Search results for: sequential confidence estimation
1151 Survey on Resilience of Chinese Nursing Interns: A Cross-Sectional Study
Authors: Yutong Xu, Wanting Zhang, Jia Wang, Zihan Guo, Weiguang Ma
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Background: The resilience education of intern nursing students has significant implications for the development and improvement of the nursing workforce. The clinical internship period is a critical time for enhancing resilience. Aims: To evaluate the resilience level of Chinese nursing interns and identify the factors affecting resilience early in their careers. Methods: The cross-sectional study design was adopted. From March 2022 to May 2023, 512 nursing interns in tertiary care hospitals were surveyed online with the Connor-Davidson Resilience Scale, the Clinical Learning Environment scale for Nurse, and the Career Adapt-Abilities Scale. Structural equation modeling was used to clarify the relationships among these factors. Indirect effects were tested using bootstrapped Confidence Intervals. Results: The nursing interns showed a moderately high level of resilience[M(SD)=70.15(19.90)]. Gender, scholastic attainment, had a scholarship, career adaptability and clinical learning environment were influencing factors of nursing interns’ resilience. Career adaptability and clinical learning environment positively and directly affected their resilience level (β = 0.58, 0.12, respectively, p<0.01). career adaptability also positively affected career adaptability (β = 0.26, p < 0.01), and played a fully mediating role in the relationship between clinical learning environment and resilience. Conclusion: Career adaptability can enhance the influence of clinical learning environment on resilience. The promotion of career adaptability and the clinical teaching environment should be the potential strategies for nursing interns to improve their resilience, especially for those female nursing interns with low academic performance. Implications for Nursing Educators Nursing educators should pay attention to the cultivation of nursing students' resilience; for example, by helping them integrate to the clinical learning environment and improving their career adaptability. Reporting Method: The STROBE criteria were used to report the results of the observations critically. Patient or Public Contribution No patient or public contribution.Keywords: resilience, clinical learning environment, career adaptability, nursing interns
Procedia PDF Downloads 891150 The Data-Driven Localized Wave Solution of the Fokas-Lenells Equation Using Physics-Informed Neural Network
Authors: Gautam Kumar Saharia, Sagardeep Talukdar, Riki Dutta, Sudipta Nandy
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The physics-informed neural network (PINN) method opens up an approach for numerically solving nonlinear partial differential equations leveraging fast calculating speed and high precession of modern computing systems. We construct the PINN based on a strong universal approximation theorem and apply the initial-boundary value data and residual collocation points to weekly impose initial and boundary conditions to the neural network and choose the optimization algorithms adaptive moment estimation (ADAM) and Limited-memory Broyden-Fletcher-Golfard-Shanno (L-BFGS) algorithm to optimize learnable parameter of the neural network. Next, we improve the PINN with a weighted loss function to obtain both the bright and dark soliton solutions of the Fokas-Lenells equation (FLE). We find the proposed scheme of adjustable weight coefficients into PINN has a better convergence rate and generalizability than the basic PINN algorithm. We believe that the PINN approach to solve the partial differential equation appearing in nonlinear optics would be useful in studying various optical phenomena.Keywords: deep learning, optical soliton, physics informed neural network, partial differential equation
Procedia PDF Downloads 701149 Image Processing techniques for Surveillance in Outdoor Environment
Authors: Jayanth C., Anirudh Sai Yetikuri, Kavitha S. N.
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This paper explores the development and application of computer vision and machine learning techniques for real-time pose detection, facial recognition, and number plate extraction. Utilizing MediaPipe for pose estimation, the research presents methods for detecting hand raises and ducking postures through real-time video analysis. Complementarily, facial recognition is employed to compare and verify individual identities using the face recognition library. Additionally, the paper demonstrates a robust approach for extracting and storing vehicle number plates from images, integrating Optical Character Recognition (OCR) with a database management system. The study highlights the effectiveness and versatility of these technologies in practical scenarios, including security and surveillance applications. The findings underscore the potential of combining computer vision techniques to address diverse challenges and enhance automated systems for both individual and vehicular identification. This research contributes to the fields of computer vision and machine learning by providing scalable solutions and demonstrating their applicability in real-world contexts.Keywords: computer vision, pose detection, facial recognition, number plate extraction, machine learning, real-time analysis, OCR, database management
Procedia PDF Downloads 261148 Implementation of an Induction Programme to Help the International Medical Graduates in the NHS
Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw
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Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.
