Search results for: fixed effect model
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 29279

Search results for: fixed effect model

749 Performance Evaluation of Fingerprint, Auto-Pin and Password-Based Security Systems in Cloud Computing Environment

Authors: Emmanuel Ogala

Abstract:

Cloud computing has been envisioned as the next-generation architecture of Information Technology (IT) enterprise. In contrast to traditional solutions where IT services are under physical, logical and personnel controls, cloud computing moves the application software and databases to the large data centres, where the management of the data and services may not be fully trustworthy. This is due to the fact that the systems are opened to the whole world and as people tries to have access into the system, many people also are there trying day-in day-out on having unauthorized access into the system. This research contributes to the improvement of cloud computing security for better operation. The work is motivated by two problems: first, the observed easy access to cloud computing resources and complexity of attacks to vital cloud computing data system NIC requires that dynamic security mechanism evolves to stay capable of preventing illegitimate access. Second; lack of good methodology for performance test and evaluation of biometric security algorithms for securing records in cloud computing environment. The aim of this research was to evaluate the performance of an integrated security system (ISS) for securing exams records in cloud computing environment. In this research, we designed and implemented an ISS consisting of three security mechanisms of biometric (fingerprint), auto-PIN and password into one stream of access control and used for securing examination records in Kogi State University, Anyigba. Conclusively, the system we built has been able to overcome guessing abilities of hackers who guesses people password or pin. We are certain about this because the added security system (fingerprint) needs the presence of the user of the software before a login access can be granted. This is based on the placement of his finger on the fingerprint biometrics scanner for capturing and verification purpose for user’s authenticity confirmation. The study adopted the conceptual of quantitative design. Object oriented and design methodology was adopted. In the analysis and design, PHP, HTML5, CSS, Visual Studio Java Script, and web 2.0 technologies were used to implement the model of ISS for cloud computing environment. Note; PHP, HTML5, CSS were used in conjunction with visual Studio front end engine design tools and MySQL + Access 7.0 were used for the backend engine and Java Script was used for object arrangement and also validation of user input for security check. Finally, the performance of the developed framework was evaluated by comparing with two other existing security systems (Auto-PIN and password) within the school and the results showed that the developed approach (fingerprint) allows overcoming the two main weaknesses of the existing systems and will work perfectly well if fully implemented.

Keywords: performance evaluation, fingerprint, auto-pin, password-based, security systems, cloud computing environment

Procedia PDF Downloads 139
748 Towards a Measuring Tool to Encourage Knowledge Sharing in Emerging Knowledge Organizations: The Who, the What and the How

Authors: Rachel Barker

Abstract:

The exponential velocity in the truly knowledge-intensive world today has increasingly bombarded organizations with unfathomable challenges. Hence organizations are introduced to strange lexicons of descriptors belonging to a new paradigm of who, what and how knowledge at individual and organizational levels should be managed. Although organizational knowledge has been recognized as a valuable intangible resource that holds the key to competitive advantage, little progress has been made in understanding how knowledge sharing at individual level could benefit knowledge use at collective level to ensure added value. The research problem is that a lack of research exists to measure knowledge sharing through a multi-layered structure of ideas with at its foundation, philosophical assumptions to support presuppositions and commitment which requires actual findings from measured variables to confirm observed and expected events. The purpose of this paper is to address this problem by presenting a theoretical approach to measure knowledge sharing in emerging knowledge organizations. The research question is that despite the competitive necessity of becoming a knowledge-based organization, leaders have found it difficult to transform their organizations due to a lack of knowledge on who, what and how it should be done. The main premise of this research is based on the challenge for knowledge leaders to develop an organizational culture conducive to the sharing of knowledge and where learning becomes the norm. The theoretical constructs were derived and based on the three components of the knowledge management theory, namely technical, communication and human components where it is suggested that this knowledge infrastructure could ensure effective management. While it is realised that it might be a little problematic to implement and measure all relevant concepts, this paper presents effect of eight critical success factors (CSFs) namely: organizational strategy, organizational culture, systems and infrastructure, intellectual capital, knowledge integration, organizational learning, motivation/performance measures and innovation. These CSFs have been identified based on a comprehensive literature review of existing research and tested in a new framework adapted from four perspectives of the balanced score card (BSC). Based on these CSFs and their items, an instrument was designed and tested among managers and employees of a purposefully selected engineering company in South Africa who relies on knowledge sharing to ensure their competitive advantage. Rigorous pretesting through personal interviews with executives and a number of academics took place to validate the instrument and to improve the quality of items and correct wording of issues. Through analysis of surveys collected, this research empirically models and uncovers key aspects of these dimensions based on the CSFs. Reliability of the instrument was calculated by Cronbach’s a for the two sections of the instrument on organizational and individual levels.The construct validity was confirmed by using factor analysis. The impact of the results was tested using structural equation modelling and proved to be a basis for implementing and understanding the competitive predisposition of the organization as it enters the process of knowledge management. In addition, they realised the importance to consolidate their knowledge assets to create value that is sustainable over time.

Keywords: innovation, intellectual capital, knowledge sharing, performance measures

Procedia PDF Downloads 195
747 Civic E-Participation in Central and Eastern Europe: A Comparative Analysis

Authors: Izabela Kapsa

Abstract:

Civic participation is an important aspect of democracy. The contemporary model of democracy is based on citizens' participation in political decision-making (deliberative democracy, participatory democracy). This participation takes many forms of activities like display of slogans and symbols, voting, social consultations, political demonstrations, membership in political parties or organizing civil disobedience. The countries of Central and Eastern Europe after 1989 are characterized by great social, economic and political diversity. Civil society is also part of the process of democratization. Civil society, funded by the rule of law, civil rights, such as freedom of speech and association and private ownership, was to play a central role in the development of liberal democracy. Among the many interpretations of concepts, defining the concept of contemporary democracy, one can assume that the terms civil society and democracy, although different in meaning, nowadays overlap. In the post-communist countries, the process of shaping and maturing societies took place in the context of a struggle with a state governed by undemocratic power. State fraud or repudiation of the institution is a representative state, which in the past was the only way to manifest and defend its identity, but after the breakthrough became one of the main obstacles to the development of civil society. In Central and Eastern Europe, there are many obstacles to the development of civil society, for example, the elimination of economic poverty, the implementation of educational campaigns, consciousness-related obstacles, the formation of social capital and the deficit of social activity. Obviously, civil society does not only entail an electoral turnout but a broader participation in the decision-making process, which is impossible without direct and participative democratic institutions. This article considers such broad forms of civic participation and their characteristics in Central and Eastern Europe. The paper is attempts to analyze the functioning of electronic forms of civic participation in Central and Eastern European states. This is not accompanied by a referendum or a referendum initiative, and other forms of political participation, such as public consultations, participative budgets, or e-Government. However, this paper will broadly present electronic administration tools, the application of which results from both legal regulations and increasingly common practice in state and city management. In the comparative analysis, the experiences of post-communist bloc countries will be summed up to indicate the challenges and possible goals for further development of this form of citizen participation in the political process. The author argues that for to function efficiently and effectively, states need to involve their citizens in the political decision-making process, especially with the use of electronic tools.

Keywords: Central and Eastern Europe, e-participation, e-government, post-communism

Procedia PDF Downloads 193
746 Interface Designer as Cultural Producer: A Dialectic Materialist Approach to the Role of Visual Designer in the Present Digital Era

Authors: Cagri Baris Kasap

Abstract:

In this study, how interface designers can be viewed as producers of culture in the current era will be interrogated from a critical theory perspective. Walter Benjamin was a German Jewish literary critical theorist who, during 1930s, was engaged in opposing and criticizing the Nazi use of art and media. ‘The Author as Producer’ is an essay that Benjamin has read at the Communist Institute for the Study of Fascism in Paris. In this article, Benjamin relates directly to the dialectics between base and superstructure and argues that authors, normally placed within the superstructure should consider how writing and publishing is production and directly related to the base. Through it, he discusses what it could mean to see author as producer of his own text, as a producer of writing, understood as an ideological construct that rests on the apparatus of production and distribution. So Benjamin concludes that the author must write in ways that relate to the conditions of production, he must do so in order to prepare his readers to become writers and even make this possible for them by engineering an ‘improved apparatus’ and must work toward turning consumers to producers and collaborators. In today’s world, it has become a leading business model within Web 2.0 services of multinational Internet technologies and culture industries like Amazon, Apple and Google, to transform readers, spectators, consumers or users into collaborators and co-producers through platforms such as Facebook, YouTube and Amazon’s CreateSpace Kindle Direct Publishing print-on-demand, e-book and publishing platforms. However, the way this transformation happens is tightly controlled and monitored by combinations of software and hardware. In these global-market monopolies, it has become increasingly difficult to get insight into how one’s writing and collaboration is used, captured, and capitalized as a user of Facebook or Google. In the lens of this study, it could be argued that this criticism could very well be considered by digital producers or even by the mass of collaborators in contemporary social networking software. How do software and design incorporate users and their collaboration? Are they truly empowered, are they put in a position where they are able to understand the apparatus and how their collaboration is part of it? Or has the apparatus become a means against the producers? Thus, when using corporate systems like Google and Facebook, iPhone and Kindle without any control over the means of production, which is closed off by opaque interfaces and licenses that limit our rights of use and ownership, we are already the collaborators that Benjamin calls for. For example, the iPhone and the Kindle combine a specific use of technology to distribute the relations between the ‘authors’ and the ‘prodUsers’ in ways that secure their monopolistic business models by limiting the potential of the technology.

