Search results for: least square error

Authors: Birendra Kumar Jha, Mingma L. Sherpa, Binod Kumar Dahal

Abstract:

Background: The metabolic syndrome is emerging as a major public health concern in the world. Urbanization, surplus energy uptake, compounded by decreased physical activities, and increasing obesity are the major factors contributing to the epidemic of metabolic syndrome worldwide. However, prevalence of metabolic syndrome and its risk factors are little studied in Terai region of Nepal. The objectives of this research were to estimate the prevalence and to identify the risk factors of metabolic syndrome among adults in Terai region of Nepal. Method: We used a community based cross sectional study design. A total of 225 adults (age: 18 to 80 years) were selected from three district of Terai region of Nepal using cluster sampling by camp approach. IDF criteria (central obesity with any two of following four factors: triglycerides ≥ 150 mg/dl or specific treatment for lipid abnormality, reduced HDL, raised blood pressure and raised fasting plasma glucose or previously diagnosed type 2 diabetes) were used to assess metabolic syndrome. Interview, physical and clinical examination, measurement of fasting blood glucose and lipid profile were conducted for all participants. Chi-square test and multivariable logistic regression were employed to explore the risk factors of metabolic syndrome. Result: The overall prevalence of metabolic syndrome was 70.7%. Hypertension, increased fasting blood sugar, increased triglycerides and decreased HDL were observed in 50.7%, 32.4%, 41.8% and 79.1% of the subjects respectively. Socio-economic and behavioral risk factors significantly associated with metabolic syndrome were gender male (OR=2.56, 955 CI: 1.42-4.63; p=0.002), in service or retired from service (OR=3.72, 95% CI: 1.72-8.03; p=0.001) and smoking (OR= 4.10, 95% CI: 1.19-14.07; p=0.016). Conclusion: Higher prevalence of Metabolic syndrome along with presence of behavioral risk factors in Terai region of Nepal likely suggest lack of awareness and health promotion activities for metabolic syndrome and indicate the need to promote public health programs in this region to maintain quality of life.

Keywords: metabolic syndrome, Nepal, prevalence, risk factors, Terai

Procedia PDF Downloads 127

Authors: Muhammad Idnan, Arshad Javid, Muhammad Nadeem

Abstract:

The present study was conducted from April 2013 to March 2014 to observe the behavioral parameters of Chinkara (Gazella bennettii) under captive conditions by comparing the captive-born and wild-caught animals for conservation strategies. Understanding the behavioral conformations plays a significant role in captive management. Due to human population explosion and mechanized hunting, the captive breeding seems to be the best way for sports hunting, bush meat, for leather industry and horns for traditional medicinal usage. Primarily, captive management has been used on trial and error basis due to deficiency of ethology of this least concerned species. Behavior of [(20 wild-caught (WC) and 10 captive-bred (CB)] adult Chinkara was observed at captive breeding facilities for ungulates at Ravi Campus, University of Veterinary and Animal Sciences at Kasur district which is situated on southeast side of Lahore. The average annual rainfall is about 650 mm, with frequent raining during monsoon. A focal sample was used to observe the various behavioral patterns for CB and WC chinkara. A similarity was observed in behavioral parameters in WC and CB animals, however, when the differences were considered, WC male deer showed a significantly higher degree of agonistic interaction as compared to the CB male chinkara. These findings suggest that there is no immediate impact of captivity on behavior of chinkara nevertheless 10 generations of captivity. It is suggested that the Chinkara is not suitable for domestication and for successful deer farming, a further study is recommended for ethology of chinkara.

Keywords: Chinkara (Gazella bennettii), domestication, deer farming, ex-situ conservation

Procedia PDF Downloads 144

Authors: Sudhir Kumar, V. R. Sinha

Abstract:

Water in oil topical microemulsions of 5-FU were developed and optimized using face centered central composite design. Topical w/o microemulsion of 5-FU were prepared using sorbitan monooleate (Span 80), polysorbate 80 (Tween 80), with different oils such as oleic acid (OA), triacetin (TA), and isopropyl myristate (IPM). The ternary phase diagrams designated the microemulsion region and face centered central composite design helped in determining the effects of selected variables viz. type of oil, smix ratio and water concentration on responses like drug content, globule size and viscosity of microemulsions. The CCD design exhibited that the factors have statistically significant effects (p<0.01) on the selected responses. The actual responses showed excellent agreement with the predicted values as suggested by the CCD with lower residual standard error. Similarly, the optimized values were found within the range as predicted by the model. Furthermore, other characteristics of microemulsions like pH, conductivity were investigated. For the optimized microemulsion batch, ex-vivo skin flux, skin irritation and retention studies were performed and compared with marketed 5-FU formulation. In ex vivo skin permeation studies, higher skin retention of drug and minimal flux was achieved for optimized microemulsion batch then the marketed cream. Results confirmed the actual responses to be in agreement with predicted ones with least residual standard errors. Controlled release of drug was achieved for the optimized batch with higher skin retention of 5-FU, which can further be utilized for the treatment of many dermatological disorders.

Keywords: 5-FU, central composite design, microemulsion, ternanry phase diagram

Procedia PDF Downloads 464

Authors: Conchita Martin de Bustamante, Christopher S. Kung, Brianne Lacy, Eunsol Park, Hien Piotrowski, Mustafa Husain, Waseem Ahmed

Abstract:

Objective: To explore the comorbidity of mental health conditions (major depressive disorder, borderline personality disorder, generalized anxiety disorder, and schizophrenia) with opioid use disorder in people incarcerated at a large urban jail. Background Schizophrenia, depression, bipolar disorder, and anxiety are all serious mental health conditions that are highly prevalent amongst incarcerated patients. However, it is seldom the only disorder these patients are suffering from. According to the US Department of Justice, about half of US prisoners, both at the state and federal level, suffer from substance use disorders. Although the opioid epidemic has been studied greatly in the recent years amongst the general population, little has been explored on how the opioid crisis has affected incarcerated patients in local jails, particularly regarding which of these patients are most susceptible. Method The cohort consisted of 507 people incarcerated at a large county jail who were evaluated by mental health providers in December 2020. A retrospective review was performed to evaluate associations between mental health diagnoses, substance use disorder, and other demographic variables. Results Participants had been diagnosed with various mental health conditions, including MDD (22.6%, n = 115), GAD (33.7%, n = 171), Schizophrenia (15.2%, n = 77) and BPD (27%, n = 137). Preliminary Chi square tests were conducted for these conditions against marijuana, alcohol, cocaine, opioid, methamphetamine, benzodiazepines, and sedative use disorders. The results showed significant associations between Schizophrenia (p = 0.013), GAD (p M 0.001), and MDD (p = 0.029) with opioid use disorders. Conclusions Determining the extent of these comorbid substance use and mental health disorders within an incarcerated population can help influence treatment plans for future incarcerated patients. Many federal and state jail systems lack pharmacological substance use intervention and the prevalence of these co-morbid conditions can shed light on the importance of treating conditions concurrently upon intake.

