Search results for: modified rankin score
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4267

Search results for: modified rankin score

1357 Value of Willingness to Pay for a Quality-Adjusted Life Years Gained in Iran; A Modified Chained-Approach

Authors: Seyedeh-Fariba Jahanbin, Hasan Yusefzadeh, Bahram Nabilou, Cyrus Alinia, Cyrus Alinia

Abstract:

Background: Due to the lack of a constant Willingness to Pay per one additional Quality Adjusted Life Years gained based on the preferences of Iran’s general public, the cost-efectiveness of health system interventions is unclear and making it challenging to apply economic evaluation to health resources priority setting. Methods: We have measured this cost-efectiveness threshold with the participation of 2854 individuals from fve provinces, each representing an income quintile, using a modifed Time Trade-Of-based Chained-Approach. In this online-based empirical survey, to extract the health utility value, participants were randomly assigned to one of two green (21121) and yellow (22222) health scenarios designed based on the earlier validated EQ-5D-3L questionnaire. Results: Across the two health state versions, mean values for one QALY gain (rounded) ranged from $6740-$7400 and $6480-$7120, respectively, for aggregate and trimmed models, which are equivalent to 1.35-1.18 times of the GDP per capita. Log-linear Multivariate OLS regression analysis confrmed that respondents were more likely to pay if their income, disutility, and education level were higher than their counterparts. Conclusions: In the health system of Iran, any intervention that is with the incremental cost-efectiveness ratio, equal to and less than 7402.12 USD, will be considered cost-efective.

Keywords: willingness to Pay, QALY, chained-approach, cost-efectiveness threshold, Iran

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1356 A Cross-Sectional Evaluation of the Lack of Racial, Sexual, and Gender Diversity among Top Dermatologist Influencers on TikTok

Authors: Madison Meyer

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Dermatological conditions are one of the most viewed medical subjects on the social media platform TikTok, resulting in the rise of several prominent American board-certified dermatologists as influencers. Notably, dermatology is one of the least diverse specialties. This cross-sectional study aimed to assess individuals’ preferences related to race, gender, and sexual identity of doctors in terms of dermatology-related information on TikTok and which group posts more reliable information. This study qualitatively and quantitatively evaluated the racial, gender, and sexual diversity of the top 55 dermatologist influencers on TikTok based on their follower count. The DISCERN tool was used to determine the reliability of consumer health content based on a score ranging from 1-5. Among the top 55 dermatologist influencers, African American (54,241.60) and Latinx (6,696) groups had the lowest mean number of followers compared to Caucasian (1,046,298.50) and Asian (1,403,393.50) physicians. Latinx and African American dermatologists had the highest DISCERN scores of 2 and 1.9, respectively. None of the physicians identified as a different gender or as LGBTQIA+ in any racial category. There is a considerable lack of minority dermatologist influencers on TikTok, especially Latinx, African American, and LGBTQIA+ physicians. The lack of diversity in the dermatology specialty can lead to inequitable care and health outcomes for racial/ethnic, gender, and sexual minority patient populations. This study’s findings also suggest Latinx and African American dermatologists post more reliable content compared with their Caucasian and Asian counterparts.

Keywords: dermatology, social media, sexual and gender minorities, racial minorities, skin of color, tiktok

Procedia PDF Downloads 65
1355 Integrating Nursing Informatics to Improve Patient-Centered Care: A Project to Reduce Patient Waiting Time at the Blood Pressure Counter

Authors: Pi-Chi Wu, Tsui-Ping Chu, Hsiu-Hung Wang

Abstract:

Background: The ability to provide immediate medical service in outpatient departments is one of the keys to patient satisfaction. Objectives: This project used electronic equipment to integrate nursing care information to patient care at a blood pressure diagnostic counter. Through process reengineering, the average patient waiting time decreased from 35 minutes to 5 minutes, while service satisfaction increased from a score of 2.7 to 4.6. Methods: Data was collected from a local hospital in Southern Taiwan from a daily average of 2,200 patients in the outpatient department. Previous waiting times were affected by (1) space limitations, (2) the need to help guide patient mobility, (3) the need for nurses to appease irate patients and give instructions, (4), the need for patients to replace lost counter tickets, (5) the need to re-enter information, (6) the replacement of missing patient information. An ad hoc group was established to enhance patient satisfaction and shorten waiting times for patients to see a doctor. A four step strategy consisting of (1) counter relocation, (2) queue reorganization, (3) electronic information integration, (4) process reengineering was implemented. Results: Implementation of the developed strategy decreased patient waiting time from 35 minutes to an average of 5 minutes, and increased patient satisfaction scores from 2.7 to 6.4. Conclusion: Through the integration of information technology and process transformation, waiting times were drastically reduced, patient satisfaction increased, and nurses were allowed more time to engage in more cost-effective services. This strategy was simultaneously enacted in separate hospitals throughout Taiwan.

Keywords: process reengineering, electronic information integration, patient satisfaction, patient waiting time

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1354 Stepping in Sustainability: Walkability an Upcoming Design Parameter for Transit Based Communities in Lahore, Pakistan

Authors: Sadaf Saeed

Abstract:

The consideration of walkability as an urban design parameter in conjunction with transit-oriented development is an established trend in the developed countries but an upcoming trend in developing countries. In Pakistan, the first Bus Rapid Transit (locally called as Metro Bus) has been introduced in the city of Lahore in 2013 where around 40 percent of the riders access to transit stations by walking. To what extent the aspect of walkability has been considered in the local scenario? To address this question, this paper presents an account of urban design parameters regarding pedestrian provisions and quality of walking environment between Metro Bus stations and users’ destination in the transit neighbourhoods (areas up to 500-meter radius). The primary and secondary data for objective and subjective walkability measurements has been used for neighbourhoods of five selected transit stations ranked against the predefined critical assessed factors (CAF). The multi-criteria approach including visual and geospatially-based parameters at street level, along with walkability index score at selected sites linked with CAF evaluation were the selected methods for this study. The acceptability of walkability as an urban design parameter for transit planning in terms of connectivity and social implications of the concept has also been analysed in the local context. The paper highlights that the aspect of walkability in Lahore is being derelict owing to the focus of government on other initiatives such as park and ride and feeder bus services for mobility of passengers. However, the pedestrian-friendly design parameters as a part of future transit planning can enhance social, liveable and interactive walking environment within transit neighbourhoods.

