Search results for: interest rate risk

Authors: Taikchan Lildar, Ayesha Samad, Suraj Sookhu

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Atrial fibrillation with rapid ventricular response results in the loss of atrial kick and shortened ventricular filling time, which often leads to decompensated heart failure. Pharmacologic rhythm control is the treatment of choice, and patients frequently benefit from the restoration of sinus rhythm. When pharmacologic treatment is unsuccessful or a patient declines hemodynamically, direct cardioversion is the treatment of choice. Torsades de pointes or “twisting of the points'' in French, is a rare but under-appreciated risk of cardioversion therapy and accounts for a significant number of sudden cardiac death each year. A 61-year-old female with no significant past medical history presented to the Emergency Department with worsening dyspnea. An electrocardiogram showed atrial fibrillation with rapid ventricular response, and a chest X-ray was significant for bilateral pulmonary vascular congestion. Full-dose anticoagulation and diuresis were initiated with moderate improvement in symptoms. A transthoracic echocardiogram revealed biventricular systolic dysfunction with a left ventricular ejection fraction of 30%. After consultation with an electrophysiologist, the consensus was to proceed with the restoration of sinus rhythm, which would likely improve the patient’s heart failure symptoms and possibly the ejection fraction. A transesophageal echocardiogram was negative for left atrial appendage thrombus; the patient was treated with a loading dose of amiodarone and underwent successful direct current cardioversion with 200 Joules. The patient was placed on telemetry monitoring for 24 hours and was noted to have frequent premature ventricular contractions with subsequent degeneration to torsades de pointes. The patient was found unresponsive and pulseless; cardiopulmonary resuscitation was initiated with cardioversion, and return of spontaneous circulation was achieved after four minutes to normal sinus rhythm. Post-cardiac arrest electrocardiogram showed sinus bradycardia with heart-rate corrected QT interval of 592 milliseconds. The patient continued to have frequent premature ventricular contractions and required two additional cardioversions to achieve a return of spontaneous circulation with intravenous magnesium and lidocaine. An automatic implantable cardioverter-defibrillator was subsequently implanted for secondary prevention of sudden cardiac death. The backup pacing rate of the automatic implantable cardioverter-defibrillator was set higher than usual in an attempt to prevent premature ventricular contractions-induced torsades de pointes. The patient did not have any further ventricular arrhythmias after implantation of the automatic implantable cardioverter-defibrillator. Overdrive pacing is a method utilized to treat premature ventricular contractions-induced torsades de pointes by preventing a patient’s susceptibility to R on T-wave-induced ventricular arrhythmias. Pacing at a rate of 90 beats per minute succeeded in controlling the arrhythmia without the need for traumatic cardiac defibrillation. In our patient, conversion of atrial fibrillation with rapid ventricular response to normal sinus rhythm resulted in a slower heart rate and an increased probability of premature ventricular contraction occurring on the T-wave and ensuing ventricular arrhythmia. This case highlights direct current cardioversion for atrial fibrillation with rapid ventricular response resulting in persistent ventricular arrhythmia requiring an automatic implantable cardioverter-defibrillator placement with overdrive pacing to prevent a recurrence.

Keywords: refractory atrial fibrillation, atrial fibrillation, overdrive pacing, torsades de pointes

Procedia PDF Downloads 121

Authors: Nhung T. Bui

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Part of the dilemma facing educational reforms in Vietnam as in other Asian contexts is how to encourage more independence in students’ learning approaches. Since 2005, the Ministry of Education and Training of Vietnam has included the students’ ability to learn independently in its national education objectives. While learner autonomy has been viewed as a goal in the teaching and learning English as a foreign language (EFL) and there has been a considerable literature on strategies to stimulate autonomy in learners, teachers’ voices have rarely been heard. Given that teachers play a central role in helping their students to be more autonomous, especially in an inherent Confucian heritage culture like Vietnam, their attitudes towards learner autonomy should be investigated before any practical implementations could be undertaken. This paper reports significant findings of a survey questionnaire with 262 lecturers of English from 5 universities in Hanoi, Vietnam giving opinions regarding the practices and prospects of learner autonomy in their classrooms. The study reveals that lecturers perceive they should be more responsible than their students in all class-related activities; they most appreciate their students’ ability to learn cooperatively and that they consider stimulating students’ interest as the most important teaching strategy to promote learner autonomy. Lecturers, then, are strongly suggested to gradually ‘empower’ their students through the application of out-of-classroom activities; of learning activities which requires collaboration and team spirit; and of activities which could boost students’ interest in learning English.

Keywords: English as a foreign language, higher education, learner autonomy, Vietnam

Procedia PDF Downloads 252

Authors: Kelsey Scanlon

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Introduction: With the rate of female collegiate and professional athletes on the rise in recent decades, fluctuations in physical performance in relation to the menstrual cycle is an important area of study. PURPOSE: The purpose of this research was to compare differences in upper and lower body maximal anaerobic capacities across a single menstrual cycle. Methode: Participants (n=11) met a total of four times; once for familiarization and again on day 1 of menses (follicular phase), day 14 (ovulation), and day 21 (luteal phase) respectively. Upper body power was assessed using a bench press weight of ~50% of the participant’s predetermined 1-repetition maximum (1-RM) on a ballistic measurement system and variables included peak force (N), mean force (N), peak power (W), mean power (W), and peak velocity (m/s). Lower body power output was collected using a standard Wingate test. The variables of interest were anaerobic capacity (w/kg), peak power (W), mean power (W), fatigue index (W/s), and total work (J). Result: Statistical significance was not observed (p > 0.05) in any of the aforementioned variables after completing multiple one ways of analyses of variances (ANOVAs) with repeated measures on time. Conclusion: Within the parameters of this research, neither female upper nor lower body power output differed across the menstrual cycle when analyzed using 50% of one repetition (1RM) maximal bench press and the 30-second maximal effort cycle ergometer Wingate test. Therefore, researchers should not alter their subject populations due to the incorrect assumption that power output may be influenced by the menstrual cycle.