Keywords: mental health conditions, opioids, substance use disorder, comorbidity

Procedia PDF Downloads 124

Authors: Rieski Prihastuti, Meliana Depo, Trisno A. Wibowo, Misinem

Abstract:

On October 19, 2017, Yogyakarta Islamic Hospital reported 38 garment employees with nausea, vomiting, headache, abdominal pain, and diarrhea after they had lunch on October 18, 2017, to Sleman District Health Office. Objectives of this study were to ensure the outbreak and identify source and route of transmission. Case-control study was conducted to analyze food items that caused the outbreak. A case was defined as a person who got symptoms such as abdominal pain, diarrhea, nausea with/without vomiting, fever, and headache after they had lunch on October 18, 2017. Samples included leftover lunch box, vomit, tap water and drinking water had been sent to the laboratory. Data were analyzed descriptively as frequency table and analyzed by using chi-square in bivariate analysis. All of 196 garment employee was included in this study. The common symptoms of this outbreak were abdominal pain (84.4%), diarrhea (72.8%), nausea (61.6%), headache (52.8%), vomiting (12.8%), and fever (6.4%) with median incubation period 13 hours (range 1-34 hours). Highest attack rate and odds ratio was found in grilled chicken (Attack Rate 58,49%) with Odds Ratio 11,023 (Confidence Interval 95% 1.383 - 87.859; p value 0,005). Almost all samples showed mold, except drinking water. Based on its sign and symptoms, also incubation period, diarrheal Bacillus cereus and Clostridium perfringens were suspected to be the causative agent of the outbreak. Limitation of this study was improper sample handling and no sample of food handler and stools in the food caterer. Outbreak investigation training needed to be given to the hospital worker, and monitoring should be done to the food caterer to prevent another outbreak.

Keywords: disease outbreak, foodborne disease, food poisoning, outbreak

Procedia PDF Downloads 139

Authors: Yen-Hui Chen, Terry Walker

Abstract:

As the world experiences an energy crisis, investing in sustainable energy resources is a pressing mission for many countries. Microalgae-derived biodiesel has attracted intensive attention as an important biofuel, and microalgae Chlorella protothecoides lipid is recognized as a renewable source for microalgae-derived biodiesel production. Supercritical carbon dioxide (SC-CO₂) is a promising green solvent that may potentially substitute the use of organic solvents for lipid extraction; however, the efficiency of SC-CO₂ extraction may be affected by many variables, including temperature, pressure and extraction time individually or in combination. In this study, response surface methodology (RSM) was used to optimize the process parameters, including temperature, pressure and extraction time, on C. protothecoides lipid yield by SC-CO₂ extraction. A second order polynomial model provided a good fit (R-square value of 0.94) for the C. protothecoides lipid yield. The linear and quadratic terms of temperature, pressure and extraction time—as well as the interaction between temperature and pressure—showed significant effects on lipid yield during extraction. The optimal lipid yield from the model was predicted as the temperature of 59 °C, the pressure of 350.7 bar and the extraction time 2.8 hours. Under these conditions, the experimental lipid yield (25%) was close to the predicted value. The principal fatty acid methyl esters (FAME) of C. protothecoides lipid-derived biodiesel were oleic acid methyl ester (60.1%), linoleic acid methyl ester (18.6%) and palmitic acid methyl ester (11.4%), which made up more than 90% of the total FAMEs. In summary, this study indicated that RSM was useful to characterize the optimization the SC-CO₂ extraction process of C. protothecoides lipid yield, and the second-order polynomial model could be used for predicting and describing the lipid yield very well. In addition, C. protothecoides lipid, extracted by SC-CO₂, was suggested as a potential candidate for microalgae-derived biodiesel production.

Keywords: Chlorella protothecoides, microalgal lipids, response surface methodology, supercritical carbon dioxide extraction

Procedia PDF Downloads 427

Authors: C. Vázquez, L. M. Gigirey, C. P. del Oro, S. Seoane

Abstract:

Poor vision is common among older people, and several studies show connections between visual impairment and cognitive function. 15 older adult live in Galician Government nursing homes, and cognitive decline is one of the main reasons of admission. Objectives: (1) To evaluate functional far and near vision of older people with cognitive impairment. (2) To determine connections between visual and cognitive state of “our” residents. Methodology: A total of 364 older adults (aged 65 years or more) underwent a visual and cognitive screening. We tested presenting visual acuity (binocular visual acuity with habitual correction if warn) for distance and near vision (E-Snellen, usual working distance for near vision). Binocular presenting visual acuity less than 0.3 was used as cut point for diagnosis of visual impairment. Exclusion criteria included immobilized residents unable to reach the USC Dual Sensory Loss Unit for visual screening. To screen cognition we employed the mini-mental examination test (Spanish version). Analysis of categorical variables was performed using chi-square tests. We utilized Pearson and Spearman correlation tests and the variance analysis to determine differences between groups of interest (SPSS 19.0 version). Results: the percentage of residents with cognitive decline reaches 32.2% Prevalence of visual impairment for distance and near vision increases among those subjects with cognitive impairment respect those with normal cognition. Shift correlation exists between distance visual acuity and mini-mental test (age and sex controlled), and moderate association was found in case of near vision (p<0.01). Conclusion: First results shows that people with cognitive impairment have poor functional distance and near vision than those with normal cognition. Next step will be to analyse the individual contribution of distance and near vision loss on cognition.

