Search results for: Major Madhukar
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7204

Search results for: Major Madhukar

7204 talk2all: A Revolutionary Tool for International Medical Tourism

Authors: Madhukar Kasarla, Sumit Fogla, Kiran Panuganti, Gaurav Jain, Abhijit Ramanujam, Astha Jain, Shashank Kraleti, Sharat Musham, Arun Chaudhury

Abstract:

Patients have often chosen to travel for care — making pilgrimages to academic meccas and state-of-the-art hospitals for sophisticated surgery. This culture is still persistent in the landscape of US healthcare, with hundred thousand of visitors coming to the shores of United States to seek the high quality of medical care. One of the major challenges in this form of medical tourism has been the language barrier. Thus, an Iraqi patient, with immediate needs of communicating the healthcare needs to the treating team in the hospital, may face huge barrier in effective patient-doctor communication, delaying care and even at times reducing the quality. To circumvent these challenges, we are proposing the use of a state-of-the-art tool, Talk2All, which can translate nearly one hundred international languages (and even sign language) in real time. The tool is an easy to download app and highly user friendly. It builds on machine learning principles to decode different languages in real time. We suggest that the use of Talk2All will tremendously enhance communication in the hospital setting, effectively breaking the language barrier. We propose that vigorous incorporation of Talk2All shall overcome practical challenges in international medical and surgical tourism.

Keywords: language translation, communication, machine learning, medical tourism

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7203 Endeavor to Develop Immunological and Hematological Early Diagnostic Marker to Check the Conversion of Asymptomatic to Symptomatic Visceral Leishmaniasis

Authors: Roshan Kamal Topno, Maneesh Kumar, Manas Ranjan Dikhit, Krishna Pandey, Major Madhukar, Vidhya Nand Rabidas, Vahab Ali, Ganesh Chandra Sahoo, Bhawana, Devendra Prasad Yadav, Rishikesh Kumar, Pradeep Das

Abstract:

A diagnostic marker for asymptomatic subject becomes a crucial need for advocating early prophylactic majors to control protozoal infection. The main issue in epidemiological affected regions is the presence of an asymptomatic individual that might potentially convert to a symptomatic visceral leishmaniasis (VL). The epidemiological study has been conducted at highly VL endemic Moriyama village in Patna district, Bihar, India that covers total population of 1540 individuals. Here, 1104(74.02%) people had been randomly screened and only 46 (4.17%) asymptomatic individuals were found sero-positive by the rK39 test. After taking signed informed consent form, blood samples were collected from 46 asymptomatic subjects for further hematological and immunological tests. Total leukocyte count, hemoglobin (gm%), neutrophil, lymphocyte, platelet count and interleukin-10 (IL-10) had been included as diagnostic markers. Interestingly only 5 (10.86%) individuals showed their asymptomatic conversion into symptomatic VL patients during quarterly surveillance. In overall analysis only two markers are suggestive for disease conversion that is hemoglobin (gm%) and IL-10. In all the infected patients, both the mean decrease in hemoglobin and mean increase of IL-10 was 19.23% from its normal value. The results might suggest that hematological and immunological changes would become helpful for early diagnosis of asymptomatic to symptomatic VL conversion.

Keywords: asymptomatic, epidemiological, symptomatic visceral leishmaniasis, hemoglobin (gm%), interleukin-10, diagnosis

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7202 Seroprevalence of Herpes Simplex Virus and Rubella Confection in Tropical Regions in Bihar, India

Authors: Bhawana, Roshan Kamal Topno, Maneesh Kumar, Major Madhukar, Krishna Pandey, Ganesh Chandra Sahoo, Manas Ranjan Dikhit, Surya Suman, Devendra Prasad Yadav, Rishikesh Kumar, Pradeep Das

Abstract:

Viral co-infection is now very common across taxa and environments that are involved in congenital infections. Herpes simplex virus (HSV) and Rubella are the two serious viral infections, well categorized in TORCH Syndrome. Here we had endeavoured the seroprevalence of co-infection of HSV and Rubella. Systematic tests have been performed to check the virulence pattern of the co-infection. The study was conducted at Department of Virology, Rajendra Memorial Research Institute of Medical Sciences (ICMR), Patna, Bihar, India during January 2018-July 2018. 299 newly cases were attended with the sign and symptoms of HSV and Rubella. After taking written consent forms from all the subjects, blood samples were collected for serological detection. ELISA was performed to detect the presence of IgM antibody level. 12 patients were found to be IgM positive from each HSV and Rubella infection. The findings of our study showed that 6 patients were positive for both HSV and rubella and hence were co-infected. Such co-infection causes severe health problems as it leads to the mortality rate of the patients during viral infectivity. Epidemiologically, proper screening should be needed to check any chance of occurrence of such co-infection in the affected regions in large scale and take suitable preventive approach to decrease the case totality. Concern has to be given to aid proper diagnosis and treatment in order to decrease the spread of HSV and Rubella co-infection.

