Search results for: birth interval
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1469

Search results for: birth interval

1199 Estimation of a Finite Population Mean under Random Non Response Using Improved Nadaraya and Watson Kernel Weights

Authors: Nelson Bii, Christopher Ouma, John Odhiambo

Abstract:

Non-response is a potential source of errors in sample surveys. It introduces bias and large variance in the estimation of finite population parameters. Regression models have been recognized as one of the techniques of reducing bias and variance due to random non-response using auxiliary data. In this study, it is assumed that random non-response occurs in the survey variable in the second stage of cluster sampling, assuming full auxiliary information is available throughout. Auxiliary information is used at the estimation stage via a regression model to address the problem of random non-response. In particular, the auxiliary information is used via an improved Nadaraya-Watson kernel regression technique to compensate for random non-response. The asymptotic bias and mean squared error of the estimator proposed are derived. Besides, a simulation study conducted indicates that the proposed estimator has smaller values of the bias and smaller mean squared error values compared to existing estimators of finite population mean. The proposed estimator is also shown to have tighter confidence interval lengths at a 95% coverage rate. The results obtained in this study are useful, for instance, in choosing efficient estimators of the finite population mean in demographic sample surveys.

Keywords: mean squared error, random non-response, two-stage cluster sampling, confidence interval lengths

Procedia PDF Downloads 107
1198 Control of Biofilm Formation and Inorganic Particle Accumulation on Reverse Osmosis Membrane by Hypochlorite Washing

Authors: Masaki Ohno, Cervinia Manalo, Tetsuji Okuda, Satoshi Nakai, Wataru Nishijima

Abstract:

Reverse osmosis (RO) membranes have been widely used for desalination to purify water for drinking and other purposes. Although at present most RO membranes have no resistance to chlorine, chlorine-resistant membranes are being developed. Therefore, direct chlorine treatment or chlorine washing will be an option in preventing biofouling on chlorine-resistant membranes. Furthermore, if particle accumulation control is possible by using chlorine washing, expensive pretreatment for particle removal can be removed or simplified. The objective of this study was to determine the effective hypochlorite washing condition required for controlling biofilm formation and inorganic particle accumulation on RO membrane in a continuous flow channel with RO membrane and spacer. In this study, direct chlorine washing was done by soaking fouled RO membranes in hypochlorite solution and fluorescence intensity was used to quantify biofilm on the membrane surface. After 48 h of soaking the membranes in high fouling potential waters, the fluorescence intensity decreased to 0 from 470 using the following washing conditions: 10 mg/L chlorine concentration, 2 times/d washing interval, and 30 min washing time. The chlorine concentration required to control biofilm formation decreased as the chlorine concentration (0.5–10 mg/L), the washing interval (1–4 times/d), or the washing time (1–30 min) increased. For the sample solutions used in the study, 10 mg/L chlorine concentration with 2 times/d interval, and 5 min washing time was required for biofilm control. The optimum chlorine washing conditions obtained from soaking experiments proved to be applicable also in controlling biofilm formation in continuous flow experiments. Moreover, chlorine washing employed in controlling biofilm with suspended particles resulted in lower amounts of organic (0.03 mg/cm2) and inorganic (0.14 mg/cm2) deposits on the membrane than that for sample water without chlorine washing (0.14 mg/cm2 and 0.33 mg/cm2, respectively). The amount of biofilm formed was 79% controlled by continuous washing with 10 mg/L of free chlorine concentration, and the inorganic accumulation amount decreased by 58% to levels similar to that of pure water with kaolin (0.17 mg/cm2) as feed water. These results confirmed the acceleration of particle accumulation due to biofilm formation, and that the inhibition of biofilm growth can almost completely reduce further particle accumulation. In addition, effective hypochlorite washing condition which can control both biofilm formation and particle accumulation could be achieved.

Keywords: reverse osmosis, washing condition optimization, hypochlorous acid, biofouling control

Procedia PDF Downloads 315
1197 The Mask of Motherhood a Changing Identity During the Transition to Motherhood

Authors: Geraldine Mc Loughlin, Mary Horgan, Rosaleen Murphy

Abstract:

Childbirth is a life-changing event, a psychological transition for the mother that must be viewed in a social context. Much has been written and documented regarding the preparation for birth and the immediate postnatal period, but the full psychological impact on the mother is not clear. One aspect of the transition process is Identity. Depending on a person’s worldview, the concept of identity is viewed differently; the nature of reality and how they construct knowledge influence these perspectives. Becoming a mother is not just an event but a process that time and experience will help to shape the understanding of the woman. To explore the emotional and psychological aspects of first-time mother’s experience during the transition to new motherhood. To identify factors affecting women’s identities in the period of 36 weeks gestation to 12 weeks postpartum. Interpretative Phenomenological Analysis (IPA) was used. It explores how these women make sense of and give meaning to their experiences. IPA is underpinned by 3 key principles: phenomenology, hermeneutics and idiographics. A purposeful sample of 10 women was recruited for this longitudinal study, to enable data to be collected during the transition to motherhood. Individual identity was interpreted and viewed as developing in response to changing contexts, such as the birth event becoming a parent, enabling one to construct one’s own sense of a meaningful life. Women effectively differentiated themselves from their personal and social identities and took responsibility for their actions. Identity is culturally and socially shaped and experienced, though not experienced similarly by all women. The individualized perspective on identity recognizes that (a) social influences are seen as external to the individual and (b) the view that social influences are, in fact, internalized by the individual.

Keywords: motherhood, transition, identity, IPA

Procedia PDF Downloads 29
1196 Inequality of Opportunities in the Health of the Adult Population of Russia

Authors: Marina Kartseva, Polina Kuznetsova

Abstract:

In our work, we estimate the contribution of inequality of opportunity to inequality in the health of the Russian population aged 25 to 74 years. The empirical basis of the study is the nationally representative data of the RLMS for 2018. Individual health is measured using a self-reported status on five-point scale. The startconditions are characterized by parental education and place of birth (country, type of settlement). Personal efforts to maintain health include the level of education, smoking status, and physical activity. To understand how start opportunities affect an individual's health, we use the methodology proposed in (Trannoy et al., 2010), which takes into account both direct and indirect (through the influence on efforts) effects. Regression analysis shows that all other things being equal, the starting capabilities of individuals have a significant impact on their health. In particular, parental education has a positive effect on self-reported health. Birth in another country, in another settlement, and in an urban area, on the contrary, reduceself-reported health. This allows to conclude that there exists an unfair inequality in health, namely inequality caused by factors that are independent of a person's own efforts. We estimate the contribution of inequality of opportunity to inequality in health using a nonparametric approach (Checchi, Peragine, 2010; Lazar, 2013). According to the obtained results, the contribution of unfair inequality as 72-74% for the population as a whole, being slightly higher for women (62-74% and 60-69% for men and women, respectively) and for older age (59- 62% and 67-75% for groups 25-44 years old and 45-74 years old, respectively). The obtained estimates are comparable with the results for other countries and indicate the importance of the problem of inequality of opportunities in health in Russia.

