Search results for: Andrew P. Smith
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 432

Search results for: Andrew P. Smith

222 SIM (Subscriber Identity Module) Banking

Authors: Okanta Andrew, Richmond Kweku Frempong

Abstract:

As mobile networks are upgraded with technologies like WAP, GPRS and UMTS to deliver next-generation multimedia services, so are the banks and other financial institutions also getting ready to unleash the financial products on the mobile platform to meet growing demand for mobile based application services. Hence, the onset of Unstructured Supplementary Services (USSD) Banking which would make banking services available at anywhere, anytime through a string of interactive SMS sessions between a mobile device and an application server of a service provider. The aim of this studies was to find out whether the public will accept the sim banking service when it is implemented. Our target group includes: Working class. E. g. Businessmen/women, office workers, fishermen, market women, teachers etc. Nonworking class. E. g. Students (Tertiary, Senior High School), housewives. etc. The survey was in the form of a questionnaire and a verbal interview (video) which was to investigate their idea about the current banking system and the yet to be introduced sim banking concept. Meanwhile, some challenges accompanied the progression of data gathering because some populace showed reluctance in freeing their information. One other suggestion was that government should put measures against foremost challenges obstructing sim banking in Ghana counter to computers hackers. Government and individual have a key role to undertake to give suitable support to facelift the sim banking industry in the country. It was also suggested that Government put strong regulations on the use of sim banking products and services to streamline all the activities and also create awareness of the need for sim banking and emphasize its relevance in the aspect of national GDP.

Keywords: banking, mobile banking, SIM banking, mobile banking in Ghana

Procedia PDF Downloads 456
221 Meta-Analysis Comparing the Femoral Tunnel Length, Femoral Tunnel Position and Graft Bending Angle of Transtibial, Anteromedial and Outside-In Techniques for Single-Bundle Anterior Cruciate Ligament Reconstruction

Authors: Andrew Tan Hwee Chye, Yeo Zhen Ning

Abstract:

This study aims to meta-analyse clinical studies comparing femoral tunnel position (FTP), femoral tunnel length (FTL) and graft bending angle (GBA) of single-bundle Anterior Cruciate Ligament (ACL) reconstruction using Transtibial (TT), Anteromedial (AM) and Outside-in (OI) techniques. A meta-analysis comparing the FTP, FTL and GBA of single-bundle ACL reconstruction utilising the TT, AM and OI was performed. Prospective Comparative Studies (PCS) and Retrospective Comparative Studies (RCS) from PubMed, Cochrane Library, and Embase were included. A total of 17 studies were included in this study. TT had the longest FTL, when compared to AM (Mean difference = 7.38, 95% CI: 3.76 to 11.00, P < 0.001) and OI (Mean difference = 9.47, 95% CI: 4.89 to 14.05, P < 0.001). In the deep-to-shallow direction, the OI resulted in a significantly deeper femoral tunnel as compared to the TT (Mean difference = 4.36, 95% CI: 1.39 to 7.33, P = 0.004) (Figure 6B). The AM technique also contributed to a significantly lower tunnel position as compared to the OI technique (Mean difference = 2.34, 95% CI: 0.76 to 3.92, P = 0.004). There were no significant differences in the graft bending angle between TT, AM and OI techniques. AM and OI techniques provide a more anatomical position as compared to the TT. Although FTL in the TT is longer than the AM and OI, all three techniques exceed the critical length of 25mm. There are no differences in the GBA between the three techniques.

Keywords: femoral tunnel position, femoral tunnel length, anterior cruciate ligament, transtibial, graft bending angle, anteromedial, outside-in

Procedia PDF Downloads 96
220 Classification of Manufacturing Data for Efficient Processing on an Edge-Cloud Network

Authors: Onyedikachi Ulelu, Andrew P. Longstaff, Simon Fletcher, Simon Parkinson

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The widespread interest in 'Industry 4.0' or 'digital manufacturing' has led to significant research requiring the acquisition of data from sensors, instruments, and machine signals. In-depth research then identifies methods of analysis of the massive amounts of data generated before and during manufacture to solve a particular problem. The ultimate goal is for industrial Internet of Things (IIoT) data to be processed automatically to assist with either visualisation or autonomous system decision-making. However, the collection and processing of data in an industrial environment come with a cost. Little research has been undertaken on how to specify optimally what data to capture, transmit, process, and store at various levels of an edge-cloud network. The first step in this specification is to categorise IIoT data for efficient and effective use. This paper proposes the required attributes and classification to take manufacturing digital data from various sources to determine the most suitable location for data processing on the edge-cloud network. The proposed classification framework will minimise overhead in terms of network bandwidth/cost and processing time of machine tool data via efficient decision making on which dataset should be processed at the ‘edge’ and what to send to a remote server (cloud). A fast-and-frugal heuristic method is implemented for this decision-making. The framework is tested using case studies from industrial machine tools for machine productivity and maintenance.

Keywords: data classification, decision making, edge computing, industrial IoT, industry 4.0

Procedia PDF Downloads 153
219 Rehabilitation Approach for Cancer Patients: Indication, Management and Outcome

Authors: Juliani Rianto, Emma Lumby, Tracey Smith

Abstract:

Cancer patients’ survival are growing with the new approach and therapy in oncology medicine. Cancer is now a new chronic disease, and rehabilitation program has become an ongoing program as part of cancer care. The focus of Cancer rehabilitation is maximising person’s physical and emotional function, stabilising general health and reducing unnecessary hospital admission. In Australia there are 150000 newly diagnosed cancer every year, and the most common Cancer are prostate, Breast, Colorectal, Melanoma and Lung Cancer. Through referral from the oncology team, we recruited cancer patient into our cancer rehabilitation program. Patients are assessed by our multi-disciplinary team including rehabilitation specialist, physiotherapist, occupational therapist, dietician, exercise physiologist, and psychologist. Specific issues are identified, including pain, side effect of chemo and radiation therapy and mental well-being. The goals were identified and reassessed every fortnight. Common goals including nutritional status, improve endurance and exercise performance, working on balance and mobility, improving emotional and vocational state, educational program for insomnia and tiredness, and reducing hospitalisation are identified and assessed. Patients are given 2 hours exercise program twice a week for 6 weeks with focus on aerobic and weight exercises and education sessions. Patients are generally benefited from the program. The quality of life is improved, support and interaction from the therapist has played an important factor in directing patient for their goals.

