Search results for: incidence rates (IR)
3673 The Acceptable Roles of Artificial Intelligence in the Judicial Reasoning Process
Authors: Sonia Anand Knowlton
Abstract:
There are some cases where we as a society feel deeply uncomfortable with the use of Artificial Intelligence (AI) tools in the judicial decision-making process, and justifiably so. A perfect example is COMPAS, an algorithmic model that predicts recidivism rates of offenders to assist in the determination of their bail conditions. COMPAS turned out to be extremely racist: it massively overpredicted recidivism rates of Black offenders and underpredicted recidivism rates of white offenders. At the same time, there are certain uses of AI in the judicial decision-making process that many would feel more comfortable with and even support. Take, for example, a “super-breathalyzer,” an (albeit imaginary) tool that uses AI to deliver highly detailed information about the subject of the breathalyzer test to the legal decision-makers analyzing their drunk-driving case. This article evaluates the point at which a judge’s use of AI tools begins to undermine the public’s trust in the administration of justice. It argues that the answer to this question depends on whether the AI tool is in a role in which it must perform a moral evaluation of a human being.Keywords: artificial intelligence, judicial reasoning, morality, technology, algorithm
Procedia PDF Downloads 813672 Status and Management of Grape Stem Borer, Celosterna scrabrator with Soil Application of Chlorantraniliprole 0.4 gr
Authors: D. N. Kambrekar, S. B. Jagginavar, J. Aruna
Abstract:
Grape stem borer, Celosterna scrabrator is an important production constraint in grapes in India. Hitherto this pest was a severe menace only on the aged and unmanaged fields but during the recent past it has also started damaging the newly established fields. In India, since Karnataka, Andra Pradesh, Tamil Nadu and Maharashtra are the major grape production states, the incidence of stem borer is also restricted and severe in these states. The grubs of the beetle bore in to the main stem and even the branches, which affect the translocation of nutrients to the areal parts of the plant. Since, the grubs bore inside the stem, the chewed material along with its excreta is discharged outside the holes and the frass is found on the ground just below the bored holes. The portion of vines above the damaged part has a sticky appearance. The leaves become pale yellow which looks like a deficiency of micronutrients. The leaves ultimately dry and drop down. The status of the incidence of the grape stem borer in different grape growing districts of Northern Karnataka was carried out during three years. In each taluka five locations were surveyed for the incidence of grape stem borer. Further, the experiment on management of stem borer was carried out in the grape gardens of Vijayapur districts under farmers field during three years. Stem borer infested plants that show live holes were selected per treatments and it was replicated three times. Live and dead holes observed during pre-treatment were closely monitored and only plants with live holes were selected and tagged. Different doses of chlorantraniliprole 0.4% GR were incorporated into the soil around the vine basins near root zone surrounded to trunk region by removing soils up to 5-10 cm with a peripheral distance of 1 to 1.5 feet from the main trunk where feeder roots are present. Irrigation was followed after application of insecticide for proper incorporation of the test chemical. The results indicated that there was sever to moderate incidence of the stem borer in all the grape growing districts of northern Karnataka. Maximum incidence was recorded in Belagavi (11 holes per vine) and minimum was in Gadag district (8.5 holes per vine). The investigations carried out to study the efficacy of chlorantraniliprole on grape stem borer for successive three years under farmers field indicated that chlorantraniliprole @ 15g/vine applied just near the active root zone of the plant followed by irrigation has successfully managed the pest. The insecticide has translocated to all the parts of the plants and thereby stopped the activity of the pest which has resulted in to better growth of the plant and higher berry yield compared to other treatments under investigation. Thus, chlorantraniliprole 0.4 GR @ 15g/vine can be effective means in managing the stem borer.Keywords: chlorantraniliprole, grape stem borer, Celosterna scrabrator, management
Procedia PDF Downloads 4423671 Exploring Entrepreneurship Intension Aptitude along Gender Lines among Business Decision Students in Nigeria
Authors: Paul O. Udofot, Emem B. Inyang
Abstract:
The study investigated the variability in aptitude amidst interactive effects of several social and environmental factors that could influence individual tendencies to engage in entrepreneurship in Nigeria. Consequently, the study targeted a population having similar backgrounds in type and level of higher education that are tailored toward enterprise management and development in the Niger Delta region of Nigeria. A two-stage sampling procedure was used to select 67 respondents. Primarily, the study assessed the salient pattern of entrepreneurship aptitude of respondents, and estimated and analyzed the index against their personal characteristics. Male respondents belonged to two extremes of aptitude index ranges (poor and high). Though female respondents did not exhibit a poor entrepreneurship aptitude index, the incidence percentage of the high index range of entrepreneurship aptitude among male trainees was more than the combined incidence percentage of their female counterparts. Respondents’ backgrounds outside gender presented a serious influence on entrepreneurship uptake likelihood if all situations were normal.Keywords: aptitude, entrepreneurship, entrepreneurial orientation, gender divide, intention, trainee
Procedia PDF Downloads 2873670 Study of Atmospheric Cascades Generated by Primary Comic Rays, from Simulations in Corsika for the City of Tunja in Colombia
Authors: Tathiana Yesenia Coy Mondragón, Jossitt William Vargas Cruz, Cristian Leonardo Gutiérrez Gómez
Abstract:
The study of cosmic rays is based on two fundamental pillars: the detection of secondary cosmic rays on the Earth's surface and the detection of the source and origin of the cascade. In addition, the constant flow of RC generates a lot of interest for study due to the incidence of various natural phenomena, which makes it relevant to characterize their incidence parameters to determine their effect not only at subsoil or terrestrial surface levels but also throughout the atmosphere. To determine the physical parameters of the primary cosmic ray, the implementation of robust algorithms capable of reconstructing the cascade from the measured values is required, with a high level of reliability. Therefore, it is proposed to build a machine learning system that will be fed from the cosmic ray simulations in CORSIKA at different energies that lie in a range [10⁹-10¹²] eV. in order to generate a trained particle and pattern recognition system to obtain greater efficiency when inferring the nature of the origin of the cascade for EAS in the atmosphere considering atmospheric models.Keywords: CORSIKA, cosmic rays, eas, Colombia