Keywords: inequality of opportunity, inequality in health, self-reported health, efforts, health-related lifestyle, Russia, RLMS

Procedia PDF Downloads 148
1195 A Review of Paleo-Depositional Environment and Thermal Alteration Index of Carboniferous, Permian, and Triassic of A1-9 Well, NW Libya

Authors: M. A. Alrabib, Y. Sherif, A. K. Mohamed, E. A. Elfandi, E. I. Fandi

Abstract:

This paper introduces a paleo-environmental and hydrocarbon show in this well was identified in the interval of Dembaba formation to the Hassaona Formation was poor to very poor oil show. And from palaeo-environmental analysis there is neither particularly good reservoir nor source rock have been developed in the area. Recent palaeo-environment work undertakes that the sedimentary succession in this area comprises the Upper Paleozoic rock of the Carboniferous and Permian and the Mesozoic (Triassic) sedimentary sequences. No early Paleozoic rocks have been found in this area, these rocks were eroding during the Late Carboniferous and Early Permian time. During Latest Permian and earliest Triassic time evidence for major marine transgression has occurred. From depths 5930-5940 feet, to 10800-10810 feet, the TAI of the Al Guidr, the Bir Al Jaja Al Uotia, Hebilia and the top varies between 3+ to 4-(mature-dry gas). This interval corporate the rest part of the Dembaba Formation. From depth 10800- 10810 feet, until total sediment depth (11944 feet Log) which corporate the rest of the Dembaba and underlying equivalents of the Assedjefar and M Rar Formations and the underlying Indeterminate unit (Hassouna Formation) the TAI varies between 4 and 5 (dry gas-black and deformed).

Keywords: paleoenvironmental, thermal alteration index, north western Libya, hydrocarbon

Procedia PDF Downloads 443
1194 Aquatic Therapy Improving Balance Function of Individuals with Stroke: A Systematic Review with Meta-Analysis

Authors: Wei-Po Wu, Wen-Yu Liu, Wei−Ting Lin, Hen-Yu Lien

Abstract:

Introduction: Improving balance function for individuals after stroke is a crucial target in physiotherapy. Aquatic therapy which challenges individual’s postural control in an unstable fluid environment may be beneficial in enhancing balance functions. The purposes of the systematic review with meta-analyses were to validate the effects of aquatic therapy in improving balance functions for individuals with strokes in contrast to conventional physiotherapy. Method: Available studies were explored from three electronic databases: PubMed, Scopus, and Web of Science. During literature search, the published date of studies was not limited. The study design of the included studies should be randomized controlled trials (RCTs) and the studies should contain at least one outcome measurement of balance function. The PEDro scale was adopted to assess the quality of included studies, while the 'Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence' was used to evaluate the level of evidence. After the data extraction, studies with same outcome measures were pooled together for meta-analysis. Result: Ten studies with 282 participants were included in analyses. The research qualities of the studies were ranged from fair to good (4 to 8 points). Levels of evidence of the included studies were graded as level 2 and 3. Finally, scores of Berg Balance Scale (BBS), Eye closed force plate center of pressure velocity (anterior-posterior, medial-lateral axis) and Timed up and Go test were pooled and analyzed separately. The pooled results shown improvement in balance function (BBS mean difference (MD): 1.39 points; 95% confidence interval (CI): 0.05-2.29; p=0.002) (Eye closed force plate center of pressure velocity (anterior-posterior axis) MD: 1.39 mm/s; 95% confidence interval (CI): 0.93-1.86; p<0.001) (Eye closed force plate center of pressure velocity (medial-lateral) MD: 1.48 mm/s; 95% confidence interval (CI): 0.15-2.82; p=0.03) and mobility (MD: 0.9 seconds; 95% CI: 0.07-1.73; p=0.03) of stroke individuals after aquatic therapy compared to conventional therapy. Although there were significant differences between two treatment groups, the differences in improvement were relatively small. Conclusion: The aquatic therapy improved general balance function and mobility in the individuals with stroke better than conventional physiotherapy.

Keywords: aquatic therapy, balance function, meta-analysis, stroke, systematic review

Procedia PDF Downloads 165
1193 Maternal Health Care Mirage: A Study of Maternal Health Care Utilization for Young Married Muslim Women in India

Authors: Saradiya Mukherjee

Abstract:

Background: Indian Muslims, compared to their counterparts in other religions, generally do not fare well on many yardsticks related to socio-economic progress and the same is true with maternal health care utilization. Due to low age at marriage a major percentage of child birth is ascribed to young (15-24 years) Muslim mothers in, which pose serious concerns on the maternal health care of Young Married Muslim women (YMMW). A thorough search of past literature on Muslim women’s health and health care reveals that studies in India have mainly focused on religious differences in fertility levels and contraceptive use while the research on the determinants of maternal health care utilization among Muslim women are lacking in India. Data and Methods: Retrieving data from the National Family Health Survey -3 (2005-06) this study attempts to assess the level of utilization and factors effecting three key maternal health indicators (full ANC, safe delivery and PNC) among YMMW (15-24 years) in India. The key socio-economic and demographic variables taken as independent or predictor variables in the study was guided by existing literature particularly for India. Bi-variate analysis and chi square test was applied and variables which were found to be significant were further included in binary logistic regression. Results: The findings of the study reveal abysmally low levels of utilization for all three indicators i.e. full ANC, safe delivery and PNC of maternal health care included in the study. Mother’s education, mass media exposure, women’s autonomy, birth order, economic status wanted status of child and region of residence were found to be significant variables effecting maternal health care utilization among YMMW. Multivariate analysis reveals that no mass media exposure, lower autonomy, education, poor economic background, higher birth order and unintended pregnancy are some of the reasons behind low maternal health care utilization. Conclusion: Considering the low level of safe maternal health care utilization and its proximate determinants among YMMW the study suggests educating Muslim girls, promoting family planning use, involving media and collaboration between religious leader and health care system could be some important policy level interventions to address the unmet need of maternity services among YMMW.