Keywords: anaerobic, athlete, female, power

Procedia PDF Downloads 137

Authors: Samuel Nderitu Muchiri, Tracy Wangechi Maina

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Truck drivers face a myriad of challenges in their profession. Enhancements in logistics effectiveness can be pivotal in propelling economic developments. The specific objective of the study was to assess the influence of driver distraction on crash risk. The study is significant as it elucidates best practices that truck drivers can embrace in an effort to enhance road safety. These include amalgamating behaviors that enable drivers to fruitfully execute multifaceted functions such as finding and following routes, evading collisions, monitoring speed, adhering to road regulations, and evaluating vehicle systems’ conditions. The analysis involved an empirical review of ten previous studies related to the research topic. The articles revealed that driver distraction plays a substantial role in road accidents and other crucial road security incidents across the globe. Africa depends immensely on the freight transport sector to facilitate supply chain operations. Several studies indicate that drivers who operate primarily on rural roads, such as those found in Sub-Saharan Africa, have an increased propensity to engage in distracted activities such as cell phone usage while driving. The findings also identified the need for digitalization in truck driving operations, including carrier management techniques such as fatigue management, artificial intelligence, and automating functions like cell phone usage controls. The recommendations can aid policymakers and commercial truck carriers in deepening their understanding of driver distraction and enforcing mitigations to foster road safety.

Keywords: truck drivers, distraction, digitalization, crash risk, road safety

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Authors: Arpine Maghakyan

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The purpose of this paper is to study the relationship between the level of industry digitalization and audit fees, especially, the relationship between Big 4 auditor fees and industry digitalization level. On the one hand, automation of business processes decreases internal control weakness and manual mistakes; increases work effectiveness and integrations. On the other hand, it may cause serious misstatements, high business risks or even bankruptcy, typically in early stages of automation. Incomplete automation can bring high audit risk especially if the auditor does not fully understand client’s business automation model. Higher audit risk consequently will cause higher audit fees. Higher audit fees for clients with high automation level are more highlighted in Big 4 auditor’s behavior. Using data of US firms from 2005-2015, we found that industry level digitalization is an interaction for the auditor quality on audit fees. Moreover, the choice of Big4 or non-Big4 is correlated with client’s industry digitalization level. Big4 client, which has higher digitalization level, pays more than one with low digitalization level. In addition, a high-digitalized firm that has Big 4 auditor pays higher audit fee than non-Big 4 client. We use audit fees and firm-specific variables from Audit Analytics and Compustat databases. We analyze collected data by using fixed effects regression methods and Wald tests for sensitivity check. We use fixed effects regression models for firms for determination of the connections between technology use in business and audit fees. We control for firm size, complexity, inherent risk, profitability and auditor quality. We chose fixed effects model as it makes possible to control for variables that have not or cannot be measured.

Keywords: audit fees, auditor quality, digitalization, Big4

Procedia PDF Downloads 285

Authors: Esra Yuce, Isil D. S. Yamaner, Murude Yazan

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Aims and objective: Antiresorptive agents including bisphosphonates and denosumab as strong suppressors of osteoclasts are the most commonly used antiresorptive medications for the treatment of osteoporosis which counteract the negative quantitative alteration of trabecular and cortical bone by inhibition of bone turnover. Oral bisphosphonate therapy for the treatment of osteopenia, osteoporosis or Paget's disease is associated with the low-grade risk of osteonecrosis of the jaw, while higher-grade risk is associated with receiving intravenous bisphosphonates therapy in the treatment of multiple myeloma and bone metastases. On the other hand, there has been a remarkable increase in incidences of antiresorptive related osteonecrosis of the jaw (ARONJ) in oral bisphosphonate users. This clinical presentation will evaluate the healing outcomes via piezoelectric bone surgery under the irrigation of PVP-I solution irrigation in patients received bisphosphonate therapy. Material-Method: The study involved 8 female and 5 male patients that have been treated for ARONJ. Among 13 necrotic sites, 9 were in the mandible and 4 were in the maxilla. All of these 13 patients treated with surgical debridement via piezoelectric bone surgery under irrigation by solution with 3% PVP-I concentration in combination with long-term antibiotic therapy and 5 also underwent removal of mobile segments of bony sequestrum. All removable prosthesis in 8 patients were relined with soft liners during the healing periods in order to eliminate chronic minor traumas. Results: All patients were on oral bisphosphonate therapy for at least 2 years and 5 of which had received intravenous bisphosphonates up to 1 year before therapy with oral bisphosphonates was started. According to the AAOMS staging system, four cases were stage II, eight cases were stage I, and one case was stage III. The majority of lesions were identified at sites of dental prostheses (38%) and dental extractions (62%). All patients diagnosed with ARONJ stage I had used unadjusted removable prostheses. No recurrence of the symptoms was observed during the present follow-up (9–37 months). Conclusion: Despite their confirmed effectiveness, the prevention and treatment of osteonecrosis of the jaw secondary to oral bisphosphonate therapy remain major medical challenges. Treatment with piezoelectric bone surgery with irrigation of povidone-iodine solution was effective for management of bisphosphonate-related osteonecrosis of the jaw. Taking precautions for patients treated with oral bisphosphonates, especially also denture users, may allow for a reduction in the rate of developing osteonecrosis of the maxillofacial region.

Keywords: antiresorptive drug related osteonecrosis, bisphosphonate therapy, piezoelectric bone surgery, povidone iodine

Procedia PDF Downloads 248

Authors: Jalal Sharib@Sarip, Dainee nor Fardzila Ahmad Tugi, Mohd Tarmizi Ishak, Mohd Izwan Abdul Adziz

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This research paper aims to determine the rate of soil erosion and sedimentation by using Cesium-137,137Cs as a medium-term tracer in the Sembrong catchment, Malaysia, over two different study seasons. The results of the analysis show that rates of soil erosion and sedimentation for both seasons were variable. This can be clearly seen where the dry season only gives the value of the rate of soil erosion. Meanwhile, the wet season has given both soil erosion and sedimentation rate values. The dry season had rates of soil erosion between 5.09 t/ha/y to 51.03 t/ha/y. The wet season had soil erosion and sedimentation rates between 8.02 t/ha/y to 39.78 t/ha/y and -4.81 t/ha/y to - 50.81 t/ha/y, each, respectively. rubber and oil palm plantations referring to Station 17 and station 4/6, located near Semberong Lake and Sembrong River, had the highest rates of soil erosion and sedimentation at 51.03 t/ha/y and -50.81 t/ha/y, respectively. Various factors must also be taken into account, such as soil types, the total volume of rainfall received for both seasons, as well as differences in land use at the study stations. In conclusion, 137Cs as a medium-term tracer was successfully used to determine rates of soil erosion and sedimentation in two different seasons for the Sembrong catchment area. The data on soil erosion and sedimentation rates for this study will be very useful for present, and future land and water management in the Sembrong catchment area and may be compared with other similar catchments in Malaysia.