Keywords: interface designer, cultural producer, Walter Benjamin, materialist aesthetics, dialectical thinking

Procedia PDF Downloads 142
745 On-Ice Force-Velocity Modeling Technical Considerations

Authors: Dan Geneau, Mary Claire Geneau, Seth Lenetsky, Ming -Chang Tsai, Marc Klimstra

Abstract:

Introduction— Horizontal force-velocity profiling (HFVP) involves modeling an athletes linear sprint kinematics to estimate valuable maximum force and velocity metrics. This approach to performance modeling has been used in field-based team sports and has recently been introduced to ice-hockey as a forward skating performance assessment. While preliminary data has been collected on ice, distance constraints of the on-ice test restrict the ability of the athletes to reach their maximal velocity which result in limits of the model to effectively estimate athlete performance. This is especially true of more elite athletes. This report explores whether athletes on-ice are able to reach a velocity plateau similar to what has been seen in overground trials. Fourteen male Major Junior ice-hockey players (BW= 83.87 +/- 7.30 kg, height = 188 ± 3.4cm cm, age = 18 ± 1.2 years n = 14) were recruited. For on-ice sprints, participants completed a standardized warm-up consisting of skating and dynamic stretching and a progression of three skating efforts from 50% to 95%. Following the warm-up, participants completed three on ice 45m sprints, with three minutes of rest in between each trial. For overground sprints, participants completed a similar dynamic warm-up to that of on-ice trials. Following the warm-up participants completed three 40m overground sprint trials. For each trial (on-ice and overground), radar was used to collect instantaneous velocity (Stalker ATS II, Texas, USA) aimed at the participant’s waist. Sprint velocities were modelled using custom Python (version 3.2) script using a mono-exponential function, similar to previous work. To determine if on-ice tirals were achieving a maximum velocity (plateau), minimum acceleration values of the modeled data at the end of the sprint were compared (using paired t-test) between on-ice and overground trials. Significant differences (P<0.001) between overground and on-ice minimum accelerations were observed. It was found that on-ice trials consistently reported higher final acceleration values, indicating a maximum maintained velocity (plateau) had not been reached. Based on these preliminary findings, it is suggested that reliable HFVP metrics cannot yet be collected from all ice-hockey populations using current methods. Elite male populations were not able to achieve a velocity plateau similar to what has been seen in overground trials, indicating the absence of a maximum velocity measure. With current velocity and acceleration modeling techniques, including a dependency of a velocity plateau, these results indicate the potential for error in on-ice HFVP measures. Therefore, these findings suggest that a greater on-ice sprint distance may be required or the need for other velocity modeling techniques, where maximal velocity is not required for a complete profile.   

Keywords: ice-hockey, sprint, skating, power

Procedia PDF Downloads 98
744 Study on the Geometric Similarity in Computational Fluid Dynamics Calculation and the Requirement of Surface Mesh Quality

Authors: Qian Yi Ooi

Abstract:

At present, airfoil parameters are still designed and optimized according to the scale of conventional aircraft, and there are still some slight deviations in terms of scale differences. However, insufficient parameters or poor surface mesh quality is likely to occur if these small deviations are embedded in a future civil aircraft with a size that is quite different from conventional aircraft, such as a blended-wing-body (BWB) aircraft with future potential, resulting in large deviations in geometric similarity in computational fluid dynamics (CFD) simulations. To avoid this situation, the study on the CFD calculation on the geometric similarity of airfoil parameters and the quality of the surface mesh is conducted to obtain the ability of different parameterization methods applied on different airfoil scales. The research objects are three airfoil scales, including the wing root and wingtip of conventional civil aircraft and the wing root of the giant hybrid wing, used by three parameterization methods to compare the calculation differences between different sizes of airfoils. In this study, the constants including NACA 0012, a Reynolds number of 10 million, an angle of attack of zero, a C-grid for meshing, and the k-epsilon (k-ε) turbulence model are used. The experimental variables include three airfoil parameterization methods: point cloud method, B-spline curve method, and class function/shape function transformation (CST) method. The airfoil dimensions are set to 3.98 meters, 17.67 meters, and 48 meters, respectively. In addition, this study also uses different numbers of edge meshing and the same bias factor in the CFD simulation. Studies have shown that with the change of airfoil scales, different parameterization methods, the number of control points, and the meshing number of divisions should be used to improve the accuracy of the aerodynamic performance of the wing. When the airfoil ratio increases, the most basic point cloud parameterization method will require more and larger data to support the accuracy of the airfoil’s aerodynamic performance, which will face the severe test of insufficient computer capacity. On the other hand, when using the B-spline curve method, average number of control points and meshing number of divisions should be set appropriately to obtain higher accuracy; however, the quantitative balance cannot be directly defined, but the decisions should be made repeatedly by adding and subtracting. Lastly, when using the CST method, it is found that limited control points are enough to accurately parameterize the larger-sized wing; a higher degree of accuracy and stability can be obtained by using a lower-performance computer.

Keywords: airfoil, computational fluid dynamics, geometric similarity, surface mesh quality

Procedia PDF Downloads 220
743 Topological Language for Classifying Linear Chord Diagrams via Intersection Graphs

Authors: Michela Quadrini

Abstract:

Chord diagrams occur in mathematics, from the study of RNA to knot theory. They are widely used in theory of knots and links for studying the finite type invariants, whereas in molecular biology one important motivation to study chord diagrams is to deal with the problem of RNA structure prediction. An RNA molecule is a linear polymer, referred to as the backbone, that consists of four types of nucleotides. Each nucleotide is represented by a point, whereas each chord of the diagram stands for one interaction for Watson-Crick base pairs between two nonconsecutive nucleotides. A chord diagram is an oriented circle with a set of n pairs of distinct points, considered up to orientation preserving diffeomorphisms of the circle. A linear chord diagram (LCD) is a special kind of graph obtained cutting the oriented circle of a chord diagram. It consists of a line segment, called its backbone, to which are attached a number of chords with distinct endpoints. There is a natural fattening on any linear chord diagram; the backbone lies on the real axis, while all the chords are in the upper half-plane. Each linear chord diagram has a natural genus of its associated surface. To each chord diagram and linear chord diagram, it is possible to associate the intersection graph. It consists of a graph whose vertices correspond to the chords of the diagram, whereas the chord intersections are represented by a connection between the vertices. Such intersection graph carries a lot of information about the diagram. Our goal is to define an LCD equivalence class in terms of identity of intersection graphs, from which many chord diagram invariants depend. For studying these invariants, we introduce a new representation of Linear Chord Diagrams based on a set of appropriate topological operators that permits to model LCD in terms of the relations among chords. Such set is composed of: crossing, nesting, and concatenations. The crossing operator is able to generate the whole space of linear chord diagrams, and a multiple context free grammar able to uniquely generate each LDC starting from a linear chord diagram adding a chord for each production of the grammar is defined. In other words, it allows to associate a unique algebraic term to each linear chord diagram, while the remaining operators allow to rewrite the term throughout a set of appropriate rewriting rules. Such rules define an LCD equivalence class in terms of the identity of intersection graphs. Starting from a modelled RNA molecule and the linear chord, some authors proposed a topological classification and folding. Our LCD equivalence class could contribute to the RNA folding problem leading to the definition of an algorithm that calculates the free energy of the molecule more accurately respect to the existing ones. Such LCD equivalence class could be useful to obtain a more accurate estimate of link between the crossing number and the topological genus and to study the relation among other invariants.

Keywords: chord diagrams, linear chord diagram, equivalence class, topological language

Procedia PDF Downloads 201
742 Mastopexy with the "Dermoglandular Autоaugmentation" Method. Increased Stability of the Result. Personalized Technique

Authors: Maksim Barsakov

Abstract:

Introduction. In modern plastic surgery, there are a large number of breast lift techniques.Due to the spreading information about the "side effects" of silicone implants, interest in implant-free mastopexy is increasing year after year. However, despite the variety of techniques, patients sometimes do not get full satisfaction from the results of mastopexy because of the unexpressed filling of the upper pole, extended anchoring postoperative scars and sometimes because of obtaining an aesthetically unattractive breast shape. The stability of the result after mastopexy depends on many factors, including postoperative rehabilitation. Stability of weight and hormonal background, stretchability of tissues. The high recurrence rate of ptosis and short-term aesthetic effect of mastopexy indicate the urgency of improving surgical techniques and increasing the stabilization of breast tissue. Purpose of the study. To develop and introduce into practice a technique of mastopexy based on the use of a modified Ribeiro flap, as well as elements of tissue movement and fixation designed to increase the stability of postoperative mastopexy. In addition, to give indications for the application of this surgical technique. Materials and Methods. it operated on 103 patients aged 18 to 53 years from 2019 to 2023 according to the reported method. These were patients with primary mastopexy, secondary mastopexy, and also patient with implant removal and one-stage mastopexy. The patients were followed up for 12 months to assess the stability of the result. Results and their discussion. Observing the patients, we noted greater stability of the breast shape and upper pole filling compared to the conventional classical methods. We did not have to resort to anchoring scars. In 90 percent of cases, a inverted T-shape scar was used. In 10 percent, the J-scar was used. The quantitative distribution of complications identified among the operated patients is as follows: worsened healing of the junction of vertical and horizontal sutures at the period of 1-1.5 months after surgery - 15 patients; at treatment with ointment method healing was observed in 7-30 days; permanent loss of NAC sensitivity - 0 patients; vascular disorders in the area of NAC/areola necrosis - 0 patients; marginal necrosis of the areola-2 patients. independent healing within 3-4 weeks without aesthetic defects. Aesthetically unacceptable mature scars-3 patients; partial liponecrosis of the autoflap unilaterally - 1 patient. recurrence of ptosis - 1 patient (after weight loss of 12 kg). In the late postoperative period, 2 patients became pregnant, gave birth, and no lactation problems were observed. Conclusion. Thus, in the world of plastic surgery methods of breast lift continue to improve, which is especially relevant in modern times, due to the increased attention to this operation. The author's proposed method of mastopexy with glandular autoflap allows obtaining in most cases a stable result, a fuller breast shape, avoiding the presence of extended anchoring scars, and also preserves the possibility of lactation. The author of this article has obtained a patent for invention for this method of mastopexy.