Keywords: HSV, Rubella, seroprevalence, co-infection, ELISA, viral infectivity

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7201 Evolutionary Prediction of the Viral RNA-Dependent RNA Polymerase of Chandipura vesiculovirus and Related Viral Species

Authors: Maneesh Kumar, Roshan Kamal Topno, Manas Ranjan Dikhit, Vahab Ali, Ganesh Chandra Sahoo, Bhawana, Major Madhukar, Rishikesh Kumar, Krishna Pandey, Pradeep Das

Abstract:

Chandipura vesiculovirus is an emerging (-) ssRNA viral entity belonging to the genus Vesiculovirus of the family Rhabdoviridae, associated with fatal encephalitis in tropical regions. The multi-functionally active viral RNA-dependent RNA polymerase (vRdRp) that has been incorporated with conserved amino acid residues in the pathogens, assigned to synthesize distinct viral polypeptides. The lack of proofreading ability of the vRdRp produces many mutated variants. Here, we have performed the evolutionary analysis of 20 viral protein sequences of vRdRp of different strains of Chandipura vesiculovirus along with other viral species from genus Vesiculovirus inferred in MEGA6.06, employing the Neighbour-Joining method. The p-distance algorithmic method has been used to calculate the optimum tree which showed the sum of branch length of about 1.436. The percentage of replicate trees in which the associated taxa are clustered together in the bootstrap test (1000 replicates), is shown next to the branches. No mutation was observed in the Indian strains of Chandipura vesiculovirus. In vRdRp, 1230(His) and 1231(Arg) are actively participated in catalysis and, are found conserved in different strains of Chandipura vesiculovirus. Both amino acid residues were also conserved in the other viral species from genus Vesiculovirus. Many isolates exhibited maximum number of mutations in catalytic regions in strains of Chandipura vesiculovirus at position 26(Ser→Ala), 47 (Ser→Ala), 90(Ser→Tyr), 172(Gly→Ile, Val), 172(Ser→Tyr), 387(Asn→Ser), 1301(Thr→Ala), 1330(Ala→Glu), 2015(Phe→Ser) and 2065(Thr→Val) which make them variants under different tropical conditions from where they evolved. The result clarifies the actual concept of RNA evolution using vRdRp to develop as an evolutionary marker. Although, a limited number of vRdRp protein sequence similarities for Chandipura vesiculovirus and other species. This might endow with possibilities to identify the virulence level during viral multiplication in a host.

Keywords: Chandipura, (-) ssRNA, viral RNA-dependent RNA polymerase, neighbour-joining method, p-distance algorithmic, evolutionary marker

Procedia PDF Downloads 154
7200 Analysis of Initial Entry-Level Technology Course Impacts on STEM Major Selection

Authors: Ethan Shafer, Timothy Graziano

Abstract:

This research seeks to answer whether first-year courses at institutions of higher learning can impact STEM major selection. Unlike many universities, an entry-level technology course (often referred to as CS0) is required for all United States Military Academy (USMA) students–regardless of major–in their first year of attendance. Students at the academy choose their major at the end of their first year of studies. Through student responses to a multi-semester survey, this paper identifies a number of factors that potentially influence STEM major selection. Student demographic data, pre-existing exposure and access to technology, perceptions of STEM subjects, and initial desire for a STEM major are captured before and after taking a CS0 course. An analysis of factors that contribute to student perception of STEM and major selection are presented. This work provides recommendations and suggestions for institutions currently providing or looking to provide CS0-like courses to their students.

Keywords: education, STEM, pedagogy, digital literacy

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7199 Simultaneous Production of Forskolin and Rosmarinic Acid in vitro Cultures of Coleus Forskohlii Briq

Authors: Ennus Tajuddin Tamboli, Madhukar Garg, Mohd. Mujeeb, Sayeed Ahmad

Abstract:

An efficient protocol for simultaneous production of forskolin and rosmarinic acid in in vitro callus derived from the leaves of Coleus forskohlii Briq. has been developed. MS media was used for the establishment of cultures and NAA + 6-BA (1.0 ppm) was found best for callus growth. The callus was further subjected to treatment with various elicitor/precursors viz. chitosan, thidiazuron and methyl jasmonate to observe their effect on production of biomass and accumulation of secondary metabolites. The content of forskolin and rosmarinic acid were estimated by HPTLC, in comparison to natural explant which showed 2 fold and 10 fold rise in forskolin and rosmarinic acid content, respectively. Methy1 jasmonate 50 µM was found best for production of forskolin, whereas thidiazuron showed best results in the yield of rosmarinic acid, separately in static culture. However, combined treatment in suspension culture showed moderated effect for increase in secondary metabolites but the biomass increased significantly as compared to static culture.

