Search results for: delayed diagnosis and poor outcome
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6671

Search results for: delayed diagnosis and poor outcome

3821 Mother-Child Attachment and Anxiety Symptoms in Middle Childhood: Differences in Levels of Attachment Security

Authors: Simran Sharda

Abstract:

There is increasing evidence that leads psychologists today to believe that the attachment formed between a mother and child plays a much more profound role in later-life outcomes than previously expected. Particularly, the fact that a link may exist between maternal attachment and the development in addition to the severity of social anxiety in middle childhood seems to be gaining ground. This research will examine and address a myriad of major issues related to the impact of mother-child attachment: behaviors of children with different levels of secure attachment, various aspects of anxiety in relation to attachment security as well as other styles of mother-child attachments, especially avoidant attachment and over-attachment. This analysis serves to compile previous literature on the subject and touch light upon a logical extension of the research. Moreover, researchers have identified links between attachment and the externalization of problem behaviors: these behaviors may later manifest as social anxiety as well as increased severity and likelihood of PTSD diagnosis (an anxiety disorder). Furthermore, secure attachment has been linked to increased health benefits, cognitive skills, emotive socialization, and developmental psychopathology.

Keywords: child development, anxiety, cognition, developmental psychopathology, mother-child relationships, maternal, cognitive development

Procedia PDF Downloads 159
3820 Stereotypical Motor Movement Recognition Using Microsoft Kinect with Artificial Neural Network

Authors: M. Jazouli, S. Elhoufi, A. Majda, A. Zarghili, R. Aalouane

Abstract:

Autism spectrum disorder is a complex developmental disability. It is defined by a certain set of behaviors. Persons with Autism Spectrum Disorders (ASD) frequently engage in stereotyped and repetitive motor movements. The objective of this article is to propose a method to automatically detect this unusual behavior. Our study provides a clinical tool which facilitates for doctors the diagnosis of ASD. We focus on automatic identification of five repetitive gestures among autistic children in real time: body rocking, hand flapping, fingers flapping, hand on the face and hands behind back. In this paper, we present a gesture recognition system for children with autism, which consists of three modules: model-based movement tracking, feature extraction, and gesture recognition using artificial neural network (ANN). The first one uses the Microsoft Kinect sensor, the second one chooses points of interest from the 3D skeleton to characterize the gestures, and the last one proposes a neural connectionist model to perform the supervised classification of data. The experimental results show that our system can achieve above 93.3% recognition rate.

Keywords: ASD, artificial neural network, kinect, stereotypical motor movements

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3819 A New Method to Estimate the Low Income Proportion: Monte Carlo Simulations

Authors: Encarnación Álvarez, Rosa M. García-Fernández, Juan F. Muñoz

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Estimation of a proportion has many applications in economics and social studies. A common application is the estimation of the low income proportion, which gives the proportion of people classified as poor into a population. In this paper, we present this poverty indicator and propose to use the logistic regression estimator for the problem of estimating the low income proportion. Various sampling designs are presented. Assuming a real data set obtained from the European Survey on Income and Living Conditions, Monte Carlo simulation studies are carried out to analyze the empirical performance of the logistic regression estimator under the various sampling designs considered in this paper. Results derived from Monte Carlo simulation studies indicate that the logistic regression estimator can be more accurate than the customary estimator under the various sampling designs considered in this paper. The stratified sampling design can also provide more accurate results.

Keywords: poverty line, risk of poverty, auxiliary variable, ratio method

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3818 Application of Deep Learning in Colorization of LiDAR-Derived Intensity Images

Authors: Edgardo V. Gubatanga Jr., Mark Joshua Salvacion

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Most aerial LiDAR systems have accompanying aerial cameras in order to capture not only the terrain of the surveyed area but also its true-color appearance. However, the presence of atmospheric clouds, poor lighting conditions, and aerial camera problems during an aerial survey may cause absence of aerial photographs. These leave areas having terrain information but lacking aerial photographs. Intensity images can be derived from LiDAR data but they are only grayscale images. A deep learning model is developed to create a complex function in a form of a deep neural network relating the pixel values of LiDAR-derived intensity images and true-color images. This complex function can then be used to predict the true-color images of a certain area using intensity images from LiDAR data. The predicted true-color images do not necessarily need to be accurate compared to the real world. They are only intended to look realistic so that they can be used as base maps.

Keywords: aerial LiDAR, colorization, deep learning, intensity images

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3817 Effect of Structure on Properties of Incrementally Formed Titanium Alloy Sheets

Authors: Lucie Novakova, Petr Homola, Vaclav Kafka

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Asymmetric incremental sheet forming (AISF) could significantly reduce costs incurred by the fabrication of complex industrial components with a minimal environmental impact. The AISF experiments were carried out on commercially pure titanium (Ti-Gr2), Timetal (15-3-3-3) alloy, and Ti-6Al-4V (Ti-Gr5) alloy. A special testing geometry was used to characterize the titanium alloys properties from the point of view of the forming zone and titanium structure effect. The structure and properties of the materials were assessed by means of metallographic analyses and microhardness measurements.The highest differences in the parameters assessed as a function of the sampling zone were observed in the case of alpha-phase Ti-Gr2at the expense of the most substantial sheet thinning occurrence. A springback causes a smaller stored deformation in Timetal (β alloy) resulting in less pronounced microstructure refinement and microhardness increase. Ti-6Al-4V alloy exhibited early failure due to its poor formability at ambient temperature.