Keywords: mastopexy, mammoplasty, autoflap, personal technique

Procedia PDF Downloads 35
741 Effect of Printing Process on Mechanical Properties and Porosity of 3D Printed Concrete Strips

Authors: Wei Chen

Abstract:

3D concrete printing technology is a novel and highly efficient construction method that holds significant promise for advancing low-carbon initiatives within the construction industry. In contrast to traditional construction practices, 3D printing offers a manual and formwork-free approach, resulting in a transformative shift in labor requirements and fabrication techniques. This transition yields substantial reductions in carbon emissions during the construction phase, as well as decreased on-site waste generation. Furthermore, when compared to conventionally printed concrete, 3D concrete exhibits mechanical anisotropy due to its layer-by-layer construction methodology. Therefore, it becomes imperative to investigate the influence of the printing process on the mechanical properties of 3D printed strips and to optimize the mechanical characteristics of these coagulated strips. In this study, we conducted three-dimensional reconstructions of printed blocks using both circular and directional print heads, incorporating various overlap distances between strips, and employed CT scanning for comprehensive analysis. Our research focused on assessing mechanical properties and micro-pore characteristics under different loading orientations.Our findings reveal that increasing the overlap degree between strips leads to enhanced mechanical properties of the strips. However, it's noteworthy that once full overlap is achieved, further increases in the degree of coincidence do not lead to a decrease in porosity between strips. Additionally, due to its superior printing cross-sectional area, the square printing head exhibited the most favorable impact on mechanical properties.This paper aims to improve the tensile strength, tensile ductility, and bending toughness of a recently developed ‘one-part’ geopolymer for 3D concrete printing (3DCP) applications, in order to address the insufficient tensile strength and brittle fracture characteristics of geopolymer materials in 3D printing scenarios where materials are subjected to tensile stress. The effects of steel fiber content, and aspect ratio, on mechanical properties, were systematically discussed, including compressive strength, flexure strength, splitting tensile strength, uniaxial tensile strength, bending toughness, and the anisotropy of 3DP-OPGFRC, respectively. The fiber distribution in the printed samples was obtained through x-ray computed tomography (X-CT) testing. In addition, the underlying mechanisms were discussed to provide a deep understanding of the role steel fiber played in the reinforcement. The experimental results showed that the flexural strength increased by 282% to 26.1MP, and the compressive strength also reached 104.5Mpa. A high tensile ductility, appreciable bending toughness, and strain-hardening behavior can be achieved with steel fiber incorporation. In addition, it has an advantage over the OPC-based steel fiber-reinforced 3D printing materials given in the existing literature (flexural strength 15 Mpa); It is also superior to the tensile strength (<6Mpa) of current geopolymer fiber reinforcements used for 3D printing. It is anticipated that the development of this 3D printable steel fiber reinforced ‘one-part’ geopolymer will be used to meet high tensile strength requirements for printing scenarios.

Keywords: 3D printing concrete, mechanical anisotropy, micro-pore structure, printing technology

Procedia PDF Downloads 76
740 Emotion-Convolutional Neural Network for Perceiving Stress from Audio Signals: A Brain Chemistry Approach

Authors: Anup Anand Deshmukh, Catherine Soladie, Renaud Seguier

Abstract:

Emotion plays a key role in many applications like healthcare, to gather patients’ emotional behavior. Unlike typical ASR (Automated Speech Recognition) problems which focus on 'what was said', it is equally important to understand 'how it was said.' There are certain emotions which are given more importance due to their effectiveness in understanding human feelings. In this paper, we propose an approach that models human stress from audio signals. The research challenge in speech emotion detection is finding the appropriate set of acoustic features corresponding to an emotion. Another difficulty lies in defining the very meaning of emotion and being able to categorize it in a precise manner. Supervised Machine Learning models, including state of the art Deep Learning classification methods, rely on the availability of clean and labelled data. One of the problems in affective computation is the limited amount of annotated data. The existing labelled emotions datasets are highly subjective to the perception of the annotator. We address the first issue of feature selection by exploiting the use of traditional MFCC (Mel-Frequency Cepstral Coefficients) features in Convolutional Neural Network. Our proposed Emo-CNN (Emotion-CNN) architecture treats speech representations in a manner similar to how CNN’s treat images in a vision problem. Our experiments show that Emo-CNN consistently and significantly outperforms the popular existing methods over multiple datasets. It achieves 90.2% categorical accuracy on the Emo-DB dataset. We claim that Emo-CNN is robust to speaker variations and environmental distortions. The proposed approach achieves 85.5% speaker-dependant categorical accuracy for SAVEE (Surrey Audio-Visual Expressed Emotion) dataset, beating the existing CNN based approach by 10.2%. To tackle the second problem of subjectivity in stress labels, we use Lovheim’s cube, which is a 3-dimensional projection of emotions. Monoamine neurotransmitters are a type of chemical messengers in the brain that transmits signals on perceiving emotions. The cube aims at explaining the relationship between these neurotransmitters and the positions of emotions in 3D space. The learnt emotion representations from the Emo-CNN are mapped to the cube using three component PCA (Principal Component Analysis) which is then used to model human stress. This proposed approach not only circumvents the need for labelled stress data but also complies with the psychological theory of emotions given by Lovheim’s cube. We believe that this work is the first step towards creating a connection between Artificial Intelligence and the chemistry of human emotions.

Keywords: deep learning, brain chemistry, emotion perception, Lovheim's cube

Procedia PDF Downloads 153
739 Comparative Study on Effectiveness and Safety of Oral Antidiabetic Medications in Patients with Type 2 Diabetes Mellitus in a Tertiary Care Hospital of Bangalore, South India – A Prospective Cohort Study

Authors: Shobha Rani R Hiremath, Keerthana R, Madhuvan H S

Abstract:

BACKGROUND: Type 2 Diabetes is a chronic health condition where the body cannot effectively use the insulin it produces, leading to elevated blood sugar levels It is often associated with lifestyle factors and insulin resistance. Globally, diabetes is on the rise, with urban areas like Bangalore seeing a surge due to lifestyle changes, stress, and dietary habits. To manage diabetes effectively, over 50 medications are available, each serving to regulate blood sugar through different mechanisms. This reflects the complex and individualized nature of diabetes treatment. Given the increase in medications for Type 2 diabetes mellitus, it is important to evaluate their effectiveness and safety so that clinicians can make informed choices while treating their patients. OBJECTIVES: To evaluate the effectiveness of various anti-diabetic medications used in the hospital in Type 2 diabetes patients by monitoring their HbA1c levels. To assess the safety of these medications by monitoring Adverse drug reactions if any. METHODOLOGY Design : Prospective Cohort study, Study period: 8 months, Sample Size: 100 patients, Inclusion Criteria: Patients above 18 years of both genders who were diagnosed with T2DM and who were prescribed oral hypoglycaemic agents. Exclusion Criteria: Diabetic patients with hepatic/renal failure, patients prescribed with insulin /not prescribed with OHAs and patients who were terminally ill, pregnant and lactating patients. Source of Data: Prescriptions, lab reports, ECG reports. Data collection forms were used to collect data which consisted of patient demographic details, drugs prescribed, laboratory investigations such as HbA1C, FBS, PPBS , ECG and any ADRs experienced. Data was collected at baseline, 3 months, and 6 months. It was statistically analyzed using SPSS (version 26) software. RESULTS: Greater number of patients (46%) were in the age group of greater than 61 years. 43 patients had no co-morbidities whereas 51 patients had Hypertension as the co morbidity. Basically 5 Drug combinations were prescribed as follows. Combination 1: Tablet Metformin HCL + Glimepiride (500, 2 mg) : 1-0-1, Combination 2: Tablet Sitagliptin + Metformin HCL (50, 500 mg) : 1-0-1, Combination 3: Tablet Vildagliptin + Metformin HCL (50, 500 mg): 1-0-1, Combination 4: Tablet Voglibose+ Glimepiride+ Metformin HCL (0.2 ,2 ,500mg): : 1-0-1, Combination 5: Tablet Voglibose+ Glimepiride+ Metformin HCL (0.2, 2 ,500mg): : 1-0-1 and T. Sitagliptin +Metformin HCL (50, 500 mg): 0-1-0. Combination 5 (Voglibose, Glimepiride, Metformin, Sitagliptin) was most effective in reducing HbA1c levels, showing a significant decrease (-0.00682, p = 0.001), followed by Combinations 4 and 3. However, Combination 5 also had the highest incidence of gastrointestinal side effects (72.7%) and ECG abnormalities (27.3%). Combination 1 (Metformin + Glimepiride) had the highest occurrence of hypoglycemia due to Glimepiride's insulin-stimulating effects. Weight loss was most notable in Combination 5, affecting 36.36% of patients. CONCLUSION: The enhanced effectiveness of Combinations 3, 4, and 5 suggests that a multi-drug approach that incorporates different mechanisms of action is more effective in managing HbA1c levels in patients with diabetes. Adverse effect profiles should be considered for personalized treatment strategies.

