Search results for: period symptoms
4496 Zinc Nanoparticles Modified Electrode as an Insulin Sensor
Authors: Radka Gorejova, Ivana Sisolakova, Jana Shepa, Frederika Chovancova, Renata Orinakova
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Diabetes mellitus (DM) is a serious metabolic disease characterized by chronic hyperglycemia. Often, the symptoms are not sufficiently observable at early stages, and so hyperglycemia causes pathological and functional changes before the diagnosis of the DM. Therefore, the development of an electrochemical sensor that will be fast, accurate, and instrumentally undemanding is currently needful. Screen-printed carbon electrodes (SPCEs) can be considered as the most suitable matrix material for insulin sensors because of the small size of the working electrode. It leads to the analyst's volume reduction to only 50 µl for each measurement. The surface of bare SPCE was modified by a combination of chitosan, multi-walled carbon nanotubes (MWCNTs), and zinc nanoparticles (ZnNPs) to obtain better electrocatalytic activity towards insulin oxidation. ZnNPs were electrochemically deposited on the chitosan-MWCNTs/SPCE surface using the pulse deposition method. Thereafter, insulin was determined on the prepared electrode using chronoamperometry and electrochemical impedance spectroscopy (EIS). The chronoamperometric measurement was performed by adding a constant amount of insulin in 0.1 M NaOH and PBS (2 μl) with the concentration of 2 μM, and the current response of the system was monitored after a gradual increase in concentration. Subsequently, the limit of detection (LOD) of the prepared electrode was determined via the Randles-Ševčík equation. The LOD was 0.47 µM. Prepared electrodes were studied also as the impedimetric sensors for insulin determination. Therefore, various insulin concentrations were determined via EIS. Based on the performed measurements, the ZnNPs/chitosan-MWCNTs/SPCE can be considered as a potential candidate for novel electrochemical sensor for insulin determination. Acknowledgments: This work has been supported by the projects Visegradfund project number 22020140, VEGA 1/0095/21 of the Slovak Scientific Grant Agency, and APVV-PP-COVID-20-0036 of the Slovak Research and Development Agency.Keywords: zinc nanoparticles, insulin, chronoamperometry, electrochemical impedance spectroscopy
Procedia PDF Downloads 1224495 Protection and Safeguarding of Groundwater in Algeria between Law and Right to Use
Authors: Aziez Ouahiba, Remini Boualem, Habi Mohamed
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The growth and the development of a pay are strongly related to the existence or the absence of water in this area, the sedentary lifestyle of the population makes that water demand is increasing and the different brandishing (dams, tablecloths or other) are increasingly solicited. In normal time rain and snow of the winter period reloads the slicks and the wadis that fill dams. Over these two decades, Global warming fact that temperature is increasingly high and rainfall is increasingly low, which induces a charge less and less important tablecloths, add to that the strong demand in irrigation. Our study will focus on the variation of rainfall and irrigation, Their effects on the degree of pollution of the groundwater in this area based on statistical analyses by the Xlstat (ACP, correlation...) software for a better explanation of these results and determine the hydrochemistry of different groups or polluted areas pou be able to offer adequate solutions for each area.Keywords: water in the basement, legislation, over exploitation, pollution, water prices
Procedia PDF Downloads 3824494 Reduced Lung Volume: A Possible Cause of Stuttering
Authors: Shantanu Arya, Sachin Sakhuja, Gunjan Mehta, Sanjay Munjal
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Stuttering may be defined as a speech disorder affecting the fluency domain of speech and characterized by covert features like word substitution, omittance and circumlocution and overt features like prolongation of sound, syllables and blocks etc. Many etiologies have been postulated to explain stuttering based on various experiments and research. Moreover, Breathlessness has also been reported by many individuals with stuttering for which breathing exercises are generally advised. However, no studies reporting objective evaluation of the pulmonary capacity and further objective assessment of the efficacy of breathing exercises have been conducted. Pulmonary Function Test which evaluates parameters like Forced Vital Capacity, Peak Expiratory Flow Rate, Forced expiratory flow Rate can be used to study the pulmonary behavior of individuals with stuttering. The study aimed: a) To identify speech motor & physiologic behaviours associated with stuttering by administering PFT. b) To recognize possible reasons for an association between speech motor behaviour & stuttering severity. In this regard, PFT tests were administered on individuals who reported signs and symptoms of stuttering and showed abnormal scores on Stuttering Severity Index. Parameters like Forced Vital Capacity, Forced Expiratory Volume, Peak Expiratory Flow Rate (L/min), Forced Expiratory Flow Rate (L/min) were evaluated and correlated with scores of Stuttering Severity Index. Results showed significant decrease in the parameters (lower than normal scores) in individuals with established stuttering. Strong correlation was also found between degree of stuttering and the degree of decrease in the pulmonary volumes. Thus, it is evident that fluent speech requires strong support of lung pressure and requisite volumes. Further research in demonstrating the efficacy of abdominal breathing exercises in this regard is needed.Keywords: forced expiratory flow rate, forced expiratory volume, forced vital capacity, peak expiratory flow rate, stuttering
Procedia PDF Downloads 2754493 Brain Atrophy in Alzheimer's Patients
Authors: Tansa Nisan Gunerhan
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Dementia comes in different forms, including Alzheimer's disease. The most common dementia diagnosis among elderly individuals is Alzheimer's disease. On average, for patients with Alzheimer’s, life expectancy is around 4-8 years after the diagnosis; however, expectancy can go as high as twenty years or more, depending on the shrinkage of the brain. Normally, along with aging, the brain shrinks at some level but doesn’t lose a vast amount of neurons. However, Alzheimer's patients' neurons are destroyed rapidly; hence problems with loss of memory, communication, and other metabolic activities begin. The toxic changes in the brain affect the stability of the neurons. Beta-amyloid and tau are two proteins that are believed to play a role in the development of Alzheimer's disease through their toxic changes. Beta-amyloid is a protein that is produced in the brain and is normally broken down and removed from the body. However, in people with Alzheimer's disease, the production of beta-amyloid increases, and it begins to accumulate in the brain. These plaques are thought to disrupt communication between nerve cells and may contribute to the death of brain cells. Tau is a protein that helps to stabilize microtubules, which are essential for the transportation of nutrients and other substances within brain cells. In people with Alzheimer's disease, tau becomes abnormal and begins to accumulate inside brain cells, forming neurofibrillary tangles. These tangles disrupt the normal functioning of brain cells and may contribute to their death, forming amyloid plaques which are deposits of a protein called amyloid-beta that build up between nerve cells in the brain. The accumulation of amyloid plaques and neurofibrillary tangles in the brain is thought to contribute to the shrinkage of brain tissue. As the brain shrinks, the size of the brain may decrease, leading to a reduction in brain volume. Brain atrophy in Alzheimer's disease is often accompanied by changes in the structure and function of brain cells and the connections between them, leading to a decline in brain function. These toxic changes that accumulate can cause symptoms such as memory loss, difficulty with thinking and problem-solving, and changes in behavior and personality.Keywords: Alzheimer, amyloid-beta, brain atrophy, neuron, shrinkage
