Search results for: vital signs

Authors: Methembe Mdlalose

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This paper synthesizes the findings of a study that utilized a purposive sampling methodology laced within a grounded theory analytical framework with LED managers, mayors, and traditional leaders representing six municipalities of uThukela District of KwaZulu-Natal, South Africa. The paper critiques the two institution’s micro-relations within local governance and their overall impact on the general development discourse of rural areas. The study is located in the province of KwaZulu-Natal, a part of South Africa that experiences extremely low levels of development in rural areas and suffers from high rates of inequality, poverty, and unemployment. The paper unpacks the role of two significant stakeholders in the local sphere. Considered as the two dominant stakeholders at the local level, questions of compatibility between traditional leaders and municipal councillors often surge, as the two institutions (who represent two autonomous entities) that operate within the same operational boarders. The discussion around community development lies very deeply on accountability, which assures citizens that fruitless spending is curbed and good governance is maintained. If development is to be assured, it is vital to monitor accountability within government spheres and its departments. It is further essential to monitor the relations within local government. The findings of this research confirmed how relationships between traditional leaders and councillors can and have contributed to economic development or its stagnation thereof in rural areas. In addition, the findings revealed that there is an extensive need for the two stakeholders to work collectively, as this is a vital move in planning for development. Furthermore, the better accountability of local government and a better understanding of how clear policy and its implementation is may be a valuable asset in the discourse of community economic development in rural areas.

Keywords: economic development, traditional leadership, democratically elected councillors, local governance

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Authors: R. A. Qawasma, F. M. Haddad, H. O. Salhab

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Hemodialysis is a life-preserving treatment for a number of patients with kidney failure. The standard procedure of hemodialysis is three times a week during the hemodialysis procedure, the patient usually suffering from many inconvenient, exhausting feeling and effect on the heart and cardiovascular system are the most common signs. This paper provides a solution to reduce the previous problems by designing a wearable artificial kidney (WAK) taking in consideration a minimization the size of the dialysis machine. The WAK system consists of two circuits: blood circuit and dialysate circuit. The blood from the patient is filtered in the dialyzer before returning back to the patient. Several parameters using an advanced microcontroller and array of sensors. WAK equipped with visible and audible alarm system to aware the patients if there is any problem.

Keywords: artificial kidney, home dialysis, renal failure, wearable kidney

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Authors: Wei-Chih Huang, Pei-Lung Chung, Ching-Heng Lin, Hsuan-Chia Yang, Der-Ming Liou

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Background: In-Hospital Cardiac Arrest (IHCA) threaten life of the inpatients, cause serious effect to patient safety, quality of inpatients care and hospital service. Health providers must identify the signs of IHCA early to avoid the occurrence of IHCA. This study will consider the potential association between early signs of IHCA and the essence of patient care provided by nurses and other professionals before an IHCA occurs. The aim of this study is to identify significant associations between nursing interventions and abnormal early evaluation results of IHCA that can assist health care providers in monitoring inpatients at risk of IHCA to increase opportunities of IHCA early detection and prevention. Materials and Methods: This study used one of the data mining techniques called association rules mining to compute associations between nursing interventions and abnormal early evaluation results of IHCA. The nursing interventions and abnormal early evaluation results of IHCA were considered to be co-occurring if nursing interventions were provided within 24 hours of last being observed in abnormal early evaluation results of IHCA. The rule based methods were utilized 23.6 million electronic medical records (EMR) from a medical center in Taipei, Taiwan. This dataset includes 733 concepts of nursing interventions that coded by clinical care classification (CCC) codes and 13 early evaluation results of IHCA with binary codes. The values of interestingness and lift were computed as Q values to measure the co-occurrence and associations’ strength between all in-hospital patient care measures and abnormal early evaluation results of IHCA. The associations were evaluated by comparing the results of Q values and verified by medical experts. Results and Conclusions: The results show that there are 4195 pairs of associations between nursing interventions and abnormal early evaluation results of IHCA with their Q values. The indication of positive association is 203 pairs with Q values greater than 5. Inpatients with high blood sugar level (hyperglycemia) have positive association with having heart rate lower than 50 beats per minute or higher than 120 beats per minute, Q value is 6.636. Inpatients with temporary pacemaker (TPM) have significant association with high risk of IHCA, Q value is 47.403. There is significant positive correlation between inpatients with hypovolemia and happened abnormal heart rhythms (arrhythmias), Q value is 127.49. The results of this study can help to prevent IHCA from occurring by making health care providers early recognition of inpatients at risk of IHCA, assist with monitoring patients for providing quality of care to patients, improve IHCA surveillance and quality of in-hospital care.