Keywords: incremental forming, metallography, hardness, titanium alloys

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3816 Constructive Alignment in the Digital Age: Challenges and Opportunities at the University of Sulaimani

Authors: Daban Mohammed Haji

Abstract:

This paper explores the application of constructive alignment in digital education at the University of Sulaimani, focusing specifically on the Language and Culture Center, Translation Department, and English Department. Constructive alignment, an outcome-based pedagogical framework developed by John Biggs, ensures that learning activities and assessments are directly aligned with the intended learning outcomes (ILOs). The study's findings reveal a significant gap in awareness and understanding of this pedagogical concept among lecturers. Many instructors are unfamiliar with constructive alignment, and those who have some knowledge of it face considerable challenges. These challenges include aligning learning activities and assessments with the ILOs and fostering higher-order cognitive skills as outlined in the SOLO taxonomy and revised Bloom’s taxonomy. To address this issue, the existing pedagogy center at the University of Sulaimani could play a pivotal role. This center has the potential to foster faculty development and promote the adoption of constructive alignment in online teaching. By leveraging the center's expertise and resources, a tailored program can be designed to enhance faculty understanding and application of this pedagogical framework.

Keywords: constructive alignment, student-centerdness, pedagogy, bologna process

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3815 Design of Reconfigurable Supernumerary Robotic Limb Based on Differential Actuated Joints

Authors: Qinghua Zhang, Yanhe Zhu, Xiang Zhao, Yeqin Yang, Hongwei Jing, Guoan Zhang, Jie Zhao

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This paper presents a wearable reconfigurable supernumerary robotic limb with differential actuated joints, which is lightweight, compact and comfortable for the wearers. Compared to the existing supernumerary robotic limbs which mostly adopted series structure with large movement space but poor carrying capacity, a prototype with the series-parallel configuration to better adapt to different task requirements has been developed in this design. To achieve a compact structure, two kinds of cable-driven mechanical structures based on guide pulleys and differential actuated joints were designed. Moreover, two different tension devices were also designed to ensure the reliability and accuracy of the cable-driven transmission. The proposed device also employed self-designed bearings which greatly simplified the structure and reduced the cost.

Keywords: cable-driven, differential actuated joints, reconfigurable, supernumerary robotic limb

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3814 Age Estimation Using Destructive and Non-Destructive Dental Methods on an Archeological Human Sample from the Poor Claire Nunnery in Brussels, Belgium

Authors: Pilar Cornejo Ulloa, Guy Willems, Steffen Fieuws, Kim Quintelier, Wim Van Neer, Patrick Thevissen

Abstract:

Dental age estimation can be performed both in living and deceased individuals. In anthropology, few studies have tested the reliability of dental age estimation methods complementary to the usually applied osteological methods. Objectives: In this study, destructive and non-destructive dental age estimation methods were applied on an archeological sample in order to compare them with the previously obtained anthropological age estimates. Materials and Methods: One hundred and thirty-four teeth from 24 individuals were analyzed using Kvaal, Kvaal and Solheim, Bang and Ramm, Lamendin, Gustafson, Maples, Dalitz and Johanson’s methods. Results: A high variability and wider age ranges than the ones previously obtained by the anthropologist could be observed. Destructive methods had a slightly higher agreement than the non-destructive. Discussion: Due to the heterogeneity of the sample and the lack of the real age at death, the obtained results were not representative, and it was not possible to suggest one dental age estimation method over another.

Keywords: archeology, dental age estimation, forensic anthropology, forensic dentistry

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3813 Mediation of the Middle Eastern Crises and Economic Growth: An Application of Times Series Analysis

Authors: Gokhan Erkal, Gulsen Aydin, Muge Yuce, Lokman Sahin

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This study aims to analyze the impacts of involving in mediation of conflicts in the Middle East from the perspective of the economic growth of the mediators. The Middle East is a highly volatile region of the world with rampant crises whose affects spill beyond its borders. Therefore, management and resolution of the conflicts in the region are of great significance. Mediation is an instrument used for abating violence and settling dispute. The recourse to mediation has grown to an important degree in recent years. However, for mediators, it is a daunting task to involve in the mediation of the deadlocks in the Middle East. This study tries to shed light on the positive correlation between economic growth of the mediator and the successful outcome of the mediation process to provide motivation for mediators. To this end, first, it briefly introduces the conflicts ongoing in the region and their negative impacts. Second, the methodology, time series analysis, and the data to be used, International Crisis Behavior Project Data, are presented. Third, the empirical test is carried out and the findings are evaluated. The conclusion highlights the benefits of successful mediation for the economic growth of the mediators of Middle Eastern crises.

Keywords: international crises, mediation, Middle East, times series analysis

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3812 Epigenetic Mechanisms Involved in the Occurrence and Development of Infectious Diseases

Authors: Frank Boris Feutmba Keutchou, Saurelle Fabienne Bieghan Same, Verelle Elsa Fogang Pokam, Charles Ursula Metapi Meikeu, Angel Marilyne Messop Nzomo, Ousman Tamgue

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Infectious diseases are one of the most important causes of morbidity and mortality worldwide. These diseases are caused by micro-pathogenic organisms, such as bacteria, viruses, parasites, and fungi. Heritable changes in gene expression that do not involve changes to the underlying DNA sequence are referred to as epigenetics. Emerging evidence suggests that epigenetic mechanisms are important in the emergence and progression of infectious diseases. Pathogens can manipulate host epigenetic machinery to promote their own replication and evade immune responses. The Human Genome Project has provided new opportunities for developing better tools for the diagnosis and identification of target genes. Several epigenetic modifications, such as DNA methylation, histone modifications, and non-coding RNA expression, have been shown to influence infectious disease outcomes. Understanding the epigenetic mechanisms underlying infectious diseases may result in the progression of new therapeutic approaches focusing on host-pathogen interactions. The goal of this study is to show how different infectious agents interact with host cells after infection.

