Search results for: approach to patient
13792 A Cultural-Sensitive Approach to Counseling a Samoan Sex Offender
Authors: Byron Malaela Sotiata Seiuli
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Sexual violation is any form of sexual violence, including rape, child molestation, incest, and similar forms of non-consensual sexual contact. Much of these acts of violation are perpetuated, but not entirely, by men against women and children. Moetolo is a Samoan term that is used to describe a person who sexually violates another while they or their family are asleep. This paper presents and discusses sexual abuse from a Samoan viewpoint. Insights are drawn from the authors’ counseling engagement with a Samoan sex offender as part of his probation review process. Relevant literature is also engaged to inform and provide interpretation to the therapeutic work carried out. This article seeks to contribute new understanding to patterned responses of some Samoan people to sexual abuse behaviors, and steps to remedy arising concerns with perpetrators seeking reintegration back into their communities.Keywords: Fa'asamoa, Samoan identity, sexual abuse counseling, Uputaua therapeutic approach
Procedia PDF Downloads 30113791 Enhancing Reading in English through a Phonics-Based Approach and Interactive Whiteboards
Authors: Carmen Manuela Pereira Carneiro Lucas
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Background: The milestones on first (L1) and second (L2) language acquisition have fascinated researchers and practitioners for decades. However, the findings from the available research do not always and instantly reflect on the classroom, specifically in Teaching English to Young Learners in Portuguese primary schools. Within this, it is worth highlighting, as per previous studies, the lack of uniformity in terms of syllabus design and implementation in the classroom. Moreover, more continuous professional development opportunities would be welcome. This paper is set out to gather the “best of both worlds”, with the aim of contributing to research-informed teaching, based in actual findings from the classroom, through and after the implementation of an action-research programme for nurturing the seeds in learning how to read in English. Therefore, the purpose of this study was to examine the effectiveness of read-aloud storybooks, associated with the use of interactive whiteboards, further anchored in a phonics-based approach to teach reading and writing to Young Learners of English. Methods: Participants were 80 (n=80) native Portuguese children, attending the second year of primary school, learning English as a Foreign Language (EFL) classes, aged 7 years old. Results and Conclusions: The findings suggest that through the use of storybooks, followed by watching the respective videos, together with follow-up phonics activities are effective strategies which Teachers of English to Young Learners can certainly use to “nurture the seeds” for English language learning.Keywords: teaching English to young learners, phonics-based approach, content for language and integrated learning, English across the curriculum, interactive whiteboards, teacher training
Procedia PDF Downloads 2313790 Embedding the Dimensions of Sustainability into City Information Modelling
Authors: Ali M. Al-Shaery
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The purpose of this paper is to address the functions of sustainability dimensions in city information modelling and to present the required sustainability criteria that support establishing a sustainable planning framework for enhancing existing cities and developing future smart cities. The paper is divided into two sections. The first section is based on the examination of a wide and extensive array of cross-disciplinary literature in the last decade and a half to conceptualize the terms ‘sustainable’ and ‘smart city,' and map their associated criteria to city information modelling. The second section is based on analyzing two approaches relating to city information modelling, namely statistical and dynamic approaches, and their suitability in the development of cities’ action plans. The paper argues that the use of statistical approaches to embedding sustainability dimensions in city information modelling have limited value. Despite the popularity of such approaches in addressing other dimensions like utility and service management in development and action plans of the world cities, these approaches are unable to address the dynamics across various city sectors with regards to economic, environmental and social criteria. The paper suggests an integrative dynamic and cross-disciplinary planning approach to embedding sustainability dimensions in city information modelling frameworks. Such an approach will pave the way towards optimal planning and implementation of priority actions of projects and investments. The approach can be used to achieve three main goals: (1) better development and action plans for world cities (2) serve the development of an integrative dynamic and cross-disciplinary framework that incorporates economic, environmental and social sustainability criteria and (3) address areas that require further attention in the development of future sustainable and smart cities. The paper presents an innovative approach for city information modelling and a well-argued, balanced hierarchy of sustainability criteria that can contribute to an area of research which is still in its infancy in terms of development and management.Keywords: information modelling, smart city, sustainable city, sustainability dimensions, sustainability criteria, city development planning
Procedia PDF Downloads 32713789 Calculating Ventricle’s Area Based on Clinical Dementia Rating Values on Coronal MRI Image
Authors: Retno Supriyanti, Ays Rahmadian Subhi, Yogi Ramadhani, Haris B. Widodo
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Alzheimer is one type of disease in the elderly that may occur in the world. The severity of the Alzheimer can be measured using a scale called Clinical Dementia Rating (CDR) based on a doctor's diagnosis of the patient's condition. Currently, diagnosis of Alzheimer often uses MRI machine, to know the condition of part of the brain called Hippocampus and Ventricle. MRI image itself consists of 3 slices, namely Coronal, Sagittal and Axial. In this paper, we discussed the measurement of the area of the ventricle especially in the Coronal slice based on the severity level referring to the CDR value. We use Active Contour method to segment the ventricle’s region, therefore that ventricle’s area can be calculated automatically. The results show that this method can be used for further development in the automatic diagnosis of Alzheimer.Keywords: Alzheimer, CDR, coronal, ventricle, active contour