Keywords: cancer, exercises, benefit, mental health

Procedia PDF Downloads 35
218 The Limits of Charity: Advancing a Rights-based Justice Model to Remedy Poverty and Hunger

Authors: Tracy Smith-Carrier

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In 1995, the World Health Organization declared that poverty was the biggest killer and the greatest cause of suffering in the world. Income is certainly a key social determinant of health, the lack of which causes innumerable health and mental health conditions. In seeking to provide relief from financial hardship for residents within their populace, states in the Global North have largely turned to the non-profit and charitable sector. The stigma and shame of accessing charity is a significant barrier for many, but what is more problematic is that the embrace of the charitable model has let governments off the hook from responding to their international human rights obligations. Although states are signatories to various human rights treaties and conventions internationally, many of these laws have not been implemented domestically. This presentation explores the limits of the charitable model in addressing poverty in countries of the Global North. Unlike in the ages passed, when poverty was thought to be an individual problem, we now know that poverty is largely systemic in nature. In this presentation, we will identify the structural determinants of poverty, outline why people are reticent to access charitable programs and services and how income security is reproduced through the charitable model, and discuss evidence-informed solutions, such as a basic income guarantee, to move beyond the charitable model in favour of a rights-based justice model. To move beyond charity, we must demand that governments recognize our fundamental human rights and address poverty and hunger using a justice model based on substantive human rights.

Keywords: basic income, charity, poverty, income security, hunger, food security, social justice, human rights

Procedia PDF Downloads 90
217 Uncertainties and Resilience: A Study of Pandemic Impact on the Pastoral-Nomadic Communities in India

Authors: Arati S. Kade, Iftikhar Hussain, Somnath Dadas

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The paper studies resilience and uncertainties among nomadic-pastoral communities in India during large events such as pandemics and attempts to understand that with changing times and increased uncertainties, how nomadic communities historically showed their resilience. A review of the literature was performed concerning nomadism and development relations and conflicts by focusing on structural violence on nomadic communities from the caste class and patriarchy as a framework along with the role of the state. Philosophical views on the anti-nomad bias of political theories by Erik Ringmar, along with the decolonial approach by Linda Smith and debrahmanization by Braj Ranjan Mani were used to analyze criminalization of nomads. Data were collected using in-depth telephonic interviews and news reports published during the COVID-19 lockdown in India. Focusing on historical context of current crises, the paper leads to the discussion on how nomadic communities negotiate with the sedentary society during the COVID-19 pandemic. Findings of the current paper approve the hypotheses that the COVID-19 pandemic followed by lockdown deeply impacted the pastoral production system, building on the continued cycle of marginalization by the state and caste society in India, while traditional knowledge stood the test of time. Be it developmental states or pandemics, the nomadic communities have shown their resilience in a number of ways, such as keeping distance from sedentary society, usage of traditional medicine, and relying on traditional leadership.

Keywords: COVID-19, criminalization, India, nomadism, pandemic, pastoralism, resilience, traditional knowledge

Procedia PDF Downloads 69
216 Implementing Service Learning in the Health Education Curriculum

Authors: Karen Butler

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Johnson C. Smith University, one of the nation’s oldest Historically Black Colleges and Universities, has a strong history of service learning and community service. We first integrated service learning and peer education into health education courses in the spring of 2000. Students enrolled in the classes served as peer educators for the semester. Since then, the program has evolved and expanded but remains an integral part of several courses. The purpose of this session is to describe our program in terms of development, successes, and obstacles, and feedback received. A detailed description of the service learning component in HED 235: Drugs and Drug Education and HED 337: Environmental Health will be provided. These classes are required of our Community Health majors but are also popular electives for students in other disciplines. Three sources of student feedback were used to evaluate and continually modify the component: the SIR II course evaluation, service learning reflection papers, and focus group interviews. Student feedback has been largely positive. When criticism was given, it was thoughtful and constructive – given in the spirit of making it better for the next group. Students consistently agreed that the service learning program increased their awareness of pertinent health issues; that both the service providers and service recipients benefited from the project; and that the goals/issues targeted by the service learning component fit the objectives of the course. Also, evidence of curriculum and learning enhancement was found in the reflection papers and focus group sessions. Service learning sets up a win-win situation. It provides a way to respond to campus and community health needs while enhancing the curriculum, as students learn more by doing things that benefit the health and wellness of others. Service learning is suitable for any health education course and any target audience would welcome the effort.

Keywords: black colleges, community health, health education, service learning

Procedia PDF Downloads 310
215 Determination of the Pull-Out/ Holding Strength at the Taper-Trunnion Junction of Hip Implants

Authors: Obinna K. Ihesiulor, Krishna Shankar, Paul Smith, Alan Fien

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Excessive fretting wear at the taper-trunnion junction (trunnionosis) apparently contributes to the high failure rates of hip implants. Implant wear and corrosion lead to the release of metal particulate debris and subsequent release of metal ions at the taper-trunnion surface. This results in a type of metal poisoning referred to as metallosis. The consequences of metal poisoning include; osteolysis (bone loss), osteoarthritis (pain), aseptic loosening of the prosthesis and revision surgery. Follow up after revision surgery, metal debris particles are commonly found in numerous locations. Background: A stable connection between the femoral ball head (taper) and stem (trunnion) is necessary to prevent relative motions and corrosion at the taper junction. Hence, the importance of component assembly cannot be over-emphasized. Therefore, the aim of this study is to determine the influence of head-stem junction assembly by press fitting and the subsequent disengagement/disassembly on the connection strength between the taper ball head and stem. Methods: CoCr femoral heads were assembled with High stainless hydrogen steel stem (trunnion) by Push-in i.e. press fit; and disengaged by Pull-out test. The strength and stability of the two connections were evaluated by measuring the head pull-out forces according to ISO 7206-10 standards. Findings: The head-stem junction strength linearly increases with assembly forces.