Keywords: young Muslim women, religion, socio-economic condition, antenatal care, delivery, post natal care

Procedia PDF Downloads 306
1192 Factors Affecting Adequate Utilisation of Ante-natal Health Care Services among Pregnant Women in Dutsin-Ma Local Government Area of Katsina State

Authors: Ilim Moses Msughter

Abstract:

The study was carried out to examine the availability of Ante-natal care services and the socio-cultural factors affecting the utilization of these services in Dutsin-Ma Local Government Area of Katsina State. Four specific objectives were outlined as thus to examine the availability of antenatal care services in Dutsin-Ma local government area, to identify the socio-cultural factors affecting the utilisation of ante-natal care services, to ascertain the challenges affecting utilisation of ante-natal care services and suggest strategies to improve efficiency in ante-natal service delivery and utilisation of same services. Data were collected from 110 respondents using a questionnaire and through the use of the interview. Data were analysed quantitatively and qualitatively. The findings revealed that ante-natal care services are available in the study area, but access to such services is hindered by several factors, which include religious and traditional beliefs, cost of services and poor attitudes of health care workers which has an adverse effect on people’s desire to visit ante-natal centres. The study recommended that Traditional Birth Attendants (TBA) need to be trained on how to handle pregnancy-related complications. It is also recommended that essential ante-natal drugs and services should be subsidised or made free by the government, and this must be closely monitored to ensure efficiency. Finally, human relation training should be organised for nurses and midwives to improve their attitudes towards patients during ante-natal visits.

Keywords: utilisation, religion, traditional birth attendant, ante-natal

Procedia PDF Downloads 137
1191 A Comparative Study of Sampling-Based Uncertainty Propagation with First Order Error Analysis and Percentile-Based Optimization

Authors: M. Gulam Kibria, Shourav Ahmed, Kais Zaman

Abstract:

In system analysis, the information on the uncertain input variables cause uncertainty in the system responses. Different probabilistic approaches for uncertainty representation and propagation in such cases exist in the literature. Different uncertainty representation approaches result in different outputs. Some of the approaches might result in a better estimation of system response than the other approaches. The NASA Langley Multidisciplinary Uncertainty Quantification Challenge (MUQC) has posed challenges about uncertainty quantification. Subproblem A, the uncertainty characterization subproblem, of the challenge posed is addressed in this study. In this subproblem, the challenge is to gather knowledge about unknown model inputs which have inherent aleatory and epistemic uncertainties in them with responses (output) of the given computational model. We use two different methodologies to approach the problem. In the first methodology we use sampling-based uncertainty propagation with first order error analysis. In the other approach we place emphasis on the use of Percentile-Based Optimization (PBO). The NASA Langley MUQC’s subproblem A is developed in such a way that both aleatory and epistemic uncertainties need to be managed. The challenge problem classifies each uncertain parameter as belonging to one the following three types: (i) An aleatory uncertainty modeled as a random variable. It has a fixed functional form and known coefficients. This uncertainty cannot be reduced. (ii) An epistemic uncertainty modeled as a fixed but poorly known physical quantity that lies within a given interval. This uncertainty is reducible. (iii) A parameter might be aleatory but sufficient data might not be available to adequately model it as a single random variable. For example, the parameters of a normal variable, e.g., the mean and standard deviation, might not be precisely known but could be assumed to lie within some intervals. It results in a distributional p-box having the physical parameter with an aleatory uncertainty, but the parameters prescribing its mathematical model are subjected to epistemic uncertainties. Each of the parameters of the random variable is an unknown element of a known interval. This uncertainty is reducible. From the study, it is observed that due to practical limitations or computational expense, the sampling is not exhaustive in sampling-based methodology. That is why the sampling-based methodology has high probability of underestimating the output bounds. Therefore, an optimization-based strategy to convert uncertainty described by interval data into a probabilistic framework is necessary. This is achieved in this study by using PBO.

Keywords: aleatory uncertainty, epistemic uncertainty, first order error analysis, uncertainty quantification, percentile-based optimization

Procedia PDF Downloads 207
1190 Clinical Impact of Delirium and Antipsychotic Therapy: 10-Year Experience from a Referral Coronary Care Unit

Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham

Abstract:

Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.

Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine

Procedia PDF Downloads 346
1189 PRENACEL: Development and Evaluation of an M-Health Strategy to Improve Prenatal Care in Brazil

Authors: E. M. Vieira, C. S. Vieira, L. P. Bonifácio, L. M. de Oliveira Ciabati, A. C. A. Franzon, F. S. Zaratini, J. A. C. Sanchez, M. S. Andrade, J. P. Dias de Souza

Abstract:

The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20th week of pregnancy up to 12th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12th and 24th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.

Keywords: cellphone, health technology, prenatal care, prevention

Procedia PDF Downloads 366
1188 Meta-Analysis of Particulate Matter Production in Developing and Developed Countries

Authors: Hafiz Mehtab Gull Nasir

Abstract:

Industrial development and urbanization have significant impacts on air emissions, and their relationship diverges at different stages of economic progress. The revolution further propelled these activities as principal paths to economic and social transformation; nevertheless, the paths also promoted environmental degradation. Resultantly, both developed and developing countries undergone through fast-paced development; in which developed countries implemented legislation towards environmental pollution control however developing countries took the advantage of technology without caring about the environment. In this study, meta-analysis is performed on production of particulate matter (i.e., PM10 and PM2.5) from urbanized cities of first, second and third world countries to assess the air quality. The cities were selected based on ranked set principles. In case of PM10, third world countries showed highest PM level (~95% confidence interval of 0.74-1.86) followed by second world countries but with managed situation. Besides, first, world countries indicated the lowest pollution (~95% confidence interval of 0.12-0.2). Similarly, highest level of PM2.5 was produced by third world countries followed by the second and first world countries. Hereby, level of PM2.5 was not significantly different for both second and third world countries; however, first world countries showed minimum PM load. Finally, the study revealed different that levels of pollution status exist among different countries; whereas developed countries also devised better strategies towards pollution control while developing countries are least caring about their environmental resources. It is suggested that although industrialization and urbanization are directly involved with interference in natural elements, however, production of nature appears to be more societal rather hermetical.