Procedia PDF Downloads 954492 Xerostomia and Caries Incidence in Relation to Metabolic Control in Children and Adolescents with Type 1 Diabetes
Authors: Eftychia Pappa, Heleni Vastardis, Christos Rahiotis, Andriani Vazaiou
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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 2894491 Resistance Training and Ginger Consumption on Cytokines Levels
Authors: Alireza Barari, Ahmad Abdi
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Regular body trainings cause adaption in various system in body. One of the important effect of body training is its effect on immune system. It seems that cytokines usually release after long period exercises or some exercises which cause skeletal muscular damages. If some of the cytokines which cause responses such as inflammation of cells in skeletal muscles, with manipulating of training program, it can be avoided or limited from those exercises which induct cytokines release. Ginger plant is a kind of medicinal plants which is known as a anti inflammation plant. This plant is as most precedence medicinal plants in medicine science especially in inflammation cure. The aim of the present study was the effect of selected resistance training and consumption of ginger extract on IL-1α and TNFα untrained young women. The population includes young women interested in participating in the study with the average of 30±2 years old from Abbas Abad city among which 32 participants were chosen randomly and divided into 4 four groups, resistance training (R), resistance training and ginger consumption(RG), Ginger consumption(G)and Control group(C). The training groups performed circuit resistance training at the intensity of 65-75% one repeat maximum, 3 days a week for 6 weeks. Besides resistance training, subjects were given either ginseng (5 mg/kg per day) or placebo. Prior to and 48 hours after interventions body composition was measured and blood samples were taken in order to assess serum levels of IL-1α and TNFα. Plasma levels of cytokines were measured with commercially available ELISA Kits.IL-1α kit and TNFα kit were used in this research. To demonstrate the effectiveness of the independent variable and the comparison between groups, t-test and ANOVA were used. To determine differences between the groups, the Scheffe test was used that showed significant changes in any of the variables. we observed that circuit resistance training in R and RG groups can significant decreased in weight and body mass index in untrained females (p<0.05). The results showed a significant decreased in the mean level of IL-1α levels before and after the training period in G group (p=0.046) and RG group (p=0.022). Comparison between groups also showed there was significant difference between groups R-RG and RG-C. Intergroup comparison results showed that the mean levels of TNFα before and after the training in group G (p=0.044) and RG (p=0.037), significantly decreased. Comparison between groups also showed there was significant difference between groups R–RG , R-G ,RG-C and G-C. The research shows that circuit resistance training with reducing overload method results in systemic inflammation had significant effect on IL-1α levels and TNFα. Of course, Ginger can counteract the negative effects of resistance training exercise on immune function and stability of the mast cell membrane. Considerable evidence supported the anti-inflammatory properties of ginger for several constituents, especially gingerols, shogaols, paradols, and zingerones, through decreased cytokine gene TNF α and IL-1Α expression and inhibition of cyclooxygenase 1 and 2. These established biological actions suggest that ingested ginger could block the increase in IL-1α.Keywords: resistance training, ginger, IL-1α , TNFα
Procedia PDF Downloads 4284490 Displaying Compostela: Literature, Tourism and Cultural Representation, a Cartographic Approach
Authors: Fernando Cabo Aseguinolaza, Víctor Bouzas Blanco, Alberto Martí Ezpeleta
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Santiago de Compostela became a stable object of literary representation during the period between 1840 and 1915, approximately. This study offers a partial cartographical look at this process, suggesting that a cultural space like Compostela’s becoming an object of literary representation paralleled the first stages of its becoming a tourist destination. We use maps as a method of analysis to show the interaction between a corpus of novels and the emerging tradition of tourist guides on Compostela during the selected period. Often, the novels constitute ways to present a city to the outside, marking it for the gaze of others, as guidebooks do. That leads us to examine the ways of constructing and rendering communicable the local in other contexts. For that matter, we should also acknowledge the fact that a good number of the narratives in the corpus evoke the representation of the city through the figure of one who comes from elsewhere: a traveler, a student or a professor. The guidebooks coincide in this with the emerging fiction, of which the mimesis of a city is a key characteristic. The local cannot define itself except through a process of symbolic negotiation, in which recognition and self-recognition play important roles. Cartography shows some of the forms that these processes of symbolic representation take through the treatment of space. The research uses GIS to find significant models of representation. We used the program ArcGIS for the mapping, defining the databases starting from an adapted version of the methodology applied by Barbara Piatti and Lorenz Hurni’s team at the University of Zurich. First, we designed maps that emphasize the peripheral position of Compostela from a historical and institutional perspective using elements found in the texts of our corpus (novels and tourist guides). Second, other maps delve into the parallels between recurring techniques in the fictional texts and characteristic devices of the guidebooks (sketching itineraries and the selection of zones and indexicalization), like a foreigner’s visit guided by someone who knows the city or the description of one’s first entrance into the city’s premises. Last, we offer a cartography that demonstrates the connection between the best known of the novels in our corpus (Alejandro Pérez Lugín’s 1915 novel La casa de la Troya) and the first attempt to create package tourist tours with Galicia as a destination, in a joint venture of Galician and British business owners, in the years immediately preceding the Great War. Literary cartography becomes a crucial instrument for digging deeply into the methods of cultural production of places. Through maps, the interaction between discursive forms seemingly so far removed from each other as novels and tourist guides becomes obvious and suggests the need to go deeper into a complex process through which a city like Compostela becomes visible on the contemporary cultural horizon.Keywords: compostela, literary geography, literary cartography, tourism
