Search results for: incomplete categorical covariates
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 504

Search results for: incomplete categorical covariates

204 Effectiveness of Adrenal Venous Sampling in the Management of Primary Aldosteronism: Single Centered Cohort Study at a Tertiary Care Hospital in Sri Lanka

Authors: Balasooriya B. M. C. M., Sujeeva N., Thowfeek Z., Siddiqa Omo, Liyanagunawardana J. E., Jayawardana Saiu, Manathunga S. S., Katulanda G. W.

Abstract:

Introduction and objectives: Adrenal venous sampling (AVS) is the gold standard to discriminate unilateral primary aldosteronism (UPA) from bilateral disease (BPA). AVS is technically demanding and only performed in a limited number of centers worldwide. To the best of our knowledge, Except for one study conducted in India, no other research studies on this area have been conducted in South Asia. This study aimed to evaluate the effectiveness of AVS in the management of primary aldosteronism. Methods: A total of 32 patients who underwent AVS at the National Hospital of Sri Lanka from April 2021 to April 2023 were enrolled. Demographic, clinical and laboratory data were obtained retrospectively. A procedure was considered successful when adequate cannulation of both adrenal veins was demonstrated. Cortisol gradient across the adrenal vein (AV) and the peripheral vein was used to establish the success of venous cannulation. Lateralization was determined by the aldosterone gradient between the two sides. Continuous and categorical variables were summarized with mean, SD, and proportions, respectively. The mean and standard deviation of the contralateral suppression index (CSI) were estimated with an intercept-only Bayesian inference model. Results: Of the 32 patients, the average age was 52.47 +26.14 and 19 (59.4%) were males. Both AVs were successfully cannulated in 12 (37.5%). Among them, lateralization was demonstrated in 11(91.7%), and one was diagnosed as a bilateral disease. There were no total failures. Right AV cannulation was unsuccessful in 18 (56.25%), of which lateralization was demonstrated in 9 (50%), and others were inconclusive. Left AV cannulation was unsuccessful only in 2 (6.25%); one was lateralized, and the other remained inconclusive. The estimated mean of the CSI was 0.33 (89% credible interval 0.11-0.86). Seven patients underwent unilateral adrenalectomy and demonstrated significant improvement in blood pressure during follow-up. Two patients await surgery. Others were treated medically. Conclusions: Despite failure due to procedural difficulties, AVS remained useful in the management of patients with PA. Moreover, the success of the procedure needs experienced hands and advanced equipment to achieve optimal outcomes in PA.

Keywords: adrenal venous sampling, lateralization, contralateral suppression index, primary aldosteronism

Procedia PDF Downloads 32
203 Assessment of Incidence and Predictors of Mortality Among HIV Positive Children on Art in Public Hospitals of Harer Town Who Were Enrolled From 2011 to 2021

Authors: Getahun Nigusie Demise

Abstract:

Background; antiretroviral treatment reduce HIV-related morbidity, and prolonged survival of patients however, there is lack of up-to-date information concerning the treatment long term effect on the survival of HIV positive children especially in the study area. Objective: The aim of this study is to assess the incidence and predictors of mortality among HIV positive children on antiretroviral therapy (ART) in public hospitals of Harer town who were enrolled from 2011 to 2021. Methodology: Institution based retrospective cohort study was conducted among 429 HIV positive children enrolled in ART clinic from January 1st 2011 to December30th 2021. Data were collected from medical cards by using a data extraction form, Descriptive analyses were used to Summarized the results, and life table was used to estimate survival probability at specific point of time after introduction of ART. Kaplan Meier survival curve together with log rank test was used to compare survival between different categories of covariates, and Multivariate Cox-proportional hazard regression model was used to estimate adjusted Hazard rate. Variables with p-values ≤0.25 in bivariable analysis were candidates to the multivariable analysis. Finally, variables with p-values < 0.05 were considered as significant variables. Results: The study participants had followed for a total of 2549.6 child-years (30596 child months) with an overall mortality rate of 1.5 (95% CI: 1.1, 2.04) per 100 child-years. Their median survival time was 112 months (95% CI: 101–117). There were 38 children with unknown outcome, 39 deaths, and 55 children transfer out to different facility. The overall survival at 6, 12, 24, 48 months were 98%, 96%, 95%, 94% respectively. being in WHO clinical Stage four (AHR=4.55, 95% CI:1.36, 15.24), having anemia(AHR=2.56, 95% CI:1.11, 5.93), baseline low absolute CD4 count (AHR=2.95, 95% CI: 1.22, 7.12), stunting (AHR=4.1, 95% CI: 1.11, 15.42), wasting (AHR=4.93, 95% CI: 1.31, 18.76), poor adherence to treatment (AHR=3.37, 95% CI: 1.25, 9.11), having TB infection at enrollment (AHR=3.26, 95% CI: 1.25, 8.49),and no history of change their regimen(AHR=7.1, 95% CI: 2.74, 18.24), were independent predictors of death. Conclusion: more than half of death occurs within 2 years. Prevalent tuberculosis, anemia, wasting, and stunting nutritional status, socioeconomic factors, and baseline opportunistic infection were independent predictors of death. Increasing early screening and managing those predictors are required.

Keywords: human immunodeficiency virus-positive children, anti-retroviral therapy, survival, treatment, Ethiopia

Procedia PDF Downloads 11
202 Association of Severe Preeclampsia with Offspring Neurodevelopmental and Psychiatric Disorders: A Finnish Population-Based Cohort Study

Authors: Linghua Kong, Xinxia Chen, Mika Gissler, Catharina Lavebratt

Abstract:

Background: Prenatal exposure to preeclampsia has been associated with an increased risk of offspring attention-deficit/hyperactivity disorders (ADHD), autism spectrum disorder (ASD), and intellectual disability. However, little is known about the association between prenatal exposure to severe preeclampsia and neurodevelopmental and psychiatric disorders in offspring. Objective: This study aimed to assess the risk of maternal preeclampsia combined with perinatal problems, specifically low birth weight and prematurity, on offspring neuropsychiatric disorders. Methods: All singleton live births in Finland between 1996 and 2014 (n=1 012 723) were followed up in nation-wide registries until 2018. Main exposures included pre-eclampsia, small for gestational age, and delivery before 34 gestational weeks. Offspring neurodevelopmental and psychiatric disorders (ICD-10 codes) were examined as outcomes variables. Offspring birth year, sex, maternal age at delivery, parity, marital status at birth, mother's country of birth, maternal smoking, maternal gestational diabetes, maternal use of psychotropic medication during pregnancy, and maternal systemic inflammatory diseases were used as covariates. Risks for neurodevelopmental and psychiatric disorders were estimated using Cox proportional hazards modeling. Results: Of the 1 012 723 offspring, 25 901 (2.6%) were exposed to preeclampsia, and 93 281 (9.2%) were diagnosed with a neuropsychiatric disorder. Compared to births unexposed to preeclampsia, small for gestational age or delivery before 34 gestational weeks, those exposed to preeclampsia only had a 21% increase in the likelihood of any neuropsychiatric disorders after adjusting for potential confounding (adjusted HR=1.21, 95% CI: 1.15-1.26), while exposure to preeclampsia combined with small for gestational age or delivery before 34 gestational weeks had a more than twofold increased risk of having a child with neuropsychiatric disorders (adjusted HR=2.16, 95% CI: 2.02-2.32). The adjusted HR for neuropsychiatric disorders in offspring with small for gestational age or delivery before 34 gestational weeks only was 1.79 (95% CI: 1.73-1.83). In addition, the risk estimate in offspring exposed to both preeclampsia and perinatal problems was greater than those only exposed to preeclampsia for having personality disorders (adjusted HR=1.66; 95% CI: 1.07-2.57), intellectual disabilities (adjusted HR=3.47; 95% CI: 2.86-4.22), specific developmental disorders (adjusted HR=2.91; 95% CI: 2.69-3.15), ASD (adjusted HR=1.75; 95% CI: 1.42-2.17), ADHD and conduct disorders (adjusted HR=2.00; 95%CI: 1.76-2.27), and other behavioral and emotional disorders (adjusted HR=2.09; 95% CI: 1.84-2.37). Conclusion: In utero exposure to severe preeclampsia increased the risk of several neurodevelopmental and psychiatric disorders in offspring. Our findings are relevant to women with hypertensive disorders with regard to pregnancy consultation and management and may yield effective clues for the prevention of neurodevelopmental and psychiatric disorders in childhood.

