Search results for: Sadie Khorramnia

Authors: Sadie Khorramnia, Asha Bonney, Kate Galloway, Andrew Kyoong

Abstract:

Sleep plays a pivotal role in the registration and consolidation of memory. Multiple observational studies have demonstrated that self-reported sleep duration and sleep quality are associated with cognitive performance. Montreal Cognitive Assessment questionnaire is a screening tool to assess mild cognitive (MCI) impairment with a 90% diagnostic sensitivity. In our current study, we used MOCA to identify MCI in patients who underwent sleep study in our sleep department. We then looked at the clinical risk factors and sleep-related parameters in subjects found to have mild cognitive impairment but without a diagnosis of sleep-disordered breathing. Clinical risk factors, including physician, diagnosed hypertension, diabetes, and depression and sleep-related parameters, measured during sleep study, including percentage time of each sleep stage, total sleep time, awakenings, sleep efficiency, apnoea hypopnoea index, and oxygen saturation, were evaluated. A total of 90 subjects who underwent sleep study between March 2019 and October 2019 were included. Currently, there is no pharmacotherapy available for MCI; therefore, identifying the risk factors and attempting to reverse or mitigate their effect is pivotal in slowing down the rate of cognitive deterioration. Further characterization of sleep parameters in this group of patients could open up opportunities for potentially beneficial interventions.

Keywords: apnoea hypopnea index, mild cognitive impairment, sleep architecture, sleep study

Procedia PDF Downloads 116

Authors: Ehsan Sadie

Abstract:

Today, the cost of repair and maintenance of structures is very important and by studying the behavior of reinforced concrete structures Will become specified several factors such as : Design and calculation errors, lack of proper implementation of structural changes, the damage caused by the introduction of random loads, concrete corrosion and environmental conditions reduce durability of the structures . Meanwhile building codes alteration also cause changes in the assessment and review of the design and structure rather if necessary will be improved and strengthened in the future.

Keywords: concrete building , expandable cement, honeycombed surface , reinforcement corrosion

Procedia PDF Downloads 401

Authors: Ehsan Sadie

Abstract:

Despite the experience of heavy losses and damages of recent earthquakes such as 8 km E of Pāhala, Hawaii, 11 km W of Salvaleón de Higüey, Dominican Republic and 49 km SSE of Punta Cana, Dominican Republic earthquakes, the possibility of large earthquakes in most populated areas of any country and the serious need for quality control in the design and implementation of buildings, not enough attention has been paid to the proper construction. Steel structures constitute a significant part of construction in any metropolitan area. This article gives a brief overview of the implementation status of these buildings in urban areas and considers the weaknesses of performance that typically occur due to negligence or insufficient mastery of the building supervisor in the principles of operation of earthquake-resistant buildings, and provide appropriate and possible solutions to improve the construction.

Keywords: bracing member, concentrated load, diaphragm system, earthquake engineering, load-bearing system, shear force, seismic retrofitting, steel building, strip foundation, supervising engineer, vulnerability of building

Procedia PDF Downloads 115

Authors: Ehsan Sadie

Abstract:

Developments in the field of damping technology and advances in the area of dampers in equipping many structures have been the result of efforts and testing by researchers in this field. In this paper, a sample of a two-story building is simulated with the help of SAP2000 software, and the effect of a viscous damper on the performance of the structure is explained. The effect of dampers on the response of the structure is investigated. This response involves the horizontal displacement of floors. In this case, the structure is modeled once without a damper and again with a damper. In this regard, the results are presented in the form of tables and graphs. Since the seismic behavior of the structure is studied, the responses show the appropriate effect of viscous dampers in reducing the displacement of floors, and also the energy dissipation in the structure with dampers compared to structures without dampers is significant. Therefore, it is economical to use viscous dampers in areas that have a higher relative earthquake risk.

Keywords: bending frame, displacement criterion, dynamic response spectra, earthquake, non-linear history spectrum, SAP2000 software, structural response, viscous damper

Procedia PDF Downloads 86

Authors: Ehsan Sadie

Abstract:

Despite the experience of heavy losses and damages of recent earthquakes such as 8 km E of Pāhala, Hawaii, 11 km W of Salvaleón de Higüey, Dominican Republic and 49 km SSE of Punta Cana, Dominican Republic earthquakes, the possibility of large earthquakes in most populated areas of any country and the serious need for quality control in the design and implementation of buildings, not enough attention has been paid to the proper construction. Steel structures constitute a significant part of construction in any metropolitan area. This article gives a brief overview of the implementation status of these buildings in urban areas and considers the weaknesses of performance that typically occur due to negligence or insufficient mastery of the building supervisor in the principles of operation of earthquake-resistant buildings, and provides appropriate and possible solutions to improve the construction.