Procedia PDF Downloads 26613788 Critical Comparison of Two Teaching Methods: The Grammar Translation Method and the Communicative Teaching Method
Authors: Aicha Zohbie
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The purpose of this paper is to critically compare two teaching methods: the communicative method and the grammar-translation method. The paper presents the importance of language awareness as an approach to teaching and learning language and some challenges that language teachers face. In addition, the paper strives to determine whether the adoption of communicative teaching methods or the grammar teaching method would be more effective to teach a language. A variety of features are considered for comparing the two methods: the purpose of each method, techniques used, teachers’ and students’ roles, the use of L1, the skills that are emphasized, the correction of students’ errors, and the students’ assessments. Finally, the paper includes suggestions and recommendations for implementing an approach that best meets the students’ needs in a classroom.Keywords: language teaching methods, language awareness, communicative method grammar translation method, advantages and disadvantages
Procedia PDF Downloads 15113787 Density-based Denoising of Point Cloud
Authors: Faisal Zaman, Ya Ping Wong, Boon Yian Ng
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Point cloud source data for surface reconstruction is usually contaminated with noise and outliers. To overcome this, we present a novel approach using modified kernel density estimation (KDE) technique with bilateral filtering to remove noisy points and outliers. First we present a method for estimating optimal bandwidth of multivariate KDE using particle swarm optimization technique which ensures the robust performance of density estimation. Then we use mean-shift algorithm to find the local maxima of the density estimation which gives the centroid of the clusters. Then we compute the distance of a certain point from the centroid. Points belong to outliers then removed by automatic thresholding scheme which yields an accurate and economical point surface. The experimental results show that our approach comparably robust and efficient.Keywords: point preprocessing, outlier removal, surface reconstruction, kernel density estimation
Procedia PDF Downloads 34413786 Anaesthetic Management of a Huge Oropharyngeal Mass
Authors: Vasudha Govil, Suresh Singhal
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Introduction: Patients with oropharyngeal masses pose a challenge for an anaesthetist in terms of ventilation and tracheal intubation. Thus, preoperative assessment and preparation become an integral part of managing such anticipated difficult airway cases. Case report: A 45- year old female presented with growth in the oropharynx causing dysphagia and hoarseness of voice. Clinical examination and investigations predicted a difficult airway. It was managed with fibreoptic nasotracheal intubation with a successful perioperative outcome. Tracheostomy was kept as plan B in case of the CVCI situation. Conclusion: Careful preoperative examination and assessment is required to prepare oneself for difficult airway. Fibreoptic bronchoscope-guided nasotracheal intubation in a spontaneously breathing patient is a safe and successful airway management technique in difficult airway cases.Keywords: airway, difficult, mass, oropharyngeal
Procedia PDF Downloads 19213785 Acupuncture and Topiramat in Treatment of Migraine
Authors: Lazgeen Mohammed
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The greatest advantage of acupuncture over western medicine is that it is safe . Unlike synthetic drugs, acupuncture has virtually no side effects, and the procedures for treating headaches are much less invasive. Migraine headaches are usually one-sided, pulsating or throbbing, and moderate or severe in intensity.. Some patients also experience auras, a neurological symptom that develops gradually over 5-20 minutes. The patient may see brief flashes or waves of light, or changes in their vision. Other common features of auras include vertigo, imbalance, confusion and numbness.Acupuncture had been used to treat 50 patients suffering from migraine ,topiramat (topamax) given to prevent the attacks, duration of treatment is 10 weeks , the patients were fallowed up for one year .Topiramat is called an anticonvulsant.Topiramat is also used to prevent migraine headaches in adults and teenagers who are at least 12 years old. This medicine will only prevent migraine headaches or reduce the number of attacks. It will not treat a headache that has already begun.Keywords: acpuncture, migraine, topiramat, headache
Procedia PDF Downloads 7113784 Systemic Approach to Risk Measurement of Drainage Systems in Urban Areas
Authors: Jadwiga Królikowska, Andrzej Królikowski, Jarosław Bajer
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The work delineates the threats of maladjustment of the capacity of rain canals, designed and built in the early 20th century, in connection to heavy rainfall, especially in summer. This is the cause of the so called 'urban floods.' It directly relates to fierce raise of paving in the cities. Resolving this problem requires a change in philosophy of draining the rainfall by wider use of retention, infiltration and usage of rainwater. In systemic approach to managing the safety of urban drainage systems the risk, which is directly connected to safety failures, has been accepted as a measure. The risk level defines the probability of occurrence of losses greater than the ones forecast for a given time frame. The procedure of risk modelling, enabling its numeric analysis by using appropriate weights, is a significant issue in this paper.Keywords: risk management, drainage system, urban areas, urban floods
Procedia PDF Downloads 36113783 Diagnostic Performance of Mean Platelet Volume in the Diagnosis of Acute Myocardial Infarction: A Meta-Analysis