Procedia PDF Downloads 1351147 Self-Reliant Peer Learning for Nursing Students
Authors: U.-B. Schaer, M. Wehr, R. Hodler
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Background: Most nursing students require more training time for necessary nursing skills than defined by nursing schools curriculum to acquire basic nursing skills. Given skills training lessons are too brief to enable effective student learning, meaning in-depth skills practice and repetition various learning steps. This increases stress levels and the pressure to succeed for a nursing student with slower learning capabilities. Another possible consequence is that nursing students are less prepared in the required skills for future clinical practice. Intervention: The Bern College of Higher Education of Nursing, Switzerland, started the independent peer practice learning program in 2012. A concept was developed which defines specific aims and content as well as student’s rights and obligations. Students enlist beforehand and order the required materials. They organize themselves and train in small groups in allocated training location in the area of Learning Training and Transfer (LTT). During the peer practice, skills and knowledge can be repeatedly trained and reflected in the peer groups without the presence of a tutor. All invasive skills are practiced only on teaching dummies. This allows students to use all their potential. The students may access learning materials as literature and their own student notes. This allows nursing students to practice their skills and to deepen their knowledge on corresponding with their own learning rate. Results: Peer group discussions during the independent peer practice learning support the students in gaining certainty and confidence in their knowledge and skills. This may improve patient safety in future daily care practice. Descriptive statics show that the number of students who take advantage of the independent peer practice learning increased continuously (2012-2018). It has to be mentioned that in 2012, solely students of the first semester attended the independent peer practice learning program, while in 2018 over one-third of the participating students were in their fifth semester and final study year. It is clearly visible that the demand for independent peer practice learning is increasing. This has to be considered in the development of future teaching curricula.Keywords: learning program, nursing students, peer learning, skill training
Procedia PDF Downloads 1211146 Innovative Screening Tool Based on Physical Properties of Blood
Authors: Basant Singh Sikarwar, Mukesh Roy, Ayush Goyal, Priya Ranjan
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This work combines two bodies of knowledge which includes biomedical basis of blood stain formation and fluid communities’ wisdom that such formation of blood stain depends heavily on physical properties. Moreover biomedical research tells that different patterns in stains of blood are robust indicator of blood donor’s health or lack thereof. Based on these valuable insights an innovative screening tool is proposed which can act as an aide in the diagnosis of diseases such Anemia, Hyperlipidaemia, Tuberculosis, Blood cancer, Leukemia, Malaria etc., with enhanced confidence in the proposed analysis. To realize this powerful technique, simple, robust and low-cost micro-fluidic devices, a micro-capillary viscometer and a pendant drop tensiometer are designed and proposed to be fabricated to measure the viscosity, surface tension and wettability of various blood samples. Once prognosis and diagnosis data has been generated, automated linear and nonlinear classifiers have been applied into the automated reasoning and presentation of results. A support vector machine (SVM) classifies data on a linear fashion. Discriminant analysis and nonlinear embedding’s are coupled with nonlinear manifold detection in data and detected decisions are made accordingly. In this way, physical properties can be used, using linear and non-linear classification techniques, for screening of various diseases in humans and cattle. Experiments are carried out to validate the physical properties measurement devices. This framework can be further developed towards a real life portable disease screening cum diagnostics tool. Small-scale production of screening cum diagnostic devices is proposed to carry out independent test.Keywords: blood, physical properties, diagnostic, nonlinear, classifier, device, surface tension, viscosity, wettability
Procedia PDF Downloads 3761145 A Survey on Students' Intentions to Dropout and Dropout Causes in Higher Education of Mongolia
Authors: D. Naranchimeg, G. Ulziisaikhan
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Student dropout problem has not been recently investigated within the Mongolian higher education. A student dropping out is a personal decision, but it may cause unemployment and other social problems including low quality of life because students who are not completed a degree cannot find better-paid jobs. The research aims to determine percentage of at-risk students, and understand reasons for dropouts and to find a way to predict. The study based on the students of the Mongolian National University of Education including its Arkhangai branch school, National University of Mongolia, Mongolian University of Life Sciences, Mongolian University of Science and Technology, Mongolian National University of Medical Science, Ikh Zasag International University, and Dornod University. We conducted the paper survey by method of random sampling and have surveyed about 100 students per university. The margin of error - 4 %, confidence level -90%, and sample size was 846, but we excluded 56 students from this study. Causes for exclusion were missing data on the questionnaire. The survey has totally 17 questions, 4 of which was demographic questions. The survey shows that 1.4% of the students always thought to dropout whereas 61.8% of them thought sometimes. Also, results of the research suggest that students’ dropouts from university do not have relationships with their sex, marital and social status, and peer and faculty climate, whereas it slightly depends on their chosen specialization. Finally, the paper presents the reasons for dropping out provided by the students. The main two reasons for dropouts are personal reasons related with choosing wrong study program, not liking the course they had chosen (50.38%), and financial difficulties (42.66%). These findings reveal the importance of early prevention of dropout where possible, combined with increased attention to high school students in choosing right for them study program, and targeted financial support for those who are at risk.Keywords: at risk students, dropout, faculty climate, Mongolian universities, peer climate
Procedia PDF Downloads 3971144 Quantitative Assessment of Soft Tissues by Statistical Analysis of Ultrasound Backscattered Signals
Authors: Da-Ming Huang, Ya-Ting Tsai, Shyh-Hau Wang
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Ultrasound signals backscattered from the soft tissues are mainly depending on the size, density, distribution, and other elastic properties of scatterers in the interrogated sample volume. The quantitative analysis of ultrasonic backscattering is frequently implemented using the statistical approach due to that of backscattering signals tends to be with the nature of the random variable. Thus, the statistical analysis, such as Nakagami statistics, has been applied to characterize the density and distribution of scatterers of a sample. Yet, the accuracy of statistical analysis could be readily affected by the receiving signals associated with the nature of incident ultrasound wave and acoustical properties of samples. Thus, in the present study, efforts were made to explore such effects as the ultrasound operational modes and attenuation of biological tissue on the estimation of corresponding Nakagami statistical parameter (m parameter). In vitro measurements were performed from healthy and pathological fibrosis porcine livers using different single-element ultrasound transducers and duty cycles of incident tone burst ranging respectively from 3.5 to 7.5 MHz and 10 to 50%. Results demonstrated that the estimated m parameter tends to be sensitively affected by the use of ultrasound operational modes as well as the tissue attenuation. The healthy and pathological tissues may be characterized quantitatively by m parameter under fixed measurement conditions and proper calibration.Keywords: ultrasound backscattering, statistical analysis, operational mode, attenuation