Keywords: walkability, sustainability, transit neighborhoods, social communities

Procedia PDF Downloads 232
1353 The Role of Satisfaction on Performance among Afe Babalola University Team Sports

Authors: B. O. Diyaolu

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Viability and competency during competition is the dream of every team sports so as to have a good result. But it seems factors abound which deter the performance of even a good sports team. Different individuals with different state of mind all come together to perform in team sports with different degree of satisfaction. This study investigated the role of satisfaction on performance among Afe Babalola University team sports. Descriptive survey research design was used and the population consists of all male and female athletes in the team sports that participated in the last 2019 Ekiti State Higher Institution games (ESHIGA). Total enumeration technique was used for the three team sports; football (44), basketball (24) and volleyball (24). A total of 92 participants were involved in the research. The instrument used for the study was a modified Athlete Satisfaction Scale (ASS). The questionnaire was divided into two sections. The Cronbach’s Alpha reliability coefficient of 0.71 was obtained. The hypotheses were tested at 0.05 significant levels. The completed questionnaire was collated, coded, and analyzed using descriptive statistics of frequency counts and percentage and inferential statistics of chi-square (X2). Findings of this study revealed that satisfaction significantly influences team sports performance among Athletes of Afe Babalola University. The responsibility of satisfying athlete lies on the coaches, fans, sports administrators as well as organizers of such event, as it is not only financial reward that gives satisfaction. The performance of a team sports is quiet important and its being determined by the degree of satisfaction of each individual that make up the team. All effort must be made to satisfy athlete in order to guarantee optimum performance.

Keywords: athlete satisfaction, optimum achievement, optimum performance, sports performance and team sports

Procedia PDF Downloads 135
1352 Pomegranate Peel Based Edible Coating Treatment for Safety and Quality of Chicken Nuggets

Authors: Muhammad Sajid Arshad, Sadaf Bashir

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In this study, the effects of pomegranate peel based edible coating were determined on safety and quality of chicken nuggets. Four treatment groups were prepared as control (without coating), coating with sodium alginate (SA) (1.5%), pomegranate peel powder (PPP) (1.5%), and combination of SA and PPP. There was a significant variation observed with respect to coating treatments and storage intervals. The chicken nuggets were subjected to refrigerated storage (40C) and were analyzed at regular intervals of 0, 7, 14 1 and 21 days. The microbiological quality was determined by total aerobic and coliform counts. Total aerobic (5.09±0.05 log CFU/g) and coliforms (3.91±0.06 log CFU/g) counts were higher in uncoated chicken nuggets whereas lower was observed in coated chicken nuggets having combination of SA and PPP. Likewise, antioxidants potential of chicken nuggets was observed by assessing total phenolic contents (TPC) and DPPH activity. Higher TPC (135.66 GAE/100g) and DPPH (64.65%) were found in combination with SA and PPP, whereas minimum TPC (91.38) and DPPH (41.48) was observed in uncoated chicken nuggets. Regarding the stability analysis of chicken nuggets, thiobarbituric acid reactive substances (TBARS) and peroxide value (POV) were determined. Higher TBARS (1.62±0.03 MDA/Kg) and POV (0.92±0.03 meq peroxide/kg) were found in uncoated chicken nuggets. Hunter color values were also observed in both uncoated and coated chicken nuggets. Sensorial attributes were also observed by the trained panelists. The higher sensory score for appearance, color, taste, texture and overall acceptability were observed in control (uncoated) while in coated treatments, it was found within acceptable limits. In nutshell, the combination of SA and PPP enhanced the overall quality, antioxidant potential, and stability of chicken nuggets.

Keywords: chicken nuggets, edible coatings, pomegranate peel powder, sodium alginate

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1351 Cadaver Free Fatty Acid Distribution Associated with Burial in Mangrove and Oil Palm Plantation Soils under Tropical Climate

Authors: Siti Sofo Ismail, Siti Noraina Wahida Mohd Alwi, Mohamad Hafiz Ameran, Masrudin M. Yusoff

Abstract:

Locating clandestine cadaver is crucially important in forensic investigations. However, it requires a lot of man power, costly and time consuming. Therefore, the development of a new method to locate the clandestine graves is urgently needed as the cases involve burial of cadaver in different types of soils under tropical climates are still not well explored. This study focused on the burial in mangrove and oil palm plantation soils, comparing the fatty acid distributions in different soil acidities. A stimulated burial experiment was conducted using domestic pig (Sus scrofa) to substitute human tissues. Approximately 20g of pig fatty flesh was allowed to decompose in mangrove and oil palm plantation soils, mimicking burial in a shallow grave. The associated soils were collected at different designated sampling points, corresponding different decomposition stages. Modified Bligh-Dyer Extraction method was applied to extract the soil free fatty acids. Then, the obtained free fatty acids were analyzed with gas chromatography-flame ionization (GC-FID). A similar fatty acid distribution was observed for both mangrove and oil palm plantations soils. Palmitic acid (C₁₆) was the most abundance of free fatty acid, followed by stearic acid (C₁₈). However, the concentration of palmitic acid (C₁₆) higher in oil palm plantation compare to mangrove soils. Conclusion, the decomposition rate of cadaver can be affected by different type of soils.