Keywords: epigenetic, infectious disease, micro-pathogenic organism, phenotype

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3811 Characteristics of an Indigenous Entrepreneur, in the Post-Apartheid South Africa

Authors: Ndivhuho Tshikovhi

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The debate about indigenous people throughout the world has been necessitated by different circumstances that indigenous communities continue to suffer. Indigenous people of the world suffer chronic diseases, poor education, high unemployment and slow economic developments. This paper contributes to the continuous debate by studying the common elements of indigenous entrepreneur of the world and that of the South African indigenous entrepreneur. The research objective of this paper is to understand what constitute an indigenous status in the South African context as opposed to the indigenous people of the world. Furthermore, the study will explore the indigenous status through their entrepreneurial engagements. The paper will adopt a secondary data research method, by utilising the literature on indigenous entrepreneurship practice and theory of indigenous entrepreneurship. The implications of this paper is to bring about an African indigenous entrepreneurship debate rooted from the correct circumstances rather than generalised definitions. Recommendations for future research will be outlined, together with further readings on circumstantial evidence that necessitate indigenous entrepreneurs status in South Africa.

Keywords: indigenous entrepreneur, indigenous, entrepreneurship, indigenous people, entrepreneurship development

Procedia PDF Downloads 478
3810 Quantitative Texture Analysis of Shoulder Sonography for Rotator Cuff Lesion Classification

Authors: Chung-Ming Lo, Chung-Chien Lee

Abstract:

In many countries, the lifetime prevalence of shoulder pain is up to 70%. In America, the health care system spends 7 billion per year about the healthy issues of shoulder pain. With respect to the origin, up to 70% of shoulder pain is attributed to rotator cuff lesions This study proposed a computer-aided diagnosis (CAD) system to assist radiologists classifying rotator cuff lesions with less operator dependence. Quantitative features were extracted from the shoulder ultrasound images acquired using an ALOKA alpha-6 US scanner (Hitachi-Aloka Medical, Tokyo, Japan) with linear array probe (scan width: 36mm) ranging from 5 to 13 MHz. During examination, the postures of the examined patients are standard sitting position and are followed by the regular routine. After acquisition, the shoulder US images were drawn out from the scanner and stored as 8-bit images with pixel value ranging from 0 to 255. Upon the sonographic appearance, the boundary of each lesion was delineated by a physician to indicate the specific pattern for analysis. The three lesion categories for classification were composed of 20 cases of tendon inflammation, 18 cases of calcific tendonitis, and 18 cases of supraspinatus tear. For each lesion, second-order statistics were quantified in the feature extraction. The second-order statistics were the texture features describing the correlations between adjacent pixels in a lesion. Because echogenicity patterns were expressed via grey-scale. The grey-scale co-occurrence matrixes with four angles of adjacent pixels were used. The texture metrics included the mean and standard deviation of energy, entropy, correlation, inverse different moment, inertia, cluster shade, cluster prominence, and Haralick correlation. Then, the quantitative features were combined in a multinomial logistic regression classifier to generate a prediction model of rotator cuff lesions. Multinomial logistic regression classifier is widely used in the classification of more than two categories such as the three lesion types used in this study. In the classifier, backward elimination was used to select a feature subset which is the most relevant. They were selected from the trained classifier with the lowest error rate. Leave-one-out cross-validation was used to evaluate the performance of the classifier. Each case was left out of the total cases and used to test the trained result by the remaining cases. According to the physician’s assessment, the performance of the proposed CAD system was shown by the accuracy. As a result, the proposed system achieved an accuracy of 86%. A CAD system based on the statistical texture features to interpret echogenicity values in shoulder musculoskeletal ultrasound was established to generate a prediction model for rotator cuff lesions. Clinically, it is difficult to distinguish some kinds of rotator cuff lesions, especially partial-thickness tear of rotator cuff. The shoulder orthopaedic surgeon and musculoskeletal radiologist reported greater diagnostic test accuracy than general radiologist or ultrasonographers based on the available literature. Consequently, the proposed CAD system which was developed according to the experiment of the shoulder orthopaedic surgeon can provide reliable suggestions to general radiologists or ultrasonographers. More quantitative features related to the specific patterns of different lesion types would be investigated in the further study to improve the prediction.

Keywords: shoulder ultrasound, rotator cuff lesions, texture, computer-aided diagnosis

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3809 Radiological Analysis of Skeletal Metastases from Cervical Cancer

Authors: Jacklynn Walters, Amanda A. Alblas, Linda M. Greyling

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Cervical carcinoma is the second most common cancer found in women. Diagnosis of skeletal metastases is uncommon in cervical cancer patients. The aim of this study was to determine the prevalence of skeletal metastases in in a Western Cape skeletal population. Skeletal samples (n=14) from the Kirsten Skeletal Collection at Stellenbosch University, diagnosed pre-mortem with cervical cancer, were examined. Macroscopic analysis was done using low magnification to examine each skeletal element for signs of disease. Skeletons were also x-rayed using the Lodox® Statscan® Imaging system and the scans evaluated by a musculoskeletal radiologist. Three (21%) of the skeletons showed metastases, with the os coxae and lower vertebral column affected in all three cases. Furthermore, metastases occurred in the scapulae and ribs in two of the cases and in one case the skull, mandible, and long bones were affected. Additionally, three skeletons without evidence of skeletal metastases presented with a periosteal reaction on the os coxae in response to the diseased adjacent soft tissue. Previous studies observed that skeletal metastases are more common than what is diagnosed pre-mortem with the vertebral spine most commonly affected. The findings of this study agree with previous reports and illustrate the effectiveness of the Lodox® scanner in diagnoses of metastases in skeletal material.