Procedia PDF Downloads 3231143 Managerial Overconfidence, Payout Policy, and Corporate Governance: Evidence from UK Companies
Authors: Abdullah AlGhazali, Richard Fairchild, Yilmaz Guney
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We examine the effect of managerial overconfidence on UK firms’ payout policy for the period 2000 to 2012. The analysis incorporates, in addition to common firm-specific factors, a wide range of corporate governance factors and managerial characteristics that have been documented to affect the relationship between overconfidence and payout policy. Our results are robust to several estimation considerations. The findings show that the influence of overconfident CEOs on the amount of, and the propensity to pay, dividends is significant within the UK context. Specifically, we detect that there is a reduction in dividend payments in firms managed by overconfident managers compared to their non-overconfident counterparts. Moreover, we affirm that cash flows, firm size and profitability are positively correlated, while leverage, firm growth and investment are negatively correlated with the amount of and propensity to pay dividends. Interestingly, we demonstrate that firms with the potential for undervaluation reduce dividend payments. Some of the corporate governance factors are shown to motivate firms to pay more dividends while these factors seem to have no influence on the propensity to pay dividends. The results also show that in general higher overconfidence leads to more share repurchases but the lower total payout. Overall, managerial overconfidence should be considered as an important factor influencing payout policy in addition to other known factors.Keywords: dividends, repurchases, UK firms, overconfidence, corporate governance, undervaluation
Procedia PDF Downloads 2701142 Developing an ANN Model to Predict Anthropometric Dimensions Based on Real Anthropometric Database
Authors: Waleed A. Basuliman, Khalid S. AlSaleh, Mohamed Z. Ramadan
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Applying the anthropometric dimensions is considered one of the important factors when designing any human-machine system. In this study, the estimation of anthropometric dimensions has been improved by developing artificial neural network that aims to predict the anthropometric measurements of the male in Saudi Arabia. A total of 1427 Saudi males from age 6 to 60 participated in measuring twenty anthropometric dimensions. These anthropometric measurements are important for designing the majority of work and life applications in Saudi Arabia. The data were collected during 8 months from different locations in Riyadh City. Five of these dimensions were used as predictors variables (inputs) of the model, and the remaining fifteen dimensions were set to be the measured variables (outcomes). The hidden layers have been varied during the structuring stage, and the best performance was achieved with the network structure 6-25-15. The results showed that the developed Neural Network model was significantly able to predict the body dimensions for the population of Saudi Arabia. The network mean absolute percentage error (MAPE) and the root mean squared error (RMSE) were found 0.0348 and 3.225 respectively. The accuracy of the developed neural network was evaluated by compare the predicted outcomes with a multiple regression model. The ANN model performed better and resulted excellent correlation coefficients between the predicted and actual dimensions.Keywords: artificial neural network, anthropometric measurements, backpropagation, real anthropometric database
Procedia PDF Downloads 5761141 The Influence of Project-Based Learning and Outcome-Based Education: Interior Design Tertiary Students in Focus
Authors: Omneya Messallam
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Technology has been developed dramatically in most of the educational disciplines. For instance, digital rendering subject, which is being taught in both Interior and Architecture fields, is witnessing almost annually updated software versions. A lot of students and educators argued that there will be no need for manual rendering techniques to be learned. Therefore, the Interior Design Visual Presentation 1 course (ID133) has been chosen from the first level of the Interior Design (ID) undergraduate program, as it has been taught for six years continually. This time frame will facilitate sound observation and critical analysis of the use of appropriate teaching methodologies. Furthermore, the researcher believes in the high value of the manual rendering techniques. The course objectives are: to define the basic visual rendering principles, to recall theories and uses of various types of colours and hatches, to raise the learners’ awareness of the value of studying manual render techniques, and to prepare them to present their work professionally. The students are female Arab learners aged between 17 and 20. At the outset of the course, the majority of them demonstrated negative attitude, lacking both motivation and confidence in manual rendering skills. This paper is a reflective appraisal of deploying two student-centred teaching pedagogies which are: Project-based learning (PBL) and Outcome-based education (OBE) on ID133 students. This research aims of developing some teaching strategies to enhance the quality of teaching in this given course over an academic semester. The outcome of this research emphasized the positive influence of applying such educational methods on improving the quality of students’ manual rendering skills in terms of: materials, textiles, textures, lighting, and shade and shadow. Furthermore, it greatly motivated the students and raised the awareness of the importance of learning the manual rendering techniques.Keywords: project-based learning, outcome-based education, visual presentation, manual render, personal competences
Procedia PDF Downloads 1611140 Stimulating the Social Emotional Development of Children through Play Activities: The Role of Teachers and Parents Support
Authors: Mahani Razali, Nordin Mamat
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The purpose of this research is to identify the teacher’s role and parent’s participation to develop children`s socio emotion through play activities. This research is based on three main objectives which are to identify children`s socio emotion during play activities, teacher’s role and parent’s participation to develop children`s socio emotion. This qualitative study was carried out among 25 pre-school children, three teachers and three parents as the research sample. On the other hand, parent’s support was obtained from their discussions, supervisions and communication at home. The data collection procedures involved structured observation which was to identify socio emotional development element among pre-school children through play activities; as for semi-structured interviews, it was done to study the perception of the teachers and parents on the acquired socio emotional development among the children. Besides, documentation analysis method was used as to triangulate acquired information with observations and interviews. In this study, the qualitative data analysis was tabulated in descriptive manner with frequency and percentage format. This study primarily focused on five main socio emotional elements among the pre-school children: 1) Cooperation, 2) Confidence and Courage, 3) Ability to communicate, 4) patience, and 5) Tolerance. The findings of this study were presented in the form of case to case manner from the researches sample. Findings revealed that the children showed positive outcomes on the socio emotional development during their play. Both teachers and parents showed positive perceptions towards the acquired socio emotional development during their play activities. In conclusion, this research summarizes that teacher’s role and parent’s support can improve children`s socio emotional development through play activities. As a whole, this research highlighted the significance of play activities as to stimulate socio emotional development among the pre-school children.Keywords: social emotional, children, play activities, stimulating
