Search results for: combined care

Authors: Ana Paula Melchiors Stahlschmidt, Cristina Py de Pinto Gomes Mairesse

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This paper presents observations on the early supervised internships in Psychology, currently called basic internships in Brazil, and its importance in professional training. The work is an experience report and focuses on the Professional training, illustrated by the reality of a Brazilian institution, used as a case study. It was developed from the authors' experience as academic supervisors of this kind of practice throughout this undergraduate course, combined with aspects investigated in the post-doctoral research of one of them. Theoretical references on the subject and related national legislation are analyzed, as well as reports of students who experienced at least one semester of this type of practice, articulated to the observations of the authors. The results demonstrate the importance of the early supervised internships as a way of creating opportunities for the students of a first contact with the professional reality and the practice of psychologists in different fields of insertion, preparing them for further experiments that require more involvement in activities of training and practices in Psychology.

Keywords: training of psychologists, internships in psychology, supervised internships, combination of theory and practice

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Authors: Muhammad Faisal Khilji, Rana Shoaib Hamid

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Subdural hematoma (SDH) is an extremely rare complication of immune thrombocytopenic purpura (ITP). We present a case of a 34 years old female who presented to the Emergency department of a tertiary care hospital with complaints of headache, on and off gums bleeding and upper respiratory tract symptoms for the last two weeks. Examination was unremarkable except some purpura over limbs. Investigations revealed zero platelets and peripheral film suggestive of ITP. Computerized tomography (CT) brain revealed bilateral SDH in the frontal areas extending into Falx cerebri. Impression of ITP with SDH was made. Patient was treated with intravenous immunoglobulin (IVIg), methyl prednisolone and initial Platelets transfusion. Patient recovered uneventfully with platelets reaching normal levels within a few days and resolution of SDH without surgery.

Keywords: headache, immune thrombocytopenia, purpura, subdural hematoma

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Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir

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Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.

Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar

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Authors: Yassir AbdelRazig, Amine Ghanem

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Construction projects are information intensive in nature and involve many activities that are related to each other. Wireless technologies can be used to improve the accuracy and timeliness of data collected from construction sites and shares it with appropriate parties. Nonetheless, the construction industry tends to be conservative and shows hesitation to adopt new technologies. A main concern for owners, contractors or any person in charge on a job site is the cost of the technology in question. Wireless technologies are not cheap. There are a lot of expenses to be taken into consideration, and a study should be completed to make sure that the importance and savings resulting from the usage of this technology is worth the expenses. This research attempts to assess the effectiveness of using the appropriate wireless technologies based on criteria such as performance, reliability, and risk. The assessment is based on a utility function model that breaks down the selection issue into alternatives attribute. Then the attributes are assigned weights and single attributes are measured. Finally, single attribute are combined to develop one single aggregate utility index for each alternative.

Keywords: analytic hierarchy process, decision theory, utility function, wireless technologies

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Authors: Nirand Anunthanakul

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This paper is to investigate a 54-story reinforced concrete residential tall building structures—238.8 meters high. Shear walls, core walls, and columns are the primary vertical components. Other special lateral components—core-outrigger and belt trusses—are studied and combined with the structural system in order to increase the structural stability during severe lateral load events, particularly, wind loads. The wind tunnel tests are conducted using the force balance technique. The overall wind loads and dynamics response of the building are also measured for 360 degrees of azimuth—basis for 10-degree intervals. The results from numerical analysis indicate that an outrigger and belt truss system clearly engages perimeter columns to efficiently reduce acceleration index and lateral deformations at the top level so that the building structures achieve lateral stability, and meet standard provision values.

Keywords: outrigger, belt truss, tall buildings, wind loadings

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Authors: A. Graa, I. Ziane, F. Benhamida, S. Souag

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This paper presents a comparative analysis study of an efficient and reliable quadratic programming (QP) to solve economic load dispatch (ELD) problem with considering transmission losses in a power system. The proposed QP method takes care of different unit and system constraints to find optimal solution. To validate the effectiveness of the proposed QP solution, simulations have been performed using Algerian test system. Results obtained with the QP method have been compared with other existing relevant approaches available in literatures. Experimental results show a proficiency of the QP method over other existing techniques in terms of robustness and its optimal search.