Authors: Kathrina Aseanne Acapulco-Gomez, Shayne Julieane Morales, Tzar Francis Verame
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Mean platelet volume (MPV) is the most accurate measure of the size of platelets and is routinely measured by most automated hematological analyzers. Several studies have shown associations between MPV and cardiovascular risks and outcomes. Although its measurement may provide useful data, MPV remains to be a diagnostic tool that is yet to be included in routine clinical decision making. The aim of this systematic review and meta-analysis is to determine summary estimates of the diagnostic accuracy of mean platelet volume for the diagnosis of myocardial infarction among adult patients with angina and/or its equivalents in terms of sensitivity, specificity, diagnostic odds ratio, and likelihood ratios, and to determine the difference of the mean MPV values between those with MI and those in the non-MI controls. The primary search was done through search in electronic databases PubMed, Cochrane Review CENTRAL, HERDIN (Health Research and Development Information Network), Google Scholar, Philippine Journal of Pathology, and Philippine College of Physicians Philippine Journal of Internal Medicine. The reference list of original reports was also searched. Cross-sectional, cohort, and case-control articles studying the diagnostic performance of mean platelet volume in the diagnosis of acute myocardial infarction in adult patients were included in the study. Studies were included if: (1) CBC was taken upon presentation to the ER or upon admission (within 24 hours of symptom onset); (2) myocardial infarction was diagnosed with serum markers, ECG, or according to accepted guidelines by the Cardiology societies (American Heart Association (AHA), American College of Cardiology (ACC), European Society of Cardiology (ESC); and, (3) if outcomes were measured as significant difference AND/OR sensitivity and specificity. The authors independently screened for inclusion of all the identified potential studies as a result of the search. Eligible studies were appraised using well-defined criteria. Any disagreement between the reviewers was resolved through discussion and consensus. The overall mean MPV value of those with MI (9.702 fl; 95% CI 9.07 – 10.33) was higher than in those of the non-MI control group (8.85 fl; 95% CI 8.23 – 9.46). Interpretation of the calculated t-value of 2.0827 showed that there was a significant difference in the mean MPV values of those with MI and those of the non-MI controls. The summary sensitivity (Se) and specificity (Sp) for MPV were 0.66 (95% CI; 0.59 - 0.73) and 0.60 (95% CI; 0.43 – 0.75), respectively. The pooled diagnostic odds ratio (DOR) was 2.92 (95% CI; 1.90 – 4.50). The positive likelihood ratio of MPV in the diagnosis of myocardial infarction was 1.65 (95% CI; 1.20 – 22.27), and the negative likelihood ratio was 0.56 (95% CI; 0.50 – 0.64). The intended role for MPV in the diagnostic pathway of myocardial infarction would perhaps be best as a triage tool. With a DOR of 2.92, MPV values can discriminate between those who have MI and those without. For a patient with angina presenting with elevated MPV values, it is 1.65 times more likely that he has MI. Thus, it is implied that the decision to treat a patient with angina or its equivalents as a case of MI could be supported by an elevated MPV value.Keywords: mean platelet volume, MPV, myocardial infarction, angina, chest pain
Procedia PDF Downloads 8713782 Coding and Decoding versus Space Diversity for Rayleigh Fading Radio Frequency Channels
Authors: Ahmed Mahmoud Ahmed Abouelmagd
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The diversity is the usual remedy of the transmitted signal level variations (Fading phenomena) in radio frequency channels. Diversity techniques utilize two or more copies of a signal and combine those signals to combat fading. The basic concept of diversity is to transmit the signal via several independent diversity branches to get independent signal replicas via time – frequency - space - and polarization diversity domains. Coding and decoding processes can be an alternative remedy for fading phenomena, it cannot increase the channel capacity, but it can improve the error performance. In this paper we propose the use of replication decoding with BCH code class, and Viterbi decoding algorithm with convolution coding; as examples of coding and decoding processes. The results are compared to those obtained from two optimized selection space diversity techniques. The performance of Rayleigh fading channel, as the model considered for radio frequency channels, is evaluated for each case. The evaluation results show that the coding and decoding approaches, especially the BCH coding approach with replication decoding scheme, give better performance compared to that of selection space diversity optimization approaches. Also, an approach for combining the coding and decoding diversity as well as the space diversity is considered, the main disadvantage of this approach is its complexity but it yields good performance results.Keywords: Rayleigh fading, diversity, BCH codes, Replication decoding, convolution coding, viterbi decoding, space diversity
Procedia PDF Downloads 44313781 The Use of Brachytherapy in the Treatment of Liver Metastases: A Systematic Review
Authors: Mateusz Bilski, Jakub Klas, Emilia Kowalczyk, Sylwia Koziej, Katarzyna Kulszo, Ludmiła Grzybowska- Szatkowska