Procedia PDF Downloads 3934489 Competitive Effects of Differential Voting Rights and Promoter Control in Indian Start-Ups
Authors: Prateek Bhattacharya
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The definition of 'control' in India is a rapidly evolving concept, owing to varying rights attached to varying securities. Shares with differential voting rights (DVRs) provide the holder with differential rights as to voting, as compared to ordinary equity shareholders of the company. Such DVRs can amount to both superior voting rights and inferior voting rights, where DVRs with superior voting rights amount to providing the holder with golden shares in the company. While DVRs are not a novel concept in India having been recognized since 2000, they were placed on a back burner by the Securities and Exchange Board of India (SEBI) in 2010 after issuance of DVRs with superior voting rights was restricted. In June 2019, the SEBI rekindled the ebbing fire of DVRs, keeping mind the fast-paced nature of the global economy, the government's faith that India’s ‘new age technology companies’ (i.e., Start-Ups) will lead the charge in achieving its goal of India becoming a $5 trillion dollar economy by 2024, and recognizing that the promoters of such Start-Ups seek to raise capital without losing control over their companies. DVRs with superior voting rights guarantee promoters with up to 74% shareholding in Start-Ups for a period of 5 years, meaning that the holder of such DVRs can exercise sole control and material influence over the company for that period. This manner of control has the potential of causing both pro-competitive and anti-competitive effects in the markets where these companies operate. On the one hand, DVRs will allow Start-Up promoters/founders to retain control of their companies and protect its business interests from foreign elements such as private/public investors – in a scenario where such investors have multiple investments in firms engaged in associated lines of business (whether on a horizontal or vertical level) and would seek to influence these firms to enter into potential anti-competitive arrangements with one another, DVRs will enable the promoters to thwart such scenarios. On the other hand, promoters/founders who themselves have multiple investments in Start-Ups, which are in associated lines of business run the risk of influencing these associated Start-Ups to engage in potentially anti-competitive arrangements in the name of profit maximisation. This paper shall be divided into three parts: Part I shall deal with the concept of ‘control’, as deliberated upon and decided by the SEBI and the Competition Commission of India (CCI) under both company/securities law and competition law; Part II shall review this definition of ‘control’ through the lens of DVRs, and Part III shall discuss the aforementioned potential pro-competitive and anti-competitive effects caused by the DVRs by examining the current Indian Start-Up scenario. The paper shall conclude by providing suggestions for the CCI to incorporate a clearer and more progressive concept of ‘control’.Keywords: competition law, competitive effects, control, differential voting rights, DVRs, investor shareholding, merger control, start-ups
Procedia PDF Downloads 1244488 Corpus Linguistic Methods in a Theoretical Study of Quran Verb Tense and Aspect in Translations from Arabic to English
Authors: Jawharah Alasmari
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In inflectional morphology of verb, tense and aspect indicate action’s time either past/present or future and their period whether completed or not. The usage and meaning of tense and aspect differ in Arabic and English, therefore is no simple one -to- one mapping from an Arabic verb inflected form an appropriate English translation depends on a range of features, including immediate and wider context of use. The Quranic Arabic Corpus includes seven alternative expertly crafted English translations of each Arabic verses, which provides a test dataset for the study of appropriate Arabic to English translations of verb tense and aspect. We applied Corpus Linguistics Methods in a theoretical study of exemplary verbs, to elicit candidate verbal contexts which influence the choice of English inflection for each verse.Keywords: Corpus linguistics methods, Arabic verb, tense and aspect, English translations
Procedia PDF Downloads 3924487 A Study of Agile Based Approaches to Improve Software Quality
Authors: Gurmeet Kaur
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Agile software development methods are being recognized as popular, and efficient approach to the development of software system that has a short delivery period with high quality also that meets customer requirements with zero defect. In agile software development, quality means quality of code where in the quality is maintained through the use of methods or approaches like refactoring, test driven development, behavior driven development, acceptance test driven development, and demand driven development. Software quality is measured in term of metrics such as the number of defects during development of software. Usage of above mentioned methods or approaches, reduces the possibilities of defects in developed software, and hence improve quality. This paper focuses on study of agile based quality methods or approaches for software development that ensures improved quality of software as well as reduced cost, and customer satisfaction. Procedia PDF Downloads 1734486 An Experimental Study to Control Single Droplet by Actuating Waveform with Preliminary and Suppressing Vibration
Authors: Oke Oktavianty, Tadayuki Kyoutani, Shigeyuki Haruyama, Ken Kaminishi
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For advancing the experiment system standard of Inkjet printer that is being developed, the actual natural period, fire limitation number in droplet weight measurement and observation distance in droplet velocity measurement was investigated. In another side, the study to control the droplet volume in inkjet printer with negative actuating waveform method is still limited. Therefore, the effect of negative waveform with preliminary and suppressing vibration addition on the droplet formation process, droplet shape, volume and velocity were evaluated. The different voltage and print-head temperature were exerted to obtain the optimum preliminary and suppressing vibration. The mechanism of different phenomenon from each waveform was also discussed.