Keywords: clandestine grave, burial, soils, free fatty acid

Procedia PDF Downloads 380
1350 Quantitative Method of Measurement for the Rights and Obligations of Contracting Parties in Standard Forms of Contract in Malaysia: A Case Study

Authors: Sim Nee Ting, Lan Eng Ng

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Standard forms of contract in Malaysia are pre-written, printed contractual documents drafted by recognised authoritative bodies in order to describe the rights and obligations of the contracting parties in all construction projects in Malaysia. Studies and form revisions are usually conducted in a relatively random and qualitative manner, but the search of contractual documents idealization remains. It is not clear how these qualitative findings could be helpful for contractual documents improvements and re-drafting. This study aims to quantitatively and systematically analyse and evaluate the rights and obligations of the contracting parties as stated in the standard forms of contract. The Institution of Engineers Malaysia (IEM) published a new standard form of contract in 2012 with a total of 63 classes but the improvements and changes in the newly revised form that are yet to be analysed. IEM form will be used as the case study for this study. Every clause in this said form were interpreted and analysed according to the involved parties including contractor, engineer and employer. Modified from Matrix Method and Likert Scale, the result analysis were conducted based on a scale from 0 to 1 with five ratings namely “Very Unbalance”, “Unbalance”, “Balance”, “Good Balance” and “Very Good Balance”. It is hoped that quantitative method of form study can be used for future form revisions and any new forms drafting so to reduce on any subjectivity in standard forms of contract studies.

Keywords: contracting parties, Malaysia, obligations, quantitative measurement, rights, standard form of contract

Procedia PDF Downloads 251
1349 Managing Pseudoangiomatous Stromal Hyperplasia Appropriately and Safely: A Retrospective Case Series Review

Authors: C. M. Williams, R. English, P. King, I. M. Brown

Abstract:

Introduction: Pseudoangiomatous Stromal Hyperplasia (PASH) is a benign fibrous proliferation of breast stroma affecting predominantly premenopausal women with no significant increased risk of breast cancer. Informal recommendations for management have continued to evolve over recent years from surgical excision to observation, although there are no specific national guidelines. This study assesses the safety of a non-surgical approach to PASH management by review of cases at a single centre. Methods: Retrospective case series review (January 2011 – August 2016) was conducted on consecutive PASH cases. Diagnostic classification (clinical, radiological and histological), management outcomes, and breast cancer incidence were recorded. Results: 43 patients were followed up for median of 25 months (3-64) with 75% symptomatic at presentation. 12% of cases (n=5) had a radiological score (BIRADS MMG or US) ≥ 4 of which 3 were confirmed malignant. One further malignancy was detected and proven radiologically occult and contralateral. No patients were diagnosed with a malignancy during follow-up. Treatment evolved from 67% surgical in 2011 to 33% in 2016. Conclusions: The management of PASH has transitioned in line with other published experience. The preliminary findings suggest this appears safe with no evidence of missed malignancies; however, longer follow up is required to confirm long-term safety. Recommendations: PASH with suspicious radiological findings ( ≥ U4/R4) warrants multidisciplinary discussion for excision. In the absence of histological or radiological suspicion of malignancy, PASH can be safely managed without surgery.

Keywords: benign breast disease, conservative management, malignancy, pseudoangiomatous stromal hyperplasia, surgical excision

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1348 Mandatory Wellness Assessments for Medical Students at the University of Ottawa

Authors: Haykal. Kay-Anne

Abstract:

The health and well-being of students is a priority for the Faculty of Medicine at the University of Ottawa. The demands of medical studies are extreme, and many studies confirm that the prevalence of psychological distress is very high among medical students and that it is higher than that of the general population of the same age. The main goal is to identify risk factors for mental health among medical students at the University of Ottawa. The secondary objectives are to determine the variation of these risk factors according to demographic variables, as well as to determine if there is a change in the mental health of students during the 1st and 3rd years of their study. Medical students have a mandatory first and third-year wellness check meeting. This assessment includes a questionnaire on demographic information, mental health, and risk factors such as physical health, sleep, social support, financial stress, education and career, stress and drug use and/or alcohol. Student responses were converted to numerical values and analyzed statistically. The results show that 61% of the variation in the mean of the mental health score is explained by the following risk factors (R2 = 0.61, F (9.396) = 67.197, p < 0.01): lack of sleep and fatigue (β = 0.281, p < 0.001), lack of social support (β = 0.217, p <0.001), poor study or career development (β = 0.195, p < 0.001) and an increase stress and drug and alcohol use (β = -0.239, p < 0.001). No demographic variable has a significant effect on the presence of risk factors. In addition, fixed-effects regression demonstrated significantly lower mental health (p < 0.1) among first-year students (M = 0.587, SD = 0.072) than among third-year students (M = 0.719, SD = 0.071). This preliminary study indicates the need to continue data collection and analysis to increase the significance of the study results. As risk factors are present at the beginning of medical studies, it is important to offer resources to students very early in their medical studies and to have close monitoring and supervision.

Keywords: assessment of mental health, medical students, risk factors for mental health, wellness assessment

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1347 Assessment of Potentially Harmful Elements in Floodplain Soils and Stream Sediments in Ile-Ife Area, South-Western Nigeria: Using Geographic Information System and Multi-Variances Approaches

Authors: I. T. Asowata, A. S. Akinwumiju

Abstract:

The enrichment of potentially harmful elements (PHEs) in stream sediments (SS) and floodplain soils (FS) poses great environmental hazards to water bodies and other parts of the ecosystem. The aim of this research was to assess the distribution pattern of selected PHEs (Cu, Pb, Zn, Co, Mn, As, Cd, V, Cr, Ni, Th, Sr, and La) in SS of selected rivers that drain Ile-Ife area and their adjacent FS, to ascertain the pollution status of these elements in the study area. 60 samples (40 SS and 20 FS) were purposely collected for this study; the samples were air-dried at room temperature, disaggregated, sieved with > 63 µm and digested with modified aqua reqia (1:1:1 HCl:HNO₃:H₂O) and were analysed with ultra-trace inductively coupled plasma mass spectrometry method (ICP-ES). The geochemical results showed decreasing trend of average contents of PHEs studied Mn > Zn > V > Cr > Pb > La > Sr > Cu > Ni > Co > Th > As > Cd for both SS and FS. Floodplain topsoil in ppm, Cu range from 10.0-180.0; mean, 71.1, Pb, 17.1-255.0; 93.5 and Zn, 83.0-3122.2; 826.0. Also, floodplain sub-soils, Cu range from 30.0-203.1; mean of 76.6, Pb, 16.0-214.0; 77.9 and Zn, 59.1-2351.0; 622.3. Similarly, SS results for Cu, 22.1-257.0; 70.3, Pb, 15.0-172.0; 67.3 and Zn, 65.0-1285.0; 357.8, among other PHEs, suggesting significant level of PHEs enrichment in the studied geo media. Elemental association showed positive and/or negative correlation among the PHEs and also showed different sources of metal enrichment to be largely anthropogenic with some geogenic. Geoaccumulation and metal ratio indexes indicated that FS and SS studied have received significant PHEs of between moderately to strongly polluted, which implies significant environmental implications in the study area.