Keywords: wear, modular hip prosthesis, taper head-stem, force assembly and disassembly

Procedia PDF Downloads 376
214 Ifrs Adoption, Enforcement, and the Value Relevant of Accounting Amounts: The Particular Case of South Africa

Authors: Edward Chamisa, Colin C. Smith, Hamutyinei H. Pamburai, Abdul C. Abdulla

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South Africa (SA) adopted International Financial Reporting Standards (IFRS) for listed firms effective 1 January 2005. However, it was not until 2011 that substantial financial reporting enforcement changes were introduced, which were meant to ensure compliance with IFRS. This innovative setting allows us to examine the value relevance of accounting amounts during the (1) pre-IFRS adoption period (2002-2004); (2) post-IFRS adoption, but pre-enforcement changes period (2006-2010); and (3) post-enforcement changes period (2011-2012). The results show that accounting amounts were most value relevant in the post-enforcement changes period (R2, 75.5%) compared to both the pre-IFRS adoption period (adjusted R2 is 24.3%) and the period after IFRS adoption but before enforcement changes (adjusted R2 is 37.5%). Also, during the 2008 financial crisis, the equity book value per share was significantly value relevant (at 1%) but not earnings per share, whereas before the crisis, the opposite was true. We make two important contributions to the literature. First, we identify SA as an innovative setting that allows researchers to examine separately the effects of IFRS adoption and enforcement changes on capital markets and accounting quality. This is a departure from prior studies that are dominated by the European Union setting, where IFRS adoption occurred contemporaneously with enforcement and other regulatory changes. Second, we provide preliminary findings which suggest that while the adoption of IFRS seems to have improved the financial reporting quality of accounting amounts of SA listed firms, its impact appears to be limited unless combined with effective enforcement.

Keywords: international financial reporting standards (ifrs), ifrs adoption, financial reporting enforcement, value relevance, price model, equity book value, earnings per share

Procedia PDF Downloads 42
213 The Need for a Consistent Regulatory Framework for CRISPR Gene-Editing in the European Union

Authors: Andrew Thayer, Courtney Rondeau, Paraskevi Papadopoulou

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The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) gene-editing technologies have generated considerable discussion about the applications and ethics of their use. However, no consistent guidelines for using CRISPR technologies have been developed -nor common legislation passed related to gene editing, especially as it is connected to genetically modified organisms (GMOs) in the European Union. The recent announcement that the first babies with CRISPR-edited genes were born, along with new studies exploring CRISPR’s applications in treating thalassemia, sickle-cell anemia, cancer, and certain forms of blindness, have demonstrated that the technology is developing faster than the policies needed to control it. Therefore, it can be seen that a reasonable and coherent regulatory framework for the use of CRISPR in human somatic and germline cells is necessary to ensure the ethical use of the technology in future years. The European Union serves as a unique region of interconnected countries without a standard set of regulations or legislation for CRISPR gene-editing. We posit that the EU would serve as a suitable model in comparing the legislations of its affiliated countries in order to understand the practicality and effectiveness of adopting majority-approved practices. Additionally, we present a proposed set of guidelines which could serve as a basis in developing a consistent regulatory framework for the EU countries to implement but also act as a good example for other countries to adhere to. Finally, an additional, multidimensional framework of smart solutions is proposed with which all stakeholders are engaged to become better-informed citizens.

Keywords: CRISPR, ethics, regulatory framework, European legislation

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212 Associations between Parental Divorce Process Variables and Parent-Child Relationships Quality in Young Adulthood

Authors: Klara Smith-Etxeberria

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main goal of this study was to analyze the predictive ability of some variables associated with the parental divorce process alongside attachment history with parents on both, mother-child and father-child relationship quality. Our sample consisted of 173 undergraduate and vocational school students from the Autonomous Community of the Basque Country. All of them belonged to a divorced family. Results showed that adequate maternal strategies during the divorce process (e.g.: stable, continuous and positive role as a mother) was the variable with greater predictive ability on mother-child relationships quality. In addition, secure attachment history with mother also predicted positive mother-child relationships. On the other hand, father-child relationship quality was predicted by adequate paternal strategies during the divorce process, such as his stable, continuous and positive role as a father, along with not badmouthing the mother and promoting good mother-child relationships. Furthermore, paternal negative emotional state due to divorce was positively associated with father-child relationships quality, and both, history of attachment with mother and with father predicted father-child relationships quality. In conclusion, our data indicate that both, paternal and maternal strategies for children´s adequate adjustment during the divorce process influence on mother-child and father-child relationships quality. However, these results suggest that paternal strategies during the divorce process have a greater predictive ability on father-child relationships quality, whereas maternal positive strategies during divorce determine positive mother-child relationships among young adults.

Keywords: father-child relationships quality, mother-child relationships quality, parental divorce process, young adulthood

Procedia PDF Downloads 237
211 Effect of Iron Oxide Addition on the Solid-State Synthesis of Ye’Elimite

Authors: F. Z. Abir, M. Mesnaoui, Y. Abouliatim, L. Nibou, Y. El Hafiane, A. Smith

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The cement industry has been taking significant steps for years to reduce its carbon footprint by opting for an eco-friendly alternative such as Calcium Sulfoaluminate Cements (CSA). These binders, compared to Ordinary Portland Cements (OPC), have two advantages: reduction of the CO2 emissions and energy-saving because the sintering temperature of CSA cements is between 1250 and 1350 °C, which means 100 to 200 °C less than OPC. The aim of this work is to study the impurities effect, such as iron oxide, on the formation of the ye'elimite phase, which represents the main phase of Calcium Sulfoaluminate Cements and the consequence on its hydration. Several elaborations and characterization techniques were used to study the structure and microstructure of ye'elimite, such as X-ray diffraction (XRD), Scanning Electron Microscopy (SEM), thermal analysis, specific surface area measurement, and electrical conductivity of diluted solutions. This study details the protocol for the solid-state synthesis of ye'elimite containing increasing amounts of iron (general formula: Ca4Al(6-2x)Fe2xSO16 with x = 0.00 to 1.13). Ye'elimite is formed by solid-state reactions between Al2O3, CaO and CaSO4 and the maximum ye'elimite content is reached at a sintering temperature of 1300 °C. The presence of iron promotes the formation of cubic ye'elimite at the expense of the orthorhombic phase. The total incorporation of iron in ye'elimite structure is possible when x < 0.12. Beyond this content, the ferritic phase (CaO)2(Al2O3,Fe2O3) appears as a minor phase and develops two different morphologies during cooling: dendritic crystals and melt morphology. The formation of the ferrous liquid phase affects the evolution of grain size of the ye’elimite and calcium aluminates.

