Search results for: potential outcome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12903

Search results for: potential outcome

12663 Selection of Lead Mobilizing Bacteria from Contaminated Soils and Their Potential in Promoting Plant Growth through Plant Growth Promoting Activity

Authors: Maria Manzoor, Iram Gul, Muhammad Arshad

Abstract:

Bacterial strains were isolated from contaminated soil collected from Rawalpindi and Islamabad. The strains were investigated for lead resistance and their effect on Pb solubility and PGPR activity. Incubation experiments were carried for inoculated and unoculated soil containing different levels of Pb. Results revealed that few stains (BTM-4, BTM-11, BTM-14) were able to tolerate Pb up to 600 mg L-1, whereas five strains (BTM-3, BTM-6, BTM-10, BTM-21 and BTM-24) showed significant increase in solubility of Pb when compared to all other strains and control. The CaCl2 extractable Pb was increased by 13.6, 6.8, 4.4 and 2.4 folds compared to un-inoculated control soil at increased soil Pb concentration (500, 1000, 1500 and 200 mg kg-1, respectively). The selected bacterial strains (11) were further investigated for plant growth promotion activity through PGPR assays including. Germination and root elongation assays were also conducted under elevated metal concentration in controlled conditions to elucidate the effects of microbial strains upon plant growth and development. The results showed that all the strains tested in this study, produced significantly varying concentrations of IAA, siderophores and gibberellic acid along with ability to phosphorus solubilization index (PSI). The results of germination and root elongation assay further confirmed the beneficial role of the microbial strains in elevating metal stress through PGPR activity. Among all tested strains, BTM-10 significantly improved plant growth. 1.3 and 2.7 folds increase in root and shoot length was observed when compared to control. Which may be attributed to presence of important plant growth promoting enzymes (IAA 74.6 μg/ml; GA 19.23 μg/ml; Sidrophore units 49% and PSI 1.3 cm). The outcome of this study indicates that these Pb tolerant and solubilizing strains may have the potential for plant growth promotion under metal stress and can be used as mediator when coupled with heavy metal hyperaccumulator plants for phytoremediation of Pb contaminated soil.

Keywords: Pb resistant bacteria, Pb mobilizing bacteria, Phytoextraction of Pb, PGPR activity of bacteria

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12662 Occupational Heat Stress Related Adverse Pregnancy Outcome: A Pilot Study in South India Workplaces

Authors: Rekha S., S. J. Nalini, S. Bhuvana, S. Kanmani, Vidhya Venugopal

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Introduction: Pregnant women's occupational heat exposure has been linked to foetal abnormalities and pregnancy complications. The presence of heat in the workplace is expected to lead to Adverse Pregnancy Outcomes (APO), especially in tropical countries where temperatures are rising and workplace cooling interventions are minimal. For effective interventions, in-depth understanding and evidence about occupational heat stress and APO are required. Methodology: Approximately 800 pregnant women in and around Chennai who were employed in jobs requiring moderate to hard labour participated in the cohort research. During the study period (2014-2019), environmental heat exposures were measured using a Questemp WBGT monitor, and heat strain markers, such as Core Body Temperature (CBT) and Urine Specific Gravity (USG), were evaluated using an Infrared Thermometer and a refractometer, respectively. Using a valid HOTHAPS questionnaire, self-reported health symptoms were collected. In addition, a postpartum follow-up with the mothers was done to collect APO-related data. Major findings of the study: Approximately 47.3% of pregnant workers have workplace WBGTs over the safe manual work threshold value for moderate/heavy employment (Average WBGT of 26.6°C±1.0°C). About 12.5% of the workers had CBT levels above the usual range, and 24.8% had USG levels above 1.020, both of which suggested mild dehydration. Miscarriages (3%), stillbirths/preterm births (3.5%), and low birth weights (8.8%) were the most common unfavorable outcomes among pregnant employees. In addition, WBGT exposures above TLVs during all trimesters were associated with a 2.3-fold increased risk of adverse fetal/maternal outcomes (95% CI: 1.4-3.8), after adjusting for potential confounding variables including age, education, socioeconomic status, abortion history, stillbirth, preterm, LBW, and BMI. The study determined that WBGTs in the workplace had direct short- and long-term effects on the health of both the mother and the foetus. Despite the study's limited scope, the findings provided valuable insights and highlighted the need for future comprehensive cohort studies and extensive data in order to establish effective policies to protect vulnerable pregnant women from the dangers of heat stress and to promote reproductive health.

Keywords: adverse outcome, heat stress, interventions, physiological strain, pregnant women

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12661 A Case Series on Isolated Lead aVR ST-Segment Elevation Clinical Significance and Outcome

Authors: Fae Princess Bermudez

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Background: One of the least significant leads on a 12-lead electrocardiogram is the augmented right lead (aVR), as it is not as specific compared to the other leads. In this case series, the value of lead aVR, which is more often than not ignored, is highlighted. Three cases of aVR ST segment elevation on 12-lead electrocardiogram are described, with the end outcome of demise of all three patients. The importance of immediate revascularization is described to improve prognosis in this group of patients. Objectives: This case series aims to primarily present under-reported cases of isolated aVR ST-segrment elevation myocardial infarction (STEMI), their course and outcome. More specific aims are to identify the criteria in determination of isolated aVR STEMI, know its clinical significance, and determine appropriate management for patients with this ECG finding. Method: A short review of previous studies, case reports, articles and guidelines from 2011-2016 was done. The author reviewed available literature, sorted out those that proved to be significant for the presented cases, and described them in conjunction with the aforementioned cases. Findings: Based on the limited information on these rare or under-reported cases, it was found that isolated aVR STEMI had a poorer prognosis that led to significant mortality and morbidity of patients. The significance of aVR ST-elevation was that of an occlusion of the left coronary artery or a severe three-vessel disease in the presence of an Acute Coronary Syndrome. Guidelines from American Heart Association/American College of Cardiology Foundation in 2013 already recognized ST-elevation of lead aVR in isolation as a STEMI; hence, recommended that patients with this particular ECG finding should undergo reperfusion strategies to improve prognosis. Conclusion: The indispensability of isolated aVR ST-segment elevation on ECG should alert physicians, especially Emergency physicians, to the high probability of Acute Coronary Syndrome with a very poor prognosis. If this group of patients is not promptly managed, demise may ensue, with cardiogenic shock as the most probable cause. With this electrocardiogram finding, physicians must be quick to make clinical decisions to increase chances of survival of this group of patients.

