Search results for: regional hospital

Authors: Maryam Panahi

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Background: Adjuvants such as ketamine, promethazine, and paracetamol could bring up patient's satisfaction and control the harmful effects of opioids besides lessening their needed doses, as seen by the fentanyl/paracetamol and fentanyl/ketamine combination before. The current study is headed to compare paracetamol and ketamine, in addition to fentanyl, applied by infusion pumps in order to pain relief following major surgery. Materials and Methods: Through a double-blinded, randomized clinical trial, patients between18 and 65 with elective surgery for tight or leg fractures with ASA Class 1 and 2 referred to a university hospital in Arak, a town in the central region of Iran, were recruited and used infusion pump for their postoperative pain control. The participants were divided into cases and controls regarding using ketamine/fentanyl (KF) or paracetamol/fentanyl (PF) infusion pumps. Results: The mean pain score was a total of 3.87, with the highest value in KF (5.06) and the lowest in PF (4.50) immediately after finishing the surgery and getting conscious when started using an infusion pump. There was no statistical difference between the groups in this regard. Concerning the side effects of the applied medications, blood pressure and heart rate had no differences comparing the groups. Conclusion: This study showed that paracetamol used in infusion pumps could be brilliant in pain control after major surgeries like those done in lower extremities and joint replacement while lessening opioid use. Although paracetamol was more effective than ketamine in the current trial, more qualified studies at bigger sizes and in other fields of surgery besides orthopedic ones would be useful to support the effects if applicable

Keywords: infusion pump, Ketamine, Paracetamol, pain

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Authors: Al-Tammar M. Shahah

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Background and Objective: A novel pneumonia caused by coronavirus disease 2019 (COVID-19), which is spreading domestically and internationally, has been identified by the Chinese city of Wuhan since the end of December 2019. Limited studies examined the psychological experience such as anxiety, depression, and stress during Corona pandemic. Moreover, to the best of author's knowledge, there is no study to date has examined the psychological resilience and mental health during Corona pandemic in Kuwait. Therefore, the present research investigates the role of psychological resilience in predicting psychological distress among Kuwaiti adults during Corona pandemic. Method: Kuwaiti citizens (N = 735) completed an online survey, which includes four scales the Hospital Anxiety and Depression Scale HADS (anxiety and depression), the Connor-Davidson Resilience Scale (CD-RISC-25), and the Perceived Stress Scale (PSS). A cross-sectional correlational design was used. Results: A high level of stress was observed, with 59% reported moderate to severe stress. In contrast, low levels of anxiety and depression were observed; with 70% reporting no anxiety symptoms and 74% report no depression symptoms. Psychological resilience was negatively correlated with anxiety, depression, and stress, consistent with previous studies. As expected, resilience was found to account for significant variance in anxiety and stress after controlling for quarantine variables and demographic variables. Conclusion: The findings suggest that increasing psychological resilience might help reduce psychological distress after confronting with stressful live events in Kuwaiti citizen.

Keywords: anxiety, corona, depression, psychological resilience, stress

Procedia PDF Downloads 125

Authors: Reza Farahmand Rad, Farnad Imani, Azadeh Emami, Reza Salehi, Ali Reza Ghavamy, Ali Nima Shariat

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Background: One of the methods of pain control after pediatric surgical procedures is regional techniques, including caudal block, despite their limitations. Objectives: In this study, the pain score and complications of caudal tramadol were evaluated in pediatrics following lower abdom- inal surgery. Methods: In this study, 46 children aged 3 to 10 years were allocated into two equal groups (R and TR) for performing caudal anal- gesia after lower abdominal surgery. The injectate contained 0.2% ropivacaine 1 mL/kg in the R group (control group) and tramadol (2 mg/kg) and ropivacaine in the TR group. The pain score, duration of pain relief, amount of paracetamol consumption, hemody- namic alterations, and possible complications at specific times (1, 2, and 6 hours) were evaluated in both groups. Results: No considerable difference was observed in the pain score between the groups in the first and second hours (P > 0.05). However, in the sixth hour, the TR group had a significantly lower pain score than the R group (P < 0.05). Compared to the R group, the TR group had a longer period of analgesia and lower consumption of analgesic drugs (P < 0.05). Heart rate and blood pressure differences were not significant between the two groups (P > 0.05). Similarly, the duration of operation and recovery time were not remarkably different between the two groups (P > 0.05). Complications had no apparent differences between these two groups, as well (P > 0.05). Conclusions: In this study, the addition of tramadol to caudal ropivacaine in pediatric lower abdominal surgery promoted pain relief without complications.

Keywords: tramadol, ropivacaine, caudal block, pediatric, lower abdominal surgery, postoperative pain

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Authors: Zhao Liu, Kang Cao

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Strategic spatial planning, which is taken as an effective and competitive way for the governors of the city to improve the development and management level of a city, has been blooming in recent years all over the world. In the context of globalization and informatization, strategic spatial planning must transfer its focus on three different levels: global, regional and urban. Internal and external changes in environmental conditions lead to new advances in strategic planning both theoretically and practically. However, such advances or changes respond differently to cities on account of different dynamic mechanisms. This article aims at two cities of Tianjin in China and Melbourne in Australia, through a comparative study on strategic planning, to explore the differentiation of mechanisms in urban planning. By comparison and exploration, the purpose of this article is to exhibit two different planning worlds, western and Chinese, in a new way. The article can be divided into four parts. The first part outlines strategic planning transformations in the new era on three levels, generally analysing the internal and external environmental factors of today. The second part indicates the concepts of strategic planning theoretically, demonstrating briefly its development background and process in western and China, respectively. The third part takes Tianjin and Melbourne urban strategic spatial planning as examples to mainly carry on the contrast research from the aspects of strategic planning mode, competitive mechanism, contents, strategy implementation and management. It is expected to summarize the differences and similarities of the two plans, meanwhile, to explore the inherent factors or mechanisms probably spatial, material, political and etc., which affect cities in the course of urban planning. The final part is a summary of general mechanisms of planning from the perspective of strategic spatial planning.