Keywords: soil erosion, sedimentation, cesium-137, catchment management

Procedia PDF Downloads 108

Authors: Zhenyu Yang, Qiunan Chen, Xiaocheng Huang

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Reliable prediction of tunnel collapse remains a prominent challenge in the field of civil engineering. In this study, leveraging the nonlinear Hoek-Brown failure criterion and the upper-bound theorem, an analytical solution for the collapse surface of shallowly buried circular tunnels was derived, taking into account the coupled effects of surface loads and pore water pressures. Initially, surface loads and pore water pressures were introduced as external force factors, equating the energy dissipation rate to the external force, yielding our objective function. Subsequently, the variational method was employed for optimization, and the outcomes were juxtaposed with previous research findings. Furthermore, we utilized the deduced equation set to systematically analyze the influence of various rock mass parameters on collapse shape and extent. To validate our analytical solutions, a comparison with prior studies was executed. The corroboration underscored the efficacy of our proposed methodology, offering invaluable insights for collapse risk assessment in practical engineering applications.

Keywords: tunnel roof stability, analytical solution, hoek–brown failure criterion, limit analysis

Procedia PDF Downloads 67

Authors: Muhammad Farooq, Muhammad R. Shahid, M. Shakeel, A. Iftikhar, M. Sagheer, Riaz A. Kainth

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Comparative demography of Coccinella septempunctata Linnaeus (Coleoptera: Coccinellidae) was studied with respect to four host aphid species viz; Rhopalosiphum padi, Rhopalosiphum maidis, Sitobion avenae, and Shizaphis graminum under laboratory conditions using Two-sex Age-stage life table instead of traditional age specific life table which considers only female. Results revealed that developmental period from egg to adult of C. septempunctata were shorter on R. padi (16.49 days) whereas longer on R. maidis (22.83 days). Net reproductive rate varied from 110.01 offspring on R. maidis to 288.78 offspring on R. padi. Mean generation time (T) ranged from 29.02 d on R. padi to 39.788 d on R. maidis. Highest to lowest values of intrinsic rate of increase (rm) were recorded on R. padi, S. graminum, S. avenae, and R. maidis (0.194, 0.143, 0.140 and 0.117 d⁻¹, respectively). Highest finite rate of increase was observed on R. padi (1.214 d⁻¹) followed by S. graminum (1.154 d⁻¹) whereas lowest values were obtained on R. maidis and S. avenae (1.124 and 1.150 d⁻¹, respectively). In this study, the data on the life table of both predator and prey provide useful information in the mass rearing and practical application of a natural agent to biological control systems.

Keywords: C. septempunctata, two-sex age-stage life table, population parameters, aphid species

Procedia PDF Downloads 179

Authors: Chun-Hao Lai, Yu-Fang Huang, Pei-Wei Wang, Meng-Han Lin, Mei-Lien Chen

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Nonylphenol (NP) is a degradation product of nonylphenol ethoxylates (NPEOs). It is a well-known endocrine disruptor which may cause estrogenic effects. The growing fetus and infants are more vulnerable to exposure to NP than adults. It is important to know the levels and influences of prenatal exposure to NP. The aims of this study were (1) to determine the levels of prenatal exposure among Taiwanese, (2) to evaluate the potential risk for the infants who were breastfed and exposed to NP through the milk. (3) To investigate the correlation between birth outcomes and prenatal exposure to NP. We analyzed thirty one pairs of maternal urines, placentas, first month’ breast milk by high-performance liquid chromatography coupling with fluorescence detector. The questionnaire included socio- demographics, lifestyle, delivery method, dietary and work history. Information about the birth outcomes were obtained from medical records. The daily intake of NP from breast milk was calculated using deterministic and probabilistic risk assessment methods. The geometric means and geometric standard deviation of NP levels in placenta, and breast milk in the first month were 31.2 (1.8) ng/g, 17.2 (1.6) ng/g, respectively. The medium of daily intake NP in breast milk was 1.33 μg/kg-bw/day in the first month. We found negative association between NP levels of placenta and birth height. And we observed negative correlation between maternal urine NP levels and birth weight. In this study, we could provide the NP exposure profile among Taiwan pregnant women and the daily intake of NP in Taiwan infants. Prenatal exposure to higher levels of NP may increase the risk of lower birth weight and shorter birth height.

Keywords: nonylphenol, mother, fetus, placenta, breast milk, urine

Procedia PDF Downloads 222

Authors: Patel Himeshkumar Ashokbhai, Suchit Sharma, Arvind Kumar Garg

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The results obtained from settling test of coal fines are used as an important tool to select the dewatering equipment such as thickeners, centrifuges and filters. Coal being hydrophobic in nature does not easily settle when mixed with water. Coal slurry that takes longer time to release water is highly undesirable because it poses additional challenge during sedimentation, centrifuge and filtration. If filter cake has higher than permitted moisture content then it not only creates handling problems but inflated freight costs and reduction in input and productivity for coke oven charges. It is to be noted that coal fines drastically increase moisture percentage in filter cake hence are to be minimized. To increase settling rate of coal fines in slurry chemical substances called flocculants or coagulants are added that cause coal particles to flocculate or coalesce into larger particles. These larger particles settle at faster rate and have higher settling velocity. Other important factors affecting settling rate are flocculent dosage, slurry or pulp density and particle size. Hence in this paper we tried to study the settling characteristic of clean coal fines by varying one of the four factors namely 1. Flocculant Dosage (acryl-amide) 2. pH of the water 3. Bulk density 4. Particle size of clean coal fines in settling experiment and drew important conclusions. Result of this paper will be much useful not only for coal beneficiation plant design but also for cost reduction of coke production facilities.