Keywords: calcium sulfoaluminate cement, ferritic phase, sintering, solid-state synthesis, ye’elimite

Procedia PDF Downloads 161
210 Real-Time Optimisation and Minimal Energy Use for Water and Environment Efficient Irrigation

Authors: Kanya L. Khatri, Ashfaque A. Memon, Rod J. Smith, Shamas Bilal

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The viability and sustainability of crop production is currently threatened by increasing water scarcity. Water scarcity problems can be addressed through improved water productivity and the options usually presumed in this context are efficient water use and conversion of surface irrigation to pressurized systems. By replacing furrow irrigation with drip or centre pivot systems, the water efficiency can be improved by up to 30 to 45%. However, the installation and application of pumps and pipes, and the associated fuels needed for these alternatives increase energy consumption and cause significant greenhouse gas emissions. Hence, a balance between the improvement in water use and the potential increase in energy consumption is required keeping in view adverse impact of increased carbon emissions on the environment. When surface water is used, pressurized systems increase energy consumption substantially, by between 65% to 75%, and produce greenhouse gas emissions around 1.75 times higher than that of gravity based irrigation. With gravity based surface irrigation methods the energy consumption is assumed to be negligible. This study has shown that a novel real-time infiltration model REIP has enabled implementation of real-time optimization and control of surface irrigation and surface irrigation with real-time optimization has potential to bring significant improvements in irrigation performance along with substantial water savings of 2.92 ML/ha which is almost equivalent to that given by pressurized systems. Thus real-time optimization and control offers a modern, environment friendly and water efficient system with close to zero increase in energy consumption and minimal greenhouse gas emissions.

Keywords: pressurised irrigation, carbon emissions, real-time, environmentally-friendly, REIP

Procedia PDF Downloads 472
209 The Role of Public Management Development in Enhancing Public Service Delivery in the South African Local Government

Authors: Andrew Enaifoghe

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The study examined the role of public management development in enhancing public service delivery in the South African local government. The study believes that the ultimate empowerment of the third tier sphere of governments in South Africa remains the instrument required to enhance both national and continental development. This over the year has been overwhelmed with problems and imbalance related to ethical practice, accountability and the functional local government system and the machinery itself. The study finds that imbalances are being strengthened by a lack of understanding and unanimity as to what a public management development in a democratic system is and how it should work to achieve the dividends of democracy in delivering public goods. Studies indicated that the magnitudes are widespread corruption and misrepresentations of government priorities; both of which weaken the ability of governments to enhance broad-based economic growth and social well-being of the people. This study addressed the problem of public management and accountable local government. The study indicates the need for citizens’ participation in the decision-making process in delivering public service in South Africa and how its accountability mechanism supports good governance. The study concludes that good and ethical watersheds in South Africa have since reached such proportions that social pressure, the pressure from the government and various institutions have to re-consider where they stand regarding ethics, ethical behaviour, accountability and professionalism in delivering public goods to the people at the local municipal government.

Keywords: accountability, development, democratic system, South Africa

Procedia PDF Downloads 91
208 The Risk of Hyperglycemia Associated with Use of Dolutegravir among Adults Living with HIV in Kampala, Uganda: A Case Control Study

Authors: Daphine Namara, Jeremy I. Schwartz, Andrew K. Tusubira, Willi McFarland, Caroline Birungi, Fred C. Semitala, Martin Muddu

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Emerging evidence suggests a possible association between hyperglycemia and dolutegravir (DTG), a preferred first-line antiretroviral agent in sub-Saharan Africa (SSA). There is a need for rigorous studies to validate this association in the face of increasing DTG use and the burden of non-communicable diseases among people living with HIV (PLHIV). We conducted a case-control study to assess the risk of hyperglycemia associated with the use of DTG among PLHIV attending Mulago ISS Clinic in Kampala. Cases had hyperglycemia, while controls had no hyperglycemia, as confirmed by fasting plasma glucose and oral glucose tolerance tests. Demographic, laboratory, and clinical data were collected using interviewer-administered questionnaires and medical record abstraction. The analysis compared cases and controls on DTG use prior to diagnosis of hyperglycemia while controlling for potential confounders using multivariable logistic regression. We included 204 cases and 231 controls. In multivariable analysis, patients with prior DTG use had seven times greater odds of subsequent diagnosis of hyperglycemia compared to those who had non-DTG-based regimens (adjusted odds ratio [aOR] 7.01, 95% CI 1.96-25.09). The odds of hyperglycemia also increased with age (56 years and above vs. 18-35, aOR 12.38, 95% CI 3.79-40.50) and hypertension (aOR 5.78, 95% CI 2.53-13.21). Our study demonstrates a strong association between prior DTG exposure and subsequent diagnosis of hyperglycemia. Given the benefits of DTG, wide-scale use, and the growing burden of diabetes mellitus (DM) in SSA, there is a need for systematic screening for hyperglycemia and consideration of alternate regimens for those at risk for DM.