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Background: Liver metastases are a common complication of primary solid tumors and sig-nificantly reduce patient survival. In the era of increasing diagnosis of oligometastatic disease and oligoprogression, methods of local treatment of metastases, i.e. MDT, are becoming more important. Implementation of such treatment can be considered for liver metastases, which are a common complication of primary solid tumors and significantly reduce patient survival. To date, the mainstay of treatment for oligometastatic disease has been surgical resection, but not all patients qualify for the procedure. As an alternative to surgical resection, radiotherapy techniques have become available, including stereotactic body radiation therapy (SBRT) or high-dose interstitial brachytherapy (iBT). iBT is an invasive method that emits very high doses of radiation from the inside of the tumor to the outside. This technique provides better tumor coverage than SBRT while having little impact on surrounding healthy tissue and elim-inates some concerns involving respiratory motion. Methods: We conducted a systematic re-view of the scientific literature on the use of brachytherapy in the treatment of liver metasta-ses from 2018 - 2023 using PubMed and ResearchGate browsers according to PRISMA rules. Results: From 111 articles, 18 publications containing information on 729 patients with liver metastases were selected. iBT has been shown to provide high rates of tumor control. Among 14 patients with 54 unresectable RCC liver metastases, after iBT LTC was 92.6% during a median follow-up of 10.2 months, PFS was 3.4 months. In analysis of 167 patients after treatment with a single fractional dose of 15-25 Gy with brachytherapy at 6- and 12-month follow-up, LRFS rates of 88,4-88.7% and 70.7 - 71,5%, PFS of 78.1 and 53.8%, and OS of 92.3 - 96.7% and 76,3% - 79.6%, respectively, were achieved. No serious complications were observed in all patients. Distant intrahepatic progression occurred later in patients with unre-sectable liver metastases after brachytherapy (PFS: 19.80 months) than in HCC patients (PFS: 13.50 months). A significant difference in LRFS between CRC patients (84.1% vs. 50.6%) and other histologies (92.4% vs. 92.4%) was noted, suggesting a higher treatment dose is necessary for CRC patients. The average target dose for metastatic colorectal cancer was 40 - 60 Gy (compared to 100 - 250 Gy for HCC). To better assess sensitivity to therapy and pre-dict side effects, it has been suggested that humoral mediators be evaluated. It was also shown that baseline levels of TNF-α, MCP-1 and VEGF, as well as NGF and CX3CL corre-lated with both tumor volume and radiation-induced liver damage, one of the most serious complications of iBT, indicating their potential role as biomarkers of therapy outcome. Con-clusions: The use of brachytherapy methods in the treatment of liver metastases of various cancers appears to be an interesting and relatively safe therapeutic method alternative to sur-gery. An important challenge remains the selection of an appropriate brachytherapy method and radiation dose for the corresponding initial tumor type from which the metastasis origi-nated.Keywords: liver metastases, brachytherapy, CT-HDRBT, iBT
Procedia PDF Downloads 11413780 A Biomechanical Model for the Idiopathic Scoliosis Using the Antalgic-Trak Technology
Authors: Joao Fialho
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The mathematical modelling of idiopathic scoliosis has been studied throughout the years. The models presented on those papers are based on the orthotic stabilization of the idiopathic scoliosis, which are based on a transversal force being applied to the human spine on a continuous form. When considering the ATT (Antalgic-Trak Technology) device, the existent models cannot be used, as the type of forces applied are no longer transversal nor applied in a continuous manner. In this device, vertical traction is applied. In this study we propose to model the idiopathic scoliosis, using the ATT (Antalgic-Trak Technology) device, and with the parameters obtained from the mathematical modeling, set up a case-by-case individualized therapy plan, for each patient.Keywords: idiopathic scoliosis, mathematical modelling, human spine, Antalgic-Trak technology
Procedia PDF Downloads 26913779 Numerical Simulation of Two-Dimensional Porous Cylinder Flow in In-Line Arrangement
Authors: Hamad Alhajeri, Abdulrahman Almutairi, A. H. Alenezi, M. H. Alhajeri, Ayedh Alajmi
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The flow around three porous cylinders in inline arrangement is investigated in this paper computationally using the commercial code FLUENT. The arrangement generally operates with the dirty gases passing through the porous cylinders, the particulate material being deposited on the outside of the cylinders. However, in a combined cycle power plant, filtration is required to allow the hot exhaust gases to be fed to a turbine without causing any physical damage to the turbine blades. Three cylinder elements are placed in a two-dimensional rectangle duct with fixed face velocity and varying the velocity ratio between the approach and face velocity. Particle trajectories are obtained for a number of particle diameters and different inlet (approach) velocity to face filtration velocity ratios to investigate the behavior of particles around the cylinder.Keywords: porous cylinders, CFD, fluid flow, filtration
Procedia PDF Downloads 48413778 Analysis of Reflection of Elastic Waves in Three Dimensional Model Comprised with Viscoelastic Anisotropic Medium
Authors: Amares Chattopadhyay, Akanksha Srivastava
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A unified approach to study the reflection of a plane wave in three-dimensional model comprised of the triclinic viscoelastic medium. The phase velocities of reflected qP, qSV and qSH wave have been calculated for the concerned medium by using the eigenvalue approach. The generalized method has been implemented to compute the complex form of amplitude ratios. Further, we discussed the nature of reflection coefficients of qP, qSV and qSH wave. The viscoelastic parameter, polar angle and azimuthal angle are found to be strongly influenced by amplitude ratios. The research article is particularly focused to study the effect of viscoelasticity associated with highly anisotropic media which exhibits the notable information about the reflection coefficients of qP, qSV, and qSH wave. The outcomes may further useful to the better exploration of all types of hydrocarbon reservoir and advancement in the field of reflection seismology.Keywords: amplitude ratios, three dimensional, triclinic, viscoelastic
Procedia PDF Downloads 23213777 Tumor Size and Lymph Node Metastasis Detection in Colon Cancer Patients Using MR Images
Authors: Mohammadreza Hedyehzadeh, Mahdi Yousefi