Keywords: plant tissue culture, secondary metabolites, coleus, forskolin, rosmarinic acid, HPTLC

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7198 Investigating the Influence of L2 Motivational Self-System on Willingness to Communicate in English: A Study of Chinese Non-English Major Students in EFL Classrooms

Authors: Wanghongshu Zhou

Abstract:

This study aims to explore the relationship between the L2MSS and WTC among Chinese non-English major students in order to provide pedagogical implications for English as a Foreign Language (EFL) classrooms in Chinese universities. By employing a mixed methods approach, we involved 103 Chinese non-English major students from a typical university in China, conducted questionnaire survey to measure their levels of L2WTC and L2MSS level, and then analyzed the correlation between the two above mentioned variables. Semi-structured interviews were conducted with eight participants to provide a deeper understanding and explanation of the questionnaire data. Findings show that 1) Chinese non-English major students’ ideal L2 self and L2 learning experience could positively predict their L2 WTC in EFL class; 2) Chinese non-English major students’ ought-to L2 self might have no significant impact on their L2 WTC in EFL class; and 3) self-confidence might be another main factor that will influence Chinese non-English major students’ L2 WTC in EFL class. These findings might shed light on the second language acquisition field and provide pedagogical recommendations for pre-service as well as in-service EFL teachers.

Keywords: L2 willingness to communicate, L2 motivation, self-confidence, Chinese non-English major students

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7197 Differential Effect of Technique Majors on Isokinetic Strength in Youth Judoka Athletes

Authors: Chungyu Chen, Yi-Cheng Chen, Po-Hsian Hsu, Hsin-Ying Chen, Yen-Po Hsiao

Abstract:

The purpose of this study was to assess the muscular strength performance of upper and lower extremity in isokinetic system for the youth judo players, and also to compare the strength difference between major techniques. Sixteen male and 20 female judo players (age: 16.7 ± 1.6 years old, training age: 4.5 ± 0.8 years) were served as the volunteers for this study. There were 21 players major hand techniques and 15 players major foot techniques. The Biodex S4 Pro was used to assess the strength performance of extensor and flexor of concentric action under the load condition of 30 degree/sec, 60 degree/sec, and 120 degree/sec for elbow joints and knee joints. The strength parameters were included the maximal torque, the normalized maximal torque, the average power, and the average maximal torque. A t test for independent groups was used to evaluate whether hand major and foot major differ significantly with an alpha level of .05. The result showed the maximal torque of left knee extensor in foot major players (243.5 ± 36.3 Nm) was higher significantly than hand major (210.7 ± 21.0 Nm) under the load of 30 degree/sec (p < .05). There were no differences in upper extremity strength between the hand and foot techniques major in three loads (ps < .05). It indicated that the judo player is required to develop the upper extremity strength overall to secure the execution of major techniques.

Keywords: knee, elbow, power, judo

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7196 Green Synthesis of Nano Liposomes Containing Berberine Chlorideagainst Leishmania major

Authors: Ali Fattahi Bafghi, Abolghasem Siyadatpanah, Farzaneh Mirzaei, Fahimeh Pournasir, Roghayeh Norouzi, Maria De Lourdes Pereira

Abstract:

Leishmaniasis caused by Leishmania major is one of the main infectious diseases that affect populations in developing countries around the world. We assessed the effectiveness of berberine chloride nano-liposome (BcNLs) against L. major promastigotes in vitro. Nano-liposomal berberine chloride was prepared using the thin-film hydration method and characterized based on encapsulation efficiency, size, and zeta potential. Anti-Leishmania effect of different concentrations (0.05-60 µg/ml) of BcNLs as studied in L. major [MRHO/IR/75/ER] at 24, 48, and 72 h using the hemocytometer technique. Berberine chloride was successfully loaded into nano-liposomes with an encapsulation efficiency of 85.54%. The surface charge of nanoparticles is neutral, and the morphology of nano-liposomal berberine chloride is spherical without any agglomeration. Cell viability assay was performed on the HFF cell line to show the biocompatibility of liposome nanoparticles. IC50 of BcNPs at 24, 48, and 72 h against L. major were found to be 7.6, 5.96, and 3.19 µg/ml, respectively. BcNLs showed a significant anti-Leishmania effect and induced a better and more tangible effect on the survival of L. major promastigotes and could be suitable candidates for further investigation. The results showed that the BcNLs agent is effective against L. major promastigotes and may be a promising alternative to current treatments.

Keywords: Leishmania major, berberine chloride, nano-liposomes, cutaneous leishmaniasis

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7195 Major Incident Tier System in the Emergency Department: An Approach

Authors: Catherine Bernard, Paul Ransom

Abstract:

Recent events have prompted emergency planners to re-evaluate their emergency response to major incidents and mass casualties. At the Royal Sussex County Hospital, we have adopted a tiered system comprised of three levels, anticipating an increasing P1, P2 or P3 load. This will aid planning in the golden period between Major Incident ‘Standby,’ and ‘Declared’. Each tier offers step-by-step instructions on appropriate patient movement within and out of the department, as well as suggestions for overflow areas and additional staffing levels. This system can be adapted to individual hospitals and provides concise instructions to be followed in a potentially overwhelming situation.