Keywords: HIV, hyperglycemia, doluteravir, diabetes

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207 A Case Report of Aberrant Vascular Anatomy of the Deep Inferior Epigastric Artery Flap

Authors: Karissa Graham, Andrew Campbell-Lloyd

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The deep inferior epigastric artery perforator flap (DIEP) is used to reconstruct large volumes of tissue. The DIEP flap is based on the deep inferior epigastric artery (DIEA) and vein. Accurate knowledge of the anatomy of these vessels allows for efficient dissection of the flap, minimal damage to surrounding tissue, and a well vascularized flap. A 54 year old lady was assessed for bilateral delayed autologous reconstruction with DIEP free flaps. The right DIEA was consistent with the described anatomy. The left DIEA had a vessel branching shortly after leaving the external iliac artery and before entering the muscle. This independent branch entered the muscle and had a long intramuscular course to the largest perforator. The main DIEA vessel demonstrated a type II branching pattern but had perforators that were too small to have a viable DIEP flap. There were no communicating arterial branches between the independent vessel and DIEA, however, there was one venous communication between them. A muscle sparing transverse rectus abdominis muscle flap was raised using the main periumbilical perforator from the independent vessel. Our case report demonstrated an unreported anatomical variant of the DIEA. A few anatomical variants have been described in the literature, including a unilateral absent DIEA and peritoneal-cutaneous perforators that had no connection to the DIEA. Doing a pre-operative CTA helps to identify these rare anatomical variations, which leads to safer, more efficient, and effective operating.

Keywords: aberrant anatomy, CT angiography, DIEP anatomy, free flap

Procedia PDF Downloads 107
206 More Precise: Patient-Reported Outcomes after Stroke

Authors: Amber Elyse Corrigan, Alexander Smith, Anna Pennington, Ben Carter, Jonathan Hewitt

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Background and Purpose: Morbidity secondary to stroke is highly heterogeneous, but it is important to both patients and clinicians in post-stroke management and adjustment to life after stroke. The consideration of post-stroke morbidity clinically and from the patient perspective has been poorly measured. The patient-reported outcome measures (PROs) in morbidity assessment help improve this knowledge gap. The primary aim of this study was to consider the association between PRO outcomes and stroke predictors. Methods: A multicenter prospective cohort study assessed 549 stroke patients at 19 hospital sites across England and Wales during 2019. Following a stroke event, demographic, clinical, and PRO measures were collected. Prevalence of morbidity within PRO measures was calculated with associated 95% confidence intervals. Predictors of domain outcome were calculated using a multilevel generalized linear model. Associated P -values and 95% confidence intervals are reported. Results: Data were collected from 549 participants, 317 men (57.7%) and 232 women (42.3%) with ages ranging from 25 to 97 (mean 72.7). PRO morbidity was high post-stroke; 93.2% of the cohort report post-stroke PRO morbidity. Previous stroke, diabetes, and gender are associated with worse patient-reported outcomes across both the physical and cognitive domains. Conclusions: This large-scale multicenter cohort study illustrates the high proportion of morbidity in PRO measures. Further, we demonstrate key predictors of adverse outcomes (Diabetes, previous stroke, and gender) congruence with clinical predictors. The PRO has been demonstrated to be an informative and useful stroke when considering patient-reported outcomes and has wider implications for considerations of PROs in clinical management. Future longitudinal follow-up with PROs is needed to consider association of long-term morbidity.

Keywords: morbidity, patient-reported outcome, PRO, stroke

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205 Protective Effect of Saponin Extract from the Root of Garcinia kola (Bitter Kola) against Paracetamol-Induced Hepatotoxicity in Albino Rats

Authors: Alli Smith Yemisi Rufina, Adanlawo Isaac Gbadura

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Liver disorders are one of the major problems of the world. Despite its frequent occurrence, high morbidity, and high mortality, its medical management is currently inadequate. This study was designed to evaluate the Hepatoprotective effect of saponin extract of the root of Garcinia kola on the integrity of the liver of paracetamol induced Wistar albino rats. Twenty-five male adult Wistar albino rats were divided into five (5) groups. Group I, was the Control group that received distilled water only, group II was the negative control that received 2 g/kg of paracetamol on the 13th day, and group III, IV, and V were pre-treated with 100, 200 and 400 mg/kg of the saponin extract before inducing the liver damage on the 13th day with 2 g/kg of paracetamol. Twenty-four hours after administration, the rats were sacrificed, and blood samples were collected. The serum Alanine Transaminase (ALT), Aspartate Transaminase (AST), Alkaline Phosphatase (ALP) activities, Bilirubin and Conjugated Bilirubin, Glucose and Protein concentrations were evaluated. The liver was fixed immediately in Formalin and was processed and stained with Haematoxylin and Eosin (H&E). Administration of saponin extract from the root of Garcinia kola significantly decreased paracetamol induced elevated enzymes in the test group. Also, histological observations showed that saponin extract of the root of Garcinia kola exhibited a significant liver protection against the toxicant as evident by the cells trying to return to normal. Saponin extract from the root of Garcinia kola indicated a protection of the structural integrity of the hepatocytic cell membrane and regeneration of the damaged liver.

Keywords: hepatoprotective, liver damage, Garcinia kola, saponin, paracetamol

Procedia PDF Downloads 240
204 A Case Study on Post-Occupancy Evaluation of User Satisfaction in Higher Educational Buildings

Authors: Yuanhong Zhao, Qingping Yang, Andrew Fox, Tao Zhang

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Post-occupancy evaluation (POE) is a systematic approach to assess the actual building performance after the building has been occupied for some time. In this paper, a structured POE assessment was conducted using the building use survey (BUS) methodology in two higher educational buildings in the United Kingdom. This study aims to help close the building performance gap, provide optimized building operation suggestions, and to improve occupants’ satisfaction level. In this research, the questionnaire survey investigated the influences of environmental factors on user satisfaction from the main aspects of building overall design, thermal comfort, perceived control, indoor environment quality for noise, lighting, ventilation, and other non-environmental factors, such as the background information about age, sex, time in buildings, workgroup size, and so on. The results indicate that the occupant satisfaction level with the main aspects of building overall design, indoor environment quality, and thermal comfort in summer and winter on both two buildings, which is lower than the benchmark data. The feedback of this POE assessment has been reported to the building management team to allow managers to develop high-performance building operation plans. Finally, this research provided improvement suggestions to the building operation system to narrow down the performance gap and improve the user work experience satisfaction and productivity level.