Keywords: differentiation, strategic planning, Melbourne, Australia, Tianjin, China

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Authors: Adebayo A. Abimbola, Anifowose O. Joseph, Olanrewaju S. Taiwo

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Green building (GB) practices have the potential to save energy, save money, and improve the quality of human habitat. They can also contribute to water conservation, more efficient use of raw materials, and ecosystem health around the globe. The Intergovernmental Panel on Climate Change (IPCC) singled out the building sector as having the most cost-effective opportunities for reducing carbon emissions—in fact, many building-related opportunities are cost-neutral, or even cost-positive, to the building owner. These benefits have made green building practices the fastest-growing trend in the building industry, but they still represent only a fraction of new construction, and the enormous stock of existing buildings has barely been touched at all. To effectively deliver the kind of (GB) that can become a force for positive change at global, regional and local scales, all workforce sectors need new skills that are both technical and interpersonal in nature. A prominent bottleneck is seen to be education and training. This paper investigates the major gaps in current GB education and training offerings in Nigeria. A questionnaire survey was developed to capture the perception of construction professionals and academics in relevant professions regarding the significance of the identified gaps as it affects GB education and training. Based on Likert scale ranking, research result shows that perception of training in specific technical fields and financial benefits and evaluation are identified as the top gaps in GB training and education offerings. The paper concludes with suggestions and actions that can enhance capabilities of the GB workforce in Nigeria.

Keywords: education and training, gaps, green building, workforce

Procedia PDF Downloads 326

Authors: Jutta Ransmayr

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The German language is known to be one of the most varied and diverse languages in Europe. This variance in the standard language can be conceptualized using the pluricentric concept, which has been useful for describing the German language for more than three decades. Up to now, there have hardly been any well-founded studies of how Austrian teachers and pupils conceptualize the German language and how they view the varieties of German and especially Austrian German. The language attitudes and norms of German teachers are of particular interest in the normative, educational language-oriented school context. The teachers’ attitudes are, in turn, formative for the attitudes of the students, especially since Austrian German is an important element in the construction of Austrian national identity. The project 'Austrian German as a Language of Instruction and Education' dealt, among other things, with the attitude of language laypeople (pupils, n = 1253) and language experts (teachers, n = 164) towards the Austrian standard variety. It also aimed to find out to what extent external factors such as regional origin, age, education, or media use to influence these attitudes. It was examined whether language change phenomena can be determined and to what extent language change is in conflict with loyalty to variants. The study also focused on what norms prevail among German teachers, how they deal with standard language variation from a normative point of view, and to what extent they correct exonorm-oriented, as claimed in the literature. Methodologically, both quantitative (questionnaire survey) and qualitative methods were used (interviews with 21 teachers, 2 group discussions, and participatory observation of lessons in 7 school classes). The data were evaluated in terms of inference statistics and discourse analysis. This paper reports on the results of this project.

Keywords: Austrian German, language attitudes and linguistic identity, linguistic loyalty, teachers and students

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Authors: Tia Morosin, Marie Shella De Robles

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Rectocele may be associated with symptoms of both obstructed defecation and faecal incontinence. Currently, numerous operative techniques exist to treat patients with rectocele; however, no single technique has emerged as the optimal approach in patients with post-partum faecal incontinence. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele for patients presenting with faecal incontinence as the predominant symptom. Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon. All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range 21 to 90 years). The median operating time and length of hospital stay were 2 hours and 7 days, respectively. Two patients developed urinary retention post-operatively, which required temporary bladder catheterization. One patient had wound dehiscence, which was managed by absorbent dressing applied by the patient and her carer. There was no operative mortality. In all patients with rectocele, there was a concomitant anal sphincter disruption. All patients had satisfactory improvement with regard to faecal incontinence on follow-up. This study suggests this method provides excellent anatomic and physiologic results with minimal morbidity. However, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.

Keywords: anal sphincter defect, faecal incontinence, rectocele, transperineal repair

Procedia PDF Downloads 131

Authors: Jean-Paul Kapuya Bulaba Nyembwe, John Omomoluwa Ogundiran, Manuel Carlos Gameiro da Silva

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Indoor environmental quality (IEQ) remains a global concern because it impacts people's comfort, health, performance, and general well-being. People spend a significant amount of time in buildings or while commuting, hence ensuring the minimal risk in indoor spaces by ensuring suitable IEQ. IEQ studies are limited regarding developing sub-Saharan countries, whereas there is also a huge risk and concern for the current population and geometric growth as many cities in the region will become mega-cities by 2040 (World Bank report). The absence of suitable IEQ regulations and energy poverty are reasons to assess the IEQ gaps for increased awareness of sustainable interventions to minimize the associated risk. This study evaluates the gaps and potential hazards that exist in the IEQ of sub-Saharan countries using empirical studies of hospital occupants and BRT bus passengers and drivers. The Surveys were conducted in 3 cities of the Democratic Republic of Congo and Lagos metropolis of Nigeria. The results suggest that gaps exist in IEQ for these regions. The gaps indicate existential risk to people’s health, comfort, and well-being. The inferential conclusions are that there is a need for further scientific studies, improvement in IEQ conditions, and ensuring suitable regulations for developing sub-Saharan countries.