Keywords: in-hospital cardiac arrest, patient safety, nursing intervention, association rule mining

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Authors: Ali Kirkbas

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R peaks in an electrocardiogram (ECG) are signs of cardiac activity in individuals that reveal valuable information about cardiac abnormalities, which can lead to mortalities in some cases. This paper examines the problem of detecting R-peaks in ECG signals, which is a two-class pattern classification problem in fact. To handle this problem with a reliable high accuracy, we propose to use the common vector approach which is a successful machine learning algorithm. The dataset used in the proposed method is obtained from MIT-BIH, which is publicly available. The results are compared with the other popular methods under the performance metrics. The obtained results show that the proposed method shows good performance than that of the other. methods compared in the meaning of diagnosis accuracy and simplicity which can be operated on wearable devices.

Keywords: ECG, R-peak classification, common vector approach, machine learning

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Authors: Sherman Ho, Ahmed Cherif Megri

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Headers play a critical role in conveying steam to regulate heating system temperatures. While various materials like steel grades 91 and 92 have been traditionally used for pipes, this research proposes the use of a robust and innovative material, INCONEL Alloy 740H. Boilers in power plant configurations are exposed to cycling conditions due to factors such as daily, seasonal, and yearly variations in weather. These cycling conditions can lead to the deterioration of headers, which are vital components with intricate geometries. Header failures result in substantial financial losses from repair costs and power plant shutdowns, along with significant public inconveniences such as the loss of heating and hot water. To address this issue and seek solutions, a mechanical analysis, as well as a structural analysis, are recommended. Transient analysis to predict heat transfer conditions is of paramount importance, as the direction of heat transfer within the header walls and the passing steam can vary based on the location of interest, load, and operating conditions. The geometry and material of the header are also crucial design factors, and the choice of pipe material depends on its usage. In this context, the heat transfer coefficient plays a vital role in header design and analysis. This research employs ANSYS Fluent, a numerical simulation program, to understand header behavior, predict heat transfer, and analyze mechanical phenomena within the header. Transient simulations are conducted to investigate parameters like heat transfer coefficient, pressure loss coefficients, and heat flux, with the results used to optimize header design.

Keywords: CFD, header, power plant, heat transfer coefficient, simulation using experimental data

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Authors: Khalid Mohammed Idrees

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Endodontic treatment aims to reverse the disease process and thereby eliminate the associated signs of symptoms. When the treatment itself appears to initiate the onset of pain and /or swelling (endodontic flare-up), the result can be distressing to both the patient and the operator. Patient might even consider postoperative symptoms as a bench mark against which the clinician’s skills are measured. Obviously the treatment with the lowest prevalence of postoperative pain is usually the treatment of choice as long as effectiveness and cost are not compromised. Knowledge of the cause and mechanism behind intra appointment flare-up is of utmost importance for the clinician to properly prevent or manage this undesirable condition. This review lecture will discuss the causative factors of flare-up with special attention to the microorganism role, various modalities of preventive measures would be discussed. Those measures are based on scientific evidence combined with the long clinical experience of the lecturer.

Keywords: endodontic flare-up, causative factors, inflammatory mediators, preventive measures

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Authors: Jeremy Schultz, Kelly Bricker