Procedia PDF Downloads 803669 Biomass and Biogas Yield of Maize as Affected by Nitrogen Rates with Varying Harvesting under Semi-Arid Condition of Pakistan
Authors: Athar Mahmood, Asad Ali
Abstract:
Management considerations including harvesting time and nitrogen application considerably influence the biomass yield, quality and biogas production. Therefore, a field study was conducted to determine the effect of various harvesting times and nitrogen rates on the biomass yield, quality and biogas yield of maize crop. This experiment was consisted of various harvesting times i.e., harvesting after 45, 55 and 65 days of sowing (DAS) and nitrogen rates i.e., 0, 100, 150 and 200 kg ha-1 respectively. The data indicated that maximum plant height, leaf area, dry matter (DM) yield, protein, acid detergent fiber, neutral detergent fiber, crude fiber contents and biogas yield were recorded 65 days after sowing while lowest was recorded 45 days after sowing. In contrary to that significantly higher chlorophyll contents were observed at 45 DAS. In case of nitrogen rates maximum plant height, leaf area, and DM yield, protein contents, ash contents, acid detergent fiber, neutral detergent fiber, crude fiber contents and chlorophyll contents were determined with nitrogen at the rate of 200 kg ha-1, while minimum was observed when no N was applied. Therefore, harvesting 65 DAS and N application @ 200 kg ha-1 can be suitable for getting the higher biomass and biogas production.Keywords: chemical composition, fiber contents, biogas, nitrogen, harvesting time
Procedia PDF Downloads 1583668 Trends in the Incidence of Bloodstream Infections in Patients with Hematological Malignancies in the Period 1991–2012
Authors: V. N. Chebotkevich, E. E. Schetinkina, V. V. Burylev, E. I. Kaytandzhan, N. P. Stizhak
Abstract:
Objective: Blood stream infections (BSI) are severe, life-threatening illness for immuno compromised patients with hematological malignancies. We report the trend in blood-stream infections in this group of patients in the period 1991-2013. Methods: A total of 4742 blood samples investigated. All blood cultures were incubated in a continuous monitoring system for 7 days before discarding negative. On signaled positive, organism was identified by conventional methods. The Real-time polymerase chain reaction (PCR) was used for the indication of human herpes virus 6 (HHV-6), Cytomegalovirus (CMV) and Epstein-Barr virus (EBV). Results: Between 1991 and 2001 the incidence of Gram-positive bacteria (Staphylococcus epidermidis, Staphylococcus aureus) being the most common germs isolated (70,9%) were as Gram-negative rods (Escherichia coli, Klebsiella spp., Pseudomonas spp.) – 29,1%. In next decade 2002-2012 the number of Gram-negative bacteria was increased up to 40.2%. It is shown that the incidence of bacteremia was significantly more frequent at the background of detectable Cytomegalovirus and Epstein-Barr virus-specific DNA in blood. Over recent years, an increased frequency of micro mycetes was registered in blood of the patients with hematological malignancies (Candida spp. was predominant). Conclusion: Accurate and timely detection of BSI is important in determining appropriate treatment of infectious complications in patients with hematological malignancies. The isolation of Staphylococcus epidermidis from blood cultures remains a clinical dilemma for physicians and microbiologists. But in many cases this agent is of the clinical significance in immunocompromised patients with hematological malignancies. The role of CMV and EBV in development of bacteremia was demonstrated.Keywords: infectious complications, blood stream infections, bacteremia, hemoblastosis
Procedia PDF Downloads 3513667 Spatial Distribution of Certified Mental Disabilities in China
Authors: Jiayue Yang
Abstract:
Based on an analysis of China's database of certified disabled persons in 2021, this study reveals several key findings. Firstly, the proportion of certified mentally disabled persons among China's certified disabled population (Certification rate 1) shows a decreasing distribution from the East to the West and from the South to the North. Secondly, the spatial distribution of the number of mentally disabled persons per 1,000 people holding certificates (certification rate 2) shows a relatively scattered pattern, with significant variations observed between cities in the eastern region. However, on an overall scale, a south-north gradient can still be observed, with higher rates in the North and lower rates in the west, while the central region demonstrates higher rates compared to the western region. The variation in the rate of mentally handicapped certificates among regions is influenced not only by traditional culture and welfare level but also exhibits a certain correlation with the level of economic development.Keywords: certified disabled persons, mentally disabled persons, spatial distribution, China
Procedia PDF Downloads 1033666 Unreliable Production Lines with Simultaneously Unbalanced Operation Time Means, Breakdown, and Repair Rates
Authors: Sabry Shaaban, Tom McNamara, Sarah Hudson
Abstract:
This paper investigates the benefits of deliberately unbalancing both operation time means (MTs) and unreliability (failure and repair rates) for non-automated production lines.The lines were simulated with various line lengths, buffer capacities, degrees of imbalance and patterns of MT and unreliability imbalance. Data on two performance measures, namely throughput (TR) and average buffer level (ABL) were gathered, analyzed and compared to a balanced line counterpart. A number of conclusions were made with respect to the ranking of configurations, as well as to the relationships among the independent design parameters and the dependent variables. It was found that the best configurations are a balanced line arrangement and a monotone decreasing MT order, coupled with either a decreasing or a bowl unreliability configuration, with the first generally resulting in a reduced TR and the second leading to a lower ABL than those of a balanced line.Keywords: unreliable production lines, unequal mean operation times, unbalanced failure and repair rates, throughput, average buffer level
Procedia PDF Downloads 4853665 Maternal Request: A Minor but Important Contributor to the Rising Rates of Caesarean Section: A Retrospective Observational Study
Authors: Katherine Russell
Abstract:
Background: Over recent decades the number of caesarean sections performed in the UK has continued to rise. The cause of the rising caesarean rate (CSR) is not well understood. However, one of the most heavily cited reasons is an increase in maternal request for caesarean section. Maternal request for caesarean section (CDMR) refers to a caesarean section performed on maternal request with no medical indication. The true rate of caesarean delivery on maternal request in the UK and its contribution to the caesarean section rate is not known. Methods: To elucidate current understanding of the cause of the rising caesarean section rate and the role of CDMR we conducted a systematic review of the literature. To determine the role of CDMR in the CSR at the PRH we conducted a retrospective observational study of the caesarean section rates and CDMR from 2009-2015. Results: We demonstrated a negative correlation between rates of elective sections and CDMR over the study period (-0.123). On average, there were more elective sections performed after 2011 (15.10% of all deliveries) than before 2011 (12.41% of all deliveries); this difference was statistically significant (p = < 0.001). There were more cases of CDMR after 2011 (1.39% of all deliveries) than before 2011 (0.85% of all deliveries). The difference in average rates of CDMR before and after 2011 was statistically significant (p ≤ 0.001). Conclusions: CDMR is only a minor contributor to the CSR at the PRH. However, it remains an important factor because it represents a target for the reduction of the CSR that is more manageable than other, more complex and ubiquitous causes of the rising CSR.Keywords: cesarean section, maternal request for cesarean section, obstetrics, pre-natal health
Procedia PDF Downloads 983664 Single Stage “Fix and Flap” Orthoplastic Approach to Severe Open Tibial Fractures: A Systematic Review of the Outcomes
Authors: Taylor Harris
Abstract:
Gustilo-anderson grade III tibial fractures are exquisitely difficult injuries to manage as they require extensive soft tissue repair in addition to fracture fixation. These injuries are best managed collaboratively by Orthopedic and Plastic surgeons. While utilizing an Orthoplastics approach has decreased the rates of adverse outcomes in these injuries, there is a large amount of variation in exactly how an Orthoplastics team approaches complex cases such as these. It is sometimes recommended that definitive bone fixation and soft tissue coverage be completed simultaneously in a single-stage manner, but there is a paucity of large scale studies to provide evidence to support this recommendation. It is the aim of this study to report the outcomes of a single-stage "fix-and-flap" approach through a systematic review of the available literature. Hopefully, this better informs an evidence-based Orthoplastics approach to managing open tibial fractures. Systematic review of the literature was performed. Medline and Google Scholar were used and all studies published since 2000, in English were included. 103 studies were initially evaluated for inclusion. Reference lists of all included studies were also examined for potentially eligible studies. Gustilo grade III tibial shaft fractures in adults that were managed with a single-stage Orthoplastics approach were identified and evaluated with regard to outcomes of interest. Exclusion criteria included studies with patients <16 years old, case studies, systemic reviews, meta-analyses. Primary outcomes of interest were the rates of deep infections and rates of limb salvage. Secondary outcomes of interest included time to bone union, rates of non-union, and rates of re-operation. 15 studies were eligible. 11 of these studies reported rates of deep infection as an outcome, with rates ranging from 0.98%-20%. The pooled rate between studies was 7.34%. 7 studies reported rates of limb salvage with a range of 96.25%-100%. The pooled rate of the associated studies was 97.8%. 6 reported rates of non-union with a range of 0%-14%, a pooled rate of 6.6%. 6 reported time to bone union with a range of 24 to 40.3 weeks and a pooled average time of 34.2 weeks, and 4 reported rates of reoperation ranging from 7%-55%, with a pooled rate of 31.1%. A few studies that compared a single stage to a multi stage approach side-by-side unanimously favored the single stage approach. Outcomes of Gustilo grade III open tibial fractures utilizing an Orthoplastics approach that is specifically done in a single-stage produce low rates of adverse outcomes. Large scale studies of Orthoplastic collaboration that were not completed in strictly a single stage, or were completed in multiple stages, have not reported as favorable outcomes. We recommend that not only should Orthopedic surgeons and Plastic surgeons collaborate in the management of severe open tibial fracture, but they should plan to undergo definitive fixation and coverage in a single-stage for improved outcomes.Keywords: orthoplastic, gustilo grade iii, single-stage, trauma, systematic review
Procedia PDF Downloads 853663 Evaluation of Dynamic Log Files for Different Dose Rates in IMRT Plans
Authors: Saad Bin Saeed, Fayzan Ahmed, Shahbaz Ahmed, Amjad Hussain
Abstract:
The aim of this study is to evaluate dynamic log files (Dynalogs) at different dose rates by dose-volume histograms (DVH) and used as a (QA) procedure of IMRT. Seven patients of phase one head and neck cancer with similar OAR`s are selected randomly. Reference plans of dose rate 300 and 600 MU/Min with prescribed dose of 50Gy in 25 fractions for each patient is made. Dynalogs produced by delivery of reference plans processed by in-house MATLAB program which produces new field files contain actual positions of multi-leaf collimators (MLC`s) instead of planned positions in reference plans. Copies of reference plans are used to import new field files generated by MATLAB program and renamed as Dyn.plan. After dose calculations of Dyn.plans for different dose rates, DVH, and multiple linear regression tools are used to evaluate reference and Dyn.plans. The results indicate good agreement of correlation between different dose rate plans. The maximum dose difference among PTV and OAR`s are found to be less than 5% and 9% respectively. The study indicates the potential of dynalogs to be used as patient-specific QA of IMRT at different dose rate.Keywords: IMRT, dynalogs, dose rate, DVH
Procedia PDF Downloads 5333662 Vertical and Horizontal Mismatches in Thailand and the Wage Penalty
Authors: Potjana Chunthanom
Abstract:
The Thai labor market experiences increasing challenges due to disruptive technologies and demographic shifts, including the COVID-19 pandemic. Consequently, there is a widening gap between the skills that firms seek and the skills that employees possess. This study aims to examine the incidence of vertical and horizontal mismatches and their impact on wages in Thailand before and during the COVID-19 pandemic using data from the third quarter of 2018 to 2021 from Thailand's National Labor Force Survey. This paper applies three methods: ordinary least squares (OLS), pooled ordinary least squares (Pooled OLS), and counterfactual decomposition. The findings suggest that the incidence of overeducation and field-of-study mismatch continues to increase during the COVID-19 pandemic in comparison to the two previous years. In contrast, there is a notable decline in the percentage of undereducated workers during the same period. Additionally, overeducated workers earn wage premiums, whereas undereducated and horizontally mismatched workers face wage penalties. The result also indicates that the COVID-19 pandemic has significant negative (positive) effects on overeducated (undereducated) workers.Keywords: COVID-19, horizontal mismatch, overeducation, undereducation