Keywords: bulk density, coal fines, flocculants, flocculation, settling velocity, pH

Procedia PDF Downloads 311

Authors: M. Safiqul Islam, Md Arafat Hossain Sarkar

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Brachytherapy is one of the most important cancer treatment management systems in radiotherapy department. Brachytherapy treatment is moved into High Dose Rate (HDR) after loader from Low Dose Rate (LDR) after loader due to radiation protection advantage. HDR Brachytherapy is a highly multipurpose system for enhancing cure and achieving palliation in many common cancers disease of developing countries. High-dose rate (HDR) Brachytherapy is a type of internal radiation therapy that delivers radiation from implants placed close to or inside, the tumor(s) in the body. This procedure is very effective at providing localized radiation to the tumor site while minimizing the patient’s whole body dose. Brachytherapy has proven to be a highly successful treatment for cancers of the prostate, cervix, endometrium, breast, skin, bronchus, esophagus, and head and neck, as well as soft tissue sarcomas and several other types of cancer. For the time being in our country we have 10 new HDR Remote after loading Brachytherapy. Right now 4 HDR Brachytherapy is already installed and running for patient’s treatment out of 10 HDR Brachytherapy. Ir-192 source is more comfortable than Co-60. In that case people or expert personnel prefer Ir-192 source for different kind of cancer patients. Ir-192 are economically, more flexible and familiar in our country.

Keywords: Ir-192, brachytherapy, cancer treatment, prostate, cervix, endometrium, breast, skin, bronchus, esophagus, soft tissue sarcomas

Procedia PDF Downloads 415

Authors: Rahaf Mandura, Fatmah Abusharkh, Layan Kurdi, Rahaf Shigdar, Khadijah Alattas

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Introduction: Age-related macular degeneration (AMD) in older individuals are serious health issues that severely impact the quality of life of millions globally. In 2020, the fourth leading cause of blindness worldwide was AMD. The global prevalence of AMD is estimated to be around 8.7%. AMD is a progressive disease involving the macular region of the retina, and it has a complex pathophysiology. RPE cell dysfunction plays a crucial step in the pathway leading to irreversible degeneration of photoreceptors with yellowish lipid-rich, protein-containing drusen deposits accumulating between Bruch's membrane and the RPE. Furthermore, lipofuscinogenesis, drusogenesis, inflammation, and neovascularization are four main processes responsible for the formation of the two types of AMD: the wet (exudative, neovascular) and dry (non-exudative, geographic atrophy) types. We retrospectively evaluated the prevalence of AMD among patients visiting the retina clinic at King Abdulaziz University Hospital (Jeddah, Makkah Province, Saudi Arabia) to identify the commonly associated risk factors of AMD. Methods: The records of 3,067 individuals from 2017 to 2021 were reviewed. Of these, 1,935 satisfied the inclusion criteria and were included in this study. We excluded all patient below 18 years, and those who did not undergo fundus imaging or attend their booked appointments, follow-ups, treatments, and referrals were excluded. Results: The prevalence of AMD among the patients was 4%. The age of patients with AMD was significantly greater than those without AMD (72.4 ± 9.8 years vs. 57.2 ± 15.5 years; p < 0.001). Participants with a family history of AMD tended to have the disease more than those without such a history (85.7% vs. 45%; p = 0.043). Ex- and current smokers were more likely to have AMD than non-smokers (34% and 18.6% vs. 7.2%; p < 0.001). Patients with hypertension and those without type 1 diabetes were at a higher risk of developing AMD than those without hypertension (5.5% vs. 2.8%; p = 0.002) and those with type 1 diabetes (4.2% vs. 0.8%; p = 0.040). In contrast, sex, nationality, type 2 diabetes, and abnormal lipid profile were not significantly associated with AMD. Regarding the clinical characteristics of AMD cases, most cases (70.4%) were of the dry type and affected both eyes (77.2%). The disease duration was ≥5 years in 43.1% of the patients. The most frequent chronic diseases associated with AMD were type 2 diabetes (69.1%), hypertension (61.7%), and dyslipidemia (18.5%). Conclusion: In summary, our single tertiary center study showed that AMD is widely prevalent in Jeddah, Saudi Arabia (4%) and linked to a wide range of risk factors. Some of these are modifiable risk factors that can be adjusted to help reduce AMD occurrence. Furthermore, this study has shown the importance of screening and follow-up of family members of patients with AMD to promote early detection and intervention of AMD. We recommend conducting further research on AMD in Saudi Arabia. Concerning the study design, a community-based cross-sectional study would be more helpful for assessing the disease's prevalence. Finally, recruiting a larger sample size is required for more accurate estimation.

Keywords: age related macular degeneration, prevelence, risk factor, dry AMD

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Authors: Pakawhat Khumkhreung, Yottana Khunatorn

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The flow pattern inside rectangular intake air duct of 300 MW lignite coal-fired power plant is investigated in order to analyze and reduce overall inlet system pressure drop. The system consists of the 45-degree inlet elbow, the flow instrument, the 90-degree mitered elbow and fans, respectively. The energy loss in each section can be determined by Bernoulli’s equation and ASHRAE standard table. Hence, computational fluid dynamics (CFD) is used in this study based on Navier-Stroke equation and the standard k-epsilon turbulence modeling. Input boundary condition is 175 kg/s mass flow rate inside the 11-m² cross sectional duct. According to the inlet air flow rate, the Reynolds number of airstream is 2.7x10⁶ (based on the hydraulic duct diameter), thus the flow behavior is turbulence. The numerical results are validated with the real operation data. It is found that the numerical result agrees well with the operating data, and dominant loss occurs at the flow rate measurement device. Normally, the air flow rate is measured by the airfoil and it gets high pressure drop inside the duct. To overcome this problem, the airfoil is planned to be replaced with the other type measuring instrument, such as the average pitot tube which generates low pressure drop of airstream. The numerical result in case of average pitot tube shows that the pressure drop inside the inlet airstream duct is decreased significantly. It should be noted that the energy consumption of inlet air system is reduced too.