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Ecotourism has proven itself to be a forerunner in the advancement of environmental conservation all the while supporting cultural tradition, uniqueness, and pride among indigenous communities. Successful private-community partnerships associated with ecotourism operations are vital to the overall prosperity of both the businesses and the local communities. Such accomplishments can be seen through numerous livelihood goals including income, food security, health, reduced vulnerability, governance, and empowerment. Private-community partnerships also support global initiatives such as the sustainable development goals and sustainable development frameworks including those proposed by the United Nations World Tourism Organization (WTO). Understanding such partnerships assists not only large organizations such as the WTO, but it also benefits smaller ecotourism operators and entrepreneurs who are trying to achieve their sustainable tourism development goals. This study examined the partnership between an ecotourism company (Rivers Fiji) and two rural villages located in Fiji’s Upper Navua Conservation Area. Focus groups were conducted in each village. Observation journals were also used to record conversations outside of the focus groups. Data were thematically organized and analyzed to offer researcher interpretations and understandings. This research supported the notion that respectful and emboldening partnerships between communities and private enterprise are vital to the composition of successful ecotourism operations that support sustainable development protocol. Understanding these partnerships can assist in shaping future ecotourism development and re-molding existing businesses. This study has offered an example of a thriving partnership through community input and critical researcher analysis. Research has identified six contributing factors to successful ecotourism partnerships, and this study provides additional support to that framework.

Keywords: community partnerships, conservation areas, ecotourism, Fiji, sustainability

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Authors: İmran Ugur, Zulfiye Acar

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Trade marks are composed of figures, signs or symbols such as logos, colours and designs to be formed for service or products to be different from their counterparts. However, trade marks have nowadays a large meaning that defines its classical description. It has an understanding that pioneers novelties by forming the perception of quality, being emotional constituents and leading to links to their consumers. While entering different markets all over the world, Turkish trade marks are encountering a new type of consumers in Turkey migrating from different countries. Most of these new consumers meet Turkish trade marks for the first time. The present study was performed to investigate the perception of Turkish trade marks living in Konya. How these consumers look at the trade marks of clothes, food, beverages, GSM operators and whiteware appliances, and perceive these trade marks were tried to be determined. Which trade marks they chose according to their preferences, and the awareness of Turkish trade marks were evaluated in the study.

Keywords: brand, brand awareness, culture, trade marks

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Authors: Yuhang Wang

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As energy is vital to industrial productivity and human existence, ensuring energy security becomes a critical government responsibility. The Chinese government has implemented the energy transition to safeguard China’s energy security. Throughout this progression, the Chinese government has faced numerous obstacles. This article seeks to describe the causes of China’s energy transition barriers and the steps taken by the Chinese government to overcome them.

Keywords: energy transition, energy market, fragmentation, path dependency

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Authors: Pamela Chia, Tay Yoong Chuan

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Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing.

Keywords: pulmonary hypertension, case report, warfarin reversal, emergency surgery

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Authors: Turquesa Topper

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The reflection focuses on recording and explaining the considerations, conceptualizations and methodological approach with which from the University, that is to say, from the academic field, the study of Trends is addressed with the intention of training professionals in the area, an area that requires disciplinary boundaries and builds a polyphonic vision. When referring to the objective of our Laboratory the detection of aesthetic trends of consumption, we find ourselves in the requirement to define our object: trends, aesthetic trends of consumption, more specifically. The pages cover a conception of trends from a theoretical framework that incorporates contributions from linguistics, semiotics, sociology, cultural studies and project disciplines, in order to consolidate a polyphonic look. The text investigates in the pre-discursive aspect of the trends, in the circulation of the notion of style and in the dynamics of affirmation - denial as the constitutive dynamics of Fashion linked to any process of innovation. From such inquiry, it is presented to Fashion as a system that operates directly on the construction of socio-individual identities unfolding through the liquefaction of signs in trends.

Keywords: fashion, methodology, narrative, trends

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Authors: S. F. Wong, W. I. Ho, B. Lin, Q. Huang

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ERP has been used in many enterprises for management, the accuracy of the production forecasting module is vital to the decision making of the enterprise, and the profit is affected directly. Therefore, enhancing the accuracy of the production forecasting module can also increase the efficiency and profitability. To deal with a lot of data, a suitable, reliable and accurate statistics model is necessary. LSSVM and Grey System are two main models to be studied in this paper, and a case study is used to demonstrate how the combination model is effective to the result of forecasting.

