Search results for: potentially%20inappropriate%20medicines

Authors: Ajit Kumar Sah, Rajesh Kumar Jha, Phoolgen Sah, Dev Kumar Shah

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Older individuals often suffer from multiple systemic diseases and are particularly more vulnerable to potentially inappropriate medicine prescribing. Inappropriate medication can cause serious medical problem for the elderly. The purpose of this study was to determine the prevalence of potentially inappropriate medicine (PIM) prescribing in older Nepalese patients in a medicine outpatient department. Beers’ criteria are the most widely used tools to assess PIM to elderly patients. Prospective observational analysis of drugs prescribed in medicine out-patient department (OPD) of a hospital of Bharatpur, Chitwan, Nepal during November 2011 to October 2012 to 869 older adults aged 65 years and above. The use of potentially inappropriate medications (PIM) in elderly patients was analyzed using Beers Criteria updated to 2013. In the 869 patients included the average number of drugs prescribed per prescription was 5.56. The most commonly used drugs were atenolol (24.3%), amlodipine (23.16%), paracetamol (17.6%), salbutamol (15.72%) and vitamin B complex (13.26%). The total number of medications prescribed was 4833. At least one instance of PIM was experienced by approximately 26.3% of patients when evaluated using the Beers criteria. Potentially inappropriate medications are highly prevalent among older patients attending medical OPD and are associated with a number of medications prescribed. Further research is warranted to study the impact of PIMs towards health-related outcomes in these elderly.

Keywords: Beers criteria, elderly, polypharmacy, potentially inappropriate medicines

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Authors: Anders Troedsson

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For us humans, risk and insecurity are intimately linked to vulnerabilities - where there is vulnerability, there is potentially risk and insecurity. Reducing vulnerability through compensatory measures means decreasing the likelihood of a certain external event be qualified as a risk/threat/assault, and thus also means increasing the individual’s sense of security. The paper suggests that a meaningful way to approach the study of risk/ insecurity is to organize thinking about the vulnerabilities that external phenomena evoke in humans as perceived by them. Such phenomena are, through a set of given vulnerabilities, potentially translated into perceptions of "insecurity." An ontological discussion about salient timespace characteristics of external phenomena as perceived by humans, including such which potentially can be qualified as risk/threat/assault, leads to the positing of two dimensions which are central for describing what in the paper is called the essence of risk/threat/assault. As is argued, such modeling helps analysis steer free of the subjective factor which is intimately connected to human perception and which mediates between phenomena “out there” potentially identified as risk/threat/assault, and their translation into an experience of security or insecurity. A proposed set of universally given vulnerabilities are scrutinized with the help of the two dimensions, resulting in a modeling effort featuring four realms of vulnerabilities which together represent a dynamic whole. This model in turn informs modeling on human security.

Keywords: human vulnerabilities, human security, immediate-inert, material-immaterial, timespace

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Authors: Anthara Vivek, Manisha Shukla, Mahesh Narayan, Prakash Narayan

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Sickle cell disease disproportionately affects sub-Saharan Africa and certain tribal populaces in India and has consequently drawn little intertest from Pharma. In sickle cell patients, adhesion of erythrocytes or reticulocytes to one another and the vessel wall results in painful ischemic episodes with few, if any, effective treatments for vaso-occlusive crises. Identification of disease-associated adhesion markers on erythrocytes or reticulocytes might inform the use of more effective therapies against vaso-occlusive crises. Increased expression of one or more of bcam, itga4, cd44, cd47, rap1a, vcam1, or icam4 has been reported in sickle cell subjects. Using the miRNet ontology knowledgebase, peripheral blood interactomes were generated by seeding various combinations of the afore-referenced mRNA. These interactomes yielded an array of miR targets. As examples, targeting hsa-miR-155-5p can potentially neutralize the rap1a-bcam-cd44-itga4-vcam1 erythrocyte/reticulocyte adhesion interactome whereas targeting hsa-miRs-103a-3p or 107 can potentially neutralize adhesion in cells overexpressing icam4-cd47-bcam-itga4-cd36. AM3380 (MIRacle™) is an off-the shelf hsa-miR-155-5p agomiR that can potentially neutralize the rap1a-bcam-cd44-itga4-vcam1 signaling axis. Phlebotomy coupled with transcriptomics represents a potentially feasible and effective precision medicine strategy to mitigate vaso-occlusive crises in sickle cell patients.