Keywords: airfoil, average pitot tube, combustion air, CFD, pressure drop, rectangular duct

Procedia PDF Downloads 147

Authors: Adriana B. Ribeiro, Camila B. Araujo, Frank L. Bueno, Luiz Eduardo V. Silva, Caroline V. Fortes, Helio C. Salgado, Rubens Fazan Jr., Claudia H. L. da Silva

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Denture-related stomatitis (DRS) has recently been associated with deleterious cardiovascular effects, including hypertension. This study evaluated salivary parameters, blood pressure (BP) and heart rate variability (HRV), before and after DRS treatment in edentulous patients (n=14). Collection of unstimulated and stimulated saliva, as well as blood pressure (BP) measurements and electrocardiogram recordings were performed before and after 10 days of DRS treatment. The salivary flow (mL/min) was found similar at both times while pH was smaller (more neutral) after treatment (7.3 ± 2.2 vs. 7.1 ± 0.24). Systolic BP (mmHg) showed a trend, but not a significant reduction after DRS treatment (158 ± 25.68 vs. 148 ± 16,72, p=0,062) while diastolic BP was found similar in both times (86 ± 13.93 and 84 ± 9.38). Overall HRV, measured by standard deviation of RR intervals was not affected by DRS treatment (24 ± 4 vs 18 ± 2 ms), but differences of successive RR intervals (an index of parasympathetic cardiac modulation) increased after the treatment (26 ± 4 vs 19 ± 2 ms). Moreover, another index of vagal modulation of the heart, the power of RR interval spectra at high-frequency, was also markedly higher after DRS treatment (236 ± 63 vs 135 ± 32 ms²). Such findings strongly suggest that DRS is linked to an autonomic imbalance with sympathetic overactivity, which is markedly deleterious, increasing cardiovascular risk and the incidence of diseases such as hypertension. Acknowledgment: This study is supported by FAPESP, CNPq.

Keywords: biofilm, denture stomatitis, HRV, blood pressure

Procedia PDF Downloads 221

Authors: Nur Azreena Idris, Soh Kheang Loh, Harrison Lau Lik Nang, Yuen May Choo, Eminour Muzalina Mustafa, Vijaysri Vello, Cheng Yau Tan, Siew Moi Phang

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It is estimated that about 0.65-0.67 m3 of palm oil mill effluent (POME) is generated when one tonne of fresh fruit bunches is processed. Owning to the high content of nutrients in POME, it has high potential as a medium for microalgae growth. This study attempted determining the growth rate, biomass productivity and biochemical composition of microalgae (Chlorella sp.) grown in different POME concentrations i.e. 6.25%, 12.5%, 25% and 50% at outdoor conditions using a 200-mL capacity high rate algae pond (HRAP) and 2 closed photobioreactors (PBRs) i.e. annular and flat panel. The strain, Chlorella sp. grown on 12.5% of POME in flat panel PBR exhibited the highest specific growth rate of 0.32/day and biomass productivity (27.1 mg/L/day) followed by those in HRAP and annular PBR. It further showed that a good growth of Chlorella sp. in 12.5% of POME could sufficiently reduce the nutrients of POME such as phosphate (PO4), nitrate (NO3), nitrite (NO2) and chemical oxygen demand (COD). The extracted algal oil from POME culture showed that the saturated fatty acids decreased while polyunsaturated fatty acids increased compared to those cultured in standard culture medium (Bold’s Basal medium). The biochemical compositions of the algae grown in flat panel PBR were the highest with lipid, protein and carbohydrate productivity of 17.91 mg/L/day, 34.65 mg/L/day and 21.44 mg/L/day, respectively. The microalgae cultivation in diluted POME had not only shown potential as biodiesel feedstock based on the fatty acids profile but also the ability to reduce pollutants e.g. PO4, NO3, NO2 and COD in biological wastewater treatment.

Keywords: wastewater treatment, photobioreactors, biomass productivity, specific growth rate

Procedia PDF Downloads 245

Authors: Tuji Mohammed Sani

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Back ground: An open tibial fracture is an injury where the fractured bone directly communicates with the outside environment. Due to the specific anatomical features of the tibia (limited soft tissue coverage), more than quarter of its fractures are classified as open, representing the most common open long-bone injuries. Open tibial fractures frequently cause significant bone comminution, periosteal stripping, soft tissue loss, contamination and are prone to bacterial entry with biofilm formation, which increases the risk of deep bone infection. Objective: The main objective of the study was to determine Prevalence of infection and its associated factors in surgically treated open tibial fracture in Addis Ababa Burn Emergency and Trauma (AaBET) center. Method: A facility based retrospective cross-sectional study was conducted among patient treated for open tibial fracture at AaBET center from September 2018 to September 2021. The data was collected from patient’s chart using structured data collection form, and Data was entered and analyzed using SPSS version 26. Bivariable and multiple binary logistic regression were fitted. Multicollinearity was checked among candidate variables using variance inflation factor and tolerance, which were less than 5 and greater than 0.2, respectively. Model adequacy were tested using Hosmer-Lemeshow goodness of fitness test (P=0.711). AOR at 95% CI was reported, and P-value < 0.05 was considered statistically significant. Result: This study found that 33.9% of the study participants had an infection. Initial IV antibiotic time (AOR=2.924, 95% CI:1.160- 7.370) and time of wound closure from injury (AOR=3.524, 95% CI: 1.798-6.908), injury to admission time (AOR=2.895, 95% CI: 1.402 – 5.977). and definitive fixation method (AOR=0.244, 95% CI: 0.113 – 0.4508) were the factors found to have a statistically significant association with the occurrence of infection. Conclusion: The rate of infection in open tibial fractures indicates that there is a need to improve the management of open tibial fracture treated at AaBET center. Time from injury to admission, time from injury to first debridement, wound closure time, and initial Intra Venous antibiotic time from the injury are an important factor that can be readily amended to improve the infection rate. Whether wound closed before seven days or not were more important factor associated with occurrences of infection.

Keywords: infection, open tibia, fracture, magnitude

Procedia PDF Downloads 60

Authors: Rashedul Islam

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A firmly-validated aim of teaching science is to support student enthusiasm for science learning with an outspread interest in scientific issues in future life. This is in keeping with the recent development in Gifted and Talented Education statement which instructs that gifted students have a renewed interest and natural aptitude in science. Yet, the practice of science teaching leaves many students with the feeling that science is difficult and compared to other school subjects, students interest in science is declining at the final years of the primary school. As a curriculum guides the teaching-learning activities in school, where significant consequences may result from the context of the curricula and syllabi, are a major feature of certain educational jurisdictions in NSW, Australia. The purpose of this study was an exploration of the curriculum sets the context to identify how science education is practiced through primary schools in Sydney, Australia. This phenomenon was explored through document review from two publicly available documents namely: the NSW Science Syllabus K-6, and Australian Curriculum: Foundation - 10 Science. To analyse the data, this qualitative study applied themed content analysis at three different levels, i.e., first cycle coding, second cycle coding- pattern codes, and thematic analysis. Preliminary analysis revealed the phenomenon of teaching-learning practices drawn from eight themes under three phenomena aligned with teachers’ practices and gifted student’s learning characteristics based on Gagné’s Differentiated Model of Gifted and Talent (DMGT). From the results, it appears that, overall, the two documents are relatively well-placed in terms of identifying the context of teaching and learning primary science to gifted students. However, educators need to make themselves aware of the ways in which the curriculum needs to be adapted to meet gifted students learning needs in science. It explores the important phenomena of teaching-learning context to provide gifted students with optimal educational practices including inquiry-based learning, problem-solving, open-ended tasks, creativity in science, higher order thinking, integration, and challenges. The significance of such a study lies in its potential to schools and further research in the field of gifted education.