Keywords: ERP, grey system, LSSVM, production forecasting

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Authors: Phillimon Mahanya

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Learners with deaf-blindness use touch to communicate. However, teachers are not well versed with tactile communication technicalities. Lack of technical know-how is compounded with a lack of standardisation of the tactile signs the world over. Thus, this study arose from the need to have efficient and effective tactile sign communication for learners who are deaf-blind. A qualitative approach that adopted a case study design was used. A sample of 22 participants comprising school administrators and teachers was purposively drawn from the institutions that enrolled learners who are deaf-blind. Data generated using semi-structured interviews, non-participant observations and document analysis were thematically analysed. It emerged that administrators and teachers used mammoth and solo touches that are not standardised to communicate with learners who are deaf-blind. It was recommended that there should be a standardised tactile sign manual in Zimbabwe to promote the inclusion of learners who are deaf-blind.

Keywords: communication, deaf-blind, signing, tactile

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Authors: Hocine Terrab , Abdelhafid Bayadi, Adel Kara, Ayman El-Hag

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Insulator flashover under polluted conditions has been a serious threat on the reliability of power systems. It is known that the flashover process is mainly affected by the environmental conditions such as; the pollution level and humidity. Those are the essential parameters influencing the wetting process. This paper presents an investigation of the characteristics of leakage current (LC) developed on the surface of porcelain insulator at contaminated conditions under AC voltage. The study is done in an artificial fog chamber and the LC is characterized for different stages; dry, wetted and presence of discharge activities. Time-frequency and spectral analysis are adopted to calculate the evolution of LC characteristics with various stages prior to flashover occurrence. The preliminary results could be used in analysing the LC to develop more effective diagnosis of early signs of dry band arcing as an indication for insulation washing.

Keywords: flashover, harmonic components, leakage current, phase angle, statistical analysis

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Authors: Darshan Lal

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The paper describes the concept of Information literacy. It is a critical component of this information age. Information literacy is the vital process in modern changing world. Information Literacy initiatives in India was also discussed. Paper also discussed Information literacy programmes for LIS professionals. Information literacy makes person capable to recognize when information is needed and how to locate, evaluate and use effectively of the needed information.

Keywords: information literacy, information communication technology (ICT), information literacy programmes

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Authors: Demet Devrimsel Dogan, Ecem Deniz Kirkpantur, Muharrem Dogan, Ahmet Aykut, Ebru Unal Akoglu, Ozge Ecmel Onur

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Introduction: Median Arcuate Ligament Syndrome (MALS) is a rare cause of chronic abdominal pain due to external compression of the celiac trunk by a fibrous arch that unites diaphragmatic crura on each side of the aortic hiatus. While 10-24% of the population may suffer from compression of celiac trunk, it rarely causes patients to develop symptoms. The typical clinical triad of symptoms includes postprandial epigastric pain, weight loss and vomiting. The diagnosis can be made using thin section multi-detector computed tomography (CT) scans which delineate the ligament and the compressed vessel. The treatment of MALS is aimed at relieving the compression of the celiac artery to restore adequate blood flow through the vessel and neurolysis to address chronic pain. Case: A 68-year-old male presented to our clinic with acute postprandial epigastric pain. This was patients’ first attack, and the pain was the worst pain of his life. The patient did not have any other symptoms like nausea, vomiting, chest pain or dyspnea. In his medical history, the patient has had an ischemic cerebrovascular stroke 5 years ago which he recovered with no sequel, and he was using 75 mg clopidogrel and 100 mg acetylsalicylic acid. He was not using any other medication and did not have a story of cardiovascular disease. His vital signs were stable (BP:113/72 mmHg, Spo2:97, temperature:36.3°C, HR:90/bpm). In his electrocardiogram, there was ST depression in leads II, III and AVF. In his physical examination, there was only epigastric tenderness, other system examinations were normal. Physical examination through his upper gastrointestinal system showed no bleeding. His laboratory results were as follows: creatinine:1.26 mg/dL, AST:42 U/L, ALT:17 U/L, amylase:78 U/L, lipase:26 U/L, troponin:10.3 pg/ml, WBC:28.9 K/uL, Hgb:12.7 gr/dL, Plt:335 K/uL. His serial high-sensitive troponin levels were also within normal limits, his echocardiography showed no segmental wall motion abnormalities, an acute myocardial infarction was excluded. In his abdominal ultrasound, no pathology was founded. Contrast-enhanced abdominal CT and CT angiography reported ‘thickened diaphragmatic cruras are compressing and stenosing truncus celiacus superior, this is likely compatible with MALS’. The patient was consulted to general surgery, and they admitted the patient for laparoscopic ligament release. Results: MALS is a syndrome that causes postprandial pain, nausea and vomiting as its most common symptoms. Affected patients are normally young, slim women between the ages of 30 and 50 who have undergone extensive examinations to find the source of their symptoms. To diagnose MALS, other underlying pathologies should initially be excluded. The gold standard is aortic angiography. Although diagnosis and treatment of MALS are unclear, symptom resolution has been achieved with multiple surgical modalities, including open, laparoscopic or robotic ligament release as well as celiac ganglionectomy, which often requires celiac artery revascularisation.