Keywords: cancer, cervix, radiology, skeletal metastases

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3808 Internal Capital Market Efficiency Study Based on Improved Cash Flow Sensitivity Coefficient - Take Tomorrow Group as an Example

Authors: Peng Lu, Liu Ting

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Because of the difficulty of financing from the external capital market, the reorganization and merger of private enterprises have formed a family group, seeking the help of the internal capital market to alleviate the capital demand. However, the inefficiency of the internal capital market can damage the effect it should have played, and even hinder the development of enterprises. This paper takes the "Tomorrow Group" as the research object to carry on the case analysis. After using the improved cash flow sensitivity coefficient to measure the efficiency of the internal capital market of Tomorrow Group, the inefficiency phenomenon is found. Then the analysis reveals that the reasons for its inefficiency include that the pyramidal equity structure is conducive to control, the separation of cash flow rights and control rights, the concentration of equity leads to poor balance, the abandonment of real industries and information asymmetry.

Keywords: tomorrow group, internal capital market, related-party transactions, Baotou tomorrow technology Co., LTD

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3807 [Keynote Speech]: Evidence-Based Outcome Effectiveness Longitudinal Study on Three Approaches to Reduce Proactive and Reactive Aggression in Schoolchildren: Group CBT, Moral Education, Bioneurological Intervention

Authors: Annis Lai Chu Fung

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While aggression had high stability throughout developmental stages and across generations, it should be the top priority of researchers and frontline helping professionals to develop prevention and intervention programme for aggressive children and children at risk of developing aggressive behaviours. Although there is a substantial amount of anti-bullying programmes, they gave disappointingly small effect sizes. The neglectful practical significance could be attributed to the overly simplistic categorisation of individuals involved as bullies or victims. In the past three decades, the distinction between reactive and proactive aggression has been well-proved. As children displaying reactively aggressive behaviours have distinct social-information processing pattern with those showing proactively aggressive behaviours, it is critical to identify the unique needs of the two subtypes accordingly when designing an intervention. The onset of reactive aggression and proactive aggression was observed at earliest in 4.4 and 6.8 years old respectively. Such findings called for a differential early intervention targeting these high-risk children. However, to the best of the author’s knowledge, the author was the first to establish an evidence-based intervention programme against reactive and proactive aggression. With the largest samples in the world, the author, in the past 10 years, explored three different approaches and their effectiveness against aggression quantitatively and qualitatively with longitudinal design. The three approaches presented are (a) cognitive-behavioral approach, (b) moral education, with Chinese marital arts and ethics as the medium, and (c) bioneurological measures (omega-3 supplementation). The studies adopted a multi-informant approach with repeated measures before and after the intervention, and follow-up assessment. Participants were recruited from primary and secondary schools in Hong Kong. In the cognitive-behavioral approach, 66 reactive aggressors and 63 proactive aggressors, aged from 11 to 17, were identified from 10,096 secondary-school children with questionnaire and subsequent structured interview. Participants underwent 10 group sessions specifically designed for each subtype of aggressor. Results revealed significant declines in aggression levels from the baseline to the follow-up assessment after 1 year. In moral education through the Chinese martial arts, 315 high-risk aggressive children, aged 6 to 12 years, were selected from 3,511 primary-school children and randomly assigned into four types of 10-session intervention group, namely martial-skills-only, martial-ethics-only, both martial-skills-and-ethics, and physical fitness (placebo). Results showed only the martial-skills-and-ethics group had a significant reduction in aggression after treatment and 6 months after treatment comparing with the placebo group. In the bioneurological approach, 218 children, aged from 8 to 17, were randomly assigned to the omega-3 supplement group and the placebo group. Results revealed that compared with the placebo group, the omega-3 supplement group had significant declines in aggression levels at the 6-month follow-up assessment. All three approaches were effective in reducing proactive and reactive aggression. Traditionally, intervention programmes against aggressive behaviour often adapted the cognitive and/or behavioural approach. However, cognitive-behavioural approach for children was recently challenged by its demanding requirement of cognitive ability. Traditional cognitive interventions may not be as beneficial to an older population as in young children. The present study offered an insightful perspective in aggression reduction measures.

Keywords: intervention, outcome effectiveness, proactive aggression, reactive aggression

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3806 Sustainability of High-Rise Affordable Housing: Critical Issues in Applying Green Building Rating Tools

Authors: Poh Im. Lim, Hillary Yee Qin. Tan

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Nowadays, going green has become a trend, and being emphasized in the construction industry. In Malaysia, there are several green rating tools available in the industry and among these, GBI and GreenRE are considered as the most common tools adopted for residential buildings. However, being green is not equal to or making something sustainable. Being sustainable is to take economic, environmental and social aspects into consideration. This is particularly essential in the affordable housing sector as the end-users belong to lower-income and places importance on many socio-economic needs beyond the environmental criteria. This paper discusses the arguments in proposing a sustainability framework that is tailor-made for high-rise affordable housing. In-depth interviews and observation mapping methods were used in gathering inputs from the end-users, non-governmental organisations (NGOs) as well as the professionals. ‘Bottom-up’ approach was applied in this research to show the significance of participation from the local community in the decision-making process. The proposed sustainability framework illustrates the discrepancies between user priorities and what the industry is providing. The outcome of this research suggests that integrating sustainability into high-rise affordable housing is achievable and beneficial to the industry, society, and the environment.