Keywords: health hazards, hospitals indoor environmental quality, indoor spaces, occupants, sub-Saharan countries, vehicles

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Authors: M. O. Adeniyi, R. T. Akinnubi

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The parameterization of turbulent heat fluxes is needed for modeling land-atmosphere interactions in Global Climate Models (GCMs). However, current GCMs still have difficulties with producing reliable turbulent heat fluxes for humid tropical regions, which may be due to inadequate parameterization of the roughness lengths for momentum (z0m) and heat (z0h) transfer. These roughness lengths are usually expressed in term of excess resistance factor (κB^(-1)), and this factor is used to account for different resistances for momentum and heat transfers. In this paper, a more appropriate excess resistance factor (〖 κB〗^(-1)) suitable for low wind speed condition was developed and incorporated into the aerodynamic resistance approach (ARA) in the GCMs. Also, the performance of various standard GCMs κB^(-1) schemes developed for high wind speed conditions were assessed. Based on the in-situ surface heat fluxes and profile measurements of wind speed and temperature from Nigeria Micrometeorological Experimental site (NIMEX), new κB^(-1) was derived through application of the Monin–Obukhov similarity theory and Brutsaert theoretical model for heat transfer. Turbulent flux parameterizations with this new formula provides better estimates of heat fluxes when compared with others estimated using existing GCMs κB^(-1) schemes. The derived κB^(-1) MBE and RMSE in the parameterized QH ranged from -1.15 to – 5.10 Wm-2 and 10.01 to 23.47 Wm-2, while that of QE ranged from - 8.02 to 6.11 Wm-2 and 14.01 to 18.11 Wm-2 respectively. The derived 〖 κB〗^(-1) gave better estimates of QH than QE during daytime. The derived 〖 κB〗^(-1)=6.66〖 Re〗_*^0.02-5.47, where Re_* is the Reynolds number. The derived κB^(-1) scheme which corrects a well documented large overestimation of turbulent heat fluxes is therefore, recommended for most regional models within the tropic where low wind speed is prevalent.

Keywords: humid, tropic, excess resistance factor, overestimation, turbulent heat fluxes

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Authors: Alasdair Warwick, Luna Dhir

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Aim: To ascertain the efficacy of overcorrecting minus lens therapy in intermittent distance exotropia. Methods: Retrospective audit of all intermittent distance exotropia patients seen in the Chelsea and Westminster Hospital pediatric eye clinic between 1st January 2014 and 1st March 2016. Change in LogMAR visual acuity, stereopsis, near and distance angles of deviation, as well as the proportions of patients converting to exophoria or undergoing strabismus surgery, were recorded. Results: 22 patients were identified, 45% male, mean age 5 years (range 0.6 to 18.5 years). The median overminus prescription was -1.0 dioptres (range -0.5 to -1.75 dioptres) and mean follow-up was 15 months (range 3 to 54 months). Visual acuity, near and distance angles of deviation improved but were not statistically significant: -0.15 LogMAR, -0.2 prism dioptres and -1.2 prism dioptres respectively (p>0.05). However, a significant change in stereopsis was observed: -74'' (p<0.01). 27% underwent strabismus surgery and 36% converted to exophoria whilst wearing their overminus prescription. Conclusions: Overcorrecting minus lens therapy is an effective therapy for intermittent distance exotropia. There was no deterioration in visual acuity and a significant improvement in stereopsis was seen in our cohort, with many patients converting to an exophoria. The proportion of patients requiring strabismus surgery was comparable to other studies. Further, follow-up is needed to ascertain long-term outcomes.

Keywords: exotropia, overcorrecting minus lens, refraction, strabismus

Procedia PDF Downloads 250

Authors: Sabrina Rahman

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The Mosque is Islam’s most symbolic structure, as well as the expression of collective identity. From the explicit words of our Prophet, 'The earth has been created for me as a masjid and a place of purity, and whatever man from my Ummah finds himself in need of prayer, let him pray' (anywhere)! it is obvious that a devout Muslim does not require a defined space or structure for divine worship since the whole earth is his prayer house. Yet we see that from time immemorial man throughout the Muslim world has painstakingly erected innumerable mosques. However, mosque design spans time, crosses boundaries, and expresses cultures. It is a cultural manifestation as much as one based on a regional building tradition or a certain interpretation of religion. The trend to express physical signs of religion is not new. Physical forms seem to convey symbolic messages. However, in recent times physical forms of mosque architecture are dominantly demising from mosque architecture projects in Bangladesh. Dome & minaret, the most prominent symbol of the mosque, is replacing by contextual and contemporary improvisation rather than subcontinental mosque architecture practice of early fellows. Thus the recent mosque projects of the last 15 years established the contemporary architectural realm in their design. Contextually, spiritual lighting, the serenity of space, tranquility of outdoor spaces, the texture of materials is widely establishing a new genre of Muslim prayer space. A case study based research will lead to specify its significant factors of modernism. Based on the findings, the paper presents evidence of recent projects as well as a guideline for the future image of contemporary Mosque architecture in Bangladesh.