Keywords: visual impairment, cognition, aging, nursing homes

Procedia PDF Downloads 410

Authors: M. Karimpour, L. Hitihamillage, N. Elkhoury, S. Moridpour, R. Hesami

Abstract:

Rail transport authorities around the world have been facing a significant challenge when predicting rail infrastructure maintenance work for a long period of time. Generally, maintenance monitoring and prediction is conducted manually. With the restrictions in economy, the rail transport authorities are in pursuit of improved modern methods, which can provide precise prediction of rail maintenance time and location. The expectation from such a method is to develop models to minimize the human error that is strongly related to manual prediction. Such models will help them in understanding how the track degradation occurs overtime under the change in different conditions (e.g. rail load, rail type, rail profile). They need a well-structured technique to identify the precise time that rail tracks fail in order to minimize the maintenance cost/time and secure the vehicles. The rail track characteristics that have been collected over the years will be used in developing rail track degradation prediction models. Since these data have been collected in large volumes and the data collection is done both electronically and manually, it is possible to have some errors. Sometimes these errors make it impossible to use them in prediction model development. This is one of the major drawbacks in rail track degradation prediction. An accurate model can play a key role in the estimation of the long-term behavior of rail tracks. Accurate models increase the track safety and decrease the cost of maintenance in long term. In this research, a short review of rail track degradation prediction models has been discussed before estimating rail track degradation for the curve sections of Melbourne tram track system using Adaptive Network-based Fuzzy Inference System (ANFIS) model.

Keywords: ANFIS, MGT, prediction modeling, rail track degradation

Procedia PDF Downloads 303

Authors: Baha-Aldeen S. Algmati, Ahmed R. Ballil

Abstract:

Multiphase flows occur widely in many engineering and industrial processes as well as in the environment we live in. In particular, bubbly flows are considered to be crucial phenomena in fluid flow applications and can be studied and analyzed experimentally, analytically, and computationally. In the present paper, the dynamic motion of an air bubble rising within a column of liquid is numerically simulated using an open-source CFD modeling tool 'OpenFOAM'. An interface tracking numerical algorithm called MULES algorithm, which is built-in OpenFOAM, is chosen to solve an appropriate mathematical model based on the volume of fluid (VOF) numerical method. The bubbles initially have a spherical shape and starting from rest in the stagnant column of liquid. The algorithm is initially verified against numerical results and is also validated against available experimental data. The comparison revealed that this algorithm provides results that are in a very good agreement with the 2D numerical data of other CFD codes. Also, the results of the bubble shape and terminal velocity obtained from the 3D numerical simulation showed a very good qualitative and quantitative agreement with the experimental data. The simulated rising bubbles yield a very small percentage of error in the bubble terminal velocity compared with the experimental data. The obtained results prove the capability of OpenFOAM as a powerful tool to predict the behavior of rising characteristics of the spherical bubbles in the stagnant column of liquid. This will pave the way for a deeper understanding of the phenomenon of the rise of bubbles in liquids.

Keywords: CFD simulations, multiphase flows, OpenFOAM, rise of bubble, volume of fluid method, VOF

Procedia PDF Downloads 107

Authors: Asher John Mohan, Krishna K. L.

Abstract:

Objectives: (1) To assess the extent of memory impairment induced by Phenytoin (PHT) at normal and reduced dose on temporal lobe epileptic mice. (2) To evaluate the protective effect of Levetiracetam (LEV) on aggravation of memory impairment in temporal lobe epileptic mice by PHT. Materials and Methods: Albino mice of either sex (n=36) were used for the study for a period of 64 days. Convulsions were induced by intraperitoneal administration of pilocarpine 280 mg/kg on every 6th day. Radial arm maze (RAM) was employed to evaluate the memory impairment activity on every 7th day. The anticonvulsant and memory impairment activity were assessed in PHT normal and reduced doses both alone and in combination with LEV. RAM error scores and convulsive scores were the parameters considered for this study. Brain acetylcholine esterase and glutamate were determined along with histopathological studies of frontal cortex. Results: Administration of PHT for 64 days on mice has shown aggravation of memory impairment activity on temporal lobe epileptic mice. Although the reduction in PHT dose was found to decrease the degree of memory impairment the same decreased the anticonvulsant potency. The combination with LEV not only brought about the correction of impaired memory but also replaced the loss of potency due to the reduction of the dose of the antiepileptic drug employed. These findings were confirmed with enzyme and neurotransmitter levels in addition to histopathological studies. Conclusion: This study thus builds a foundation in combining a nootropic anticonvulsant with an antiepileptic drug to curb the adverse effect of memory impairment associated with temporal lobe epilepsy. However further extensive research is a must for the practical incorporation of this approach into disease therapy.

Keywords: anti-epileptic drug, Phenytoin, memory impairment, Pilocarpine

Procedia PDF Downloads 297

Authors: Cruz Queen Allysa Rose, Bautista Joymeeh Anne, Lantoria Kaye, Barretto Katya Louise

Abstract:

The study presents the preferences of passengers on the quality of service provided by the two airline check-in methods currently present in airports-traditional counter check-in and common-use self-service kiosks. Since a study has shown that airlines perceive self-service kiosks alone are sufficient enough to ensure adequate services and customer satisfaction, and in contrast, agents and passengers stated that it alone is not enough and that human interaction is essential. In reference with former studies that established opposing ideas about the choice of the more favorable airline check-in method to employ, it is the purpose of this study to present a recommendation that shall somehow fill-in the gap between the conflicting ideas by means of comparing the perceived quality of service through the RATER model. Furthermore, this study discusses the major competencies present in each method which are supported by the theories–FIRO Theory of Needs upholding the importance of inclusion, control and affection, and the Queueing Theory which points out the discipline of passengers and the length of the queue line as important factors affecting quality service. The findings of the study were based on the data gathered by the researchers from selected Thomasian third year and fourth year college students currently enrolled in the first semester of the academic year 2014-2015, who have already experienced both airline check-in methods through the implication of a stratified probability sampling. The statistical treatments applied in order to interpret the data were mean, frequency, standard deviation, t-test, logistic regression and chi-square test. The final point of the study revealed that there is a greater effect in passenger preference concerning the satisfaction experienced in common-use self-service kiosks in comparison with the application of the traditional counter check-in.