Keywords: green building rating tools, high-rise affordable housing, sustainability framework, sustainable development

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3805 Clinico-pathological Study of Xeroderma Pigmentosa: A Case Series of Eight Cases

Authors: Kakali Roy, Sahana P. Raju, Subhra Dhar, Sandipan Dhar

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Introduction: Xeroderma pigmentosa (XP) is a rare inherited (autosomal recessive) disease resulting from impairment in DNA repair that involves recognition and repair of ultraviolet radiation (UVR) induced DNA damage in the nucleotide excision repair pathway. Which results in increased photosensitivity, UVR induced damage to skin and eye, increased susceptibility of skin and ocular cancer, and progressive neurodegeneration in some patients. XP is present worldwide, with higher incidence in areas having frequent consanguinity. Being extremely rare, there is limited literature on XP and associated complications. Here, the clinico-pathological experience (spectrum of clinical presentation, histopathological findings of malignant skin lesions, and progression) of managing 8 cases of XP is presented. Methodology: A retrospective study was conducted in a pediatric tertiary care hospital in eastern India during a ten-year period from 2013 to 2022. A clinical diagnosis was made based on severe sun burn or premature photo-aging and/or onset of cutaneous malignancies at early age (1st decade) in background of consanguinity and autosomal recessive inheritance pattern in family. Results: The mean age of presentation was 1.2 years (range of 7month-3years), while three children presented during their infancy. Male to female ratio was 5:3, and all were born of consanguineous marriage. They presented with dermatological manifestations (100%) followed by ophthalmic (75%) and/or neurological symptoms (25%). Patients had normal skin at birth but soon developed extreme sensitivity to UVR in the form of exaggerated sun tanning, burning, and blistering on minimal sun exposure, followed by abnormal skin pigmentation like freckles and lentiginosis. Subsequently, over time there was progressive xerosis, atrophy, wrinkling, and poikiloderma. Six patients had varied degree of ocular involvement, while three of them had severe manifestation, including madarosis, tylosis, ectropion, Lagopthalmos, Pthysis bulbi, clouding and scarring of the cornea with complete or partial loss of vision, and ophthalmic malignancies. 50% (n=4) cases had skin and ocular pre-malignant (actinic keratosis) and malignant lesions, including melanoma and non melanoma skin cancer (NMSC) like squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) in their early childhood. One patient had simultaneous occurrence of multiple malignancies together (SCC, BCC, and melanoma). Subnormal intelligence was noticed as neurological feature, and none had sensory neural hearing loss, microcephaly, neuroregression, or neurdeficit. All the patients had been being managed by a multidisciplinary team of pediatricians, dermatologists, ophthalmologists, neurologists and psychiatrists. Conclusion: Although till date there is no complete cure for XP and the disease is ultimately fatal. But increased awareness, early diagnosis followed by persistent vigorous protection from UVR, and regular screening for early detection of malignancies along with psychological support can drastically improve patients’ quality of life and life expectancy. Further research is required on formulating optimal management of XP, specifically the role and possibilities of gene therapy in XP.

Keywords: childhood malignancies, dermato-pathological findings, eastern India, Xeroderma pigmentosa

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3804 Implementing a Comprehensive Emergency Care and Life Support Course in a Low- and Middle-Income Country Setting: A Survey of Learners in India

Authors: Vijayabhaskar Reddy Kandula, Peter Provost Taillac, Balasubramanya M. A., Ram Krishnan Nair, Gokul Toshnival, Vibhu Dhawan, Vijaya Karanam, Buffy Cramer

Abstract:

Introduction: The lack of Emergency Care Services (ECS) is a cause of extensive and serious public health problems in low- and middle-income countries (LMIC), Many LMIC countries have ambulance services that allow timely transfer of ill patients but due to poor care during the ‘Golden Hour’ many deaths occur which are otherwise preventable. Lack of adequate training as evidenced by a study in India is a major reason for poor care during the ‘Golden Hour’. Adapting developed country models which includes staffing specialty-trained doctors in emergency care, is neither feasible nor guarantees cost-effective ECS. Methods: Based on our assessment and felt needs by first-line doctors providing emergency care in 2014, Rajiv Gandhi Health Sciences University’s JeevaRaksha Trust in partnership with the University of Utah, USA, designed, piloted and successfully implemented a 4-day Comprehensive-Emergency Care and Life Support course (C-ECLS) for allopathic doctors. 1730 doctors completed the 4-day course between June 2014 and December- 2020. Subsequently, we conducted a survey to investigate the utilization rates and usefulness of the training. 1662 were contacted but only 309 completed the survey. The respondents had the following designations: Senior faculty (33%), junior faculty (25), Resident (16%), Private-Practitioners (8%), Medical-Officer (16%) and not-working (11%). 51% were generalists (51%) and the rest were specialists (>30 specialties). Results: 97% (271/280) felt they are better doctors because of C-ECLS. 79% (244/309) reported that training helped to save life- specialists more likely than generalists (91% v/s 68%. P<0.05). 64% agreed that they were confident of managing COVID-19 symptomatic patients better because of C-ECLS. 27% (77) were neutral; 9% (24) disagreed. 66% agreed that training helps to be confident in managing COVID-19 critically ill patients. 26% (72) were neutral; 8% (23) disagreed. Frequency of use of C-ECLS skills: Hemorrhage-control (70%), Airway (67%), circulation skills (62%), Safe-transport and communication (60%), managing critically ill patients (58%), cardiac arrest (51%), Trauma (49%), poisoning/animal bites/stings (44%), neonatal-resuscitation (39%), breathing (36%), post-partum-hemorrhage and eclampsia (35%). Among those who used the skills, the majority (ranging from (88%-94%) reported that they were able to apply the skill more effectively because of ECLS training. Conclusion: JeevaRaksha’s C-ECLS is the world’s first comprehensive training. It improves the confidence of front-line doctors and enables them to provide quality care during the ‘Golden Hour’ of emergency. It also prepares doctors to manage unknown emergencies (e.g., COVID-19). C-ECLS was piloted in Morocco, and Uzbekistan and implemented countrywide in Bhutan. C-ECLS is relevant to most settings and offers a replicable model across LMIC.