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Colon cancer is one of the most common cancer, which predicted to increase its prevalence due to the bad eating habits of peoples. Nowadays, due to the busyness of people, the use of fast foods is increasing, and therefore, diagnosis of this disease and its treatment are of particular importance. To determine the best treatment approach for each specific colon cancer patients, the oncologist should be known the stage of the tumor. The most common method to determine the tumor stage is TNM staging system. In this system, M indicates the presence of metastasis, N indicates the extent of spread to the lymph nodes, and T indicates the size of the tumor. It is clear that in order to determine all three of these parameters, an imaging method must be used, and the gold standard imaging protocols for this purpose are CT and PET/CT. In CT imaging, due to the use of X-rays, the risk of cancer and the absorbed dose of the patient is high, while in the PET/CT method, there is a lack of access to the device due to its high cost. Therefore, in this study, we aimed to estimate the tumor size and the extent of its spread to the lymph nodes using MR images. More than 1300 MR images collected from the TCIA portal, and in the first step (pre-processing), histogram equalization to improve image qualities and resizing to get the same image size was done. Two expert radiologists, which work more than 21 years on colon cancer cases, segmented the images and extracted the tumor region from the images. The next step is feature extraction from segmented images and then classify the data into three classes: T0N0، T3N1 و T3N2. In this article, the VGG-16 convolutional neural network has been used to perform both of the above-mentioned tasks, i.e., feature extraction and classification. This network has 13 convolution layers for feature extraction and three fully connected layers with the softmax activation function for classification. In order to validate the proposed method, the 10-fold cross validation method used in such a way that the data was randomly divided into three parts: training (70% of data), validation (10% of data) and the rest for testing. It is repeated 10 times, each time, the accuracy, sensitivity and specificity of the model are calculated and the average of ten repetitions is reported as the result. The accuracy, specificity and sensitivity of the proposed method for testing dataset was 89/09%, 95/8% and 96/4%. Compared to previous studies, using a safe imaging technique (MRI) and non-use of predefined hand-crafted imaging features to determine the stage of colon cancer patients are some of the study advantages.Keywords: colon cancer, VGG-16, magnetic resonance imaging, tumor size, lymph node metastasis
Procedia PDF Downloads 5913776 Post-Earthquake Road Damage Detection by SVM Classification from Quickbird Satellite Images
Authors: Moein Izadi, Ali Mohammadzadeh
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Detection of damaged parts of roads after earthquake is essential for coordinating rescuers. In this study, an approach is presented for the semi-automatic detection of damaged roads in a city using pre-event vector maps and both pre- and post-earthquake QuickBird satellite images. Damage is defined in this study as the debris of damaged buildings adjacent to the roads. Some spectral and texture features are considered for SVM classification step to detect damages. Finally, the proposed method is tested on QuickBird pan-sharpened images from the Bam City earthquake and the results show that an overall accuracy of 81% and a kappa coefficient of 0.71 are achieved for the damage detection. The obtained results indicate the efficiency and accuracy of the proposed approach.Keywords: SVM classifier, disaster management, road damage detection, quickBird images
Procedia PDF Downloads 62313775 Item Response Calibration/Estimation: An Approach to Adaptive E-Learning System Development
Authors: Adeniran Adetunji, Babalola M. Florence, Akande Ademola
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In this paper, we made an overview on the concept of adaptive e-Learning system, enumerates the elements of adaptive learning concepts e.g. A pedagogical framework, multiple learning strategies and pathways, continuous monitoring and feedback on student performance, statistical inference to reach final learning strategy that works for an individual learner by “mass-customization”. Briefly highlights the motivation of this new system proposed for effective learning teaching. E-Review literature on the concept of adaptive e-learning system and emphasises on the Item Response Calibration, which is an important approach to developing an adaptive e-Learning system. This paper write-up is concluded on the justification of item response calibration/estimation towards designing a successful and effective adaptive e-Learning system.Keywords: adaptive e-learning system, pedagogical framework, item response, computer applications
Procedia PDF Downloads 59613774 Distribution and Taxonomy of Marine Fungi in Nha Trang Bay and Van Phong Bay, Vietnam
Authors: Thu Thuy Pham, Thi Chau Loan Tran, Van Duy Nguyen
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Marine fungi play an important role in the marine ecosystems. Marine fungi also supply biomass and metabolic products of industrial value. Currently, the biodiversity of marine fungi along the coastal areas of Vietnam has not yet been studied fully. The objective of this study is to assess the spatial and temporal diversity of planktonic fungi from the coastal waters of Nha Trang Bay and Van Phong Bay in Central Vietnam using culture-dependent and independent approach. Using culture-dependent approach, filamentous fungi and yeasts were isolated on selective media and then classified by phenotype and genotype based on the sequencing of ITS (internal transcribed spacers) regions of rDNA with two primer pairs (ITS1F_KYO2 and ITS4; NS1 and NS8). Using culture-independent approach, environmental DNA samples were isolated and amplified using fungal-specific ITS primer pairs. A total of over 160 strains were isolated from 10 seawater sampling stations at 50 cm depth. They were classified into diverse genera and species of both yeast and mold. At least 5 strains could be potentially novel species. Our results also revealed that planktonic fungi were molecularly diverse with hundreds of phylotypes recovered across these two bays. The results of the study provide data about the distribution and taxonomy of mycoplankton in this area, thereby allowing assessment of their positive role in the biogeochemical cycle of coastal ecosystems and the development of new bioactive compounds for industrial applications.Keywords: biodiversity, ITS, marine fungi, Nha Trang Bay, Van Phong Bay