Keywords: meta-analysis, particulate matter, developing countries, urbanization

Procedia PDF Downloads 312
1187 Identification of Workplace Hazards of Underground Coal Mines

Authors: Madiha Ijaz, Muhammad Akram, Sima Mir

Abstract:

Underground mining of coal is carried out manually in Pakistan. Exposure to ergonomic hazards (musculoskeletal disorders) are very common among the coal cutters of these mines. Cutting coal in narrow spaces poses a great threat to both upper and lower limbs of these workers. To observe the prevalence of such hazards, a thorough study was conducted on 600 workers from 30 mines (20 workers from 1 mine), located in two districts of province Punjab, Pakistan. Rapid Upper Limb Assessment sheet and Rapid Entire Body Assessment sheet were used for the study along with a standard Nordic Musculoskeleton disorder questionnaire. SPSS, 25, software was used for data analysis on upper and lower limb disorders, and regression analysis models were run for upper and lower back pain. According to the results obtained, it was found that work stages (drilling & blasting, coal cutting, timbering & supporting, etc.), wok experience and number of repetitions performed/minute were significant (with p-value 0.00,0.004 and 0.009, respectively) for discomfort in upper and lower limb. Age got p vale 0.00 for upper limb and 0.012 for lower limb disorder. The task of coal cutting was strongly associated with the pain in upper back (with odd ratios13.21, 95% confidence interval (CI)14.0-21.64)) and lower back pain (3.7, 95% confidence interval 1.3-4.2). scored on RULA and REBA sheets, every work-stage was ranked at 7-highest level of risk involved. Workers were young (mean value of age= 28.7 years) with mean BMI 28.1 kg/m2

Keywords: workplace hazards, ergonomic disorders, limb disorders, MSDs.

Procedia PDF Downloads 56
1186 The Importance of Organized and Non-Organized Bildung for a Comprehensive Term of Bildung

Authors: Christine Pichler

Abstract:

The German word Bildung in a comprehensive understanding can be defined as the development of the personality and as a process, which lasts from birth, or even before birth, until death. Gaining experience, acquiring abilities and knowledge as a lifelong learning process is what Bildung means. The development of the personality is intransitive because of the personality’s development itself, and transitive because of influences on the formation of a person by individuals and institutions. In public and political discussions, the term Bildung is understood with a constricted usage as education at schools. This leads to the research question, which consequences this limited comprehension of the term Bildung implies and how a comprehensive term of Bildung has to be defined. In discussions, Bildung is limited to its formal part. The limited understanding prevents from accurate analyses and discussions as well as adequate actions. This hypothesis and the research issue will be processed by theoretical analyses of the factors of Bildung, guideline-controlled expert interviews and a qualitative content analysis. The limited understanding on the term Bildung is a methodological problem. This results in inaccuracies in the analysis of the processes of Bildung and their effects on the development of personality structures. On the one hand, an individual is influenced by formal structures in the system of Bildung (e.g. schools) and on the other hand an individual is influenced by gained individual and informal personality and character attributes. In general, too little attention is given to these attributes and individual qualifications. The aim of this work is to demonstrate informative terms so the educational process with all its facets could be considered and applicable analyses can be made. If the informative terms can be defined, it´s also possible to identify and discuss the components of a comprehensive term Bildung to enable correct action.

Keywords: Bildung, development of personality, education, formative process, organized and non-organized Bildung

Procedia PDF Downloads 97
1185 Comprehensive Analysis of Electrohysterography Signal Features in Term and Preterm Labor

Authors: Zhihui Liu, Dongmei Hao, Qian Qiu, Yang An, Lin Yang, Song Zhang, Yimin Yang, Xuwen Li, Dingchang Zheng

Abstract:

Premature birth, defined as birth before 37 completed weeks of gestation is a leading cause of neonatal morbidity and mortality and has long-term adverse consequences for health. It has recently been reported that the worldwide preterm birth rate is around 10%. The existing measurement techniques for diagnosing preterm delivery include tocodynamometer, ultrasound and fetal fibronectin. However, they are subjective, or suffer from high measurement variability and inaccurate diagnosis and prediction of preterm labor. Electrohysterography (EHG) method based on recording of uterine electrical activity by electrodes attached to maternal abdomen, is a promising method to assess uterine activity and diagnose preterm labor. The purpose of this study is to analyze the difference of EHG signal features between term labor and preterm labor. Free access database was used with 300 signals acquired in two groups of pregnant women who delivered at term (262 cases) and preterm (38 cases). Among them, EHG signals from 38 term labor and 38 preterm labor were preprocessed with band-pass Butterworth filters of 0.08–4Hz. Then, EHG signal features were extracted, which comprised classical time domain description including root mean square and zero-crossing number, spectral parameters including peak frequency, mean frequency and median frequency, wavelet packet coefficients, autoregression (AR) model coefficients, and nonlinear measures including maximal Lyapunov exponent, sample entropy and correlation dimension. Their statistical significance for recognition of two groups of recordings was provided. The results showed that mean frequency of preterm labor was significantly smaller than term labor (p < 0.05). 5 coefficients of AR model showed significant difference between term labor and preterm labor. The maximal Lyapunov exponent of early preterm (time of recording < the 26th week of gestation) was significantly smaller than early term. The sample entropy of late preterm (time of recording > the 26th week of gestation) was significantly smaller than late term. There was no significant difference for other features between the term labor and preterm labor groups. Any future work regarding classification should therefore focus on using multiple techniques, with the mean frequency, AR coefficients, maximal Lyapunov exponent and the sample entropy being among the prime candidates. Even if these methods are not yet useful for clinical practice, they do bring the most promising indicators for the preterm labor.

Keywords: electrohysterogram, feature, preterm labor, term labor

Procedia PDF Downloads 528
1184 Temperature-Dependent Post-Mortem Changes in Human Cardiac Troponin-T (cTnT): An Approach in Determining Postmortem Interval

Authors: Sachil Kumar, Anoop Kumar Verma, Wahid Ali, Uma Shankar Singh

Abstract:

Globally approximately 55.3 million people die each year. In the India there were 95 lakh annual deaths in 2013. The number of deaths resulted from homicides, suicides and unintentional injuries in the same period was about 5.7 lakh. The ever-increasing crime rate necessitated the development of methods for determining time since death. An erroneous time of death window can lead investigators down the wrong path or possibly focus a case on an innocent suspect. In this regard a research was carried out by analyzing the temperature dependent degradation of a Cardiac Troponin-T protein (cTnT) in the myocardium postmortem as a marker for time since death. Cardiac tissue samples were collected from (n=6) medico-legal autopsies, (in the Department of Forensic Medicine and Toxicology, King George’s Medical University, Lucknow India) after informed consent from the relatives and studied post-mortem degradation by incubation of the cardiac tissue at room temperature (20±2 OC), 12 0C, 25 0C and 37 0C for different time periods ((~5, 26, 50, 84, 132, 157, 180, 205, and 230 hours). The cases included were the subjects of road traffic accidents (RTA) without any prior history of disease who died in the hospital and their exact time of death was known. The analysis involved extraction of the protein, separation by denaturing gel electrophoresis (SDS-PAGE) and visualization by Western blot using cTnT specific monoclonal antibodies. The area of the bands within a lane was quantified by scanning and digitizing the image using Gel Doc. The data shows a distinct temporal profile corresponding to the degradation of cTnT by proteases found in cardiac muscle. The disappearance of intact cTnT and the appearance of lower molecular weight bands are easily observed. Western blot data clearly showed the intact protein at 42 kDa, two major (27 kDa, 10kDa) fragments, two additional minor fragments (32 kDa) and formation of low molecular weight fragments as time increases. At 12 0C the intensity of band (intact cTnT) decreased steadily as compared to RT, 25 0C and 37 0C. Overall, both PMI and temperature had a statistically significant effect where the greatest amount of protein breakdown was observed within the first 38 h and at the highest temperature, 37 0C. The combination of high temperature (37 0C) and long Postmortem interval (105.15 hrs) had the most drastic effect on the breakdown of cTnT. If the percent intact cTnT is calculated from the total area integrated within a Western blot lane, then the percent intact cTnT shows a pseudo-first order relationship when plotted against the log of the time postmortem. These plots show a good coefficient of correlation of r = 0.95 (p=0.003) for the regression of the human heart at different temperature conditions. The data presented demonstrates that this technique can provide an extended time range during which Postmortem interval can be more accurately estimated.