Keywords: building performance assessment systems, higher educational buildings, post-occupancy evaluation, user satisfaction

Procedia PDF Downloads 125
203 Characterization and Degradation of 3D Printed Polycaprolactone-Freeze Dried Bone Matrix Constructs for Use in Critical Sized Bone Defects

Authors: Samantha Meyr, Eman Mirdamadi, Martha Wang, Tao Lowe, Ryan Smith, Quinn Burke

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Critical-sized bone defects (CSD) treatment options remain a major clinical orthopedic challenge. They are uniquely contoured diseased or damaged bones and can be defined as those that will not heal spontaneously and require surgical intervention. Autografts are the current gold standard CSD treatment, which are histocompatible and provoke a minimal immunogenic response; however, they can cause donor site morbidity and will not suffice for the size required for replacement. As an alternative to traditional surgical methods, bone tissue engineering will be implemented via 3D printing methods. A freeze-dried bone matrix (FDBM) is a type of graft material available but will only function as desired when in the presence of bone growth factors. Polycaprolactone (PCL) is a known biodegradable material with good biocompatibility that has been proven manageable in 3D printing as a medical device. A 3D-extrusion printing strategy is introduced to print these materials into scaffolds for bone grafting purposes, which could be more accessible and rapid than the current standard. Mechanical, thermal, cytotoxic, and physical properties were investigated throughout a degradation period of 6 months using fibroblasts and dental pulp stem cells. PCL-FDBM scaffolds were successfully printed with high print fidelity in their respective pore sizes and allograft content. Additionally, we have created a method for evaluating PCL using differential scanning calorimetry (DSC) and have evaluated PCL degradation over roughly 6 months.

Keywords: 3D printing, bone tissue engineering, cytotoxicity, degradation, scaffolds

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202 Cytogenetic Characterization of the VERO Cell Line Based on Comparisons with the Subline; Implication for Authorization and Quality Control of Animal Cell Lines

Authors: Fumio Kasai, Noriko Hirayama, Jorge Pereira, Azusa Ohtani, Masashi Iemura, Malcolm A. Ferguson Smith, Arihiro Kohara

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The VERO cell line was established in 1962 from normal tissue of an African green monkey, Chlorocebus aethiops (2n=60), and has been commonly used worldwide for screening for toxins or as a cell substrate for the production of viral vaccines. The VERO genome was sequenced in 2014; however, its cytogenetic features have not been fully characterized as it contains several chromosome abnormalities and different karyotypes coexist in the cell line. In this study, the VERO cell line (JCRB0111) was compared with one of the sublines. In contrast to 59 chromosomes as the modal chromosome number in the VERO cell line, the subline had two peaks of 56 and 58 chromosomes. M-FISH analysis using human probes revealed that the VERO cell line was characterized by a translocation t(2;25) found in all metaphases, which was absent in the subline. Different abnormalities detected only in the subline show that the cell line is heterogeneous, indicating that the subline has the potential to change its genomic characteristics during cell culture. The various alterations in the two independent lineages suggest that genomic changes in both VERO cells can be accounted for by progressive rearrangements during their evolution in culture. Both t(5;X) and t(8;14) observed in all metaphases of the two cell lines might have a key role in VERO cells and could be used as genetic markers to identify VERO cells. The flow karyotype shows distinct differences from normal. Further analysis of sorted abnormal chromosomes may uncover other characteristics of VERO cells. Because of the absence of STR data, cytogenetic data are important in characterizing animal cell lines and can be an indicator of their quality control.

Keywords: VERO, cell culture passage, chromosome rearrangement, heterogeneous cells

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201 An Audit of Local Guidance Compliance For Stereotactic Core Biopsy For DCIS In The Breast Screening Programme

Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester

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Background: The breast unit local guideline recommends that 12 cores should be used in a stereotactic-guided biopsy to diagnose DCIS. Twelve cores are regarded to provide good diagnostic value without removing more breast tissue than necessary. This study aimed to determine compliance with guidelines and investigated how the number of cores impacted upon the re-excision rate and size discrepancies. Methods: This single-centre retrospective cohort study of 72 consecutive breast screened patients with <15mm DCIS on radiological report underwent stereotactic-guided core biopsy and subsequent surgical excision. Clinical, radiological, and histological data were collected over 5 years, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Results: Forty-six (63.9%) patients had <12 cores taken, and 26 (36.1%) patients had ≥12 cores taken. Only six (8.3%) patients had 12 cores taken in their stereotactic biopsy. Incomplete surgical excision was seen in 17 patients overall (23.6%), and of these patients, twelve (70.6%) had fewer than 12 cores taken (p=0.55 for the difference between groups). Mammogram and biopsy underestimated the size of the DCIS in this subgroup by a median of 15mm (range: 6-135mm). Re-excision was required in 9 patients (12.5%), and five patients (6.9%) were found to have invasive ductal carcinoma on excision (80% had <12 cores, p=0.43). Discussion: There is poor compliance with the breast unit local guidelines and higher rates of re-excision in patients who did not have ≥12 cores taken. Taking ≥12 cores resulted in fewer missed invasive cancers lower incomplete excision and re-excision rates.

Keywords: stereotactic core biopsy, DCIS, breast screening, Re-excision rates, core biopsy

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200 Early Depression Detection for Young Adults with a Psychiatric and AI Interdisciplinary Multimodal Framework

Authors: Raymond Xu, Ashley Hua, Andrew Wang, Yuru Lin

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During COVID-19, the depression rate has increased dramatically. Young adults are most vulnerable to the mental health effects of the pandemic. Lower-income families have a higher ratio to be diagnosed with depression than the general population, but less access to clinics. This research aims to achieve early depression detection at low cost, large scale, and high accuracy with an interdisciplinary approach by incorporating clinical practices defined by American Psychiatric Association (APA) as well as multimodal AI framework. The proposed approach detected the nine depression symptoms with Natural Language Processing sentiment analysis and a symptom-based Lexicon uniquely designed for young adults. The experiments were conducted on the multimedia survey results from adolescents and young adults and unbiased Twitter communications. The result was further aggregated with the facial emotional cues analyzed by the Convolutional Neural Network on the multimedia survey videos. Five experiments each conducted on 10k data entries reached consistent results with an average accuracy of 88.31%, higher than the existing natural language analysis models. This approach can reach 300+ million daily active Twitter users and is highly accessible by low-income populations to promote early depression detection to raise awareness in adolescents and young adults and reveal complementary cues to assist clinical depression diagnosis.