Keywords: bracing member, concentrated load, diaphragm system, earthquake engineering, load-bearing system, shear force, seismic retrofitting, steel building, strip foundation, supervising engineer, vulnerability of building

Procedia PDF Downloads 97

Authors: Ehsan Sadie

Abstract:

Today, after devastating earthquakes and many deaths due to the destruction of residential buildings, the scientific community has attracted the attention of the existing structures to strengthen and standardize construction. Due to the fact that the existing buildings are sometimes constructed without sufficient knowledge of the correct design, and even the buildings built according to the old standards today need to be reinforced due to changes in some provisions of the regulations. The location of some countries in the seismic zone has always caused a lot of human and economic damage throughout history, and attention to the strengthening of buildings, important facilities, and vital arteries is the result of this situation. Engineers' efforts to design earthquake-resistant buildings began when decades had passed since the development of design criteria and ensuring the safety of buildings against loads. New methods, mass reduction, reducing the weight of the building, use of moving structures to deal with earthquakes, as well as the use of new technologies in this field, including the use of dampers, composites in the reinforcement of structures are discussed, and appropriate solutions have been provided in each of the fields.

Keywords: brace, concrete structure, damper, earthquake, FRP reinforcement, lightweight material, retrofitting, seismic isolator, shear wall, steel structure

Procedia PDF Downloads 45

Authors: Ehsan Sadie

Abstract:

The use of steel braces in concrete structures has been considered by researchers in recent decades due to its easy implementation, economics and the ability to create skylights in braced openings compared to shear wall openings as well as strengthening weak concrete structures to earthquakes. The purpose of this article is to improve and strengthen concrete structures with steel bracing. In addition, cases such as different numbers of steel braces in different openings of concrete structures and interaction between concrete frames and metal braces have been studied. In this paper, by performing static nonlinear analysis and examining ductility, the relative displacement of floors, examining the performance of samples, and determining the coefficient of behavior of composite frames (concrete frames with metal bracing), the behavior of reinforced concrete frames is compared with frame without bracing. The results of analyzes and studies show that the addition of metal bracing increases the strength and stiffness of the frame and reduces the ductility and lateral displacement of the structure. In general, the behavior of the structure against earthquakes will be improved.

Keywords: behavior coefficient, bracing, concrete structure, convergent bracing, earthquake, linear static analysis, nonlinear analysis, pushover curve

Procedia PDF Downloads 132

Authors: Rory Brown, Jessica Daniels, Babatunde Oremule, William Tsang, Sadie Khwaja

Abstract:

Introduction: Dentures are common and are an intervention for both physical and psychological symptoms associated with tooth loss. However, the humble denture can cause morbidity and mortality if swallowed or aspirated. Numerous case reports document complications including hollow viscus perforation, fistula formation and airway compromise. The purpose of this review was to examine the literature documenting cases of swallowed or aspirated dentures over the past ten years to investigate factors that contribute to developing complications. Methods: A Medline literature search was performed to identify cases of denture ingestion or aspiration for over ten years. Data was collected to include patient, appliance and temporal factors that may contribute to developing complications including hollow viscus perforation, fistula formation, abscess, bowel obstruction, necrosis, hemorrhage and airway obstruction. The data was analyzed using observational and inferential statistics in the form of Chi-Squared and Pearson correlation tests. Results: Eighty-five cases of ingested or aspirated dentures were identified from 77 articles published between 1/10/2009 and 31/10/2019. Fourteen articles were excluded because they did not provide sufficient information on individual cases. Complications were documented in 37.6% of patients, and 2 cases resulted in death. There was no significant difference in complication risk based on patient age, hooked appliance, level of impaction, or radiolucency. However, symptoms of greater than 1-day duration are associated with an increased risk of complication (p=0.005). Increased time from ingestion or aspiration to removal is associated with an increased risk of complications, and the p-value remains significant up to and including day 4 (p=0.017). Conclusions: With denture use predicted to rise complications from the denture, ingestion and aspiration may become more frequent. We have demonstrated that increased symptom duration significantly increases the risk of developing complications. Additionally, we established the risk of developing complications is significantly reduced if the denture is removed with four days of aspiration or ingestion. By actively intervening early when presented with a case of swallowed or aspirated dentures, we may be able to reduce the morbidity associated with this unassuming device.

Keywords: aspiration, denture, ingestion, endoscopic foreign, body removal, foreign body impaction

Procedia PDF Downloads 101

Authors: Sadie Namani, Lindita Ajazaj, Arjeta Zogaj, Vera Berisha, Bahrije Halili, Luljeta Hasani, Ajete Aliu

Abstract:

Background: The outcome of bacterial meningitis is strongly related to the resistance of bacterial pathogens to the initial antimicrobial therapy. The objective of the study was to analyze the initial antimicrobial therapy, the resistance of meningeal pathogens and the outcome of adults bacterial meningitis cases. Materials/methods: This prospective study enrolled 46 adults older than 16 years of age, treated for bacterial meningitis during the years 2009 and 2010 at the infectious diseases clinic in Prishtinë. Patients are categorized into specific age groups: > 16-26 years of age (10 patients), > 26-60 years of age (25 patients) and > 60 years of age (11 patients). All p-values < 0.05 were considered statistically significant. Data were analyzed using Stata 7.1 and SPSS 13. Results: During the two year study period 46 patients (28 males) were treated for bacterial meningitis. 33 patients (72%) had a confirmed bacterial etiology; 13 meningococci, 11 pneumococci, 7 gram-negative bacilli (Ps. aeruginosa 2, Proteus sp. 2, Acinetobacter sp. 2 and Klebsiella sp. 1 case) and 2 staphylococci isolates were found. Neurological complications developed in 17 patients (37%) and the overall mortality rate was 13% (6 deaths). Neurological complications observed were: cerebral abscess (7/46; 15.2%), cerebral edema (4/46; 8.7%); haemiparesis (3/46; 6.5%); recurrent seizures (2/46; 4.3%), and single cases of thrombosis sinus cavernosus, facial nerve palsy and decerebration (1/46; 2.1%). The most common meningeal pathogens were meningococcus in the youngest age group, gram negative-bacilli in second age group and pneumococcus in eldery age group. Initial single-agent antibiotic therapy (ceftriaxone) was used in 17 patients (37%): in 60% of patients in the youngest age group and in 44% of cases in the second age group. 29 patients (63%) were treated with initial dual-agent antibiotic therapy; ceftriaxone in combination with vancomycin or ampicillin. Ceftriaxone and ampicillin were the most commonly used antibiotics for the initial empirical therapy in adults > 50 years of age. All adults > 60 years of age were treated with the initial dual-agent antibiotic therapy as in this age group was recorded the highest mortality rate (M=27%) and adverse outcome (64%). Resistance of pathogens to antimicrobics was recorded in cases caused by gram-negative bacilli and was associated with greater risk for developing neurological complications (p=0.09). None of the gram-negative bacilli were resistant to carbapenems; all were resistant to ampicillin while 5/7 isolates were resistant to cefalosporins. Resistance of meningococci and pneumococci to beta-lactams was not recorded. There were no statistical differences in the occurrence of neurological complications (p > 0.05), resistance of meningeal pathogens to antimicrobics (p > 0.05) and the inital antimicrobial therapy (one vs. two antibiotics) concerning group-ages in adults. Conclusions: The initial antibiotic therapy with ceftriaxone alone or in combination with vancomycin or ampicillin did not cover cases caused by gram-negative bacilli.

Keywords: adults, bacterial meningitis, outcomes, therapy

Procedia PDF Downloads 143

Authors: Rosie Cooper, Tracey Chantler, Ellen Pringle, Sadie Bell, Emily Edmundson, Heidi Nielsen, Sheila Roberts, Michael Edelstein, Sandra Mounier Jack

Abstract:

Introduction: In line with the National Health Service’s (NHS) long-term plan, the NHS is looking to implement more digital health interventions. This study explores a case study in this area: a digital intervention used by NHS Trusts in London to consent adolescents for Human Papilloma Virus (HPV) immunisation. Methods: The electronic consent intervention was implemented in 14 secondary schools in inner city, London. These schools were statistically matched with 14 schools from the same area that were consenting using paper forms. Schools were matched on deprivation and English as an additional language. Consent form return rates and HPV vaccine uptake were compared quantitatively between intervention and matched schools. Data from observations of immunisation sessions and school feedback forms were analysed thematically. Individual and group interviews were undertaken with implementers parents and adolescents and a focus group with adolescents were undertaken and analysed thematically. Results: Twenty-eight schools (14 e-consent schools and 14 paper consent schools) comprising 3219 girls (1733 in paper consent schools and 1486 in e-consent schools) were included in the study. The proportion of pupils eligible for free school meals, with English as an additional language and students' ethnicity profile, was similar between the e-consent and paper consent schools. Return of consent forms was not increased by the implementation of the e-consent intervention. There was no difference in the proportion of pupils that were vaccinated at the scheduled vaccination session between the paper (n=14) and e-consent (n=14) schools (80.6% vs. 81.3%, p=0.93). The transition to using the system was not straightforward, whilst schools and staff understood the potential benefits, they found it difficult to adapt to new ways of working which removed some level or control from schools. Part of the reason for lower consent form return in e-consent schools was that some parents found the intervention difficult to use due to limited access to the internet, finding it hard to open the weblink, language barriers, and in some cases, the system closed a few days prior to sessions. Adolescents also highlighted the potential for e-consent interventions to by-pass their information needs. Discussion: We would advise caution against dismissing the e-consent intervention because it did not achieve its goal of increasing the return of consent forms. Given the problems embedding a news service, it was encouraging that HPV vaccine uptake remained stable. Introducing change requires stakeholders to understand, buy in, and work together with others. Schools and staff understood the potential benefits of using e-consent but found the new ways of working removed some level of control from schools, which they found hard to adapt to, possibly suggesting implementing digital technology will require an embedding process. Conclusion: The future direction of the NHS will require implementation of digital technology. Obtaining electronic consent from parents could help streamline school-based adolescent immunisation programmes. Findings from this study suggest that when implementing new digital technologies, it is important to allow for a period of embedding to enable them to become incorporated in everyday practice.

Keywords: consent, digital, immunisation, prevention

Procedia PDF Downloads 103