Keywords: inkjet printer, DoD, waveform, preliminary and suppressing vibration
Procedia PDF Downloads 2394485 Comparison of the Seismic Response of Planar Regular and Irregular Steel Frames
Authors: Robespierre Chavez, Eden Bojorquez, Alfredo Reyes-Salazar
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This study compares the seismic response of regular and vertically irregular steel frames determined by nonlinear time history analysis and by using several sets of earthquake records, which are divided in two categories: The first category having 20 stiff-soil ground motion records obtained from the NGA database, and the second category having 30 soft-soil ground motions recorded in the Lake Zone of Mexico City and exhibiting a dominant period (Ts) of two seconds. The steel frames in both format regular and irregular were designed according to the Mexico City Seismic Design Provisions (MCSDP). The effects of irregularity throught the height on the maximum interstory drifts are estimated.Keywords: irregular steel frames, maximum interstory drifts, seismic response, seismic records
Procedia PDF Downloads 3274484 Optimization of Hydraulic Fracturing for Horizontal Wells in Enhanced Geothermal Reservoirs
Authors: Qudratullah Muradi
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Geothermal energy is a renewable energy source that can be found in abundance on our planet. Only a small fraction of it is currently converted to electrical power, though in recent years installed geothermal capacity has increased considerably all over the world. In this paper, we assumed a model for designing of Enhanced Geothermal System, EGS. We used computer modeling group, CMG reservoir simulation software to create the typical Hot Dry Rock, HDR reservoir. In this research two wells, one injection of cold water and one production of hot water are included in the model. There are some hydraulic fractures created by the mentioned software. And cold water is injected in order to produce energy from the reservoir. The result of injecting cold water to the reservoir and extracting geothermal energy is defined by some graphs at the end of this research. The production of energy is quantified in a period of 10 years.Keywords: geothermal energy, EGS, HDR, hydraulic fracturing
Procedia PDF Downloads 2004483 20 Definitions in 20 Years: Exploring the Evolution of Blended Learning Definitions from 2003-2022
Authors: Damian Gordon, Paul Doyle, Anna Becevel, Tina Baloh
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The goal of this research is to explore the evolution of the concept of “blended learning” over a twenty-year period, to see whether or not the conceptualization has remained consistent or if it has become either more specific or more general. To achieve this goal, the term “blended learning” (and variations) was searched for in various bibliographical repositories for each year 2003-2022 to locate a highly cited paper that is not behind a paywall, to locate unique definitions that would be freely available to all academics each year. Each of the twenty unique definitions is explored to identify how they categorize both the Classroom Component and the Computer Component of blended learning, as well as identify which discipline each definition originates from and which country it comes from to see if there are any significant geographical variations. Based on this analysis, trends that appear in the definitions are noted, as well as an overall interpretation of the notion of “Blended Learning.”Keywords: blended learning, definitions of blended learning, e-learning, thematic searches
Procedia PDF Downloads 1304482 River's Bed Level Changing Pattern Due to Sedimentation, Case Study: Gash River, Kassala, Sudan
Authors: Faisal Ali, Hasssan Saad Mohammed Hilmi, Mustafa Mohamed, Shamseddin Musa
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The Gash rivers an ephemeral river, it usually flows from July to September, it has a braided pattern with high sediment content, of 15200 ppm in suspension, and 360 kg/sec as bed load. The Gash river bed has an average slope of 1.3 m/Km. The objectives of this study were: assessing the Gash River bed level patterns; quantifying the annual variations in Gash bed level; and recommending a suitable method to reduce the sediment accumulation on the Gash River bed. The study covered temporally the period 1905-2013 using datasets included the Gash river flows, and the cross sections. The results showed that there is an increasing trend in the river bed of 5 cm3 per year. This is resulted in changing the behavior of the flood routing and consequently the flood hazard is tremendously increased in Kassala city.Keywords: bed level, cross section, gash river, sedimentation
Procedia PDF Downloads 5434481 A Cross-Sectional Study of Parents’ Knowledge, Attitude, and Health-Seeking Behaviour Towards Childhood Tuberculosis during COVID-19 Pandemic: Lessons Learned from Indonesia
Authors: Windy Rakhmawati, Suryani Suryani, Sri Hendrawati, Nenden Nur Asriyani Maryam
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Tuberculosis (TB) is one of the leading causes of death in the world. Fear of COVID-19 has made people reluctant to visit health facilities, leading to disruptions to childhood TB control programs, which may increase household transmission and delay diagnosis and treatment. This study aimed to describe parents' knowledge, attitudes, and health-seeking behaviour towards childhood TB during the COVID-19 pandemic. This cross-sectional study was performed on 392 parents with TB children in three provinces with the highest proportion of TB cases in Indonesia. This study was conducted from February to December 2022. The inclusion criteria of respondents were parents with a child aged 0-14 years old with TB diagnosis who live with their parents. Data were collected using the Knowledge, Attitude, and Practice (KAP) survey guidelines from the World Health Organization and analyzed descriptively, as well as Spearman’s correlation. Overall, 392 parents of children with TB had poor knowledge (51.8%) including about causes, risk factors, transmission, symptoms, treatment, and prevention, which about 52.3%, 55.1%, 61.2%, 69.6%, 100%, 59.2%, respectively. Parents' health service-seeking behaviour towards Child TB was not normally distributed (P < 0.05) with knowledge test results (.000) and Seeking Health Services (.000). Health-seeking behaviour of parents in pediatric TB care was self-medication or self-treatment (86.2%), Traditional health seeking behaviour (4.8%), and modern health seeking behaviour (8.9%). The correlation between knowledge and seeking health services (Sig= .609) means there is no correlation between knowledge about TB and parents' health-seeking behaviour. Furthermore, 60.2% of the respondents would be shocked if their child had TB. More than half of the families in this study have poor knowledge and did self-medication or self-treatment regarding health-seeking behaviour for TB disease. Therefore, health workers, especially nurses, must provide TB-related education and health promotion and emphasize the importance of early detection. Health workers can also optimize their role in caring for and providing care to patients by increasing their trust in health workers, which will impact health-seeking behaviour in the future.Keywords: attitude, child, health seeking behaviour, knowledge, tuberculosis