Keywords: degradation, postmortem interval, proteolysis, temperature, troponin

Procedia PDF Downloads 357
1183 Processes of Identity Construction for Generation 1.5 Students in Canada

Authors: Timothy Mossman

Abstract:

The number of adolescent children accompanying their immigrant parents to Canada has steadily increased since the 1990s. Much of the applied linguistics literature on these so-called ‘Generation 1.5’ youth has focused on their deficiencies as academic writers in US Rhetoric and Composition and ESL contexts in higher education and the stigma of ESL in US K-12 contexts. However, the literature on Generation 1.5 students and identity in Canadian higher education is limited. This qualitative study investigates the processes of identity construction of three Generation 1.5 students studying at a university in Metro Vancouver to find out what types of identities and representations of self and other they make relevant, the meanings they attribute to their identities, and what motivates them to construct these identities. The study analyzes the accounts and experiences of the participants in interviews, focus groups, and texts and as ‘culture-in-action,’ positing that they constructed identities as social categories associated with the languages and social practices of their countries of birth, in liminal spaces among a continuum between Canada and their countries of birth, and a spectrum of related cultural representations. Ideas and beliefs associated with broader ‘macro’ social structures in Canadian society related to language, culture, legitimacy, immigration, power, distinction, and racism were shown to be transcended in and through their representations of themselves and others. Data suggest that moving to Canada caused participants to experience discontinuities between their cultures, languages, and social practices, and in some cases a conflicting sense of self. The study brings implications for finding ways to understand the complexity of immigrant students, avoid reifying and generalizing about them, and not see them as stuck-in-between or lacking.

Keywords: culture-in-action, generation 1.5, identity, membership categorization analysis

Procedia PDF Downloads 127
1182 Deficits in Perceptual and Musical Memory in Individuals with Major Depressive Disorder

Authors: Toledo-Fernandez Aldebaran

Abstract:

Introduction: One of the least explored cognitive functions in relation with depression is the one related to musical stimuli. Music perception and memory can become impaired as well. The term amusia is used to define a type of agnosia caused by damage to basic processes that creates a general inability to perceive music. Therefore, the main objective is to explore performance-based and self-report deficits in music perception and memory on people with major depressive disorder (MDD). Method: Data was collected through April-October 2021 recruiting people who met the eligibility criteria and using the Montreal Battery of Evaluation of Amusia (MBEA) to evaluate performance-based music perception and memory, along with the module for depression of the Mini International Neuropsychiatric Interview, and the Amusic Dysfunction Inventory (ADI) which evaluates the participants’ self-report concerning their abilities in music perception. Results: 64 participants were evaluated. The main study, referring to analyzing the differences between people with MDD and the control group, only showed one statistical difference on the Interval subtest of the MBEA. No difference was found in the dimensions assessed by the ADI. Conclusion: Deficits in interval perception can be explained by mental fatigue, to which people with depression are more vulnerable, rather than by specific deficits in musical perception and memory associated with depressive disorder. Additionally, significant associations were found between musical deficits as observed by performance-based evidence and music dysfunction according to self-report, which could suggest that some people with depression are capable of detecting these deficits in themselves.

Keywords: depression, amusia, music, perception, memory

Procedia PDF Downloads 30
1181 Artificial Insemination of Bali Cattle with Frozen-Thawed Sexed Sperm Under District AI Station Conditions in Lombok: A Preliminary Trial

Authors: Chairussyuhur Arman, Totti Tjiptosumirat, Muhammad Gunawan, Mastur, Joko Priyono, Baiq Tri Ratna Erawati

Abstract:

The present study was undertaken to synchronize oestrus of bali cattle and artificially inseminated with frozen-thawed sexed-semen. The experiment was carried out at District AI Station. Four pluriparous cows and four nulliparous heifers were used in this study and they were housed in free stall barns. The heifers fed with corn silage supplemented with UMMB, while the cows fed with green fodder. All animals were given 500 mg cloprostenolum i.m. injections PGF2α twice, 11 days apart, to synchronize the occurrence of estrus. Estrus was detected by visual observation twice a day and determined if all cattle accepted mount from other females. All animals were inseminated twice with Bali sexed-semen at 72 and 76 h after observed oestrus. Results suggested that the percentage of calving rate either for pluriparous cows or nulliparous heifers were recorded to be 75 percent. One cow and one heifer did not produce calves because of embryonic lost. Regardless the sex of calves, the mean of birth weight of calves in cows was higher than that of heifers (18.50 ± 2.60 kg vs 13.83 ± 5.20 kg). One female calf from heifer with lower birth weight (8.0 kg) was dead one day after born. In pluriparous group, two cows delivered male calves and the other delivered female calf. Conversely in nulliparous group, two heifers delivered female calves and the other male calf. It is concluded that under the conditions of this preliminary trials, the sex ratio between pluriparous and nulliparous groups was found to be 50:50 (male:female).

Keywords: artificial insemination, bali cattle, calves, sexed sperm

Procedia PDF Downloads 289
1180 The Effects of Blanching, Boiling and Steaming on Ascorbic Acid Content, Total Phenolic Content, and Colour in Cauliflowers (Brassica oleracea var. Botrytis)

Authors: Huei Lin Lee, Wee Sim Choo

Abstract:

The effects of blanching, boiling and steaming on the ascorbic acid content, total phenolic content and colour in cauliflower (Brassica oleraceavar. Botrytis) was investigated. It was found that blanching was the best thermal processing to be applied on cauliflower compared to boiling and steaming processes. Blanching and steaming processes on cauliflower retained most of the ascorbic acid content (AAC) compared to those of boiling. As for the total phenolic content (TPC), blanching process retained a higher TPC in cauliflower compared to those of boiling and steaming processes. There were no significant differences between the TPC of boiled and steamed cauliflowers. As for the colour measurement, there were no significant differences in the colour of the cauliflower at different lead time (after processing to the point of consumption) of 30 minutes interval up to 3 hours but there were slight variations in L*, a*, and b* values among the thermal processed cauliflowers (blanched, boiled and steamed). The cauliflowers in this study were found to give a desirable white colour (L* value in the range of 77-83) in all the three thermal processes (blanching, boiling and steaming). There was no significant difference on the effect of lead time (30-minutes interval up to 3 hours) in raw and all the three thermal processed (blanched, boiled and steamed) cauliflowers.