Keywords: contemporary architecture, modernism, prayer space, symbolism

Procedia PDF Downloads 125

Authors: Md. Kamrul Hassan, Ari Pappinen

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Wood energy is the single most important form of renewable energy in many parts of the world especially in the least developing countries in South Asia like Bangladesh. The last portion of the national population of this country depends on wood energy for their daily primary energy need. This paper deals with the estimation of wood fuel at the current level and identifies the challenges and strategies related to the development of this resource. Desk research, interactive research and field survey were conducted for gathering and analyzing of data for this study. The study revealed that wood fuel plays a significant role in total primary energy supply in Bangladesh, and the contribution of wood fuel in final energy consumption in 2013 was about 24%. Trees on homestead areas, secondary plantation on off forest lands, and forests are the main sources of supplying wood fuel in the country. Insufficient supply of wood fuel against high upward demand is the main cause of concern for sustainable consumption, which eventually leads deterioration and depletion of the resources. Inadequate afforestation programme, lack of initiatives towards the utilization of set-aside lands for wood energy plantations, and inefficient management of the existing resources have been identified as the major impediments to the development of wood energy in Bangladesh. The study argued that enhancement of public-private-partnership afforestation programmes, intensifying the waste and marginal lands with short-rotation tree species, and formulation of biomass-based rural energy strategies at the regional level are relevant to the promotion of sustainable wood energy in the country.

Keywords: Bangladesh, challenge, supply, wood energy

Procedia PDF Downloads 192

Authors: A. Alhusban, M. Alqawasmeh, F. Alfawares

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Introduction: Diabetes is a chronic health problem and a major risk factor of stroke. A number of therapeutic modalities exist for diabetes management. It’s still unknown whether the different oral hypoglycemic agents would ameliorate the detrimental effect of diabetes on stroke severity. The objective of this work is to assess the effect of pretreatment with oral hypoglycemic agents, insulin and their combination on stroke severity at presentation. Patients and Methods: Patients admitted to the King Abdullah University Hospital (KAUH)-Jordan with ischemic stroke between January 2015 and December 2016 were evaluated and their comorbid diseases, treatment on admission and their neurologic severity was assessed using the National Institute of Health Stroke Scale (NIHSS) were documented. Stroke severity was compared for non-diabetic patients and diabetic patients treated with different antidiabetic agents. Results: Data from 324 patients with acute stroke was documented. The median age of participants was 69 years. Diabetes was documented in about 50% of the patients. Multinomial regression analysis identified diabetes treatment status as an independent predictor of neurological severity of stroke (p=0.032). Patients treated with oral hypoglycemic agents had a significantly lower NIHSS as compared to nondiabetic patients and insulin treated patients (p < 0.02). The positive effect of oral hypoglycemic agents was blunted by insulin co-treatment. Insulin did not alter the severity of stroke as compared to non-diabetics. Conclusion: Oral hypoglycemic agents may reduce the severity of neurologic deficit of ischemic stroke and may have neuroprotective effect.

Keywords: diabetes, stroke, neuroprotection, oral hypoglycemic agents

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Authors: Helen Nelly Naiga, Christopher Garimoi Orach

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Introduction: Long-acting reversible contraceptive (LARC) methods are highly effective. However, LARC use in Uganda is low (13%). We assessed the factors associated with the use of long-acting reversible contraceptives among women of reproductive age (15-49 yrs) in Jinja District. Methods: We conducted a facility-based cross-sectional study. A total of 314 women aged 15–49 years attending public health facilities (1 hospital and 3 health center IV) in Jinja district, were randomly selected. A total of 6 key informants and 6 in-depth interviews were conducted. Logistic regression analysis was conducted using Stata version 14. Qualitative data were analysed using thematic analysis. Results: The study found that 40.45% of the respondents had ever used LARC. The commonest LARC method used was implanting (38.22%). The factors significantly associated with use of LARC were employment (AOR =2.91; 95% CI (1.05-8.08), access to LARC methods (AOR =4.48; 95% CI (1.24-16.21), husband support (AOR =4.90; 95% CI (1.56-15.41), and experience of no side effects (AOR =3.48; 95% CI (1.00-12.19). Conclusion and recommendations: The study showed that 4 in 10 women of reproductive age in Jinja District were using LARC. The factors associated with LARC use were employment, husband support, access to LARC methods, and the lack of side effects. There is a need to strengthen client education, improve accessibility to LARC methods at all levels of health centers, improve male partner’s decision-making in LARC use and manage the side effects effectively.

Keywords: family planning, implants, intrauterine device, long-acting reversible contraceptives (LARC)

Procedia PDF Downloads 249

Authors: Yunita Ratih Wijayanti, Dwi Rahmawati, Turniningtyas Ayu Rahmawati

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Gresik is one of the districts in East Java Province, Indonesia. Gresik Regency has three major rivers, namely Bengawan Solo River, Brantas River, and Lamong River. Lamong River is a tributary of Bengawan Solo River. Flood disasters that occur in Gresik Regency are often caused by the overflow of the Lamong River. The losses caused by the flood were very large and certainly detrimental to the affected people. Therefore, to be able to minimize the impact caused by the flood, it is necessary to take preventive action. However, before taking preventive action, it is necessary to have information regarding potential inundation areas and water levels at various points. For this reason, a flood simulation model is needed. In this study, the simulation was carried out using the Geographic Information System (GIS) method with the help of Global Mapper software. The approach used in this simulation is to use a topographical approach with Digital Elevation Models (DEMs) data. DEMs data have been widely used for various researches to analyze hydrology. The results obtained from this flood simulation are the distribution of flood inundation and water level. The location of the inundation serves to determine the extent of the flooding that occurs by referring to the 50-100 year flood plan, while the water level serves to provide early warning information. Both will be very useful to find out how much loss will be caused in the future due to flooding in Gresik Regency so that the Gresik Regency Regional Disaster Management Agency can take precautions before the flood disaster strikes.