Procedia PDF Downloads 4071139 An Early Attempt of Artificial Intelligence-Assisted Language Oral Practice and Assessment
Authors: Paul Lam, Kevin Wong, Chi Him Chan
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Constant practicing and accurate, immediate feedback are the keys to improving students’ speaking skills. However, traditional oral examination often fails to provide such opportunities to students. The traditional, face-to-face oral assessment is often time consuming – attending the oral needs of one student often leads to the negligence of others. Hence, teachers can only provide limited opportunities and feedback to students. Moreover, students’ incentive to practice is also reduced by their anxiety and shyness in speaking the new language. A mobile app was developed to use artificial intelligence (AI) to provide immediate feedback to students’ speaking performance as an attempt to solve the above-mentioned problems. Firstly, it was thought that online exercises would greatly increase the learning opportunities of students as they can now practice more without the needs of teachers’ presence. Secondly, the automatic feedback provided by the AI would enhance students’ motivation to practice as there is an instant evaluation of their performance. Lastly, students should feel less anxious and shy compared to directly practicing oral in front of teachers. Technically, the program made use of speech-to-text functions to generate feedback to students. To be specific, the software analyzes students’ oral input through certain speech-to-text AI engine and then cleans up the results further to the point that can be compared with the targeted text. The mobile app has invited English teachers for the pilot use and asked for their feedback. Preliminary trials indicated that the approach has limitations. Many of the users’ pronunciation were automatically corrected by the speech recognition function as wise guessing is already integrated into many of such systems. Nevertheless, teachers have confidence that the app can be further improved for accuracy. It has the potential to significantly improve oral drilling by giving students more chances to practice. Moreover, they believe that the success of this mobile app confirms the potential to extend the AI-assisted assessment to other language skills, such as writing, reading, and listening.Keywords: artificial Intelligence, mobile learning, oral assessment, oral practice, speech-to-text function
Procedia PDF Downloads 1031138 Analysis of NMDA Receptor 2B Subunit Gene (GRIN2B) mRNA Expression in the Peripheral Blood Mononuclear Cells of Alzheimer's Disease Patients
Authors: Ali̇ Bayram, Semih Dalkilic, Remzi Yigiter
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N-methyl-D-aspartate (NMDA) receptor is a subtype of glutamate receptor and plays a pivotal role in learning, memory, neuronal plasticity, neurotoxicity and synaptic mechanisms. Animal experiments were suggested that glutamate-induced excitotoxic injuriy and NMDA receptor blockage lead to amnesia and other neurodegenerative diseases including Alzheimer’s disease (AD), Huntington’s disease, amyotrophic lateral sclerosis. Aim of this study is to investigate association between NMDA receptor coding gene GRIN2B expression level and Alzheimer disease. The study was approved by the local ethics committees, and it was conducted according to the principles of the Declaration of Helsinki and guidelines for the Good Clinical Practice. Peripheral blood was collected 50 patients who diagnosed AD and 49 healthy control individuals. Total RNA was isolated with RNeasy midi kit (Qiagen) according to manufacturer’s instructions. After checked RNA quality and quantity with spectrophotometer, GRIN2B expression levels were detected by quantitative real time PCR (QRT-PCR). Statistical analyses were performed, variance between two groups were compared with Mann Whitney U test in GraphpadInstat algorithm with 95 % confidence interval and p < 0.05. After statistical analyses, we have determined that GRIN2B expression levels were down regulated in AD patients group with respect to control group. But expression level of this gene in each group was showed high variability. İn this study, we have determined that NMDA receptor coding gene GRIN2B expression level was down regulated in AD patients when compared with healthy control individuals. According to our results, we have speculated that GRIN2B expression level was associated with AD. But it is necessary to validate these results with bigger sample size.Keywords: Alzheimer’s disease, N-methyl-d-aspartate receptor, NR2B, GRIN2B, mRNA expression, RT-PCR
Procedia PDF Downloads 3941137 A Study on Eliteathletes and Coaches' Attitude towards Sport Psychologyi the Areas of Sports
Authors: Mahdi PourAsghar, Abbas Mas'udzadeh, Abdulhakim Tirgari, Saeed Dabiri Roushan, Hooman Rashidi, Fariba Salehi
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Objective: One of the major objectives in sports areas is to achieve maximum athletic performance. Physical and psychological preparations are the basic factors for achieving maximum performance in athletes. Unfortunately, in the field of physical preparation, we can see maximum attention and planning of trainers and sports officials. But despite the importance of psychological preparation of athletes and its serious and profound effect on athletic performance, the results of sports competitions show that less attention is paid to this topic, and it is less under the control of counselors and psychologists in different areas of our sport. Therefore, this study aimed to evaluate the attitude of athletes and coaches to sport psychology. Materials and methods: A descriptive study with a sample size of 234 elite athletes and 216 skilled coaches was conducted in different areas of sports, in Sari, Mazandaran in 2015.The instrument was a questionnaire consisting of two parts of demographic data and Martin questionnaire, assessing the attitude to sport psychology. The data from this study were analyzed using Spss version 18, descriptive statistics tests, and Chi-square test. Results: In this study, positive attitudes of participants in need and confidence towards sport psychology consultation in athletes and coaches group were 55/1 and 56/5 percent, respectively. The positive attitude of female athletes in belief to psychology consultation was more than male athletes. Athletes with higher education had more positive attitude towards the presence of psychologists and psychiatrists in fields of sports. Conclusion: According to the findings based on the need to the psychology consultation in different areas of sports, it is recommended that through training of specialists in the field of sport psychology and review of sports programs in different fields of sports, the presence of these counselors to maintain the psychological preparation of athletes to achieve maximum athletic performance and reduce anxiety and stress be used.Keywords: Keywords: Athletes, Eliteathletes, Coaches, Attitude, Sport psychology.
Procedia PDF Downloads 3441136 Investigating the Essentiality of Oxazolidinones in Resistance-Proof Drug Combinations in Mycobacterium tuberculosis Selected under in vitro Conditions
Authors: Gail Louw, Helena Boshoff, Taeksun Song, Clifton Barry