Keywords: differential diagnosis, epigastric pain, median arcuate ligament syndrome, celiac trunk

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Authors: Shabnam Dadparvar, Laijin Shen

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After a period of conflict between Russia and the West, new signs of confrontation between the United States and China are observed. China, as the most populous country in the world with a high rate of economic growth, neither stands the hegemonic power of the United States nor has the intention of direct confrontation with it. By raising the costs of the United States’ leadership at the international level, China seeks to find a better status without direct confrontation with the US. Meanwhile, the Shanghai Cooperation Organization (SCO), as a soft balancing strategy against the hegemony of the United States is used as a tool to reach this goal. The authors by using a descriptive-analytical method try to explain the policies of China and the United States on Shanghai Cooperation Organization as well as confrontation between these two countries within the framework of 'balance of soft power theory'.

Keywords: balance of soft power, Central Asia, Shanghai cooperation organization, terrorism

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Authors: Launcelot.McGrath

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A comprehensive understanding of physiological data is a vital aid to the anaesthesiologist in monitoring and maintaining the well-being of a patient undergoing surgery. Biosignal analysis is one of the most important topics that researchers have tried to develop over the last century to understand numerous human diseases. Understanding which biological signals are most important during anaesthesia is critically important. It is important that the anaesthesiologist understand both the signals themselves and the limitations introduced by the processes of acquisition. In this article, we provide an overview of different types of biological signals as well as the mechanisms applied to acquire them.

Keywords: general biosignals, anaesthesia, biological, electroencephalogram

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Authors: Maria Cristina B. Cabanag, Elijinese Marie S. Culangen

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Pregnancy is a period in a woman's life wherein the body may undergo different physiological changes. These changes can be attributed to the interplay of hormones in the body but can mask a more sinister type of disease such as malignancy on rare occasions. Colorectal cancer (CRC) in pregnancy is an epidemiologically rare disease worldwide. To our knowledge, no available studies were reported in the Philippines at the time of this writing, posing a dilemma for its appropriate diagnosis and management. Signs and symptoms of colorectal malignancy may camouflage a normal pregnancy and, when overlooked, impedes an appropriate approach. This case of a 38-year-old elderly primigravid who presented with hematochezia on her 25th week of gestation. She was diagnosed with rectal adenocarcinoma later in pregnancy which warranted a predicament regarding her appropriate care and management. This paper explores the repertoire of the different diagnostic and treatment approaches to colorectal cancer in the second trimester of pregnancy, with the least possible maternal and fetal hazards.

Keywords: cancer in pregnancy, chemotherapy in pregnancy, colorectal cancer, hematochezia in pregnancy

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Authors: Khalid Sekkat, Fredj Fhima, Ridha Nouira

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This paper focuses on three main limitations of the literature regarding the impact of corruption on democracy. These limitations relate to the distinction between causality and correlation, the components of democracy underlying the impact and the shape of the relationship between corruption and democracy. The study uses recent developments in panel data causality econometrics, breaks democracy down into different components, and examines the types of the relationship. The results show that Control of Corruption leads to a higher quality of democracy. Regarding the estimated coefficients of the components of democracy, they are significant at the 1% level, and their signs and levels are in accordance with expectations except in a few cases. Overall, the results add to the literature in three respects: i). corruption has a causal effect on democracy and, hence, single equation estimation may pose a problem, ii) the assumption of the linearity of the relationships between control of corruption and democracy is also possibly problematic, and iii) the channels of transmission of the effects of corruption on democracy can be diverse. Disentangling them is useful from a policy perspective.