Keywords: AVR ST-elevation, diffuse ST-segment depression, left coronary artery infarction, myocardial infarction

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12660 Predictive Analytics for Theory Building

Authors: Ho-Won Jung, Donghun Lee, Hyung-Jin Kim

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Predictive analytics (data analysis) uses a subset of measurements (the features, predictor, or independent variable) to predict another measurement (the outcome, target, or dependent variable) on a single person or unit. It applies empirical methods in statistics, operations research, and machine learning to predict the future, or otherwise unknown events or outcome on a single or person or unit, based on patterns in data. Most analyses of metabolic syndrome are not predictive analytics but statistical explanatory studies that build a proposed model (theory building) and then validate metabolic syndrome predictors hypothesized (theory testing). A proposed theoretical model forms with causal hypotheses that specify how and why certain empirical phenomena occur. Predictive analytics and explanatory modeling have their own territories in analysis. However, predictive analytics can perform vital roles in explanatory studies, i.e., scientific activities such as theory building, theory testing, and relevance assessment. In the context, this study is to demonstrate how to use our predictive analytics to support theory building (i.e., hypothesis generation). For the purpose, this study utilized a big data predictive analytics platform TM based on a co-occurrence graph. The co-occurrence graph is depicted with nodes (e.g., items in a basket) and arcs (direct connections between two nodes), where items in a basket are fully connected. A cluster is a collection of fully connected items, where the specific group of items has co-occurred in several rows in a data set. Clusters can be ranked using importance metrics, such as node size (number of items), frequency, surprise (observed frequency vs. expected), among others. The size of a graph can be represented by the numbers of nodes and arcs. Since the size of a co-occurrence graph does not depend directly on the number of observations (transactions), huge amounts of transactions can be represented and processed efficiently. For a demonstration, a total of 13,254 metabolic syndrome training data is plugged into the analytics platform to generate rules (potential hypotheses). Each observation includes 31 predictors, for example, associated with sociodemographic, habits, and activities. Some are intentionally included to get predictive analytics insights on variable selection such as cancer examination, house type, and vaccination. The platform automatically generates plausible hypotheses (rules) without statistical modeling. Then the rules are validated with an external testing dataset including 4,090 observations. Results as a kind of inductive reasoning show potential hypotheses extracted as a set of association rules. Most statistical models generate just one estimated equation. On the other hand, a set of rules (many estimated equations from a statistical perspective) in this study may imply heterogeneity in a population (i.e., different subpopulations with unique features are aggregated). Next step of theory development, i.e., theory testing, statistically tests whether a proposed theoretical model is a plausible explanation of a phenomenon interested in. If hypotheses generated are tested statistically with several thousand observations, most of the variables will become significant as the p-values approach zero. Thus, theory validation needs statistical methods utilizing a part of observations such as bootstrap resampling with an appropriate sample size.

Keywords: explanatory modeling, metabolic syndrome, predictive analytics, theory building

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12659 Grading of Emulsified Agarwood Oil Using Gel Electrophoresis Technique

Authors: Y. T. Boon, M. N. Naim, R. Zakaria, N. F. Abu Bakar, N. Ahmad, I. W. Lenggoro

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In this study, encapsulation of agarwood oil with non-ionic surfactant, Tween 80 was prepared at critical micelle concentration of 0.0167 % v/v to produce the most stable nano-emulsion in aqueous. The encapsulation has minimized the bioactive compounds degradation in various pH conditions thus prolong their shelf life and maintained its initial oil grade. The oil grading of the prepared samples were conducted using the gel electrophoresis instead of using common analytical industrial grading such as gas chromatography- mass spectrometry (GC- MS). The grading method was chosen due to their unique zeta potential value after the encapsulation process. This paper demonstrates the feasibility of applying the electrophoresis principles to separate the encapsulated agarwood oil or grading of the emulsified agarwood oil. The results indicated that the grading process are potential to be further investigate based on their droplet size and zeta potential value at various pH condition when the droplet were migrate through polyacrylamide gel.

Keywords: electrophoretic mobility, essential oil, nanoemulsion, polyacrylamide gel electrophoresis, tween 80, zeta potential

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12658 The Differences and Similarities between the Ship Waste Tracking Regulations of Turkey and Particular European Union Member Countries

Authors: Kaan Koyuncu, Umut Celen Arican, Sevilay Can

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In the maritime industry, there have been regulations to prevent pollution, and the first attempt to offer a legal basis was Marpol Convention which was held in 1973 in order to provide a framework for the disposal of ship wastes. Based on this convention, ports are obliged to build waste receiving facilities. European Union regulations make several member countries to follow these directions, In Turkey, under Blue Card System, the quantity and types of wastes, the delivery time, the capacity of the receiving facilities, and other required information can be monitored online. Therefore, yachts and other boats with the bilge, sewage, and waste which illegally discharge into the sea, can be blocked. This system is an outcome of the law adopted from European Union regulations. In this study, the present systems in Turkey which occurred in 2010 after the integration of the system, which has been put in the force in 2000 in Europe will be analyzed and interpreted to provide a useful comparison, a practical guide, and a roadmap for potential improvements.