Procedia PDF Downloads 19013773 From Mathematics Project-Based Learning to Commercial Product Using Geometer’s Sketchpad (GSP)
Authors: Krongthong Khairiree
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The purpose of this research study is to explore mathematics project-based learning approach and the use of technology in the context of school mathematics in Thailand. Data of the study were collected from 6 sample secondary schools and the students were 6-14 years old. Research findings show that through mathematics project-based learning approach and the use of GSP, students were able to make mathematics learning fun and challenging. Based on the students’ interviews they revealed that, with GSP, they were able to visualize and create graphical representations, which will enable them to develop their mathematical thinking skills, concepts and understanding. The students had fun in creating variety of graphs of functions which they can not do by drawing on graph paper. In addition, there are evidences to show the students’ abilities in connecting mathematics to real life outside the classroom and commercial products, such as weaving, patterning of broomstick, and ceramics design.Keywords: mathematics, project-based learning, Geometer’s Sketchpad (GSP), commercial products
Procedia PDF Downloads 33613772 Results of Twenty Years of Laparoscopic Hernia Repair Surgeries
Authors: Arun Prasad
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Introduction: Laparoscopic surgery of hernia started in early 1990 and has had a mixed acceptance across the world, unlike laparoscopic cholecystectomy that has become a gold standard. Laparoscopic hernia repair claims to have less pain, less recurrence, and less wound infection compared to open hernia repair leading to early recovery and return to work. Materials and Methods: Laparoscopic hernia repair has been done in 2100 patients from 1995 till now with a follow-up data of 1350 patients. Data was analysed for results and satisfaction. Results: There is a recurrence rate of 0.1%. Early complications include bleeding, trocar injury and nerve pain. Late complications were rare. Conclusion: Laparoscopic inguinal hernia repair has a steep learning curve but after that the results and patient satisfaction are very good. It should be the procedure of choice in all bilateral and recurrent hernias.Keywords: laparoscopy, hernia, mesh, surgery
Procedia PDF Downloads 25313771 Multimodal Ophthalmologic Evaluation Can Detect Retinal Injuries in Asymptomatic Patients With Primary Antiphospholipid Syndrome
Authors: Taurino S. R. Neto, Epitácio D. S. Neto, Flávio Signorelli, Gustavo G. M. Balbi, Alex H. Higashi, Mário Luiz R. Monteiro, Eloisa Bonfá, Danieli C. O. Andrade, Leandro C. Zacharias
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Purpose: To perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with healthy individuals. Methods: A complete structural and functional ophthalmological evaluation using OCTA and microperimetry (MP) exam in patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were recorded and then statistical analysis was performed for comparative purposes; p <0.05 was considered statistically significant. Results: 104 eyes of 52 subjects (26 patients with PAPS without ocular complaints and 26 healthy individuals) were included. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. Thrombotic PAPS was the main clinical criteria manifestation (100%); 65.4% had venous and 34.6% had arterial thrombosis. Obstetrical criteria were present in 34.6% of all thrombotic PAPS patients. Lupus anticoagulant was present in all patients. 19.2% of PAPS patients presented ophthalmologic findings against none of the healthy individuals. The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen-like deposits (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (1 patient, 1 eye). Systemic hypertension and hyperlipidaemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together. In the quantitative OCTA evaluation, we found significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) in the high-speed protocol, as well as in the SVC in the high-resolution protocol. In the analysis of the foveal avascular zone (FAZ) parameters, the PAPS group had a larger area of FAZ in the DVC using the high-speed method compared to the control group (p=0.047). In the quantitative analysis of the MP, the PAPS group had lower central (p=0.041) and global (p<0.001) retinal sensitivity compared to the control group, as well as in the sector analysis, with the exception of the inferior sector. In the quantitative evaluation of fixation stability, there was a trend towards worse stability in the PAPS subgroup with PAMM in both studied methods. Conclusions: PAMM was observed in 11.5% of PAPS patients with no previous ocular complaints. Systemic hypertension concomitant with hyperlipidemia was the most commonly associated risk factor for PAMM in patients with PAPS. PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without PAMM.Keywords: antiphospholipid syndrome, optical coherence angio tomography, optical coherence tomography, retina
Procedia PDF Downloads 8013770 A Framework for Teaching the Intracranial Pressure Measurement through an Experimental Model
Authors: Christina Klippel, Lucia Pezzi, Silvio Neto, Rafael Bertani, Priscila Mendes, Flavio Machado, Aline Szeliga, Maria Cosendey, Adilson Mariz, Raquel Santos, Lys Bendett, Pedro Velasco, Thalita Rolleigh, Bruna Bellote, Daria Coelho, Bruna Martins, Julia Almeida, Juliana Cerqueira