Keywords: teaching primary science, gifted student learning, curriculum context, science syllabi, Australia

Procedia PDF Downloads 408

Authors: Ifeoma Anozie, Teka Apalata, Dominic Abaver

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Introduction: Despite use of Anti-retroviral therapy to reduce the incidence of opportunistic infections among HIV/AIDS patients, rapid episodes of re-infection after deworming are still common occurrences because pharmaceutical intervention alone does not prevent reinfection. Unsafe water and inadequate personal hygiene and parasitic infections are widely expected to accelerate the progression of HIV infection. This is because the chronic immunosuppression of HIV infection encourages susceptibility to opportunistic (including parasitic) infections which is linked to CD4+ cell count of <200 cells/μl. Intestinal parasites such as G. intestinalis and Entamoeba spp are ubiquitous protozoa that remain infectious over a long time in an environment and show resistance to standard disinfection. To control re-infection, the social factors that underpin the prevention need to be controlled. This study aims at prevention of intestinal parasites in people living with HIV/AIDS by using a treatment, hygiene education and sanitation (THEdS) bundle approach. Methods: This study was conducted in four clinics (Ngangelizwe health centre, Tsolo gateway clinic, Idutywa health centre and Nqamakwe health centre) across the seven districts in Eastern cape, South Africa. The four clinics were divided in two: experimental and control, for the purpose of intervention. Data was collected from March 2019 to February 2020. Six hundred participants were screened for intestinal parasitic infections. Stool samples were collected and analysed twice: before (Pre-test infection screening) and after (Post-test re-infection) THEdS bundle intervention. The experimental clinics received full intervention package, which include therapeutic treatment, health education on personal hygiene and sanitation training, while the control clinics received only therapeutic treatment for those found with intestinal parasitic infections. Results: Baseline prevalence of Intestinal Parasites isolated shows 12 intestinal parasites with overall frequency of 65, with Ascaris lumbricoides having most frequency (44.6%). The intervention had a cure rate of 60%, with odd ratio of 1.42, which indicates that the intervention group is 1.42 times more likely of parasite clearing as compared to the control group. The relative risk ratio of 1.17 signifies that there is 1.17 times more likelihood to clear intestinal parasite if there no intervention. Discussion and conclusion: Infection with multiple parasites can cause health defects, especially among HIV/AIDS patients. Efficiency of some HIV vaccines in HIV/AIDS patients is affected because treatment of re-infection amplifies drug resistance, affects the efficacy of the front-line drugs, and still permits transmission. In South Africa, treatment of intestinal parasites is usually offered to clinic attending HIV/AIDS patients upon suspicion but not as a mandate for patients being initiated into Antiretroviral (ART) program. The effectiveness of THEdS bundle advocates for inclusiveness of mandatory screening for intestinal parasitic infections among attendees of HIV/Aids clinics on regular basis.

Keywords: cure rate, , HIV/AIDS patients, intestinal parasites, intervention studies, reinfection rate

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Authors: Khadija Al-Hosni, Moon Fai Chan, Mohammed Al-Azri

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Background: Several studies suggest that most school-age adolescents are poorly informed on cancer warning signs and risk factors. Providing adolescents with sufficient knowledge would increase their awareness in adulthood and improve seeking behaviors later. Significant: The results will provide a clear vision in assisting key decision-makers in formulating policies on the students' awareness programs towards cancer. So, the likelihood of avoiding cancer in the future will be increased or even promote early diagnosis. Objectives: to evaluate the effectiveness of an education program designed to increase awareness of cancer signs and symptoms risk factors, improve the behavior of seeking help among school students in Oman, and address the barriers to obtaining medical help. Methods: A randomized controlled trial with two groups was conducted in Oman. A total of 1716 students (n=886/control, n= 830/education), aged 15-17 years, at 10th and 11th grade from 12 governmental schools 3 in governorates from 20-February-2022 to 12-May-2022. Basic demographic data were collected, and the Cancer Awareness Measure (CAM) was used as the primary outcome. Data were collected at baseline (T0) and 4 weeks after (T1). The intervention group received an education program about cancer's cause and its signs and symptoms. In contrast, the control group did not receive any education related to this issue during the study period. Non-parametric tests were used to compare the outcomes between groups. Results: At T0, the lamp was the most recognized cancer warning sign in the control (55.0%) and intervention (55.2%) groups. However, there were no significant changes at T1 for all signs in the control group. In contrast, all sign outcomes were improved significantly (p<0.001) in the intervention group, and the highest response was unexplained pain (93.3%). Smoking was the most recognized risk factor in both groups: (82.8% for control; 84.1% for intervention) at T0. However, there was no significant change in T1 for the control group, but there was for the intervention group (p<0.001), the highest identification was smoking cigarettes (96.5%). Too scared was the largest barrier to seeking medical help by students in the control group at T0 (63.0%) and T1 (62.8%). However, there were no significant changes in all barriers in this group. Otherwise, being too embarrassed (60.2%) was the largest barrier to seeking medical help for students in the intervention group at T0 and too scared (58.6%) at T1. Although there were reductions in all barriers, significant differences were found in six of ten only (p<0.001). Conclusion: The intervention was effective in improving students' awareness of cancer symptoms, warning signs (p<0.001), and risk factors (p<0.001 reduced the most addressed barriers to seeking medical help (p<0.001) in comparison to the control group. The Ministry of Education in Oman could integrate awareness of cancer within the curriculum, and more interventions are needed on the sociological part to overcome the barriers that interfere with seeking medical help.