Keywords: type 2 diabetes, safety, oral anti diabetic medications, effectiveness

Procedia PDF Downloads 5
738 Formulation and Optimization of Self Nanoemulsifying Drug Delivery System of Rutin for Enhancement of Oral Bioavailability Using QbD Approach

Authors: Shrestha Sharma, Jasjeet K. Sahni, Javed Ali, Sanjula Baboota

Abstract:

Introduction: Rutin is a naturally occurring strong antioxidant molecule belonging to bioflavonoid category. Due to its free radical scavenging properties, it has been found to be beneficial in the treatment of various diseases including inflammation, cancer, diabetes, allergy, cardiovascular disorders and various types of microbial infections. Despite its beneficial effects, it suffers from the problem of low aqueous solubility which is responsible for low oral bioavailability. The aim of our study was to optimize and characterize self-nanoemulsifying drug delivery system (SNEDDS) of rutin using Box-Behnken design (BBD) combined with a desirability function. Further various antioxidant, pharmacokinetic and pharmacodynamic studies were performed for the optimized rutin SNEDDS formulation. Methodologies: Selection of oil, surfactant and co-surfactant was done on the basis of solubility/miscibility studies. Sefsol+ Vitamin E, Solutol HS 15 and Transcutol P were selected as oil phase, surfactant and co-surfactant respectively. Optimization of SNEDDS formulations was done by a three-factor, three-level (33)BBD. The independent factors were Sefsol+ Vitamin E, Solutol HS15, and Transcutol P. The dependent variables were globule size, self emulsification time (SEF), % transmittance and cumulative percentage drug released. Various response surface graphs and contour plots were constructed to understand the effect of different factor, their levels and combinations on the responses. The optimized Rutin SNEDDS formulation was characterized for various parameters such as globule size, zeta potential, viscosity, refractive index , % Transmittance and in vitro drug release. Ex vivo permeation studies and pharmacokinetic studies were performed for optimized formulation. Antioxidant activity was determined by DPPH and reducing power assays. Anti-inflammatory activity was determined by using carrageenan induced rat paw oedema method. Permeation of rutin across small intestine was assessed using confocal laser scanning microscopy (CLSM). Major findings:The optimized SNEDDS formulation consisting of Sefsol+ Vitamin E - Solutol HS15 -Transcutol HP at proportions of 25:35:17.5 (w/w) was prepared and a comparison of the predicted values and experimental values were found to be in close agreement. The globule size and PDI of optimized SNEDDS formulation was found to be 16.08 ± 0.02 nm and 0.124±0.01 respectively. Significant (p˂0.05) increase in percentage drug release was achieved in the case of optimized SNEDDS formulation (98.8 %) as compared to rutin suspension. Furthermore, pharmacokinetic study showed a 2.3-fold increase in relative oral bioavailability compared with that of the suspension. Antioxidant assay results indicated better efficacy of the developed formulation than the pure drug and it was found to be comparable with ascorbic acid. The results of anti-inflammatory studies showed 72.93 % inhibition for the SNEDDS formulation which was significantly higher than the drug suspension 46.56%. The results of CLSM indicated that the absorption of SNEDDS formulation was considerably higher than that from rutin suspension. Conclusion: Rutin SNEDDS have been successfully prepared and they can serve as an effective tool in enhancing oral bioavailability and efficacy of Rutin.

Keywords: rutin, oral bioavilability, pharamacokinetics, pharmacodynamics

Procedia PDF Downloads 499
737 Bi-Directional Impulse Turbine for Thermo-Acoustic Generator

Authors: A. I. Dovgjallo, A. B. Tsapkova, A. A. Shimanov

Abstract:

The paper is devoted to one of engine types with external heating – a thermoacoustic engine. In thermoacoustic engine heat energy is converted to an acoustic energy. Further, acoustic energy of oscillating gas flow must be converted to mechanical energy and this energy in turn must be converted to electric energy. The most widely used way of transforming acoustic energy to electric one is application of linear generator or usual generator with crank mechanism. In both cases, the piston is used. Main disadvantages of piston use are friction losses, lubrication problems and working fluid pollution which cause decrease of engine power and ecological efficiency. Using of a bidirectional impulse turbine as an energy converter is suggested. The distinctive feature of this kind of turbine is that the shock wave of oscillating gas flow passing through the turbine is reflected and passes through the turbine again in the opposite direction. The direction of turbine rotation does not change in the process. Different types of bidirectional impulse turbines for thermoacoustic engines are analyzed. The Wells turbine is the simplest and least efficient of them. A radial impulse turbine has more complicated design and is more efficient than the Wells turbine. The most appropriate type of impulse turbine was chosen. This type is an axial impulse turbine, which has a simpler design than that of a radial turbine and similar efficiency. The peculiarities of the method of an impulse turbine calculating are discussed. They include changes in gas pressure and velocity as functions of time during the generation of gas oscillating flow shock waves in a thermoacoustic system. In thermoacoustic system pressure constantly changes by a certain law due to acoustic waves generation. Peak values of pressure are amplitude which determines acoustic power. Gas, flowing in thermoacoustic system, periodically changes its direction and its mean velocity is equal to zero but its peak values can be used for bi-directional turbine rotation. In contrast with feed turbine, described turbine operates on un-steady oscillating flows with direction changes which significantly influence the algorithm of its calculation. Calculated power output is 150 W with frequency 12000 r/min and pressure amplitude 1,7 kPa. Then, 3-d modeling and numerical research of impulse turbine was carried out. As a result of numerical modeling, main parameters of the working fluid in turbine were received. On the base of theoretical and numerical data model of impulse turbine was made on 3D printer. Experimental unit was designed for numerical modeling results verification. Acoustic speaker was used as acoustic wave generator. Analysis if the acquired data shows that use of the bi-directional impulse turbine is advisable. By its characteristics as a converter, it is comparable with linear electric generators. But its lifetime cycle will be higher and engine itself will be smaller due to turbine rotation motion.

Keywords: acoustic power, bi-directional pulse turbine, linear alternator, thermoacoustic generator

Procedia PDF Downloads 377
736 Possibilities and Limits for the Development of Care in Primary Health Care in Brazil

Authors: Ivonete Teresinha Schulter Buss Heidemann, Michelle Kuntz Durand, Aline Megumi Arakawa-Belaunde, Sandra Mara Corrêa, Leandro Martins Costa Do Araujo, Kamila Soares Maciel

Abstract:

Primary Health Care is defined as the level of a system of services that enables the achievement of answers to health needs. This level of care produces services and actions of attention to the person in the life cycle and in their health conditions or diseases. Primary Health Care refers to a conception of care model and organization of the health system that in Brazil seeks to reorganize the principles of the Unified Health System. This system is based on the principle of health as a citizen's right and duty of the State. Primary health care has family health as a priority strategy for its organization according to the precepts of the Unified Health System, structured in the logic of new sectoral practices, associating clinical work and health promotion. Thus, this study seeks to know the possibilities and limits of the care developed by professionals working in Primary Health Care. It was conducted by a qualitative approach of the participant action type, based on Paulo Freire's Research Itinerary, which corresponds to three moments: Thematic Investigation; Encoding and Decoding; and, Critical Unveiling. The themes were investigated in a health unit with the development of a culture circle with 20 professionals, from a municipality in southern Brazil, in the first half of 2021. The participants revealed as possibilities the involvement, bonding and strengthening of the interpersonal relationships of the professionals who work in the context of primary care. Promoting welcoming in primary care has favoured care and teamwork, as well as improved access. They also highlighted that care planning, the use of technologies in the process of communication and the orientation of the population enhances the levels of problem-solving capacity and the organization of services. As limits, the lack of professional recognition and the scarce material and human resources were revealed, conditions that generate tensions for health care. The reduction in the number of professionals and the low salary are pointed out as elements that boost the motivation of the health team for the development of the work. The participants revealed that due to COVID-19, the flow of care had as a priority the pandemic situation, which affected health care in primary care, and prevention and health promotion actions were canceled. The study demonstrated that empowerment and professional involvement are fundamental to promoting comprehensive and problem-solving care. However, limits of the teams are observed when exercising their activities, these are related to the lack of human and material resources, and the expansion of public health policies is urgent.

Keywords: health promotion, primary health care, health professionals, welcoming.

Procedia PDF Downloads 97
735 Biodegradation Effects onto Source Identification of Diesel Fuel Contaminated Soils

Authors: Colin S. Chen, Chien-Jung Tien, Hsin-Jan Huang

Abstract:

For weathering studies, the change of chemical constituents by biodegradation effect in diesel-contaminated soils are important factors to be considered, especially when there is a prolonged period of weathering processes. The objective was to evaluate biodegradation effects onto hydrocarbon fingerprinting and distribution patterns of diesel fuels, fuel source screening and differentiation, source-specific marker compounds, and diagnostic ratios of diesel fuel constituents by laboratory and field studies. Biodegradation processes of diesel contaminated soils were evaluated by experiments lasting for 15 and 12 months, respectively. The degradation of diesel fuel in top soils was affected by organic carbon content and biomass of microorganisms in soils. Higher depletion of total petroleum hydrocarbon (TPH), n-alkanes, and polynuclear aromatic hydrocarbons (PAHs) and their alkyl homologues was observed in soils containing higher organic carbon content and biomass. Decreased ratio of selected isoprenoids (i.e., pristane (Pr) and phytane (Ph)) including n-C17/pristane and n-C18/phytane was observed. The ratio of pristane/phytane was remained consistent for a longer period of time. At the end of the experimental period, a decrease of pristane/phytane was observed. Biomarker compounds of bicyclic sesquiterpanes (BS) were less susceptible to the effects of biodegradation. The ratios of characteristic factors such as C15 sesquiterpane/ 8β(H)-drimane (BS3/BS5), C15 sesquiterpane/ 8β(H)-drimane (BS4/BS5), 8β(H)-drimane/8β(H)-homodrimane (BS5/BS10), and C15 sesquiterpane/8β(H)-homodrimane (BS3/BS10) could be adopted for source identification of diesel fuels in top soil. However, for biodegradation processes lasted for six months but shorter than nine months, only BS3/BS5 and BS3/BS10 could be distinguished in two diesel fuels. In subsoil experiments (contaminated soil located 50 cm below), the ratios of characteristic factors including BS3/BS5, BS4/BS5, and BS5/BS10 were valid for source identification of two diesel fuels for nine month biodegradation. At the early stage of contamination, biomass of soil decreased significantly. However, 6 and 7 dominant species were found in soils in top soil experiments, respectively. With less oxygen and nutrients in subsoil, less biomass of microorganisms was observed in subsoils. Only 2 and 4 diesel-degrading species of microorganisms were identified in two soils, respectively. Parameters of double ratio such as fluorene/C1-fluorene: C2-phenanthrene/C3-phenanthrene (C0F/C1F:C2P/C3P) in both top and subsoil, C2-naphthalene/C2-phenanthrene: C1-phenanthrene/C3-phenanthrene (C2N/C2P:C1P/C3P), and C1-phenanthrene/C1-fluorene: C3-naphthalene/C3-phenanthrene (C1P/C1F:C3N/C3P) in subsoil could serve as forensic indicators in diesel contaminated sites. BS3/BS10:BS4/BS5 could be used in 6 to 9 months of biodegradation processes. Results of principal component analysis (PCA) indicated that source identification of diesel fuels in top soil could only be perofrmed for weathering process less than 6 months. For subsoil, identification can be conducted for weathering process less than 9 months. Ratio of isoprenoids (pristane and phytane) and PAHs might be affected by biodegradation in spilled sites. The ratios of bicyclic sesquiterpanes could serve as forensic indicators in diesel-contaminated soils. Finally, source identification was attemped for samples collected from different fuel contaminated sites by using the unique pattern of sesquiterpanes. It was anticipated that the information generated from this study would be adopted by decision makers to evaluate the liability of cleanup in diesel contaminated sites.