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Drug resistance in Mycobacterium tuberculosis is primarily attributed to mutations in target genes. These mutations incur a fitness cost and result in bacterial generations that are less fit, which subsequently acquire compensatory mutations to restore fitness. We hypothesize that mutations in specific drug target genes influence bacterial metabolism and cellular function, which affects its ability to develop subsequent resistance to additional agents. We aim to determine whether the sequential acquisition of drug resistance and specific mutations in a well-defined clinical M. tuberculosis strain promotes or limits the development of additional resistance. In vitro mutants resistant to pretomanid, linezolid, moxifloxacin, rifampicin and kanamycin were generated from a pan-susceptible clinical strain from the Beijing lineage. The resistant phenotypes to the anti-TB agents were confirmed by the broth microdilution assay and genetic mutations were identified by targeted gene sequencing. Growth of mono-resistant mutants was done in enriched medium for 14 days to assess in vitro fitness. Double resistant mutants were generated against anti-TB drug combinations at concentrations 5x and 10x the minimum inhibitory concentration. Subsequently, mutation frequencies for these anti-TB drugs in the different mono-resistant backgrounds were determined. The initial level of resistance and the mutation frequencies observed for the mono-resistant mutants were comparable to those previously reported. Targeted gene sequencing revealed the presence of known and clinically relevant mutations in the mutants resistant to linezolid, rifampicin, kanamycin and moxifloxacin. Significant growth defects were observed for mutants grown under in vitro conditions compared to the sensitive progenitor. Mutation frequencies determination in the mono-resistant mutants revealed a significant increase in mutation frequency against rifampicin and kanamycin, but a significant decrease in mutation frequency against linezolid and sutezolid. This suggests that these mono-resistant mutants are more prone to develop resistance to rifampicin and kanamycin, but less prone to develop resistance against linezolid and sutezolid. Even though kanamycin and linezolid both inhibit protein synthesis, these compounds target different subunits of the ribosome, thereby leading to different outcomes in terms of fitness in the mutants with impaired cellular function. These observations showed that oxazolidinone treatment is instrumental in limiting the development of multi-drug resistance in M. tuberculosis in vitro.Keywords: oxazolidinones, mutations, resistance, tuberculosis
Procedia PDF Downloads 1631135 Bridge Healthcare Access Gap with Artifical Intelligence
Authors: Moshmi Sangavarapu
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The US healthcare industry has undergone tremendous digital transformation in recent years, but critical care access to lower-income ethnicities is still in its nascency. This population has historically showcased substantial hesitation to seek any medical assistance. While the lack of sufficient financial resources plays a critical role, the existing cultural and knowledge barriers also contribute significantly to widening the access gap. It is imperative to break these barriers to ensure timely access to therapeutic procedures that can save important lives! Based on ongoing research, healthcare access barriers can be best addressed by tapping the untapped potential of caregiver communities first. They play a critical role in patients’ diagnoses, building healthcare knowledge and instilling confidence in required therapeutic procedures. Recent technological advancements have opened many avenues by developing smart ways of reaching the large caregiver community. A digitized go-to-market strategy featuring connected media coupled with smart IoT devices and geo-location targeting can be collectively leveraged to reach this key audience group. AI/ML algorithms can be thoroughly trained to identify relevant data signals from users' location and browsing behavior and determine useful marketing touchpoints. The web behavior can be further assimilated with natural language processing to identify contextually relevant interest topics and decipher potential caregivers on digital avenues to serve that brand message. In conclusion, grasping the true health access journey of any lower-income ethnic group is important to design beneficial touchpoints that can alleviate patients’ concerns and allow them to break their own access barriers and opt for timely and quality healthcare.Keywords: healthcare access, market access, diversity barriers, patient journey
Procedia PDF Downloads 541134 Estimation of Thermal Conductivity of Nanofluids Using MD-Stochastic Simulation-Based Approach
Authors: Sujoy Das, M. M. Ghosh
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The thermal conductivity of a fluid can be significantly enhanced by dispersing nano-sized particles in it, and the resultant fluid is termed as "nanofluid". A theoretical model for estimating the thermal conductivity of a nanofluid has been proposed here. It is based on the mechanism that evenly dispersed nanoparticles within a nanofluid undergo Brownian motion in course of which the nanoparticles repeatedly collide with the heat source. During each collision a rapid heat transfer occurs owing to the solid-solid contact. Molecular dynamics (MD) simulation of the collision of nanoparticles with the heat source has shown that there is a pulse-like pick up of heat by the nanoparticles within 20-100 ps, the extent of which depends not only on thermal conductivity of the nanoparticles, but also on the elastic and other physical properties of the nanoparticle. After the collision the nanoparticles undergo Brownian motion in the base fluid and release the excess heat to the surrounding base fluid within 2-10 ms. The Brownian motion and associated temperature variation of the nanoparticles have been modeled by stochastic analysis. Repeated occurrence of these events by the suspended nanoparticles significantly contributes to the characteristic thermal conductivity of the nanofluids, which has been estimated by the present model for a ethylene glycol based nanofluid containing Cu-nanoparticles of size ranging from 8 to 20 nm, with Gaussian size distribution. The prediction of the present model has shown a reasonable agreement with the experimental data available in literature.Keywords: brownian dynamics, molecular dynamics, nanofluid, thermal conductivity
Procedia PDF Downloads 3711133 The Role of Temporary Migration as Coping Mechanism of Weather Shock: Evidence from Selected Semi-Arid Tropic Villages in India
Authors: Kalandi Charan Pradhan
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In this study, we investigate does weather variation determine temporary labour migration using 210 sample households from six Semi-Arid Tropic (SAT) villages for the period of 2005-2014 in India. The study has made an attempt to examine how households use temporary labour migration as a coping mechanism to minimise the risk rather than maximize the utility of the households. The study employs panel Logit regression model to predict the probability of household having at least one temporary labour migrant. As per as econometrics result, it is found that along with demographic and socioeconomic factors; weather variation plays an important role to determine the decision of migration at household level. In order to capture the weather variation, the study uses mean crop yield deviation over the study periods. Based on the random effect logit regression result, the study found that there is a concave relationship between weather variation and decision of temporary labour migration. This argument supports the theory of New Economics of Labour Migration (NELM), which highlights the decision of labour migration not only maximise the households’ utility but it helps to minimise the risks.Keywords: temporary migration, socioeconomic factors, weather variation, crop yield, logit estimation
Procedia PDF Downloads 2231132 Variation of Airfoil Pressure Profile Due to Confined Air Streams: Application in Gas-Oil Separators
Authors: Amir Hossein Haji, Nabeel Al-Rawahi, Gholamreza Vakili-Nezhaad