Keywords: disaster planning, emergency preparedness, major incident planning, mass casualty event

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7194 Genomic Analysis of Whole Genome Sequencing of Leishmania Major

Authors: Fatimazahrae Elbakri, Azeddine Ibrahimi, Meryem Lemrani, Dris Belghyti

Abstract:

Leishmaniasis represents a major public health problem because of the number of cases recorded each year and the wide distribution of the disease. It is a parasitic disease of flagellated protozoa transmitted by the bite of certain species of sandfly, causing a spectrum of clinical pathology in humans ranging from disfiguring skin lesions to fatal visceral leishmaniasis. Cutaneous leishmaniasis due to Leishmania major is a polymorphic disease; in fact, the infection can be asymptomatic, localized, or disseminated. The objective of this work is to determine the genomic diversity that contributes to clinical variability by trying to identify the variation in chromosome number and to extract SNPs and SNPs and InDels; it is based on four sequences (WGS) of Leishmania major available on NCBI in Fastq form, from three countries: Tunisia, Algeria, and Israel, the analysis is set up from a pipeline to facilitate the discovery of genetic diversity, in particular SNP and chromosomal somy.

Keywords: Leshmania major, cutaneous Leishmania, NGS, genomic, somy, variant calling

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7193 Influence of Major Axis on the Aerodynamic Characteristics of Elliptical Section

Authors: K. B. Rajasekarababu, J. Karthik, G. Vinayagamurthy

Abstract:

This paper is intended to explain the influence of major axis on aerodynamic characteristics of elliptical section. Many engineering applications such as off shore structures, bridge piers, civil structures and pipelines can be modelled as a circular cylinder but flow over complex bodies like, submarines, Elliptical wing, fuselage, missiles, and rotor blades, in which the parameters such as axis ratio can influence the flow characteristics of the wake and nature of separation. Influence of Major axis in Flow characteristics of elliptical sections are examined both experimentally and computationally in this study. For this research, four elliptical models with varying major axis [*AR=1, 4, 6, 10] are analysed. Experimental works have been conducted in a subsonic wind tunnel. Furthermore, flow characteristics on elliptical model are predicted from k-ε turbulence model using the commercial CFD packages by pressure based transient solver with Standard wall conditions.The analysis can be extended to estimation and comparison of Drag coefficient and Fatigue analysis of elliptical sections.

Keywords: elliptical section, major axis, aerodynamic characteristics, k-ε turbulence model

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7192 Effects of Major and Minor Modes to Emotional Perceptions of 'Happy' and 'Sad' in Piano Music among Students Aged 9-17

Authors: Nurezlin Mohd Azib, Pan Kok Chang

Abstract:

This quantitative study investigates the effects of major and minor modes, and contributing musical parameter of tempo, to the emotional perceptions of ‘happy’ and ‘sad’ in piano music among subjects aged 9-17 years old. The study was conducted in two phases; survey-questionnaire, and listening activity. Subjects (N=31) were sampled from piano music students’ population in Bangi, Selangor. In the survey-questionnaire, subjects answered 20 questions on demographic characteristics, music listening and preference, and understanding of emotional perception in music. In the listening activity, subjects listened to 20 untitled piano music excerpts and rated the emotion perceived for each excerpt, whether ‘happy’ or ‘sad’. Results from survey-questionnaire show that most percentage of subjects are 11 years old, in Grade 1, of 3 years of learning piano, prefer classical music, always listen to music, prefer both major and minor modes’ music, and find it easy to understand emotion in music, as well as major and minor modes. Results from listening activity show that 60 % of major mode music are perceived as ‘major-happy’, while 60 % too, of minor mode music are perceived as ‘minor-sad’. However, Chi-square test of independence statistical analysis indicates that there are no association and significant relationship between modes (major and minor) and ‘happy’, as well as ‘sad’ perceptions (x2 (1, N = 20) = 0.80, p = 0.371), at the significance level of p ≤ 0.05. Contrastingly, there are association and significant relationship between tempo (fast and slow), and ‘happy’, as well as ‘sad’ perceptions (x2 (1, N = 20) = 9.899, p = 0.005). Therefore, it is concluded that tempo plays an important role in effects of major and minor mode to ‘happy’ and ‘sad’ emotional perceptions in piano music among subjects aged 9 to 17 in this study.

