Search results for: routine

Authors: Yishu Gong, Liangliang Yang, Jianyu Zhang, Zhengyu Chen, Sihong He, Xusheng Zhang, Wei Zhang

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Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that affects millions of people worldwide and is characterized by cognitive decline and behavioral changes. People living with Alzheimer’s disease often find it hard to complete routine tasks. However, there are limited objective assessments that aim to quantify the difficulty of certain tasks for AD patients compared to non-AD people. In this study, we propose to use speech emotion recognition (SER), especially the frustration level, as a potential biomarker for quantifying the difficulty patients experience when describing a picture. We build an SER model using data from the IEMOCAP dataset and apply the model to the DementiaBank data to detect the AD/non-AD group difference and perform longitudinal analysis to track the AD disease progression. Our results show that the frustration level detected from the SER model can possibly be used as a cost-effective tool for objective tracking of AD progression in addition to the Mini-Mental State Examination (MMSE) score.

Keywords: Alzheimer’s disease, speech emotion recognition, longitudinal biomarker, machine learning

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Authors: A. Wahid Uddin

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Osmotic dilator for cervical ripening bypasses the initial hormonal exposure necessary for a routine method of induction. The study was a clinical intervention with an osmotic dilator followed by prospective observation. The aim was to calculate the percentage of women who had successful cervical ripening using modified BISHOP score as evidenced by artificial rupture of membrane. The study also estimated the delivery interval following a single administration of osmotic dilators. Randomly selected patients booked for induction of labour accepting the intervention were included in the study. The study population comprised singleton term pregnancy, cephalic presentation, intact membranes with a modified BISHOP score of less than 6. Initial sample recruited was 30, but 6 patients left the study and the study was concluded on 24 patients. The data were collected in a pre-designed questionnaire and analysis were expressed in percentages along with using mean value for continuous variables. In 70 % of cases, artificial rupture of the membrane was possible and the mean time from insertion of the osmotic dilator to the delivery interval was 30 hours. The study concluded that an osmotic dilator could be a suitable alternative for hormone-based induction of labour.

Keywords: dilator, induction, labour, osmotic

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Authors: Y. S. Baraya, B. Umar, A. Aliyu, A. A. Raji, K. A. N. Esievo

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This study was performed to determine the presence of anaemia in randomly selected apparently healthy camels (Camelus dromedarius) brought for slaughter at the Sokoto metropolitan abattoir, Sokoto State, Nigeria. The camels were derived from both sexes, different age groups, functional usages and kept at various localities within and outside Sokoto town. In the study area, studies involving camels were limited in particular the emphasis on the anaemic status of camels brought daily for human consumption. A total of eighty (80) blood samples were collected once a week from these camels within the period of eight (8) weeks to investigate the haematological variations especially packed cell volume (PCV). The PCV analysis revealed anaemia in more than fifty (50) % of the camels studied. However, the actual cause of the anaemia was not investigated but could be caused by infectious agent like protozoan parasite Trypanosoma specie and non-infectious cause such as nutritional deficiency. The PCV examination as a simple, inexpensive and reliable procedure could be part of the routine ante-mortem assessment to evaluate camels for the existence of anaemia since many of the causes of anaemia besides being affecting the meat quality could also be of zoonotic significance.

Keywords: anaemia, camels, packed cell volume, Sokoto abattoir

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Authors: Swarna Pundir, Prabuddha Hans

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As AI has already stepped into the daily life of human society, one cannot be ignorant about the data it collects and used it to provide a quality of services depending up on the individuals’ choices. It also helps in giving option for making decision Vs choice selection with a calculation based on the history of our search criteria. Over the past decade or so, the way Artificial Intelligence (AI) has impacted society is undoubtedly large.AI has changed the way we shop, the way we entertain and challenge ourselves, the way information is handled, and has automated some sections of our life. We have answered as to what AI is, but not why one may see it as useful. AI is useful because it is capable of learning and predicting outcomes, using Machine Learning (ML) and Deep Learning (DL) with the help of Artificial Neural Networks (ANN). AI can also be a system that can act like humans. One of the major impacts be Joblessness through automation via AI which is seen mostly in manufacturing sectors, especially in the routine manual and blue-collar occupations and those without a college degree. It raises some serious concerns about AI in regards of less employment, ethics in making moral decisions, Individuals privacy, human judgement’s, natural emotions, biased decisions, discrimination. So, the question is if an error occurs who will be responsible, or it will be just waved off as a “Machine Error”, with no one taking the responsibility of any wrongdoing, it is essential to form some rules for using the AI where both machines and humans are involved.