Keywords: biodegradation, diagnostic ratio, diesel fuel, environmental forensics

Procedia PDF Downloads 227
734 Robust Inference with a Skew T Distribution

Authors: M. Qamarul Islam, Ergun Dogan, Mehmet Yazici

Abstract:

There is a growing body of evidence that non-normal data is more prevalent in nature than the normal one. Examples can be quoted from, but not restricted to, the areas of Economics, Finance and Actuarial Science. The non-normality considered here is expressed in terms of fat-tailedness and asymmetry of the relevant distribution. In this study a skew t distribution that can be used to model a data that exhibit inherent non-normal behavior is considered. This distribution has tails fatter than a normal distribution and it also exhibits skewness. Although maximum likelihood estimates can be obtained by solving iteratively the likelihood equations that are non-linear in form, this can be problematic in terms of convergence and in many other respects as well. Therefore, it is preferred to use the method of modified maximum likelihood in which the likelihood estimates are derived by expressing the intractable non-linear likelihood equations in terms of standardized ordered variates and replacing the intractable terms by their linear approximations obtained from the first two terms of a Taylor series expansion about the quantiles of the distribution. These estimates, called modified maximum likelihood estimates, are obtained in closed form. Hence, they are easy to compute and to manipulate analytically. In fact the modified maximum likelihood estimates are equivalent to maximum likelihood estimates, asymptotically. Even in small samples the modified maximum likelihood estimates are found to be approximately the same as maximum likelihood estimates that are obtained iteratively. It is shown in this study that the modified maximum likelihood estimates are not only unbiased but substantially more efficient than the commonly used moment estimates or the least square estimates that are known to be biased and inefficient in such cases. Furthermore, in conventional regression analysis, it is assumed that the error terms are distributed normally and, hence, the well-known least square method is considered to be a suitable and preferred method for making the relevant statistical inferences. However, a number of empirical researches have shown that non-normal errors are more prevalent. Even transforming and/or filtering techniques may not produce normally distributed residuals. Here, a study is done for multiple linear regression models with random error having non-normal pattern. Through an extensive simulation it is shown that the modified maximum likelihood estimates of regression parameters are plausibly robust to the distributional assumptions and to various data anomalies as compared to the widely used least square estimates. Relevant tests of hypothesis are developed and are explored for desirable properties in terms of their size and power. The tests based upon modified maximum likelihood estimates are found to be substantially more powerful than the tests based upon least square estimates. Several examples are provided from the areas of Economics and Finance where such distributions are interpretable in terms of efficient market hypothesis with respect to asset pricing, portfolio selection, risk measurement and capital allocation, etc.

Keywords: least square estimates, linear regression, maximum likelihood estimates, modified maximum likelihood method, non-normality, robustness

Procedia PDF Downloads 396
733 Nano-Enabling Technical Carbon Fabrics to Achieve Improved Through Thickness Electrical Conductivity in Carbon Fiber Reinforced Composites

Authors: Angelos Evangelou, Katerina Loizou, Loukas Koutsokeras, Orestes Marangos, Giorgos Constantinides, Stylianos Yiatros, Katerina Sofocleous, Vasileios Drakonakis

Abstract:

Owing to their outstanding strength to weight properties, carbon fiber reinforced polymer (CFRPs) composites have attracted significant attention finding use in various fields (sports, automotive, transportation, etc.). The current momentum indicates that there is an increasing demand for their employment in high value bespoke applications such as avionics and electronic casings, damage sensing structures, EMI (electromagnetic interference) structures that dictate the use of materials with increased electrical conductivity both in-plane and through the thickness. Several efforts by research groups have focused on enhancing the through-thickness electrical conductivity of FRPs, in an attempt to combine the intrinsically high relative strengths exhibited with improved z-axis electrical response as well. However, only a limited number of studies deal with printing of nano-enhanced polymer inks to produce a pattern on dry fabric level that could be used to fabricate CFRPs with improved through thickness electrical conductivity. The present study investigates the employment of screen-printing process on technical dry fabrics using nano-reinforced polymer-based inks to achieve the required through thickness conductivity, opening new pathways for the application of fiber reinforced composites in niche products. Commercially available inks and in-house prepared inks reinforced with electrically conductive nanoparticles are employed, printed in different patterns. The aim of the present study is to investigate both the effect of the nanoparticle concentration as well as the droplet patterns (diameter, inter-droplet distance and coverage) to optimize printing for the desired level of conductivity enhancement in the lamina level. The electrical conductivity is measured initially at ink level to pinpoint the optimum concentrations to be employed using a “four-probe” configuration. Upon printing of the different patterns, the coverage of the dry fabric area is assessed along with the permeability of the resulting dry fabrics, in alignment with the fabrication of CFRPs that requires adequate wetting by the epoxy matrix. Results demonstrated increased electrical conductivities of the printed droplets, with increase of the conductivity from the benchmark value of 0.1 S/M to between 8 and 10 S/m. Printability of dense and dispersed patterns has exhibited promising results in terms of increasing the z-axis conductivity without inhibiting the penetration of the epoxy matrix at the processing stage of fiber reinforced composites. The high value and niche prospect of the resulting applications that can stem from CFRPs with increased through thickness electrical conductivities highlights the potential of the presented endeavor, signifying screen printing as the process to to nano-enable z-axis electrical conductivity in composite laminas. This work was co-funded by the European Regional Development Fund and the Republic of Cyprus through the Research and Innovation Foundation (Project: ENTERPRISES/0618/0013).

Keywords: CFRPs, conductivity, nano-reinforcement, screen-printing

Procedia PDF Downloads 151
732 DIF-JACKET: a Thermal Protective Jacket for Firefighters

Authors: Gilda Santos, Rita Marques, Francisca Marques, João Ribeiro, André Fonseca, João M. Miranda, João B. L. M. Campos, Soraia F. Neves

Abstract:

Every year, an unacceptable number of firefighters are seriously burned during firefighting operations, with some of them eventually losing their life. Although thermal protective clothing research and development has been searching solutions to minimize firefighters heat load and skin burns, currently commercially available solutions focus in solving isolated problems, for example, radiant heat or water-vapor resistance. Therefore, episodes of severe burns and heat strokes are still frequent. Taking this into account, a consortium composed by Portuguese entities has joined synergies to develop an innovative protective clothing system by following a procedure based on the application of numerical models to optimize the design and using a combinationof protective clothing components disposed in different layers. Recently, it has been shown that Phase Change Materials (PCMs) can contribute to the reduction of potential heat hazards in fire extinguish operations, and consequently, their incorporation into firefighting protective clothing has advantages. The greatest challenge is to integrate these materials without compromising garments ergonomics and, at the same time, accomplishing the International Standard of protective clothing for firefighters – laboratory test methods and performance requirements for wildland firefighting clothing. The incorporation of PCMs into the firefighter's protective jacket will result in the absorption of heat from the fire and consequently increase the time that the firefighter can be exposed to it. According to the project studies and developments, to favor a higher use of the PCM storage capacityand to take advantage of its high thermal inertia more efficiently, the PCM layer should be closer to the external heat source. Therefore, in this stage, to integrate PCMs in firefighting clothing, a mock-up of a vest specially designed to protect the torso (back, chest and abdomen) and to be worn over a fire-resistant jacketwas envisaged. Different configurations of PCMs, as well as multilayer approaches, were studied using suitable joining technologies such as bonding, ultrasound, and radiofrequency. Concerning firefighter’s protective clothing, it is important to balance heat protection and flame resistance with comfort parameters, namely, thermaland water-vapor resistances. The impact of the most promising solutions regarding thermal comfort was evaluated to refine the performance of the global solutions. Results obtained with experimental bench scale model and numerical simulation regarding the integration of PCMs in a vest designed as protective clothing for firefighters will be presented.