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An innovative design has been examined for a gas-oil separator based on pressure reduction over an airfoil surface. The primary motivations are to shorten the release trajectory of the bubbles by minimizing the thickness of the oil layer as well as improving uniform pressure reduction zones. Restricted airflow over an airfoil is investigated for its effect on the pressure drop enhancement and the maximum attainable attack angle prior to the stall condition. Aerodynamic separation is delayed based on numerical simulation of Wortmann FX 63137 Airfoil in a confined domain using FLUENT 6.3.26. The proposed set up results in higher pressure drop compared with the free stream case. With the aim of optimum power consumption we have pursued further restriction to an air jet case over the airfoil. Then, a curved strip model is suggested for the air jet which can be applied as an analysis/design tool for the best performance conditions. Pressure reduction is shown to be inversely proportional to the curvature of the upper airfoil profile. This reduction occurs within the tracking zones where the air jet is effectively attached to the airfoil surface. The zero slope condition is suggested to estimate the onset of these zones after which the minimum curvature should be searched. The corresponding zero slope curvature is applied for estimation of the maximum pressure drop which shows satisfactory agreement with the simulation results.Keywords: airfoil, air jet, curved fluid flow, gas-oil separator
Procedia PDF Downloads 4741131 E-Portfolios as a Means of Perceiving Students’ Listening and Speaking Progress
Authors: Heba Salem
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This paper aims to share the researcher’s experience of using e-Portfolios as an assessment tool to follow up on students’ learning experiences and performance throughout the semester. It also aims at highlighting the importance of students’ self-reflection in the process of language learning. The paper begins by introducing the advanced media course, with its focus on listening and speaking skills, and introduces the students’ profiles. Then it explains the students’ role in the e-portfolio process as they are given the option to choose a listening text they studied throughout the semester and to choose a recorded oral production of their collection of artifacts throughout the semester. Students showcase and reflect on their progress in both listening comprehension and speaking. According to the research, re-listening to work given to them and to their production is a means of reflecting on both their progress and achievement. And choosing the work students want to showcase is a means to promote independent learning as well as self-expression. Students are encouraged to go back to the class learning outcomes in the process of choosing the work. In their reflections, students express how they met the specific learning outcome. While giving their presentations, students expressed how useful the experience of returning and going over what they covered to select one and going over their production as well. They also expressed how beneficial it was to listen to themselves and literally see their progress in both listening comprehension and speaking. Students also reported that they grasped more details from the texts than they did when first having it as an assignment, which coincided with one of the class learning outcomes. They also expressed the fact that they had more confidence speaking as well as they were able to use a variety of vocabulary and idiomatic expressions that students have accumulated. For illustration, this paper includes practical samples of students’ tasks and instructions as well as samples of their reflections. The results of students’ reflections coincide with what the research confirms about the effectiveness of the e-portfolios as a means of assessment. The employment of e-Portfolios has two-folded benefits; students are able to measure the achievement of the targeted learning outcomes, and teachers receive constructive feedback on their teaching methods.Keywords: e-portfolios, assessment, self assessment, listening and speaking progress, foreign language, reflection, learning out comes, sharing experience
Procedia PDF Downloads 981130 Learning through Reflective Practice of Nursing Students in the Delivery Room: A Qualitative Research
Authors: Peeranan Wisanskoonwong, Sumitta Sawangtook
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Practicum in Midwifery II is the subject that affects most students to be stressed and anxious because they lack of experiences and self-confidence in delivery baby. This study is a qualitative research. That research objectives were (1) to study learning through reflective practice of nursing students (2) to explain the effects of learning through reflective practice of nursing students in the delivery room. The selected key informant method was criterion-based selection. Thirty-two of fourth-year nursing students in Kuakarun Faculty of nursing who practiced in Delivery room at Taksin Hospital in academic year 2014 were selected. Data collection was data triangulation which consisted of in-depth interview, group discussion and reading students’ reflective practice journal. The research instruments were students’ reflective practice journal, semi-structured questionnaires for in-depth interview, group discussion. Data analysis was thematic analysis. The research result found that: The learning method through reflective practice of nursing students in the delivery room were (1) reflective practice journal (2) dialogue (3) critical thinking and problem solving (4) incident analysis (5) self-criticism (6) observation and evaluation of practice. There were eight issues that students learned through their reflective practice were that (1) students' ethics and morality. (2) students' knowledge and comprehension (3) creative thinking of students (4) communications and collaboration (5) experiential learning of students (6) students’memories and impressions (7) students’experience in delivery baby (8) self-learning of students. Learning through reflective practice supported students’ awareness in improving knowledge and learning continuously and systematically. It helped to adjust the attitude to learning and leadership to be careful which help develop their skills, including critical thinking and understand themselves and understand others. Recommendation for applying research results: midwifery and nursing lecturers can apply these results to be a guide for development their clinical teaching in delivery rooms and other wards.Keywords: learning, reflection, birth, qualitative research
Procedia PDF Downloads 2801129 Preparing and Scaling up Resiliency among Female Entrepreneurs in Mountain Environments
Authors: Shadreck Muchaku, Grey Magaiza, Jerit Dube
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The high insolvency rate of female-led emerging enterprises in the Southern African mountain region reflects the various vulnerabilities that exist. Although this is the case, there is a limited understanding of how these vulnerabilities influence entrepreneurship failure. This paper focuses on female entrepreneurs because of their role in economic development. Emerging female entrepreneurs in this region often operate in uncertain environments, which makes it difficult for them to thrive. The form and nature of entrepreneurial opportunities rural women of the Afro Montane region engage in are largely unsustainable as a lot of women struggle with confidence, and they need help with understanding their skills. However, there is still a gap in the existing literature on women entrepreneurship resilience and vulnerability reduction in the Afromontane. Furthermore, a major problem is the lack of empirical studies on this matter and limited studies indicating a general profile of emerging female entrepreneurs in this region. This systematic literature review attempts to fill in the gap of knowledge on entrepreneurship resilience and vulnerability reduction of emerging female entrepreneurs in the Afromontane regions and other similar precarious environments. In this review, we focus much on highlighting the nexus between entrepreneurship resilience and vulnerability reduction of emerging female entrepreneurs in academic literature through a chronological dispersal of publications in developing countries. This review adopts an ATLAS ti.22 software-based thematic analysis to analyze results obtained from reviewed academic journal articles. As research on entrepreneurship resilience and vulnerability reduction is still developing in the Sothern African mountain region, the results of this review will contribute to the body of literature and provide recommendations and a foundation for future research. This systematic review paper provides valuable insights and methodological approaches to scholarship in a nascent area of emerging female entrepreneurs in the Afromontane.Keywords: entrepreneurship resiliency, vulnerability reduction, female entrepreneurs, mountain regions