Keywords: ascorbic acid, cauliflower, colour, phenolics

Procedia PDF Downloads 294
1179 Delay in the Diagnosis of Tuberculosis and Initiation of TB Treatment in the Private and Public Health Sectors, Udaipur District, Rajasthan, India, Nov 2013

Authors: Yogita Tulsian, R. S. Gupta, K. F. Laserson

Abstract:

Background: Delays in the diagnosis and treatment of TB facilitates disease transmission in the community, so we conducted a study to evaluate the burden of and risk factors for delay in TB diagnosis and initiation of TB treatment among patients in the private and public sectors in Udaipur district, Rajasthan, India. Methods: A retrospective cohort study was conducted among 100 new sputum-positive TB. Patients were interviewed in the intensive phase of treatment September 2013-November 2013 Long total diagnosis delay (TDD) was defined as a time interval between first symptom to confirmed diagnosis > 30 days. Long health treatment delay (HTD) was defined as a time interval between confirmed diagnosis to treatment initiation > 7 days. Results: We observed a median TDD of 55 days (range: 7-136 days) in the public sector and of 92 days (11-380 days) in the private sector. Long TDD in the private sector was significantly associated with middle-higher socio-economic status (Risk Ratio (RR): 2;95% CI: 1.3-3). The reasons reported from the private sector for long TDD were suspect TB patients not advised for sputum examination (RR: 42; 95% CI:2.6-660), practise of self-medication (RR: 17.4; 95% CI: 1.1-267), or lack of awareness (RR: 9.7;95% CI: 0.6-145). The median HTD in the public sector was 3 days (range: 0-14 days), and in the private sector, 2 days (range: 0-11 days) (non-significant difference). Conclusions: Long TDD in private sector may be improved through sputum referral for all suspect TB cases and better education to all regarding TB.

Keywords: diagnosis delay, treatment delay, privatesector, public sector

Procedia PDF Downloads 393
1178 Prediction of Live Birth in a Matched Cohort of Elective Single Embryo Transfers

Authors: Mohsen Bahrami, Banafsheh Nikmehr, Yueqiang Song, Anuradha Koduru, Ayse K. Vuruskan, Hongkun Lu, Tamer M. Yalcinkaya

Abstract:

In recent years, we have witnessed an explosion of studies aimed at using a combination of artificial intelligence (AI) and time-lapse imaging data on embryos to improve IVF outcomes. However, despite promising results, no study has used a matched cohort of transferred embryos which only differ in pregnancy outcome, i.e., embryos from a single clinic which are similar in parameters, such as: morphokinetic condition, patient age, and overall clinic and lab performance. Here, we used time-lapse data on embryos with known pregnancy outcomes to see if the rich spatiotemporal information embedded in this data would allow the prediction of the pregnancy outcome regardless of such critical parameters. Methodology—We did a retrospective analysis of time-lapse data from our IVF clinic utilizing Embryoscope 100% of the time for embryo culture to blastocyst stage with known clinical outcomes, including live birth vs nonpregnant (embryos with spontaneous abortion outcomes were excluded). We used time-lapse data from 200 elective single transfer embryos randomly selected from January 2019 to June 2021. Our sample included 100 embryos in each group with no significant difference in patient age (P=0.9550) and morphokinetic scores (P=0.4032). Data from all patients were combined to make a 4th order tensor, and feature extraction were subsequently carried out by a tensor decomposition methodology. The features were then used in a machine learning classifier to classify the two groups. Major Findings—The performance of the model was evaluated using 100 random subsampling cross validation (train (80%) - test (20%)). The prediction accuracy, averaged across 100 permutations, exceeded 80%. We also did a random grouping analysis, in which labels (live birth, nonpregnant) were randomly assigned to embryos, which yielded 50% accuracy. Conclusion—The high accuracy in the main analysis and the low accuracy in random grouping analysis suggest a consistent spatiotemporal pattern which is associated with pregnancy outcomes, regardless of patient age and embryo morphokinetic condition, and beyond already known parameters, such as: early cleavage or early blastulation. Despite small samples size, this ongoing analysis is the first to show the potential of AI methods in capturing the complex morphokinetic changes embedded in embryo time-lapse data, which contribute to successful pregnancy outcomes, regardless of already known parameters. The results on a larger sample size with complementary analysis on prediction of other key outcomes, such as: euploidy and aneuploidy of embryos will be presented at the meeting.

Keywords: IVF, embryo, machine learning, time-lapse imaging data

Procedia PDF Downloads 64
1177 Maternal and Neonatal Outcomes in Women Undergoing Bariatric Surgery: A Systematic Review and Meta-Analysis

Authors: Nicolas Galazis, Nikolina Docheva, Constantinos Simillis, Kypros Nicolaides

Abstract:

Background: Obese women are at increased risk for many pregnancy complications, and bariatric surgery (BS) before pregnancy has shown to improve some of these. Objectives: To review the current literature and quantitatively assess the obstetric and neonatal outcomes in pregnant women who have undergone BS. Search Strategy: MEDLINE, EMBASE and Cochrane databases were searched using relevant keywords to identify studies that reported on pregnancy outcomes after BS. Selection Criteria: Pregnancy outcome in firstly, women after BS compared to obese or BMI-matched women with no BS and secondly, women after BS compared to the same or different women before BS. Only observational studies were included. Data Collection and Analysis: Two investigators independently collected data on study characteristics and outcome measures of interest. These were analysed using the random effects model. Heterogeneity was assessed and sensitivity analysis was performed to account for publication bias. Main Results: The entry criteria were fulfilled by 17 non-randomised cohort or case-control studies, including seven with high methodological quality scores. In the BS group, compared to controls, there was a lower incidence of preeclampsia (OR, 0.45, 95% CI, 0.25-0.80; p=0.007), GDM (OR, 0.47, 95% CI, 0.40-0.56; P<0.001) and large neonates (OR 0.46, 95% CI 0.34-0.62; p<0.001) and a higher incidence of small neonates (OR 1.93, 95% CI 1.52-2.44; p<0.001), preterm birth (OR 1.31, 95% CI 1.08-1.58; p=0.006), admission for neonatal intensive care (OR 1.33, 95% CI 1.02-1.72; p=0.03) and maternal anaemia (OR 3.41, 95% CI 1.56-7.44, p=0.002). Conclusions: BS as a whole improves some pregnancy outcomes. Laparoscopic adjustable gastric banding does not appear to increase the rate of small neonates that was seen with other BS procedures. Obese women of childbearing age undergoing BS need to be aware of these outcomes.