Keywords: adhesion, interactome, precision, medicine

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Authors: Itulelo Matiyabu Imaja, Patrick Ndayizigamiye, Manoj Maharaj

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There are many catalysts of corruption. These include amongst others, lack of effective control measures to deter or detect corrupt behaviour. Literature suggests that ICT could assist in curbing corruption through the implementation of automated systems, citizens engagement through e-government and online media to name a few. In the Democratic Republic of Congo, lack of transparency and accountability in public funds collection and allocation contribute to corruption in funds mismanagement. Using the accountability theory and available literature, this paper analyses how Democratic Republic of Congo (DRC) institutions could be strengthened through ICT in order to deter instances of corruption. Findings reveal that DRC lacks reliable control, monitoring and evaluation mechanisms that could identify potentially corrupt behavior. In addition, citizens and civil society organizations who are meant to hold the institutions accountable are not given secure platform to express their views and potentially flag any corrupt behavior. Hence, the paper presents a preliminary conceptual framework that depicts how ICT could be used to strengthen current institutions to potentially deter corrupt behavior in public funds management in Congo.

Keywords: corruption, ICT adoption, transparency, DR Congo

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Authors: Daniel Rosero, Johan S. Arana, Sebastian Arango, Alejandro Cruz, Isabel Gomez-Gutierrez, Peter Thomson

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Santiago de Cali is located in the southwestern Colombia in a high seismic hazard zone. About 50% of the city is on the banks of the Cauca River, which is the second most important hydric affluent in the country and whose alluvial deposits contain potentially liquefiable sands. Among the methods used to study a site's liquefaction potential is the finite elements method which use constitutive models to simulate the soil response for different load types. Among the different constitutive models, the Modified UBCSand stands out to study the seismic behavior of sands, and especially the liquefaction phenomenon. In this paper, the dynamic behavior of a potentially liquefiable sand of Santiago de Cali is studied by cyclic triaxial and CPTu tests. Subsequently, the behavior of the sand is simulated using the Modified UBCSand constitutive model, whose parameters are calibrated using the results of cyclic triaxial and CPTu tests. The above with the aim of analyze the constitutive model applicability for studying the geotechnical problems associated to liquefaction in the city.

Keywords: constitutive model, cyclic triaxial test, dynamic behavior, liquefiable sand, modified ubcsand

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

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

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

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Authors: Raja Ezman Raja Shariff

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Acute kidney injury (AKI) is commonly seen in inpatients, and places a great cost on the NHS and patients. Timely and appropriate management is both nephron sparing and potentially life-saving. Ultrasound scanning (USS) is a well-recognised method for stratifying patients. Subsequently, the NICE AKI guidance has defined groups in whom scanning is recommended within 6 hours of request (pyonephrosis), within 24 hours (obstruction/cause unknown), and in whom routine scanning isn't recommended (cause for AKI identified). The audit looks into whether Stockport NHS Trust USS practice was in line with such recommendations. The audit evaluated 92 patients with AKI who had USS, between 01/01/14 to 30/04/14. Data collection was divided into 2 parts. Firstly, radiology request cards and the online imaging software (PACS) were evaluated. Then, the electronic case notes (ADVANTIS) was evaluated further. Based on request cards, 10% of requests were for pyonephrosis. Only 33% were scanned within 6hours and a further 33% within 24hours. 75% were requested for possible obstructions and unknown cause collectively. Of those due to possible obstruction, 71% of patients were scanned within 24 hours. Of those with unknown cause, 50% were scanned within 24 hours. 15% of requests had a cause declared and so potentially did not require scanning. Evaluation of the patients’ notes suggested further interesting findings. Firstly, potentially 39% of patients had a known cause for AKI, therefore, did not need USS. Subsequently, the cohort of unknown cause and possible obstruction was collectively reduced to 45%. Alarmingly the patient cohort with possible pyonephrosis went up to 16%, suggesting an under-recognition of this life-threatening condition. We plan to highlight these findings within our institution and make changes to encourage more appropriate requesting and timely scanning. Time will tell if we manage to save or increase our costs in this cost-conscious NHS. Patient benefits, though, seem to be guaranteed.

Keywords: AKI, ARF, kidney, renal

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Authors: Charlotte Lülf

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Migration flows cannot be tackled by single states but need to be addressed as a transnational and international responsibility. However, the current international framework staggers. Widely excluded from legal protection are people that flee from the indiscriminate effects of an armed conflict as well as people fleeing natural disasters. This paper as part of an on-going PhD Project deals with the current and partly contradicting approaches to the protection of so-called war- and climate refugees in the European Union. The analysis will emphasize and evaluate the role of the European judiciary to define, redefine and potentially expand legal protection. Changing jurisprudential practice of national and regional courts will be assessed, as will be their dialogue to interpret the international obligations of human rights law, migration laws and asylum laws in an interacting world.

Keywords: human rights law, asylum law, migration, refugee protection

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Authors: Chien-Wan Hun, Shao-Fu Chang, Jheng-En Yang, Chien-Chon Chen, Wern-Dare Jheng

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This research provides a systematic way to study and better understand double nano-tubular structure of alunina (Al2O3) and titania (TiO2). The TiO2 NT was prepared by immersing Al2O3 template in 0.02 M titanium fluoride (TiF4) solution (pH=3) at 25 °C for 120 min, followed by annealing at 450 °C for 1 h to obtain anatase TiO2 NT in the Al2O3 template. Large-scale development of film for nanotube-based CO2 capture and conversion can potentially result in more efficient energy harvesting. In addition, the production process will be relatively environmentally friendly. The knowledge generated by this research will significantly advance research in the area of Al2O3, TiO2, CaO, and Ca2O3 nano-structure film fabrication and applications for CO2 capture and conversion. This green energy source will potentially reduce reliance on carbon-based energy resources and increase interest in science and engineering careers.