Keywords: traditional counter check-in, common-use self-service Kiosks, airline check-in methods

Procedia PDF Downloads 395

Authors: Mahboobeh Hemmati, Tahar Messadi, Hongmei Gu

Abstract:

Today, life cycle assessment (LCA) is a leading method in mitigating the environmental impacts emerging from the building sector. In this paper, LCA is used to quantify the Green House Gas (GHG) emissions during the construction phase of the largest mass timber residential structure in the United States, Adohi Hall. This building is a 200,000 square foot 708-bed complex located on the campus of the University of Arkansas. The energy used for buildings’ operation is the most dominant source of emissions in the building industry. Lately, however, the efforts were successful at increasing the efficiency of building operation in terms of emissions. As a result, the attention is now shifted to the embodied carbon, which is more noticeable in the building life cycle. Unfortunately, most of the studies have, however, focused on the manufacturing stage, and only a few have addressed to date the construction process. Specifically, less data is available about environmental impacts associated with the construction of mass timber. This study presents, therefore, an assessment of the environmental impact of the construction processes based on the real and newly built mass timber building mentioned above. The system boundary of this study covers modules A4 and A5 based on building LCA standard EN 15978. Module A4 includes material and equipment transportation. Module A5 covers the construction and installation process. This research evolves through 2 stages: first, to quantify materials and equipment deployed in the building, and second, to determine the embodied carbon associated with running equipment for construction materials, both transported to, and installed on, the site where the edifice is built. The Global Warming Potential (GWP) of the building is the primary metric considered in this research. The outcomes of this study bring to the front a better understanding of hotspots in terms of emission during the construction process. Moreover, the comparative analysis of the mass timber construction process with that of a theoretically similar steel building will enable an effective assessment of the environmental efficiency of mass timber.

Keywords: construction process, GWP, LCA, mass timber

Procedia PDF Downloads 152

Authors: Arezou Rezazadeh, Nasrin Omidvar, Hassan Eini-Zinab, Mahmoud Ghazi-Tabatabaie, Reza Majdzadeh, Saeid Ghavamzadeh, Sakineh Nouri-Saeidlou

Abstract:

Dietary pattern analysis method can reflect more information about the nutritional etiology of chronic diseases such as obesity. The aim of this study was to determine the relationship between major dietary patterns and anthropometric measures in men and women living in the city of Urmia. In this cross-sectional study, 723 participants (427 women and 296 men), aged 20–64 in Urmia city were selected from all four zones of Urmia city, in the north-west of Iran. Anthropometrics (weight, height, waist and hip circumference) were measured with standard methods. Body Mass Index (BMI) was calculated by dividing weight (in kilograms) by the square of height (in meter). Dietary intake information was collected by a semi-quantitative food frequency questionnaire in the last year. Dietary patterns were determined using principal component analysis. The relationship between dietary patterns and obesity was analyzed by logistic regression. Three major dietary patterns (DPs) were identified that were named ‘Traditional Higher SES (THS)’, ‘Traditional Low SES (TLS)’ and ‘Transitional’. THS DP was positively and Transitional DP was negatively associated with BMI and waist circumference (W.C), however, after adjusting for confounding variables (age, gender, ethnicity, energy intake, physical activity and SES), the associations were not significant. The TLS was not significantly associated with BMI, but after adjusting for confounders, a significant positive association was detected with W.C and Waist to hip ratio (WHR). Findings showed that both traditional patterns were positively and the western type transitional pattern was reversely associated with anthropometric indices. But this relationship was highly affected by demographic, socioeconomic and energy input and output determinants. The results indicate the inevitable effect of environmental factors on the relationship between dietary patterns and anthropometric indices.

Keywords: anthropometric indices, dietary pattern, Iran, North-west

Procedia PDF Downloads 151

Authors: Mehwish Sarfaraz Ahmad

Abstract:

Background: There is a prevailing perception in Pakistan that private hospitals offer better services than government hospitals. Unfortunately, Pakistan faces challenges in providing efficient healthcare due to limited resources and management capabilities, resulting in demotivation among healthcare workers. Aim: The purpose of this study was to conduct a comprehensive assessment of the occupational health and well-being of healthcare workers in both public and private sector tertiary care hospitals in Lahore, Pakistan, to compare the well-being of healthcare professionals in these two sectors and investigate the influence of workplace culture and experiences on their overall health. Methods: A cross-sectional study was conducted using a validated International Questionnaire, and data from 440 participants was collected using a stratified random sampling technique from a diverse group of healthcare professionals from the public and private tertiary care hospitals in Lahore, Pakistan. The researcher conducted a comparative analysis using appropriate statistical tests, such as Anova, t-tests, chi-square tests, and regression analysis, to explore potential relationships between various factors. Results: The majority of respondents (70.2%) reported their health as "Good" or "Very good, a small percentage (8.2%) rated their health as "Poor," while 24.1% considered their health as "Fair". 39.6% reported being satisfied with their workplace culture, while a majority of 60.4% indicated being unsatisfied with their workplace culture. Results showed that workplace culture has a positive correlation with the overall health and well-being of healthcare professionals. The study found significant differences in health ratings, prevalence of chronic health conditions, workplace culture, and safety perceptions between healthcare professionals in public and private sector tertiary care hospitals. Conclusion: The study's findings emphasize the significance of promoting a positive workplace culture, ensuring workplace safety, and addressing chronic health conditions among healthcare workers.

Keywords: occupational health and well-being, workplace culture, frequency of fatigue, availabity of benefits

Procedia PDF Downloads 45

Authors: Eda Arat Maden, Ceyhan Altun, Bilal Ozmen, Feridun Basak

Abstract:

Purpose: The purpose of this study was to compare the antimicrobial effect of toothpastes containing fluoride, xylitol or xylitol-probiotic in vivo, Streptococcus mutans and Lactobacillus in 13-15 years old children. Method: The study consisted of 60 pediatric patients were randomly divided into 3 groups of 20 each. Group 1 received fluoride toothpaste (Colgate Max Fresh), group 2 used xylitol toothpaste (Xyliwhite) and group 3 used xylitol-probiotic toothpaste (PerioBiotic). Subjects were asked to use the allocated dentifrice two times a day, for 6 weeks. We performed tests on the samples of saliva in the beginning of the study and after 6 weeks’ duration following the use of toothpaste. Result and Conclusion: All of the participants of the study stated that they brushed their teeth well twice a day by using the toothpastes given to them for 6 weeks. Majority of the subjects had high counts of salivary mutans streptococci and Lactobacillus at baseline. When the number of cariogenic bacteria (S. mutans and Lactobacillus) at the start of the PerioBiotic Probiotic toothpaste usage are compared with the results measured after 6 weeks, an important decrease is observed in the S. mutans and Lactobacillus bacteria according to the CRT Tests. After the 6-week use of Probiotic toothpaste, the S. mutans (≥105) decreased to 20% from 75% in the group with S. mutans and Lactobacillus (≥105) decreased to 30% from 60% in the group with Lactobacillus. In addition, an important decrease was recorded in the participants with the S. mutans percentage (80% - 45%) and Lactobacillus (70% - 55%) after using the Colgate Max Fresh toothpaste for six weeks. On the other hand, it was determined with the Chi-square that there were not important changes between the Xyliwhite toothpaste group and the other groups with S. mutans (80% - 75%) and Lactobacillus (75% -65%). It was also determined after the comparison of the groups that the decrease in the S. mutans was higher than the group using PerioBiotic Probiotic toothpaste at a significant level, when compared with the Colgate Max Fresh toothpaste and Xyliwhite toothpaste. S. mutans were more sensitive to the antimicrobial activity of the PerioBiotic Probiotic toothpaste and to the Colgate Max Fresh toothpaste when compared with the Lactobacillus. In the light of the data obtained in this in vivo study, the use of probiotics ensure the balance between the bacterial flora in the oral cavity.

Keywords: lactobacillus, probiotic, Streptococcus mutans, toothpaste

Procedia PDF Downloads 243

Authors: Yong Eun Yoon, Eric N. Johnson, Liling Ren

Abstract:

Multirotor is one of the most popular types of small unmanned aircraft systems and has already been used in many areas including transport, military, surveillance, and leisure. Together with its popularity, the needs for proper flight control is growing because in most applications it is required to conduct its missions autonomously, which is in many aspects based on autonomous flight control. There have been many studies about the flight control for multirotor, but there is still room for enhancements in terms of performance and efficiency. This paper presents an autonomous flight control method for multirotor based on alternative input output linearization coupled with nested saturations. With alternative choice of the output of the multirotor flight control system, we can reduce computational cost regarding Lie algebra, and the linearized system can be stabilized with the introduction of nested saturations with real poles of our own design. Stabilization of internal dynamics is also based on the nested saturations and accompanies the determination of part of desired states. In particular, outer control loops involving state variables which originally are not included in the output of the flight control system is naturally rendered through this internal dynamics stabilization. We can also observe that desired tilting angles are determined by error dynamics from outer loops. Simulation results show that in any tracking situations multirotor stabilizes itself with small time constants, preceded by tuning process for control parameters with relatively low degree of complexity. Future study includes control of piecewise linear behavior of multirotor with actuator saturations, and the optimal determination of desired states while tracking multiple waypoints.

Keywords: automatic flight control, input output linearization, multirotor, nested saturations

Procedia PDF Downloads 214

Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

Abstract:

Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

Procedia PDF Downloads 618

Authors: Naghmeh Zamani, Ashkan Pourkand, David Grow

Abstract:

This paper presents the design and mechanical model of a hybrid impedance/admittance haptic device optimized for applications, like bone drilling, spinal awl probe use, and other surgical techniques were high force is required in the tool-axial direction, and low impedance is needed in all other directions. The performance levels required cannot be satisfied by existing, off-the-shelf haptic devices. This design may allow critical improvements in simulator fidelity for surgery training. The device consists primarily of two low-mass (carbon fiber) plates with a rod passing through them. Collectively, the device provides 6 DOF. The rod slides through a bushing in the top plate and it is connected to the bottom plate with a universal joint, constrained to move in only 2 DOF, allowing axial torque display the user’s hand. The two parallel plates are actuated and located by means of four cables pulled by motors. The forward kinematic equations are derived to ensure that the plates orientation remains constant. The corresponding equations are solved using the Newton-Raphson method. The static force/torque equations are also presented. Finally, we present the predicted distribution of location error, cables velocity, cable tension, force and torque for the device. These results and preliminary hardware fabrication indicate that this design may provide a revolutionary approach for haptic display of many surgical procedures by means of an architecture that allows arbitrary workspace scaling. Scaling of the height and width can be scaled arbitrarily.

Keywords: cable direct driven robot, haptics, parallel plates, bone drilling

Procedia PDF Downloads 245

Authors: Muhammad Minhaj Khan, Jaemin Lee, Suhong Lee, Jinyoung Chung, Johoo Whang

Abstract:

The Republic of Korea has been facing strong storage crisis from nuclear waste generation as At Reactor (AR) temporary storage sites are about to reach saturation. Since the country is densely populated with a rate of 491.78 persons per square kilometer, Construction of High-level waste repository will not be a feasible option. In order to tackle the storage waste generation problem which is increasing at a rate of 350 tHM/Yr. and 380 tHM/Yr. in case of 20 PWRs and 4 PHWRs respectively, the study strongly focuses on the advancement of current nuclear power plants to GEN-IV sustainable and ecological nuclear systems by burning TRUs (Pu, MAs). First, Calculations has made to estimate the generation of SNF including Pu and MA from PWR and PHWR NPPS by using the IAEA code Nuclear Fuel Cycle Simulation System (NFCSS) for the period of 2016, 2030 (including the saturation period of each site from 2024~2028), 2089 and 2109 as the number of NPPS will increase due to high import cost of non-nuclear energy sources. 2ndly, in order to produce environmentally sustainable nuclear energy systems, 4 scenarios to burnout the Plutonium and MAs are analyzed with the concentration on burning of MA only, MA and Pu together by utilizing SFR, LFR and KALIMER-600 burner reactor after recycling the spent oxide fuel from PWR through pyro processing technology developed by Korea Atomic Energy Research Institute (KAERI) which shows promising and sustainable future benefits by minimizing the HLW generation with regard to waste amount, decay heat, and activity. Finally, With the concentration on front and back end fuel cycles for open and closed fuel cycles of PWR and Pyro-SFR respectively, an overall assessment has been made which evaluates the quantitative as well as economical combativeness of SFR metallic fuel against PWR once through nuclear fuel cycle.