Keywords: economic dispatch, quadratic programming, Algerian network, dynamic load

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Authors: Riadh Habash, Kristina Djukic, Gandhi Habash

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Sustainable design is one of the emerging milestones in building construction. This concept is defined as buildings that on a yearly average consume as much energy as they generate using renewable energy sources. Realization of sustainable buildings requires a wide range of technologies, systems and solutions with varying degrees of complexity and sophistication, depending upon the location and surrounding environmental conditions. This paper will address not only the role of the above technologies and solutions but will provide solutions to reduce the electromagnetic fields (EMFs) in the building as much as possible so that the occupiers can recover from electro-hyper-sensitivity, if any. The objective is to maximize energy efficiency, optimize occupant comfort, reduce dependency on the grid and provide safer and healthier EMF environment especially for hypersensitive people. Creative architectural and engineering solutions that capitalize on the design of energy efficient technologies; combined cooling, heating and power (CCHP) microgrid (MG); and EMF mitigation will be presented.

Keywords: sustainable buildings, energy efficiency, thermal simulation, electromagnetic environment

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Authors: D. Nareshyadav, K. Anand Kishore, D. Bhagawan

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Water scarcity is the much-identified issue all over the world. The available sources of water need to be reused to sustainable future. The present work explores the treatment of dye wastewater using combinative photocatalysis and ceramic nanofiltration membrane. Commercial ceramic membrane and TiO₂ catalyst were used in this study to investigate the removal of crystal violet dye from the aqueous solution. The effect of operating parameters such as inlet pressure, initial concentration of crystal violet dye, catalyst (TiO₂) loading, initial pH was investigated in the individual system as well as the combined system. In this study, 95 % of dye water was decolorized and 89 % of total organic carbon (TOC) was removed by the hybrid system for 500 ppm of dye and 0.75 g/l of TiO₂ concentrations at pH 9. The operation of the integrated photocatalytic reactor and ceramic membrane filtration has shown the maximum removal of crystal violet dye compared to individual systems. Hence this proposed method may be effective for the removal of Crystal violet dye from effluents.

Keywords: advanced oxidation process, ceramic nanoporous membrane, dye degradation/removal, hybrid system, photocatalysis

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Authors: W. Hasan, H. Farhat

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A hybrid quasi-steady thermal lattice Boltzmann model was used to study the combined effects of temperature and contact angle on the movement of slugs and droplets of oil in water (O/W) system flowing between two parallel plates. The model static contact angle due to the deposition of the O/W droplet on a flat surface with simulated hydrophilic characteristic at different fluid temperatures, matched very well the proposed theoretical calculation. Furthermore, the model was used to simulate the dynamic behavior of droplets and slugs deposited on the domain’s upper and lower surfaces, while subjected to parabolic flow conditions. The model accurately simulated the contact angle hysteresis for the dynamic droplets cases. It was also shown that at elevated temperatures the required power to transport the mixture diminished remarkably.

Keywords: lattice Boltzmann method, Gunstensen model, thermal, contact angle, high viscosity ratio

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Authors: Joo Min Kim, Dongyoun Shin

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The project Future Station (FS) seek for a deeper understanding of metro station. The main idea of the project is enhancing the underground environment by combining new architectural design with IoT technology. This research shows the understanding of the metro environment giving references regarding traditional design approaches and IoT combined space design. Based on the analysis, this research presents design alternatives in two metro stations those are chosen for a testbed. It also presents how the FS platform giving a response to travelers and deliver the benefit to metro operators. In conclusion, the project describes methods to build future metro service and platform that understand traveler’s intentions and giving appropriate services back for enhancing travel experience. It basically used contemporary technology such as smart sensing grid, big data analysis, smart building, and machine learning technology.

Keywords: future station, digital lifestyle experience, sustainable metro, smart metro, smart city

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Authors: Thaminda Liyanage, Anuga Liyanage, Chamila Kurukulasuriya, Sidath Bandara