Keywords: low birth weight, neurodevelopmental disorders, preeclampsia, prematurity, psychiatric disorders

Procedia PDF Downloads 116
201 Experimental Study of Particle Deposition on Leading Edge of Turbine Blade

Authors: Yang Xiao-Jun, Yu Tian-Hao, Hu Ying-Qi

Abstract:

Breathing in foreign objects during the operation of the aircraft engine, impurities in the aircraft fuel and products of incomplete combustion can produce deposits on the surface of the turbine blades. These deposits reduce not only the turbine's operating efficiency but also the life of the turbine blades. Based on the small open wind tunnel, the simulation of deposits on the leading edge of the turbine has been carried out in this work. The effect of film cooling on particulate deposition was investigated. Based on the analysis, the adhesive mechanism for the molten pollutants’ reaching to the turbine surface was simulated by matching the Stokes number, TSP (a dimensionless number characterizing particle phase transition) and Biot number of the test facility and that of the real engine. The thickness distribution and growth trend of the deposits have been observed by high power microscope and infrared camera under different temperature of the main flow, the solidification temperature of the particulate objects, and the blowing ratio. The experimental results from the leading edge particulate deposition demonstrate that the thickness of the deposition increases with time until a quasi-stable thickness is reached, showing a striking effect of the blowing ratio on the deposition. Under different blowing ratios, there exists a large difference in the thickness distribution of the deposition, and the deposition is minimal at the specific blow ratio. In addition, the temperature of main flow and the solidification temperature of the particulate have a great influence on the deposition.

Keywords: deposition, experiment, film cooling, leading edge, paraffin particles

Procedia PDF Downloads 123
200 Prognosis of Patients with COVID-19 and Hematologic Malignancies

Authors: Elizabeth Behrens, Anne Timmermann, Alexander Yerkan, Joshua Thomas, Deborah Katz, Agne Paner, Melissa Larson, Shivi Jain, Seo-Hyun Kim, Celalettin Ustun, Ankur Varma, Parameswaran Venugopal, Jamile Shammo

Abstract:

Coronavirus Disease-2019 (COVID-19) causes persistent concern for poor outcomes in vulnerable populations. Patients with hematologic malignancies (HM) have been found to have higher COVID-19 case fatality rates compared to those without malignancy. While cytopenias are common in patients with HM, especially in those undergoing chemotherapy treatment, hemoglobin (Hgb) and platelet count have not yet been studied, to our best knowledge, as potential prognostic indicators for patients with HM and COVID-19. The goal of this study is to identify factors that may increase the risk of mortality in patients with HM and COVID-19. In this single-center, retrospective, observational study, 65 patients with HM and laboratory confirmed COVID-19 were identified between March 2020 and January 2021. Information on demographics, laboratory data the day of COVID-19 diagnosis, and prognosis was extracted from the electronic medical record (EMR), chart reviewed, and analyzed using the statistical software SAS version 9.4. Chi-square testing was used for categorical variable analyses. Risk factors associated with mortality were established by logistic regression models. Non-Hodgkin lymphoma (37%), chronic lymphocytic leukemia (20%), and plasma cell dyscrasia (15%) were the most common HM. Higher Hgb level upon COVID-19 diagnosis was related to decreased mortality, odd ratio=0.704 (95% confidence interval [CI]: 0.511-0.969; P = .0263). Platelet count the day of COVID-19 diagnosis was lower in patients who ultimately died (mean 127 ± 72K/uL, n=10) compared to patients who survived (mean 197 ±92K/uL, n=55) (P=.0258). Female sex was related to decreased mortality, odd ratio=0.143 (95% confidence interval [CI]: 0.026-0.785; P = .0353). There was no mortality difference between the patients who were on treatment for HM the day of COVID-19 diagnosis compared to those who were not (P=1.000). Lower Hgb and male sex are independent risk factors associated with increased mortality of HM patients with COVID-19. Clinicians should be especially attentive to patients with HM and COVID-19 who present with cytopenias. Larger multi-center studies are urgently needed to further investigate the impact of anemia, thrombocytopenia, and demographics on outcomes of patients with hematologic malignancies diagnosed with COVID-19.

Keywords: anemia, COVID-19, hematologic malignancy, prognosis

Procedia PDF Downloads 132
199 Utilization of Long Acting Reversible Contraceptive Methods, and Associated Factors among Female College Students in Gondar Town, Northwest Ethiopia, 2018

Authors: Woledegebrieal Aregay

Abstract:

Introduction: Family planning is defined as the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is part of a strategy to reduce poverty, maternal, infant and child mortality; empowers women by lightening the burden of excessive childbearing. Family planning is achieved through the use of different contraceptive methods among which the most effective method is modern family planning methods like Long-Acting Reversible Contraceptive (LARCs) which are IUCD and Implant and these methods have multiple advantages over other reversible methods. Most importantly, once in place, they do not require maintenance and their duration of action is long, ranging from 3 to10 years. Methods: An institutional-based cross-sectional study was conducted in Gondar town among female college students from April-May. A simple random sampling technique was employed to recruit a total of 1166 study subjects. Descriptive variables were computed for all predictors & dependent variables. The presence of an association between covariates & LARC use was observed by two tables’ findings using the chi-square test. Bivariate logistic regression was conducted to identify all possible factors affecting LARC utilization & its crude Odds Ratio, 95% Confidence Interval (CI) & P-value was observed. A multivariable logistic regression model was developed to control possible confounding variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) &P-values will be computed to identify significantly associated factors (P < 0.05) with LARC utilization. Result: Utilization of LARCs was 20.4%, the most common is Implant 86(96.5%), and followed by Intra-Uterine Contraceptive Device (IUCD) 3(3.5%). The result of the multivariate analysis revealed that the significant association of marital status of the respondent on utilization of LARC [AOR 3.965(2.051-7.665)], discussion of the respondent about LARC utilization with the husband/boyfriend [AOR 2.198(1.191-4.058)], and attitude of the respondent on implant was found to be associated [AOR 0.365(0.143-0.933)].Conclusion: The level of knowledge and attitude in this study was not satisfactory, the utilization of long-acting reversible contraceptives among college students was relatively satisfactory but if the knowledge and attitude of the participant has improved the prevalence of LARC were increased.