Keywords: GEN IV nuclear fuel cycle, nuclear waste, waste sustainability, transmutation

Procedia PDF Downloads 339

Authors: Shanika Y. Koreshi

Abstract:

Sri Lanka housed the lingerie product development and manufacturing subsidiary to renowned brands such as La Senza, Marks & Spencer, H&M, Etam, Lane Bryant, and George. Over the last few years, they have produced local brands such as Amante to cater to the local and regional customers. Past research has identified factors such as quality, price, and design to be vital when marketing lingerie to consumers. However, there has been minimum research that looks into the ethnically targeted market and skin colour within the Asian population. Therefore, the main aim of the research was to identify whether consumer preference for lingerie is influenced by the skin tone of the model wearing it. Moreover, the secondary aim was to investigate if the consumer preference for lingerie is influenced by the consumer’s ethnic identification with the skin tone of the model. An experimental design was used to explore the above aims. The participants constituted of 66 females residing in the western province of Sri Lanka and were gathered via convenience sampling. Six computerized images of a real model were used in the study, and her skin tone was digitally manipulated to express three different skin tones (light, tan and dark). Consumer preferences were measured through a ranking order scale that was constructed via a focus group discussion and ethnic identity was measured by the Multigroup Ethnic Identity Measure-Revised. Wilcoxon signed-rank test, Friedman test, and chi square test of independence were carried out using SPSS version 20. The results indicated that majority of the consumers ethnically identified and preferred the tan skin over the light and dark skin tones. The findings support the existing literature that states there is a preference among consumers when models have a medium skin tone over a lighter skin tone. The preference for a tan skin tone in a model is consistent with the ethnic identification of the Sri Lankan sample. The study implies that lingerie brands should consider the model's skin tones when marketing the brand to different ethnic backgrounds.

Keywords: consumer preference, ethnic identification, lingerie, skin tone

Procedia PDF Downloads 242

Authors: Larifah Mohd Sidik, Anuar Kasa

Abstract:

In recent years, the demands for raw water are increasing along with the growth of the economy and population. Hence, the need for the construction and operation of dams is one of the solutions for the management of water resources problems. The stability of the embankment should be taken into consideration to evaluate the safety of retaining water. The safety of the dam is mostly based on numerous measurable components, for instance, seepage flowrate, pore water pressure and deformation of the embankment. Seepage and slope stability is the primary and most important reason to ascertain the overall safety behavior of the dams. This research study was conducted to evaluate static condition seepage and slope stability performances of Batu dam which is located in Kuala Lumpur capital city. The numerical solution Geostudio-2012 software was employed to analyse the seepage using finite element method, SEEP/W and slope stability using limit equilibrium method, SLOPE/W for three different cases of reservoir level operations; normal and flooded condition. Results of seepage analysis using SEEP/W were utilized as parental input for the analysis of SLOPE/W. Sensitivity analysis on hydraulic conductivity of material was done and calibrated to minimize the relative error of simulation SEEP/W, where the comparison observed field data and predicted value were also carried out. In seepage analysis, such as leakage flow rate, pore water distribution and location of a phreatic line are determined using the SEEP/W. The result of seepage analysis shows the clay core effectively lowered the phreatic surface and no piping failure is shown in the result. Hence, the total seepage flux was acceptable and within the permissible limit.

Keywords: earth dam, dam safety, seepage, slope stability, pore water pressure

Procedia PDF Downloads 203

Authors: Matthew Venunye Fianu, Jerry Fiave, Ebenezer Kye-Mensah, Dacosta Aboagye, Felix Osei-Sarpong

Abstract:

Introduction: Road traffic accidents involving motorbikes are a priority public health concern in Ghana. While there are local initiatives to address this public health challenge, little is known about motor riders’ knowledge and compliance with road safety regulations (RSR) and their association with RTAs. The aim of this study was, therefore, to assess motorbike riders’ knowledge and compliance with RSRs. Methodology: Motorbike riders in Hohoe Municipality were randomly sampled in a cross-sectional study in June 2022. Data were collected from 237 riders using a questionnaire designed in Kobocollect and administered by ten research assistants. A score of 70% or less is considered low for knowledge and compliance. The data were exported into Excel and imported into STATA 17 for analysis. A chi-square test was performed to generate descriptive and inferential statistics to establish the association between independent and dependent variables. Results: All 237 respondents were male, and each of them completed the questionnaire representing a 100% response rate. Participants who had knowledge about speed limit at different segments of the road were 59(24.9%), the use of helmet were 124 (52.3%), and alcohol use were 152 (64.1%). Participants who complied with regulations on speed limits, helmet use, and alcohol use were 108 (45.6%), 179(75.5%), and 168(70.8%), respectively. Riders who had at least junior high school education were 2.43 times more likely to adhere to RSR [cOR =2.43(95%CI= 1.15-6.33) p= 0.023] than those who had less education. Similarly, riders who had high knowledge about RSR were 2.07 times more likely to comply with RSR than those who had less knowledge [AOR= -2.07 (95% CI= 0.34-0.97), p=0.038]. Conclusion: Motor riders in the Hohoe Municipality had low knowledge as well as low compliance with road safety regulations. This could be a contributor to road traffic accidents. It is therefore recommended that road safety regulatory authorities and relevant stakeholders enhance the enforcement of RSR. There should also be country-specific efforts to increase awareness among all motor riders, especially those with less than junior high school education.

Keywords: compliance, motor riders, road safety regulations, road traffic accident

Procedia PDF Downloads 64

Authors: Karla D. Vazquez-Valdez, Bradley P. Wynne

Abstract:

In the last decades manufacturing needs have been changing, leading to the study of manufacturing methods that were underdeveloped, such as incremental forming processes like shear forming. These processes use rotating tools in constant local contact with the workpiece, which is often also rotating, to generate shape. This means much lower loads to forge large parts and no need for expensive special tooling. Potential has already been established by demonstrating manufacture of high-value products, e.g., turbine and satellite parts, with high dimensional accuracy from difficult to manufacture materials. Thus, huge opportunities exist for these processes to replace the current method of manufacture for a range of high value components, e.g., eliminating lengthy machining, reducing material waste and process times; or the manufacture of a complicated shape without the development of expensive tooling. However, little is known about the exact deformation conditions during processing and why certain materials are better than others for shear forming, leading to a lot of trial and error before production. Three alloys were used for this study: Ti-54M, Jethete M154, and IN718. General Microscopy and Electron Backscatter Diffraction (EBSD) were used to measure strains and orientation maps during shear forming. A Design of Experiments (DOE) analysis was also made in order to understand the impact of process parameters in the properties of the final workpieces. Such information was the key to develop a reliable Finite Element Method (FEM) model that closely resembles the deformation paths of this process. Finally, the potential of these three materials to be shear spun was studied using the FEM model and their Forming Limit Diagram (FLD) which led to the development of a rough methodology for testing the shear spinnability of various metals.