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Background: The burden of chronic kidney disease (CKD) is growing rapidly around the world, particularly in Asia. Over the last two decades Sri Lanka has experienced an epidemic of CKD with ever growing number of patients pursuing medical care due to CKD and its complications, specially in the “Mahaweli” river basin in north central region of the island nation. This was apparently a new form of CKD which was not attributable to conventional risk factors such as diabetes mellitus, hypertension or infection and widely termed as “CKD-unknown” or “CKDu”. In the past decade a number of small scale studies were conducted to determine the aetiology, prevalence and complications of CKDu in North Central region. These hospital-based studies did not provide an accurate estimate of the problem as merely 10% or less of the people with CKD are aware of their diagnosis even in developed countries with better access to medical care. Interestingly, similar observations were made on the changing epidemiology of obesity in the region but no formal study was conducted to date to determine the magnitude of obesity burden. Moreover, if increasing obesity in the region is associated with CKD epidemic is yet to be explored. Methods: We will conduct an area wide cross sectional survey among all adult residents of the “Mahaweli” development project area 5, in the North Central Province of Sri Lanka. We will collect relevant medical history, anthropometric measurements, blood and urine for hematological and biochemical analysis. We expect a participation rate of 75%-85% of all eligible participants. Participation in the study is voluntary, there will be no incentives provided for participation. Every analysis will be conducted in a central laboratory and data will be stored securely. We will calculate the prevalence of obesity and chronic kidney disease, overall and by stage using total number of participants as the denominator and report per 1000 population. The association of obesity and CKD will be assessed with regression models and will be adjusted for potential confounding factors and stratified by potential effect modifiers where appropriate. Results: This study will provide accurate information on the prevalence of obesity and CKD in the region. Furthermore, this will explore the association between obesity and CKD, although causation may not be confirmed. Conclusion: Obesity and CKD are increasingly recognized as major public health problems in Sri Lanka. Clearly, documenting the magnitude of the problem is the essential first step. Our study will provide this vital information enabling the government to plan a coordinated response to tackle both obesity and CKD in the region.

Keywords: BMI, Chronic Kidney Disease, obesity, Sri Lanka

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Authors: Man-Yu Wong, Siyu Zhou, Zhiqiang Cao

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In quality of life, health service utilization is an important determinant of medical resource expenditures on Colorectal cancer (CRC) care, a better understanding of the increased utilization of health services is essential for optimizing the allocation of healthcare resources to services and thus for enhancing the service quality, especially for high expenditure on CRC care like Hong Kong region. In assessing the association between the health-related quality of life (HRQOL) and health service utilization in patients with colorectal neoplasm, count data models can be used, which account for over dispersion or extra zero counts. In our data, the HRQOL evaluation is a self-reported measure obtained from a questionnaire completed by the patients, misreports and variations in the data are inevitable. Besides, there are more zero counts from the observed number of clinical consultations (observed frequency of zero counts = 206) than those from a Poisson distribution with mean equal to 1.33 (expected frequency of zero counts = 156). This suggests that excess of zero counts may exist. Therefore, we study tests for detecting zero-inflation in models with measurement error in covariates. Method: Under classical measurement error model, the approximate likelihood function for zero-inflation Poisson regression model can be obtained, then Approximate Maximum Likelihood Estimation(AMLE) can be derived accordingly, which is consistent and asymptotically normally distributed. By calculating score function and Fisher information based on AMLE, a score test is proposed to detect zero-inflation effect in ZIP model with measurement error. The proposed test follows asymptotically standard normal distribution under H0, and it is consistent with the test proposed for zero-inflation effect when there is no measurement error. Results: Simulation results show that empirical power of our proposed test is the highest among existing tests for zero-inflation in ZIP model with measurement error. In real data analysis, with or without considering measurement error in covariates, existing tests, and our proposed test all imply H0 should be rejected with P-value less than 0.001, i.e., zero-inflation effect is very significant, ZIP model is superior to Poisson model for analyzing this data. However, if measurement error in covariates is not considered, only one covariate is significant; if measurement error in covariates is considered, only another covariate is significant. Moreover, the direction of coefficient estimations for these two covariates is different in ZIP regression model with or without considering measurement error. Conclusion: In our study, compared to Poisson model, ZIP model should be chosen when assessing the association between condition-specific HRQOL and health service utilization in patients with colorectal neoplasm. and models taking measurement error into account will result in statistically more reliable and precise information.