Keywords: utilization, long-acting reversible contraceptive, Ethiopia, Gondar

Procedia PDF Downloads 197
198 Private and Public Health Sector Difference on Client Satisfaction: Results from Secondary Data Analysis in Sindh, Pakistan

Authors: Wajiha Javed, Arsalan Jabbar, Nelofer Mehboob, Muhammad Tafseer, Zahid Memon

Abstract:

Introduction: Researchers globally have strived to explore diverse factors that augment the continuation and uptake of family planning methods. Clients’ satisfaction is one of the core determinants facilitating continuation of family planning methods. There is a major debate yet scanty evidence to contrast public and private sectors with respect to client satisfaction. The objective of this study is to compare quality-of-care provided by public and private sectors of Pakistan through a client satisfaction lens. Methods: We used Pakistan Demographic Heath Survey 2012-13 dataset (Sindh province) on a total of 3133 Married Women of Reproductive Age (MWRA) aged 15-49 years. Source of family planning (public/private sector) was the main exposure variable. Outcome variable was client satisfaction judged by ten different dimensions of client satisfaction. Means and standard deviations were calculated for continuous variable while for categorical variable frequencies and percentages were computed. For univariate analysis, Chi-square/Fisher Exact test was used to find an association between clients’ satisfaction in public and private sectors. Ten different multivariate models were made. Variables were checked for multi-collinearity, confounding, and interaction, and then advanced logistic regression was used to explore the relationship between client satisfaction and dependent outcome after adjusting for all known confounding factors and results are presented as OR and AOR (95% CI). Results: Multivariate analyses showed that clients were less satisfied in contraceptive provision from private sector as compared to public sector (AOR 0.92,95% CI 0.63-1.68) even though the result was not statistically significant. Clients were more satisfied from private sector as compared to the public sector with respect to other determinants of quality-of-care (follow-up care (AOR 3.29, 95% CI 1.95-5.55), infection prevention (AOR 2.41, 95% CI 1.60-3.62), counseling services (AOR 2.01, 95% CI 1.27-3.18, timely treatment (AOR 3.37, 95% CI 2.20-5.15), attitude of staff (AOR 2.23, 95% CI 1.50-3.33), punctuality of staff (AOR 2.28, 95% CI 1.92-4.13), timely referring (AOR 2.34, 95% CI 1.63-3.35), staff cooperation (AOR 1.75, 95% CI 1.22-2.51) and complications handling (AOR 2.27, 95% CI 1.56-3.29).

Keywords: client satisfaction, family planning, public private partnership, quality of care

Procedia PDF Downloads 385
197 Analyzing Music Theory in Different Countries: Compare with Greece and China

Authors: Baoshan Wang

Abstract:

The present study investigates how music theory has developed across different countries due to their diverse histories, religions, and cultural differences. It is unknown how these various factors may contribute to differences in music theory across countries. Therefore, we examine the differences between China and Greece, which have developed unique music theories over time. Specifically, our analysis looks at musical notation and scales. For example, Tonal music originates from Greece, which harbors quite complex notation and scaling. There exist seven notes in each scale within seven modes of scales. Each mode of the diatonic scale has a unique temperament, two of which are most commonly used in modern music. In contrast, we find that Chinese music has only five notes in its scales. Interestingly, a unique feature of Chinese music theory is that there is no half-step, resulting in a highly divergent and culture-specific sound. Fascinatingly, these differences may arise from the contrasting ways that Western and Eastern musicians perceive music. While Western musicians tend to believe in music “without borders,” Eastern musicians generally embrace differing perspectives. Yet, the vast majority of colleges or music conservatories teach the borderless theory of Western music, which renders the music educational system incomplete. This is critically important because learning music is not simply a profession for musicians. Rather, it is an intermediary to facilitate understanding and appreciation for different countries’ cultures and religions. Education is undoubtedly the optimal mode to promote different countries’ music theory so people across the world can learn more about music and, in turn, each other. Even though Western music theory is predominantly taught, it is crucial we also pursue an understanding of other countries’ music because their unique aspects contribute to the systematic completeness of Music Theory in its entirety.

Keywords: culture, development, music theory, music history, religion, western music

Procedia PDF Downloads 65
196 Language Development and Learning about Violence

Authors: Karen V. Lee

Abstract:

The background and significance of this study involves research about a music teacher discovering how language development and learning can help her overcome harmful and lasting consequences from sexual violence. Education about intervention resources from language development that helps her cope with consequences influencing her career as teacher. Basic methodology involves the qualitative method of research as theoretical framework where the author is drawn into a deep storied reflection about political issues surrounding teachers who need to overcome social, psychological, and health risk behaviors from violence. Sub-themes involve available education from learning resources to ensure teachers receive social, emotional, physical, spiritual, and intervention resources that evoke visceral, emotional responses from the audience. Major findings share how language development and learning provide helpful resources to victims of violence. It is hoped the research dramatizes an episodic yet incomplete story that highlights the circumstances surrounding the protagonist’s life. In conclusion, the research has a reflexive storied framework that embraces harmful and lasting consequences from sexual violence. The reflexive story of the sensory experience critically seeks verisimilitude by evoking lifelike and believable feelings from others. Thus, the scholarly importance of using language development and learning for intervention resources can provide transformative aspects that contribute to social change. Overall, the circumstance surrounding the story about sexual violence is not uncommon in society. Language development and learning supports the moral mission to help teachers overcome sexual violence that socially impacts their professional lives as victims.

Keywords: intervention, language development and learning, sexual violence, story

Procedia PDF Downloads 309
195 Evidence Theory Based Emergency Multi-Attribute Group Decision-Making: Application in Facility Location Problem

Authors: Bidzina Matsaberidze

Abstract:

It is known that, in emergency situations, multi-attribute group decision-making (MAGDM) models are characterized by insufficient objective data and a lack of time to respond to the task. Evidence theory is an effective tool for describing such incomplete information in decision-making models when the expert and his knowledge are involved in the estimations of the MAGDM parameters. We consider an emergency decision-making model, where expert assessments on humanitarian aid from distribution centers (HADC) are represented in q-rung ortho-pair fuzzy numbers, and the data structure is described within the data body theory. Based on focal probability construction and experts’ evaluations, an objective function-distribution centers’ selection ranking index is constructed. Our approach for solving the constructed bicriteria partitioning problem consists of two phases. In the first phase, based on the covering’s matrix, we generate a matrix, the columns of which allow us to find all possible partitionings of the HADCs with the service centers. Some constraints are also taken into consideration while generating the matrix. In the second phase, based on the matrix and using our exact algorithm, we find the partitionings -allocations of the HADCs to the centers- which correspond to the Pareto-optimal solutions. For an illustration of the obtained results, a numerical example is given for the facility location-selection problem.