Keywords: AI, ML, DL, ANN

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Authors: Olivier Mulisya, Guelord Barasima, Henry Mark Lugobe, Philémon Matumo, Bienfait Mumbere Vahwere, Hilaire Mutuka, Zawadi Léocadie, Wesley Lumika

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Abdominal pregnancy is defined as pregnancy anywhere within the peritoneal cavity, exclusive of tubal, ovarian, or broad ligament locations. It is a rare form of ectopic pregnancy with high morbidity and mortality for both the mother and the fetus. Diagnosis can be frequently missed in most poor-resource settings because of poor antenatal coverage, low socioeconomic status in most of the patients as well as lack of adequate medical resources. Clinical diagnosis can be very difficult and an ultrasound scan is very helpful during the early stages of gestation but can also be disappointing in the later stages. We report a case of a 25-year-old woman with severe abdominal pain not amended with any medication. A clinical picture of shock lead to an emergency laparotomy which confirmed the diagnosis of abdominal pregnancy. The ministry of health in developing countries should make an effort to make routine early ultrasounds accessible to pregnant women, and obstetricians should keep in mind the possibility of ectopic pregnancy, irrespective of the gestational age.

Keywords: abdominal pregnancy, live new bron, ultrasound imaging, abdominal pain

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Authors: Funda Terzi, Elif Dogan, Ayse B. Kapcak

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In this report, clinical, radiological, macroscopic, and histopathological findings of apocrine sweat gland adenocarcinoma are presented in a 13-year-old male tabby cat. In clinical examination, soft tissue masses were detected in the caudal abdomen and left tuber coxae. On radiological examination, subcutaneous masses with soft tissue contrast appearance were detected, and the masses were surgically removed under general anesthesia. The sizes of the masses were approximately 2x2x3 cm in the caudal abdomen and approximately 1x1x2 cm in the tuber coxae region. The cross-section of the mass was whitish-yellow in color. After the masses were fixed in 10% formaldehyde solution, a routine histopathology procedure was applied. In histopathological examination, apocrine sweat glands in a cystic structure and extensions from the center of the cyst to the lumen were determined, and anisonucleosis, anisocytosis, and anaplastic cells with giant nuclei were observed in the epithelial cells of the gland facing the lumen. A diagnosis of papillary-cystic type apocrine sweat gland adenocarcinoma was made with these findings.

Keywords: apocrine sweat gland, carcinoma, cat, histopathology

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Authors: Nurgul Senol, Melda Azman

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In this study, the rate of release of gastrointestinal peptides heavy metal compounds applied to a certain extent (gastrin/CCK) on immunohistochemical aimed to determine the effect. This study was supported by TÜBİTAK. Subjects were randomly grouped into three. Group I; iron (Fe), Group II; zinc (Zn), Group III; control; gavage technique was applied to each group once a day throughout 30 days. At the end of the experiment, rats were decapitated and their stomach-intestine tissues removed, Peroxidase anti peroxidase method was applied following the routine histological follow-ups. According to the control group, in the stomach, had more positive cell density of gastrin in Fe groups, it was observed that group followed by Zn. It was found between the groups in the stomach and intestinal gastrin, gastrin-positive cell density decreases towards the intestines from the stomach. Although CCK differences in staining were observed in the control group, the intensity of staining intensity between the two groups in positive cells was determined to be more than the stomach. The group in the intestines, there is no change in terms of positivity CCK. Consequently, there is no significant effect on gastrointestinal peptides in Zn application. It has been identified Fe application has a significant effect on the releasing of CCK/gastrin peptides.

Keywords: alimentary canal, CCK, iron, gastrin, zinc

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Authors: Ankit Nagar, Dinesh Kumar Nauriyal, S. P. Singh

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This paper examines farmers' perceptions of the efficacy of extension services in equipping them with the necessary information and skills required to maximise agricultural productivity. It is based on primary data collected through an interview schedule in India's Western Uttar Pradesh region. It uses descriptive statistics, factor analysis, and MANOVA to determine the typical farmer's view of an extension worker's technical prowess and behavioural traits, as well as the key factors associated with farmers' perception and the demographic characteristics that affect farmer's perception variations. The vast majority of farmers appear to consider extension personnel's efficiency and accessibility unfavourably. Farmers feel that extension personnel are well-trained notwithstanding their disagreements on the viability of their technical advice. Small and marginal farmers view the effectiveness, objectivity, and cooperativeness of extension agents less favourably than large farmers. This study proposes strategies such as routine follow-ups, practical demonstrations, and regular extension professional training camps as part of a holistic plan to increase farmer trust in the agricultural extension system. In addition, it proposes ensuring their accountability.