Keywords: aqua regia, enrichment, GIS, Ile-Ife, potentially harmful elements

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1346 Structural, Electrochemical and Electrocatalysis Studies of a New 2D Metal-Organic Coordination Polymer of Ni (II) Constructed by Naphthalene-1,4-Dicarboxylic Acid; Oxidation and Determination of Fructose

Authors: Zohreh Derikvand

Abstract:

One new 2D metal-organic coordination polymer of Ni(II) namely [Ni2(ndc)2(DMSO)4(H2O)]n, where ndc = naphthalene-1,4-dicarboxylic acid and DMSO= dimethyl sulfoxide has been synthesized and characterized by elemental analysis, spectral (IR, UV-Vis), thermal (TG/DTG) analysis and single crystal X-ray diffraction. Compound 1 possesses a 2D layer structure constructed from dinuclear nickel(II) building blocks in which two crystallographically independent Ni2+ ions are bridged by ndc2– ligands and water molecule. The ndc2– ligands adopt μ3 bridging modes, linking the metal centers into a two-dimensional coordination framework. The two independent NiII cations are surrounded by dimethyl sulfoxide and naphthalene-1,4-dicarboxylate molecules in distorted octahedron geometry. In the crystal structures of 1 there are non-classical hydrogen bonding arrangements and C-H–π stacking interactions. Electrochemical behavior of [Ni2(ndc)2(DMSO)4(H2O)]n, (Ni-NDA) on the surface of carbon nanotube (CNTs) glassy carbon electrode (GCE) was described. The surface structure and composition of the sensor were characterized by scanning electron microscopy (SEM). Oxidation of fructose on the surface of modified electrode was investigated with cyclic voltammetry and electrochemical impedance spectroscopy (EIS) and the results showed that the Ni-NDA/CNTs film displays excellent electrochemical catalytic activities towards fructose oxidation.

Keywords: naphthalene-1, 4-dicarboxylic acid, crystal structure, coordination polymer, electrocatalysis, impedance spectroscopy

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1345 Subject, Language, and Representation: Snyder's Poetics of Emptiness

Authors: Son Hyesook

Abstract:

This project explores the possibility of poetics of emptiness in the poetry of Gary Snyder, one of the most experimental American poets, interpreting his works as an expression of his Buddhist concept, emptiness. This philosophical term demonstrates the lack of intrinsic nature in all phenomena and the absence of an independent, perduring self. Snyder’s poetics of emptiness locates the extralinguistic reality, emptiness, within the contingent nexus of language itself instead of transcending or discarding it. Language, therefore, plays an important role in his poetry, a medium intentionally applied to the carrying out of this Buddhist telos. Snyder’s poetry is characterized by strangeness and disruptiveness of language as is often the case with Asian Zen discourses. The elision of a lyric ‘I’ and transitive verbs, for example, is his grammatic attempt to represent the illusory nature of the self. He replaces the solitary speaker with sparely modified, concrete but generic images to prevent any anthropocentric understanding of the world and to demonstrate human enactment into a harmonious interplay with other elements of life as a part of a vast web of interconnections, where everything is interrelated to every other thing. In many of his poems, Snyder employs grammatical and structural ellipses and paratactical construction to avoid a facile discursive relation and to help the reader illogically imagine the inexpressible, the void. Through various uses of typographical and semantical space, his poetry forces the reader to experience the ‘thought-pause’ and intuitively perceive things-as-they-are. Snyder enacts in his Poetics an alternative to postmodern perspectives on the subject, language, and representation, and revitalizes their skeptical look at any account of human agency and the possibility of language.

Keywords: subject, language, representation, poetics of emptiness

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1344 Simulation of the Flow in Bilayer Coextrusion Dies with Gradually Changing Calibrator Profiles

Authors: Mahesh Gupta

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The main goal in the design of a die for extrusion of a complex profile is to obtain a uniform velocity at the die exit. If the velocity at the exit of an extrusion die is not uniform, the shape of the extrudate profile can change significantly after the polymer exits the die. To rectify the extrudate distortion caused by non-uniform exit velocity, calibrators and sizers are often installed along the extrudate cooling system. Furthermore, the profile shape in calibrators and sizers is sometimes gradually changed to intentionally deform the extrudate to the required final product shape. This is exploited to simplify extrusion die design, because a relatively simple profile at the die exit can be modified to obtain a more complex profile by deforming it in calibrators or sizers. The gradual change in the shape of calibrator or sizer profiles can also be used to extrude slightly different profiles from the same die. In the present work, a combined flow, thermal and structural analysis is used to accurately predict distortion of extrudate profile after the polymer leaves a die. Simulations of the flow and extrudate deformation in two different bilayer coextrusion dies with gradually changing profile shape in successive calibrators and sizers will be presented. The effect of non-uniform exit velocity, cooling shrinkage and shape of sizer profiles on extrudate deformation is included in the simulation. The predicted extrudate shape and layer structure is found to match accurately with those in a coextruded product.

Keywords: coextrusion, extrusion die design, finite element method, polymers

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1343 Thiopental-Fentanyl versus Midazolam-Fentanyl for Emergency Department Procedural Sedation and Analgesia in Patients with Shoulder Dislocation and Distal Radial Fracture-Dislocation: A Randomized Double-Blind Controlled Trial

Authors: D. Farsi, G. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani

Abstract:

Background and aim:It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FTversusfentanyl-midazolam (FM)in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods:In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccess rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.