Keywords: firefighters, multilayer system, phase change material, thermal protective clothing

Procedia PDF Downloads 162
731 Improved Approach to the Treatment of Resistant Breast Cancer

Authors: Lola T. Alimkhodjaeva, Lola T. Zakirova, Soniya S. Ziyavidenova

Abstract:

Background: Breast cancer (BC) is still one of the urgent oncology problems. The essential obstacle to the full anti-tumor therapy implementation is drug resistance development. Taking into account the fact that chemotherapy is main antitumor treatment in BC patients, the important task is to improve treatment results. Certain success in overcoming this situation has been associated with the use of methods of extracorporeal blood treatment (ECBT), plasmapheresis. Materials and Methods: We examined 129 women with resistant BC stages 3-4, aged between 56 to 62 years who had previously received 2 courses of CAF chemotherapy. All patients additionally underwent 2 courses of CAF chemotherapy but against the background ECBT with ultrasonic exposure. We studied the following parameters: 1. The highlights of peripheral blood before and after therapy. 2. The state of cellular immunity and identification of activation markers CD23 +, CD25 +, CD38 +, CD95 + on lymphocytes was performed using monoclonal antibodies. Evaluation of humoral immunity was determined by the level of main classes of immunoglobulins IgG, IgA, IgM in serum. 3. The degree of tumor regression was assessed by WHO recommended 4 gradations. (complete - 100%, partial - more than 50% of initial size, process stabilization–regression is less than 50% of initial size and tumor advance progressing). 4. Medical pathomorphism in the tumor was determined by Lavnikova. 5. The study of immediate and remote results, up to 3 years and more. Results and Discussion: After performing extracorporeal blood treatment anemia occurred in 38.9%, leukopenia in 36.8%, thrombocytopenia in 34.6%, hypolymphemia in 26.8%. Studies of immunoglobulin fractions in blood serum were able to establish a certain relationship between the classes of immunoglobulin A, G, M and their functions. The results showed that after treatment the values of main immunoglobulins in patients’ serum approximated to normal. Analysis of expression of activation markers CD25 + cells bearing receptors for IL-2 (IL-2Rα chain) and CD95 + lymphocytes that were mediated physiological apoptosis showed the tendency to increase, which apparently was due to activation of cellular immunity cytokines allocated by ultrasonic treatment. To carry out ECBT on the background of ultrasonic treatment improved the parameters of the immune system, which were expressed in stimulation of cellular immunity and correcting imbalances in humoral immunity. The key indicator of conducted treatment efficiency is the immediate result measured by the degree of tumor regression. After ECBT performance the complete regression was 10.3%, partial response - 55.5%, process stabilization - 34.5%, tumor advance progressing no observed. Morphological investigations of tumor determined therapeutic pathomorphism grade 2 in 15%, in 25% - grade 3 and therapeutic pathomorphism grade 4 in 60% of patients. One of the main criteria for the effect of conducted treatment is to study the remission terms in the postoperative period (up to 3 years or more). The remission terms up to 3 years with ECBT was 34.5%, 5-year survival was 54%. Carried out research suggests that a comprehensive study of immunological and clinical course of breast cancer allows the differentiated approach to the choice of methods for effective treatment.

Keywords: breast cancer, immunoglobulins, extracorporeal blood treatment, chemotherapy

Procedia PDF Downloads 272
730 Evaluation of Toxicity of Cerium Oxide on Zebrafish Developmental Stages

Authors: Roberta Pecoraro, Elena Maria Scalisi

Abstract:

Engineered Nanoparticles (ENPs) and Nanomaterials (ENMs) concern an active research area and a sector in full expansion. They have physical-chemical characteristics and small size that improve their performance compared to common materials. Due to the increase in their production and their subsequent release into the environment, new strategies are emerging to assess risk of nanomaterials. NPs can be released into the environment through aquatic systems by human activities and exert toxicity on living organisms. We evaluated the potential toxic effect of cerium oxide (CeO2) nanoparticles because it’s used in different fields due to its peculiar properties. In order to assess nanoparticles toxicity, Fish Embryo Toxicity (FET) test was performed. Powders of CeO2 NPs supplied by the CNR-IMM of Catania are indicated as CeO2 type 1 (as-prepared) and CeO2 type 2 (modified), while CeO2 type 3 (commercial) is supplied by Sigma-Aldrich. Starting from a stock solution (0.001g/10 ml dilution water) of each type of CeO2 NPs, the other concentration solutions were obtained adding 1 ml of the stock solution to 9 ml of dilution water, leading to three different solutions of concentration (10-4, 10-5, 10-6 g/ml). All the solutions have been sonicated to avoid natural tendency of NPs to aggregate and sediment. FET test was performed according to the OECD guidelines for testing chemicals using our internal protocol procedure. A number of eight selected fertilized eggs were placed in each becher filled with 5 ml of each concentration of the three types of CeO2 NPs; control samples were incubated only with dilution water. Replication was performed for each concentration. During the exposure period, we observed four endpoints (embryo coagulation, lack of formation of somites, failure to lift the yolk bag, no heartbeat) by a stereomicroscope every 24 hours. Immunohistochemical analysis on treated larvae was performed to evaluate the expression of metallothioneins (MTs), Heat Shock Proteins 70 (HSP70) and 7-ethoxyresorufin-O-diethylase (EROD). Our results have not shown evident alterations on embryonic development because all embryos completed the development and the hatching of the eggs, started around the 48th hour after exposure, took place within the last observation at 72 hours. A good reactivity, both in the embryos and in the newly hatched larvae, was found. The presence of heartbeat has also been observed in embryos with reduced mobility confirming their viability. A higher expression of EROD biomarker was observed in the larvae exposed to the three types of CeO2, showing a clear difference with the control. A weak positivity was found for MTs biomarker in treated larvae as well as in the control. HSP70 are expressed homogeneously in all the type of nanoparticles tested but not too much greater than control. Our results are in agreement with other studies in the literature, in which the exposure of Danio rerio larvae to other metal oxide nanoparticles does not show adverse effects on survival and hatching time. Further studies are necessary to clarify the role of these NPs and also to solve conflicting opinions.

Keywords: Danio rerio, endpoints, fish embryo toxicity test, metallic nanoparticles

Procedia PDF Downloads 132
729 On-Farm Biopurification Systems: Fungal Bioaugmentation of Biomixtures For Carbofuran Removal

Authors: Carlos E. Rodríguez-Rodríguez, Karla Ruiz-Hidalgo, Kattia Madrigal-Zúñiga, Juan Salvador Chin-Pampillo, Mario Masís-Mora, Elizabeth Carazo-Rojas

Abstract:

One of the main causes of contamination linked to agricultural activities is the spillage and disposal of pesticides, especially during the loading, mixing or cleaning of agricultural spraying equipment. One improvement in the handling of pesticides is the use of biopurification systems (BPS), simple and cheap degradation devices where the pesticides are biologically degraded at accelerated rates. The biologically active core of BPS is the biomixture, which is constituted by soil pre-exposed to the target pesticide, a lignocellulosic substrate to promote the activity of ligninolitic fungi and a humic component (peat or compost), mixed at a volumetric proportion of 50:25:25. Considering the known ability of lignocellulosic fungi to degrade a wide range of organic pollutants, and the high amount of lignocellulosic waste used in biomixture preparation, the bioaugmentation of biomixtures with these fungi represents an interesting approach for improving biomixtures. The present work aimed at evaluating the effect of the bioaugmentation of rice husk based biomixtures with the fungus Trametes versicolor in the removal of the insectice/nematicide carbofuran (CFN) and to optimize the composition of the biomixture to obtain the best performance in terms of CFN removal and mineralization, reduction in formation of transformation products and decrease in residual toxicity of the matrix. The evaluation of several lignocellulosic residues (rice husk, wood chips, coconut fiber, sugarcane bagasse or newspaper print) revealed the best colonization by T. versicolor in rice husk. Pre-colonized rice husk was then used in the bioaugmentation of biomixtures also containing soil pre-exposed to CFN and either peat (GTS biomixture) or compost (GCS biomixture). After spiking with 10 mg/kg CBF, the efficiency of the biomixture was evaluated through a multi-component approach that included: monitoring of CBF removal and production of CBF transformation products, mineralization of radioisotopically labeled carbofuran (14C-CBF) and changes in the toxicity of the matrix after the treatment (Daphnia magna acute immobilization test). Estimated half-lives of CBF in the biomixtures were 3.4 d and 8.1 d in GTS and GCS, respectively. The transformation products 3-hydroxycarbofuran and 3-ketocarbofuran were detected at the moment of CFN application, however their concentration continuously disappeared. Mineralization of 14C-CFN was also faster in GTS than GCS. The toxicological evaluation showed a complete toxicity removal in the biomixtures after 48 d of treatment. The composition of the GCS biomixture was optimized using a central composite design and response surface methodology. The design variables were the volumetric content of fungally pre-colonized rice husk and the volumetric ratio compost/soil. According to the response models, maximization of CFN removal and mineralization rate, and minimization in the accumulation of transformation products were obtained with an optimized biomixture of composition 30:43:27 (pre-colonized rice husk:compost:soil), which differs from the 50:25:25 composition commonly employed in BPS. Results suggest that fungal bioaugmentation may enhance the performance of biomixtures in CFN removal. Optimization reveals the importance of assessing new biomixture formulations in order to maximize their performance.