Keywords: Europe-Turkey, blue card, marine environment, ship waste tracking system

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12657 Assessment of the Natural and Human Potential of the Municipality of Tirana for the Development of Agritourism

Authors: Dritan Lloçi, Xhulia Bygjymi

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The topic is about one of the new trends with the greatest expectations in the field of tourism, such as agritourism. It is chosen exactly this type of tourism to address as this issue is one of the newest trends not only for Tirana or Albania but also beyond. The other reason is that this topic is quite current and challenging for the reality in which we find ourselves, and the opportunities for research work and to make our own contribution are quite large. It is chosen Tirana because seeing the many opportunities it offers for the development of agritourism as a result of the rich natural potential it offers; the fact that it is the capital of Albania makes this space absorb a good part of the investments in the rural tourism sector but not alone. The study is organized into several main issues regarding the natural and human potentials of the area, which are in function of the development of agrotourism. The first issue has to do with the natural potentials of the municipality of Tirana and how they can be used for agritourism. The second issue has to do with the cultural potential that the municipality of Tirana possesses, causing tourist flows to be more concentrated in this geographical-administrative space. The third issue has to do with the human potential that is a function of agrotourism. So the way of life, hospitality, cooking, etc.

Keywords: agrotourism, natural potential, agrotourism farms, tirana municipality, tourism development

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12656 Outcomes of the Gastrocnemius Flap Performed by Orthopaedic Surgeons in Salvage Revision Knee Arthroplasty: A Retrospective Study at a Tertiary Orthopaedic Centre

Authors: Amirul Adlan, Robert McCulloch, Scott Evans, Michael Parry, Jonathan Stevenson, Lee Jeys

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Background and Objectives: The gastrocnemius myofascial flap is used to manage soft-tissue defects over the anterior aspect of the knee in the context of a patient presenting with a sinus and periprosthetic joint infection (PJI) or extensor mechanism failure. The aim of this study was twofold: firstly, to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons in the context of PJI and, secondly, to evaluate the infection-free survival of this patient group. Methods: We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97 %) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52 % of PJIs were polymicrobial. The primary outcome measure was flap failure, and the secondary outcome measure was a recurrent infection. Results: Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Using limb salvage as the outcome, 77% (23 of 30 patients) retained the limb. Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65). Conclusion: The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.

Keywords: gastrocnemius flap, limb salvage, revision arthroplasty, outcomes

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12655 Clique and Clan Analysis of Patient-Sharing Physician Collaborations

Authors: Shahadat Uddin, Md Ekramul Hossain, Arif Khan

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The collaboration among physicians during episodes of care for a hospitalised patient has a significant contribution towards effective health outcome. This research aims at improving this health outcome by analysing the attributes of patient-sharing physician collaboration network (PCN) on hospital data. To accomplish this goal, we present a research framework that explores the impact of several types of attributes (such as clique and clan) of PCN on hospitalisation cost and hospital length of stay. We use electronic health insurance claim dataset to construct and explore PCNs. Each PCN is categorised as ‘low’ and ‘high’ in terms of hospitalisation cost and length of stay. The results from the proposed model show that the clique and clan of PCNs affect the hospitalisation cost and length of stay. The clique and clan of PCNs show the difference between ‘low’ and ‘high’ PCNs in terms of hospitalisation cost and length of stay. The findings and insights from this research can potentially help the healthcare stakeholders to better formulate the policy in order to improve quality of care while reducing cost.

Keywords: clique, clan, electronic health records, physician collaboration

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12654 A Deep Learning Based Method for Faster 3D Structural Topology Optimization

Authors: Arya Prakash Padhi, Anupam Chakrabarti, Rajib Chowdhury

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Topology or layout optimization often gives better performing economic structures and is very helpful in the conceptual design phase. But traditionally it is being done in finite element-based optimization schemes which, although gives a good result, is very time-consuming especially in 3D structures. Among other alternatives machine learning, especially deep learning-based methods, have a very good potential in resolving this computational issue. Here convolutional neural network (3D-CNN) based variational auto encoder (VAE) is trained using a dataset generated from commercially available topology optimization code ABAQUS Tosca using solid isotropic material with penalization (SIMP) method for compliance minimization. The encoded data in latent space is then fed to a 3D generative adversarial network (3D-GAN) to generate the outcome in 64x64x64 size. Here the network consists of 3D volumetric CNN with rectified linear unit (ReLU) activation in between and sigmoid activation in the end. The proposed network is seen to provide almost optimal results with significantly reduced computational time, as there is no iteration involved.

Keywords: 3D generative adversarial network, deep learning, structural topology optimization, variational auto encoder

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12653 Bayesian Variable Selection in Quantile Regression with Application to the Health and Retirement Study

Authors: Priya Kedia, Kiranmoy Das

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There is a rich literature on variable selection in regression setting. However, most of these methods assume normality for the response variable under consideration for implementing the methodology and establishing the statistical properties of the estimates. In many real applications, the distribution for the response variable may be non-Gaussian, and one might be interested in finding the best subset of covariates at some predetermined quantile level. We develop dynamic Bayesian approach for variable selection in quantile regression framework. We use a zero-inflated mixture prior for the regression coefficients, and consider the asymmetric Laplace distribution for the response variable for modeling different quantiles of its distribution. An efficient Gibbs sampler is developed for our computation. Our proposed approach is assessed through extensive simulation studies, and real application of the proposed approach is also illustrated. We consider the data from health and retirement study conducted by the University of Michigan, and select the important predictors when the outcome of interest is out-of-pocket medical cost, which is considered as an important measure for financial risk. Our analysis finds important predictors at different quantiles of the outcome, and thus enhance our understanding on the effects of different predictors on the out-of-pocket medical cost.