Keywords: adolescents, awareness, cancer, education, intervention, student

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Authors: Pankaj Verma, Gagandeep Singh Walia, Padma Devi, H. P. Singh

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Code Division Multiple Access 2000 operates on various RF channel bandwidths 1.2288 or 3.6864 Mcps. CDMA offers high bandwidth and wireless broadband services but the efficiency gets decreased because of many interfering factors like fading, interference, scattering, diffraction, refraction, reflection etc. To reduce the spectral bandwidth is one of the major concerns in modern day technology and this is achieved by pulse shaping filter. This paper investigates the effect of diversity (MRC), interpolation factor in Root Raised Cosine (RRC) filter for the QPSK and BPSK modulation schemes. It is made possible to send information with minimum inter symbol interference and within limited bandwidth with proper pulse shaping technique. Bit error rate (BER) performance is analyzed by applying diversity technique by varying the interpolation factor for Binary Phase Shift Keying (BPSK) and Quadrature Phase Shift Keying (QPSK). Interpolation factor increases the original sampling rate of a sequence to a higher rate and reduces the interference and diversity reduces the fading.

Keywords: CDMA2000, root raised cosine, roll off factor, ISI, diversity, interference, fading

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Authors: Oussama Derdous, Lakhdar Djemili, Hamza Bouchahed

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The consequences of a dam breach can be devastating; both in terms of lives lost and damaged infrastructure and property. Hydraulic modeling provides a clear picture of the possible consequences of partial or complete failure of a dam, which is the key to carry out emergency planning and conduct reliable risk assessments. In this paper, the MIKE11 model developed by the Danish Hydrologic Institute (DHI) was used to simulate the flood wave propagation associated with a potential failure analysis failure of Zardezas dam located in the city of Skikda in the North East of Algeria. MIKE11 results including inundation maps and the representative channel/valley cross-sections depicting flow depth and maximal flow velocities showed that Zardezas reservoir presents a significant risk to downstream areas in the event of a dam failure. These results can be used as the basis of the development of an Emergency Action Plan (EAP).The main objective of this plan is to predict the appropriate steps to avoid or at least decrease the consequences of unexpected failure of Zardezas dam.

Keywords: MIKE11, dam break, inundation maps, emergency action plan

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Authors: Mohammad Reza Dawoudi

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With the increasing rate of patients suffering from chronic pain, several methods for evaluating of chronic pain are suggested. Motion of morbid has been defined as the rate of pine and it is linked with various co-morbid conditions. This study provides a summary of procedure useful to statistics performing direct behavioral observation in hospital settings. We describe the need for and usefulness of comprehensive “morbid motions” observations; provide a primer on the identification, definition, and assessment of morbid behaviors; and outline and discuss specific statistical procedures, including formulating referral motions, describing and conducting the observation. We also provide practical devices for observing and analyzing the obtained information into a report that guides clinical intervention.

Keywords: assessing pain, DNA modeling, image matching technique, pain scale

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Authors: S. Pullteap, M. Pathomsuriyaporn

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In this article, a study of employee’s opinion to the factors that affect to the flood preventive and the corrective action plan in an electronic industry at the Sharp Manufacturing (Thailand) Co., Ltd. has been investigated. The surveys data of 175 workers and supervisors have, however, been selected for data analysis. The results is shown that the employees emphasize about the needs in a subsidy at the time of disaster at high levels of 77.8%, as the plan focusing on flood prevention of the rehabilitation equipment is valued at the intermediate level, which is 79.8%. Demonstration of the hypothesis has found that the different education levels has thus been affected to the needs factor at the flood disaster time. Moreover, most respondents give priority to flood disaster risk management factor. Consequently, we found that the flood prevention plan is valued at high level, especially on information monitoring, which is 93.4% for the supervisor item. The respondents largely assume that the flood will have impacts on the industry, up to 80%, thus to focus on flood management plans is enormous.

Keywords: flood prevention plan, flood event, electronic industrial plant, disaster, risk management

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Authors: M. S. Said, J. A. Ghani, C. H. Che Hassan, N. N. Wan, M. A. Selamat, R. Othman

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Metal Matrix Composite (MMCs) have attracted considerable attention as a result of their ability to provide high strength, high modulus, high toughness, high impact properties, improved wear resistance and good corrosion resistance than unreinforced alloy. Aluminium Silicon (Al/Si) alloys Metal Matrix composite (MMC) has been widely used in various industrial sectors such as transportation, domestic equipment, aerospace, military, construction, etc. Aluminium silicon alloy is MMC reinforced with aluminium nitride (AlN) particle and becomes a new generation material for automotive and aerospace applications. The AlN material is one of the advanced materials with light weight, high strength, high hardness and stiffness qualities which have good future prospects. However, the high degree of ceramic particles reinforcement and the irregular nature of the particles along the matrix material that contribute to its low density, is the main problem that leads to the machining difficulties. This paper examines tool wear when milling AlSi/AlN Metal Matrix Composite using a TiB2 coated carbide cutting tool. The volume of the AlN reinforced particle was 10%. The milling process was carried out under dry cutting condition. The TiB2 coated carbide insert parameters used were the cutting speed of (230 m/min, feed rate 0.4mm tooth, DOC 0.5mm, 300 m/min, feed rate 0.8mm/tooth, DOC 0.5mm and 370 m/min, feed rate 0.8, DOC 0.4m). The Sometech SV-35 video microscope system was used for tool wear measurements respectively. The results have revealed that the tool life increases with the cutting speed (370 m/min, feed rate 0.8 mm/tooth and depth of cut 0.4mm) constituted the optimum condition for longer tool life which is 123.2 min. While at medium cutting speed, it is found that the cutting speed of 300m/min, feed rate 0.8 mm/tooth and depth of cut 0.5mm only 119.86 min for tool wear mean while the low cutting speed give 119.66 min. The high cutting speed gives the best parameter for cutting AlSi/AlN MMCs materials. The result will help manufacture to machining the AlSi/AlN MMCs materials.

Keywords: AlSi/AlN Metal Matrix Composite milling process, tool wear, TiB2 coated carbide tool, manufacturing engineering

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Authors: A. Kazemi Jouybari, A. Mirabdolah Lavasani

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This paper seeks to the solution of condensation around of a flat plate, circular and elliptical tube in way of numerical and analytical methods. Also, it calculates the entropy production rates. The first, problem was solved by using mesh dynamic and rational assumptions, next it was compared with the numerical solution that the result had acceptable errors. An additional supporting relation was applied based on a characteristic of condensation phenomenon for condensing elements. As it has been shown here, due to higher rates of heat transfer for elliptical tubes, they have more entropy production rates, in comparison to circular ones. Findings showed that two methods were efficient. Furthermore, analytical methods can be used to optimize the problem and reduce the entropy production rate.