Keywords: corruption, governance, causality, threshold models

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Authors: Poopak Dehshahri

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The applicability of intellectual property rights in the sports industry from the present paper’s perspective includes athletic skills, which are comprised of two parts: athletic movements and athletic methods. Also, the applicability pertaining to the athletes᾽ personality, such as the Name, the Image, the Voice, the Signature and their Shirt Number, are deemed as related to the sports natural persons. Radio and TV broadcasting rights of the sports events, the signs and symbols of the athletic institutions including the sign and symbol, trademark (brand name), the name and the place of residence of the sports clubs, the Sports events and the special sports, special slogan of the sports clubs or sports competitions and the sports clothing design are Included under the athletic institutions᾽ applicability of intellectual property rights.

Keywords: sport industry, intellectual property, sport skills, right to fame, radio and television broadcasting right, sport sign

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Authors: Nur-E-Jannat Tinu

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Water is absolutely vital not only for the survival of human beings but also for plants, animals, and all other living organisms. Water bodies, such as lakes, rivers, ponds, and estuaries, are the source of water supply in domestic, industrial, agriculture, and aquaculture purposes. The Buriganga River flows through the south and west of Dhaka city. The water quality of this river has become a matter of concern due to anthropogenic intervention of vital pollutants such as industrial effluents, urban sewage, and solid wastes in this area. Buriganga River is at risk to contamination from untreated municipal wastes, industrial discharges, runoff from organic and inorganic fertilizers, pesticides, insecticides, and oil emission around the river. The residential and commercial establishments along the river discharge wastewater either directly into the river or through drains and canals into the river. However, several regulatory measures and policies have been enforced by the Government to protect the river Buriganga from pollution, in most cases to no affect. Water quality assessment reveals that the water is also not appropriate for irrigation purposes. The physical parameters (pH, TDS, EC, Temperature, DO, COD, BOD) indicated that the water is too poor to be useable for agricultural, drinking, or other purposes. Chemical concentrations showed significant seasonal variations with high-level concentrations during the monsoon season, presumably due to extreme seasonal surface runoff. A comparative study of Electrical Conductivity (EC) and Total Dissolved Solids (TDS) indicated a considerable increase over the last five years A change in trend was observed from 2020 June-July, probably due to monsoon and post-monsoon. EC values decreased from 775 to 665 mmho/cm during this period. DO increased significantly from the mid-post-monsoon months to the early monsoon period. The pH value of river water is strongly alkaline, ranging between 6.5 and 7.79. This indicates that ecological organic compounds cause the water to become alkaline after the monsoon and monsoon seasons. As the water pollution level is very high, an effective remediation and pollution control plan should be considered.

Keywords: precipitation, spatial distribution, effluent, remediation

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Authors: N. N. Pilau, M. S. Abubakar, A. Danmaigoro, P. C. Mshelia, Y. Sani

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A severely debilitated 4months old Caucasian male dog presented dehydration, emaciation, vomiting, icteric ocular and oral mucous membranes, generalized lymphadenopathy, hematuria, anorexia and prolonged recumbency. Clinical workup was done in established protocols for diagnosis based on history, clinical signs and selected laboratory tests. Treatment course were administered over 48hours during which the patient died of overwhelming hepatopathy, nephropathy and pneumonia. Postmortem findings supported by ante mortem laboratory test results tentatively diagnosed leptospirosis, a disease endemic and presenting potentially fatal epidemics and zoonoses in some countries amongst the developing regions of the world. This disease is reviewed and a call for attention on the public health significance of the disease is hereby presented through this case report.

Keywords: canine, endemic, leptospirosis, prevalence

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Authors: Saleh Alshehri

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Human skin detection is a vital step in many applications. Some of the applications are critical especially those related to security. This leverages the importance of a high-performance detection algorithm. To validate the accuracy of the algorithm, image databases are usually used. However, the suitability of these image databases is still questionable. It is suggested that the suitability can be measured mainly by the span the database covers of the color space. This research investigates the validity of three famous image databases.