Keywords: alumina, titania, nano-tubular, film, CO2

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Authors: Cristina Galván-Fernández, Elena Barberà, Jingjing Zhang

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In recent years, MOOCs have been in the spotlight for its high drop-out rates, which potentially impact on the quality of the learning experience. This study attempts to explore how learning support can be used to keep student retention, and in turn to improve the quality of learning in MOOCs. In this study, the patterns of learning support were identified from a total of 4202592 units of video sessions, clickstream data of 25600 students, and 382 threads generated in 10 forums (optional and mandatory) in five different types of MOOCs (e.g. conventional MOOCs, professional MOOCs, and informal MOOCs). The results of this study have shown a clear correlation between the types of MOOCs, the design framework of the MOOCs, and the learning support. The patterns of tutor-peer interaction are identified, and are found to be highly correlated with student retention in all five types of MOOCs. In addition, different patterns of ‘good’ students were identified, which could potentially inform the instruction design of MOOCs.

Keywords: higher education, learning support, MOOC, retention

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Authors: John Rothrock

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Background: The role of transthoracic echocardiography (TTE) in the diagnosis and management of patients with acute ischemic stroke remains controversial. While many stroke subspecialist reserve TTE for selected patients, others consider the procedure obligatory for most or all acute stroke patients. This study was undertaken to assess the cost vs. benefit of 'routine' TTE. Methods: We examined a consecutive series of patients who were admitted to a single institution in 2019 for acute ischemic stroke and underwent TTE. We sought to determine the frequency with which the results of TTE led to a new diagnosis of cardioembolism, redirected therapeutic cerebrovascular management, and at least potentially influenced the short or long-term clinical outcome. We recorded the direct cost associated with TTE. Results: There were 1076 patients in the study group, all of whom underwent TTE. TTE identified an unsuspected source of possible/probable cardioembolism in 62 patients (6%), confirmed an initially suspected source (primarily endocarditis) in an additional 13 (1%) and produced findings that stimulated subsequent testing diagnostic of possible/probable cardioembolism in 7 patients ( < 1%). TTE results potentially influenced the clinical outcome in a total of 48 patients (4%). With a total direct cost of $1.51 million, the mean cost per case wherein TTE results potentially influenced the clinical outcome in a positive manner was $31,375. Diagnostically and therapeutically, TTE was most beneficial in 67 patients under the age of 55 who presented with 'cryptogenic' stroke, identifying patent foramen ovale in 21 (31%); closure was performed in 19. Conclusions: The utility of TTE in the setting of acute ischemic stroke is modest, with its yield greatest in younger patients with cryptogenic stroke. Given the greater sensitivity of transesophageal echocardiography in detecting PFO and evaluating the aortic arch, TTE’s role in stroke diagnosis would appear to be limited.

Keywords: cardioembolic, cost-benefit, stroke, TTE

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Authors: R. K. Vinnakota, D. A. Genov, Z. Dong, A. F. Briggs, L. Nordin, S. R. Bank, D. Wasserman

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We present a semiconductor-based plasmonic electro-optic modulator based on excitation and active control of surface plasmon polaritons (SPPs) at the interface of degenerately doped In₀.₅₃Ga₀.₄₇As pn++ junctions. Set of devices, which we refer to as a surface plasmon polariton diode (SPPD), are fabricated and characterized electrically and optically. Optical characterization predicts far-field voltage-aided reflectivity modulation for mid-IR wavelengths. Numerical device characterizations using a self-consistent electro-optic multiphysics model have been performed to confirm the experimental findings were predicting data rates up to 1Gbits/s and 3dB bandwidth as high as 2GHz. Our findings also show that decreasing the device dimensions can potentially lead to data rates of more than 50Gbits/s, thus potentially providing a pathway toward fast all-semiconductor-based plasmotronic devices.