Procedia PDF Downloads 363661 Data Rate Based Grouping Scheme for Cooperative Communications in Wireless LANs
Authors: Sunmyeng Kim
Abstract:
IEEE 802.11a/b/g standards provide multiple transmission rates, which can be changed dynamically according to the channel condition.Cooperative communications we reintroduced to improve the overallperformance of wireless LANs with the help of relay nodes with higher transmission rates. The cooperative communications are based on the fact that the transmission is much faster when sending data packets to a destination node through a relay node with higher transmission rate, rather than sending data directly to the destination node at low transmission rate. To apply the cooperative communications in wireless LAN, several MAC protocols have been proposed. Some of them can result in collisions among relay nodes in a dense network. In order to solve this problem, we propose a new protocol. Relay nodes are grouped based on their transmission rates. And then, relay nodes only in the highest group try to get channel access. Performance evaluation is conducted using simulation, and shows that the proposed protocol significantly outperforms the previous protocol in terms of throughput and collision probability.Keywords: cooperative communications, MAC protocol, relay node, WLAN
Procedia PDF Downloads 4653660 Effect of Salicylic Acid and Nitrogen Fertilizer on Wheat Growth and Yield
Authors: Omar Ibrahim, Aly A. Gaafar, K. A. Ratib
Abstract:
Two field experiments in micro plots were carried out during the winter seasons of 2012/2013 and 2013/2014, Soil Salinity Laboratory, Alexandria, Egypt, to study the effect of three levels of salicylic acid (SA) as a growth regulator (0, 50, 100 ppm) and three rates of nitrogen fertilizer (75, 100, 125 kg N/feddan) on growth and yield of a spring wheat (Giza 168). The experimental design was a split plot with the main plots in randomized complete block design (RCBD) and four replicates. The results indicated that increasing nitrogen fertilizer rates resulted in insignificant effect on both plant height (cm) and grain weight/spike only. However, a significant effect was observed in all the other studied characters due to the increase in nitrogen fertilizer. On the other hand, increasing salicylic acid rates resulted in insignificant effect in all the studied characters except for chlorophyll a, chlorophyll b, number of grain/spike, and grain yield (gm/ plot). The highest effects on grain yield in wheat were obtained by the rate of 125 kg/feddan of nitrogen fertilizer and 100 ppm of salicylic acid. In conclusion, the data indicated that a high grain yield could be obtained by adding 100 kg/feddan of nitrogen fertilizer and spraying of 50 ppm of salicylic acid with no significant difference with the highest rates. Finally, the interaction had no significant effect on all the studied characters.Keywords: growth regulator, nitrogen fertilizer, spring wheat, salicylic acid
Procedia PDF Downloads 1153659 Investigating the Effects of Cylinder Disablement on Diesel Engine Fuel Economy and Exhaust Temperature Management
Authors: Hasan Ustun Basaran
Abstract:
Diesel engines are widely used in transportation sector due to their high thermal efficiency. However, they also release high rates of NOₓ and PM (particulate matter) emissions into the environment which have hazardous effects on human health. Therefore, environmental protection agencies have issued strict emission regulations on automotive diesel engines. Recently, these regulations are even increasingly strengthened. Engine producers search novel on-engine methods such as advanced combustion techniques, utilization of renewable fuels, exhaust gas recirculation, advanced fuel injection methods or use exhaust after-treatment (EAT) systems in order to reduce emission rates on diesel engines. Although those aforementioned on-engine methods are effective to curb emission rates, they result in inefficiency or cannot decrease emission rates satisfactorily at all operating conditions. Therefore, engine manufacturers apply both on-engine techniques and EAT systems to meet the stringent emission norms. EAT systems are highly effective to diminish emission rates, however, they perform inefficiently at low loads due to low exhaust gas temperatures (below 250°C). Therefore, the objective of this study is to demonstrate that engine-out temperatures can be elevated above 250°C at low-loaded cases via cylinder disablement. The engine studied and modeled via Lotus Engine Simulation (LES) software is a six-cylinder turbocharged and intercooled diesel engine. Exhaust temperatures and mass flow rates are predicted at 1200 rpm engine speed and several low loaded conditions using LES program. It is seen that cylinder deactivation results in a considerable exhaust temperature rise (up to 100°C) at low loads which ensures effective EAT management. The method also improves fuel efficiency through reduced total pumping loss. Decreased total air induction due to inactive cylinders is thought to be responsible for improved engine pumping loss. The technique reduces exhaust gas flow rate as air flow is cut off on disabled cylinders. Still, heat transfer rates to the after-treatment catalyst bed do not decrease that much since exhaust temperatures are increased sufficiently. Simulation results are promising; however, further experimental studies are needed to identify the true potential of the method on fuel consumption and EAT improvement.Keywords: cylinder disablement, diesel engines, exhaust after-treatment, exhaust temperature, fuel efficiency
Procedia PDF Downloads 1753658 Spatio-Temporal Analysis of Rabies Incidence in Herbivores of Economic Interest in Brazil
Authors: Francisco Miroslav Ulloa-Stanojlovic, Gina Polo, Ricardo Augusto Dias
Abstract:
In Brazil, there is a high incidence of rabies in herbivores of economic interest (HEI) transmitted by the common vampire bat Desmodus rotundus, the presence of human rabies cases and the huge economic losses in the world's largest cattle industry, it is important to assist the National Program for Control of Rabies in herbivores in Brazil, that aims to reduce the incidence of rabies in HEI populations, mainly through epidemiological surveillance, vaccination of herbivores and control of vampire-bat roosts. Material and Methods: A spatiotemporal retrospective Kulldorff's spatial scan statistic based on a Poisson model and Monte Carlo simulation and an Anselin's Local Moran's I statistic were used to uncover spatial clustering of HEI rabies from 2000 – 2014. Results: Were identify three important clusters with significant year-to-year variation (Figure 1). In 2000, was identified one area of clustering in the North region, specifically in the State of Tocantins. Between the year 2000 and 2004, a cluster centered in the Midwest and Southeast region including the States of Goiás, Minas Gerais, Rio de Janeiro, Espirito Santo and São Paulo was prominent. And finally between 2000 and 2005 was found an important cluster in the North, Midwest and South region. Conclusions: The HEI rabies is endemic in the country, in addition, appears to be significant differences among the States according to their surveillance services, that may be difficulting the control of the disease, also other factors could be influencing in the maintenance of this problem like the lack of information of vampire-bat roosts identification, and limited human resources for realization of field monitoring. A review of the program control by the authorities it’s necessary.Keywords: Brazil, Desmodus rotundus, herbivores, rabies