Keywords: variable selection, quantile regression, Gibbs sampler, asymmetric Laplace distribution

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12652 Advancements in Predicting Diabetes Biomarkers: A Machine Learning Epigenetic Approach

Authors: James Ladzekpo

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Background: The urgent need to identify new pharmacological targets for diabetes treatment and prevention has been amplified by the disease's extensive impact on individuals and healthcare systems. A deeper insight into the biological underpinnings of diabetes is crucial for the creation of therapeutic strategies aimed at these biological processes. Current predictive models based on genetic variations fall short of accurately forecasting diabetes. Objectives: Our study aims to pinpoint key epigenetic factors that predispose individuals to diabetes. These factors will inform the development of an advanced predictive model that estimates diabetes risk from genetic profiles, utilizing state-of-the-art statistical and data mining methods. Methodology: We have implemented a recursive feature elimination with cross-validation using the support vector machine (SVM) approach for refined feature selection. Building on this, we developed six machine learning models, including logistic regression, k-Nearest Neighbors (k-NN), Naive Bayes, Random Forest, Gradient Boosting, and Multilayer Perceptron Neural Network, to evaluate their performance. Findings: The Gradient Boosting Classifier excelled, achieving a median recall of 92.17% and outstanding metrics such as area under the receiver operating characteristics curve (AUC) with a median of 68%, alongside median accuracy and precision scores of 76%. Through our machine learning analysis, we identified 31 genes significantly associated with diabetes traits, highlighting their potential as biomarkers and targets for diabetes management strategies. Conclusion: Particularly noteworthy were the Gradient Boosting Classifier and Multilayer Perceptron Neural Network, which demonstrated potential in diabetes outcome prediction. We recommend future investigations to incorporate larger cohorts and a wider array of predictive variables to enhance the models' predictive capabilities.

Keywords: diabetes, machine learning, prediction, biomarkers

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12651 Improving Engagement: Dental Veneers, a Qualitative Analysis of Posts on Instagram

Authors: Matthew Sedgwick

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Introduction: Social media continues to grow in popularity and Instagram is one of the largest platforms available. It provides an invaluable method of communication between health care professionals and patients. Both patients and dentists can benefit from seeing clinical cases posted by other members of the profession. It can prompt discussion about how the outcome was achieved and showcases what is possible with the right techniques and planning. This study aimed to identify what people were posting about the topic ‘veneers’ and inform health care professionals as to what content had the most engagement and make recommendations as to how to improve the quality of social media posts. Design: 150 consecutive posts for the search term ‘veneers’ were analyzed retrospectively between 21st October 2021 to 31st October 2021. Non-English language posts duplicated posts, and posts not about dental veneers were excluded. After exclusions were applied, 80 posts were included in the study for analysis. The content of the posts was analyzed and coded and the main themes were identified. The number of comments, likes and views were also recorded for each post. Results: The themes were: before and after treatment, cost, dental training courses, treatment process and trial smiles. Dentists were the most common posters of content (82.5%) and it was interesting to note that there were no patients who posted about treatment in this sample. The main type of media was photographs (93.75%) compared to video (6.25%). Videos had an average of 45,541 views and more comments and likes than the average for photographs. The average number of comments and likes per post were 20.88 and 761.58, respectively. Conclusion: Before and after photographs were the most common finding as this is how dentists showcase their work. The study showed that videos showing the treatment process had more engagement than photographs. Dentists should consider making video posts showing the patient journey, including before and after veneer treatment, as this can result in more potential patients and colleagues viewing the content. Video content could help dentists distinguish their posts from others as it can also be used across other platforms such as TikTok or Facebook reaching a wider audience. More informative posts about how the result has shown are achieved required, including potential costs. This will help increase transparency regarding this treatment method, including the financial and potential biological cost to teeth. As a result, this will improve patient understanding and become an invaluable adjunct in informed consent.

Keywords: content analysis, dental veneers, Instagram, social media

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12650 Innovative Ideas through Collaboration with Potential Users

Authors: Martin Hewing, Katharina Hölzle

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Organizations increasingly use environmental stimuli and ideas from users within participatory innovation processes in order to tap new sources of knowledge. The research presented in this article focuses on users who shape the distant edges of markets and currently are not using products and services from a domain– so called potential users. Those users at the peripheries are perceived to contribute more novel information, by which they better reflect shifts in needs and behavior than current users in the core market. Their contributions in collaborative and creative problem-solving processes and how they generate ideas for discontinuous innovations are of particular interest. With an experimental design, we compare ideas from potential and current users and analyze the effects of cognitive distance in collaboration and the utilization of explicit and tacit knowledge. We find potential users to generate more original ideas, particularly when they collaborate with someone experienced within the domain. Their ideas are most obviously characterized by an increased level of surprise and unusualness compared to dominant designs, which is rooted in contexts and does not require technological leaps. Collaboration with potential users can therefore result in new ways to leverage technological competences. Furthermore, the cross-fertilization arising from cognitive distance between a potential and a current user is asymmetric due to differences in the nature of their utilized knowledge and personal objectives. This paper discusses implications for innovation research and the management of early innovation processes.