Keywords: plasmonics, optoelectronics, PN junctions, surface plasmon polaritons

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Authors: Mohd Taufiq bin Azmy, Yahaya Hassan, Shubashini Gnanasan, Loganathan Fahrni

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Inappropriate prescribing in older patients has been associated with resource utilization and adverse drug events (ADE) such as hospitalization, morbidity and mortality. Globally, there is a lack of published data on ADE induced by inappropriate prescribing. Our study is specific to an older population and is aimed at identifying risk factors for ADE and to develop a model that will link ADE to inappropriate prescribing. The design of the study was prospective whereby computerized medical records of 302 hospitalized elderly aged 65 years and above in 3 public hospitals in Malaysia (Hospital Serdang, Hospital Selayang and Hospital Sungai Buloh) were studied over a 7 month period from September 2013 until March 2014. Potentially inappropriate medications and potential prescribing omissions were determined using the published and validated START-STOPP criteria. Patients who had at least one inappropriate medication were included in Phase II of the study where ADE were identified by local expert consensus panel based on the published and validated Naranjo ADR probability scale. The panel also assessed whether ADE were causal or contributory to current hospitalization. The association between inappropriate prescribing and ADE (hospitalization, mortality and adverse drug reactions) was determined by identifying whether or not the former was causal or contributory to the latter. Rate of ADE avoidability was also determined. Our findings revealed that the prevalence of potential inappropriate prescribing was 58.6%. A total of ADEs were detected in 31 of 105 patients (29.5%) when STOPP criteria were used to identify potentially inappropriate medication; All of the 31 ADE (100%) were considered causal or contributory to admission. Of the 31 ADEs, 28 (90.3%) were considered avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when a potentially inappropriate medication was prescribed (odds ratio, 11.18; 95% confidence interval [CI], 5.014 - 24.93; p < .001). The medications identified by STOPP criteria, are significantly associated with avoidable ADE in older people that cause or contribute to urgent hospitalization but contributed less towards morbidity and mortality. Findings of the study underscore the importance of preventing inappropriate prescribing.

Keywords: adverse drug events, appropriate prescribing, health services research

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Authors: Fury Khristianty Fitriyah

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This study aims to identify the extent of the role of the Satuan Pengawas Intern (Internal Audit Unit) in detecting and preventing fraud in public universities in West Java under the Ministry of Research, Technology and Higher Education. The research method applied was a qualitative case study approach, while the unit of analysis for this study is the Internal Audit Unit at each public university. Results of this study indicate that the Internal Audit Unit is able to detect and prevent fraud within a public university environment by means of red flags to mark accounting anomalies. These stem from inaccurate budget planning that prompts inappropriate use of funds, exacerbated by late disbursements of funds, which potentially lead to fictitious transactions, and discrepancies in recording state-owned assets into a state property management system (SIMAK BMN), which, if not conducted properly, potentially causes loss to the state.

Keywords: governance, internal control, fraud, public university

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Authors: Moncer Malika, Ben Brahim Mounir, Bel Hassen Malika, Hamza Asma

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During the last decades, microalgae communities have presented significant changes in their structure and taxa composition along the Mediterranean littoral shallow waters. The main purpose of this work was to evaluate possible changes, over a 17-year scale (1997–2013), in the diversity and abundance of three toxic and potentially toxic microalgae related to changes in environmental parameters on Sfax coasts, a pole of shellfish production in Tunisia. In this 17-year span, a chronological series of data showed that a clear disparity from one year to another was observed in the abundance of studied species. The distribution of these species has been subjected to a seasonal cycle. The studied microalgae, especially Prorocentrum lima, seem to have significant relationships with many physicochemicaland meteorological parameters.

Keywords: long-term monitoring HABs, physico-chemical parameters, meteorological parameters, Prorocentrum lima, Ostreopsis cf. ovata, Coolia monotis

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Authors: Z. Abdollahi Biron, P. Pisu

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Connected vehicles are one of the promising technologies for future Intelligent Transportation Systems (ITS). A connected vehicle system is essentially a set of vehicles communicating through a network to exchange their information with each other and the infrastructure. Although this interconnection of the vehicles can be potentially beneficial in creating an efficient, sustainable, and green transportation system, a set of safety and reliability challenges come out with this technology. The first challenge arises from the information loss due to unreliable communication network which affects the control/management system of the individual vehicles and the overall system. Such scenario may lead to degraded or even unsafe operation which could be potentially catastrophic. Secondly, faulty sensors and actuators can affect the individual vehicle’s safe operation and in turn will create a potentially unsafe node in the vehicular network. Further, sending that faulty sensor information to other vehicles and failure in actuators may significantly affect the safe operation of the overall vehicular network. Therefore, it is of utmost importance to take these issues into consideration while designing the control/management algorithms of the individual vehicles as a part of connected vehicle system. In this paper, we consider a connected vehicle system under Co-operative Adaptive Cruise Control (CACC) and propose a fault diagnosis scheme that deals with these aforementioned challenges. Specifically, the conventional CACC algorithm is modified by adding a Kalman filter-based estimation algorithm to suppress the effect of lost information under unreliable network. Further, a sliding mode observer-based algorithm is used to improve the sensor reliability under faults. The effectiveness of the overall diagnostic scheme is verified via simulation studies.