Keywords: flood hazard, simulation model, potential inundation, global mapper, Gresik Regency

Procedia PDF Downloads 90

Authors: Patricia O. Carvalho, Marcia C. F. Messias, Salvador Sanchez Vinces, Caroline F. A. Gatinoni, Vitor P. Iordanu, Carlos A. R. Martinez

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Lipidomics methods are widely used in the identification and validation of disease-specific biomarkers and therapy response evaluation. The present study aimed to identify a panel of potential lipid biomarkers to evaluate response to neoadjuvant chemoradiotherapy in rectal adenocarcinoma (RAC). Liquid chromatography–mass spectrometry (LC-MS)-based untargeted lipidomic was used to profile human serum samples from patients with clinical stage T2 or T3 resectable RAC, after and before chemoradiotherapy treatment. A total of 28 blood plasma samples were collected from 14 patients with RAC who recruited at the São Francisco University Hospital (HUSF/USF). The study was approved by the ethics committee (CAAE 14958819.8.0000.5514). Univariate and multivariate statistical analyses were applied to explore dysregulated metabolic pathways using untargeted lipidic profiling and data mining approaches. A total of 36 statistically significant altered lipids were identified and the subsequent partial least-squares discriminant analysis model was both cross validated (R2, Q2) and permutated. Lisophosphatidyl-choline (LPC) plasmalogens containing palmitoleic and oleic acids, with high variable importance in projection score, showed a tendency to be lower after completion of chemoradiotherapy. Chemoradiotherapy seems to change plasmanyl-phospholipids levels, indicating that these lipids play an important role in the RAC pathogenesis.

Keywords: lipidomics, neoadjuvant chemoradiotherapy, plasmalogens, rectal adenocarcinoma

Procedia PDF Downloads 134

Authors: R. Begum, M. M. R. Jahangir, M. Jahiruddin, M. R. Islam, M. M. Rahman, M. B. Hossain, P. Hossain

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Quantifying carbon (C) sequestration in soils is necessary to help better understand the effect of agricultural practices on the C cycle. The estimated contribution of agricultural carbon dioxide (CO₂) and methane (CH₄) to global warming potential (GWP) has a wide range. The underlying causes of this huge uncertainty are the difficulties to predict the regional CO₂ and CH₄ loss due to the lack of experimental evidence on CO₂ and CH₄ emissions and associated drivers. The CH₄ and CO₂ emissions were measured in irrigated wheat in subtropical floodplain soils which have been under two soil disturbance levels (strip vs. conventional tillage; ST vs. CT being both with 30% residue retention) and three N fertilizer rates (60, 100, and 140% of the recommended N fertilizer dose, RD) in annual wheat (Triticum aestivum)-mungbean (Vigna radiata)-rice (Oryza sativa L) for seven consecutive years. The highest CH₄ and CO₂ emission peak was observed on day 3 after urea application in both tillages except CO₂ flux in CT. Nitrogen fertilizer application rate significantly influenced mean and cumulative CH₄ and CO₂ fluxes. The CH₄ and CO₂ fluxes decreased in an optimum dose of N fertilizer except for ST for CH₄. The CO₂ emission significantly showed higher emission at minimum (60% of RD) fertilizer application at both tillages. Soil microbial biomass carbon (MBC), organic carbon (SOC), Particulate organic carbon (POC), permanganate oxidisable carbon (POXC), basal respiration (BR) were significantly higher in ST which were negative and significantly correlated with CO₂. However, POC and POXC were positively and significantly correlated with CH₄ emission.

Keywords: carbon dioxide emissions, methane emission, nitrogen rate, tillage

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Authors: Chen-Yu Tsai, Wen-Te Liu, Chen-Chen Lo, Kang Lo, Yin-Tzu Lin

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Background: Driving drowsiness related to insufficient or disordered sleep accounts for a major percentage of vehicular accidents. Sleep deprivation is the primary reason related to low sleep efficiency. Nevertheless, the mechanism of sleep deprivation induces driving fatigue to remain unclear. Objective: The objective of this study is to associate the relationship between insufficient sleep efficiency and driving fatigue. Methodologies: The physical condition while driving was obtained from the questionnaires to classify the state of driving fatigue. Sleep efficiency was quantified as the polysomnography (PSG), and the sleep stages were sentenced by the reregistered Technologist during examination in a hospital in New Taipei City (Taiwan). The independent T-test was used to investigate the correlation between sleep efficiency, sleep stages ratio, and driving drowsiness. Results: There were 880 subjects recruited in this study, who had been done polysomnography for evaluating severity for obstructive sleep apnea syndrome (OSAS) as well as completed the driver condition questionnaire. Four-hundred-eighty-four subjects (55%) were classified as fatigue group, and 396 subjects (45%) were served as the control group. The ratio of stage three sleep (N3) (0.032 ± 0.056) in fatigue group were significantly lower than the control group (p < 0.01). The significantly higher value of snoring index (242.14 ± 205.51 /hours) was observed in the fatigue group (p < 0.01). Conclusion: We observe the considerable correlation between deep sleep reduce and driving drowsiness. To avoid drowsy driving, the sleep deprivation, and the snoring events during the sleeping time should be monitored and alleviated.