Procedia PDF Downloads 704480 Assessing the Impact of Frailty in Elderly Patients Undergoing Emergency Laparotomies in Singapore
Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan
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Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.Keywords: frailty elderly, emergency, laparotomy
Procedia PDF Downloads 1474479 A Versatile Data Processing Package for Ground-Based Synthetic Aperture Radar Deformation Monitoring
Authors: Zheng Wang, Zhenhong Li, Jon Mills
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Ground-based synthetic aperture radar (GBSAR) represents a powerful remote sensing tool for deformation monitoring towards various geohazards, e.g. landslides, mudflows, avalanches, infrastructure failures, and the subsidence of residential areas. Unlike spaceborne SAR with a fixed revisit period, GBSAR data can be acquired with an adjustable temporal resolution through either continuous or discontinuous operation. However, challenges arise from processing high temporal-resolution continuous GBSAR data, including the extreme cost of computational random-access-memory (RAM), the delay of displacement maps, and the loss of temporal evolution. Moreover, repositioning errors between discontinuous campaigns impede the accurate measurement of surface displacements. Therefore, a versatile package with two complete chains is developed in this study in order to process both continuous and discontinuous GBSAR data and address the aforementioned issues. The first chain is based on a small-baseline subset concept and it processes continuous GBSAR images unit by unit. Images within a window form a basic unit. By taking this strategy, the RAM requirement is reduced to only one unit of images and the chain can theoretically process an infinite number of images. The evolution of surface displacements can be detected as it keeps temporarily-coherent pixels which are present only in some certain units but not in the whole observation period. The chain supports real-time processing of the continuous data and the delay of creating displacement maps can be shortened without waiting for the entire dataset. The other chain aims to measure deformation between discontinuous campaigns. Temporal averaging is carried out on a stack of images in a single campaign in order to improve the signal-to-noise ratio of discontinuous data and minimise the loss of coherence. The temporal-averaged images are then processed by a particular interferometry procedure integrated with advanced interferometric SAR algorithms such as robust coherence estimation, non-local filtering, and selection of partially-coherent pixels. Experiments are conducted using both synthetic and real-world GBSAR data. Displacement time series at the level of a few sub-millimetres are achieved in several applications (e.g. a coastal cliff, a sand dune, a bridge, and a residential area), indicating the feasibility of the developed GBSAR data processing package for deformation monitoring of a wide range of scientific and practical applications.Keywords: ground-based synthetic aperture radar, interferometry, small baseline subset algorithm, deformation monitoring
Procedia PDF Downloads 1634478 Achieving Process Stability through Automation and Process Optimization at H Blast Furnace Tata Steel, Jamshedpur
Authors: Krishnendu Mukhopadhyay, Subhashis Kundu, Mayank Tiwari, Sameeran Pani, Padmapal, Uttam Singh
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Blast Furnace is a counter current process where burden descends from top and hot gases ascend from bottom and chemically reduce iron oxides into liquid hot metal. One of the major problems of blast furnace operation is the erratic burden descent inside furnace. Sometimes this problem is so acute that burden descent stops resulting in Hanging and instability of the furnace. This problem is very frequent in blast furnaces worldwide and results in huge production losses. This situation becomes more adverse when blast furnaces are operated at low coke rate and high coal injection rate with adverse raw materials like high alumina ore and high coke ash. For last three years, H-Blast Furnace Tata Steel was able to reduce coke rate from 450 kg/thm to 350 kg/thm with an increase in coal injection to 200 kg/thm which are close to world benchmarks and expand profitability. To sustain this regime, elimination of irregularities of blast furnace like hanging, channeling, and scaffolding is very essential. In this paper, sustaining of zero hanging spell for consecutive three years with low coke rate operation by improvement in burden characteristics, burden distribution, changes in slag regime, casting practices and adequate automation of the furnace operation has been illustrated. Models have been created to comprehend and upgrade the blast furnace process understanding. A model has been developed to predict the process of maintaining slag viscosity in desired range to attain proper burden permeability. A channeling prediction model has also been developed to understand channeling symptoms so that early actions can be initiated. The models have helped to a great extent in standardizing the control decisions of operators at H-Blast Furnace of Tata Steel, Jamshedpur and thus achieving process stability for last three years.Keywords: hanging, channelling, blast furnace, coke
Procedia PDF Downloads 1974477 Atmospheric Circulation Drivers Of Nationally-Aggregated Wind Energy Production Over Greece
Authors: Kostas Philippopoulos, Chris G. Tzanis, Despina Deligiorgi