Keywords: count data, measurement error, score test, zero inflation

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Authors: Le Jiang, Chua Jinxing

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Introduction: The recent outbreak of Ebola virus disease in the west Africa has drawn global concern. With a high fatality rate and direct human-to-human transmission, it has spread between countries and caused great damages for patients and family who are affected. Being the designated hospital to manage epidemic outbreak in Singapore, Tan Tock Seng Hospital (TTSH) is facing great challenges in preparation and managing of potential outbreak of emerging infectious disease such as Ebola virus disease. Aim: We conducted an infection control drill in TTSH emergency department to assess the readiness of healthcare and allied health workers in managing suspected Ebola patients. It also helps to review current Ebola clinical protocol and work instruction to ensure more smooth and safe practice in managing Ebola patients in TTSH emergency department. Result: General preparedness level of staffs involved in managing Ebola virus disease in TTSH emergency department is not adequate. Knowledge deficits of staffs on Ebola personal protective equipment gowning and degowning process increase the risk of potential cross contamination in patient care. Loopholes are also found in current clinical protocol, such as unclear instructions and inaccurate information, which need to be revised to promote better staff performance in patient management. Logistic issues such as equipment dysfunction and inadequate supplies can lead to ineffective communication among teams and causing harm to patients in emergency situation. Conclusion: The infection control drill identified the need for more well-structured and clear clinical protocols to be in place to promote participants performance. In addition to quality protocols and guidelines, systemic training and annual refresher for all staffs in the emergency department are essential to prepare staffs for the outbreak of Ebola virus disease. Collaboration and communication with allied health staffs are also crucial for smooth delivery of patient care and minimising the potential human suffering, properties loss or injuries caused by disease. Therefore, more clinical drills with collaboration among various departments involved are recommended to be conducted in the future to monitor and assess readiness of TTSH emergency department in managing Ebola virus disease.

Keywords: ebola, emergency department, infection control drill, Tan Tock Seng Hospital

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Authors: Mohamed Hafid, Marcel Lacroix

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This study presents an inverse analysis for predicting the thermal conductivities and the heat flux of a high-temperature metallurgical reactor simultaneously. Once these thermal parameters are predicted, the time-varying thickness of the protective phase-change bank that covers the inside surface of the brick walls of a metallurgical reactor can be calculated. The enthalpy method is used to solve the melting/solidification process of the protective bank. The inverse model rests on the Levenberg-Marquardt Method (LMM) combined with the Broyden method (BM). A statistical analysis for the thermal parameter estimation is carried out. The effect of the position of the temperature sensors, total number of measurements and measurement noise on the accuracy of inverse predictions is investigated. Recommendations are made concerning the location of temperature sensors.

Keywords: inverse heat transfer, phase change, metallurgical reactor, Levenberg–Marquardt method, Broyden method, bank thickness

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Authors: W. F. Ribeiro, J. L. N. Góes

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The industrial process adds to engineering wood products features absent in solid wood, with homogeneous structure and reduced defects, improved physical and mechanical properties, bio-deterioration, resistance and better dimensional stability, improving quality and increasing the reliability of structures wood. These features combined with using fast-growing trees, make them environmentally ecological products, ensuring a strong consumer market. The wood I-joists are manufactured by the industrial profiles bonding flange and web, an important aspect of the production of wooden I-beams is the adhesive joint that bonds the web to the flange. Adhesives can effectively transfer and distribute stresses, thereby increasing the strength and stiffness of the composite. The objective of this study is to evaluate different resins in a shear strain specimens with the aim of analyzing the most efficient resin and possibility of using national products, reducing the manufacturing cost. First was conducted a literature review, where established the geometry and materials generally used, then established and analyzed 8 national resins and produced six specimens for each.

Keywords: engineered wood products, structural resin, wood i-joist, Pinus taeda

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Authors: Jung-Ho Moon, Tae Kwon Ha

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M2 steels, the typical Co-free high speed steel (HSS) possessing hardness level of 63~65 HRc, are most widely used for cutting tools. On the other hand, Co-containing HSS’s, such as M35 and M42, show a higher hardness level of 65~67 HRc and used for high quality cutting tools. In the fabrication of HSS’s, it is very important to control cleanliness and eutectic carbide structure of the ingot and it is required to increase productivity at the same time. Production of HSS ingots includes a variety of processes such as casting, electro-slag remelting (ESR), forging, blooming, and wire rod rolling processes. In the present study, electro-slag rapid remelting (ESRR) process, an advanced ESR process combined by continuous casting, was successfully employed to fabricate HSS billets of M2, M35, and M42 steels. Distribution and structure of eutectic carbides of the billets were analysed and cleanliness, hardness, and composition profile of the billets were also evaluated.