Keywords: user collaboration, co-creation, discontinuous innovation, innovation research

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12649 A Study on The Relationship between Building Façade and Solar Energy Utilization Potential in Urban Residential Area in West China

Authors: T. Wen, Y. Liu, J. Wang, W. Zheng, T. Shao

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Along with the increasing density of urban population, solar energy potential of building facade in high-density residential areas become a question that needs to be addressed. This paper studies how the solar energy utilization potential of building facades in different locations of a residential areas changes with different building layouts and orientations in Xining, a typical city in west China which possesses large solar radiation resource. Solar energy potential of three typical building layouts of residential areas, which are parallel determinant, gable misalignment, transverse misalignment, are discussed in detail. First of all, through the data collection and statistics of Xining new residential area, the most representative building parameters are extracted, including building layout, building height, building layers, and building shape. Secondly, according to the results of building parameters extraction, a general model is established and analyzed with rhinoceros 6.0 and its own plug-in grasshopper. Finally, results of the various simulations and data analyses are presented in a visualized way. The results show that there are great differences in the solar energy potential of building facades in different locations of residential areas under three typical building layouts. Generally speaking, the solar energy potential of the west peripheral location is the largest, followed by the East peripheral location, and the middle location is the smallest. When the deflection angle is the same, the solar energy potential shows the result that the West deflection is greater than the East deflection. In addition, the optimal building azimuth range under these three typical building layouts is obtained. Within this range, the solar energy potential of the residential area can always maintain a high level. Beyond this range, the solar energy potential drops sharply. Finally, it is found that when the solar energy potential is maximum, the deflection angle is not positive south, but 5 °or 15°south by west. The results of this study can provide decision analysis basis for residential design of Xining city to improve solar energy utilization potential and provide a reference for solar energy utilization design of urban residential buildings in other similar areas.

Keywords: building facade, solar energy potential, solar radiation, urban residential area, visualization, Xining city

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12648 Audit Examining Maternity Assessment Suite Triage Compliance with Birmingham Symptom Specific Obstetric Triage System in a London Teaching Hospital

Authors: Sarah Atalla, Shubham Gupta, Kim Alipio, Tanya Maric

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Background: Chelsea and Westminster Hospital have introduced the Birmingham Symptom Specific Obstetric Triage System (BSOTS) for patients who present acutely to the Maternity Assessment Suite (MAS) to prioritise care by urgency. The primary objective was to evaluate whether BSOTS was used appropriately to assess patients (defined as a 90% threshold). The secondary objective was to assess whether patients were seen within their designated triaged timeframe (defined as a 90% threshold). Methodology: MAS records were retrospectively reviewed for a randomly selected one-week period of data from 2020 (21/09/2020 - 27/09/2020). 189 patients presented to MAS during this time. Data were collected on the presenting complaint, time of attendance (divided into four time categories), and triage colour code for the urgency of a review by a doctor (red: immediately, orange: within 15 minutes, yellow: within 1 hour, green: within 4 hours). The number of triage waiting times that were breached and the outcome of the attendance was noted. Results: 49% of patients presenting to MAS during this time period were triaged, which therefore did not meet the 90% target. 67% of patients who were triaged were seen within their allocated timeframe as designated by their triage colour code, which therefore did not meet the 90% target. The most frequent reason for patient attendance was reduced fetal movements (30.5% of attendances). The busiest time of day (when most patients presented) was between 06:01-12:00, and this was also when the highest number of patients were not triaged (26 patients or 54% of patients presenting in this time category). The most used triage category (59%) was the green colour code (to be seen by a doctor within 4 hours), followed by orange (24%), yellow (14%), and red (3%). 45% of triaged patients were admitted, whilst 55% were discharged. 62% of patients allocated to the green triage category were discharged, as compared to 56% of yellow category patients, 27% of orange category patients, and 50% of red category patients. The time of patient presentation to the hospital was also associated with the level of urgency and outcome. Patients presenting from 12:01 to 18:00 were more likely to be discharged (72% discharged) compared to 00:01-06:00 where only 12.5% of patients were discharged. Conclusion: The triage system for assessing the urgency of acutely presenting obstetric patients is only being effectively utilised for 49% of patients. There is potential for enhancing the employment of the triage system to enable further efficiency and boost the promotion of patient safety. It is noted that MAS was busiest at 06:01 - 12:00 when there was also the highest number of non-triaged patients – this highlights some areas where we can improve, including higher levels of staffing, better use of BSOTS to triage patients, and patient education.

Keywords: birmingham, BSOTS, maternal, obstetric, pregnancy, specific, symptom, triage

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12647 Effect of Grayanotoxins on Skeletal Muscle Cell C2C12

Authors: Bayan Almofty, Yuto Yamaki, Tadamasa Terai, Sadahito Uto

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Myopathy (muscles disease) treatment are expected in the field of regenerative medicine and applied research of cultured muscle to bio actuator is performed in Biomedical Engineering as applied research of cultured muscle. This study is about cultured myoblast C2C12 from mouse skeletal muscle and a mechanism of cultured muscle contraction by electric stimulation is investigated. Grayanotoxins (GTXs) belong to neurotoxins known to enhance the permeability of cell membrane for Na ions. Grayanotoxins are extracted from a famous Pieris japonica and Ericaceae as a phytotoxin. We investigated the functional role of GTXs on muscle cells (C2C12) contraction and membrane potential. A change in membrane potential is measured using a micro glass tube electrode contraction of myotubes is induced by applying an external electrical stimulation. The contraction and membrane potential change induced by injection of current using the micro glass electrode are also measured. From the result, contraction and membrane potential of muscle cells was affected by GTXs treatment, suggesting that the diverse chemical structures of GTXs are responsible for contraction and membrane potential of muscle cells.

Keywords: skeletal muscle, C2C12, myoblast, myotubes, contraction, Grayanotoxins, membrane potential, neurotoxins, phytotoxin

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12646 Outcome-Based Water Resources Management in the Gash River Basin, Eastern Sudan

Authors: Muna Mohamed Omer Mirghani

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This paper responds to one of the key national development strategies and a typical challenge in the Gash Basin as well as in different parts of Sudan, namely managing water scarcity in view of climate change impacts in minor water systems sustaining over 50% of the Sudan population. While now focusing on the Gash river basin, the ultimate aim is to replicate the same approach in similar water systems in central and west Sudan. The key objective of the paper is the identification of outcome-based water governance interventions in Gash Basin, guided by the global Sustainable Development Goal six (SDG 6 on water and sanitation) and the Sudan water resource policy framework. The paper concluded that improved water resources management of the Gash Basin is a prerequisite for ensuring desired policy outcomes of groundwater use and flood risk management purposes. Analysis of various water governance dimensions in the Gash indicated that the operationalization of a Basin-level institutional reform is critically focused on informed actors and adapted practices through knowledge and technologies along with the technical data and capacity needed to make that. Adapting the devolved Institutional structure at state level is recommended to strengthen the Gash basin regulatory function and improve compliance of groundwater users.