Keywords: image databases, image processing, pattern recognition, neural networks

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Authors: Ng Liang Shen, Ngahzaifa Abdul Ghani

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This research aimed at developing an early warning system for pre-diabetic and diabetics by analyzing simple and easily determinable signs and symptoms of diabetes among the people living in Malaysia using Particle Swarm Optimized Artificial. With the skyrocketing prevalence of Type 2 diabetes in Malaysia, the system can be used to encourage affected people to seek further medical attention to prevent the onset of diabetes or start managing it early enough to avoid the associated complications. The study sought to find out the best predictive variables of Type 2 Diabetes Mellitus, developed a system to diagnose diabetes from the variables using Artificial Neural Networks and tested the system on accuracy to find out the patent generated from diabetes diagnosis result in machine learning algorithms even at primary or advanced stages.

Keywords: diabetes diagnosis, Artificial Neural Networks, artificial intelligence, soft computing, medical diagnosis

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Authors: Godwin Dennison, Edwin Cooper, George Theobald, Richard Dalton

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We report an unusual case of giant filiform polyposis in a patient with ulcerative colitis, causing a large stricture in the colon. A 62-year-old man was referred to the Bowel Cancer Screening Programme with a positive Faecal Immunochemical Test (FIT). He was known to have UC for 30 years. A CT scan showed a 9 cm stricture in the transverse colon suspicious of malignancy. A colonoscopy was attempted three times, and biopsies confirmed features of ulcerative colitis. A laparoscopic assisted transverse colectomy (Left hemicolectomy) was performed, and the histology revealed giant filiform polyposis. This should be considered in a UC patient presenting with signs of obstruction mimicking a carcinoma. Whilst it is a benign condition, because of the size of the lesion, it often causes obstruction, and surgery is indicated to relieve symptoms.

Keywords: giant inflammatory polyposis, filiform polyposis, ulcerative colitis, inflammatory bowel disease

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Authors: Sudheer Dhume, T. Prasad

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There are distinct signs of Business Education losing its sheen. It is more so in developing countries. One of the reasons is the value addition at the end of 2 year MBA program is not matching with the requirements of present times and expectations of the students. In this backdrop, Pedagogy Innovation has become prerequisite for making our MBA programs relevant and useful. This paper is the description and analysis of innovative Action Learning pedagogical approach adopted by a group of faculty members at NITIE Mumbai. It not only promotes multidisciplinary research but also enhances integration of the functional areas skillsets in the students. The paper discusses the theoretical bases of this pedagogy and evaluates the effectiveness of it vis-à-vis conventional pedagogical tools. The evaluation research using Bloom’s taxonomy framework showed that this blended method of Business Education is much superior as compared to conventional pedagogy.

Keywords: action learning, blooms taxonomy, business education, innovation, pedagogy

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Authors: Sarah Hazelwood, Janice Hay

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Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.

Keywords: analgesia, benefits, emergency, methoxyflurane

Procedia PDF Downloads 113

Authors: Muluwerk Ayele Derebe

Abstract:

Background: Antenatal care (ANC) is an essential element in the continuum of reproductive health care for preventing preventable pregnancy-related morbidity and mortality. Objective: The aim of this study is to assess the spatial pattern and predictors of ANC visits in Ethiopia. Method: This study was done using Ethiopian Demographic and Health Survey data of 2016 among 7,174 pregnant women aged 15-49 years which was a nationwide community-based cross-sectional survey. Spatial analysis was done using Getis-Ord Gi* statistics to identify hot and cold spot areas of ANC visits. Multilevel glmmTMB packages adjusted for spatial effects were used in R software. Spatial multilevel count regression was conducted to identify predictors of antenatal care visits for pregnant women, and proportional change in variance was done to uncover the effect of individual and community-level factors of ANC visits. Results: The distribution of ANC visits was spatially clustered Moran’s I = 0.271, p<.0.001, ICC = 0.497, p<0.001). The highest spatial outlier areas of ANC visit was found in Amhara (South Wollo, Weast Gojjam, North Shewa), Oromo (west Arsi and East Harariga), Tigray (Central Tigray) and Benishangul-Gumuz (Asosa and Metekel) regions. The data was found with excess zeros (34.6%) and over-dispersed. The expected ANC visit of pregnant women with pregnancy complications was higher at 0.7868 [ARR= 2.1964, 95% CI: 1.8605, 2.5928, p-value <0.0001] compared to pregnant women who had no pregnancy complications. The expected ANC visit of a pregnant woman who lived in a rural area was 1.2254 times higher [ARR=3.4057, 95% CI: 2.1462, 5.4041, p-value <0.0001] as compared to a pregnant woman who lived in an urban. The study found dissimilar clusters with a low number of zero counts for a mean number of ANC visits surrounded by clusters with a higher number of counts of an average number of ANC visits when other variables held constant. Conclusion: This study found that the number of ANC visits in Ethiopia had a spatial pattern associated with socioeconomic, demographic, and geographic risk factors. Spatial clustering of ANC visits exists in all regions of Ethiopia. The predictor age of the mother, religion, mother’s education, husband’s education, mother's occupation, husband's occupation, signs of pregnancy complication, wealth index and marital status had a strong association with the number of ANC visits by each individual. At the community level, place of residence, region, age of the mother, sex of the household head, signs of pregnancy complications and distance to health facility factors had a strong association with the number of ANC visits.