Keywords: shear forming, damage, principal strains, forming limit diagram

Procedia PDF Downloads 145

Authors: Soukaina Ounss, Hamid Mounir, Abdellatif El Marjani

Abstract:

Sandwich materials with composite reinforced skins are mostly required in advanced construction applications with a view to ensure resistant structures. Their lightweight, their high flexural stiffness and their optimal thermal insulation make them a suitable solution to obtain efficient structures with performing rigidity and optimal energy safety. In this paper, the mechanical behavior of a sandwich beam with composite skins reinforced by unidirectional carbon fibers is investigated numerically through analyzing the impact of reinforcements specifications on the longitudinal elastic modulus in order to select the adequate sandwich configuration that has an interesting rigidity and an accurate convergence to the analytical approach which is proposed to verify performed numerical simulations. Therefore, concerned study starts by testing flexion performances of skins with various fibers orientations and volume fractions to determine those to use in sandwich beam. For that, the combination of a reinforcement inclination of 30° and a volume ratio of 60% is selected with the one with 60° of fibers orientation and 40% of volume fraction, this last guarantees to chosen skins an important rigidity with an optimal fibers concentration and a great enhance in convergence to analytical results in the sandwich model for the reason of the crucial core role as transverse shear absorber. Thus, a resistant sandwich beam is elaborated from a face-sheet constituted from two layers of previous skins with fibers oriented in 60° and an epoxy core; concerned beam has a longitudinal elastic modulus of 54 Gpa (gigapascal) that equals to the analytical value by a negligible error of 2%.

Keywords: fibers orientation, fibers volume ratio, longitudinal elastic modulus, sandwich beam

Procedia PDF Downloads 141

Authors: Getinet Gezahegn Gebre

Abstract:

The study examined the impact of gender differences on Crop productivity in Decha woreda of southwest Kafa zone, located 140 Km from Jimma Town and 460 km southwest of Addis Ababa, between Bonga town and Omo River. The specific objectives were to assess the extent to which the agricultural production system is gender oriented, to examine access and control over productive resources, and to estimate men’s and women’s productivity in agriculture. Cross-sectional data collected from a total of 140 respondents were used in this study, whereby 65 were female-headed and 75 were male-headed households. The data were analyzed by using Statistical Package for Social Science (SPSS). Descriptive statistics such as frequency, mean, percentage, t-test and chi-square were used to summarize and compare the information between the two groups. Moreover, Cobb-Douglas(CD) production function was used to estimate the productivity difference in agriculture between male and female-headed households. Results of the study showed that male-headed households (MHH) own more productive resources such as land, livestock, labor and other agricultural inputs as compared to female-headed households (FHH). Moreover, the estimate of CD production function shows that livestock, herbicide use, land size and male labor were statistically significant for MHH, while livestock, land size, herbicides use and female labor were significant variables for FHH. The crop productivity difference between MHH and FHH was about 68.83% in the study area. However, if FHH had equal access to the inputs as MHH, the gross value of the output would be higher by 23.58% for FHH. This might suggest that FHH would be more productive than MHH if they had equal access to inputs as MHH. Based on the results obtained, the following policy implication can be drawn: accessing FHH to inputs that increase the productivity of agriculture, such as herbicides, livestock and male labor; increasing the productivity of land; and introducing technologies that reduce the time and energy of women, especially for enset processing.

Keywords: gender difference, crop productivity, GDP, efficiency

Procedia PDF Downloads 56

Authors: Yu-Tzu Hsu, Alice Wu, Hsiang-Kuang Tseng

Abstract:

Introduction: Hepatitis A virus causes acute hepatitis and is usually transmitted by a fecal-oral route of food contamination, which is more prevalent in areas with poor hygienic practices. However, we described a hepatitis A outbreak associated with a fecal-oral route of sexual behavior in men who has sex with men (MSM) in Northern Taiwan. Methods: We retrospectively collected patients with acute HAV infection in MacKay Memorial Hospital, Taipei, Taiwan between July 2015 and November 2016. Demographic data (age, gender, onset time and infection risk), laboratory data (GOT, GPT, bilirubin, HIV status, HBsAg, HCV antibody and syphilis), clinical symptoms and travel history with a foreign tour were analyzed. We compared variables between HIV and non-HIV group. Unless otherwise stated, continuous variables were expressed as mean ± SD, and categorical variables were expressed as number (percentage) for each item. The t test for continuous variables was applied for the comparison between two groups and chi-square for categorical variables were applied for measures of association. Results: We collected 80 cases during the study period. Among them, 54 (67.5%) cases were MSM and 43 (53.8%) cases were HIV positive. The average age was 32.6±7.59 years-old. The average value of initial liver function was 1324 IU/L for AST (GOT), 2100 IU/L for ALT (GPT), and 5.82 mg/dL for bilirubin. We found seven (8.6%) cases were in the status of HBV carrier, five (6.3%) cases were positive for HCV antibody, and 15 (18.6%) cases were co-infected with syphilis. With regards to associated symptoms, 32 (40%) had fever, 46 (57.5%) had nausea, 34 (42.5%) had abdominal discomfort and 46 (57.5%) had general malaise. To compare the non-HIV patients with HIV patients, HIV patients were more likely to be male (p=0.008), MSM (p=0.000), co-infected syphilis (p=0.000) and slowly improving liver function of transaminases (p=0.033, 0.027). Conclusion: The HAV outbreak in Northern Taiwan was mainly occurred in MSM population. Hereafter, our cohort data support a policy in Taiwan to provide one dose of free HAV vaccine shot in this population. Hopefully, the outbreak could be stop by the free vaccine policy and public education.

Keywords: acute hepatitis A, men who has sex with men, human immunodeficiency virus, vaccine

Procedia PDF Downloads 188

Authors: Okwara O. S., Osunsina I. O. O., Pitan O. R., Afolabi C. G.