Keywords: high speed tool steel, eutectic carbide, microstructure, hardness, fracture toughness

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Authors: Marcos Fabris

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The flaccidity of the contemporary art production, its banality and incapacity of raising social and political relevant issues, and its ubiquitous connection to an ever prospering art market have become a trite, prosaic mantra, a thought-terminating cliché repeated by many, at least in the academic circles, who constantly lament the absence of pressing issues, artistically articulated from a Marxist perspective. This ‘resignation’ or crystalized insistence to consider Contemporary Art as a monolithic block – insufficiently critical – seems to be part of a pattern in Art History, not excluding its leftist wings: the idea that Modernism was, too, a homogeneous movement, one that despite its attempts to establish meaningful connections between art and society are now part of a museological past. This post-mortem attributed to a ‘flat’ modernism disregards it’s highly contradictory character and diverging tendencies, in permanent conflict between themselves and part of a larger movement that questioned Capitalism – as a system. The aim of this presentation is to shed light on some of the most radical modern tendencies, how they articulated ways to figure the uneven and combined development, and how this ‘Alternative Modernism’ may inform, inspire, and make us advance critically in our struggles against the returns of Capitalism.

Keywords: art criticism, art history, contemporary art, modernism

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: Shangdong Zhu, Yunzhou Zhang, Jie Zhang, Hang Hu, Yazhou Zhang

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Image stitching is a very important branch in the field of computer vision, especially for panoramic map. In order to eliminate shape distortion, a novel stitching method is proposed based on gradually changing matrix when images are horizontal. For images captured horizontally, this paper assumes that there is only translational operation in image stitching. By analyzing each parameter of the homography matrix, the global homography matrix is gradually transferred to translation matrix so as to eliminate the effects of scaling, rotation, etc. in the image transformation. This paper adopts matrix approximation to get the minimum value of the energy function so that the shape distortion at those regions corresponding to the homography can be minimized. The proposed method can avoid multiple horizontal images stitching failure caused by accumulated shape distortion. At the same time, it can be combined with As-Projective-As-Possible algorithm to ensure precise alignment of overlapping area.

Keywords: image stitching, gradually changing matrix, horizontal direction, matrix approximation, homography matrix

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Authors: Hsiang-Chun Lai, Hsien-Yin Liao, Yi-Wen Lin

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Migraine is a primary headache disorder which presented as recurrent and moderate to severe headaches and affects nearly fifteen percent of people’s daily life. In East Asia, acupuncture is a common treatment for migraine prevention. Acupuncture can modulate migraine through both peripheral and central mechanism and decrease the allodynia process. Molecular pathway suggests that acupuncture relief migraine by regulating neurotransmitters/neuromodulators. This process was also proven by neural imaging. Acupuncture decrease the headache frequency and intensity compared to routine care. We also review the most common chosen acupoints to treat migraine and its treatment protocol. As a result, we suggested that acupuncture can serve as an option to migraine treatment and prevention. However, more studies are needed to establish the mechanism and therapeutic roles of acupuncture in treating migraine.

Keywords: acupuncture, allodynia, headache, migraine

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Authors: Dr. Jenit Gandhi, Dr. Manojith SS, Dr. Nakul GV, Dr. Sharath Honnani, Dr. Shaurav Ghosh, Dr. Neel Shetty, Dr. Nagabhushan JS, Dr. Manish Joshi

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Introduction: Acute pancreatitis is an inflammatory condition of the pancreas which begins in pancreatic acinar cells and triggers local inflammation that may progress to systemic inflammatory response (SIRS) and causing distant organ involvement and its function and ending up with multiple organ dysfunction syndromes (MODS). Aim: A comparative study in acute pancreatitis to find out the effectiveness of early addition of Ulinastatin to current standard care in Indian subjects . Methodology: A current prospective observational study is done during study period of 1year (Dec 2018 –Dec 2019) duration to evaluate the effect of early addition of Ulinastatin to the current standard treatment and its efficacy to reduce the early complication, analgesic requirement and duration of hospital stay in patients with Acute Pancreatitis. Results: In the control group 25 were males and 05 were females. In the test group 18 were males and 12 females. Majority was in the age group between 30 - 70 yrs of age with >50% in the 30-50yrs age group in both test and control groups. The VAS was median grade 3 in control group as compared to median grade 2 in test group , the pain was more in the initial 2 days in test group compared to 4 days in test group , the analgesic requirement was used for more in control group (median 6) to test group( median 3 days ). On follow up after 5 days for a period of 2 weeks none of the patients in the test group developed any complication. Where as in the control group 8 patients developed pleural effusion, 04-Pseudopancreatic cyst, 02 – patient developed portal vein and splenic vein thrombosis, 02 patients – ventilator with ARDS which were treated symptomatically whereas in test group 02 patient developed pleural effusions and 01 pseudo pancreatic cyst with splenic artery aneurysm, 01 – patient with AKI and MODS symptomatically treated. The duration of hospital stay for a median period of 4 days (2 – 7 days) in test group and 7 days (4 -10 days) in control group. All patients were able to return to normal work on an average of 5days compared 8days in control group, the difference was significant. Conclusion:The study concluded that early addition of Ulinastatin to current standard treatment of acute Pancreatitis is effective in reducing pain, early complication and duration of hospital stay in Indian subject