Procedia PDF Downloads 4153657 Apollo Clinical Excellence Scorecard (ACE@25): An Initiative to Drive Quality Improvement in Hospitals
Authors: Anupam Sibal
Abstract:
Whatever is measured tends to improve. With a view to objectively measuring and improving clinical quality across the Apollo Group Hospitals, the initiative of ACE @ 25 (Apollo Clinical Excellence@25) was launched on Jan 09. ACE @ 25 is a clinically balanced scorecard incorporating 25 clinical quality parameters involving complication rates, mortality rates, one-year survival rates and average length of stay after major procedures like liver and renal transplant, CABG, TKR, THR, TURP, PTCA, endoscopy, large bowel resection and MRM covering all major specialties. Also included are hospital acquired infection rates, pain satisfaction and medication errors. Benchmarks have been chosen from the world’s best hospitals. There are weighted scores for outcomes color coded green, orange and red. The cumulative score is 100. Data is reported monthly by 43 Group Hospitals online on the Lighthouse platform. Action taken reports for parameters falling in red are submitted quarterly and reviewed by the board. An audit team audits the data at all locations every six months. Scores are linked to appraisal of the medical head and there is an “ACE @ 25” Champion Award for the highest scorer. Scores for different parameters were variable from green to red at the start of the initiative. Most hospitals showed an improvement in scores over the last four years for parameters where they had showed scores in red or orange at the start of the initiative. The overall scores for the group have shown an increase from 72 in 2010 to 81 in 2015.Keywords: benchmarks, clinical quality, lighthouse, platform, scores
Procedia PDF Downloads 3003656 Influence of Copper-Methionine on Hematological and Biochemical Changes and Ascites Incidence in Cold-Stressed Broilers
Authors: M. Bagheri Varzaneh, H. R. Rahmani, R. Jahanian
Abstract:
The present study aimed to investigate the effects of copper-methionine on ascites incidence and hematological, morphological and enzymatic responses in broiler chickens. A total of 480 one-day-old Ross 308 broiler chicks were used in a completely randomized design in a 2×3 factorial arrangement of treatments including two ambient temperatures (thermoneutral and cold stress) and three copper levels (0, 100, and 200 mg/kg as copper-methionine) with 4 replicates (20 birds in each replicate). Broilers were kept in an environmentally-controlled room from 1 to 28 days; then, half of them exposed to cold temperature from 28 to 45 days of age. The birds were sacrificed at days 38 and 45 of age. Heparinized blood samples were collected to measure hematocrit, hemoglobin concentration, red blood cell (RBC) count, alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Heart, lungs, liver, and spleen were collected and weighed separately on a sensitive digital scale. At d 38 of age, none of hematological variables, enzymatic parameters, and relative weights of organs were affected by treatments. Ascitic broilers were observed in group subjected to cold temperature and control diet (without supplemental copper) at d 45 of age. Relative weight of lungs and relative weight of heart in broilers fed on copper-methionine supplemented diets in cold temperature were lower compared with other groups. Relative liver weight, ALT, AST activities, and hematological parameters such as hematocrit, hemoglobin concentration, red blood cell count in ascitic broilers were significantly increased. In contrast, a significant decrease of the relative weight of spleen was shown in these chickens. The results showed that dietary supplementation with copper–methionine can decrease probability of ascites incidence in broilers chicks, especially under cold condition.Keywords: ascites, cold temperature, copper-methionine, cold-stressed broiler
Procedia PDF Downloads 6333655 Implications of Human Cytomegalovirus as a Protective Factor in the Pathogenesis of Breast Cancer
Authors: Marissa Dallara, Amalia Ardeljan, Lexi Frankel, Nadia Obaed, Naureen Rashid, Omar Rashid
Abstract:
Human Cytomegalovirus (HCMV) is a ubiquitous virus that remains latent in approximately 60% of individuals in developed countries. Viral load is kept at a minimum due to a robust immune response that is produced in most individuals who remain asymptomatic. HCMV has been recently implicated in cancer research because it may impose oncomodulatory effects on tumor cells of which it infects, which could have an impact on the progression of cancer. HCMV has been implicated in increased pathogenicity of certain cancers such as gliomas, but in contrast, it can also exhibit anti-tumor activity. HCMV seropositivity has been recorded in tumor cells, but this may also have implications in decreased pathogenesis of certain forms of cancer such as leukemia as well as increased pathogenesis in others. This study aimed to investigate the correlation between cytomegalovirus and the incidence of breast cancer. Methods The data used in this project was extracted from a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to analyze the patients infected versus patients not infection with cytomegalovirus using ICD-10, ICD-9 codes. Permission to utilize the database was given by Holy Cross Health, Fort Lauderdale, for the purpose of academic research. Data analysis was conducted using standard statistical methods. Results The query was analyzed for dates ranging from January 2010 to December 2019, which resulted in 14,309 patients in both the infected and control groups, respectively. The two groups were matched by age range and CCI score. The incidence of breast cancer was 1.642% and 235 patients in the cytomegalovirus group compared to 4.752% and 680 patients in the control group. The difference was statistically significant by a p-value of less than 2.2x 10^-16 with an odds ratio of 0.43 (0.4 to 0.48) with a 95% confidence interval. Investigation into the effects of HCMV treatment modalities, including Valganciclovir, Cidofovir, and Foscarnet, on breast cancer in both groups was conducted, but the numbers were insufficient to yield any statistically significant correlations. Conclusion This study demonstrates a statistically significant correlation between cytomegalovirus and a reduced incidence of breast cancer. If HCMV can exert anti-tumor effects on breast cancer and inhibit growth, it could potentially be used to formulate immunotherapy that targets various types of breast cancer. Further evaluation is warranted to assess the implications of cytomegalovirus in reducing the incidence of breast cancer.Keywords: human cytomegalovirus, breast cancer, immunotherapy, anti-tumor