Keywords: effects, emotional perceptions, major and minor modes, piano music

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7191 Appropriate Depth of Needle Insertion during Rhomboid Major Trigger Point Block

Authors: Seongho Jang

Abstract:

Objective: To investigate an appropriate depth of needle insertion during trigger point injection into the rhomboid major muscle. Methods: Sixty-two patients who visited our department with shoulder or upper back pain participated in this study. The distance between the skin and the rhomboid major muscle (SM) and the distance between the skin and rib (SB) were measured using ultrasonography. The subjects were divided into 3 groups according to BMI: BMI less than 23 kg/m2 (underweight or normal group); 23 kg/m2 or more to less than 25 kg/m2 (overweight group); and 25 kg/m2 or more (obese group). The mean ±standard deviation (SD) of SM and SB of each group were calculated. A range between mean+1 SD of SM and the mean-1 SD of SB was defined as a safe margin. Results: The underweight or normal group’s SM, SB, and the safe margin were 1.2±0.2, 2.1±0.4, and 1.4 to 1.7 cm, respectively. The overweight group’s SM and SB were 1.4±0.2 and 2.4±0.9 cm, respectively. The safe margin could not be calculated for this group. The obese group’s SM, SB, and the safe margin were 1.8±0.3, 2.7±0.5, and 2.1 to 2.2 cm, respectively. Conclusion: This study will help us to set the standard depth of safe needle insertion into the rhomboid major muscle in an effective manner without causing any complications.

Keywords: pneumothorax, rhomboid major muscle, trigger point injection, ultrasound

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7190 Organization of the Olfactory System and the Mushroom Body of the Weaver Ant, Oecophylla smaragdina

Authors: Rajashekhar K. Patil, Martin J. Babu

Abstract:

Weaver ants-Oecophylla smaragdina live in colonies that have polymorphic castes. The females which include the queen, major and minor workers are haploid. The individuals of castes are dependent on olfactory cues for carrying out caste-specific behaviour. In an effort to understand whether organizational differences exist to support these behavioural differences, we studied the olfactory system at the level of the sensilla on the antennae, olfactory glomeruli and the Kenyon cells in the mushroom bodies (MB). The MB differ in major and minor workers in terms of their size, with the major workers having relatively larger calyces and peduncle. The morphology of different types of Kenyon cells as revealed by Golgi-rapid staining was studied and the major workers had more dendritic arbors than minor workers. This suggests a greater degree of olfactory processing in major workers. Differences in caste-specific arrangement of sensilla, olfactory glomeruli and celluar architecture of MB indicate a developmental programme that forms basis of differential behaviour.

Keywords: ant, oecophylla, caste, mushroom body

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7189 Examining the Level of Career Maturity on Cultural Aspect among Undergraduate Foreign Students in A Public University in Malaysia

Authors: Mustafa Tekke, Nurullah Kurt

Abstract:

This study examined the level of career maturity of undergraduate foreign students in a public university in Malaysia by examining on cultural aspect by using the Career Maturity Inventory. Two hundred and twenty nine (Male = 106, Female = 123) foreign students studying in various majors completed the Career Maturity Inventory and the scores of the foreign students on the CMI suggested that they had slightly higher levels than the mean level of maturity in career. Result was also supported by testing the feeling about major, consideration of changing major and planning after graduation, which indicated that foreign students had their own career decision making. However, this result should be viewed with caution within ethnic difference.

Keywords: career maturity, foreign students, career decision making, feeling about major, knowledge about major

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7188 Time Overrun in Pre-Construction Planning Phase of Construction Projects

Authors: Hafiz Usama Imad, Muhammad Akram Akhund, Tauha Hussain Ali, Ali Raza Khoso, Fida Hussain Siddiqui

Abstract:

Construction industry plays a significant role in fulfilling the major requirements of the human being. It is one of the major constituents of every developed country. Although the construction industry of both the developing and developed countries encompasses a major part of the economy, and millions of rupees are utilized every year on various kinds of construction projects. But, this industry is facing numerous hurdles in terms of its budget and timely completion. Construction projects generally consist of several phases like planning, designing, execution, and finishing. This research study aims to determine the significant factors of time overrun in pre-construction planning (PCP) phase of construction projects in Pakistan. Questionnaires were distributed by various means and responses of respondents were compiled and collected data were then analyzed through a statistical technique using SPSS version 24. Major causes of time overrun in pre-construction planning phase; which is an extremely important phase of construction projects, were revealed. The research conclusion will provide a pathway for stakeholders to pay attention to the mentioned causes to overcome the major issue of time overrun.

Keywords: construction industry, Pakistan, pre-construction planning phase, time overrun

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7187 Vascular Crossed Aphasia in Dextrals: A Study on Bengali-Speaking Population in Eastern India

Authors: Durjoy Lahiri, Vishal Madhukar Sawale, Ashwani Bhat, Souvik Dubey, Gautam Das, Biman Kanti Roy, Suparna Chatterjee, Goutam Gangopadhyay

Abstract:

Crossed aphasia has been an area of considerable interest for cognitive researchers as it offers a fascinating insight into cerebral lateralization for language function. We conducted an observational study in the stroke unit of a tertiary care neurology teaching hospital in eastern India on subjects with crossed aphasia over a period of four years. During the study period, we detected twelve cases of crossed aphasia in strongly right-handed patients, caused by ischemic stroke. The age, gender, vernacular language and educational status of the patients were noted. Aphasia type and severity were assessed using Bengali version of Western Aphasia Battery (validated). Computed tomography, magnetic resonance imaging and angiography were used to evaluate the location and extent of the ischemic lesion in brain. Our series of 12 cases of crossed aphasia included 7 male and 5 female with mean age being 58.6 years. Eight patients were found to have Broca’s aphasia, 3 had trans-cortical motor aphasia and 1 patient suffered from global aphasia. Nine patients were having very severe aphasia and 3 suffered from mild aphasia. Mirror-image type of crossed aphasia was found in 3 patients, whereas 9 had anomalous variety. In our study crossed aphasia was found to be more frequent in males. Anomalous pattern was more common than mirror-image. Majority of the patients had motor-type aphasia and no patient was found to have pure comprehension deficit. We hypothesize that in Bengali-speaking right-handed population, lexical-semantic system of the language network remains loyal to the left hemisphere even if the phonological output system is anomalously located in the right hemisphere.

Keywords: aphasia, crossed, lateralization, language function, vascular

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7186 Self-Inflicted Major Trauma: Inpatient Mental Health Management and Patient Outcomes

Authors: M. Walmsley, S. Elmatarri, S. Mannion

Abstract:

Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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7185 Determining Inventory Replenishment Policy for Major Component in Assembly-to-Order of Cooling System Manufacturing

Authors: Tippawan Nasawan

Abstract:

The objective of this study is to find the replenishment policy in Assembly-to-Order manufacturing (ATO) which some of the major components have lead-time longer than customer lead-time. The variety of products, independent component demand, and long component lead-time are the difficulty that has resulted in the overstock problem. In addition, the ordering cost is trivial when compared to the cost of material of the major component. A conceptual design of the Decision Supporting System (DSS) has introduced to assist the replenishment policy. Component replenishment by using the variable which calls Available to Promise (ATP) for making the decision is one of the keys. The Poisson distribution is adopted to realize demand patterns in order to calculate Safety Stock (SS) at the specified Customer Service Level (CSL). When distribution cannot identify, nonparametric will be applied instead. The test result after comparing the ending inventory between the new policy and the old policy, the overstock has significantly reduced by 46.9 percent or about 469,891.51 US-Dollars for the cost of the major component (material cost only). Besides, the number of the major component inventory is also reduced by about 41 percent which helps to mitigate the chance of damage and keeping stock.

Keywords: Assembly-to-Order, Decision Supporting System, Component replenishment , Poisson distribution

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7184 Ensuring Cyber Security Using Kippo Honeypots

Authors: S. Vivekananda Pandian

Abstract:

A major challenging task in this current scenario is protecting your computer and other electronic gadgets against Cyber-attacks. In this current era Cyber warfare becomes a major threat to the entire world which targets a particular organization or a country spreading the Malwares, Breaching the securities, causing major loss to the organization. Several sectors both public and private are computerized such as Energy sectors, Oil refinery sectors, Defense sectors and Aviation sectors are prone to attacks. Several attacks are unknown while accessing the internet. To study the characteristics and Intention of the Attacker Kippo Honeypots are used. Honeypots are the trap set by us which enables them to monitor the malicious activities and detailed study about attackers which leads to strengthening of the security.

Keywords: attackers, security, Kippo Honeypots, virtual machine

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7183 Comparison of Tourist Shopping Patterns in Korea, 2009-2015: A Case of China and Japan

Authors: Miju Choi, Ava Seo

Abstract:

Japan has been positioned as a major inbound market to Korea, accounting for about 31% of total inbound visitors until 2012. The percentage has sharply dropped each year since and remained in second place, reaching 13.33% in 2016. Meanwhile, China has been boosted as a major inbound market, reaching 46.79% in 2016. Chinese tourists mainly visit Korea with the major purpose of shopping. They consume Korean cosmetic/beauty products and clothes while Japanese tourists prefer to purchase healthy food such as ginseng and seaweed. This study aims to investigate and compare tourist shopping patterns across two major inbound markets, China and Japan. A quantitative approach using survey was applied from 2009 to 2016. Findings suggest Chinese visit Korea due to quality of product, value for money, and accessibility, and trust. Meanwhile, Japanese choose Korea as a shopping destination mainly due to convenience, affordability, and tourist attractions. Also, there were significant differences in shopping venues. For example, Japanese tourists prefer shopping at department stores while Chinese tourists prefer retail outlets and local markets. This study contributes to deeper understanding on two major inbound markets to Korea and suggests future marketing strategies.