Keywords: fault diagnostics, communication network, connected vehicles, packet drop out, platoon

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Authors: Denis Mustafov, Emmanouil Karteris, Maria Braoudaki

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Glioblastoma multiform (GBM) is a heterogenous primary brain tumour that kills most affected patients. To the authors best knowledge, despite all research efforts there is no early diagnostic biomarker for GBM. MicroRNAs (miRNAs) are short non-coding RNA molecules which are deregulated in many cancers. The aim of this research was to determine miRNAs with a diagnostic impact and to potentially identify promising therapeutic targets for glioblastoma multiform. In silico analysis was performed to identify deregulated miRNAs with diagnostic relevance for glioblastoma. The expression profiles of the chosen miRNAs were then validated in vitro in the human glioblastoma cell lines A172 and U-87MG. Briefly, RNA extraction was carried out using the Trizol method, whilst miRNA extraction was performed using the mirVANA miRNA isolation kit. Quantitative Real-Time Polymerase Chain Reaction was performed to verify their expression. The presence of five target proteins within the A172 cell line was evaluated by Western blotting. The expression of the CORO1C protein within 32 GBM cases was examined via immunohistochemistry. The miRNAs identified in silico included miR-21-5p, miR-34a and miR-128a. These miRNAs were shown to target deregulated GBM genes, such as CDK6, E2F3, BMI1, JAG1, and CORO1C. miR-34a and miR-128a showed low expression profiles in comparison to a control miR-RNU-44 in both GBM cell lines suggesting tumour suppressor properties. Opposing, miR-21-5p demonstrated greater expression indicating that it could potentially function as an oncomiR. Western blotting revealed expression of all five proteins within the A172 cell line. In silico analysis also suggested that CORO1C is a target of miR-128a and miR-34a. Immunohistochemistry demonstrated that 75% of the GBM cases showed moderate to high expression of CORO1C protein. Greater understanding of the deregulated expression of miR-128a and the upregulation of CORO1C in GBM could potentially lead to the identification of a promising diagnostic biomarker signature for glioblastomas.

Keywords: non-coding RNAs, gene expression, brain tumours, immunohistochemistry

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Authors: Emine Akar

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The majority of privacy-related regulation has traditionally focused on concepts that are perceived to be well-understood or easily describable, such as certain categories of data and personal information or images. In the past century, such regulation appeared reasonably suitable for its purposes. However, technologies such as AI, combined with ever-increasing capabilities to collect, process, and store “big data”, not only require calibration of these traditional understandings but may require re-thinking of entire categories of privacy law. In the presentation, it will be explained, against the background of various emerging technologies under the umbrella term “emotional artificial intelligence”, why modern privacy law will need to embrace human emotions as potentially private subject matter. This argument can be made on a jurisprudential level, given that human emotions can plausibly be accommodated within the various concepts that are traditionally regarded as the underlying foundation of privacy protection, such as, for example, dignity, autonomy, and liberal values. However, the practical reasons for regarding human emotions as potentially private subject matter are perhaps more important (and very likely more convincing from the perspective of regulators). In that respect, it should be regarded as alarming that, according to most projections, the usefulness of emotional data to governments and, particularly, private companies will not only lead to radically increased processing and analysing of such data but, concerningly, to an exponential growth in the collection of such data. In light of this, it is also necessity to discuss options for how regulators could address this emerging threat.

Keywords: AI, privacy law, data protection, big data

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Authors: Ryan J. Trefethen, Vincent H. Smith

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This study explores the relationship between national spending on the Medicaid program, and total Medicaid spending and enrollment in Montana, a state that ranks thirty-third in per capita income and thirty-seventh in median household income in the United States. The purpose of the research is to estimate the potential effects that specific changes to national healthcare policy would likely have on funding for the Montana Medicaid Program and enrollees in the program, members of families in poverty whose incomes are low, even though in many cases they have steady jobs. A particular concern is the effect on access to care for children in poverty who tend to be food insecure and, therefore, especially in need of access to health care. The research uses data collected from a variety of government publications, including the Medicaid Financial Management Report, the Medicaid Managed Care Enrollment Report, and the Centers for Medicare and Medicaid Services MSIS State Summaries for fiscal years 2000-2015. These data were examined using econometric analysis, to assess these impacts. The evidence indicates that the changes included in recent congressional legislative initiatives would potentially leave an additional 50,000 to 60,000 Montana residents, five to six percent of the state’s population, in poverty without access to health care. Impacts on children in poverty would potentially be substantial.

Keywords: children, healthcare, medicaid, montana, poverty

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Authors: Joanne M. Emmens

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This paper makes use of the case notes of a single psychoanalytically informed psychotherapy of a now 72-year-old man over a four-year period to explore the potential of qualitative data to be incorporated into a research methodology that can contribute theory and knowledge to the wider professional community involved in mental health care. The clinical material arising out of any psychoanalysis provides a potentially rich source of clinical data that could contribute valuably to our historical understanding of both individual and societal traumata. As psychoanalysis is primarily an investigation, it is argued that clinical case material is a rich source of qualitative data which has relevance for sociological and historical understandings and that it can potentially aluminate important ‘gaps’ and collective blind spots that manifest unconsciously and are a contributing factor in the transmission of trauma, silently across generations. By attending to this case material the hope is to illustrate the value of using a psychoanalytic centred methodology. It is argued that the study of individual defences and the manner in which they come into consciousness, allows an insight into group defences and the unconscious forces that contribute to the silencing or un-noticing of important sources (or originators) of mental suffering.