Keywords: emergency MAGDM, q-rung orthopair fuzzy sets, evidence theory, HADC, facility location problem, multi-objective combinatorial optimization problem, Pareto-optimal solutions

Procedia PDF Downloads 63
194 Retail Strategy to Reduce Waste Keeping High Profit Utilizing Taylor's Law in Point-of-Sales Data

Authors: Gen Sakoda, Hideki Takayasu, Misako Takayasu

Abstract:

Waste reduction is a fundamental problem for sustainability. Methods for waste reduction with point-of-sales (POS) data are proposed, utilizing the knowledge of a recent econophysics study on a statistical property of POS data. Concretely, the non-stationary time series analysis method based on the Particle Filter is developed, which considers abnormal fluctuation scaling known as Taylor's law. This method is extended for handling incomplete sales data because of stock-outs by introducing maximum likelihood estimation for censored data. The way for optimal stock determination with pricing the cost of waste reduction is also proposed. This study focuses on the examination of the methods for large sales numbers where Taylor's law is obvious. Numerical analysis using aggregated POS data shows the effectiveness of the methods to reduce food waste maintaining a high profit for large sales numbers. Moreover, the way of pricing the cost of waste reduction reveals that a small profit loss realizes substantial waste reduction, especially in the case that the proportionality constant  of Taylor’s law is small. Specifically, around 1% profit loss realizes half disposal at =0.12, which is the actual  value of processed food items used in this research. The methods provide practical and effective solutions for waste reduction keeping a high profit, especially with large sales numbers.

Keywords: food waste reduction, particle filter, point-of-sales, sustainable development goals, Taylor's law, time series analysis

Procedia PDF Downloads 104
193 Intelligent Control of Bioprocesses: A Software Application

Authors: Mihai Caramihai, Dan Vasilescu

Abstract:

The main research objective of the experimental bioprocess analyzed in this paper was to obtain large biomass quantities. The bioprocess is performed in 100 L Bioengineering bioreactor with 42 L cultivation medium made of peptone, meat extract and sodium chloride. The reactor was equipped with pH, temperature, dissolved oxygen, and agitation controllers. The operating parameters were 37 oC, 1.2 atm, 250 rpm and air flow rate of 15 L/min. The main objective of this paper is to present a case study to demonstrate that intelligent control, describing the complexity of the biological process in a qualitative and subjective manner as perceived by human operator, is an efficient control strategy for this kind of bioprocesses. In order to simulate the bioprocess evolution, an intelligent control structure, based on fuzzy logic has been designed. The specific objective is to present a fuzzy control approach, based on human expert’ rules vs. a modeling approach of the cells growth based on bioprocess experimental data. The kinetic modeling may represent only a small number of bioprocesses for overall biosystem behavior while fuzzy control system (FCS) can manipulate incomplete and uncertain information about the process assuring high control performance and provides an alternative solution to non-linear control as it is closer to the real world. Due to the high degree of non-linearity and time variance of bioprocesses, the need of control mechanism arises. BIOSIM, an original developed software package, implements such a control structure. The simulation study has showed that the fuzzy technique is quite appropriate for this non-linear, time-varying system vs. the classical control method based on a priori model.

Keywords: intelligent, control, fuzzy model, bioprocess optimization

Procedia PDF Downloads 290
192 Process Parameter Study on Friction Push Plug Welding of AA6061 Alloy

Authors: H. Li, W. Qin, Ben Ye

Abstract:

Friction Push Plug Welding (FPPW) is a solid phase welding suitable for repairing defective welds and filling self-reacting weld keyholes in Friction Stir Welds. In FPPW process, a tapered shaped plug is rotated at high speed and forced into a tapered hole in the substrate. The plug and substrate metal is softened by the increasing temperature generated by friction and material plastic deformation. This paper aims to investigate the effect of process parameters on the quality of the weld. Orthogonal design methods were employed to reduce the amount of experiment. Three values were selected for each process parameter, rotation speed (1500r/min, 2000r/min, 2500r/min), plunge depth (2mm, 3mm, 4mm) and plunge speed (60mm/min, 90mm/min, 120r/min). AA6061aluminum alloy plug and substrate plate was used in the experiment. In a trial test with the plunge depth of 1mm, a noticeable defect appeared due to the short plunge time and insufficient temperature. From the recorded temperature profiles, it was found that the peak temperature increased with the increase of the rotation speed, plunge speed and plunge depth. In the initial stage, the plunge speed was the main factor affecting heat generation, while in the steady state welding stage, the rotation speed played a more important role. The FPPW weld defect includes flash and incomplete penetration in the upper, middle and bottom interface with the substrate. To obtain defect free weld, the higher rotation speed and proper plunge depth were recommended.

Keywords: friction push plug welding, process parameter, weld defect, orthogonal design

Procedia PDF Downloads 119
191 Cognitive Impairment in Chronic Renal Patients on Hemodialysis

Authors: Fabiana Souza Orlandi, Juliana Gomes Duarte, Gabriela Dutra Gesualdo

Abstract:

Chronic renal disease (CKD), accompanied by hemodialysis, causes chronic renal failure in a number of situations that compromises not only physical, personal and environmental aspects, but also psychological, social and family aspects. Objective: To verify the level of cognitive impairment of chronic renal patients on hemodialysis. Methodology: This is a descriptive, cross-sectional study. The present study was performed in a Dialysis Center of a city in the interior of the State of São Paulo. The inclusion criteria were: being 18 years or older; have a medical diagnosis of CKD; being in hemodialysis treatment in this unit; and agree to participate in the research, with the signature of the Informed Consent (TCLE). A total of 115 participants were evaluated through the Participant Characterization Instrument and the Addenbrooke Cognitive Exam - Revised Version (ACE-R), being scored from 0 to 100, stipulating the cut-off note for the complete battery <78 and subdivided into five domains: attention and guidance; memory; fluency; language; (66.9%) and caucasian (54.7%), 53.7 (±14.8) years old. Most of the participants were retired (74.7%), with incomplete elementary schooling (36.5%) and the average time of treatment was 46 months. Most of the participants (61.3%) presented impairment in the area of attention and orientation, 80.4% in the spatial visual domain. Regarding the total ACE-R score, 75.7% of the participants presented scores below the established cut grade. Conclusion: There was a high percentage (75.7%) below the cut-off score established for ACE-R, suggesting that there may be some cognitive impairment among these participants, since the instrument only performs a screening on cognitive health. The results of the study are extremely important so that possible interventions can be traced in order to minimize impairment, thus improving the quality of life of chronic renal patients.