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Climate change adaptation requires the exploitation of renewable energy sources such as wind. However, climate variability can affect the regional wind energy potential and consequently the available wind power production. The goal of the research project is to examine the impact of atmospheric circulation on wind energy production over Greece. In the context of synoptic climatology, the proposed novel methodology employs Self-Organizing Maps for grouping and classifying the atmospheric circulation and nationally-aggregated capacity factor time series for a 30-year period. The results indicate the critical effect of atmospheric circulation on the national aggregated wind energy production values and therefore address the issue of optimum distribution of wind farms for a specific region.Keywords: wind energy, atmospheric circulation, capacity factor, self-organizing maps
Procedia PDF Downloads 1624476 The Impact of the Global Financial Crises on MILA Stock Markets
Authors: Miriam Sosa, Edgar Ortiz, Alejandra Cabello
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This paper examines the volatility changes and leverage effects of the MILA stock markets and their changes since the 2007 global financial crisis. This group integrates the stock markets from Chile, Colombia, Mexico and Peru. Volatility changes and leverage effects are tested with a symmetric GARCH (1,1) and asymmetric TARCH (1,1) models with a dummy variable in the variance equation. Daily closing prices of the stock indexes of Chile (IPSA), Colombia (COLCAP), Mexico (IPC) and Peru (IGBVL) are examined for the period 2003:01 to 2015:02. The evidence confirms the presence of an overall increase in asymmetric market volatility in the Peruvian share market since the 2007 crisis.Keywords: financial crisis, Latin American Integrated Market, TARCH, GARCH
Procedia PDF Downloads 2794475 Determination of the Gain in Learning the Free-Fall Motion of Bodies by Applying the Resource of Previous Concepts
Authors: Ricardo Merlo
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In this paper, we analyzed the different didactic proposals for teaching about the free fall motion of bodies available online. An important aspect was the interpretation of the direction and sense of the acceleration of gravity and of the falling velocity of a body, which is why we found different applications of the Cartesian reference system used and also different graphical presentations of the velocity as a function of time and of the distance traveled vertically by the body in the period of time that it was dropped from a height h0. In this framework, a survey of previous concepts was applied to a voluntary group of first-year university students of an Engineering degree before and after the development of the class of the subject in question. Then, Hake's index (0.52) was determined, which resulted in an average learning gain from the meaningful use of the reference system and the respective graphs of v=ƒ (t) and h=ƒ (t).Keywords: didactic gain, free–fall, physics teaching, previous knowledge
Procedia PDF Downloads 1634474 Discovering the Effects of Meteorological Variables on the Air Quality of Bogota, Colombia, by Data Mining Techniques
Authors: Fabiana Franceschi, Martha Cobo, Manuel Figueredo
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Bogotá, the capital of Colombia, is its largest city and one of the most polluted in Latin America due to the fast economic growth over the last ten years. Bogotá has been affected by high pollution events which led to the high concentration of PM10 and NO2, exceeding the local 24-hour legal limits (100 and 150 g/m3 each). The most important pollutants in the city are PM10 and PM2.5 (which are associated with respiratory and cardiovascular problems) and it is known that their concentrations in the atmosphere depend on the local meteorological factors. Therefore, it is necessary to establish a relationship between the meteorological variables and the concentrations of the atmospheric pollutants such as PM10, PM2.5, CO, SO2, NO2 and O3. This study aims to determine the interrelations between meteorological variables and air pollutants in Bogotá, using data mining techniques. Data from 13 monitoring stations were collected from the Bogotá Air Quality Monitoring Network within the period 2010-2015. The Principal Component Analysis (PCA) algorithm was applied to obtain primary relations between all the parameters, and afterwards, the K-means clustering technique was implemented to corroborate those relations found previously and to find patterns in the data. PCA was also used on a per shift basis (morning, afternoon, night and early morning) to validate possible variation of the previous trends and a per year basis to verify that the identified trends have remained throughout the study time. Results demonstrated that wind speed, wind direction, temperature, and NO2 are the most influencing factors on PM10 concentrations. Furthermore, it was confirmed that high humidity episodes increased PM2,5 levels. It was also found that there are direct proportional relationships between O3 levels and wind speed and radiation, while there is an inverse relationship between O3 levels and humidity. Concentrations of SO2 increases with the presence of PM10 and decreases with the wind speed and wind direction. They proved as well that there is a decreasing trend of pollutant concentrations over the last five years. Also, in rainy periods (March-June and September-December) some trends regarding precipitations were stronger. Results obtained with K-means demonstrated that it was possible to find patterns on the data, and they also showed similar conditions and data distribution among Carvajal, Tunal and Puente Aranda stations, and also between Parque Simon Bolivar and las Ferias. It was verified that the aforementioned trends prevailed during the study period by applying the same technique per year. It was concluded that PCA algorithm is useful to establish preliminary relationships among variables, and K-means clustering to find patterns in the data and understanding its distribution. The discovery of patterns in the data allows using these clusters as an input to an Artificial Neural Network prediction model.Keywords: air pollution, air quality modelling, data mining, particulate matter
Procedia PDF Downloads 2594473 Social Reforms and the Welfare State in America after the New Deal (1945-1969)
Authors: Aziza Tahar Djebbar