Keywords: procedural sedation and analgesia, thiopental, fentanyl, midazolam, orthopedic procedure, emergency department, pain

Procedia PDF Downloads 242
1342 Design and Optimization of Open Loop Supply Chain Distribution Network Using Hybrid K-Means Cluster Based Heuristic Algorithm

Authors: P. Suresh, K. Gunasekaran, R. Thanigaivelan

Abstract:

Radio frequency identification (RFID) technology has been attracting considerable attention with the expectation of improved supply chain visibility for consumer goods, apparel, and pharmaceutical manufacturers, as well as retailers and government procurement agencies. It is also expected to improve the consumer shopping experience by making it more likely that the products they want to purchase are available. Recent announcements from some key retailers have brought interest in RFID to the forefront. A modified K- Means Cluster based Heuristic approach, Hybrid Genetic Algorithm (GA) - Simulated Annealing (SA) approach, Hybrid K-Means Cluster based Heuristic-GA and Hybrid K-Means Cluster based Heuristic-GA-SA for Open Loop Supply Chain Network problem are proposed. The study incorporated uniform crossover operator and combined crossover operator in GAs for solving open loop supply chain distribution network problem. The algorithms are tested on 50 randomly generated data set and compared with each other. The results of the numerical experiments show that the Hybrid K-means cluster based heuristic-GA-SA, when tested on 50 randomly generated data set, shows superior performance to the other methods for solving the open loop supply chain distribution network problem.

Keywords: RFID, supply chain distribution network, open loop supply chain, genetic algorithm, simulated annealing

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1341 Physical, Microstructural and Functional Quality Improvements of Cassava-Sorghum Composite Snacks

Authors: Adil Basuki Ahza, Michael Liong, Subarna Suryatman

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Healthy chips now dominating the snack market shelves. More than 80% processed snack foods in the market are chips. This research takes the advantages of twin extrusion technology to produce two types of product, i.e. directly expanded and intermediate ready-to-fry or microwavable chips. To improve the functional quality, the cereal-tuber based mix was enriched with antioxidant rich mix of temurui, celery, carrot and isolated soy protein (ISP) powder. Objectives of this research were to find best composite cassava-sorghum ratio, i.e. 60:40, 70:30 and 80:20, to optimize processing conditions of extrusion and study the microstructural, physical and sensorial characteristics of the final products. Optimization was firstly done by applying metering section of extruder barrel temperatures of 120, 130 and 140 °C with screw speeds of 150, 160 and 170 rpm to produce direct expanded product. The intermediate product was extruded in 100 °C and 100 rpm screw speed with feed moisture content of 35, 40 and 45%. The directly expanded products were analyzed for color, hardness, density, microstructure, and organoleptic properties. The results showed that interaction of ratio of cassava-sorghum and cooking methods affected the product's color, hardness, and bulk density (p<0.05). Extrusion processing conditions also significantly affected product's microstructure (p<0.05). The direct expanded snacks of 80:20 cassava-sorghum ratio and fried expanded one 70:30 and 80:20 ratio shown the best organoleptic score (slightly liked) while baking the intermediate product with microwave were resulted sensorial not acceptable quality chips.

Keywords: cassava-sorghum composite, extrusion, microstructure, physical characteristics

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1340 Comparative Study on Performance of Air-Cooled Condenser (ACC) Steel Platform Structures using SCBF Frames, Spatial Structures and CFST Frames

Authors: Hassan Gomar, Shahin Bagheri, Nader Keyvan, Mozhdeh Shirinzadeh

Abstract:

Air-Cooled Condenser (ACC) platform structures are the most complicated and principal structures in power plants and other industrial parts which need to condense the low-pressure steam in the cycle. Providing large spans for this structure has great merit as there would be more space for other subordinate buildings and pertinent equipment. Moreover, applying methods to reduce the overall cost of construction while maintaining its strength against severe seismic loading is of high significance. Tabular spatial structures and composite frames have been widely used in recent years to satisfy the need for higher strength at a reasonable price. In this research program, three different structural systems have been regarded for ACC steel platform using Special Concentrate Braced Frames (SCBF), which is the most common system (first scheme), modular spatial frames (second scheme) and finally, a modified method applying Concrete Filled Steel Tabular (CFST) columns (third scheme). The finite element method using Sap2000 and Etabs software was conducted to investigate the behavior of the structures and make a precise comparison between the models. According to the results, the total weight of the steel structure in the second scheme decreases by 13% compared to the first scheme and applying CFST columns in the third scheme causes a 3% reduction in the total weight of the structure in comparison with the second scheme while all the lateral displacements and P-M interaction ratios are in the admissible limit.

Keywords: ACC, SCBF frames, spatial structures, CFST frames

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1339 Study of the Influence of Non Genetic Factors Affecting over Nutrition Students in Ayutthaya Province, Thailand

Authors: Thananyada Buapian

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Overnutrition is emerging as a morbid disease in developing and Westernized countries. Because of its comorbidity diseases, it is cost-effective to prevent and manage this disease earlier. In Thailand, this alarming disease has long been studied, but the prevalence is still higher than that in the past. Physicians should recognize it well and have a definite direction to face and combat this dangerous disease. Rapid changes in the tremendous figure of overnutrition students indicate that genetic factors are not the primary determinants since human genes have remained unchanged for a century. This study aims to assess the prevalence of overnutrition students and to investigate the non-genetic factors affecting over nutrition students. A cross-sectional school-based survey was conducted. A two-stage sampling was adopted. Respondents included 1,850 students in grades 4 to 6 in Ayutthaya Province. An anthropometric measurement and questionnaire were developed. Childhood over nutrition was defined as a weight-for-height Z-score above +2SD of NCHS/WHO references. About thirty three percent of the children were over nutrition in Ayutthaya province. Stepwise multiple logistic regression analysis showed that 8 statistically significant non genetic factors explain the variation of childhood over nutrition by 18 percent. Sex is the prime factor to explain the variation of childhood over nutrition, followed by duration of light physical activities, duration of moderate physical activities, having been breastfed, the presence of a healthy role model of the caregiver, number of siblings, birth order, and occupation of the caregiver, respectively. Non genetic factors, especially the subjects’ demographic and physical activities, as well as the caregivers’ background and family environment, should be considered in viable approach to remedy this health imbalance in children.