Keywords: dream furniture (Bion) and psychotic functioning, reverie, screen memories, selected fact

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Authors: Matthew McNees

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An inductive aesthetic approach to sports yields critical and meaningful insight into sports philosophy, sports governance, and sports history. Critical reflection will always remain key to the analysis of the past, present and future of sporting institutions, but a philosophically imaginative method of induction allows certain salient connections to be articulated and potentially implemented between various sporting entities who exist as individuals, particularly between practitioner, owner/manager and observer (‘fan’ or interested party.) By honing in on the concept of beauty in sports, the primary reason for viewership, consumption or engagement with sports comes into focus as an aesthetic concept. While always a subjective or shadowy articulation, an aesthetic state often remains unnecessarily unrevealed due to claims about unconscious states, entire rhetorics (or counter-rhetorics) about beauty, and Misalliance among sporting development systems. Since aesthetics require an inductive state of subjectivity in determining various levels of beauty (which the so-called world of sports often thinks of as morality), the audience for aesthetics in sports also needs an inductive explanation of the concept in which one comes to see a process of viewership at work within themselves that is revealed by a simple need parried outward by a complex process of engagement. The potentially redemptive moment of revelation regarding the beauty of sports and the athlete within these systems creates in the viewer a new space of consciousness where the world of sports discovers some of its longed-for transparency, openness, parity and equity upon which its immediate future depends.

Keywords: aesthetics, governance, history, philosophy

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Authors: Sayed Obeidullah Abrar

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Nanosensor is the combination of two terms nanoparticles and sensors. These are chemical or physical sensor constructed using nanoscale components, usually microscopic or submicroscopic in size. These sensors are very sensitive and can detect single virus particle or even very low concentrations of substances that could be potentially harmful. Nanosensors have a large scope of research especially in the field of medical sciences, military applications, pharmaceuticals etc.

Keywords: HIV/AIDS, nanosensors, DNA, RNA

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Authors: Mike R. Bambach

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Increasing awareness of environmental concerns is leading a drive towards more sustainable structural products for the built environment. Natural fibres such as flax, jute and hemp have recently been considered for fibre-resin composites, with a major motivation for their implementation being their notable sustainability attributes. While recent decades have seen substantial interest in the use of such natural fibres in composite materials, much of this research has focused on the materials aspects, including fibre processing techniques, composite fabrication methodologies, matrix materials and their effects on the mechanical properties. The present study experimentally investigates the compression strength of structural channel sections of flax, jute and hemp, with a particular focus on their suitability for residential stud wall applications. The section geometry is optimised for maximum strength via the introduction of complex stiffeners in the webs and flanges. Experimental results on both natural fibre composite channel sections and typical steel and timber residential wall studs are compared. The geometrically optimised natural fibre composite channels are shown to have compression capacities suitable for residential wall stud applications, identifying them as a potentially viable alternative to traditional building materials in such application, and potentially other light structural applications.

Keywords: channel sections, natural fibre composites, residential stud walls, structural composites

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Authors: Claire Xu, Welton Wang, Manasvi Pinnaka, Anqi Pan, Michael Han

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Hospitalizations account for one-third of the total health care spending in the US. Early risk detection and intervention can reduce this high cost and increase the satisfaction of both patients and physicians. Due to the lack of awareness of the potential arising risks in home environment, the opportunities for patients to seek early actions of clinical visits are dramatically reduced. This research aims to offer a highly personalized remote patients monitoring and risk assessment AI framework to identify the potentially preventable hospitalization for both acute as well as chronic diseases. A hybrid-AI framework is trained with data from clinical setting, patients surveys, as well as online databases. 20+ risk factors are analyzed ranging from activities, biometric info, demographic info, socio-economic info, hospitalization history, medication info, lifestyle info, etc. The AI model yields high performance of 87% accuracy and 88 sensitivity with 20+ features. This hybrid-AI framework is proven to be effective in identifying the potentially preventable hospitalization. Further, the high indicative features are identified by the models which guide us to a healthy lifestyle and early intervention suggestions.