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Throughout American history, many American presidents have tried to create new reforms to enhance the living conditions of the American citizens and promote their welfare. Among these reforms were those dealing with health care, education, as well as social security, which would facilitate accordingly the evolution of the American welfare state. After the New Deal, from 1945 to 1969, American presidents sought to carry out and enlarge the scope of the welfare state that emerged during the Roosevelt Administration by introducing new social reforms. Yet, there were some American presidents who succeeded, and there were some presidents who failed.The task of this research work is to depict the postwar period from 1945 to 1969. Some light will be shed on the main causes that led to the delay of many programs from 1945 to 1960. Further, the focus will be on the main factors that contributed to the reappearance of many social reforms and the dramatic expansion of the welfare state all along the 1960s.Keywords: new deal, great society, medicaid, medicare, war on poverty, social reforms, welfare reforms
Procedia PDF Downloads 4584472 Analyzing Electricity Demand Multipliers in the Malaysian Economy
Authors: Hussain Ali Bekhet, Tuan Ab Rashid Bin Tuan Abdullah, Tahira Yasmin
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It is very important for electric utility to determine dominant sectors which have more impacts on electricity consumption in national economy system. The aim of this paper is to examine the electricity demand multipliers in Malaysia for (2005-2014) period. Malaysian Input-output tables, 2005 and 2010 are used. Besides, a new concept, electricity demand multiplier (EDM), is presented to identify key sectors imposing great impacts on electricity demand quantitatively. In order to testify the effectiveness of the Malaysian energy policies, it notes that there is fluctuation of the ranking sectors between 2005 and 2010. This could be reflected that there is efficiency with pace of development in Malaysia. This can be good indication for decision makers for designing future energy policies.Keywords: input-output model, demand multipliers, electricity, key sectors, Malaysia
Procedia PDF Downloads 3724471 Predictability of Kiremt Rainfall Variability over the Northern Highlands of Ethiopia on Dekadal and Monthly Time Scales Using Global Sea Surface Temperature
Authors: Kibrom Hadush
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Countries like Ethiopia, whose economy is mainly rain-fed dependent agriculture, are highly vulnerable to climate variability and weather extremes. Sub-seasonal (monthly) and dekadal forecasts are hence critical for crop production and water resource management. Therefore, this paper was conducted to study the predictability and variability of Kiremt rainfall over the northern half of Ethiopia on monthly and dekadal time scales in association with global Sea Surface Temperature (SST) at different lag time. Trends in rainfall have been analyzed on annual, seasonal (Kiremt), monthly, and dekadal (June–September) time scales based on rainfall records of 36 meteorological stations distributed across four homogenous zones of the northern half of Ethiopia for the period 1992–2017. The results from the progressive Mann–Kendall trend test and the Sen’s slope method shows that there is no significant trend in the annual, Kiremt, monthly and dekadal rainfall total at most of the station's studies. Moreover, the rainfall in the study area varies spatially and temporally, and the distribution of the rainfall pattern increases from the northeast rift valley to northwest highlands. Methods of analysis include graphical correlation and multiple linear regression model are employed to investigate the association between the global SSTs and Kiremt rainfall over the homogeneous rainfall zones and to predict monthly and dekadal (June-September) rainfall using SST predictors. The results of this study show that in general, SST in the equatorial Pacific Ocean is the main source of the predictive skill of the Kiremt rainfall variability over the northern half of Ethiopia. The regional SSTs in the Atlantic and the Indian Ocean as well contribute to the Kiremt rainfall variability over the study area. Moreover, the result of the correlation analysis showed that the decline of monthly and dekadal Kiremt rainfall over most of the homogeneous zones of the study area are caused by the corresponding persistent warming of the SST in the eastern and central equatorial Pacific Ocean during the period 1992 - 2017. It is also found that the monthly and dekadal Kiremt rainfall over the northern, northwestern highlands and northeastern lowlands of Ethiopia are positively correlated with the SST in the western equatorial Pacific, eastern and tropical northern the Atlantic Ocean. Furthermore, the SSTs in the western equatorial Pacific and Indian Oceans are positively correlated to the Kiremt season rainfall in the northeastern highlands. Overall, the results showed that the prediction models using combined SSTs at various ocean regions (equatorial and tropical) performed reasonably well in the prediction (With R2 ranging from 30% to 65%) of monthly and dekadal rainfall and recommends it can be used for efficient prediction of Kiremt rainfall over the study area to aid with systematic and informed decision making within the agricultural sector.Keywords: dekadal, Kiremt rainfall, monthly, Northern Ethiopia, sea surface temperature
Procedia PDF Downloads 1424470 Translating Creativity to an Educational Context: A Method to Augment the Professional Training of Newly Qualified Secondary School Teachers
Authors: Julianne Mullen-Williams
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This paper will provide an overview of a three year mixed methods research project that explores if methods from the supervision of dramatherapy can augment the occupational psychology of newly qualified secondary school teachers. It will consider how creativity and the use of metaphor, as applied in the supervision of dramatherapists, can be translated to an educational context in order to explore the explicit / implicit dynamics between the teacher trainee/ newly qualified teacher and the organisation in order to support the super objective in training for teaching; how to ‘be a teacher.’ There is growing evidence that attrition rates among teachers are rising after only five years of service owing to too many national initiatives, an unmanageable curriculum and deteriorating student discipline. The fieldwork conducted entailed facilitating a reflective space for Newly Qualified Teachers from all subject areas, using methods from the supervision of dramatherapy, to explore the social and emotional aspects of teaching and learning with the ultimate aim of improving the occupational psychology of teachers. Clinical supervision is a formal process of professional support and learning which permits individual practitioners in frontline service jobs; counsellors, psychologists, dramatherapists, social workers and nurses to expand their knowledge and proficiency, take responsibility for their own practice, and improve client protection and safety of care in complex clinical situations. It is deemed integral to continued professional practice to safeguard vulnerable people and to reduce practitioner burnout. Dramatherapy supervision incorporates all of the above but utilises creative methods as a tool to gain insight and a deeper understanding of the situation. Creativity and the use of metaphor enable the supervisee to gain an aerial view of the situation they are exploring. The word metaphor in Greek means to ‘carry across’ indicating a transfer of meaning form one frame of reference to another. The supervision support was incorporated into each group’s induction training programme. The first year group attended fortnightly one hour sessions, the second group received two one hour sessions every term. The existing literature on the supervision and mentoring of secondary school teacher trainees calls for changes in pre-service teacher education and in the induction period. There is a particular emphasis on the need to include reflective and experiential learning, within training programmes and within the induction period, in order to help teachers manage the interpersonal dynamics and emotional impact within a high pressurised environmentKeywords: dramatherapy supervision, newly qualified secondary school teachers, professional development, teacher education
Procedia PDF Downloads 3884469 Bronchoscopy and Genexpert in the Diagnosis of Pulmonary Tuberculosis in the Indian Private Health Sector: A Short Case Series
Authors: J. J. Mathew
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Pulmonary tuberculosis is highly prevalent in the Indian subcontinent. Most cases of pulmonary tuberculosis are diagnosed with sputum examinations and the vast majority of these are undertaken by the government run establishments. However, mycobacterial cultures are not routinely done, unless drug resistance is detected based on clinical response. Modern diagnostic tests like bronchoscopy and Genexpert are not routinely employed in the government institutions for the diagnosis of pulmonary tuberculosis, but have been accepted widely by good private institutions. The utility of these investigations in the private sector is not yet well recognized. This retrospective study aims to assess the usefulness of bronchoscopy and Genexpert in the diagnosis of pulmonary tuberculosis in quaternary care private hospital in India. 30 patients with respiratory symptoms raising the possibility of tuberculosis based on clinical and radiological features, but without any significant sputum production, were subject to bronchoscopy and BAL samples taken for microbiological studies, including Genexpert. 6 out of the 30 patients were found to be Genexpert positive and none of them showed Rifampicin resistance. All the 6 cases had upper zone predominant disease. One of the 6 cases of tuberculosis had another co-existent bacterial infection according to the routine culture studies. 6 other cases were proven to be due to other bacterial infections alone, 2 had a malignant diagnosis and the remaining cases were thought to be non-infective pathologies. The Genexpert results were made available within 48 hours in the 6 positive cases. All of them were commenced on standard anti-tuberculous regimen with excellent clinical response. The other infective cases were also managed successfully based on the drug susceptibilities. The study has shown the usefulness of these investigations as early intervention enabled diagnosis facilitating treatment and prevention of any clinical deterioration. The study lends support to early bronchoscopy and Genexpert testing in suspected cases of pulmonary tuberculosis without significant sputum production, in a high prevalence country which normally relies on sputum examination for the diagnosis of pulmonary tuberculosis.Keywords: pulmonary, tuberculosis, bronchoscopy, genexpert
Procedia PDF Downloads 2454468 A Robust Optimization for Multi-Period Lost-Sales Inventory Control Problem
Authors: Shunichi Ohmori, Sirawadee Arunyanart, Kazuho Yoshimoto
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We consider a periodic review inventory control problem of minimizing production cost, inventory cost, and lost-sales under demand uncertainty, in which product demands are not specified exactly and it is only known to belong to a given uncertainty set, yet the constraints must hold for possible values of the data from the uncertainty set. We propose a robust optimization formulation for obtaining lowest cost possible and guaranteeing the feasibility with respect to range of order quantity and inventory level under demand uncertainty. Our formulation is based on the adaptive robust counterpart, which suppose order quantity is affine function of past demands. We derive certainty equivalent problem via second-order cone programming, which gives 'not too pessimistic' worst-case.Keywords: robust optimization, inventory control, supply chain managment, second-order programming
Procedia PDF Downloads 4104467 Stress Variation of Underground Building Structure during Top-Down Construction
Authors: Soo-yeon Seo, Seol-ki Kim, Su-jin Jung
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In the construction of a building, it is necessary to minimize construction period and secure enough work space for stacking of materials during the construction especially in city area. In this manner, various top-down construction methods have been developed and widely used in Korea. This paper investigates the stress variation of underground structure of a building constructed by using SPS (Strut as Permanent System) known as a top-down method in Korea through an analytical approach. Various types of earth pressure distribution related to ground condition were considered in the structural analysis of an example structure at each step of the excavation. From the analysis, the most high member force acting on beams was found when the ground type was medium sandy soil and a stress concentration was found in corner area.Keywords: construction of building, top-down construction method, earth pressure distribution, member force, stress concentration
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