Keywords: non genetic factors, non-genetic, over nutrition, over nutrition students

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1338 Electrochemical Properties of Bimetallic Silver-Platinum Core-Shell Nanoparticles

Authors: Fredrick O. Okumu, Mangaka C. Matoetoe

Abstract:

Silver-platinum (Ag-Pt) bimetallic nanoparticles (NPs) with varying mole fractions (1:1, 1:3 and 3:1) were prepared by co-reduction of hexachloroplatinate and silver nitrate with sodium citrate. Upon successful formation of both monometallic and bimetallic (BM) core shell nanoparticles, cyclic voltammetry (CV) was used to characterize the NPs. The drop coated nanofilms on the GC substrate showed characteristic peaks of monometallic Ag NPs; Ag+/Ag0 redox couple as well as the Pt NPs; hydrogen adsorption and desorption peaks. These characteristic peaks were confirmed in the bimetallic NPs voltammograms. The following varying current trends were observed in the BM NPs ratios; GCE/Ag-Pt 1:3 > GCE/Ag-Pt 3:1 > GCE/Ag-Pt 1:1. Fundamental electrochemical properties which directly or indirectly affects the applicability of films such as; diffusion coefficient (D), electroactive surface coverage, electrochemical band gap, electron transfer coefficient (α) and charge (Q) were assessed using Randles - Sevcik plot and Laviron’s equations . High charge and surface coverage was observed in GCE/Ag-Pt 1:3 which supports its enhanced current. GCE/Ag-Pt 3:1 showed high diffusion coefficient while GCE/Ag-Pt 1:1 possessed high electron transfer coefficient that is facilitated by its high apparent heterogeneous rate constant relative to other BM NPs ratios. Surface redox reaction was determined as adsorption controlled in all modified GCEs. Surface coverage is inversely proportional to size; therefore the surface coverage data suggests that Ag-Pt 1:1 NPs have a small particle size. Generally, GCE/Ag-Pt 1:3 depicts the best electrochemical properties.

Keywords: characterization, core-shell, electrochemical, nanoparticles

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1337 Effect of Oral Clonidine Premedication on Subarachnoid Block Characteristics of 0.5 % Hyperbaric Bupivacaine for Laparoscopic Gynecological Procedures – A Randomized Control Study

Authors: Buchh Aqsa, Inayat Umar

Abstract:

Background- Clonidine, α 2 agonist, possesses several properties to make it valuable adjuvant for spinal anesthesia. The study was aimed to evaluate the clinical effects of oral clonidine premedication for laparoscopic gynecological procedures under subarachnoid block. Patients and method- Sixtyfour adult female patients of ASA physical status I and II, aged 25 to 45 years and scheduled for laparoscopic gynecological procedures under the subarachnoid block, were randomized into two comparable equal groups of 32 patients each to received either oral clonidine, 100 µg (Group I) or placebo (Group II), 90 minutes before the procedure. Subarachnoid block was established with of 3.5 ml of 0.5% hyperbaric bupivacaine in all patients. Onset and duration of sensory and motor block, maximum cephalad level, and the regression time to reach S1 sensory level were assessed as primary end points. Sedation, hemodynamic variability, and respiratory depression or any other side effects were evaluated as secondary outcomes. Results- The demographic profile was comparable. The intraoperative hemodynamic parameters showed significant differences between groups. Oral clonidine was accelerated the onset time of sensory and motor blockade and extended the duration of sensory block (216.4 ± 23.3 min versus 165 ± 37.2 min, P <0.05). The duration of motor block showed no significant difference. The sedation score was more than 2 in the clonidine group as compared to the control group. Conclusion- Oral clonidine premedication has extended the duration of sensory analgesia with arousable sedation. It also prevented the post spinal shivering of the subarachnoid block.

Keywords: oral clonidine, subarachnoid block, sensory analgesia, laparoscopic gynaecological

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1336 Evaluation of the Grammar Questions at the Undergraduate Level

Authors: Preeti Gacche

Abstract:

A considerable part of undergraduate level English Examination papers is devoted to grammar. Hence the grammar questions in the question papers are evaluated and the opinions of both students and teachers about them are obtained and analyzed. A grammar test of 100 marks is administered to 43 students to check their performance. The question papers have been evaluated by 10 different teachers and their scores compared. The analysis of 38 University question papers reveals that on an average 20 percent marks are allotted to grammar. Almost all the grammar topics are tested. Abundant use of grammatical terminology is observed in the questions. Decontextualization, repetition, possibility of multiple correct answers and grammatical errors in framing the questions have been observed. Opinions of teachers and students about grammar questions vary in many respects. The students responses are analyzed medium-wise and sex-wise. The Medium at the School level and the sex of the students are found to play no role as far as interest in the study of grammar is concerned. English medium students solve grammar questions intuitively whereas non-English medium students are required to recollect the rules of grammar. Prepositions, Verbs, Articles and Model auxiliaries are found to be easy topics for most students whereas the use of conjunctions is the most difficult topic. Out of context items of grammar are difficult to answer in comparison with contextualized items of grammar. Hence contextualized texts to test grammar items are desirable. No formal training in setting questions is imparted to teachers by the competent authorities like the University. They need to be trained in testing. Statistically there is no significant change of score with the change in the rater in testing of grammar items. There is scope of future improvement. The question papers need to be evaluated and feedback needs to be obtained from students and teachers for future improvement.