Keywords: comprehensive emergency care and life support, training, capacity building, low- and middle-income countries, developing countries

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3803 Crack Initiation Assessment during Fracture of Heat Treated Duplex Stainless Steels

Authors: Faraj Ahmed E. Alhegagi, Anagia M. Khamkam Mohamed, Bassam F. Alhajaji

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Duplex stainless steels (DSS) are widely employed in industry for apparatus working with sea water in petroleum, refineries and in chemical plants. Fracture of DSS takes place by cleavage of the ferrite phase and the austenite phase ductile tear off. Pop-in is an important feature takes place during fracture of DSS. The procedure of Pop-ins assessment plays an important role in fracture toughness studies. In present work, Zeron100 DSS specimens were heat treated at different temperatures, cooled and pulled to failure to assess the pop-ins criterion in crack initiation prediction. The outcome results were compared to the British Standard (BS 7448) and the ASTEM standard (E1290) for Crack-Tip Opening Displacement (CTOD) fracture toughness measurement. Pop-in took place during specimens loading specially for those specimens heat treated at higher temperatures. The standard BS7448 was followed to check specimen validity for fractured toughness assessment by direct determination of KIC. In most cases, specimens were invalid for KIC measurement. The two procedures were equivalent only when single pop-ins were assessed. A considerable contrast in fracture toughness value between was observed where multiple pop-ins were assessed.

Keywords: fracture toughness, stainless steels, pop ins, crack assessment

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3802 Thermal Interruption Performance of High Voltage Gas Circuit Breaker Operating with CO₂ Mixtures

Authors: Yacine Babou, Nitesh Ranjan, Branimir Radisavljevic , Martin Seeger, Daniel Over, Torsten Votteler, Bernardo Galletti, Paulo Cristini

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In the frame of replacement of Sulfur hexafluoride (SF6) gas as insulating and switching medium, diverse alternative gases, offering acceptable Global Warming Potential and fulfilling requirements in terms of heat dissipation, insulation and arc quenching performances are currently investigated for High Voltage Circuit Breaker applications. Among the potential gases, CO₂ seems a promising candidate for replacing SF6, because on one hand it is environmentally friendly, harmless, non-toxic, non-corrosive, non-flammable and on the other hand previous studies have demonstrated its fair interruption capabilities. The present study aims at investigating the performance of CO₂ for the thermal interruption in high voltage self-blast circuit breakers. In particular, the correlation between thermal interruption performance and arc voltage is considered and the effect of the arc-network interaction on the performance is rigorously analyzed. For the considered designs, the thermal interruption was evaluated by varying the slope at current zero (i.e., di/dt) for which the breaker could interrupt. Besides, the characteristics of the post-arc current are examined in detail for various rated voltages and currents. The outcome of these experimental investigations will be reported and analyzed.

Keywords: current zero measurement, high voltage circuit breaker, thermal arc discharge, thermal interruption

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3801 Revising Our Ideas on Revisions: Non-Contact Bridging Plate Fixation of Vancouver B1 and B2 Periprosthetic Femoral Fractures

Authors: S. Ayeko, J. Milton, C. Hughes, K. Anderson, R. G. Middleton

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Background: Periprosthetic femoral fractures (PFF) in association with hip hemiarthroplasty or total hip arthroplasty is a common and serious complication. In the Vancouver Classification system algorithm, B1 fractures should be treated with Open Reduction and Internal Fixation (ORIF) and preferentially revised in combination with ORIF if B2 or B3. This study aims to assess patient outcomes after plate osteosynthesis alone for Vancouver B1 and B2 fractures. The main outcome is the 1-year re-revision rate, and secondary outcomes are 30-day and 1-year mortality. Method: This is a retrospective single-centre case-series review from January 2016 to June 2021. Vancouver B1 and B2, non-malignancy fractures in adults over 18 years of age treated with polyaxial Non-Contact Bridging plate osteosynthesis, have been included. Outcomes were gathered from electronic notes and radiographs. Results: There were 50 B1 and 64 B2 fractures. 26 B2 fractures were managed with ORIF and revision, 39 ORIF alone. Of the revision group, one died within 30 days (3.8%), one at one year (3.8%), and two were revised within one year (7.7). Of the B2 ORIF group, three died within 30-day mortality (7.96%), eight at one year (21.1%), and 0 were revised in 1 year. Conclusion: This study has demonstrated that satisfactory outcomes can be achieved with ORIF, excluding revision in the management of B2 fractures.