Procedia PDF Downloads 2063654 Systematic Review and Meta-Analysis of Mid-Term Survival, and Recurrent Mitral Regurgitation for Robotic-Assisted Mitral Valve Repair
Authors: Ramanen Sugunesegran, Michael L. Williams
Abstract:
Over the past two decades surgical approaches for mitral valve (MV) disease have evolved with the advent of minimally invasive techniques. Robotic mitral valve repair (RMVr) safety and efficacy has been well documented, however, mid- to long-term data are limited. The aim of this review was to provide a comprehensive analysis of the available mid- to long-term term data for RMVr. Electronic searches of five databases were performed to identify all relevant studies reporting minimum 5-year data on RMVr. Pre-defined primary outcomes of interest were overall survival, freedom from MV reoperation and freedom from moderate or worse mitral regurgitation (MR) at 5-years or more post-RMVr. A meta-analysis of proportions or means was performed, utilizing a random effects model, to present the data. Kaplan-Meier curves were aggregated using reconstructed individual patient data. Nine studies totaling 3,300 patients undergoing RMVr were identified. Rates of overall survival at 1-, 5- and 10-years were 99.2%, 97.4% and 92.3%, respectively. Freedom from MV reoperation at 8-years post RMVr was 95.0%. Freedom from moderate or worse MR at 7-years was 86.0%. Rates of early post-operative complications were low with only 0.2% all-cause mortality and 1.0% cerebrovascular accident. Reoperation for bleeding was low at 2.2% and successful RMVr was 99.8%. Mean intensive care unit and hospital stay were 22.4 hours and 5.2 days, respectively. RMVr is a safe procedure with low rates of early mortality and other complications. It can be performed with low complication rates in high volume, experienced centers. Evaluation of available mid-term data post-RMVr suggests favorable rates of overall survival, freedom from MV reoperation and freedom from moderate or worse MR recurrence.Keywords: mitral valve disease, mitral valve repair, robotic cardiac surgery, robotic mitral valve repair
Procedia PDF Downloads 813653 Environmental, Climate Change, and Health Outcomes in the World
Authors: Felix Aberu
Abstract:
The high rate of greenhouse gas (CO₂) emission and increased concentration of Carbon Dioxide in the atmosphere are not unconnected to both human and natural activities. This has caused climate change and global warming in the world. The adverse effect of these climatic changes has no doubt threatened human existence. Hence, this study examined the effects of environmental and climate influence on mortality and morbidity rates, with particular reference to the world’s leading CO₂ emission countries, using both the pre-estimation, estimation, and post-estimation techniques for more dependable outcomes. Hence, the System Generalized Method of Moments (SGMM) was adopted as the main estimation technique for the data analysis from 1996 to 2023. The coefficient of carbon emissions confirmed a positive and significant relationship among CO₂ emission, mortality, and morbidity rates in the world’s leading CO₂ emissions countries, which implies that carbon emission has contributed to mortality and morbidity rates in the world. Therefore, significant action should be taken to facilitate the expansion of environmental protection and sustainability initiatives in any CO₂ emissions nations of the world.Keywords: environmental, mortality, morbidity, health outcomes, carbon emissions
Procedia PDF Downloads 523652 Competing Risk Analyses in Survival Trials During COVID-19 Pandemic
Authors: Ping Xu, Gregory T. Golm, Guanghan (Frank) Liu
Abstract:
In the presence of competing events, traditional survival analysis may not be appropriate and can result in biased estimates, as it assumes independence between competing events and the event of interest. Instead, competing risk analysis should be considered to correctly estimate the survival probability of the event of interest and the hazard ratio between treatment groups. The COVID-19 pandemic has provided a potential source of competing risks in clinical trials, as participants in trials may experienceCOVID-related competing events before the occurrence of the event of interest, for instance, death due to COVID-19, which can affect the incidence rate of the event of interest. We have performed simulation studies to compare multiple competing risk analysis models, including the cumulative incidence function, the sub-distribution hazard function, and the cause-specific hazard function, to the traditional survival analysis model under various scenarios. We also provide a general recommendation on conducting competing risk analysis in randomized clinical trials during the era of the COVID-19 pandemic based on the extensive simulation results.Keywords: competing risk, survival analysis, simulations, randomized clinical trial, COVID-19 pandemic
Procedia PDF Downloads 1863651 Influence of Moringa Leaves Extract on the Response of Hb Molecule to Dose Rates’ Changes: II. Relaxation Time and Its Thermodynamic Driven State Functions
Authors: Mohamed M. M. Elnasharty, Azhar M. Elwan
Abstract:
Irradiation deposits energy through ionisation changing the bio-system’s net dipole, allowing the use of dielectric parameters and thermodynamic state functions related to these parameters as biophysical detectors to electrical inhomogeneity within the biosystem. This part is concerned with the effect of Moringa leaves extract, natural supplement, on the response of the biosystem to two different dose rates of irradiation. Having Hb molecule as a representative to the biosystem to be least invasive to the biosystem, dielectric measurements were used to extract the relaxation time of certain process found in the Hb spectrum within the indicated frequency window and the interrelated thermodynamic state functions were calculated from the deduced relaxation time. The results showed that relaxation time was decreased for both dose rates indicating a strong influence of Moringa on the response of biosystem and consequently Hb molecule. This influence was presented in the relaxation time and other parameters as well.Keywords: activation energy, DC conductivity, dielectric relaxation, enthalpy change, Moringa leaves extract, relaxation time
Procedia PDF Downloads 1463650 Improving Patient Outcomes for Aspiration Pneumonia
Authors: Mary Farrell, Maria Soubra, Sandra Vega, Dorothy Kakraba, Joanne Fontanilla, Moira Kendra, Danielle Tonzola, Stephanie Chiu
Abstract:
Pneumonia is the most common infectious cause of hospitalizations in the United States, with more than one million admissions annually and costs of $10 billion every year, making it the 8th leading cause of death. Aspiration pneumonia is an aggressive type of pneumonia that results from inhalation of oropharyngeal secretions and/or gastric contents and is preventable. The authors hypothesized that an evidence-based aspiration pneumonia clinical care pathway could reduce 30-day hospital readmissions and mortality rates, while improving the overall care of patients. We conducted a retrospective chart review on 979 patients discharged with aspiration pneumonia from January 2021 to December 2022 at Overlook Medical Center. The authors identified patients who were coded with aspiration pneumonia and/or stable sepsis. Secondarily, we identified 30-day readmission rates for aspiration pneumonia from a SNF. The Aspiration Pneumonia Clinical Care Pathway starts in the emergency department (ED) with the initiation of antimicrobials within 4 hours of admission and early recognition of aspiration. Once this is identified, a swallow test is initiated by the bedside nurse, and if the patient demonstrates dysphagia, they are maintained on strict nothing by mouth (NPO) followed by a speech and language pathologist (SLP) referral for an appropriate modified diet recommendation. Aspiration prevention techniques included the avoidance of straws, 45-degree positioning, no talking during meals, taking small bites, placement of the aspiration wrist band, and consuming meals out of the bed in a chair. Nursing education was conducted with a newly created online learning module about aspiration pneumonia. The authors identified 979 patients, with an average age of 73.5 years old, who were diagnosed with aspiration pneumonia on the index hospitalization. These patients were reviewed for a 30-day readmission for aspiration pneumonia or stable sepsis, and mortality rates from January 2021 to December 2022 at Overlook Medical Center (OMC). The 30-day readmission rates were significantly lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011). When evaluating the mortality rates in the pre and post intervention cohort the authors discovered the mortality rates were lower in the post intervention cohort (23.7% vs 22.4%, p = 0.61) Mortality among non-white (self-reported as non-white) patients were lower in the post intervention cohort (34.4% vs. 21.0% , p = 0.05). Patients who reported as a current smoker/vaper in the pre and post cohorts had increased mortality rates (5.9% vs 22%). There was a decrease in mortality for the male population but an increase in mortality for women in the pre and post cohorts (19% vs. 25%). The authors attributed this increase in mortality in the post intervention cohort to more active smokers, more former smokers, and more being admitted from a SNF. This research identified that implementation of an Aspiration Pneumonia Clinical Care Pathway showed a statistically significant decrease in readmission rates and mortality rates in non-whites. The 30-day readmission rates were lower in the cohort that received the clinical care pathway (35.0% vs. 27.5%, p = 0.011).Keywords: aspiration pneumonia, mortality, quality improvement, 30-day pneumonia readmissions
Procedia PDF Downloads 623649 Observational Study Reveals Inverse Relationship: Rising PM₂.₅ Concentrations Linked to Decreasing Muon Flux
Authors: Yashas Mattur, Jensen Coonradt
Abstract:
Muon flux, the rate of muons reaching Earth from the atmosphere, is impacted by various factors such as air pressure, temperature, and humidity. However, the influence of concentrations of PM₂.₅ (particulate matter with diameters 2.5 mm or smaller) on muon detection rates remains unexplored. During the summer of 2023, smoke from Canadian wildfires (containing significant amounts of particulate matter) blew over regions in the Northern US, introducing huge fluctuations in PM₂.₅ concentrations, thus inspiring our experiment to investigate the correlation of PM₂.₅ concentrations and muon rates. To investigate this correlation, muon collision rates were measured and analyzed alongside PM₂.₅ concentration data over the periods of both light and heavy smoke. Other confounding variables, including temperature, humidity, and atmospheric pressure, were also considered. The results reveal a statistically significant inverse correlation between muon flux and PM₂.₅ concentrations, indicating that particulate matter has an impact on the rate of muons reaching the earth’s surface.Keywords: Muon Flux, atmospheric effects on muons, PM₂.₅, airborne particulate matter
Procedia PDF Downloads 723648 Numerical Study of Off-Design Performance of a Highly Loaded Low Pressure Turbine Cascade
Authors: Shidvash Vakilipour, Mehdi Habibnia, Rouzbeh Riazi, Masoud Mohammadi, Mohammad H. Sabour
Abstract:
The flow field passing through a highly loaded low pressure (LP) turbine cascade is numerically investigated at design and off-design conditions. The Field Operation And Manipulation (OpenFOAM) platform is used as the computational Fluid Dynamics (CFD) tool. Firstly, the influences of grid resolution on the results of k-ε, k-ω, and LES turbulence models are investigated and compared with those of experimental measurements. A numerical pressure under-shoot is appeared near the end of blade pressure surface which is sensitive to grid resolution and flow turbulence modeling. The LES model is able to resolve separation on a coarse and fine grid resolutions. Secondly, the off-design flow condition is modeled by negative and positive inflow incidence angles. The numerical experiments show that a separation bubble generated on blade pressure side is predicted by LES. The total pressure drop is also been calculated at incidence angle between -20◦ and +8◦. The minimum total pressure drop is obtained by k-ω and LES at the design point.Keywords: low pressure turbine, off-design performance, openFOAM, turbulence modeling, flow separation
Procedia PDF Downloads 3593647 Four-Electron Auger Process for Hollow Ions
Authors: Shahin A. Abdel-Naby, James P. Colgan, Michael S. Pindzola
Abstract:
A time-dependent close-coupling method is developed to calculate a total, double and triple autoionization rates for hollow atomic ions of four-electron systems. This work was motivated by recent observations of the four-electron Auger process in near K-edge photoionization of C+ ions. The time-dependent close-coupled equations are solved using lattice techniques to obtain a discrete representation of radial wave functions and all operators on a four-dimensional grid with uniform spacing. Initial excited states are obtained by relaxation of the Schrodinger equation in imaginary time using a Schmidt orthogonalization method involving interior subshells. The radial wave function grids are partitioned over the cores on a massively parallel computer, which is essential due to the large memory requirements needed to store the coupled-wave functions and the long run times needed to reach the convergence of the ionization process. Total, double, and triple autoionization rates are obtained by the propagation of the time-dependent close-coupled equations in real-time using integration over bound and continuum single-particle states. These states are generated by matrix diagonalization of one-electron Hamiltonians. The total autoionization rates for each L excited state is found to be slightly above the single autoionization rate for the excited configuration using configuration-average distorted-wave theory. As expected, we find the double and triple autoionization rates to be much smaller than the total autoionization rates. Future work can be extended to study electron-impact triple ionization of atoms or ions. The work was supported in part by grants from the American University of Sharjah and the US Department of Energy. Computational work was carried out at the National Energy Research Scientific Computing Center (NERSC) in Berkeley, California, USA.Keywords: hollow atoms, autoionization, auger rates, time-dependent close-coupling method