Keywords: water governance, Gash Basin, integrated groundwater management, Sudan

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12645 Business Constraints and Growth Potential of Smes: Case Study of Electrical Industry in Pakistan

Authors: Muhammad Waseem Akram

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The current study attempts to analyze the impact of business constraints on the growth potential and performance of Small and Medium Enterprises (SMEs) in the electrical industry of Pakistan. Primary data have been utilized for the study collected from the electrical industry cluster in Sargodha, Pakistan. OLS regression is used to assess the impact of business constraints on the performance of SMEs by controlling the effect of Technology Level, Innovations, and Firm Size. To associate business constraints with the growth potential of SMEs, the study utilized Tetrachoric Correlation and Logistic Regression. Findings reveal that all the business constraints negatively affect the performance of SMEs in the electrical industry except Political Instability. Results of Tetrachoric Correlation show that all the business constraints are negatively correlated with the growth potential of SMEs. Logistic Regression results show that Energy Constraint, Inflation and Price Instability, and Bad Business Practices, all three business constraints cause to reduce the probability of income growth in sample SMEs.

Keywords: SMEs, business constraints, performance, growth potential

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12644 An Empirical Study of Factors that Impact Government E-Services Acceptance by Citizens: Case Study from UAE

Authors: Emad Bataineh, Sara Al-Mutawa

Abstract:

The primary focus of this study is to investigate and identify the perceptions of potential end users relating to factors which impact on e-services acceptance. Technology Acceptance Model (TAM) has been adopted in this study as it can be extended when technologies are introduced. This research validates the developed TAM model and evaluates the variance of the outcome variable (acceptance of e-services). Five factors were adopted as determinants of acceptance of e-services: ease of use, security, trust, web skills, and language. The study was undertaken in the General Directorate of Residency and Foreigners Affairs (GDRFA) in the UAE. A quantitative survey methodology was adopted in this study, which surveyed 466 customers who use the GDRFA e-services. The overall findings revealed that security language, web skills and support significantly affected ease of use and perceived usefulness. However, the trust doesn’t affect the ease of use. Further, ease of use significantly affects intention to use and perceived usefulness while in turn intention to use was influenced by perceived usefulness. This study offers an understanding of people’s adoption of e-government services with the help of established theories such as TAM and various factors that influence the e-government adoption with reference to UAE.

Keywords: e-government portal, e-service, usability, TAM model

Procedia PDF Downloads 423
12643 Quantifying and Prioritizing Agricultural Residue Biomass Energy Potential in Ethiopia

Authors: Angesom Gebrezgabiher Tesfay, Afafaw Hailesilasie Tesfay, Muyiwa Samuel Adaramola

Abstract:

The energy demand boost in Ethiopia urges sustainable fuel options while it is mainly supplemented by traditional biomass and imported conventional fuels. To satisfy the deficiency it has to be sourced from all renewables. Thus identifying resources and estimating potential is vital to the sector. This study aims at an in-depth assessment to quantify, prioritize, and analyze agricultural residue biomass energy and related characteristic forms. Biomass use management and modernization seeks successive information and a clue about the resource quantity and characteristic. Five years of crop yield data for thirteen crops were collected. Conversion factors for their 20 residues are surveyed from the literature. Then residues amount potentially available for energy and their energy is estimated regional, crop-wise, residue-wise, and shares compared. Their potential value for energy is analyzed from two perspectives and prioritized. The gross potential is estimated to be 495PJ, equivalent to 12/17 million tons of oil/coal. At 30% collection efficiency, it is the same as conventional fuel import in 2018. Maize and sorghum potential and spatial availability are preeminent. Cotton and maize presented the highest potential values for energy from application and resource perspectives. Oromia and Amhara regions' contributions are the highest. The resource collection and application trends are required for future management that implicates a prospective study.

Keywords: crop residue, biomass potential, biomass resource, Ethiopian energy

Procedia PDF Downloads 112
12642 Prevalence and Clinical Significance of Antiphospholipid Antibodies in COVID-19 Patients Admitted to Intensive Care Units

Authors: Mostafa Najim, Alaa Rahhal, Fadi Khir, Safae Abu Yousef, Amer Aljundi, Feryal Ibrahim, Aliaa Amer, Ahmed Soliman Mohamed, Samira Saleh, Dekra Alfaridi, Ahmed Mahfouz, Sumaya Al-Yafei, Faraj Howady, Mohamad Yahya Khatib, Samar Alemadi

Abstract:

Background: Coronavirus disease 2019 (COVID-19) increases the risk of coagulopathy among critically ill patients. Although the presence of antiphospholipid antibodies (aPLs) has been proposed as a possible mechanism of COVID-19 induced coagulopathy, their clinical significance among critically ill patients with COVID-19 remains uncertain. Methods: This prospective observational study included patients with COVID-19 admitted to intensive care units (ICU) to evaluate the prevalence and clinical significance of aPLs, including anticardiolipin IgG/IgM, anti-β2-glycoprotein IgG/IgM, and lupus anticoagulant. The study outcomes included the prevalence of aPLs, a primary composite outcome of all-cause mortality, and arterial or venous thrombosis among aPLs positive patients versus aPLs negative patients during their ICU stay. Multiple logistic regression was used to assess the influence of aPLs on the primary composite outcome of mortality and thrombosis. Results: A total of 60 critically ill patients were enrolled. Of whom, 57 (95%) were male, with a mean age of 52.8 ± 12.2 years, and the majority were from Asia (68%). Twenty-two patients (37%) were found to have positive aPLs; of whom 21 patients were positive for lupus anticoagulant, whereas one patient was positive for anti-β2-glycoprotein IgG/IgM. The composite outcome of mortality and thrombosis during ICU did not differ among patients with positive aPLs compared to those with negative aPLs (4 (18%) vs. 6 (16%), aOR= 0.98, 95% CI 0.1-6.7; p-value= 0.986). Likewise, the secondary outcomes, including all-cause mortality, venous thrombosis, arterial thrombosis, discharge from ICU, time to mortality, and time to discharge from ICU, did not differ between those with positive aPLs upon ICU admission in comparison to patients with negative aPLs. Conclusion: The presence of aPLs does not seem to affect the outcomes of critically ill patients with COVID-19 in terms of all-cause mortality and thrombosis. Therefore, clinicians may not screen critically ill patients with COVID-19 for aPLs unless deemed clinically appropriate.