Keywords: cognition, chronic renal insufficiency, adult health, dialysis

Procedia PDF Downloads 338
190 A Case Study of Alkali-Silica Reaction Induced Consistent Damage and Strength Degradation Evaluation in a Textile Mill Building Due to Slow-Reactive Aggregates

Authors: Ahsan R. Khokhar, Fizza Hassan

Abstract:

Alkali-Silica Reaction (ASR) has been recognized as a potential cause of concrete degradation in the world since the 1940s. In Pakistan, mega hydropower structures like dams, weirs constructed from aggregates extracted from a local riverbed exhibited different levels of alkali-silica reactivity over an extended service period. The concrete expansion potential due to such aggregates has been categorized as slow-reactive. Apart from hydropower structures, ASR existence has been identified in the concrete structural elements of a Textile Mill building which used aggregates extracted from the nearby riverbed. The original structure of the Textile Mill was erected in the 80s with the addition of a textile ‘sizing and wrapping’ hall constructed in the 90s. In the years to follow, intensive spalling was observed in the structural members of the subject hall; enough to threat to the overall stability of the building. Limitations such as incomplete building data posed hurdles during the detailed structural investigation. The paper lists observations made while assessing the extent of damage and its effect on the building hall structure. Core testing and Petrographic tests were carried out as per the ASTM standards for strength degradation analysis followed by the identifying its root cause. Results confirmed significant structural strength reduction because of ASR which necessitated the formulation of an immediate re-strengthening solution. The paper also discusses the possible tracks of rehabilitative measures which are being adapted to stabilize the structure and seize further concrete expansion.

Keywords: Alkali-Silica Reaction (ASR), concrete strength degradation, damage assessment, damage evaluation

Procedia PDF Downloads 99
189 An Audit of Restaging Transurethral Resection of Bladder Tumor (Re-TURBT) Quality in a District General Hospital

Authors: Rizwan Iqbal

Abstract:

Introduction: Re-TURBT has been recommended by international guidelines for patients with non-muscle invasive bladder cancer (NMIBC) who are deemed high-risk. Indications for re-TURBTs remain controversial and studies show mixed outcomes. It should be performed when the initial TURBT specimen lacks detrusor muscle, has tumor stage pT1 or G3/high-grade, or where resection is deemed incomplete. This ensures complete resection of tumors that have a high risk of recurrence as well as accurately identifying any tumors which have been upstaged. The aim of this audit was to evaluate the quality of re-TURBTs in a district general hospital. Method: Data were retrospectively collected from 31 patients who had re-TURBTs between April 2021 and September 2022. Data included baseline demographics, time from initial to re-TURBT, quality of operation note, presence of residual tumor, complications, and administration of chemotherapy within 24 hours of the initial TURBT. Data collection remains ongoing at the time of writing. Results: The mean age was 76 years old and 71.0% of patients were male. 32.3% of patients had their re-TURBT within six weeks and 32.3% had intravesical chemotherapy administered within 24 hours of the initial TURBT. 74.2% of initial TURBTs had detrusor muscle present in the specimen. 48.4% of patients had residual disease following re-TURBT. Just one patient had their pathology upstaged at re-TURBT. The use of the TURBT proforma on the operation note was variable, with 51.6% and 38.7% of surgeons using the proforma after the initial and re-TURBT. Conclusion: Re-TURBT improves bladder cancer staging and is necessary in patients who are deemed high-risk in order to identify any upstaging or recurrence of the disease.

Keywords: urology, bladder cancer, turbt, cancer

Procedia PDF Downloads 42
188 An Investigation into the Impacts of High-Frequency Electromagnetic Fields Utilized in the 5G Technology on Insects

Authors: Veriko Jeladze, Besarion Partsvania, Levan Shoshiashvili

Abstract:

This paper addresses a very topical issue today. The frequency range 2.5-100 GHz contains frequencies that have already been used or will be used in modern 5G technologies. The wavelengths used in 5G systems will be close to the body dimensions of small size biological objects, particularly insects. Because the body and body parts dimensions of insects at these frequencies are comparable with the wavelength, the high absorption of EMF energy in the body tissues can occur(body resonance) and therefore can cause harmful effects, possibly the extinction of some of them. An investigation into the impact of radio-frequency nonionizing electromagnetic field (EMF) utilized in the future 5G on insects is of great importance as a very high number of 5G network components will increase the total EMF exposure in the environment. All ecosystems of the earth are interconnected. If one component of an ecosystem is disrupted, the whole system will be affected (which could cause cascading effects). The study of these problems is an important challenge for scientists today because the existing studies are incomplete and insufficient. Consequently, the purpose of this proposed research is to investigate the possible hazardous impact of RF-EMFs (including 5G EMFs) on insects. The project will study the effects of these EMFs on various insects that have different body sizes through computer modeling at frequencies from 2.5 to 100 GHz. The selected insects are honey bee, wasp, and ladybug. For this purpose, the detailed 3D discrete models of insects are created for EM and thermal modeling through FDTD and will be evaluated whole-body Specific Absorption Rates (SAR) at selected frequencies. All these studies represent a novelty. The proposed study will promote new investigations about the bio-effects of 5G-EMFs and will contribute to the harmonization of safe exposure levels and frequencies of 5G-EMFs'.

Keywords: electromagnetic field, insect, FDTD, specific absorption rate (SAR)

Procedia PDF Downloads 64
187 The Association of Excessive Work Stress with Job Satisfaction and Turnover Intention in Operating Room Nurses: A Cross-Sectional Study in a Metropolitan Teaching Hospital in Southern Taiwan

Authors: Chia Yu Chen, Shu Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Shu Jiuan Chen, Yen Ling Liu

Abstract:

Aim: It remains undetermined that whether increased work stress may affect the job satisfaction and career loyalty among nursing staffs in the operating room. The long-term goal of this study is to lengthen the professional life of operating room nurses by attenuating the work stress and enhancing their contentment in work. Method: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in the southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses. Chi-square test was used to analyze the categorical data and Pearson correlation was used to analyze the association between two numerical datasets (SPSS version 20.0). Results: The response rate was 80% (80/100) and a total of 73 (73%) completed forms were eventually proceeded for analysis. The average scores for work stress and job satisfaction of the operating room nurses were 145.96±32.91 and 47.38±6.07, respectively. The correlation coefficients of work stress versus job satisfaction and organizational identity were (r=-0.338, p=0.003 and r=-0.354, p=0.002), respectively. There were more nurses who took rotating shift quitted works from the operating room than those who took only dayshift (2=5.176, p<0.05). Nurses who reported of having lower job satisfaction were associated with significantly higher turnover intention (t=3.714, p< 0.01). Following multivariate regression analysis, rotating shift and low job satisfaction were identified as the two independent predictors of intention to quit from working in the operating room. Conclusion: Our study clearly demonstrates that increased work stress significantly attenuates job satisfaction and organizational identity. Rotating shift is associated with higher work stress, lower job satisfaction, and higher turnover intention, which is consistent with the previous surveys carried out in the department of medical technology. Therefore, improvement of working quality in the operating rooms is essential to increase the retain intention of the well-trained nursing staffs. Further investigation into types of work shifts and other strategies of attenuating stress in workplace is currently undertaken in order to improve the job satisfaction and to decrease turnover intention in the operating room.