Procedia PDF Downloads 1431128 Carbon Stock Estimation of Urban Forests in Selected Public Parks in Addis Ababa
Authors: Meseret Habtamu, Mekuria Argaw
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Urban forests can help to improve the microclimate and air quality. Urban forests in Addis Ababa are important sinks for GHGs as the number of vehicles and the traffic constrain is steadily increasing. The objective of this study was to characterize the vegetation types in selected public parks and to estimate the carbon stock potential of urban forests by assessing carbon in the above, below ground biomass, in the litter and soil. Species which vegetation samples were taken using a systematic transect sampling within value DBH ≥ 5cm were recorded to measure the above, the below ground biomass and the amount of C stored. Allometric models (Y= 34.4703 - 8.0671(DBH) + 0.6589(DBH2) were used to calculate the above ground and Below ground biomass (BGB) = AGB × 0.2 and sampling of soil and litter was based on quadrates. There were 5038 trees recorded from the selected study sites with DBH ≥ 5cm. Most of the Parks had large number of indigenous species, but the numbers of exotic trees are much larger than the indigenous trees. The mean above ground and below ground biomass is 305.7 ± 168.3 and 61.1± 33.7 respectively and the mean carbon in the above ground and below ground biomass is 143.3±74.2 and 28.1 ± 14.4 respectively. The mean CO2 in the above ground and below ground biomass is 525.9 ± 272.2 and 103.1 ± 52.9 respectively. The mean carbon in dead litter and soil carbon were 10.5 ± 2.4 and 69.2t ha-1 respectively. Urban trees reduce atmospheric carbon dioxide (CO2) through sequestration which is important for climate change mitigation, they are also important for recreational, medicinal value and aesthetic and biodiversity conservation.Keywords: biodiversity, carbon sequestration, climate change, urban forests
Procedia PDF Downloads 2291127 Laser Data Based Automatic Generation of Lane-Level Road Map for Intelligent Vehicles
Authors: Zehai Yu, Hui Zhu, Linglong Lin, Huawei Liang, Biao Yu, Weixin Huang
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With the development of intelligent vehicle systems, a high-precision road map is increasingly needed in many aspects. The automatic lane lines extraction and modeling are the most essential steps for the generation of a precise lane-level road map. In this paper, an automatic lane-level road map generation system is proposed. To extract the road markings on the ground, the multi-region Otsu thresholding method is applied, which calculates the intensity value of laser data that maximizes the variance between background and road markings. The extracted road marking points are then projected to the raster image and clustered using a two-stage clustering algorithm. Lane lines are subsequently recognized from these clusters by the shape features of their minimum bounding rectangle. To ensure the storage efficiency of the map, the lane lines are approximated to cubic polynomial curves using a Bayesian estimation approach. The proposed lane-level road map generation system has been tested on urban and expressway conditions in Hefei, China. The experimental results on the datasets show that our method can achieve excellent extraction and clustering effect, and the fitted lines can reach a high position accuracy with an error of less than 10 cm.Keywords: curve fitting, lane-level road map, line recognition, multi-thresholding, two-stage clustering
Procedia PDF Downloads 1281126 Development and Psychometric Validation of the Hospitalised Older Adults Dignity Scale for Measuring Dignity during Acute Hospital Admissions
Authors: Abdul-Ganiyu Fuseini, Bernice Redley, Helen Rawson, Lenore Lay, Debra Kerr
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Aim: The study aimed to develop and validate a culturally appropriate patient-reported outcome measure for measuring dignity for older adults during acute hospital admissions. Design: A three-phased mixed-method sequential exploratory design was used. Methods: Concept elicitation and generation of items for the scale was informed by older adults’ perspectives about dignity during acute hospitalization and a literature review. Content validity evaluation and pre-testing were undertaken using standard instrument development techniques. A cross-sectional survey design was conducted involving 270 hospitalized older adults for evaluation of construct and convergent validity, internal consistency reliability, and test–retest reliability of the scale. Analysis was performed using Statistical Package for the Social Sciences, version 25. Reporting of the study was guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: We established the 15-item Hospitalized Older Adults’ Dignity Scale that has a 5-factor structure: Shared Decision-Making (3 items); Healthcare Professional-Patient Communication (3 items); Patient Autonomy (4 items); Patient Privacy (2 items); and Respectful Care (3 items). Excellent content validity, adequate construct and convergent validity, acceptable internal consistency reliability, and good test-retest reliability were demonstrated. Conclusion: We established the Hospitalized Older Adults Dignity Scale as a valid and reliable scale to measure dignity for older adults during acute hospital admissions. Future studies using confirmatory factor analysis are needed to corroborate the dimensionality of the factor structure and external validity of the scale. Routine use of the scale may provide information that informs the development of strategies to improve dignity-related care in the future. Impact: The development and validation of the Hospitalized Older Adults Dignity Scale will provide healthcare professionals with a feasible and reliable scale for measuring older adults’ dignity during acute hospitalization. Routine use of the scale may enable the capturing and incorporation of older patients’ perspectives about their healthcare experience and provide information that informs the development of strategies to improve dignity-related care in the future.Keywords: dignity, older adults, hospitalisation, scale, patients, dignified care, acute care
Procedia PDF Downloads 901125 Estimation of Pressure Profile and Boundary Layer Characteristics over NACA 4412 Airfoil
Authors: Anwar Ul Haque, Waqar Asrar, Erwin Sulaeman, Jaffar S. M. Ali