Keywords: antiphospholipid antibodies, critically ill patients, coagulopathy, coronavirus

Procedia PDF Downloads 159
12641 Effect of Ultrasonic Treatment on the Suspension Stability, Zeta Potential and Contact Angle of Celestite

Authors: Kiraz Esmeli, Alper Ozkan

Abstract:

In this study, firstly, the effect of ultrasonic treatment on the stability of celestite suspension was investigated. In this context, the variations of the suspension stability with ultrasonic power, treatment time, immersion depth of ultrasonic probe, and treatment regime (batch and continuous) were determined. The experimental results showed that the suspension stability and zeta potential of celestite decreased with ultrasonic treatment. Also, the treatment time, immersion depth of probe, and treatment regime affected the stability of celestite suspension. Secondly, the effect of pre-treatment of the suspension with the ultrasonic process on the shear flocculation of celestite using sodium dodecyl sulfate (SDS) was studied and the variations of the flocculation, zeta potential, and contact angle of the mineral with SDS concentration were presented. It was found that the ultrasonic pre-treatment slightly improved the shear flocculation of celestite particles in accordance with the increase in the contact angles. In addition, the ultrasonic process again relatively reduced the magnitude of the negative potential of celestite particles in the presence of SDS.

Keywords: celestite, contact angle, suspension stability, ultrasonic treatment, zeta potential

Procedia PDF Downloads 221
12640 Shedding Light on the Black Box: Explaining Deep Neural Network Prediction of Clinical Outcome

Authors: Yijun Shao, Yan Cheng, Rashmee U. Shah, Charlene R. Weir, Bruce E. Bray, Qing Zeng-Treitler

Abstract:

Deep neural network (DNN) models are being explored in the clinical domain, following the recent success in other domains such as image recognition. For clinical adoption, outcome prediction models require explanation, but due to the multiple non-linear inner transformations, DNN models are viewed by many as a black box. In this study, we developed a deep neural network model for predicting 1-year mortality of patients who underwent major cardio vascular procedures (MCVPs), using temporal image representation of past medical history as input. The dataset was obtained from the electronic medical data warehouse administered by Veteran Affairs Information and Computing Infrastructure (VINCI). We identified 21,355 veterans who had their first MCVP in 2014. Features for prediction included demographics, diagnoses, procedures, medication orders, hospitalizations, and frailty measures extracted from clinical notes. Temporal variables were created based on the patient history data in the 2-year window prior to the index MCVP. A temporal image was created based on these variables for each individual patient. To generate the explanation for the DNN model, we defined a new concept called impact score, based on the presence/value of clinical conditions’ impact on the predicted outcome. Like (log) odds ratio reported by the logistic regression (LR) model, impact scores are continuous variables intended to shed light on the black box model. For comparison, a logistic regression model was fitted on the same dataset. In our cohort, about 6.8% of patients died within one year. The prediction of the DNN model achieved an area under the curve (AUC) of 78.5% while the LR model achieved an AUC of 74.6%. A strong but not perfect correlation was found between the aggregated impact scores and the log odds ratios (Spearman’s rho = 0.74), which helped validate our explanation.

Keywords: deep neural network, temporal data, prediction, frailty, logistic regression model

Procedia PDF Downloads 151
12639 Large-Eddy Simulations for Flow Control

Authors: Reda Mankbadi

Abstract:

There are several technologically-important flow situations in which there is a need to control the outcome of the fluid flow. This could include flow separation, drag, noise, as well as particulate separations, to list only a few. One possible approach is the passive control, in which the design geometry is changed. An alternative approach is the Active Flow Control (AFC) technology in which an actuator is imbedded in the flow field to change the outcome. Examples of AFC are pulsed jets, synthetic jets, plasma actuators, heating and cooling, Etc. In this work will present an overview of the development of this field. Some examples will include: Airfoil Noise Suppression: LES is used to simulate the effect of the synthetic jet actuator on controlling the far field sound of a transitional airfoil. The results show considerable suppression of the noise if the synthetic jet is operated at frequencies. Mixing Enhancement and suppression: Results will be presented to show that imposing acoustic excitations at the nozzle exit can lead to enhancement or reduction of the jet plume mixing. In a vertical takeoff of Aircraft or in Space Launch, we will present results on the effects of water injection on reducing noise, and on protect the structure and pay load from fatigue damage. Other applications will include airfoil-gust interaction and propulsion systems optimizations.