Abstract:

Rice (Oryza sativa L.) belongs to the family poaceae and has become the most popular food. Globally, this crop is been faced with the menace of vertebrate pests, of which birds and rodents are the most implicated. The study avian and rodents’ infestations and the evaluation of attributable losses was carried out in 2020 and 2021 with the objectives of identifying the types of bird and rodent species associated with lowland rice and to determine the infestation levels, damage intensity, and the crop loss induced by these pests. The experiment was laid out in a split plot arrangement fitted into a Randomized Complete Block Design (RCBD), with the main plots being protected and unprotected groups and the sub-plots being four rice varieties, Ofada, WITA-4, NERICA L-34, and Arica-3. Data collection was done over a 16-week period, and the data obtained were transformed using square root transformation model before Analysis of Variance (ANOVA) was done at 5% probability level. The results showed the infestation levels of both birds and rodents across all the treatment means of thevarieties as not significantly different (p > 0.05) in both seasons. The damage intensity by these pests in both years were also not significantly different (p > 0.05) among the means of the varieties, which explains the diverse feeding nature of birds and rodents when it comes to infestations. The infestation level under the protected group was significantly lower (p < 0.05) than the infestation level recorded under the unprotected group.Consequently, an estimated crop loss of 91.94 % and 90.75 % were recorded in 2020 and 2021, respectively, andthe identified pest birds were Ploceus melanocephalus, Ploceus cuculatus, and Spermestes cucullatus. Conclusively, vertebrates pest cause damage to lowland rice which could result to a high percentage crop loss if left uncontrolled.

Keywords: pests, infestations, evaluation, losses, rodents, avian

Procedia PDF Downloads 106

Authors: Eftychia Pappa, Heleni Vastardis, Christos Rahiotis, Andriani Vazaiou

Abstract:

The aim of this study was to evaluate the prevalence of dry-mouth symptoms (xerostomia) and compare it with alterations in salivary characteristics of children and adolescents with type 1 diabetes (DM1), as measured with the use of chair-side saliva tests. This study also investigated the possible association between salivary dysfunction and incidence of caries, in relation to the level of metabolic control. A cross-sectional study was performed on young patients (6-18 years old) allocated among 3 groups: 40 patients poorly-controlled (DM1-A, HbA1c>8%), 40 well-controlled (DM1-B, HbA1c≤8%) and 40 age- and sex-matched healthy controls. The study was approved by the Research Ethics Committee of University of Athens and the parents signed written informed consent. All subjects were examined for dental caries, oral hygiene and salivary factors. Assessments of salivary function included self-reported xerostomia, quantification of resting and stimulated whole saliva flow rates, pH values, buffering capacity and saliva’s viscosity. Salivary characteristics were evaluated with the use of GC Saliva Check Buffer (3Μ ESPE). Data were analysed by chi-square and Kruskal-Wallis tests. Subjects with diabetes reported xerostomia more frequently than healthy controls (p<0.05). Unstimulated salivary flow rate and pH values remained significantly lower in DM1-A compared to DM1-B and controls. Low values of resting salivary flow rate were associated with a higher prevalence of dental caries in children and adolescents with poorly-controlled DM1 (p<0.05). The results suggested that diabetes-induced alterations in salivary characteristics are indicative of higher caries susceptibility of diabetics and chair-side saliva tests are a useful tool for the evaluation of caries risk assessment.

Keywords: caries risk assessment, saliva diagnostic tests, type 1 diabetes, xerostomia

Procedia PDF Downloads 270

Authors: Marc Solé, Francesc Giné, Magda Valls, Nina Bijedic

Abstract:

What people say on social media has turned into a rich source of information to understand social behavior. Specifically, the growing use of Twitter social media for political communication has arisen high opportunities to know the opinion of large numbers of politically active individuals in real time and predict the global political tendencies of a specific country. It has led to an increasing body of research on this topic. The majority of these studies have been focused on polarized political contexts characterized by only two alternatives. Unlike them, this paper tackles the challenge of forecasting Spanish political trends, characterized by multiple political parties, by means of analyzing the Twitters Users political tendency. According to this, a new strategy, named Tweets Analysis Strategy (TAS), is proposed. This is based on analyzing the users tweets by means of discovering its sentiment (positive, negative or neutral) and classifying them according to the political party they support. From this individual political tendency, the global political prediction for each political party is calculated. In order to do this, two different strategies for analyzing the sentiment analysis are proposed: one is based on Positive and Negative words Matching (PNM) and the second one is based on a Neural Networks Strategy (NNS). The complete TAS strategy has been performed in a Big-Data environment. The experimental results presented in this paper reveal that NNS strategy performs much better than PNM strategy to analyze the tweet sentiment. In addition, this research analyzes the viability of the TAS strategy to obtain the global trend in a political context make up by multiple parties with an error lower than 23%.

Keywords: political tendency, prediction, sentiment analysis, Twitter

Procedia PDF Downloads 217

Authors: Adelson G. Guillarte, M. D., Noel J. Belonguel, Jarungchai Anton S. Vatanagul

Abstract:

Patients with malignant middle cerebral infarction (MCA) (with massive brain swelling and herniation) were reported to have a mortality rate of 80% even with the appropriate conservative medical therapy. European Trials (DECIMAL, DESTINY I, and II, HAMLET) showed significant improvement in mortality and functional outcome with hemicraniectomy. No known published local studies in the region, thus a local study is vital. This is a single center, retrospective, descriptive, cross-sectional, chart review study which includes ≥18 year-old patients with malignant MCA infarction, who underwent hemicraniectomy, and those who were given conservative medical therapy alone, from January 2008 to December 2012 at Perpetual Succour Hospital. Excluded were patients whose charts are with insufficient data, prior MCA stroke, with concomitant intracerebral hemorrhage and with other serious medical conditions or terminal illnesses. Minimum of 32 populations were needed. Data were presented in mean, standard deviation, frequency and percentage distribution. Man n Whitney U test and Chi Square test were used. P-values lesser than 0.05 alpha were considered statistically significant. A total of 672 stroke patients were admitted. 34 patients pass the inclusion criteria. 9 underwent hemicraniectomy and 25 were treated by conservative medical therapy alone. Although not statistically significant (64% vs 33%, p=0.112) there were more patients noted improved in the conservative treatment group. Meanwhile, the Hemicraniectomy group have increased percentage of mortality (67%) (p=0.112). There was a decreasing trend in the average NIHSS score in both groups from admission to post-op 7 days (p=0.198, p=0.78). A bigger multicenter prospective study is recommended to control inherent biases and limitations of a retrospective and smaller study.

Keywords: cerebral infarct, hemicraniectomy, ischemic stroke, malignant middle cerebral artery (MCA) infarct

Procedia PDF Downloads 302