property are comparable or better than the natural aggregates. The present study investigates the effect of partial and full replacement of natural coarse aggregate with coarse EAF slag aggregate and partial replacement of cement with ground granulated blast furnace slag (GGBFS) on the mechanical and durability properties of roller compacted concrete pavement (RCCP).The replacement level of EAF slag aggregate were at five levels (i.e. 0% ,25% ,50%,75% & 100%) and of GGBFS was (0 % & 30%).The EAF slag aggregate was stabilized by exposing to outdoor condition for several years and the volumetric expansion test using steam exposure device was done to check volume stability. Soil compaction method was used for mix proportioning of RCCP. The fresh properties of RCCP investigated were fresh density and modified vebe test was done to measure the consistency of concrete. For investigating the mechanical properties various tests were done at 7 and 28 days (i.e. Compressive strength, split tensile strength, flexure strength modulus of elasticity) and also non-destructive testing was done at 28 days (i.e. Ultra pulse velocity test (UPV) & rebound hammer test). The durability test done at 28 days were water absorption, skid resistance & abrasion resistance. The results showed that with the increase in slag aggregate percentage there was an increase in the fresh density of concrete and also slight increase in the vebe time but with the 30 % GGBFS replacement the vebe time decreased and the fresh density was comparable to 0% GGBFS mix. The compressive strength, split tensile strength, flexure strength & modulus of elasticity increased with the increase in slag aggregate percentage in concrete when compared to control mix. But with the 30 % GGBFS replacement there was slight decrease in mechanical properties when compared to 100 % cement concrete. In UPV test and rebound hammer test all the mixes showed excellent quality of concrete. With the increase in slag aggregate percentage in concrete there was an increase in water absorption, skid resistance and abrasion resistance but with the 30 % GGBFS percentage the skid resistance, water absorption and abrasion resistance decreased when compared to 100 % cement concrete. From the study it was found that the mix containing 30 % GGBFS with different percentages of EAF slag aggregate were having comparable results for all the mechanical and durability property when compared to 100 % cement mixes. Hence 30 % GGBFS can be used as cement replacement with 100 % EAF slag aggregate as natural coarse aggregate replacement.Keywords: durability properties, electric arc furnace slag aggregate, GGBFS, mechanical properties, roller compacted concrete pavement, soil compaction method
Procedia PDF Downloads 1491678 Liquidity Risk of Banks in Light of a Dominant Share of Foreign Capital in the Polish Banking Sector
Authors: Karolina Patora
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This article investigates liquidity risk management by banks, which has gained significant importance since the global financial crisis of 2008. The issue is of particular interest for countries like Poland, in which foreign capital plays a dominant role. Such an ownership structure poses certain risks to the local banking sector, which faces an increased probability of the withdrawal of funding or assets’ transfers abroad in case of a crisis. Both these factors can have a detrimental influence on the liquidity position of foreign-owned banks and hence negatively affect the financial stability of the whole banking sector. The aim of this study is to evaluate the impact of a dominating share of foreign investors in the Polish banking sector on the liquidity position of commercial banks. The study hypothesizes that the ownership structure of the Polish banking sector, in which there are banks predominantly controlled by foreign investors, does not pose a threat to the liquidity position of Polish banks. A supplementary research hypothesis is that the liquidity risk profile of foreign-owned banks differs from that of domestic banks. The sample consists of 14 foreign-owned banks and 5 domestic banks owned by local investors, which together constitute approximately 87% of the banking sector’s assets. The data covers the period of 2004–2014. The results of the regression models show no evidence of significant differences in terms of the dynamics of changes of the liquidity buffers between the foreign-owned and domestic banks, although the signs of the coefficients might suggest that the foreign-owned banks were decreasing the holdings of liquid assets at a slower pace over the examined period, compared to the domestic banks. However, no proof of the statistical significance of these findings has been found. The supplementary research hypothesis that the liquidity risk profile of foreign-controlled banks differs from that of domestic banks was rejected.Keywords: foreign-owned banks, liquidity position, liquidity risk, financial stability
Procedia PDF Downloads 2981677 Estimated Heat Production, Blood Parameters and Mitochondrial DNA Copy Number of Nellore Bulls with High and Low Residual Feed Intake
Authors: Welder A. Baldassini, Jon J. Ramsey, Marcos R. Chiaratti, Amália S. Chaves, Renata H. Branco, Sarah F. M. Bonilha, Dante P. D. Lanna
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With increased production costs there is a need for animals that are more efficient in terms of meat production. In this context, the role of mitochondrial DNA (mtDNA) on physiological processes in liver, muscle and adipose tissues may account for inter-animal variation in energy expenditures and heat production. The purpose this study was to investigate if the amounts of mtDNA in liver, muscle and adipose tissue (subcutaneous and visceral depots) of Nellore bulls are associated with residual feed intake (RFI) and estimated heat production (EHP). Eighteen animals were individually fed in a feedlot for 90 days. RFI values were obtained by regression of dry matter intake (DMI) in relation to average daily gain (ADG) and mid-test metabolic body weight (BW). The animals were classified into low (more efficient) and high (less efficient) RFI groups. The bulls were then randomly distributed in individual pens where they were given excess feed twice daily to result in 5 to 10% orts for 90 d with diet containing 15% crude protein and 2.7 Mcal ME/kg DM. The heart rate (HR) of bulls was monitored for 4 consecutive days and used for calculation of EHP. Electrodes were fitted to bulls with stretch belts (POLAR RS400; Kempele, Finland). To calculate oxygen pulse (O2P), oxygen consumption was obtained using a facemask connected to the gas analyzer (EXHALYZER, ECOMedics, Zurich, Switzerland) and HR were simultaneously measured for 15 minutes period. Daily oxygen (O2) consumption was calculated by multiplying the volume of O2 per beat by total daily beats. EHP was calculated multiplying O2P by the average HR obtained during the 4 days, assuming 4.89 kcal/L of O2 to measure daily EHP that was expressed in kilocalories/day/kilogram metabolic BW (kcal/day/kg BW0.75). Blood samples were collected between days 45 and 90th after the beginning of the trial period in order to measure the concentration of hemoglobin and hematocrit. The bulls were slaughtered in an experimental slaughter house in accordance with current guidelines. Immediately after slaughter, a section of liver, a portion of longissimus thoracis (LT) muscle, plus a portion of subcutaneous fat (surrounding LT muscle) and portions of visceral fat (kidney, pelvis and inguinal fat) were collected. Samples of liver, muscle and adipose tissues were used to quantify mtDNA copy number per cell. The number of mtDNA copies was determined by normalization of mtDNA amount against a single copy nuclear gene (B2M). Mean of EHP, hemoglobin and hematocrit of high and low RFI bulls were compared using two-sample t-tests. Additionally, the one-way ANOVA was used to compare mtDNA quantification considering the mains effects of RFI groups. We found lower EHP (83.047 vs. 97.590 kcal/day/kgBW0.75; P < 0.10), hemoglobin concentration (13.533 vs. 15.108 g/dL; P < 0.10) and hematocrit percentage (39.3 vs. 43.6 %; P < 0.05) in low compared to high RFI bulls, respectively, which may be useful traits to identify efficient animals. However, no differences were observed between the mtDNA content in liver, muscle and adipose tissue of Nellore bulls with high and low RFI.Keywords: bioenergetics, Bos indicus, feed efficiency, mitochondria
Procedia PDF Downloads 249