Keywords: bariatric surgery, pregnancy, preeclampsia, gestational diabetes, birth weight

Procedia PDF Downloads 383
1176 Prompt Photons Production in Compton Scattering of Quark-Gluon and Annihilation of Quark-Antiquark Pair Processes

Authors: Mohsun Rasim Alizada, Azar Inshalla Ahmdov

Abstract:

Prompt photons are perhaps the most versatile tools for studying the dynamics of relativistic collisions of heavy ions. The study of photon radiation is of interest that in most hadron interactions, photons fly out as a background to other studied signals. The study of the birth of prompt photons in nucleon-nucleon collisions was previously carried out in experiments on Relativistic Heavy Ion Collider (RHIC) and the Large Hadron Collider (LHC). Due to the large energy of colliding nucleons, in addition to prompt photons, many different elementary particles are born. However, the birth of additional elementary particles makes it difficult to determine the accuracy of the effective section of the birth of prompt photons. From this point of view, the experiments planned on the Nuclotron-based Ion Collider Facility (NICA) complex will have a great advantage, since the energy obtained for colliding heavy ions will reduce the number of additionally born elementary particles. Of particular importance is the study of the processes of birth of prompt photons to determine the gluon leaving hadrons since the photon carries information about a rigid subprocess. At present, paper production of prompt photon in Compton scattering of quark-gluon and annihilation of quark–antiquark processes is investigated. The matrix elements Compton scattering of quark-gluon and annihilation of quark-antiquark pair processes has been written. The Square of matrix elements of processes has been calculated in FeynCalc. The phase volume of subprocesses has been determined. Expression to calculate the differential cross-section of subprocesses has been obtained: Given the resulting expressions for the square of the matrix element in the differential section expression, we see that the differential section depends not only on the energy of colliding protons, but also on the mass of quarks, etc. Differential cross-section of subprocesses is estimated. It is shown that the differential cross-section of subprocesses decreases with the increasing energy of colliding protons. Asymmetry coefficient with polarization of colliding protons is determined. The calculation showed that the squares of the matrix element of the Compton scattering process without and taking into account the polarization of colliding protons are identical. The asymmetry coefficient of this subprocess is zero, which is consistent with the literary data. It is known that in any single polarization processes with a photon, squares of matrix elements without taking into account and taking into account the polarization of the original particle must coincide, that is, the terms in the square of the matrix element with the degree of polarization are equal to zero. The coincidence of the squares of the matrix elements indicates that the parity of the system is preserved. The asymmetry coefficient of annihilation of quark–antiquark pair process linearly decreases from positive unit to negative unit with increasing the production of the polarization degrees of colliding protons. Thus, it was obtained that the differential cross-section of the subprocesses decreases with the increasing energy of colliding protons. The value of the asymmetry coefficient is maximal when the polarization of colliding protons is opposite and minimal when they are directed equally. Taking into account the polarization of only the initial quarks and gluons in Compton scattering does not contribute to the differential section of the subprocess.

Keywords: annihilation of a quark-antiquark pair, coefficient of asymmetry, Compton scattering, effective cross-section

Procedia PDF Downloads 124
1175 Effects of Poultry Manure Rates on Some Growth and Yield Attributes of Cucumber in Owerri, South Eastern Nigeria

Authors: Chinwe Pearl Poly-Mbah, Evelyn Obioma, Juliet Amajuoyi

Abstract:

The investigation here reported examined growth and yield responses of Cucumber to manure rates in Owerri, Southeastern Nigeria. Fruit vegetables are widely cultivated and produced in Northern Nigeria but greatly consumed in Southern Nigeria where cucumbers command high demand and price but are minimally cultivated. Unfortunately, farmers in northern Nigeria incur lots of losses because cucumber is a perishable vegetable and is transported all the way from the northern Nigeria where cucumbers are produced to Southern Nigeria where cucumbers are consumed, hence the high cost of cucumber fruits in Southern Nigeria. There is a need, therefore, to evolve packages that will enhance cucumber production in Southern Nigeria. The main objective of this study was to examine the effects of poultry manure rates on the growth and yield of cucumber in Owerri, South Eastern Nigeria. Specifically, this study was designed to assess the effect of poultry manure rates on number of days to 50% seedling emergence, vine length/plant, leaf area per plant and the number of leaves produced per plant. The design used for the experiment was Randomized Complete Block Design (RCBD) with three blocks (replications). Treatment consisted of four rates of well-decomposed poultry manure at the rate of 0 tons/ha, 2 tons/ha, 4 tons/ha and 6 tons/ha. Data were collected on number of days to 50% seedling emergence, vine length per plant at two weeks interval, leaf number per plant at two weeks interval, leaf area per plant at two weeks interval, number of fruits produced per plant, and fresh weight of fruits per plant at harvest. Results from the analysis of variance (ANOVA) showed that there were highly significant effects (P=0.05) of poultry manure on growth and yield parameters studied which include number of days to 50% seedling emergence, vine length per plant, leaf number per plant, leaf area per plant, fruit number and fruit weight per plant such that increase in poultry manure rates lead to increase in growth and yield parameters studied. Therefore, the null hypothesis (Ho) was rejected, while the alternative hypothesis was accepted. Farmers should be made to know that growing cucumber with poultry manure in southeastern Nigeria agro ecology is a successful enterprise

Keywords: cucumber, effects, growth and yield, manure

Procedia PDF Downloads 195
1174 A Five-Year Follow-up Survey Using Regression Analysis Finds Only Maternal Age to Be a Significant Medical Predictor for Infertility Treatment

Authors: Lea Stein, Sabine Rösner, Alessandra Lo Giudice, Beate Ditzen, Tewes Wischmann

Abstract:

For many couples bearing children is a consistent life goal; however, it cannot always be fulfilled. Undergoing infertility treatment does not guarantee pregnancies and live births. Couples have to deal with miscarriages and sometimes even discontinue infertility treatment. Significant medical predictors for the outcome of infertility treatment have yet to be fully identified. To further our understanding, a cross-sectional five-year follow-up survey was undertaken, in which 95 women and 82 men that have been treated at the Women’s Hospital of Heidelberg University participated. Binary logistic regressions, parametric and non-parametric methods were used for our sample to determine the relevance of biological (infertility diagnoses, maternal and paternal age) and lifestyle factors (smoking, drinking, over- and underweight) on the outcome of infertility treatment (clinical pregnancy, live birth, miscarriage, dropout rate). During infertility treatment, 72.6% of couples became pregnant and 69.5% were able to give birth. Suffering from miscarriages 27.5% of couples and 20.5% decided to discontinue an unsuccessful fertility treatment. The binary logistic regression models for clinical pregnancies, live births and dropouts were statistically significant for the maternal age, whereas the paternal age in addition to maternal and paternal BMI, smoking, infertility diagnoses and infections, showed no significant predicting effect on any of the outcome variables. The results confirm an effect of maternal age on infertility treatment, whereas the relevance of other medical predictors remains unclear. Further investigations should be considered to increase our knowledge of medical predictors.