Keywords: agriculture extension, farmers’ perception, extension agents, factor analysis

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Authors: A. Asambe

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A study was conducted to determine the level of compliance with sanitary measures in piggeries, and awareness and risk factors of African swine fever in Benue State, Nigeria. Questionnaires were distributed to 74 respondents consisting of piggery owners and attendants in different piggeries across 12 LGAs to collect data for this study. Sanitary measures in piggeries were observed to be generally very poor, though respondents admitted being aware of ASF. Piggeries located within a 1 km radius of a slaughter slab (OR=9.2, 95% CI - 3.0-28.8), piggeries near refuse dump sites (OR=3.0, 95% CI - 1.0-9.5) and piggeries where farm workers wear their work clothes outside of the piggery premises (OR=0.2, 95% CI - 0.1-0.7) showed higher chances of ASFV infection and were significantly associated (p < 0.0001), (p < 0.05) and (p < 0.01), and were identified as potential risk factors. The study concluded that pigs in Benue State are still at risk of an ASF outbreak. Proper sanitary and hygienic practices is advocated and emphasized in piggeries, while routine surveillance for ASFV antibodies in pigs in Benue State is strongly recommended to provide a reliable reference data base to plan for the prevention of any devastating ASF outbreak.

Keywords: African swine fever, awareness, piggery, risk factors, sanitary measures

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Authors: S. Ramia, N. Melhem, K. Kreidieh

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The world is facing an unprecedented displacement crisis. Recently, over 1.1 million asylum seekers have been granted protection status in the European Union (EU). The majority of these asylum seekers were from countries of the Middle East and North Africa (MENA) region.This influx carries with it a potential introduction of infectious diseases that have been eliminated in the EU, which poses a challenge for EU health authorities. Compared to MENA region countries where Hepatitis A Virus (HAV) endemicity is high to intermediate, member states of the EU show very low (Western Europe) to low (Eastern Europe) levels of HAV endemicity. Because of this situation, there is an ongoing public health concern in high-income countries, like members of the EU, that many adults remain susceptible to HAV outbreaks. The overwhelming majority of the EU members’ states do not include HAV vaccine in their immunization calendars. Hence, this paper urgently calls for the implementation of new policies regarding HAV in EU members’ states.

Keywords: European union, hepatitis A, MENA region refugees, vaccine preventable diseases

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Authors: S. Alireza Mirghasemi, Narges Rahimi Gabaran

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Although sacral fractures in children are rare due to the fact that the occurrence of pelvic fracture is not common in childhood. Sacral fractures present a high risk of neurological damage. This kind of fracture is often missed because the routine pelvic X-rays imaging scarcely show this fracture. Also, the treatment is controversial, and it ranges from fine reduction to conservative treatments without any try to reduce the dislocation. In this article, a case of fracture dislocation of S1 and S2 along with a suggested diagnostic test and treatment based on similar cases are presented. The case investigates a 14-year-old boy who entered the hospital one week after a car accident that knocked him to the ground in crawling position and a rack fell down on his body. Pain and tenderness in the sacral region and a fracture in the left leg were notable--we detected incomplete bilateral palsy of L5, S1 and S2 roots. In radiographs of the spine fracture dislocation of S1, the sacral fracture was seen. The treatment included a skeletal traction with a halo over the patient’s head and two femoral pins. After one week, another surgery was performed in order to stabilize and reduce the fracture, and we employed a posterior approach with CD and a pedicular screw. After two years of follow-up, the fracture is completely cured without any loss of reduction.

Keywords: adolescent, fracture in adolescent, fracture dislocation, sacrum

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Authors: Amjed Sid Ahmed, Rosilah Hassan, Nor Effendy Othman

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Limited functioning of the Internet Protocol version 4 (IPv4) has necessitated the development of the Internetworking Protocol next generation (IPng) to curb the challenges. Indeed, the IPng is also referred to as the Internet Protocol version 6 (IPv6) and includes the Neighbor Discovery Protocol (NDP). The latter performs the role of Address Auto-configuration, Router Discovery (RD), and Neighbor Discovery (ND). Furthermore, the role of the NDP entails redirecting the service, detecting the duplicate address, and detecting the unreachable services. Despite the fact that there is an NDP’s assumption regarding the existence of trust the links’ nodes, several crucial attacks may affect the Protocol. Internet Engineering Task Force (IETF) therefore has recommended implementation of Secure Neighbor Discovery Protocol (SEND) to tackle safety issues in NDP. The SEND protocol is mainly used for validation of address rights, malicious response inhibiting techniques and finally router certification procedures. For routine running of these tasks, SEND utilizes on the following options, Cryptographically Generated Address (CGA), RSA Signature, Nonce and Timestamp option. CGA is produced at extra high costs making it the most notable disadvantage of SEND. In this paper a clear description of the constituents of CGA, its operation and also recommendations for improvements in its generation are given.