Keywords: driving drowsiness, sleep deprivation, stage three sleep, snoring index

Procedia PDF Downloads 149

Authors: Kalyan Koganti

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Background: In India, platelet transfusions are given to large no. of patients suffering from dengue due to the fear of bleeding especially when the platelet counts are low. Though many patients do not bleed when the platelet count falls to less than 20,000, certain patients bleed even if the platelet counts are more than 20,000 without any comorbid condition (like gastrointestinal ulcer) in the past. This fear has led to huge amounts of unnecessary platelet transfusions which cause significant economic burden to low and middle-income countries like India and also sometimes these transfusions end with transfusion-related adverse reactions. Objective: To identify the role of Activated Partial Thromboplastin Time (APTT) in comparison with thrombocytoenia as an indicator to assess the real need of platelet transfusions. Method: A prospective study was conducted at a hospital in South India which included 176 admitted cases of dengue confirmed by immunochromatography. APTT was performed in all these patients along with platelet count. Cut off values of > 60 seconds for APTT and < 20,000 for platelet count were considered to assess the bleeding manifestations. Results: Among the total 176 patients, 56 patients had bleeding manifestations like malena, hematuria, bleeding gums etc. APTT > 60 seconds had a sensitivity and specificity of 93% and 90% respectively in identifying bleeding manifestations where as platelet count of < 20,000 had a sensitivity and specificity of 64% and 73% respectively. Conclusion: Elevated APTT levels can be considered as an indicator to assess the need of platelet transfusion in dengue. As there is a significant variation among patients who bleed with respect to platelet count, APTT can be considered to avoid unnecessary transfusions.

Keywords: activated partial thromboplastin time, dengue, platelet transfusion, thrombocytopenia

Procedia PDF Downloads 219

Authors: Wooseok Byon, Eunyoung Kim, Junseong Kwon, Byung Joo Song, Chan Heun Park

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Background/Purpose: Previous preclinical and clinical data suggest that increased lymphocytic infiltration would be associated with good prognosis and benefit from immunogenic chemotherapy especially in triple-negative breast cancer (TNBC). We investigated a single-center experience of TNBC and relationship with lymphocytic infiltration. Methods: From January 2004 to December 2012, at the Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, we retrospectively reviewed 897 breast cancer patients-clinical outcomes, clinicopathological characteristics, breast cancer subtypes. And we reviewed lymphocytic infiltration of TNBC specimens by two pathologists. Statistical analysis of risk factors associated with recurrence was performed. Results: A total of 897 patients, 76 were TNBC (8.47%). Mean age of TNBC patients were 50.95 (SD10.42) years, mean follow-up periods was 40.06 months. We reviewed 49 slides, and there were 8 recurrent breast cancer patients (16.32%), and 4 patients were expired (8.16%). There were 9 lymphocytic predominant breast cancers (LPBC)-carcinomas with either intratumoral lymphocytes in >60% of tumor cell nests. 1 patient of LPBC was recurred and 8 were not. In multivariate logistic regression, the odds ratio of lymphocytic infiltration was 0.59 (p=0.643). Conclusion: In a single-center experience of TNBC, the lymphocytic infiltration in tumor cell nest might be a good trend on the prognosis but there was not statistically significant.

Keywords: tumor-infiltrating lymphocytes, triple negative breast cancer, medical and health sciences

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Authors: Lucia Salvioni, Pietro Giorgio Lovaglio, Valerio Leoni, Miriam Colombo, Luisa Fiandra

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The involvement of plasmatic surfactant protein-D (SP-D) in pulmonary diseases has been long investigated, and over the last two years, more interest has been directed to determine its role as a marker of COVID-19. In this direction, several studies aimed to correlate pulmonary surfactant proteins with the clinical manifestations of the virus indicated SP-D as a prognostic biomarker of COVID-19 pneumonia severity. The present work has performed a retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio (Lombardia, Italy) with the aim to assess differences in the hematic SP-D concentrations among COVID-19 patients and healthy donors and the role of SP-D as a prognostic marker of severity and/or of mortality risk. The obtained results showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors, so as between dead and survived patients. SP-D values were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. SP-D levels at admission and increasing differences among follow-up and admission values resulted in the strongest significant risk factors of mortality. Therefore, this study demonstrated the role of SP-D as a predictive marker of SARS-CoV-2 infection and its outcome. A significant correlation of SP-D with patient mortality indicated that it is also a prognostic factor in terms of mortality, and its early detection should be considered to design adequate preventive treatments for COVID-19 patients.