Keywords: Ulinastatin, VAS – visual analogue score , AKI – acute kidney injury , ARDS – acute respiratory distress syndrome

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Authors: Judith Partouche-Sebban, Saeedeh Rezaee Vessal

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Because of the rising number of new cases of cancer, especially among women, it is more than essential to better understand how women experience cancer in order to bring them adapted to support and care and enhance their well-being and patient experience. Cancer stands for a traumatic experience in which the diagnosis, its medical treatments, and the related side effects lead to deep physical and psychological changes that may arouse considerable stress and anxiety. In order to reduce these negative emotions, women tend to use various defense mechanisms, among which denial has been defined as the most frequent mechanism used by breast cancer patients. This study aims to better understand the consequences of the experience of cancer and their link with the adoption of a denial strategy. The empirical research was done among female cancer survivors in France. Since the topic of this study is relatively unexplored, a qualitative methodology and open-ended interviews were employed. In total, 25 semi-directive interviews were conducted with a female with different cancers, different stages of treatment, and different ages. A systematic inductive method was performed to analyze data. The content analysis enabled to highlight three different denial-related behaviors among women with cancer, which serve a self-protective function. First, women who expressed high levels of anxiety confessed they tended to completely deny the existence of their cancer immediately after the diagnosis of their illness. These women mainly exhibit many fears and a deep distrust toward the medical context and professionals. This coping mechanism is defined by the patient as being unconscious. Second, other women deliberately decided to deny partial information about their cancer, whether this information is related to the stages of the illness, the emotional consequences, or the behavioral consequences of the illness. These women use this strategy as a way to avoid the reality of the illness and its impact on the different aspects of their life as if cancer does not exist. Third, some women tend to reinterpret and give meaning to their cancer as a way to reduce its impact on their life. To this end, they may use magical thinking or positive reframing, or reinterpretation. Because denial may lead to delays in medical treatments, this topic deserves a deep investigation, especially in the context of oncology. As denial is defined as a specific defense mechanism, this study contributes to the existing literature in service marketing which focuses on emotions and emotional regulation in healthcare services which is a crucial issue. Moreover, this study has several managerial implications for healthcare professionals who interact with patients in order to implement better care and support for the patients.

Keywords: cancer, coping mechanisms, denial, healthcare services

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Authors: Mhaned Oubounyt, Jan Baumbach

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Differences in co-expression networks between two or multiple cells (sub)types across conditions is a pressing problem in single-cell RNA sequencing (scRNA-seq). A key challenge is to define those co-variations that differ between or among cell types and/or conditions and phenotypes to examine small regulatory networks that can explain mechanistic differences. To this end, we developed SCANet, an all-in-one Python package that uses state-of-the-art algorithms to facilitate the workflow of a combined single-cell GCN (Gene Correlation Network) and GRN (Gene Regulatory Networks) pipeline, including inference of gene co-expression modules from scRNA-seq, followed by trait and cell type associations, hub gene detection, co-regulatory networks, and drug-gene interactions. In an example case, we illustrate how SCANet can be applied to identify regulatory drivers behind a cytokine storm associated with mortality in patients with acute respiratory illness. SCANet is available as a free, open-source, and user-friendly Python package that can be easily integrated into systems biology pipelines.