Keywords: rotating shift, work stress, job satisfaction, turnover intention

Procedia PDF Downloads 161
186 Performance of the Photovoltaic Module under Different Shading Patterns

Authors: E. T. El Shenawy, O. N. A. Esmail, Adel A. Elbaset, Hesham F. A. Hamed

Abstract:

Generation of the electrical energy based on photovoltaic (PV) technology has been increased over the world due to either the continuous reduction in the traditional energy sources in addition to the pollution problems related to their usage, or the clean nature and safe usage of the PV technology. Also, PV systems can generate clean electricity in the site of use without any transmission, which can be considered cost effective than other generation systems. The performance of the PV system is highly affected by the amount of solar radiation incident on it. Completely or partially shaded PV systems can affect its output. The PV system can be shaded by trees, buildings, dust, incorrect system configuration, or other obstacles. The present paper studies the effect of the partial shading on the performance of a thin film PV module under climatic conditions of Cairo, Egypt. This effect was measured and evaluated according to practical measurement of the characteristic curves such as current-voltage and power-voltage for two identical PV modules (with and without shading) placed at the same time on one mechanical structure for comparison. The measurements have been carried out for the following shading patterns; half cell (bottom, middle, and top of the PV module); complete cell; and two adjacent cells. The results showed that partially shading the PV module changes the shapes of the I-V and P-V curves and produces more than one maximum power point, that can disturb the traditional maximum power point trackers. Also, the output power from the module decreased according to the incomplete solar radiation reaching the PV module due to shadow patterns. The power loss due shading was 7%, 22%, and 41% for shading of half-cell, one cell, and two adjacent cells of the PV module, respectively.

Keywords: I-V measurements, PV module characteristics, PV module power loss, PV module shading

Procedia PDF Downloads 107
185 Digitalization and High Audit Fees: An Empirical Study Applied to US Firms

Authors: Arpine Maghakyan

Abstract:

The purpose of this paper is to study the relationship between the level of industry digitalization and audit fees, especially, the relationship between Big 4 auditor fees and industry digitalization level. On the one hand, automation of business processes decreases internal control weakness and manual mistakes; increases work effectiveness and integrations. On the other hand, it may cause serious misstatements, high business risks or even bankruptcy, typically in early stages of automation. Incomplete automation can bring high audit risk especially if the auditor does not fully understand client’s business automation model. Higher audit risk consequently will cause higher audit fees. Higher audit fees for clients with high automation level are more highlighted in Big 4 auditor’s behavior. Using data of US firms from 2005-2015, we found that industry level digitalization is an interaction for the auditor quality on audit fees. Moreover, the choice of Big4 or non-Big4 is correlated with client’s industry digitalization level. Big4 client, which has higher digitalization level, pays more than one with low digitalization level. In addition, a high-digitalized firm that has Big 4 auditor pays higher audit fee than non-Big 4 client. We use audit fees and firm-specific variables from Audit Analytics and Compustat databases. We analyze collected data by using fixed effects regression methods and Wald tests for sensitivity check. We use fixed effects regression models for firms for determination of the connections between technology use in business and audit fees. We control for firm size, complexity, inherent risk, profitability and auditor quality. We chose fixed effects model as it makes possible to control for variables that have not or cannot be measured.

Keywords: audit fees, auditor quality, digitalization, Big4

Procedia PDF Downloads 270
184 Challenges and Future Prospects of Teaching English in Secondary Schools of Jharkhand Board: An Extensive Survey of the Present Status

Authors: Neha Toppo

Abstract:

Plans and programs for successful secondary education are incomplete without the inclusion of teaching English as an important area. Even after sixteen years of the formation of Jharkhand as a separate state, the students are still struggling to achieve quality education of English. This paper intends to account the present condition of teaching English in Jharkhand board secondary level schools through discussion on various issues of English language teaching, language need and learning challenges of its students. The study is to analyze whether the learning environment, teaching methods and materials, teaching resources, goals of language curriculum are appropriately convincing for the students of the board or require to be reanalyzed and also to provide appropriate suggestions for improvement. Immediate attention must be drawn towards the problem for benefitting those students, who despite their knowledge and talent are lagging behind in numerous fields only due to the lack of proficiency in English. The data and discussion provided are on the basis of a survey, in which semi structured interview with teachers, students and administrators in several schools including both rural and urban area has been taken. Questionnaire, observation and testing were used as important tools. The survey has been conducted in Ranchi district, as it covers large geographical area which includes number of villages and at the same time several towns. The district primarily possesses tribes as well as different class of people including immigrants from all over and outside Jharkhand with their social, economical strata. The observation makes it clear that the English language teaching at the state board is not complementing its context and the whole language teaching system should be re-examined to establish learner oriented environment.

Keywords: material, method, secondary level, teaching resources

Procedia PDF Downloads 540
183 Electrocatalysts for Lithium-Sulfur Energy Storage Systems

Authors: Mirko Ante, Şeniz Sörgel, Andreas Bund

Abstract:

Li-S- (Lithium-Sulfur-) battery systems provide very high specific gravimetric energy (2600 Wh/kg) and volumetric energy density (2800Wh/l). Hence, Li-S batteries are one of the key technologies for both the upcoming electromobility and stationary applications. Furthermore, the Li-S battery system is potentially cheap and environmentally benign. However, the technical implementation suffers from cycling stability, low charge and discharge rates and incomplete understanding of the complex polysulfide reaction mechanism. The aim of this work is to develop an effective electrocatalyst for the polysulfide reactions so that the electrode kinetics of the sulfur half-cell will be improved. Accordingly, the overvoltage will be decreased, and the efficiency of the cell will be increased. An enhanced electroactive surface additionally improves the charge and discharge rates. To reach this goal, functionalized electrocatalytic coatings are investigated to accelerate the kinetics of the polysulfide reactions. In order to determine a suitable electrocatalyst, apparent exchange current densities of a variety of materials (Ni, Co, Pt, Cr, Al, Cu, ITO, stainless steel) have been evaluated in a polysulfide containing electrolyte by potentiodynamic measurements and a Butler-Volmer fit including diffusion limitation. The samples have been examined by Scanning Electron Microscopy (SEM) after the potentiodynamic measurements. Up to now, our work shows that cobalt is a promising material with good electrocatalytic properties for the polysulfide reactions and good chemical stability in the system. Furthermore, an electrodeposition from a modified Watt’s nickel electrolyte with a sulfur source seems to provide an autocatalytic effect, but the electrocatalytic behavior decreases after several cycles of the current-potential-curve.

Keywords: electrocatalyst, energy storage, lithium sulfur battery, sulfur electrode materials

Procedia PDF Downloads 341
182 Need of Medicines Information OPD in Tertiary Health Care Settings: A Cross Sectional Study

Authors: Swanand Pathak, Kiran R. Giri, Reena R. Giri, Kamlesh Palandurkar, Sangita Totade, Rajesh Jha, S. S. Patel

Abstract:

Background: Population burden, illiteracy, availability of few doctors for larger group of population leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) to assess the present status of knowledge about the medicines in the patients and its correlation with education; (2) to assess the medicine information dispensing modalities, their use and sufficiency from the patients view point; (3) to assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.