Keywords: bioaugmentation, biopurification systems, degradation, fungi, pesticides, toxicity

Procedia PDF Downloads 310
728 Assessment of Antioxidant and Cholinergic Systems, and Liver Histopathologies in Lithobates catesbeianus Exposed to the Waters of an Urban Stream

Authors: Diego R. Boiarski, Camila M. Toigo, Thais M. Sobjak, Andrey F. P. Santos, Silvia Romao, Ana T. B. Guimaraes

Abstract:

Anthropogenic activities promote changes in the community’s structures and decrease the species abundance of amphibians. Biological communities of fluvial systems are assemblies of organisms that have adapted to regional conditions, including the physical environment and food resources, and are further refined through interactions with other species. The aim of this study was to assess neurotoxic alterations and in the antioxidant system on tadpoles of Lithobates catesbeianus exposed to waters from Cascavel River, in the south of Brazil. A total of 420 L of water was collected from the Cascavel River, 140 L from each of the three different locations: Site 1 – headwater; Site 2 – stretch of the stream that runs through an urbanized area; Site 3 – a stretch from the rural area. Twelve tadpoles were acclimated in each aquarium (100 L of water) for seven days. The water from each aquarium was replaced with the ones sampled from the river, except the one from the control aquarium. After seven days, a portion of the liver was removed and conditioned for ChE, SOD, CAT and LPO analysis; other part of the tissue was conditioned for histological analysis. The statistical analysis performed was one-way ANOVA, followed by post-hoc Tukey-HSD test, and the multivariate principal components analysis. It was not observed any neurotoxic effect, but a slight increase in SOD activity and elevation of CAT activity in both urban and rural environment. A decrease in LPO reaction was detected, mainly among the tadpoles exposed to the waters from the rural area. The results of the present study demonstrate the alteration of the antioxidant system, as well as liver histopathologies in tadpoles exposed mainly to waters collected in urban and rural environments. These alterations may cause the reduction in the velocity of the metamorphosis process from the tadpoles. Further, were observed histological alterations, highlighting necrotic areas mainly among the animals exposed to urban waters. Those damages can lead to metabolic dysfunction, interfering with survival capacity, diminishing not only individual fitness but for the whole population. In the interpretation synthesis of all biomarkers, the cellular damage gradient is perceptible, characterized by the variables related to the antioxidant system, due to the flow direction of the stream. This result is indicative that along the course of the creek occurs dumping of organic material, which promoted an acute response upon tadpoles of L. catesbeianus. and it was also observed the difference in tissue damage between the experimental groups and the control group, the latter presenting histological alterations, but to a lesser degree than the animals exposed to the waters of the Cascavel river. These damages, caused by reactive oxygen species possibly resulting from the contamination by organic compounds, can lead the animals to a series of metabolic dysfunctions, interfering with its metamorphosis capacity. Interruption of metamorphosis may affect survival, which may impair its growth, development and reproduction, diminishing not only the fitness of each individual but in a long-term, to the entire population.

Keywords: American bullfrog, histopathology, oxidative stress, urban creeks pollution

Procedia PDF Downloads 185
727 Public Participation for an Effective Flood Risk Management: Building Social Capacities in Ribera Alta Del Ebro, Spain

Authors: Alba Ballester Ciuró, Marc Pares Franzi

Abstract:

While coming decades are likely to see a higher flood risk in Europe and greater socio-economic damages, traditional flood risk management has become inefficient. In response to that, new approaches such as capacity building and public participation have recently been incorporated in natural hazards mitigation policy (i.e. Sendai Framework for Action, Intergovernmental Panel on Climate Change reports and EU Floods Directive). By integrating capacity building and public participation, we present a research concerning the promotion of participatory social capacity building actions for flood risk mitigation at the local level. Social capacities have been defined as the resources and abilities available at individual and collective level that can be used to anticipate, respond to, cope with, recover from and adapt to external stressors. Social capacity building is understood as a process of identifying communities’ social capacities and of applying collaborative strategies to improve them. This paper presents a proposal of systematization of participatory social capacity building process for flood risk mitigation, and its implementation in a high risk of flooding area in the Ebro river basin: Ribera Alta del Ebro. To develop this process, we designed and tested a tool that allows measuring and building five types of social capacities: knowledge, motivation, networks, participation and finance. The tool implementation has allowed us to assess social capacities in the area. Upon the results of the assessment we have developed a co-decision process with stakeholders and flood risk management authorities on which participatory activities could be employed to improve social capacities for flood risk mitigation. Based on the results of this process, and focused on the weaker social capacities, we developed a set of participatory actions in the area oriented to general public and stakeholders: informative sessions on flood risk management plan and flood insurances, interpretative river descents on flood risk management (with journalists, teachers, and general public), interpretative visit to the floodplain, workshop on agricultural insurance, deliberative workshop on project funding, deliberative workshops in schools on flood risk management (playing with a flood risk model). The combination of obtaining data through a mixed-methods approach of qualitative inquiry and quantitative surveys, as well as action research through co-decision processes and pilot participatory activities, show us the significant impact of public participation on social capacity building for flood risk mitigation and contributes to the understanding of which main factors intervene in this process.

Keywords: flood risk management, public participation, risk reduction, social capacities, vulnerability assessment

Procedia PDF Downloads 210
726 Evidence-Triggers for Care of Patients with Cleft Lip and Palate in Srinagarind Hospital: The Tawanchai Center and Out-Patients Surgical Room

Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

Abstract:

Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

Procedia PDF Downloads 217
725 Strategic Entrepreneurship: Model Proposal for Post-Troika Sustainable Cultural Organizations

Authors: Maria Inês Pinho

Abstract:

Recent literature on issues of Cultural Management (also called Strategic Management for cultural organizations) systematically seeks for models that allow such equipment to adapt to the constant change that occurs in contemporary societies. In the last decade, the world, and in particular Europe has experienced a serious financial problem that has triggered defensive mechanisms, both in the direction of promoting the balance of public accounts and in the sense of the anonymous loss of the democratic and cultural values of each nation. If in the first case emerged the Troika that led to strong cuts in funding for Culture, deeply affecting those organizations; in the second case, the commonplace citizen is seen fighting for the non-closure of cultural equipment. Despite this, the cultural manager argues that there is no single formula capable of solving the need to adapt to change. In another way, it is up to this agent to know the existing scientific models and to adapt them in the best way to the reality of the institution he coordinates. These actions, as a rule, are concerned with the best performance vis-à-vis external audiences or with the financial sustainability of cultural organizations. They forget, therefore, that all this mechanics cannot function without its internal public, without its Human Resources. The employees of the cultural organization must then have an entrepreneurial posture - must be intrapreneurial. This paper intends to break this form of action and lead the cultural manager to understand that his role should be in the sense of creating value for society, through a good organizational performance. This is only possible with a posture of strategic entrepreneurship. In other words, with a link between: Cultural Management, Cultural Entrepreneurship and Cultural Intrapreneurship. In order to prove this assumption, the case study methodology was used with the symbol of the European Capital of Culture (Casa da Música) as well as qualitative and quantitative techniques. The qualitative techniques included the procedure of in-depth interviews to managers, founders and patrons and focus groups to public with and without experience in managing cultural facilities. The quantitative techniques involved the application of a questionnaire to middle management and employees of Casa da Música. After the triangulation of the data, it was proved that contemporary management of cultural organizations must implement among its practices, the concept of Strategic Entrepreneurship and its variables. Also, the topics which characterize the Cultural Intrapreneurship notion (job satisfaction, the quality in organizational performance, the leadership and the employee engagement and autonomy) emerged. The findings show then that to be sustainable, a cultural organization should meet the concerns of both external and internal forum. In other words, it should have an attitude of citizenship to the communities, visible on a social responsibility and a participatory management, only possible with the implementation of the concept of Strategic Entrepreneurship and its variable of Cultural Intrapreneurship.

Keywords: cultural entrepreneurship, cultural intrapreneurship, cultural organizations, strategic management

Procedia PDF Downloads 182
724 The French Ekang Ethnographic Dictionary. The Quantum Approach

Authors: Henda Gnakate Biba, Ndassa Mouafon Issa

Abstract:

Dictionaries modeled on the Western model [tonic accent languages] are not suitable and do not account for tonal languages phonologically, which is why the [prosodic and phonological] ethnographic dictionary was designed. It is a glossary that expresses the tones and the rhythm of words. It recreates exactly the speaking or singing of a tonal language, and allows the non-speaker of this language to pronounce the words as if they were a native. It is a dictionary adapted to tonal languages. It was built from ethnomusicological theorems and phonological processes, according to Jean. J. Rousseau 1776 hypothesis /To say and to sing were once the same thing/. Each word in the French dictionary finds its corresponding language, ekaη. And each word ekaη is written on a musical staff. This ethnographic dictionary is also an inventive, original and innovative research thesis, but it is also an inventive, original and innovative research thesis. A contribution to the theoretical, musicological, ethno musicological and linguistic conceptualization of languages, giving rise to the practice of interlocution between the social and cognitive sciences, the activities of artistic creation and the question of modeling in the human sciences: mathematics, computer science, translation automation and artificial intelligence. When you apply this theory to any text of a folksong of a world-tone language, you do not only piece together the exact melody, rhythm, and harmonies of that song as if you knew it in advance but also the exact speaking of this language. The author believes that the issue of the disappearance of tonal languages and their preservation has been structurally resolved, as well as one of the greatest cultural equations related to the composition and creation of tonal, polytonal and random music. The experimentation confirming the theorization designed a semi-digital, semi-analog application which translates the tonal languages of Africa (about 2,100 languages) into blues, jazz, world music, polyphonic music, tonal and anatonal music and deterministic and random music). To test this application, I use a music reading and writing software that allows me to collect the data extracted from my mother tongue, which is already modeled in the musical staves saved in the ethnographic (semiotic) dictionary for automatic translation ( volume 2 of the book). Translation is done (from writing to writing, from writing to speech and from writing to music). Mode of operation: you type a text on your computer, a structured song (chorus-verse), and you command the machine a melody of blues, jazz and, world music or, variety etc. The software runs, giving you the option to choose harmonies, and then you select your melody.