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Pressure distribution data of the standard airfoils is usually used for the calibration purposes in subsonic wind tunnels. Results of such experiments are quite old and obtained by using the model in the spanwise direction. In this manuscript, pressure distribution over NACA 4412 airfoil model was presented by placing the 3D model in the lateral direction. The model is made of metal with pressure ports distributed longitudinally as well as in the lateral direction. The pressure model was attached to the floor of the tunnel with the help of the base plate to give the specified angle of attack to the model. Before the start of the experiments, the pressure tubes of the respective ports of the 128 ports pressure scanner are checked for leakage, and the losses due to the length of the pipes were also incorporated in the results for the specified pressure range. Growth rate maps of the boundary layer thickness were also plotted. It was found that with the increase in the velocity, the dynamic pressure distribution was also increased for the alpha seep. Plots of pressure distribution so obtained were overlapped with those obtained by using XFLR software, a low fidelity tool. It was found that at moderate and high angles of attack, the distribution of the pressure coefficients obtained from the experiments is high when compared with the XFLR ® results obtained along with the span of the wing. This under-prediction by XFLR ® is more obvious on the windward than on the leeward side.Keywords: subsonic flow, boundary layer, wind tunnel, pressure testing
Procedia PDF Downloads 3201124 Estimation of Residual Stresses in Thick Walled Cylinder by Radial Basis Artificial Neural
Authors: Mohammad Heidari
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In this paper a method for high strength steel is proposed of residual stresses in autofrettaged tubes by combination of artificial neural networks is presented. Many different thick walled cylinders that were subjected to different conditions were studied. At first, the residual stress is calculated by analytical solution. Then by changing of the parameters that influenced in residual stresses such as percentage of autofrettage, internal pressure, wall ratio of cylinder, material property of cylinder, bauschinger and hardening effect factor, a neural network is created. These parameters are the input of network. The output of network is residual stress. Numerical data, employed for training the network and capabilities of the model in predicting the residual stress has been verified. The output obtained from neural network model is compared with numerical results, and the amount of relative error has been calculated. Based on this verification error, it is shown that the radial basis function of neural network has the average error of 2.75% in predicting residual stress of thick wall cylinder. Further analysis of residual stress of thick wall cylinder under different input conditions has been investigated and comparison results of modeling with numerical considerations shows a good agreement, which also proves the feasibility and effectiveness of the adopted approach.Keywords: thick walled cylinder, residual stress, radial basis, artificial neural network
Procedia PDF Downloads 4161123 Electrodeposition of Silicon Nanoparticles Using Ionic Liquid for Energy Storage Application
Authors: Anjali Vanpariya, Priyanka Marathey, Sakshum Khanna, Roma Patel, Indrajit Mukhopadhyay
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Silicon (Si) is a promising negative electrode material for lithium-ion batteries (LiBs) due to its low cost, non-toxicity, and a high theoretical capacity of 4200 mAhg⁻¹. The primary challenge of the application of Si-based LiBs is large volume expansion (~ 300%) during the charge-discharge process. Incorporation of graphene, carbon nanotubes (CNTs), morphological control, and nanoparticles was utilized as effective strategies to tackle volume expansion issues. However, molten salt methods can resolve the issue, but high-temperature requirement limits its application. For sustainable and practical approach, room temperature (RT) based methods are essentially required. Use of ionic liquids (ILs) for electrodeposition of Si nanostructures can possibly resolve the issue of temperature as well as greener media. In this work, electrodeposition of Si nanoparticles on gold substrate was successfully carried out in the presence of ILs media, 1-butyl-3-methylimidazolium-bis (trifluoromethyl sulfonyl) imide (BMImTf₂N) at room temperature. Cyclic voltammetry (CV) suggests the sequential reduction of Si⁴⁺ to Si²⁺ and then Si nanoparticles (SiNs). The structure and morphology of the electrodeposited SiNs were investigated by FE-SEM and observed interconnected Si nanoparticles of average particle size ⁓100-200 nm. XRD and XPS data confirm the deposition of Si on Au (111). The first discharge-charge capacity of Si anode material has been found to be 1857 and 422 mAhg⁻¹, respectively, at current density 7.8 Ag⁻¹. The irreversible capacity of the first discharge-charge process can be attributed to the solid electrolyte interface (SEI) formation via electrolyte decomposition, and trapped Li⁺ inserted into the inner pores of Si. Pulverization of SiNs results in the creation of a new active site, which facilitates the formation of new SEI in the subsequent cycles leading to fading in a specific capacity. After 20 cycles, charge-discharge profiles have been stabilized, and a reversible capacity of 150 mAhg⁻¹ is retained. Electrochemical impedance spectroscopy (EIS) data shows the decrease in Rct value from 94.7 to 47.6 kΩ after 50 cycles of charge-discharge, which demonstrates the improvements of the interfacial charge transfer kinetics. The decrease in the Warburg impedance after 50 cycles of charge-discharge measurements indicates facile diffusion in fragmented and smaller Si nanoparticles. In summary, Si nanoparticles deposited on gold substrate using ILs as media and characterized well with different analytical techniques. Synthesized material was successfully utilized for LiBs application, which is well supported by CV and EIS data.Keywords: silicon nanoparticles, ionic liquid, electrodeposition, cyclic voltammetry, Li-ion battery
Procedia PDF Downloads 1251122 Hormone Replacement Therapy (HRT) and Its Impact on the All-Cause Mortality of UK Women: A Matched Cohort Study 1984-2017
Authors: Nurunnahar Akter, Elena Kulinskaya, Nicholas Steel, Ilyas Bakbergenuly
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Although Hormone Replacement Therapy (HRT) is an effective treatment in ameliorating menopausal symptoms, it has mixed effects on different health outcomes, increasing, for instance, the risk of breast cancer. Because of this, many symptomatic women are left untreated. Untreated menopausal symptoms may result in other health issues, which eventually put an extra burden and costs to the health care system. All-cause mortality analysis may explain the net benefits and risks of the HRT therapy. However, it received far less attention in HRT studies. This study investigated the impact of HRT on all-cause mortality using electronically recorded primary care data from The Health Improvement Network (THIN) that broadly represents the female population in the United Kingdom (UK). The study entry date for this study was the record of the first HRT prescription from 1984, and patients were followed up until death or transfer to another GP practice or study end date, which was January 2017. 112,354 HRT users (cases) were matched with 245,320 non-users by age at HRT initiation and general practice (GP). The hazards of all-cause mortality associated with HRT were estimated by a parametric Weibull-Cox model adjusting for a wide range of important medical, lifestyle, and socio-demographic factors. The multilevel multiple imputation techniques were used to deal with missing data. This study found that during 32 years of follow-up, combined HRT reduced the hazard ratio (HR) of all-cause mortality by 9% (HR: 0.91; 95% Confidence Interval, 0.88-0.94) in women of age between 46 to 65 at first treatment compared to the non-users of the same age. Age-specific mortality analyses found that combined HRT decreased mortality by 13% (HR: 0.87; 95% CI, 0.82-0.92), 12% (HR: 0.88; 95% CI, 0.82-0.93), and 8% (HR: 0.92; 95% CI, 0.85-0.98), in 51 to 55, 56 to 60, and 61 to 65 age group at first treatment, respectively. There was no association between estrogen-only HRT and women’s all-cause mortality. The findings from this study may help to inform the choices of women at menopause and to further educate the clinicians and resource planners.Keywords: hormone replacement therapy, multiple imputations, primary care data, the health improvement network (THIN)
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