Keywords: information, prescription, unbiased, clinically relevant

Procedia PDF Downloads 408
181 A Preliminary Study of the Reconstruction of Urban Residential Public Space in the Context of the “Top-down” Construction Model in China: Based on Research of TianZiFang District in Shanghai and Residential Space in Hangzhou

Authors: Wang Qiaowei, Gao Yujiang

Abstract:

With the economic growth and rapid urbanization after the reform and openness, some of China's fast-growing cities have demolished former dwellings and built modern residential quarters. The blind, incomplete reference to western modern cities and the one-off construction lacking feedback mechanism have intensified such phenomenon, causing the citizen gradually expanded their living scale with the popularization of car traffic, and the peer-to-peer lifestyle gradually settled. The construction of large-scale commercial centers has caused obstacles to small business around the residential areas, leading to space for residents' interaction has been compressed. At the same time, the advocated Central Business District (CBD) model even leads to the unsatisfactory reconstruction of many historical blocks such as the Hangzhou Southern Song Dynasty Imperial Street. However, the popularity of historical spaces such as Wuzhen and Hongcun also indicates the collective memory and needs of the street space for Chinese residents. The evolution of Shanghai TianZiFang also proves the importance of the motivation of space participants in space construction in the context of the “top-down” construction model in China. In fact, there are frequent occurrences of “reconstruction”, which may redefine the space, in various residential areas. If these activities can be selectively controlled and encouraged, it will be beneficial to activate the public space as well as the residents’ intercourse, so that the traditional Chinese street space can be reconstructed in the context of modern cities.

Keywords: rapid urbanization, traditional street space, space re-construction, bottom-up design

Procedia PDF Downloads 79
180 Factors Associated with Cytomegalovirus Infection: A Prospective Single Centre Study

Authors: Marko Jankovic, Aleksandra Knezevic, Maja Cupic, Dragana Vujic, Zeljko Zecevic, Borko Gobeljic, Marija Simic, Tanja Jovanovic

Abstract:

The human cytomegalovirus (CMV) is a notorious pathogen in the pediatric transplant setting. Although studies on factors in complicity with CMV infection abound, the role of age, gender, allogeneic hematopoietic stem cell transplantation (alloHSCT) modality, and underlying disease as regards CMV infection and viral load in children are poorly explored. We examined the significance of various factors related to the risk of CMV infection and viral load in Serbian children and adolescents undergoing alloHSCT. This was a prospective single centre study of thirty two pediatric patients in receipt of alloHSCT for various malignant and non-malignant disorders. Screening for active viral infection was performed by regular weekly monitoring. The Real-Time PCR method was used for CMV DNA detection and quantitation. Statistical analysis was performed using the IBM SPSS Statistics v20 software. Chi-square test was used to evaluate categorical variables. Comparison between scalar and nominal data was done by Wilcoxon-Mann-Whitney test. Pearson correlation was applied for studying the association between patient age and viral load. CMV was detected in 23 (71.9%) patients. Infection occurred significantly more often (p=0.015) in patients with haploidentical donors. The opposite was noted for matched sibling grafts (p=0.006). The viral load was higher in females (p=0.041) and children in the aftermath of alloHSCT with malignant diseases (p=0.019). There was no significant relationship between the viral infection dynamics and overt medical consequences. This is the first study of risk factors for CMV infection in Serbian pediatric alloHSCT patients. Transplanted patients presented with a high incidence of CMV viremia. The HLA compatibility of donated graft is associated with the frequency of CMV positive events. Age, gender, underlying disease, and medically relevant events were not conducive to occurrences of viremia. Notably, substantial viral burdens were evidenced in females and patients with neoplastic diseases. Studies comprising larger populations are clearly needed to scrutinize current results.

Keywords: allogeneic hematopoietic stem cell transplantation, children, cytomegalovirus, risk factors, viral load

Procedia PDF Downloads 121
179 Juridically Secure Trade Mechanisms for Alternative Dispute Resolution in Transnational Business Negotiations

Authors: Linda Frazer

Abstract:

A pluralistic methodology focuses on promoting an understanding that an alternative juridical framework for the regulation of transnational business negotiations (TBN) between private business parties is fundamentally required. This paper deals with the evolving assessment of the doctoral research of the author which demonstrated that due to insufficient juridical tools, negotiations are commonly misunderstood within the complexity of pluralistic and conflicting legal regimes. This inadequacy causes uncertainty in the enforcement of legal remedies, leaving business parties surprised. Consequently, parties cannot sufficiently anticipate when and how legal rights and obligations are created, often counting on oral or incomplete agreements which may lead to the misinterpretation of the extent of their legal rights and obligations. This uncertainty causes threats to business parties for fear of creating unintended legal obligations or, conversely, that law will not enforce intended agreements for failure to pass the tests of contractual validity. A need to find a manner to set default standards of communications and standards of conduct to monitor our evolving global trade would aid law to provide the security, predictability and foreseeability during alternative dispute resolution required by TBN parties. The conclusion of this study includes a proposal of new trade mechanisms, termed 'Bills of Negotiations' (BON) to enhance party autonomy and promote the ability for TBN parties to self-regulate within the boundaries of law. BON will be guided by a secure juridical institutionalized setting that caters to guiding communications during TBN and resolving disputes that arise along the negotiation processes on a fast track basis.

Keywords: alternative resolution disputes, ADR, good faith, good faith, juridical security, legal regulation, trade mechanisms, transnational business negotiations

Procedia PDF Downloads 120
178 Long-Term Cohort of Patients with Beta Thalassemia; Prevailing Role of Serum Ferritin Levels in Hypocalcemia and Growth Retardation

Authors: Shervin Rashidinia, Sara Shahmoradi, Seyyed Shahin Eftekhari, Mohsen Talebizadeh, Mohammad Saleh Sadeghi

Abstract:

Background: Beta-thalassemia Major (BTM) is a kind of hereditary hemolytic anemia which depended on regular monthly blood transfusion. However, iron deposition into the organs leads to multi-organ damage. The present study is the first study which aimed to evaluate the average of five-years serum ferritin level and compared by the prevalence of short stature and hypocalcemia. Materials/Methods: A cross-sectional retrospective study which a total of 140 patients with beta-thalassemia who were referred to Qom Thalassemia Clinic between February 2011 and July 2016 were enrolled to be reviewed. The exclusion criteria were consisting of incomplete medical records, diagnosis less than 2-years-ago and the blood transfusion less than every 4 weeks. The data including age, gender, weight, height, age of initial blood transfusion, age of initial chelation therapy, ferritin, and calcium were collected and analysis by SPSS version 24. Results: A total of 140 patients were enrolled. Of them, 75 (53.4%) were female. The mean age of the patients was 13.4±4.6 years.The mean age of initial diagnosis was 20.2±7.4 months. Hypocalcemia and short stature were occurred in 41 (29.3%) and 37 (26.4%) patients, respectively. The mean five-years serum ferritin level was significantly higher in the patients with short stature and hypocalcemia (P<0.0001). However, rise in serum ferritin level significantly increases the risk of short-stature and hypocalcemia (1.0004- and 1.0029 fold, respectively). Conclusion: We demonstrated that prevalence of short stature and hypocalcemia were significantly higher in the BTM.However, ferritin significantly increases the risk of short stature and hypocalcemia.