Keywords: single-cell, co-expression networks, drug-gene interactions, co-regulatory networks

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Authors: Brenda Thean I. Lim, Safurah Jaafar

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Augmented reality (AR) in the healthcare industry has been gaining popularity in recent years, principally in areas of medical education, patient care and digital health solutions. One of the drivers in deciding to invest in AR technology is the potential economic benefits it could bring for patients and healthcare providers, including the pharmaceutical and medical technology sectors. Works of literature have shown that the benefits and impact of AR technologies have left trails of achievements in improving medical education and patient health outcomes. However, little has been published on the economic impact of AR in healthcare, a very resource-intensive industry. This systematic review was performed on studies focused on the benefits and impact of AR in healthcare to appraise if they meet the founded quality criteria so as to identify relevant publications for an in-depth analysis of the economic impact assessment. The literature search was conducted using multiple databases such as PubMed, Cochrane, Science Direct and Nature. Inclusion criteria include research papers on AR implementation in healthcare, from education to diagnosis and treatment. Only papers written in English language were selected. Studies on AR prototypes were excluded. Although there were many articles that have addressed the benefits of AR in the healthcare industry in the area of medical education, treatment and diagnosis and dental medicine, there were very few publications that identified the specific economic impact of technology within the healthcare industry. There were 13 publications included in the analysis based on the inclusion criteria. Out of the 13 studies, none comprised a systematically comprehensive cost impact evaluation. An outline of the cost-effectiveness and cost-benefit framework was made based on an AR article from another industry as a reference. This systematic review found that while the advancements of AR technology is growing rapidly and industries are starting to adopt them into respective sectors, the technology and its advancements in healthcare were still in their early stages. There are still plenty of room for further advancements and integration of AR into different sectors within the healthcare industry. Future studies will require more comprehensive economic analyses and costing evaluations to enable economic decisions for or against implementing AR technology in healthcare. This systematic review concluded that the current literature lacked detailed examination and conduct of economic impact and benefit analyses. Recommendations for future research would be to include details of the initial investment and operational costs for the AR infrastructure in healthcare settings while comparing the intervention to its conventional counterparts or alternatives so as to provide a comprehensive comparison on impact, benefit and cost differences.

Keywords: augmented reality, benefit, economic impact, healthcare, patient care

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Authors: Taechit Cheuypoung

Abstract:

The research will focus on creating pattern designs that are inspired by the pagodas, Phra Maha Chedi of King Rama I-IV, that are located in the temple, Wat Phra Chetuphon Vimolmangklararm Rajwaramahaviharn. Different aspects of the temple were studied, including the history, architecture, significance of the temple, and techniques used to decorate the pagodas, Phra Maha Chedi of King Rama I-IV. Moreover, composition of arts and the form of pattern designs which all led to the outcome of four Thai application pattern. The four patterns combine Thai traditional design with international scheme, however, maintaining the distinctiveness of the glaze mosaic tiles of each Phra Maha Chedi. The patterns consist of rounded and notched petal flowers, leaves and vine, and various square shapes, and original colors which are updated for modernity. These elements are then grouped and combined with new techniques, resulting in pattern designs with modern aspects and simultaneously reflecting the charm and the aesthetic of Thai craftsmanship which are eternally embedded in the designs.

Keywords: Chedi, Pagoda, pattern, Wat

Procedia PDF Downloads 374

Authors: S. H. Rashmi, G. M. Madhu, A. A. Kittur, R. Suresh

Abstract:

Polymer nanocomposites represent a new class of materials in which nanomaterials act as the reinforcing material in composites, wherein small additions of nanomaterials lead to large enhancements in thermal, optical, and mechanical properties. A boost in these properties is due to the large interfacial area per unit volume or weight of the nanoparticles and the interactions between the particle and the polymer. Micro-sized particles used as reinforcing agents scatter light, thus, reducing light transmittance and optical clarity. Efficient nanoparticle dispersion combined with good polymer–particle interfacial adhesion eliminates scattering and allows the exciting possibility of developing strong yet transparent films, coatings and membranes. This paper aims at synthesizing zinc oxide nanoparticles which are reinforced in poly vinyl alcohol (PVA) polymer. The mechanical properties showed that the tensile strength of the PVA nanocomposites increases with the increase in the amount of nanoparticles.