Keywords: hospitalization prevention, machine learning, remote patient monitoring, risk prediction

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Authors: C. Kuoh, C. Lucas, T. Lopes, I. Mechie, J. Yoong, W. Yoong

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For all surgeons, there is one preventable but still highly occurring complication – wrong site surgeries. They can have potentially catastrophic, irreversible, or even fatal consequences on patients. With the exponential development of microsurgery and the use of advanced technological tools, the consequences of operating on the wrong side, anatomical part, or even person is seen as the most visible and destructive of all surgical errors and perhaps the error that is dreaded by most clinicians as it threatens their licenses and arouses feelings of guilt. Despite the implementation of the WHO surgical safety checklist more than a decade ago, the incidence of wrong-site surgeries remains relatively high, leading to tremendous physical and psychological repercussions for the clinicians involved, as well as a financial burden for the healthcare institution. In this presentation, the authors explore various factors which can lead to wrong site surgery – a combination of environmental and human factors and evaluate their impact amongst patients, practitioners, their families, and the medical industry. Major contributing factors to these “never events” include deviations from checklists, excessive workload, and poor communication. Two real-life cases are discussed, and systems that can be implemented to prevent these errors are highlighted alongside lessons learnt from other industries. The authors suggest that reinforcing speaking-up, implementing medical professional trainings, and higher patient’s involvements can potentially improve safety in surgeries and electrosurgeries.

Keywords: wrong side surgery, never events, checklist, workload, communication

Procedia PDF Downloads 157

Authors: Lotfi Khiari, Antoine Karam, Claude-Alla Joseph, Marc Hébert

Abstract:

The main objective of incineration of sludge generated from municipal or agri-food waste treatment plant is to reduce the volume of sludge to be disposed of as a solid or liquid waste, whilst concentrating or destroying potentially harmful volatile substances. In some cities in Canada and United States of America (USA), a large amount of sludge is incinerated, which entails a loss of organic matter and water leading to phosphorus, potassium and some metallic trace element (MTE) accumulation in ashes. The purpose of this study was to evaluate the concentration of potentially hazardous MTE such as cadmium (Cd), lead (Pb) and mercury (Hg) in twelve sludge incineration ash samples obtained from municipal wastewater and other food processing waste treatments from Canada and USA. The average, maximum, and minimum values of MTE in ashes were calculated for each city individually and all together. The trace metal concentration values were compared to the literature reported values. The concentrations of MTE in ashes vary widely depending on the sludge origins and treatment options. The concentrations of MTE in ashes were found the range of 0.1-6.4 mg/kg for Cd; 13-286 mg/kg for Pb and 0.1-0.5 mg/kg for Hg. On average, the following order of metal concentration in ashes was observed: Pb > Cd > Hg. Results show that metal contents in most ashes were similar to MTE levels in synthetic inorganic fertilizers and many fertilizing residual materials. Consequently, the environmental effects of MTE content of these ashes would be low.

Keywords: biosolids, heavy metals, recycling, sewage sludge

Procedia PDF Downloads 352

Authors: O. Ubani, H. I. Atagana, M. S. Thantsha, R. Adeleke

Abstract:

The oil sludge components (polycyclic aromatic hydrocarbons, PAHs) have been found to be cytotoxic, mutagenic and potentially carcinogenic and microorganisms such as bacteria and fungi can degrade the oil sludge to less toxic compounds such as carbon dioxide, water and salts. In the present study, we isolated different bacteria with PAH-degrading potentials from the co-composting of oil sludge and different animal manure. These bacteria were isolated on the mineral base medium and mineral salt agar plates as a growth control. A total of 31 morphologically distinct isolates were carefully selected from 5 different compost treatments for identification using polymerase chain reaction (PCR) of the 16S rDNA gene with specific primers (16S-P1 PCR and 16S-P2 PCR). The amplicons were sequenced and sequences were compared with the known nucleotides from the gene bank database. The phylogenetical analyses of the isolates showed that they belong to 3 different clades namely Firmicutes, Proteobacteria and Actinobacteria. These bacteria identified were closely related to genera Bacillus, Arthrobacter, Staphylococcus, Brevibacterium, Variovorax, Paenibacillus, Ralstonia and Geobacillus species. The results showed that Bacillus species were more dominant in all treated compost piles. Based on their characteristics these bacterial isolates have high potential to utilise PAHs of different molecular weights as carbon and energy sources. These identified bacteria are of special significance in their capacity to emulsify the PAHs and their ability to utilize them. Thus, they could be potentially useful for bioremediation of oil sludge and composting processes.

Keywords: bioaugmentation, biodegradation, bioremediation, composting, oil sludge, PAHs, animal manures

Procedia PDF Downloads 225

Authors: Katalin Gombos, Bence Gálik, Krisztina Ildikó Kalács, Krisztina Gödöny, Ákos Várnagy, József Bódis, Attila Gyenesei, Gábor L. Kovács

Abstract:

Although non-invasive pre-implantation genetic testing for aneuploidy (NIPGT-A) is potentially appropriate to assess chromosomal ploidy of the embryo, practical application of it in a routine IVF center has not been started in the absence of a recommendation. We developed a comprehensive workflow for a clinically applicable strategy for NIPGT-A based on next-generation sequencing (NGS) technology. We performed MALBAC whole genome amplification and NGS on spent blastocyst culture media of Day 3 embryos fertilized with intra-cytoplasmic sperm injection (ICSI). Spent embryonic culture media of morphologically good quality score embryos were enrolled in further analysis with the blank culture media as background control. Chromosomal abnormalities were identified by an optimized bioinformatics pipeline applying a copy number variation (CNV) detecting algorithm. We demonstrate a comprehensive workflow covering both wet- and dry-lab procedures supporting a clinically applicable strategy for NIPGT-A. It can be carried out within 48 h which is critical for the same-cycle blastocyst transfer, but also suitable for “freeze all” and “elective frozen embryo” strategies. The described integrated approach of non-invasive evaluation of embryonic DNA content of the culture media can potentially supplement existing pre-implantation genetic screening methods.