Keywords: arthroplasty, bridging plate, periprosthetic fracture, revision surgery

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3800 Improving the Strength Characteristics of Soil Using Cotton Fibers

Authors: Bindhu Lal, Karnika Kochal

Abstract:

Clayey soil contains clay minerals with traces of metal oxides and organic matter, which exhibits properties like low drainage, high plasticity, and shrinkage. To overcome these issues, various soil reinforcement techniques are used to elevate the stiffness, water tightness, and bearing capacity of the soil. Such techniques include cementation, bituminization, freezing, fiber inclusion, geo-synthetics, nailing, etc. Reinforcement of soil with fibers has been a cost-effective solution to soil improvement problems. An experimental study was undertaken involving the inclusion of cotton waste fibers in clayey soil as reinforcement with different fiber contents (1%, 1.5%, 2%, and 2.5% by weight) and analyzing its effects on the unconfined compressive strength of the soil. Two categories of soil were taken, comprising of natural clay and clay mixed with 5% sodium bentonite by weight. The soil specimens were subjected to proctor compaction and unconfined compression tests. The validated outcome shows that fiber inclusion has a strikingly positive impact on the compressive strength and axial strain at failure of the soil. Based on the commendatory results procured, compressive strength was found to be directly proportional to the fiber content, with the effect being more pronounced at lower water content.

Keywords: bentonite clay, clay, cotton fibers, unconfined compressive strength

Procedia PDF Downloads 179
3799 Creative Thinking in Structural Design of Historic Constructions

Authors: Avraham Mosseri

Abstract:

The architectural conservation process of the built heritage is a very complex process dealing with the integration of professional knowledge from many fields like history, sociology, economy, engineering, etc. One of the most important fields is the structural field, which has a great influence on the final architectural and aesthetic solution of the built heritage. In many cases, the ability to protect and save the heritage values of the historical buildings is an outcome of the structural creativity and conceptual design of the conservation engineers. This creativity is especially important when dealing with structural engineering of historic construction, where there are a lot of constraints and contradictions between different aspects like aesthetics, artistic values, culture, authenticity, structural performance, etc. But in spite of the importance of this creativity in conservation engineering, many research efforts are mainly devoted to the structural analysis of historic construction, which of course is very important and vital. But, in general, more attention can be paid to the creative process in the conceptual stage. In this situation there is a need, in parallel to analysis research, to devote more resources in order to improve the creative and conceptual theories in relation to conservation engineering. This paper focuses on the creativity aspects in the structural design process in the conservation of historic buildings as part of conservation theories.

Keywords: conservation, creativity, historic constructions, structural design

Procedia PDF Downloads 242
3798 Study of Physico-Chimical Properties of a Silty Soil

Authors: Moulay Smaïne Ghembaza, Mokhtar Dadouch, Nour-Said Ikhlef

Abstract:

Soil treatment is to make use soil that does not have the characteristics required in a given context. We limit ourselves in this work to the field of road earthworks where we have chosen to develop a local material in the region of Sidi Bel Abbes (Algeria). This material has poor characteristics not meeting the standards used in road geo technics. To remedy this, firstly, we were trying to improve the Proctor Standard characteristics of this material by mechanical treatment increasing the compaction energy. Then, by a chemical treatment, adding some cement dosages, our results show that this material classified A1h a increase maximum dry density and a reduction in the water content of compaction. A comparative study is made on the optimal properties of the material between the two modes of treatment. On the other hand, after treatment, one finds a decrease in the plasticity index and the methylene blue value. This material exhibits a change of class. Therefore, soil class CL turned into a soil class composed CL-ML (Silt of low plasticity). This observation allows this material to be used as backfill or sub grade.

Keywords: treatment of soil, cement, subgrade, Atteberg limits, classification, optimum proctor properties

Procedia PDF Downloads 472
3797 The Conservatoire Crisis: An Exploration into the Lived Experiences of Conservatoire Graduates

Authors: Scott Caizley

Abstract:

Widening participation amongst state schooled and British and Minority Ethnic (BME) students in UK conservatoires throughout the past years has persisted to remain at an all time low despite major efforts to increase access for those from underrepresented backgrounds. In the academic year of 2017/18, two of the UK’s leading music conservatoires recruited less state school students than Oxbridge. Whilst conservatories face further public stigmatisation and heavy financial penalties for failing to meet government benchmarks; there appears to be a more costly outcome to this crisis. This of course, is the lack of sociocultural diversity, which is perpetuated both within the conservatoire sector and the classical music industry. This research investigates the lived experiences of former state-schooled students who attended a UK music conservatoire. Given the participant’s underrepresented status, the research seeks to answer whether or not the students are fitting in or standing out within the conservatoire environment. The research will explore the findings through a Bourdieusian contextual framework with hope of generating a wealth of new practises to the field of Higher Music Education. It is through illuminating the underrepresented voices within these elite spaces, which could aid future research and policy to help tackle the diversity dilemma and give classical music the social and cultural renewal it so desperately needs.

Keywords: classical music, lived experiences, higher music education, Bourdieusian

Procedia PDF Downloads 134
3796 An Investigation on Climate Responsive Design Strategies of Apartment Buildings in Athens of the Period 1920-1960s

Authors: Angeliki Chronopoulou, Eleni Alexandrou

Abstract:

This paper thoroughly investigates residential buildings of the period 1920 – 1960 in Athens and evaluates their bioclimatic response and energy performance. A methodology adapted to the specific context of the city is proposed and applied in order to assess and extract results related to the climate analysis of the city of Athens, the general/architectural design and construction characteristics of the apartment buildings constructed during the period 1920 – 1960, the bioclimatic strategies applied on them, and the achieved thermal comfort based on questionnaires answered by their users. The results of the current study indicate that the residential architecture of that period in the city of Athens is adapted to an extend to the local climate with various climate responsive strategies. As an outcome of the analysis, the most frequently applied depending on the period of construction are presented. For this reason, the examined period is divided into 3 sub – periods: 1st period 1920s – 1930s (late neoclassicism & eclecticism), 2nd period 1930s – 1940s (modernism), 3rd period 1940s – 1960s (postwar modernism).