Keywords: context, evaluation, grammar, tests

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1335 Increase in Specificity of MicroRNA Detection by RT-qPCR Assay Using a Specific Extension Sequence

Authors: Kyung Jin Kim, Jiwon Kwak, Jae-Hoon Lee, Soo Suk Lee

Abstract:

We describe an innovative method for highly specific detection of miRNAs using a specially modified method of poly(A) adaptor RT-qPCR. We use uniquely designed specific extension sequence, which plays important role in providing an opportunity to affect high specificity of miRNA detection. This method involves two steps of reactions as like previously reported and which are poly(A) tailing and reverse-transcription followed by real-time PCR. Firstly, miRNAs are extended by a poly(A) tailing reaction and then converted into cDNA. Here, we remarkably reduced the reaction time by the application of short length of poly(T) adaptor. Next, cDNA is hybridized to the 3’-end of a specific extension sequence which contains miRNA sequence and results in producing a novel PCR template. Thereafter, the SYBR Green-based RT-qPCR progresses with a universal poly(T) adaptor forward primer and a universal reverse primer. The target miRNA, miR-106b in human brain total RNA, could be detected quantitatively in the range of seven orders of magnitude, which demonstrate that the assay displays a dynamic range of at least 7 logs. In addition, the better specificity of this novel extension-based assay against well known poly(A) tailing method for miRNA detection was confirmed by melt curve analysis of real-time PCR product, clear gel electrophoresis and sequence chromatogram images of amplified DNAs.

Keywords: microRNA(miRNA), specific extension sequence, RT-qPCR, poly(A) tailing assay, reverse transcription

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1334 Difficulties in the Emotional Processing of Intimate Partner Violence Perpetrators

Authors: Javier Comes Fayos, Isabel RodríGuez Moreno, Sara Bressanutti, Marisol Lila, Angel Romero MartíNez, Luis Moya Albiol

Abstract:

Given the great impact produced by gender-based violence, its comprehensive approach seems essential. Consequently, research has focused on risk factors for violent behaviour, linking various psychosocial variables, as well as cognitive and neuropsychological deficits with the aggressors. However, studies on affective processing are scarce, so the present study investigates possible emotional alterations in men convicted of gender violence. The participants were 51 aggressors, who attended the CONTEXTO program with sentences of less than two years, and 47 men with no history of violence. The sample did not differ in age, socioeconomic level, education, or alcohol and other substances consumption. Anger, alexithymia and facial recognition of other people´s emotions were assessed through the State-Trait Anger Expression Inventory (STAXI-2), the Toronto Alexithymia Scale (TAS-20) and Reading the mind in the eyes (REM), respectively. Men convicted of gender-based violence showed higher scores on the anger trait and temperament dimensions, as well as on the anger expression index. They also scored higher on alexithymia and in the identification and emotional expression subscales. In addition, they showed greater difficulties in the facial recognition of emotions by having a lower score in the REM. These results seem to show difficulties in different affective areas in men condemned for gender violence. The deficits are reflected in greater difficulty in identifying and expressing emotions, in processing anger and in recognizing the emotions of others. All these difficulties have been related to the use of violent behavior. Consequently, it is essential and necessary to include emotional regulation in intervention programs for men who have been convicted of gender-based violence.

Keywords: alexithymia, anger, emotional processing, emotional recognition, empathy, intimate partner violence

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1333 YOLO-IR: Infrared Small Object Detection in High Noise Images

Authors: Yufeng Li, Yinan Ma, Jing Wu, Chengnian Long

Abstract:

Infrared object detection aims at separating small and dim target from clutter background and its capabilities extend beyond the limits of visible light, making it invaluable in a wide range of applications such as improving safety, security, efficiency, and functionality. However, existing methods are usually sensitive to the noise of the input infrared image, leading to a decrease in target detection accuracy and an increase in the false alarm rate in high-noise environments. To address this issue, an infrared small target detection algorithm called YOLO-IR is proposed in this paper to improve the robustness to high infrared noise. To address the problem that high noise significantly reduces the clarity and reliability of target features in infrared images, we design a soft-threshold coordinate attention mechanism to improve the model’s ability to extract target features and its robustness to noise. Since the noise may overwhelm the local details of the target, resulting in the loss of small target features during depth down-sampling, we propose a deep and shallow feature fusion neck to improve the detection accuracy. In addition, because the generalized Intersection over Union (IoU)-based loss functions may be sensitive to noise and lead to unstable training in high-noise environments, we introduce a Wasserstein-distance based loss function to improve the training of the model. The experimental results show that YOLO-IR achieves a 5.0% improvement in recall and a 6.6% improvement in F1-score over existing state-of-art model.

Keywords: infrared small target detection, high noise, robustness, soft-threshold coordinate attention, feature fusion

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1332 Production of Biotechnological Chondroitin from Recombinant E, Coli K4 Strains on Renewable Substrates

Authors: Donatella Cimini, Sergio D’ambrosio, Saba Sadiq, Chiara Schiraldi

Abstract:

Chondroitin sulfate (CS), as well as modified CS, and unsulfated chondroitin, are largely applied in research today. CS is a linear glycosaminoglycan normally present in cartilage-rich tissues and bones in the form of proteoglycans decorated with sulfate groups in different positions. CS is used as an effective non-pharmacological alternative for the treatment of osteoarthritis, and other potential applications in the biomedical field are being investigated. Some bacteria, such as E. coli K4, produce a polysaccharide that is a precursor of CS (unsulfated chondroitin). This work focused on the construction of integrative E. coli K4 recombinant strains overexpressing genes (kfoA, kfoF, pgm and galU in different combinations) involved in the biosynthesis of the nucleotide sugars necessary for polysaccharide synthesis. Strain growth and polymer production were evaluated using renewable waste materials as substrates in shake flasks and small-scale batch fermentation processes. Results demonstrated the potential to replace pure sugars with cheaper medium components to establish environmentally sustainable and cost-effective production routes for potential industrial development. In fact, although excellent fermentation results have been described so far by employing strains that naturally produce chondroitin-like polysaccharides on semi-defined media, there is still the need to reduce manufacturing costs by providing a cost-effective biotechnological alternative to currently used animal-based extraction procedures.