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This project presents a framework for teaching intracranial pressure monitoring (ICP) concepts using a low-cost experimental model in a neurointensive care education program. Data concerning ICP monitoring contribute to the patient's clinical assessment and may dictate the course of action of a health team (nursing, medical staff) and influence decisions to determine the appropriate intervention. This study aims to present a safe method for teaching ICP monitoring to medical students in a Simulation Center. Methodology: Medical school teachers, along with students from the 4th year, built an experimental model for teaching ICP measurement. The model consists of a mannequin's head with a plastic bag inside simulating the cerebral ventricle and an inserted ventricular catheter connected to the ICP monitoring system. The bag simulating the ventricle can also be changed for others containing bloody or infected simulated cerebrospinal fluid. On the mannequin's ear, there is a blue point indicating the right place to set the "zero point" for accurate pressure reading. The educational program includes four steps: 1st - Students receive a script on ICP measurement for reading before training; 2nd - Students watch a video about the subject created in the Simulation Center demonstrating each step of the ICP monitoring and the proper care, such as: correct positioning of the patient, anatomical structures to establish the zero point for ICP measurement and a secure range of ICP; 3rd - Students train the procedure in the model. Teachers help students during training; 4th - Student assessment based on a checklist form. Feedback and correction of wrong actions. Results: Students expressed interest in learning ICP monitoring. Tests concerning the hit rate are still being performed. ICP's final results and video will be shown at the event. Conclusion: The study of intracranial pressure measurement based on an experimental model consists of an effective and controlled method of learning and research, more appropriate for teaching neurointensive care practices. Assessment based on a checklist form helps teachers keep track of student learning progress. This project offers medical students a safe method to develop intensive neurological monitoring skills for clinical assessment of patients with neurological disorders.Keywords: neurology, intracranial pressure, medical education, simulation
Procedia PDF Downloads 17213769 Statistical Design of Synthetic VP X-bar Control Chat Using Markov Chain Approach
Authors: Ali Akbar Heydari
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Control charts are an important tool of statistical quality control. Thesecharts are used to detect and eliminate unwanted special causes of variation that occurred during aperiod of time. The design and operation of control charts require the determination of three design parameters: the sample size (n), the sampling interval (h), and the width coefficient of control limits (k). Thevariable parameters (VP) x-bar controlchart is the x-barchart in which all the design parameters vary between twovalues. These values are a function of the most recent process information. In fact, in the VP x-bar chart, the position of each sample point on the chart establishes the size of the next sample and the timeof its sampling. The synthetic x-barcontrol chartwhich integrates the x-bar chart and the conforming run length (CRL) chart, provides significant improvement in terms of detection power over the basic x-bar chart for all levels of mean shifts. In this paper, we introduce the syntheticVP x-bar control chart for monitoring changes in the process mean. To determine the design parameters, we used a statistical design based on the minimum out of control average run length (ARL) criteria. The optimal chart parameters of the proposed chart are obtained using the Markov chain approach. A numerical example is also done to show the performance of the proposed chart and comparing it with the other control charts. The results show that our proposed syntheticVP x-bar controlchart perform better than the synthetic x-bar controlchart for all shift parameter values. Also, the syntheticVP x-bar controlchart perform better than the VP x-bar control chart for the moderate or large shift parameter values.Keywords: control chart, markov chain approach, statistical design, synthetic, variable parameter
Procedia PDF Downloads 15413768 Multi-Institutional Report on Toxicities of Concurrent Nivolumab and Radiation Therapy
Authors: Neha P. Amin, Maliha Zainib, Sean Parker, Malcolm Mattes
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Purpose/Objectives: Combination immunotherapy (IT) and radiation therapy (RT) is an actively growing field of clinical investigation due to promising findings of synergistic effects from immune-mediated mechanisms observed in preclinical studies and clinical data from case reports of abscopal effects. While there are many ongoing trials of combined IT-RT, there are still limited data on toxicity and outcome optimization regarding RT dose, fractionation, and sequencing of RT with IT. Nivolumab (NIVO), an anti-PD-1 monoclonal antibody, has been rapidly adopted in the clinic over the past 2 years, resulting in more patients being considered for concurrent RT-NIVO. Knowledge about the toxicity profile of combined RT-NIVO is important for both the patient and physician when making educated treatment decisions. The acute toxicity profile of concurrent RT-NIVO was analyzed in this study. Materials/Methods: A retrospective review of all consecutive patients who received NIVO from 1/2015 to 5/2017 at 4 separate centers within two separate institutions was performed. Those patients who completed a course of RT from 1 day prior to initial NIVO infusion through 1 month after last NIVO infusion were considered to have received concurrent therapy and included in the subsequent analysis. Descriptive statistics are reported for patient/tumor/treatment characteristics and observed acute toxicities within 3 months of RT completion. Results: Among 261 patients who received NIVO, 46 (17.6%) received concurrent RT to 67 different sites. The median f/u was 3.3 (.1-19.8) months, and 11/46 (24%) were still alive at last analysis. The most common histology, RT prescription, and treatment site included non-small cell lung cancer (23/46, 50%), 30 Gy in 10 fractions (16/67, 24%), and central thorax/abdomen (26/67, 39%), respectively. 79% (53/67) of irradiated sites were treated with 3D-conformal technique and palliative dose-fractionation. Grade 3, 4, and 5 toxicities were experienced by 11, 1, and 2 patients, respectively. However all grade 4 and 5 toxicities were outside of the irradiated area and attributed to the NIVO alone, and only 4/11 (36%) of the grade 3 toxicities were attributed to the RT-NIVO. The irradiated site in these cases included the brain [2/10 (20%)] and central thorax/abdomen [2/19 (10.5%)], including one unexpected grade 3 pancreatitides following stereotactic body RT to the left adrenal gland. Conclusions: Concurrent RT-NIVO is generally well tolerated, though with potentially increased rates of severe toxicity when irradiating the lung, abdomen, or brain. Pending more definitive data, we recommend counseling patients on the potentially increased rates of side effects from combined immunotherapy and radiotherapy to these locations. Future prospective trials assessing fractionation and sequencing of RT with IT will help inform combined therapy recommendations.Keywords: combined immunotherapy and radiation, immunotherapy, Nivolumab, toxicity of concurrent immunotherapy and radiation