Keywords: tourist shopping patterns, Korea, China, Japan, historical data

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7182 Detection of Leishmania Mixed Infection from Phlebotomus papatasi in Central Iran

Authors: Nassibeh Hosseini-Vasoukolaei, Amir Ahmad Akhavan, Mahmood Jeddi-Tehrani, Ali Khamesipour, Mohammad Reza Yaghoobi Ershadi, Kamhawi Shaden, Valenzuela Jesus, Hossein Mirhendi, Mohammad Hossein Arandian

Abstract:

Zoonotic cutaneous leishmaniasis (ZCL) is an endemic disease in many rural areas of Iran. Sand flies were collected from rural areas of Esfahan province and were identified using valid identification keys. DNA was extracted from sand flies and Nested PCRs were done using specific primers. In this study, 44 out of 152 (28.9 %) sand flies were infected with L. majoralone. Eight sand flies showed mixed infection: four sand flies (2.6 %) were infected with L. major, L. turanicaand L. gerbili, one sand fly (0.7 %) was infected with L. major and L. turanica and three sand flies (2 %) were infected with L. turanicaand L. gerbili. Our results demonstrate the natural infection of P. papatasi sand fly with three species of L. major, L. turanica and L. gerbili which are circulating among R. opimusreservoir host and P. papatasi sand fly vector in central Iran.

Keywords: Phlebotomus papatasi, Leishmania major, Leishmania turanica, Leishmania gerbili, mixed infection, Iran

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7181 Trauma System in England: An Overview and Future Directions

Authors: Raheel Shakoor Siddiqui, Sanjay Narayana Murthy, Manikandar Srinivas Cheruvu, Kash Akhtar

Abstract:

Major trauma is a dynamic public health epidemic that is continuously evolving. Major trauma care services rely on multi-disciplinary team input involving highly trained pre and in-hospital critical care teams. Pre-hospital critical care teams (PHCCTs), major trauma centres (MTCs), trauma units, and rehabilitation facilities all form an efficient and organised trauma system. England comprises 27 MTCs funded by the National Health Service (NHS). Major trauma care entails enhanced resuscitation protocols coupled with the expertise of dedicated trauma teams and rapid radiological imaging to improve trauma outcomes. Literature reports a change in the demographic of major trauma as elderly patients (silver trauma) with injuries sustained from a fall of 2 metres or less commonly present to services. Evidence of an increasing population age with multiple comorbidities necessitates treatment within the first hour of injury (golden hour) to improve trauma survival outcomes. Staffing and funding pressures within the NHS have subsequently led to a shortfall of available physician-led PHCCTs. Thus, there is a strong emphasis on targeted research and funding to appropriately deploy resources to deprived areas. This review article will discuss the current English trauma system whilst critically appraising present challenges, identifying insufficiencies, and recommending aims for an improved future trauma system in England.

Keywords: trauma, orthopaedics, major trauma, trauma system, trauma network

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7180 Prevalence of Cognitive Decline in Major Depressive Illness

Authors: U. B. Zubair, A. Kiyani

Abstract:

Introduction: Depressive illness predispose individuals to a lot of physical and mental health issues. Anxiety and substance use disorders have been studied widely as comorbidity. Biological symptoms also now considered part of the depressive spectrum. Cognitive abilities also decline or get affected and need to be looked into in detail in depressed patients. Objective: To determine the prevalence of cognitive decline among patients with major depressive illness and analyze the associated socio-demographic factors. Methods: 190 patients of major depressive illness were included in our study to determine the presence of cognitive decline among them. Depression was diagnosed by a consultant psychiatrist by using the ICD-10 criteria for major depressive disorder. British Columbia Cognitive Complaints Inventory (BC-CCI) was the psychometric tool used to determine the cognitive decline. Sociodemographic profile was recorded and the relationship of various factors with cognitive decline was also ascertained. Findings: 70% of the patients suffering from depression included in this study showed the presence of some degree of cognitive decline, while 30% did not show any evidence of cognitive decline when screened through BCCCI. Statistical testing revealed that the female gender was the only socio-demographic parameter linked significantly with the presence of cognitive decline. Conclusion: Decline in cognitive abilities was found in a significant number of patients suffering from major depression in our sample population. Screening for this parameter f mental function should be done in depression clinics to pick it early.

Keywords: depression, cognitive decline, prevalence, socio-demographic factors

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7179 Strain Softening of Soil under Cyclic Loading

Authors: Kobid Panthi, Suttisak Soralump, Suriyon Prempramote

Abstract:

In June 27, 2014 slope movement was observed in upstream side of Khlong Pa Bon Dam, Thailand. The slide did not have any major catastrophic impact on the dam structure but raised a very important question; why did the slide occur after 10 years of operation? Various site investigations (Bore Hole Test, SASW, Echo Sounding, and Geophysical Survey), laboratory analysis and numerical modelling using SIGMA/W and SLOPE/W were conducted to determine the cause of slope movement. It was observed that the dam had undergone the greatest differential drawdown in its operational history in the year 2014 and was termed as the major cause of movement. From the laboratory tests, it was found that the shear strength of clay had decreased with a period of time and was near its residual value. The cyclic movement of water, i.e., reservoir filling and emptying was coined out to be the major cause for the reduction of shear strength. The numerical analysis was carried out using a modified cam clay (MCC) model to determine the strain softening behavior of the clay. The strain accumulation was observed in the slope with each reservoir cycle triggering the slope failure in 2014. It can be inferred that if there was no major drawdown in 2014, the slope would not have failed but eventually would have failed after a long period of time. If there was no major drawdown in 2014, the slope would not have failed. However, even if there hadn’t been a drawdown, it would have failed eventually in the long run.