Keywords: beta-thalassemia, ferritin, growth retardation, hypocalcemia

Procedia PDF Downloads 303
177 Correlation between Nutritional Status and Length of Stay and Hospital Costs in Critical Care and IPD Patients of Somdech Phra Debaratana Medical Center (SDMC), Faculty of Medicine, Ramathibodi Hospital

Authors: Nuttapimon Bhirommuang, Kulapong Jayanama

Abstract:

Background: Prevalence of malnutrition in hospitalized patient is higher than general population. As a result of the unawareness of consequence and the more concerning in the other aspects of care, many patients with high risk of malnutrition are unrecognized. Even if malnutrition has been identified as affecting in many patient outcomes, the impact may differ in each population and group of patients. Objectives: The aims of this study were to examine the association between the nutritional status and the length of stay and hospital costs in hospitalized patients, to investigate the factors related these outcomes and to determine the frequency of malnutrition in hospitals. Method: This retrospective cohort study enrolled all patients aged 15 years old or older and admitted in SDMC, Ramathibodi Hospital between 1st January 2016 and 30th September 2016. The nutritional status assessment by Nutrition Alert Form (NAF) was performed by well-trained nurses in all patients at admission. Baseline characteristics were recorded. Length of stay and hospital costs were collected during their hospitalization. Univariate analysis, nonparametric rank test, Kruskal-Wallis test were used to compare means in the case of nonnormally and noncontinuously distributed data. Chi-square used to analyze categorical variables, the nutritional status and the length of stay and hospital costs and identify possible confounding factors (data were analyzed using SPSS version 18.0). Result: Of the 2,906 patients, 3.9% were severe malnutrition (NAF-C score > 10) and 11.4% were moderate malnutrition (NAF-B score 6 - 10). Both length of stay and hospital costs were found significantly higher in more severe malnutrition group (p < 0.001), NAF = A: 3.21 days, 95% CI 3.06-3.35 and 111,544.25 THB, 95% CI 106,994.41 – 116,094.1; NAF = B: 7.54 days, 95% CI 6.32 – 8.76 and 162,302.4 THB, 95% CI 129,557.88 – 195,046.92; NAF =C: 14.77 days, 95% CI 11.34 – 18.2 and 323,572.11 THB, 95% CI 226,958.1 – 420,096.13 (1 THB = 0.03019 USD). Age of each nutritional status group had also significant increase from NAF A to NAF C (p < 0.001): 55.07, 67.03 and 73.88 years old, respectively. Conclusion: The prevalence of malnutrition in Ramathibodi hospital is voluminous. Severe malnutrition screening by NAF is significantly correlated with worse clinical outcome, especially higher length of stay and hospital costs. Elderly is also a significant factor which correlates with malnutrition. The results of this study could change the awareness of health personnel and the practice protocol. Moreover, the further study concerning nutritional support in high-risk group of malnutrition is ongoing to confirm this hypothesis.

Keywords: malnutrition, NAF, length of stay, hospital costs

Procedia PDF Downloads 248
176 Urban Logistics Dynamics: A User-Centric Approach to Traffic Modelling and Kinetic Parameter Analysis

Authors: Emilienne Lardy, Mariam Lafkihi, Eric Ballot

Abstract:

Efficient city logistics requires a comprehensive understanding of traffic dynamics, particularly as it pertains to kinetic parameters influencing energy consumption and trip duration estimations. While real-time traffic information is increasingly accessible, current high-precision forecasting services embedded in route planning often function as opaque 'black boxes' for users. These services, typically relying on AI-processed counting data, fall short in accommodating open design parameters essential for management studies, notably within Supply Chain Management. This work revisits the modeling of traffic conditions in the context of city logistics, emphasizing its significance from the user’s point of view, with two focuses. Firstly, the focus is not on the vehicle flow but on the vehicles themselves and the impact of the traffic conditions on their driving behaviour. This means opening the range of studied indicators beyond vehicle speed to describe extensively the kinetic and dynamic aspects of driving behaviour. To achieve this, we leverage the Art. Kinema parameters are designed to characterize driving cycles. Secondly, this study examines how the driving context (i.e., exogenous factors to the traffic flow) determines the mentioned driving behaviour. Specifically, we explore it investigates how accurately the kinetic behaviour of a vehicle can be predicted based on a limited set of exogenous factors, such as time, day, road type, orientation, slope, and weather conditions. To answer this question, statistical analysis was conducted on real-world driving data, which includes high-frequency measurements of vehicle speed. A Generalized Linear Model has been established to link kinetic parameters with independent categorical contextual variables. The results include the analysis of the regression’s accuracy, as well as the utilization of the regression’s results in freight distribution scenario elaboration and analysis for Supply Chain Management purposes.

Keywords: driving context, generalized linear model, kinetic behaviour, real world driving data

Procedia PDF Downloads 33
175 The Neuroscience Dimension of Juvenile Law Effectuates a Comprehensive Treatment of Youth in the Criminal System

Authors: Khushboo Shah

Abstract:

Categorical bans on the death penalty and life-without-parole sentences for juvenile offenders in a growing number of countries have established a new era in juvenile jurisprudence. This has been brought about by integration of the growing knowledge in cognitive neuroscience and appreciation of the inherent differences between adults and adolescents over the last ten years. This evolving understanding of being a child in the criminal system can be aptly reflected through policies that incorporate the mitigating traits of youth. First, the presentation will delineate the structures in cognitive neuroscience and in particular, focus on the prefrontal cortex, the amygdala, and the basal ganglia. These key anatomical structures in the brain are linked to three mitigating adolescent traits—an underdeveloped sense of responsibility, an increased vulnerability to negative influences, and transitory personality traits—that establish why juveniles have a lessened culpability. The discussion will delve into the details depicting how an underdeveloped prefrontal cortex results in the heightened emotional angst, high-energy and risky behavior characteristic of the adolescent time period or how the amygdala, the emotional center of the brain, governs different emotional expression resulting in why teens are susceptible to negative influences. Based on this greater understanding, it is incumbent that policies adequately reflect the adolescent physiology and psychology in the criminal system. However, it is important to ensure that these views are appropriately weighted while considering the jurisprudence for the treatment of children in the law. To ensure this balance is appropriately stricken, policies must incorporate the distinctive traits of youth in sentencing and legal considerations and yet refrain from the potential fallacies of absolving a juvenile offender of guilt and culpability. Accordingly, three policies will demonstrate how these results can be achieved: (1) eliminate housing of juvenile offenders in the adult prison system, (2) mandate fitness hearings for all transfers of juveniles to adult criminal court, and (3) use the post-disposition review as a type of rehabilitation method for juvenile offenders. Ultimately, this interdisciplinary approach of science and law allows for a better understanding of adolescent psychological and social functioning and can effectuate better legal outcomes for juveniles tried as adults.

Keywords: criminal law, Juvenile Justice, interdisciplinary, neuroscience

Procedia PDF Downloads 301