Keywords: Ethiopia, ANC, spatial, multilevel, zero inflated Poisson

Procedia PDF Downloads 60

Authors: M. Fry, L. Fitzpatrick, Julie Considine, R. Z. Shaban, Kate Curtis

Abstract:

Introduction: The vast majority of older Australians lives independently and are self-managing at home, despite a growing number living with a chronic illness that requires health intervention. Evidence shows that between 50% and 80% of people presenting to the emergency department (ED) are in pain. Australian EDs manage 7.2 million attendances every year and 1.4 million of these are people aged 65 years or more. Research shows that 28% of ED patients aged 65 years or more have Cognitive impairment (CI) associated with dementia, delirium and neurological conditions. Background: Traditional ED service delivery may not be suitable for older people who present with multiple, complex and ongoing illnesses. Likewise, ED clinical staff often perceive that their role should be focused more on immediate and potential lifethreatening illness and conditions which are episodic in nature. Therefore, the needs of older people and their family/carers may not be adequately addressed in the context of an ED presentation. Aim: We aimed to explore the utilisation and characteristics of older people presenting to four metropolitan EDs. Method: The findings being presented are part of a program of research exploring pain management practices for older persons with long bone fractures. The study was conducted across four metropolitan emergency departments of older patients (65years and over) and involved a 12-month randomised medical record audit (n=255). Results: ED presentations across four ED sites in 2012 numbered 168021, with 44778 (26.6%) patients aged 65 and over. Of the 44778 patients, the average age was 79.1 years (SD 8.54). There were more females 23932 (53.5%). The majority (26925: 85.0%) of older persons self-referred to the ED and lived independently. The majority arrived by ambulance (n=18553: 41.4%) and were allocated triage category was 3 (n=19,507:43.65%) or Triage category 4 at (n=15,389: 34.43%). The top five triage symptom presentations involved pain (n=8088; 18.25%), dyspnoea (n=4735; 10.7%), falls (n=4032; 9.1%), other (n=3984; 9.0%), cardiac (n=2987; 6.7%). The top five system based diagnostic presentations involved musculoskeletal (n=8902; 20.1%), cardiac (n=6704:15.0%), respiratory (n=4933; 11.0%), neurological (n=4909; 11.0%), gastroenterology (n=4321; 9.7%). On review of one tertiary hospital database the vital signs on average at time triage: Systolic Blood Pressure 143.6mmHg. Heart Rate 83.4 beats/minute; Respiratory Rate 18.5 breaths/ minute; Oxygen saturation 97.0% and Tympanic temperature 36.7 and Blood Glucose Level 7.4mmols/litre. The majority presented with a Glasgow Coma Score of 14 or higher. On average the older person stayed in the ED 4:56 (SD 3:28minutes).The average time to be seen was 39 minutes (SD 48 minutes). The majority of older persons were admitted (n=27562: 61.5%), did not wait for treatment (n= 8879: 0.02%) discharged home (n=16256: 36.0%). Conclusion: The vast majority of older persons are living independently, although many require admission on arrival to the ED. Many arrived in pain and with musculoskeletal injuries and or conditions. New models of care need to be considered, which may better support self-management and independent living of the older person and the National Emergency Access Targets.

Keywords: chronic, older person, aged care, emergency department

Procedia PDF Downloads 220