Keywords: SARS-CoV-2 infection, COVID-19, surfactant protein-D (SP-D), mortality, biomarker

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Authors: Dana Mohammed, Fatemah Abdullah, Hawraa Ali, Najat Al-Shaer, Rawan Al-Awadhi, , Magdy Helal

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We study the patient service performance at the emergency department of a major Kuwaiti public hospital, using discrete simulation and lean concepts. In addition to the common problems in such health care systems (over crowdedness, facilities planning and usage, scheduling and staffing, capacity planning) the emergency department suffered from several cultural and patient behavioural issues. Those contributed significantly to the system problems and constituted major obstacles in maintaining the performance in control. This led to overly long waiting times and the potential of delaying providing help to critical cases. We utilized the visual management tools to mitigate the impact of the patients’ behaviours and attitudes and improve the logistics inside the system. In addition a proposal is made to automate the date collection and communication within the department using RFID-based barcoding system. Discrete event simulation models were developed as decision support systems; to study the operational problems and assess achieved improvements. The simulation analysis resulted in cutting the patient delays to about 35% of their current values by reallocating and rescheduling the medical staff. Combined with the application of the visual management concepts, this provided the basis to improving patient service without any major investments.

Keywords: simulation, visual management, health care system, patient

Procedia PDF Downloads 478

Authors: Pitchaporn Purngpiputtrakul, Suttasinee Petsakul, Sunisa Chatmongkolchart

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Nasogastric tube (NGT) insertion in anaesthetized and intubated patients can be challenging even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between the GlideScope visualization and neck flexion with lateral neck pressure techniques. This randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery under relaxant general anaesthesia who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of first and second attempts, duration of insertion, and complications were recorded. The total success rate was 79.1% in Group G compared with 76.7% in Group F (P=1) The median time required for NGT insertion was significantly longer in Group G, for both first and second attempts (97 vs 42 seconds P<0.001) and (70 vs 48.5 seconds P=0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications in both techniques. Using GlideScope visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique in degree of success rate of insertion, while neck flexion with lateral neck pressure technique had fewer complications and was less time-consuming.

Keywords: anaesthesia, nasogastric tube, GlideScope, intubation

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Authors: Malay Kumar Pramanik

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Climate change induced sea level rise increases storm surge, erosion, and inundation, which are stirred by an intricate interplay of physical environmental components at the coastal region. The Mumbai coast is much vulnerable to accelerated regional sea level change due to its highly dense population, highly developed economy, and low topography. To determine the significant causes behind coastal vulnerability, this study analyzes four different iterations of CVI by incorporating the pixel-based differentially weighted rank values of the selected five geological (CVI5), three physical (CVI8 with including geological variables), and four socio-economic variables (CVI4). However, CVI5 and CVI8 results yielded broadly similar natures, but after including socio-economic variables (CVI4), the results CVI (CVI12) has been changed at Mumbai and Kurla coastal portion that indicates the study coastal areas are mostly sensible with socio-economic variables. Therefore, the results of CVI12 show that out of 274.1 km of coastline analyzed, 55.83 % of the coast is very low vulnerable, 60.91 % of the coast is moderately vulnerable while 50.75 % is very high vulnerable. Finding also admits that in the context of growing urban population and the increasing rate of economic activities, socio-economic variables are most important variable to use for validating and testing the CVI. Finally, some recommendations are presented for concerned decision makers and stakeholders to develop appropriate coastal management plans, nourishment projects and mitigation measures considering socio-economic variables.

Keywords: coastal vulnerability index, sea level change, Mumbai coast, geospatial approach, coastal management, climate change

Procedia PDF Downloads 140

Authors: Ionel Zagan, Vasile Gheorghita Gaitan, Adrian Brezulianu

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This paper presents the contributions in designing a mobile system named Tele-ECG implemented for remote monitoring of cardiac patients. For a better flexibility of this application, the authors chose to implement a local memory and multiple communication interfaces. The project described in this presentation is based on the ARM Cortex M0+ microcontroller and the ADAS1000 dedicated chip necessary for the collection and transmission of Electrocardiogram signals (ECG) from the patient to the microcontroller, without altering the performances and the stability of the system. The novelty brought by this paper is the implementation of a remote monitoring system for cardiac patients, having a real-time behavior and multiple interfaces. The microcontroller is responsible for processing digital signals corresponding to ECG and also for the implementation of communication interface with the main server, using GSM/Bluetooth SIMCOM SIM800C module. This paper translates all the characteristics of the Tele-ECG project representing a feasible implementation in the biomedical field. Acknowledgment: This paper was supported by the project 'Development and integration of a mobile tele-electrocardiograph in the GreenCARDIO© system for patients monitoring and diagnosis - m-GreenCARDIO', Contract no. BG58/30.09.2016, PNCDI III, Bridge Grant 2016, using the infrastructure from the project 'Integrated Center for research, development and innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for fabrication and control', Contract No. 671/09.04.2015, Sectoral Operational Program for Increase of the Economic Competitiveness co-funded from the European Regional Development Fund.

Keywords: Tele-ECG, real-time cardiac monitoring, electrocardiogram, microcontroller

Procedia PDF Downloads 274

Authors: Shrutisingh Tomar, Madhu Sharan

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It has been an undisputed fact that the culture of a nation has always been reflected in its practice, visual content and in forms of its oral traditions. Regional and communal costumes in India since ancient times have worked as a strong repository for its people to comprehend not only the locality but also the community of the wearer. Such a strong visual language apparently was ordained to communicate basic details about the person such as age, marital status, and socio-cultural status. Most of the fragments of this visual vocabulary have been intensively investigated, recorded, diversified and revived, while a limited range of these has died a slow death. Some of the rare existent kinds of such threads have survived as a mainstream article of clothing: simpler, apparent and a product for daily life yet unique in their own kind. The paper intends to consider and elaborate the investigated repository pertinent to the Pacchedi weaving tradition of Gujarat. The research involved field surveys across seven districts of the two states of India namely Gujarat and Rajasthan. Ethnographic interviews, observations, recording of oral histories and archival research was conducted through multi-timed and multi-cited studies between from the year 2012 to 2015. The results include varied forms of Pacchedi based on the sartorial expressions in the male costume. The characteristic features of these textiles were accorded by the sumptuous use of brocaded cross borders and weft heavy ends along with the details on the languishing fabrication procedure.