Keywords: aerodynamics, simulations, aeroacoustics, active flow control (AFC), Large-Eddy Simulations (LES)

Procedia PDF Downloads 274
12638 Mapping of Potential Areas for Groundwater Storage in the Sais Plateau and Its Middle Atlas Borders, Morocco

Authors: Abdelghani Qadem, Zohair Qadem, Mohamed Lasri

Abstract:

At the level of the Moroccan Sais Plateau, groundwater constitutes strategic natural resources for agricultural, industrial, and domestic use. Today, due to climate change and population growth, the pressure on groundwater has increased considerably. This contribution aims to delineate and map potential areas for groundwater storage in the area in question using GIS and remote sensing. The methodology adopted is based on the identification of the thematic layers used to assess the potential recharge of the aquifer. The mapping of potential areas for groundwater storage is developed through the method of modeling and weighted overlay using the spatial analysis tool on the Geographic Information System. The results obtained can be used for the planning of future artificial recharge projects in the study area in order to ensure the good sustainable use of this underground gift.

Keywords: Morocco, climate change, groundwater, mapping, recharge

Procedia PDF Downloads 76
12637 Adopting the Transition Management Model as a Tool for Sustainable Groundwater Management in Nigeria

Authors: Ali Bakari Mohammed

Abstract:

Transitioning is a continuous process of radical change in a society which involves co-evolution of institutional, technological, socio-cultural, and ecological developments at different scales and levels. Transition management model is a methodology that influences structural change of complex systems over a period (0-30 years) by experimenting and implementing new techniques. A transition management in the context of groundwater is a radical change from the current operate and control system to a next generation integrated and sustainable system that takes into account quality protection and sustained supply into the future. This study evaluates the transition management model in adopting it as a viable tool for the attainment of sustainable groundwater management. The outcome of the evaluation shows that there are three levels (strategic, tactical and operational) of operating the transition management model. At the strategic level, long-term goals for sustainable groundwater management are formulated, at the tactical level activities such as inter institutional networking, negotiation, planning and financing are carried out, and at the operational level, transition experiments and strategic niche management are carried out at the societal level. Overall, different actors and set of activities are required to partake at each management level. The outcome of this paper will provide basis for the implementation of the Sustainable Development Goal (SDG) 6 in Nigeria.

Keywords: transition management, groundwater, sustainable management, tool, Nigeria

Procedia PDF Downloads 264
12636 Evaluation of the Role of Circulating Long Non-Coding RNA H19 as a Promising Biomarker in Plasma of Patients with Gastric Cancer

Authors: Doaa Hashad, Amany Elbanna, Abeer Ibrahim, Gihan Khedr

Abstract:

Background: H19 is one of the long non coding RNAs (LncRNA) that is related to the progression of many diseases including cancers. This work was carried out to study the level of the long non-coding RNA; H119, in plasma of patients with gastric cancer (GC) and to assess its significance in their clinical management. Methods: A total of sixty-two participants were enrolled in the present study. The first group included thirty-two GC patients, while the second group was formed of thirty age and sex matched healthy volunteers serving as a control group. Plasma samples were used to assess H19 gene expression using real time quantitative PCR technique. Results: H19 expression was up-regulated in GC patients with positive correlation to TNM cancer stages. Conclusions: Up-regulation of H19 is closely associated with gastric cancer and correlates well with tumor staging. Convenient, efficient quantification of H19 in plasma using real time PCR technique implements its role as a potential noninvasive prognostic biomarker in gastric cancer, that predicts patient’s outcome and most importantly as a novel target in gastric cancer treatment with better performance achieved on using both CEA and H19 simultaneously.

Keywords: biomarker, gastric, cancer, LncRNA

Procedia PDF Downloads 313
12635 Unravelling Domestic Electricity Demand by Domestic Renewable Energy Supply: A Case Study in Yogyakarta and Central Java, Indonesia

Authors: Diyono Harun

Abstract:

Indonesia aims to reduce carbon emissions from energy generation by reaching 23% and 31% of the national energy supply from renewable energy sources (RES) in 2025 and 2030. The potential for RES in Indonesia is enormous, but not all province has the same potential for RES. Yogyakarta, one of the most travel-destinated provinces in Indonesia, has less potential than its neighbour, Central Java. Consequently, Yogyakarta must meet its electricity demand by importing electricity from Central Java if this province only wants to use electricity from RES. Thus, achieving the objective is balancing the electricity supply between an importer (Yogyakarta) and an exporter province (Central Java). This research aims to explore the RES potential and the current capacity of RES for electricity generation in both provinces. The results show that the present capacity of RES meets the annual domestic electricity demand in both provinces only with an extension of the RES potential. The renewable energy mixes in this research also can lower CO2 emissions compared to gas-fired power plants. This research eventually provides insights into exploring and using the domestic RES potentials between two areas with different RES capacities.

Keywords: energy mix, renewable energy sources, domestic electricity, electricity generation

Procedia PDF Downloads 81
12634 Large-Eddy Simulations for Aeronautical Systems

Authors: R. R. Mankbadi

Abstract:

There are several technologically-important flow situations in which there is a need to control the outcome of the fluid flow. This could include flow separation, drag, noise, as well as particulate separations, to list only a few. One possible approach is the passive control, in which the design geometry is changed. An alternative approach is the Active Flow Control (AFC) technology in which an actuator is embedded in the flow field to change the outcome. Examples of AFC are pulsed jets, synthetic jets, plasma actuators, heating, and cooling, etc. In this work will present an overview of the development of this field. Some examples will include Airfoil Noise Suppression: Large-Eddy Simulations (LES) is used to simulate the effect of synthetic jet actuator on controlling the far field sound of a transitional airfoil. The results show considerable suppression of the noise if the synthetic jet is operated at frequencies. Mixing Enhancement and suppression: Results will be presented to show that imposing acoustic excitations at the nozzle exit can lead to enhancement or reduction of the jet plume mixing. In vertical takeoff of Aircrafts or in Space Launch, we will present results on the effects of water injection on reducing noise, and on protecting the structure and payload from fatigue damage. Other applications will include airfoil-gust interaction and propulsion systems optimizations.

Keywords: aeroacoustics, flow control, aerodynamics, large eddy simulations

Procedia PDF Downloads 281