Procedia PDF Downloads 1533646 The Role Previous Cytomegalovirus Infection in Subsequent Lymphoma Develompment
Authors: Amalia Ardeljan, Lexi Frankel, Divesh Manjani, Gabriela Santizo, Maximillian Guerra, Omar Rashid
Abstract:
Introduction: Cytomegalovirus (CMV) infection is a widespread infection affecting between 60-70% of people in industrialized countries. CMV has been previously correlated with a higher incidence of Hodgkin Lymphoma compared to noninfected persons. Research regarding prior CMV infection and subsequent lymphoma development is still controversial. With limited evidence, further research is needed in order to understand the relationship between previous CMV infection and subsequent lymphoma development. This study assessed the effect of CMV infection and the incidence of lymphoma afterward. Methods: A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th,10th codes, and Current Procedural Terminology (CPT) codes. These were used to identify lymphoma diagnosis in a previously CMV infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). A chi-squared test was used to assess statistical significance. Results: A total number of 14,303 patients was obtained in the CMV infected group as well as in the control population (matched by age range and CCI score). Subsequent lymphoma development was seen at a rate of 11.44% (1,637) in the CMV group and 5.74% (822) in the control group, respectively. The difference was statistically significant by p= 2.2x10-16, odds ratio = 2.696 (95% CI 2.483- 2.927). In an attempt to stratify the population by antiviral medication exposure, the outcomes were limited by the decreased number of members exposed to antiviral medication in the control population. Conclusion: This study shows a statistically significant correlation between prior CMV infection and an increased incidence of lymphoma afterward. Further exploration is needed to identify the potential carcinogenic mechanism of CMV and whether the results are attributed to a confounding bias.Keywords: cytomegalovirus, lymphoma, cancer, microbiology
Procedia PDF Downloads 2183645 Child Labor and Injury Occurrence in Nicaragua: A Gender Perspective Analysis
Authors: Cristina Domínguez, Steven N. Cuadra
Abstract:
Aims: The aims of this study are: 1) to describe the occurrence and estimate the risk of suffering injuries of any kind, especially work-related injuries, in rural children working in agricultural activities and in urban children working on the street 2) to explore factors that might be associated with the occurrence of work-related injuries among child workers such as gender, school attendance, and performance of household chore. Method: We performed a crossectional study among working children in agricultural activities (120) and on the street (108) and in non-working referents (140) in 2019. We investigated self-reported injuries during the last 12 months, with focus on work-related injuries. Incidence rate, rate ratios, and 95% CI were calculated by Poisson regression. Results: Agricultural workers have a higher incidence of work-related injuries (2.1 per 1000 person-days) than children working on the street (1.8 per 1000 person-days). However, when considering girl’s unpaid work at home, girls had higher occurrence. Girls had a 30% increase on the risk of suffering work related injuries compared to boys. Performing household chore and attending school were the major predictors of injury occurrence. Discussion: Our data suggest If such partial and full-time girl’s housework is taken into account, there would be little or no variation between the sexes with regard to injuries occurrence, and the incidence rate of work related injuries among girls could even exceed that of boys A greater understanding of the interaction of factors related to how child workers spend their time, and its impact on children’s health, is needed in order to identify feasible and appropriate strategies to reduce the negative effect of work on children when elimination of child labor is not reachable in the short term. Clearly, gender aspects on child labor may allow for more effective targeting of prevention efforts.Keywords: injuries, child labor, agricultural work, gender
Procedia PDF Downloads 1223644 Trends of Cancer Patients Who Underwent Curative/radical Radiotherapy at Radiotherapy Center, Tikur Anbessa Specialized Hospital
Authors: Emeshaw Damtew Zebene, Edom Seife, Hagos Tesfay, Gurja Belay
Abstract:
Background: cancer incidence and mortality has grown rapidly throughout the world. Aging of the population, urbanization, physical inactivity, economic growth followed by smoking and drinking contributed a lot for the increased incidence of cancer all over the globe. Objective: the aim of this study was to assess a one-year trend of cancer patients who underwent curative/radical radiotherapy at radiotherapy center, Tikur Anbessa specialized hospital, Ethiopia. Methodology: We performed a prospective descriptive study of cancer patients treated with LINAC at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia, from April 2021- March 2022. A standardized questionnaire was used to collect sociodemographic and clinical characteristics of the patients. Descriptive statistics and chi-square results were generated using SPSS version 24. The level of significance was obtained at 0.05. Results: Sixty-four (64) curative/radical patients-44 females and 20 males were analyzed. Majority, 27(42.2%), of the patients age range from 45 to 64, and 45(70%) of them were urban residents where a group of higher gynecologic cancer was observed.78% of the patients were with locally advanced cancer, and 54(84.4%) of them had no awareness about cancer. Generally, head & neck cancer were found the most prevalent cancer 20(31.3%), and the leading cause of cancer among women was cervical cancer 17(38.6%), where about half 7(15.9%) of them were HIV positive. Conclusion: Our finding revealed that most of curative/radical patients presented at a locally advanced stage of the disease. Hence, maintaining the already available teletherapy machines and installing additional radiotherapy centers may help in treating the patients at the early stage of the disease. Since almost all of our study participants did not have information about cancer, awareness raising mechanisms should be done. Additionally, understanding differences in cancer incidence between urban and rural is important. Key words: Cancer, Curative/radical, Radiotherapy, Tikur Anbessa Specialized HospitalKeywords: cancer, curative/radical, radiotherapy, tkur anbessa specialized hospital
Procedia PDF Downloads 79