Keywords: condensation, numerical solution, analytical solution, entropy rate

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Authors: Vivian Khamis

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Exposure to war and forced migration have been widely linked to child subsequent adaptation. What remains sparse is research spanning multiple risk and protective factors and examining their unique and relative implications to difficulties in mental health among refugee girls. This study investigated the mechanisms through which posttraumatic stress disorder (PTSD), emotion dysregulation , neuroticism, and behavioral and emotional disorders in Syrian refugee girls is impacted by exposure to war traumas, age, and other risk and protective factors such as coping styles, family relationships, and school environment. The sample consisted of 539 Syrian refugee girls who ranged in age from 7 to 18 years attending public schools in various governorates in Lebanon and Jordan. Two school counselors carried out the interviews with children at school. Results indicated that war trauma, older age, and a combination of negative copying style associated with conflict in the family could lead to an overall state of emotion dysregulation, neuroticism, behavioral and emotional disorders, and PTSD in refugee girls. On the other hand, lapse of time since resettlement in host country, positive copying style, cohesion, and expressiveness in the family would lead to more positive mental health status, including lower levels of emotion dysregulation, neuroticism, behavioral and emotional disorders, and PTSD . Enhanced understanding of the mechanistic role of risk and protective factors in contributing to difficulties in mental health in refugee girls may contribute to the development of effective interventions to target the psychological effects of the refugee experience.

Keywords: refugee girls, PTSD, emotion dysregulation, neuroticism, behavioral and emotional disorders

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Authors: Tamar Grdzelishvili, Zaza Sinauridze

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Introduction: Preeclampsia is a complication of the second trimester of pregnancy, which is characterized by high morbidity and multiorgan damage. Many complex pathogenic mechanisms are now implicated to be responsible for this disease (1). Preeclampsia is one of the leading causes of maternal mortality worldwide. Statistics are enough to convince you of the seriousness of this pathology: about 100,000 women die of preeclampsia every year. It occurs in 3-14% (varies significantly depending on racial origin or ethnicity and geographical region) of pregnant women, in 75% of cases - in a mild form, and in 25% - in a severe form. During severe pre-eclampsia-eclampsia, perinatal mortality increases by 5 times and stillbirth by 9.6 times. Considering that the only way to treat the disease is to end the pregnancy, the main thing is timely diagnosis and prevention of the disease. Identification of high-risk pregnant women for PE and giving prophylaxis would reduce the incidence of preterm PE. First-trimester screening model developed by the Fetal Medicine Foundation (FMF), which uses the Bayes-theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, has been proven to be effective and have superior screening performance to that of traditional risk factor-based approach for the prediction of PE (2) Methods: Retrospective single center screening study. The study population consisted of women from the Tbilisi maternity hospital “Pineo medical ecosystem” who met the following criteria: they spoke Georgian, English, or Russian and agreed to participate in the study after discussing informed consent and answering questions. Prior to the study, the informed consent forms approved by the Institutional Review Board were obtained from the study subjects. Early assessment of preeclampsia was performed between 11-13 weeks of pregnancy. The following were evaluated: anamnesis, dopplerography of the uterine artery, mean arterial blood pressure, and biochemical parameter: Pregnancy-associated plasma protein A (PAPP-A). Individual risk assessment was performed with performed by Fast Screen 3.0 software ThermoFisher scientific. Results: A total of 513 women were recruited and through the study, 51 women were diagnosed with preeclampsia (34.5% in the pregnant women with high risk, 6.5% in the pregnant women with low risk; P<0.000 1). Conclusions: First-trimester screening combining maternal factors with uterine artery Doppler, blood pressure, and pregnancy-associated plasma protein-A is useful to predict PE in a routine care setting. More patient studies are needed for final conclusions. The research is still ongoing.

Keywords: first-trimester, preeclampsia, screening, pregnancy-associated plasma protein

Procedia PDF Downloads 63

Authors: Abdalrahman D. Alsulaili, Sheikha Y. Aljeraiwi, Athba N. Almanaie, Raghad Y. Alhajeri, Mariam Z. Almijren

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The water accompanying oil in the oil production process is increasing and due to its increasing rates a problem with handling it occurred. Current solutions like discharging into the environment, dumping water in evaporation pits, usage in the industry and reinjection in oil reservoirs to enhance oil production are used worldwide. The water injection method has been introduced to the oil industry with a process that either immediately injects water to the reservoir or goes to the filtration process before injection all depending on the porosity of the soil. Reinjection of unfiltered effluent water with high Total Suspended Solid (TSS) and Oil in Water (O/W) into soils with low porosity cause a blockage of pores, whereas soils with high porosity do not need high water quality. Our study mainly talks about the filtration and adsorption of the water using organic media as the adsorbent. An adsorbent is a substance that has the ability to physically hold another substance in its surface. Studies were done on nutshell and date pits with different surface areas and flow rates by using a 10inch filter connected with three tanks to perform as one system for the filtration process. Our approach in the filtration process using different types of medias went as follow: starting first with crushed nutshell, second with ground nutshell, and third using carbonized date pits with medium flow rate then high flow rate to compare different results. The result came out nearly as expected from our study where both O/W and TSS were reduced from our oily water sample by using this organic material. The effect of specific area was noticed when using nutshell as the filter media, where the crushed nutshell gave us better results than ground nutshell. The effect of flow rate was noticed when using carbonized date pits as the filter media whereas the treated water became more acceptable when the flow rate was on the medium level.

Keywords: date pits, nutshell, oil water, TSS

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Authors: Ela Ari, Aysi̇ma Findikoglu

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Consumers’ switching GSM operators’ has been an important research issue since the rise of their competitive offers. Recent research has looked at consumer switching behavior through the theory of planned behavior, but not yet extended the theory with identity, psycho-social and cultural influences within the service context. This research explores an extended version of the theory of planned behavior including social and financial risks and brand loyalty. Moreover, the role of individualism and collectivism at the individual level is investigated in a collectivistic culture that moves toward to individualism due to changing family relationships, use of technology and education. Our preliminary analysis showed that financial risk and vertical individualism prove to be a significant determinant of intention to switch. The study also investigates social risk and intention, subjective norm, perceived behavioral control relationship. The effect of individualism and collectivism and attitudes relationship has been also examined within a service industry. Implications for marketing managers and scholars are also discussed.

Keywords: attitude, individualism, intention, subjective norm

Procedia PDF Downloads 437