Keywords: artificial intelligence, COVID-19, depression detection, psychiatric disorder

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199 iPSC-Derived Brain Organoids To Study The Mechanisms Underlying Disease Variability In Patients With SYNGAP1-Intelectual Disability

Authors: Aliyah Penn, Vasiliki Machairaki, Constance Smith-hicks, Sarven Sabunciyan, Lena Smirnova

Abstract:

Rare neurodevelopmental disorders (RNDDs) encompass a spectrum of conditions affecting a minority of the global population yet pose significant challenges due to their heterogeneity and limited understanding. Among these disorders, SYNGAP1 mutations contribute to a range of cognitive impairments, autism spectrum disorder (ASD), and epilepsy. Despite its rarity, SYNGAP1-Intellectual Disability disorder manifests with varying severity, underscoring the need for improved insights into their underlying biological mechanisms. This research project aims to elucidate the molecular pathways driving the heterogeneous disease severity observed in individuals with SYNGAP1 mutations. Employing a multi-faceted approach, we first characterize SYNGAP1-induced pluripotent stem cells (iPSCs) and iPSC-derived brain organoids, comparing them with familial neurotypically-developed (NTD) controls. Subsequently, we identify molecular signatures of intellectual disability (ID) and epilepsy using RNA sequencing, shedding light on the pathological mechanisms underlying these conditions. Finally, we evaluate and establish a SYNGAP1 seizure model, leveraging MaxWell high-density micro-electrode array (HD-MEA) recordings to assess electrical activity and synaptic function in SYNGAP-ID patients with different intensity of seizures. This comprehensive approach aims to enhance our understanding of SYNGAP1-related disorders and pave the way for personalized treatment strategies tailored to individual patients.

Keywords: SYNGAP, autism, organoids, neurodevelopment

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198 The Prevalence of Symptoms of Common Mental Disorders Among Professional Golfers

Authors: Georgia Hopley, Andrew Murray, Alan Macpherson

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Objectives: This study aims to (i) assess the prevalence of symptoms of mental health disorders among a cohort of professional golfers, (ii) compare prevalence values with data from the general population and other elite athlete cohorts, and (iii) assess how players cope with mental health problems and players’ opinions on the mental health support services available to them. Methods: Players competing on the 2020 Challenge Tour (n=261) were sent a questionnaire that assessed symptoms of depression, distress, anxiety, sleep disturbance, and obsessive-compulsive disorder. Questions were also included to assess coping behaviors and opinions on current support measures. Results: The two-week symptom prevalence was 10.3% for depression, 51.7% for distress, 8.6% for anxiety, 10.3% for sleep disturbance, 13.8% for obsessive thoughts, and 27.6% for compulsive behavior. The prevalence of symptoms is comparable with other elite athlete cohorts, and symptoms of anxiety and distress were reported more frequently than in the general population. 67% of players who had experienced a mental health issue did not seek professional help at the time, and 61% of players did not think sufficient support was available to them. Conclusion: Mental health problems are prevalent among elite golfers; however, this study demonstrates that the majority of players do not seek help from professionally accredited practitioners. Following the discussion of this study, the European Tour Group now provides a 24/7 mental health crisis hotline for players and has educated staff members on how to identify players with mental health issues and signpost them to the appropriate support.

Keywords: elite athletes, golf, mental health, sport science, sport psychiatry

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197 Time to CT in Major Trauma in Coffs Harbour Health Campus - The Australian Rural Centre Experience

Authors: Thampi Rawther, Jack Cecire, Andrew Sutherland

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Introduction: CT facilitates the diagnosis of potentially life-threatening injuries and facilitates early management. There is evidence that reduced CT acquisition time reduces mortality and length of hospital stay. Currently, there are variable recommendations for ideal timing. Indeed, the NHS standard contract for a major trauma service and STAG both recommend immediate access to CT within a maximum time of 60min and appropriate reporting within 60min of the scan. At Coffs Harbour Health Campus (CHHC), a CT radiographer is on site between 8am-11pm. Aim: To investigate the average time to CT at CHHC and assess for any significant relationship between time to CT and injury severity score (ISS) or time of triage. Method: All major trauma calls between Jan 2021-Oct 2021 were audited (N=87). Patients were excluded if they went from ED to the theatre. Time to CT is defined as the time between triage to the timestamp on the first CT image. Median and interquartile range was used as a measure of central tendency as the data was not normally distributed, and Chi-square test was used to determine association. Results: The median time to CT is 51.5min (IQR 40-74). We found no relationship between time to CT and ISS (P=0.18) and time of triage to time to CT (P=0.35). We compared this to other centres such as John Hunter Hospital and Gold Coast Hospital. We found that the median CT acquisition times were 76min (IQR 52-115) and 43min, respectively. Conclusion: This shows an avenue for improvement given 35% of CT’s were >30min. Furthermore, being proactive and aware of time to CT as an important factor to trauma management can be another avenue for improvement. Based on this, we will re-audit in 12-24months to assess if any improvement has been made.