Keywords: Athens, climatic design strategies, residential buildings, middle war and post war architecture, thermal comfort

Procedia PDF Downloads 102
3795 Textile Based Physical Wearable Sensors for Healthcare Monitoring in Medical and Protective Garments

Authors: Sejuti Malakar

Abstract:

Textile sensors have gained a lot of interest in recent years as it is instrumental in monitoring physiological and environmental changes, for a better diagnosis that can be useful in various fields like medical textiles, sports textiles, protective textiles, agro textiles, and geo-textiles. Moreover, with the development of flexible textile-based wearable sensors, the functionality of smart clothing is augmented for a more improved user experience when it comes to technical textiles. In this context, conductive textiles using new composites and nanomaterials are being developed while considering its compatibility with the textile manufacturing processes. This review aims to provide a comprehensive and detailed overview of the contemporary advancements in textile-based wearable physical sensors, used in the field of medical, security, surveillance, and protection, from a global perspective. The methodology used is through analysing various examples of integration of wearable textile-based sensors with clothing for daily use, keeping in mind the technological advances in the same. By comparing various case studies, we come across various challenges textile sensors, in terms of stability, the comfort of movement, and reliable sensing components to enable accurate measurements, in spite of progress in the engineering of the wearable. Addressing such concerns is critical for the future success of wearable sensors.

Keywords: flexible textile-based wearable sensors, contemporary advancements, conductive textiles, body conformal design

Procedia PDF Downloads 185
3794 Online Social Network Vital to Hospitality and Tourism Marketing and Management

Authors: Nureni Asafe Yekini, Olawale Nasiru Lawal, Bola Dada, Gabriel Adeyemi Okunlola

Abstract:

This study is focused on the strengths and challenges associated with using the online social network as a rapidly evolving medium in marketing tourism services and businesses among the youths in Nigeria. The paper examines the Nigerian tourists’ attitude, mainly towards three aspects: application of Internet for travel and tourism; usage of online social networks in sharing travel and tourism experiences; and trust in electronic-media for marketing tourism businesses and services. The aim of this research is to determine the level of application of internet tools in marketing tourism businesses and services in Nigeria. This study reports an empirical analysis based on data obtained from a survey among 1004 Nigerian tourists. The outcome confirms the research hypothesis and points to crucial importance of introducing online social network site for marketing tourism businesses and services in Nigeria, and increasing the awareness for Nigeria as a tourist destination. Moreover, the paper strongly recommends the use of online social network as a tool for marketing tourism businesses and services, and the need for identifying effective framework for application of ICT tools in marketing tourism businesses and services in Nigeria at large.

Keywords: tourism business, internet, online social networks, tourism services, ICT

Procedia PDF Downloads 356
3793 Deep Learning Based, End-to-End Metaphor Detection in Greek with Recurrent and Convolutional Neural Networks

Authors: Konstantinos Perifanos, Eirini Florou, Dionysis Goutsos

Abstract:

This paper presents and benchmarks a number of end-to-end Deep Learning based models for metaphor detection in Greek. We combine Convolutional Neural Networks and Recurrent Neural Networks with representation learning to bear on the metaphor detection problem for the Greek language. The models presented achieve exceptional accuracy scores, significantly improving the previous state-of-the-art results, which had already achieved accuracy 0.82. Furthermore, no special preprocessing, feature engineering or linguistic knowledge is used in this work. The methods presented achieve accuracy of 0.92 and F-score 0.92 with Convolutional Neural Networks (CNNs) and bidirectional Long Short Term Memory networks (LSTMs). Comparable results of 0.91 accuracy and 0.91 F-score are also achieved with bidirectional Gated Recurrent Units (GRUs) and Convolutional Recurrent Neural Nets (CRNNs). The models are trained and evaluated only on the basis of training tuples, the related sentences and their labels. The outcome is a state-of-the-art collection of metaphor detection models, trained on limited labelled resources, which can be extended to other languages and similar tasks.

Keywords: metaphor detection, deep learning, representation learning, embeddings

Procedia PDF Downloads 153
3792 Using Deep Learning Neural Networks and Candlestick Chart Representation to Predict Stock Market

Authors: Rosdyana Mangir Irawan Kusuma, Wei-Chun Kao, Ho-Thi Trang, Yu-Yen Ou, Kai-Lung Hua

Abstract:

Stock market prediction is still a challenging problem because there are many factors that affect the stock market price such as company news and performance, industry performance, investor sentiment, social media sentiment, and economic factors. This work explores the predictability in the stock market using deep convolutional network and candlestick charts. The outcome is utilized to design a decision support framework that can be used by traders to provide suggested indications of future stock price direction. We perform this work using various types of neural networks like convolutional neural network, residual network and visual geometry group network. From stock market historical data, we converted it to candlestick charts. Finally, these candlestick charts will be feed as input for training a convolutional neural network model. This convolutional neural network model will help us to analyze the patterns inside the candlestick chart and predict the future movements of the stock market. The effectiveness of our method is evaluated in stock market prediction with promising results; 92.2% and 92.1 % accuracy for Taiwan and Indonesian stock market dataset respectively.

Keywords: candlestick chart, deep learning, neural network, stock market prediction

Procedia PDF Downloads 447