Keywords: advanced maternal age, assisted reproductive technology, female factor, male factor, medical predictors, infertility treatment, reproductive medicine

Procedia PDF Downloads 83
1173 Physical Exam-Indicated Cerclage with Mesh Cap Prolonged Gestation on Average for 9 Weeks and 4 Days: 11 Years of Experience

Authors: M. Keršič, M. Lužnik, J. Lužnik

Abstract:

Cervical dilatation and membrane herniation before 26th week of gestation poses very high risk for extremely and very premature childbirth. Cerclage with mesh cap (mesh cerclage, MC) can greatly diminish this risk and provide additional positive effects. Between 2005 and 2014, MC has been performed in 9 patients with singleton pregnancies who had prolapsed membranes beyond external cervical/uterine os before 25th week of pregnancy (one in 29th). With patients in general anaesthesia, lithotomy and Trendelenburg position (about 25°) prolapsed membranes were repositioned in the uterine cavity, using tampon soaked in antiseptic solution (Skinsept mucosa). A circular, a type of purse-string suture (main band) with double string Ethilon 1 was applied at about 1 to 1.5 cm from the border of the external uterine os - 6 to 8 stitches were placed, so the whole external uterine os was encircled (modified McDonald). In the next step additional Ethilon 0 sutures were placed around all exposed parts of the main double circular suture and loosely tightened. On those sutures, round tailored (diameter around 6 cm) mesh (Prolene® or Gynemesh* PS) was attached. In all 9 cases, gestation was prolonged on average for 9 weeks and 4 days (67 days). In four cases maturity was achieved. Mesh was removed in 37th–38th week of pregnancy or if spontaneous labour began. In two cases, a caesarean section was performed because of breech presentation. In the first week after birth in 22nd week one new born died because of immaturity (premature birth was threatening in 18th week and then MC was placed). Ten years after first MC, 8 of 9 women with singleton pregnancy and MC performed have 8 healthy children from these pregnancies. Mesh cerclage successfully closed the opened cervical canal or uterine orifice and prevented further membrane herniation and membrane rupture. MC also provides a similar effect as with occluding the external os with suturing but without interrupting the way for excretion of abundant cervical mucus. The mesh also pulls the main circular band outwards and thus lowers the chance of suture cutting through the remaining cervix. MC prolonged gestation very successfully (mean for 9 weeks and 4 days) and thus increased possibility for survival and diminished the risk for complications in very early preterm delivered survivors in cases with cervical dilatation and membrane herniation before 26th week of gestation. Without action possibility to achieve at least 28th or 32nd week of gestation would be poor.

Keywords: cervical insufficiency, mesh cerclage, membrane protrusion, premature birth prevention, physical exam-indicated cerclage, rescue cerclage

Procedia PDF Downloads 162
1172 Risk Factors of Hospital Acquired Infection Mortality in a Tunisian Intensive Care Unit

Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

Abstract:

Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

Procedia PDF Downloads 454
1171 Application of Forensic Entomology to Estimate the Post Mortem Interval

Authors: Meriem Taleb, Ghania Tail, Fatma Zohra Kara, Brahim Djedouani, T. Moussa

Abstract:

Forensic entomology has grown immensely as a discipline in the past thirty years. The main purpose of forensic entomology is to establish the post mortem interval or PMI. Three days after the death, insect evidence is often the most accurate and sometimes the only method of determining elapsed time since death. This work presents the estimation of the PMI in an experiment to test the reliability of the accumulated degree days (ADD) method and the application of this method in a real case. The study was conducted at the Laboratory of Entomology at the National Institute for Criminalistics and Criminology of the National Gendarmerie, Algeria. The domestic rabbit Oryctolagus cuniculus L. was selected as the animal model. On 08th July 2012, the animal was killed. Larvae were collected and raised to adulthood. Estimation of oviposition time was calculated by summing up average daily temperatures minus minimum development temperature (also specific to each species). When the sum is reached, it corresponds to the oviposition day. Weather data were obtained from the nearest meteorological station. After rearing was accomplished, three species emerged: Lucilia sericata, Chrysomya albiceps, and Sarcophaga africa. For Chrysomya albiceps species, a cumulation of 186°C is necessary. The emergence of adults occured on 22nd July 2012. A value of 193.4°C is reached on 9th August 2012. Lucilia sericata species require a cumulation of 207°C. The emergence of adults occurred on 23rd, July 2012. A value of 211.35°C is reached on 9th August 2012. We should also consider that oviposition may occur more than 12 hours after death. Thus, the obtained PMI is in agreement with the actual time of death. We illustrate the use of this method during the investigation of a case of a decaying human body found on 03rd March 2015 in Bechar, South West of Algerian desert. Maggots were collected and sent to the Laboratory of Entomology. Lucilia sericata adults were identified on 24th March 2015 after emergence. A sum of 211.6°C was reached on 1st March 2015 which corresponds to the estimated day of oviposition. Therefore, the estimated date of death is 1st March 2015 ± 24 hours. The estimated PMI by accumulated degree days (ADD) method seems to be very precise. Entomological evidence should always be used in homicide investigations when the time of death cannot be determined by other methods.

Keywords: forensic entomology, accumulated degree days, postmortem interval, diptera, Algeria

Procedia PDF Downloads 253
1170 Approximation by Generalized Lupaş-Durrmeyer Operators with Two Parameter α and β

Authors: Preeti Sharma

Abstract:

This paper deals with the Stancu type generalization of Lupaş-Durrmeyer operators. We establish some direct results in the polynomial weighted space of continuous functions defined on the interval [0, 1]. Also, Voronovskaja type theorem is studied.

Keywords: Lupas-Durrmeyer operators, polya distribution, weighted approximation, rate of convergence, modulus of continuity

Procedia PDF Downloads 317