Keywords: glutaraldehyde, polymer nanocomposites, poly vinyl alcohol, zinc oxide

Procedia PDF Downloads 284

Authors: Bhavneet Bharti, Prahbhjot Malhi, Vandana Thakur

Abstract:

Introduction: Children of the urban migrant laborers have great difficulty in accessing government programs which are otherwise routinely available in rural settings. These include programs for child care, nutrition, health and education. There are major communicative fault-lines preventing advocacy for these marginalized children. The overarching aim of this study was to investigate the role of an innovative strategy of children’s drawings in supporting communication between children, social workers, pediatricians and other child advocates to fulfil their fundamental child rights. Materials and Methods: The data was collected over a period of one-year April 2015 to April 2016 during the routine visits by the members of the Social Pediatrics team including a social worker, pediatricians and an artist to the makeshift colony of migrant laborers. Once a week a drawing session was organized where the children including adolescents were asked to any drawing and provide a narrative thereafter. 5-30 children attended these weekly sessions for one year. All these drawings were then classified into various themes and exhibited on 16th April 2016 in the Govt. College of Art Museum. The forum was used for advocacy of Child Rights of these underprivileged children to Secretary social welfare. Results: Mean (SD) age of children in present observational study was 8.5 (2.5) years, with 60% of the boys. Majority of children demonstrated themes which were local and contextualized to their daily needs, threats and festivals which clearly underscored their fundamental right to basic services and equality of opportunities to achieve their full development Drawings of tap with flowing water, queues of people collecting water from hand pumps reflect the local problem of water availability for these children. Young children talking about fear of rape and murder following their drawings indicate the looming threat of potential abuse and neglect. Besides reality driven drawing, children also echoed supernatural beliefs, dangers and festivities in their drawings. Anyone who watched these children at work with art materials was able to see the intense level of absorption, clearly indicating the enjoyment they received, making it a meaningful activity. Indeed, this self-advocacy through art exhibition led to the successful establishment of mobile Anganwadi (A social safety net programme of the government) in their area of stay. Conclusions: This observational study is an example of how children were able to do self-advocacy to protect their rights. Of particular importance, these drawings address how psychologists and other child advocates can ensure in a child-centered manner that the voice of children is heard and represented in all assessments of their well-being and future care options.

Keywords: child advocacy, children drawings, child rights, marginalized children

Procedia PDF Downloads 166

Authors: Nidhi Gadura

Abstract:

Given the increase in the number of students and administrators asking for online courses the author developed two partially online courses. One was a biology majors at genetics course while the other was a non-majors at biology course. The student body at Queensborough Community College is generally underprepared and has work and family obligations. As an educator, one has to be mindful about changing the pedagogical approach, therefore, special care was taken when designing the course material. Despite the initial concerns, both of these partially online courses were received really well by students. Lessons learnt were that student engagement is the key to success in an online course. Good practices to run a successful online course for underprepared students are discussed in this paper. Also discussed are the lessons learnt for making the eLearning environment better for all the students in the class, overachievers and underachievers alike.

Keywords: partially online course, pedagogy, student engagement, community college

Procedia PDF Downloads 381

Authors: Maryam Akbarzadeh, F. Esmaeilzadeh, A. Poostvar, M. Manuchehri

Abstract:

Preparation of regional input-output tables requires statistical methods combined with high costs and too much time. Obtained estimates by non-statistical methods have low confidence coefficient. Therefore, integrated methods for this purpose are suggested by recent input–output studies. In this study, first GRIT method is introduced as an appropriate integrated method for preparation of input-output table of Fars province. Next, input-output table is prepared for Fars province using this method. Therefore, this study is based on input-output table of national economy in 2001. Necessary modifications performed in the field of changes at level of prices and differences of regional trade compared with other areas at national level. Moreover, up to date statistics and information and technical experts view on the various economic sectors along with input-output table 33 was used in 2011 followed by investigation of general structure of the province economy based on the amounts of added value obtained from this table.

Keywords: grit, input-output, table, regional

Procedia PDF Downloads 250

Authors: B. Kishore Kumar, Pogula Rakesh, T. Kishore Kumar

Abstract:

The music analysis is a part of the audio content analysis used to analyze the music by using the different features of audio signal. In music analysis, the first step is to divide the music signal to different sections based on the feature profiles of the music signal. In this paper, we present a music segmentation technique that will effectively segmentize the signal and thresholding technique to remove silence from the percussive sounds produced by percussive instruments, which uses two features of music, namely signal energy and spectral centroid. The proposed method impose thresholds on both the features which will vary depends on the music signal. Depends on the threshold, silence part is removed and the segmentation is done. The effectiveness of the proposed method is analyzed using MATLAB.

Keywords: percussive sounds, spectral centroid, spectral energy, silence removal, feature extraction

Procedia PDF Downloads 574