Keywords: slope movement, strain softening, residual strength, modified cam clay

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7178 Erythema Multiforme Exudativum Major Caused by Isoniazid Hypersensitivity in a Child

Authors: Azwin Lubis, Rika Hapsari, Zahrah Hikmah, Anang Endaryanto, Ariyanto Harsono

Abstract:

Erythema Multiforme Exudativum Major (EMEM) is one of the drug allergy diseases. Drug allergies caused by isoniazid rarely causes EMEM. Cutaneous reactions caused by isoniazid were obtained in 0.98% of patients, but the precise occurrence of Steven Johnson’s Syndrome (SJS) and Toxic Epidermolisis Necrolisis (TEN) due to isoniazid is not known for certain. We present this case to show hypersensitivity of isoniazid in a child. Based on the history of drug intake, physical diagnostic tests, drug elimination and provocation; we established the diagnosis of isoniazid hypersensitivity. The child showed improvement on skin manifestation after stopped isoniazid therapy.

Keywords: erythema multiforme exudativum major, hypersensitivity, elimination test, provocation test

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7177 To Determine the Effects of Regulatory Food Safety Inspections on the Grades of Different Categories of Retail Food Establishments across the Dubai Region

Authors: Shugufta Mohammad Zubair

Abstract:

This study explores the Effect of the new food System Inspection system also called the new inspection color card scheme on reduction of critical & major food safety violations in Dubai. Data was collected from all retail food service establishments located in two zones in the city. Each establishment was visited twice, once before the launch of the new system and one after the launch of the system. In each visit, the Inspection checklist was used as the evaluation tool for observation of the critical and major violations. The old format of the inspection checklist was concerned with scores based on the violations; but the new format of the checklist for the new inspection color card scheme is divided into administrative, general major and critical which gives a better classification for the inspectors to identify the critical and major violations of concerned. The study found that there has been a better and clear marking of violations after the launch of new inspection system wherein the inspectors are able to mark and categories the violations effectively. There had been a 10% decrease in the number of food establishment that was previously given A grade. The B & C grading were also considerably dropped by 5%.

Keywords: food inspection, risk assessment, color card scheme, violations

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7176 Love Is Color-Blind: Perceptions among Sunway University Students toward Interracial Relationship

Authors: Azman Ramlie, Vivian Foo Jing Wen

Abstract:

As the advancement of technology has tremendously changed the way people communicate with each other, it has opened up opportunities for interracial relationships. Interracial relationship is also known as intercultural or interethnic relationships. This research topic aims to study on students’ perceptions toward interracial relationship in terms of their level of acceptance and approval. In addition, the study also focuses on determining and ranking the factors that affects students’ perceptions towards interracial relationship. This study also targets to determine the differences in students’ perceptions from business and communication major. This study uses a sample of university students from Sunway University, particularly on students in business and communication major. The study was conducted through online survey questionnaires. Results revealed that students’ level of acceptance towards interracial relationship was high. In addition, results also further indicated that family members’ support was one of the most important factors in influencing students’ perception towards interracial relationship. No diverse differences of perceptions among students in business and communication major towards interracial relationship were shown in the findings. Most of the result showed that both majors turned out to have similar perceptions towards interracial relationship. It can be said that the students’ perception towards interracial relationship did not differ from which major the students was in but their family background that would shape their perceptions.

Keywords: interracial relationship, racial, relationship, perceptions

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7175 Acupuncture for Major Depressive Disorders: A Systematic Review of the Randomized Clinical Trials

Authors: Derick Shi-Chen Ou, Liang-Yu Chen

Abstract:

Background: Acupuncture, a potential alternative, and complementary therapy revealed insufficient evidence in depression treatment. The efficacy of acupuncture treatment was still uncertainty. To evaluate the effect of acupuncture in treating depression, the randomized controlled trials (RCTs) were examined. Methods: RCTs of the acupuncture therapy in treating major depression were searched from MEDLINE from 2007 to 2017. Keywords used for searching strategy included acupuncture, acupoint, and major depressive disorder. Results: Among the nine RCTs, four studies demonstrated great improvement in acupuncture treatment and five studies revealed the effectiveness of acupuncture intervention in medication. General trends suggest that acupuncture treatment is as effective as antidepressants with minimal side effects. Conclusion: Despite the promising results from the RCTs, there are still a variety of limitations, including small sample size, imprecise enrollment criteria, difficulties with blinding, randomization, short duration of study and lack of longitudinal follow-up. Therefore, the evidence that acupuncture as an alternative therapy for depression is inconclusive. More rigorously designed RCTs should be conducted in the future.

Keywords: acupuncture, major depressive disorders, randomized clinical trials, antidepressants

Procedia PDF Downloads 209