Keywords: next generation sequencing, in vitro fertilization, embryo assessment, non-invasive pre-implantation genetic testing

Procedia PDF Downloads 132

Authors: Laura Valdés-Santiago, José Luis Castro-Guillén, Jorge Noé García-Chávez, Rosalba Alonso-Rodríguez, Rafael Vargas-Bernal

Abstract:

The quality and availability of the water contained in dams (artificial bodies of water) are at risk due to the presence of uncontrolled growths of cyanobacteria capable of producing cyanotoxins that affect the ecosystem and harm the health of humans and animals. The physicochemical properties were measured, and the degree of eutrophy of four dams from Guanajuato was determined. They presented a pH of 6.1 to 8.4, conductivity of 121 to 415 μS/cm², chlorophyll of 0.43-42.43 μg/L, NO₃- 0-1.2 mg/L and PO₄3- 0.11 to 0.84 mg/L; considering these parameters, the prey most prone to the development of cyanobacterial blooms were El Palote dam, La Purísima dam, and Allende dam, but not El Conejo dam. The potentially toxic cyanobacteria identified were Planktothrix agardhii, Oscillatoria sp., Raphidiopsis sp., and Microcystis sp., Microcystin-LR, Nodularin, and Cylindrospermopsin were quantified, presenting values between 0.08-0.42 and 0.02-2.05 ppb, respectively, the water bodies with the highest concentration were El Palote dam and La Purísima dam. Microcystin-LR and/or Nodularin levels are within the guideline values for human consumption in drinking water established by the World Health Organization for Microcystin-LR and for Cylindrospermopsin by the Oregon Health Authority (OHA) in all dams. This work is relevant due to the use of these bodies of water for agriculture and human consumption in the state, and the presence of toxin-producing cyanobacteria can represent an environmental, ecotoxicological, and health problem, so it is recommended to establish a program of frequent monitoring of cyanobacteria and cyanotoxins in the state's dams.

Keywords: Planktrothrix agardhii, Raphidiopsis sp., Microcystis sp., Cyanobacterial blooms, Cyanotoxins

Procedia PDF Downloads 33

Authors: Anna Ching-Yu Wong

Abstract:

Introduction: Textbooks play a sizable portion of the overall cost of higher education students. It is a board consent that open education resources (OER) reduce the te4xtbook costs and provide students a way to receive high-quality learning materials at little or no cost to them. However, there is less agreement over exactly how much. This study presents an approach for calculating OER savings by using SUNY Canton NON-OER courses (N=233) to estimate the potentially textbook savings for one semester – Fall 2022. The purpose in collecting data is to understand how much potentially saved from using OER materials and to have a record for future further studies. Literature Reviews: In the past years, researchers identified the rising cost of textbooks disproportionately harm students in higher education institutions and how much an average cost of a textbook. For example, Nyamweya (2018) found that on average students save $116.94 per course when OER adopted in place of traditional commercial textbooks by using a simple formula. Student PIRGs (2015) used reports of per-course savings when transforming a course from using a commercial textbook to OER to reach an estimate of $100 average cost savings per course. Allen and Wiley (2016) presented at the 2016 Open Education Conference on multiple cost-savings studies and concluded $100 was reasonable per-course savings estimates. Ruth (2018) calculated an average cost of a textbook was $79.37 per-course. Hilton, et al (2014) conducted a study with seven community colleges across the nation and found the average textbook cost to be $90.61. There is less agreement over exactly how much would be saved by adopting an OER course. This study used SUNY Canton as a case study to create an approach for estimating OER savings. Methodology: Step one: Identify NON-OER courses from UcanWeb Class Schedule. Step two: View textbook lists for the classes (Campus bookstore prices). Step three: Calculate the average textbook prices by averaging the new book and used book prices. Step four: Multiply the average textbook prices with the number of students in the course. Findings: The result of this calculation was straightforward. The average of a traditional textbooks is $132.45. Students potentially saved $1,091,879.94. Conclusion: (1) The result confirms what we have known: Adopting OER in place of traditional textbooks and materials achieves significant savings for students, as well as the parents and taxpayers who support them through grants and loans. (2) The average textbook savings for adopting an OER course is variable depending on the size of the college and as well as the number of enrollment students.

Keywords: textbook savings, open textbooks, textbook costs assessment, open access

Procedia PDF Downloads 45