Keywords: music, language, entenglement, science, research

Procedia PDF Downloads 69
723 Collaborative Governance to Foster Public Good: The Case of the Etorkizuna Eraikiz Initiative

Authors: Igone Guerra, Xabier Barandiaran

Abstract:

The deep crisis (economic, social and cultural) in which Europe and Gipuzkoa, in the Basque Country (Spain), have been immersed in since 2008 forces governments to face a necessary transformation. These challenges demand different solutions and answers to meet the needs of the citizens. Adapting to continuous and sometimes abrupt changes in the social and political landscape requires an undeniable will to reinvent the way in which governments practice politics. This reinvention of government should help us build different organizations that, first, develop challenging public services, second, respond effectively to the needs of the citizens, and third, manage scarce resources, ultimately offering a contemporary concept of public value. In this context, the Etorkizuna Eraikiz initiative was designed to face the future challenges of the territory in a collaborative way. The aim of the initiative is to promote an alternative form of governance to generate common good and greater public value. In Etorkizuna Eraikiz democratic values, such as collaboration, participation, and accountability are prominent. This government approach is based on several features such as the creation of relational spaces to design and deliberate about the public politics or the promotion of a team-working approach, breaking down the silos between and within organizations, as an exercise in defining a shared vision regarding the Future of the Territory. A future in which the citizens are becoming actors in the problem-solving process and in the construction of a culture of participation and collective learning. In this paper, the Etorkizuna Eraikiz initiative will be presented (vision and methodology) as a model of a local approach to public policy innovation resulting in a way of governance that is more open and collaborative. Based on this case study, this paper explores the way in which collaborative governance leads to better decisions, better leadership, and better citizenry. Finally, the paper also describes some preliminary findings of this local approach, such as the level of knowledge of the citizenry about the projects promoted within Etorkizuna Eraikiz as well as the link between the challenges of the territory, as identified by the citizenry, and the political agenda promoted by the provincial government. Regarding the former, the Survey on the socio-political situation of Gipuzkoa showed that 27.9% of the respondents confirmed that they knew about the projects promoted within the initiative and gave it a mark of 5.71. In connection with the latter, over the last three years, 65 millions of euros have been allocated for a total of 73 projects that have covered socio-economic and political challenges such as aging, climate change, mobility, participation in democratic life, and so on. This governance approach of Etorkizuna Eraikiz has allowed the local government to match the needs of citizens to the political agenda fostering in this way a shared vision about the public value.

Keywords: collaborative governance, citizen participation, public good, social listening, public innovation

Procedia PDF Downloads 138
722 A Nutrient Formulation Affects Brain Myelination in Infants: An Investigative Randomized Controlled Trial

Authors: N. Schneider, M. Bruchhage, M. Hartweg, G. Mutungi, J. O Regan, S. Deoni

Abstract:

Observational neuroimaging studies suggest differences between breast-fed and formula-fed infants in developmental myelination, a key brain process for learning and cognitive development. However, the possible effects of a nutrient formulation on myelin development in healthy term infants in an intervention study have not been investigated. Objective was, therefore, to investigate the efficacy of a nutrient formulation with higher levels of myelin-relevant nutrients as compared to a control formulation with lower levels of the same nutrients on brain myelination and cognitive development in the first 6 months of life. The study is an ongoing randomized, controlled, double-blind, two-center, parallel-group clinical trial with a nonrandomized, non-blinded arm of exclusively breastfed infants. The current findings result from a staged statistical analysis at 6 months; the recruitment and intervention period has been completed for all participants. Follow-up visits at 12, 18 and 24 months are still ongoing. N= 81 enrolled full term, neurotypical infants of both sexes were randomized into either the investigational (N= 42) or the control group (N= 39), and N= 108 children in the breast-fed arm served as a natural reference group. The effect of a blend of docosahexaenoic acid, arachidonic acid, iron, vitamin B12, folic acid as well as sphingomyelin from a uniquely proceed whey protein concentrate enriched in alpha-lactalbumin and phospholipids in an infant nutrition product matrix was investigated. The main outcomes for the staged statistical analyses at 6 months included brain myelination measures derived from MRI. Additional outcomes were brain volume, cognitive development and safety. The full analyses set at 6 months comprised N= 66 infants. Higher levels of myelin-relevant nutrients compared to lower levels resulted in significant differences in myelin structure, volume, and rate of myelination as early as 3 and 6 months of life. The cross-sectional change of means between groups for whole-brain myelin volume was 8.4% for investigational versus control formulation (3.5% versus the breastfeeding reference) group at 3 months and increased to 36.4% for investigational versus control formulation (14.1% versus breastfeeding reference) at 6 months. No statistically significant differences were detected for early cognition scores. Safety findings were largely similar across groups. This is the first pediatric nutritional neuroimaging study demonstrating the efficacy of a myelin nutrient blend on developmental myelination in well-nourished term infants. Myelination is a critical process in learning and development. The effects were demonstrated across the brain, particularly in temporal and parietal regions, known to be functionally involved in sensory, motor and language skills. These first results add to the field of nutritional neuroscience by demonstrating early life nutrition benefits for brain architecture which may be foundational for later cognitive and behavioral outcomes. ClinicalTrials.gov Identifier: NCT03111927 (Infant Nutrition and Brain Development - Full-Text View - ClinicalTrials.gov).

Keywords: brain development, infant nutrition, MRI, myelination

Procedia PDF Downloads 193
721 Malaria Menace in Pregnancy; Hard to Ignore

Authors: Nautiyal Ruchira, Nautiyal Hemant, Chaudhury Devnanda, Bhargava Surbhi, Chauhan Nidhi

Abstract:

Introduction: South East Asian region contributes 2.5 million cases of malaria each year to the global burden of 300 to 500 million of which 76% is reported from India. Government of India launched a national program almost half a century ago, still malaria remains a major public health challenge. Pregnant women are more susceptible to severe malaria and its fetomaternal complications. Inadequate surveillance and under-reporting underestimates the problem. Aim: Present study aimed to analyze the clinical course and pattern of malaria during pregnancy and to study the feto-maternal outcome. Methodology: This is a prospective observational study carried out at Himalayan Institute of Medical Sciences – a tertiary care center in the sub-Himalayan state of Uttarakhand, Northern India. All the pregnant women with malaria and its complications were recruited in the study during 2009 to 2014 which included referred cases from the state of western Uttar Pradesh. A thorough history and clinical examination were carried out to assess maternal and fetal condition. Relevant investigations including haemogram, platelet count, LFT, RFT, and USG was done. Blood slides and rapid diagnostic tests were done to diagnose the type of malaria.The primary outcomes measured were the type of malaria infection, maternal complications associated with malaria, outcome of pregnancy and effect on the fetus. Results: 67 antenatal cases with malaria infection were studied. 71% patients were diagnosed with plasmodium vivax infection, 25% cases were plasmodium falciparum positive and in 3% cases mixed infection was found. 38(56%) patients were primigravida and 29(43%) were multiparous. Most of the patients had already received some treatment from their local doctors and presented with severe malaria with the complications. Thrombocytopenia was the commonest manifestation seen in 35(52%) patients, jaundice in 28%, severe anemia in 18%, and severe oligohydramnios in 10% and renal failure in 6% cases. Regarding pregnancy outcome there were 44 % preterm deliveries, 22% had IUFD and abortions in 6% cases.20% of newborn were low birth weight and 6% were IUGR. There was only one maternal death which occurred due to ARDS in falciparum malaria. Although Plasmodium vivax was the main parasite considering the severity of clinical presentation, all the patients received intensive care. As most of the patients had received chloroquine therapy hence they were treated with IV artesunate followed by oral artemesinin combination therapy. Other therapies in the form of packed RBC’s and platelet transfusions, dialysis and ventilator support were provided when required. Conclusion: Even in areas with annual parasite index (API) less than 2 like ours, malaria in pregnancy could be an alarming problem. Vivax malaria cannot be considered benign in pregnancy because of high incidence of morbidity. Prompt diagnosis and aggressive treatment can reduce morbidity and mortality significantly. Increased community level research, integrating ANC checkups with the distribution of insecticide-treated nets in areas of high endemicity, imparting education and awareness will strengthen the existing control strategies.

Keywords: severe malaria, pregnancy, plasmodium vivax, plasmodium falciparum

Procedia PDF Downloads 280
720 Forging A Distinct Understanding of Implicit Bias

Authors: Benjamin D Reese Jr

Abstract:

Implicit bias is understood as unconscious attitudes, stereotypes, or associations that can influence the cognitions, actions, decisions, and interactions of an individual without intentional control. These unconscious attitudes or stereotypes are often targeted toward specific groups of people based on their gender, race, age, perceived sexual orientation or other social categories. Since the late 1980s, there has been a proliferation of research that hypothesizes that the operation of implicit bias is the result of the brain needing to process millions of bits of information every second. Hence, one’s prior individual learning history provides ‘shortcuts’. As soon as one see someone of a certain race, one have immediate associations based on their past learning, and one might make assumptions about their competence, skill, or danger. These assumptions are outside of conscious awareness. In recent years, an alternative conceptualization has been proposed. The ‘bias of crowds’ theory hypothesizes that a given context or situation influences the degree of accessibility of particular biases. For example, in certain geographic communities in the United States, there is a long-standing and deeply ingrained history of structures, policies, and practices that contribute to racial inequities and bias toward African Americans. Hence, negative biases among groups of people towards African Americans are more accessible in such contexts or communities. This theory does not focus on individual brain functioning or cognitive ‘shortcuts.’ Therefore, attempts to modify individual perceptions or learning might have negligible impact on those embedded environmental systems or policies that are within certain contexts or communities. From the ‘bias of crowds’ perspective, high levels of racial bias in a community can be reduced by making fundamental changes in structures, policies, and practices to create a more equitable context or community rather than focusing on training or education aimed at reducing an individual’s biases. The current paper acknowledges and supports the foundational role of long-standing structures, policies, and practices that maintain racial inequities, as well as inequities related to other social categories, and highlights the critical need to continue organizational, community, and national efforts to eliminate those inequities. It also makes a case for providing individual leaders with a deep understanding of the dynamics of how implicit biases impact cognitions, actions, decisions, and interactions so that those leaders might more effectively develop structural changes in the processes and systems under their purview. This approach incorporates both the importance of an individual’s learning history as well as the important variables within the ‘bias of crowds’ theory. The paper also offers a model for leadership education, as well as examples of structural changes leaders might consider.

Keywords: implicit bias, unconscious bias, bias, inequities

Procedia PDF Downloads 3