Keywords: imaging, rural surgery, trauma surgery, improvement

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196 Pavement Quality Evaluation Using Intelligent Compaction Technology: Overview of Some Case Studies in Oklahoma

Authors: Sagar Ghos, Andrew E. Elaryan, Syed Ashik Ali, Musharraf Zaman, Mohammed Ashiqur Rahman

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Achieving desired density during construction is an important indicator of pavement quality. Insufficient compaction often compromises pavement performance and service life. Intelligent compaction (IC) is an emerging technology for monitoring compaction quality during the construction of asphalt pavements. This paper aims to provide an overview of findings from four case studies in Oklahoma involving the compaction quality of asphalt pavements, namely SE 44th St project (Project 1) and EOC Turnpike project (Project 2), Highway 92 project (Project 3), and 108th Avenue project (Project 4). For this purpose, an IC technology, the intelligent compaction analyzer (ICA), developed at the University of Oklahoma, was used to evaluate compaction quality. Collected data include GPS locations, roller vibrations, roller speed, the direction of movement, and temperature of the asphalt mat. The collected data were analyzed using a widely used software, VETA. The average densities for Projects 1, 2, 3 and 4, were found as 89.8%, 91.50%, 90.7% and 87.5%, respectively. The maximum densities were found as 94.6%, 95.8%, 95.9%, and 89.7% for Projects 1, 2, 3, and 4, respectively. It was observed that the ICA estimated densities correlated well with the field core densities. The ICA results indicated that at least 90% of the asphalt mats were subjected to at least two roller passes. However, the number of passes required to achieve the desired density (94% to 97%) differed from project to project depending on the underlying layer. The results of these case studies show both opportunities and challenges in using IC for monitoring compaction quality during construction in real-time.

Keywords: asphalt pavement construction, density, intelligent compaction, intelligent compaction analyzer, intelligent compaction measure value

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195 Evaluation of the Role of Theatre for Development in Combating Climate Change in South Africa

Authors: Isaiah Phillip Smith, Sam Erevbenagie Usadolo, Pamela Theresa Tancsik

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This paper is part of ongoing doctoral research that examines the role of Theatre for Development (TfD) in addressing climate change in the Mosuthu community in Reservoir Hills, Durban, South Africa. The context of the research underscores the pressing challenges facing South Africa, including drought, water shortages, deterioration of land, and civil unrest that require innovative approaches to the mitigation of climate change. TfD, described as a dialogical form of theatre that allows communities to express and contribute to development, emerges as a strategic medium for engaging communities in the process. The research problem focused on the unexamined potential of TfD in promoting community involvement and critical awareness of climate change. The study objectives included assessing the community's understanding of climate change, exploring TfD's potential as a participatory tool, examining its role in community mobilization, and developing recommendations for its effective implementation. A review of relevant literature and preliminary investigations in the research community indicates that TfD is an effective medium for promoting societal transformation and engaging marginalized communities. Through culturally resonant narratives, TfD can instill a deeper understanding of environmental challenges, fostering empathy and motivating behavioural changes. By integrating community voices and cultural elements, TfD serves as a powerful catalyst for promoting climate change awareness and inspiring collective action within the South African context. This research contributes to the global discourse on innovative approaches to climate change awareness and action.

Keywords: TfD, climate change, community involvement, societal transformation, culture

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194 Primary Analysis of a Randomized Controlled Trial of Topical Analgesia Post Haemorrhoidectomy

Authors: James Jin, Weisi Xia, Runzhe Gao, Alain Vandal, Darren Svirkis, Andrew Hill

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Background: Post-haemorrhoidectomy pain is concerned by patients/clinicians. Minimizing the postoperation pain is highly interested clinically. Combinations of topical cream targeting three hypothesised post-haemorrhoidectomy pain mechanisms were developed and their effectiveness were evaluated. Specifically, a multi-centred double-blinded randomized clinical trial (RCT) was conducted in adults undergoing excisional haemorrhoidectomy. The primary analysis was conveyed on the data collected to evaluate the effectiveness of the combinations of topical cream targeting three hypothesized pain mechanisms after the operations. Methods: 192 patients were randomly allocated to 4 arms (each arm has 48 patients), and each arm was provided with pain cream 10% metronidazole (M), M and 2% diltiazem (MD), M with 4% lidocaine (ML), or MDL, respectively. Patients were instructed to apply topical treatments three times a day for 7 days, and record outcomes for 14 days after the operations. The primary outcome was VAS pain on day 4. Covariates and models were selected in the blind review stage. Multiple imputations were applied for the missingness. LMER, GLMER models together with natural splines were applied. Sandwich estimators and Wald statistics were used. P-values < 0.05 were considered as significant. Conclusions: The addition of topical lidocaine or diltiazem to metronidazole does not add any benefit. ML had significantly better pain and recovery scores than combination MDL. Multimodal topical analgesia with ML after haemorrhoidectomy could be considered for further evaluation. Further trials considering only 3 arms (M, ML, MD) might be worth exploring.

Keywords: RCT, primary analysis, multiple imputation, pain scores, haemorrhoidectomy, analgesia, lmer

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193 Bioremediation Potentials of Some Indigenous Microorganisms Isolated from Auto Mechanic Workshops on Irrigation Water Used in Lokoja Kogi State of Nigeria

Authors: Emmanuel Ekpa, Adaji Andrew, Queen Opaluwa, Isreal Daraobong

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Three (3) indigenous bacteria species (Bacillus spp, Acinectobacter spp and Moraxella spp) previously isolated from contaminated soil of some auto mechanic workshops were used for bioremediation studies on some irrigation water used at Sarkin-noma Fadama farms located in Lokoja Kogi State, Nigeria. This was done in order to investigate their bioremediation potentials using a simple pour plate method. The physicochemical parameters and heavy metal analysis (using AAS iCE 3000) of the irrigation water were performed before and after inoculation of the isolated organisms. Nitrate and phosphate concentration were found to be 10.56mg/L and 12.63mg/L prior to inoculation while iron and zinc were 0.9569mg/L and 0.2245mg/L respectively. Other physicochemical parameters were also observed to be high prior to inoculation. After the bioremediation test (inoculation with the isolated organisms), a nitrate and phosphate content of 2.53mg/L and 2.61mg/L were recorded respectively, iron and zinc gave 0.1694mg/L and 0.0174mg/L concentrations while other physicochemical parameters measured were also found to be lower in their respective values. The implication of this present study is that a number of carefully isolated indigenous bacteria species are capable of reducing the amount of heavy metal concentrations in water. Also, non-metallic contaminants like nitrate and phosphate are susceptible to bioremediation in the presence of such efficient system.

Keywords: bioremediation, heavy metals, physicochemical parameters, Bacillus spp, Acinectobacter spp and Moraxella spp, AAS, spectrometer 3000

Procedia PDF Downloads 307