Keywords: handloom weaving, material culture, sartorial expressions and vernacular textile craft

Procedia PDF Downloads 150

Authors: Ribut Alam Malau, Durri Andriani, C. B. Supartomo

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Universitas Terbuka (UT) as a higher education institution implements open and distance education is responsible to provide higher education to all Indonesian citizen wherever they live, including those reside in cultural diversity aras. Operate from Jakarta Head Office and 37 regional centers (ROs), UT is accustomed to the challenge. UT-Kupang and UT-Ambon which oversee East Nusa Tenggara and Maluku have successfully provided quality educational services for students. The two ROs have provided educational facilities which could assist the students to cope with their study in spite of the diversity situations. In order to analyze the effectiveness of the facilities provided, questionnaires focusing on tutorial services were sent to 90 students in the two ROs asking them to assess the facilities which best fulfills students’ needs in terms of their culture diversity. The results showed that UT-Kupang and UT-Ambon have successful in providing education for students in their areas as reflected in more than 80% of respondents aware of the facilities concerning tutorial service except for tutorial mechanism where only 34,5% of respondents aware of. However, despite lower rate of awareness in tutorial mechanism, majority of respondent 90.8% of respondents registered in tutorials and 95.4% will register in tutorials next semester. The majority of respondents showed appreciation for the ROs efforts to provide tutorials on weekdays which could accommodate their beliefs. In addition, conducting tutorials in all islands also perceived highly since students did not have to commute between islands. Efforts done by UT-Kupang and UT-Ambon have proven to be appreciated by students.

Keywords: archipelago, cultural diversity, ODL, service quality, Universitas Terbuka

Procedia PDF Downloads 473

Authors: S. M. P Manjula, Ishara Amarathunga, Aryan Nath Koura, Jaideepraj Rao

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Background: Laparoscopic D2 Gastrectomy for non metastatic advanced Gastric cancer (AGC) has become a controversial topic as there are confronting ideas from experts in the field. Lack of consensus are mainly due to non feasibility of the dissection and safety and efficacy. Method: Data from all D2 Gastrectomies performed (both Subtotal and Total Gastrectomies) in our unit from 2009 December to 2013 December were retrospectively analysed. Computor database was prospectively maintained. Pathological stage two A (iiA) and above considered advanced Gastric cancers, who underwent curative intent D2 Gastrectomy were included for analysis(n=46). Four patients excluded from the study as peritoneal fluid cytology came positive for cancer cells and one patient exempted as microscopic resection margin positive(R1) after curative resection. Thirty day morbidity and mortality, operative time, lymph nodes harvest and survival (disease free and overall) analyzed. Results: Complete curative resection achieved in 40 patients. Mean age of the study population was 62.2 (32-88) and male to female ratio was 23: 17. Thirty day mortality (1/40) and morbidity (6/40). Average operative time 203.7 minutes (185- 400) and average lymphnodes harvest was 40.5 (18-91). Disease free survival of the AGC in this study population was 16.75 months (1-49). Average hospital stay was 6.8 days (3-31). Conclusion: Laparoscopic dissection is effective feasible and safe in AGC.

Keywords: laparoscopy, advanced gastric cancer, safety, efficacy

Procedia PDF Downloads 339

Authors: Rajarshi Sharma, Rashidul Alam, Visavino Seleyi, Yuvila Sangtam

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The Intensity-Duration-Frequency (IDF) relationship of rainfall amounts is one of the most commonly used tools in water resources engineering for planning, design and operation of water resources project, or for various engineering projects against design floods. The establishment of such relationships was reported as early as in 1932 (Bernard). Since then many sets of relationships have been constructed for several parts of the globe. The objective of this research is to derive IDF relationship of rainfall for western watershed of Guwahati, Assam. These relationships are useful in the design of urban drainage works, e.g. storm sewers, culverts and other hydraulic structures. In the study, rainfall depth for 10 years viz. 2001 to 2010 has been collected from the Regional Meteorological Centre Borjhar, Guwahati. Firstly, the data has been used to construct the mass curve for duration of more than 7 hours rainfall to calculate the maximum intensity and to form the intensity duration curves. Gumbel’s frequency analysis technique has been used to calculate the probable maximum rainfall intensities for a period of 2 yr, 5 yr, 10 yr, 50 yr, 100 yr from the maximum intensity. Finally, regression analysis has been used to develop the intensity-duration-frequency (IDF) curve. Thus, from the analysis the values for the constants ‘a’,‘b’ &‘c’ have been found out. The values of ‘a’ for which the sum of the squared deviation is minimum has been found out to be 40 and when the corresponding value of ‘c’ and ‘b’ for the minimum squared deviation of ‘a’ are 0.744 and 1981.527 respectively. The results obtained showed that in all the cases the correlation coefficient is very high indicating the goodness of fit of the formulae to estimate IDF curves in the region of interest.

Keywords: intensity-duration-frequency relationship, mass curve, regression analysis, correlation coefficient

Procedia PDF Downloads 250

Authors: A. Benaiche

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

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

Procedia PDF Downloads 249