Procedia PDF Downloads 39213767 Complications of Contact Lens-Associated Keratitis: A Refresher for Emergency Departments
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Microbial keratitis is a serious complication of contact lens wear that can be vision and eye-threatening. Diverse presentations relating to contact lens wear include dry corneal surface, corneal infiltrate, ulceration, scarring, and complete corneal melt leading to perforation. Contact lens wear is a major risk factor and, as such, is an important consideration in any patient presenting with a red eye in the primary care setting. This paper aims to provide an overview of the risk factors, common organisms, and spectrum of contact lens-associated keratitis (CLAK) complications. It will highlight some of the salient points relevant to the assessment and workup of patients suspected of CLAK in the emergency department based on the recent literature and therapeutic guidelines. An overview of the management principles will also be provided.Keywords: microbial keratitis, corneal pathology, contact lens-associated complications, painful vision loss
Procedia PDF Downloads 11013766 Operations Research Applications in Audit Planning and Scheduling
Authors: Abdel-Aziz M. Mohamed
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This paper presents a state-of-the-art survey of the operations research models developed for internal audit planning. Two alternative approaches have been followed in the literature for audit planning: (1) identifying the optimal audit frequency; and (2) determining the optimal audit resource allocation. The first approach identifies the elapsed time between two successive audits, which can be presented as the optimal number of audits in a given planning horizon, or the optimal number of transactions after which an audit should be performed. It also includes the optimal audit schedule. The second approach determines the optimal allocation of audit frequency among all auditable units in the firm. In our review, we discuss both the deterministic and probabilistic models developed for audit planning. In addition, game theory models are reviewed to find the optimal auditing strategy based on the interactions between the auditors and the clients.Keywords: operations research applications, audit frequency, audit-staff scheduling, audit planning
Procedia PDF Downloads 81513765 A Survey on Quasi-Likelihood Estimation Approaches for Longitudinal Set-ups
Authors: Naushad Mamode Khan
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The Com-Poisson (CMP) model is one of the most popular discrete generalized linear models (GLMS) that handles both equi-, over- and under-dispersed data. In longitudinal context, an integer-valued autoregressive (INAR(1)) process that incorporates covariate specification has been developed to model longitudinal CMP counts. However, the joint likelihood CMP function is difficult to specify and thus restricts the likelihood based estimating methodology. The joint generalized quasilikelihood approach (GQL-I) was instead considered but is rather computationally intensive and may not even estimate the regression effects due to a complex and frequently ill conditioned covariance structure. This paper proposes a new GQL approach for estimating the regression parameters (GQLIII) that are based on a single score vector representation. The performance of GQL-III is compared with GQL-I and separate marginal GQLs (GQL-II) through some simulation experiments and is proved to yield equally efficient estimates as GQL-I and is far more computationally stable.Keywords: longitudinal, com-Poisson, ill-conditioned, INAR(1), GLMS, GQL
Procedia PDF Downloads 35513764 Financial Assets Return, Economic Factors and Investor's Behavioral Indicators Relationships Modeling: A Bayesian Networks Approach
Authors: Nada Souissi, Mourad Mroua
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The main purpose of this study is to examine the interaction between financial asset volatility, economic factors and investor's behavioral indicators related to both the company's and the markets stocks for the period from January 2000 to January2020. Using multiple linear regression and Bayesian Networks modeling, results show a positive and negative relationship between investor's psychology index, economic factors and predicted stock market return. We reveal that the application of the Bayesian Discrete Network contributes to identify the different cause and effect relationships between all economic, financial variables and psychology index.Keywords: Financial asset return predictability, Economic factors, Investor's psychology index, Bayesian approach, Probabilistic networks, Parametric learning
Procedia PDF Downloads 15013763 Solving Flowshop Scheduling Problems with Ant Colony Optimization Heuristic
Authors: Arshad Mehmood Ch, Riaz Ahmad, Imran Ali Ch, Waqas Durrani
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This study deals with the application of Ant Colony Optimization (ACO) approach to solve no-wait flowshop scheduling problem (NW-FSSP). ACO algorithm so developed has been coded on Matlab computer application. The paper covers detailed steps to apply ACO and focuses on judging the strength of ACO in relation to other solution techniques previously applied to solve no-wait flowshop problem. The general purpose approach was able to find reasonably accurate solutions for almost all the problems under consideration and was able to handle a fairly large spectrum of problems with far reduced CPU effort. Careful scrutiny of the results reveals that the algorithm presented results better than other approaches like Genetic algorithm and Tabu Search heuristics etc; earlier applied to solve NW-FSSP data sets.Keywords: no-wait, flowshop, scheduling, ant colony optimization (ACO), makespan
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