Keywords: E. coli K4, chondroitin, microbial cell factories, glycosaminoglycans, renewable resources

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1331 The Effects of Functionality Level on Gait in Subjects with Low Back Pain

Authors: Vedat Kurt, Tansel Koyunoglu, Gamze Kurt, Ozgen Aras

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Low back pain is one of the most common health problem in public. Common symptoms that can be associated with low back pain include; pain, functional disability, gait disturbances. The aim of the study was to investigate the differences between disability scores and gait parameters in subjects with low back pain. Sixty participants are included in our study, (35 men, 25 women, mean age: 37.65±10.02 years). Demographic characteristics of participants were recorded. Pain (visual analog scale) and disability level (Oswestry Disability Index(ODI)) were evaluated. Gait parameters were measured with Zebris-FDM-2 platform. Independent samples t-test was used to analyse the differences between subjects with under 40 points (n=31, mean age:35.8±11.3) and above 40 points (n=29, mean age:39.6±8.1) of ODI scores. Significant level in statistical analysis was accepted as 0.05. There was no significant difference between the ODI scores and groups’ ages. Statistically significant differences were found in step width between subjects with under 40 points of ODI and above 40 points of ODI score(p < 0.05). But there were non-significant differences with other gait parameters (p > 0.05). The differences between gait parameters and pain scores were not statistically significant (p > 0.05). Researchers generally agree that individuals with LBP walk slower and take shorter steps and have asymmetric step lengths when compared with than their age-matched pain-free counterparts. Also perceived general disability may have moderate correlation with walking performance. In the current study, the patients classified as minimal/moderate and severe disability level by using ODI scores. As a result, a patient with LBP who have higher disability level tends to increase support surface. On the other hand, we did not find any relation between pain intensity and gait parameters. It may be caused by the classification system of pain scores. Additional research is needed to investigate the effects of functionality level and pain intensity on gait in subjects with low back pain under different classification types.

Keywords: functionality, low back pain, gait, pain

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1330 Sleep Disturbance in Indonesian School-Aged Children and Its Relationship to Nutritional Aspect

Authors: William Cheng, Rini Sekartini

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Background: Sleep is essential for children because it provides enhancement for the neural system activities that give physiologic effects for the body to support growth and development. One of the modifiable factors that relates with sleep is nutrition, which includes nutritional status, iron intake, and magnesium intake. Nutritional status represents the balance between nutritional intake and expenditure, while iron and magnesium are micronutrients that are related to sleep regulation. The aim of this study is to identify prevalence of sleep disturbance among Indonesian children and to evaluate its relation with aspect to nutrition. Methods : A cross-sectional study involving children aged 5 to 7-years-old in an urban primary health care between 2012 and 2013 was carried out. Related data includes anthropometric status, iron intake, and magnesium intake. Iron and magnesium intake was obtained by 24-hours food recall procedure. Sleep Disturbance Scale for Children (SDSC) was used as the diagnostic tool for sleep disturbance, with score under 39 indicating presence of problem. Results: Out of 128 school-aged children included in this study, 28 (23,1%) of them were found to have sleep disturbance. The majority of children had good nutritional status, with only 15,7% that were severely underweight or underweight, and 12,4% that were identified as stunted. On the contrary, 99 children (81,8%) were identified to have inadequate magnesium intake and 56 children (46,3%) with inadequate iron intake. Our analysis showed there was no significant relation between all of the nutritional status indicators and sleep disturbance (p>0,05%). Moreover, inadequate iron and magnesium intake also failed to prove significant relation with sleep disturbance in this population. Conclusion: Almost fourth of school-aged children in Indonesia were found to have sleep disturbance and further study are needed to overcome this problem. According to our finding, there is no correlation between nutritional status, iron intake, magnesium intake, and sleep disturbance.

Keywords: iron intake, magnesium intake, nutritional status, school-aged children, sleep disturbance

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1329 Feature Based Unsupervised Intrusion Detection

Authors: Deeman Yousif Mahmood, Mohammed Abdullah Hussein

Abstract:

The goal of a network-based intrusion detection system is to classify activities of network traffics into two major categories: normal and attack (intrusive) activities. Nowadays, data mining and machine learning plays an important role in many sciences; including intrusion detection system (IDS) using both supervised and unsupervised techniques. However, one of the essential steps of data mining is feature selection that helps in improving the efficiency, performance and prediction rate of proposed approach. This paper applies unsupervised K-means clustering algorithm with information gain (IG) for feature selection and reduction to build a network intrusion detection system. For our experimental analysis, we have used the new NSL-KDD dataset, which is a modified dataset for KDDCup 1999 intrusion detection benchmark dataset. With a split of 60.0% for the training set and the remainder for the testing set, a 2 class classifications have been implemented (Normal, Attack). Weka framework which is a java based open source software consists of a collection of machine learning algorithms for data mining tasks has been used in the testing process. The experimental results show that the proposed approach is very accurate with low false positive rate and high true positive rate and it takes less learning time in comparison with using the full features of the dataset with the same algorithm.

Keywords: information gain (IG), intrusion detection system (IDS), k-means clustering, Weka

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1328 Single Atom Manipulation with 4 Scanning Tunneling Microscope Technique

Authors: Jianshu Yang, Delphine Sordes, Marek Kolmer, Christian Joachim

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Nanoelectronics, for example the calculating circuits integrating at molecule scale logic gates, atomic scale circuits, has been constructed and investigated recently. A major challenge is their functional properties characterization because of the connecting problem from atomic scale to micrometer scale. New experimental instruments and new processes have been proposed therefore. To satisfy a precisely measurement at atomic scale and then connecting micrometer scale electrical integration controller, the technique improvement is kept on going. Our new machine, a low temperature high vacuum four scanning tunneling microscope, as a customer required instrument constructed by Omicron GmbH, is expected to be scaling down to atomic scale characterization. Here, we will present our first testified results about the performance of this new instrument. The sample we selected is Au(111) surface. The measurements have been taken at 4.2 K. The atomic resolution surface structure was observed with each of four scanners with noise level better than 3 pm. With a tip-sample distance calibration by I-z spectra, the sample conductance has been derived from its atomic locally I-V spectra. Furthermore, the surface conductance measurement has been performed using two methods, (1) by landing two STM tips on the surface with sample floating; and (2) by sample floating and one of the landed tips turned to be grounding. In addition, single atom manipulation has been achieved with a modified tip design, which is comparable to a conventional LT-STM.

Keywords: low temperature ultra-high vacuum four scanning tunneling microscope, nanoelectronics, point contact, single atom manipulation, tunneling resistance

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