Keywords: CGA, IPv6, NDP, SEND

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Authors: H. J. Pramod, S. Pethkar

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The evaluation of antiurolithiatic potentials from the extracts of Cucumis sativus fruits at different doses and cystone (standard formulation) at a dose of 750 mg/kg were measured for both preventive and curative regimen in wistar rats by adding 0.75% v/v ethylene glycol (EG) to drinking water for 28 days, except normal rats. After the completion of the experimental period, (28th day) urinary parameters like (urine volume, routine urine analysis, levels of calcium, phosphate, oxalate, magnesium, sodium) serum biomarkers like (creatinine, BUN, uric acid, ALP, ALT, AST) kidney homogenate analysis for (levels of calcium, oxalate and phosphate) were analysed. The treated groups shows increased in the urine output significantly compared to the normal. The extract shows significantly decreased in the urinary excretion of the calcium, phosphate, magnesium, sodium and oxalate. The both preventive and curative treatment of extracts showed decrease in the stone forming constituents in the kidneys of urolithiatic rats further the kidneys of all the groups were excised and sectioned for histopathological examination which further claims to posses antiurolithiatic activity.

Keywords: Cucumis sativus, urolithiasis, ethylene glycol, cystone

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Authors: Hatem A. El-Mezayen, Ahmed Abdelmajeed, Fatehya Metwally, Usama Elsaly, Salwa Atef

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Tumor metastasis involves the dissemination of malignant cells into the basement membrane and vascular system contributes to the circulating pool of these markers. In this context our aim has been focused on development of a non-invasive. Circulating tumor cells (CTCs) represent a unique liquid biopsy carrying comprehensive biological information of the primary tumor. Herein, we sought to develop a novel score based on the combination of the most significant CTCs biomarkers with and routine laboratory tests for accurate detection of metastatic breast cancer. Methods: Cytokeratin 18 (CK18), Cytokeratin 19 (CK19), and CA15.3 were assayed in metastatic breast cancer (MBC) patients (75), non-MBC patients (50) and healthy control (20). Results: Areas under receiving operating curve (AUCs) were calculated and used for construction on novel score. A novel score named MBC-CTCs = CA15.3 (U/L) × 0.08 + CK 18 % × 2.9 + CK19 × 3.1– 510. That function correctly classified 87% of metastatic breast cancer at cut-off value = 0.55. (i.e great than 0.55 indicates patients with metastatic breast cancer and less than 0.55 indicates patients with non-metastatic breast cancer). Conclusion: MBC-CTCs is a novel, non-invasive and simple can applied to discriminate patients with metastatic breast cancer.

Keywords: metastatic breast cancer, circulating tumor cells, cytokeratin, EpiCam

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Authors: Hatem Mrad, Alban Notin, Mohamed Bouazara

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Sheet metal forming process has a multiple successive steps starting from sheets fixation to sheets evacuation. Often after forming operation, the sheet has defects requiring additional corrections steps. For example, in the drawing process, the formed sheet may have several defects such as springback, localized thinning and bends. All these defects are directly dependent on process, geometric and material parameters. The prediction and elimination of these defects requires the control of most sensitive parameters. The present study is concerned with a reliable parametric study of deep forming process in order to control the localized thinning. The proposed approach will be based on stochastic finite element method. Especially, the polynomial Chaos development will be used to establish a reliable relationship between input (process, geometric and material parameters) and output variables (sheet thickness). The commercial software Abaqus is used to conduct numerical finite elements simulations. The automatized parametrical modification is provided by coupling a FORTRAN routine, a PYTHON script and input Abaqus files.

Keywords: sheet metal forming, reliability, localized thinning, parametric simulation

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Authors: Suglo Tohari Luri

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Data analysis is an important aspect of business performance. With the application of artificial intelligence within databases, selecting a suitable database engine for an application design is also very crucial for business data analysis. The application of business intelligence (BI) software into some relational databases such as Neo4j has proved highly effective in terms of customer data analysis. Yet what remains of great concern is the fact that not all business organizations have the neo4j business intelligence software applications to implement for customer data analysis. Further, those with the BI software lack personnel with the requisite expertise to use it effectively with the neo4j database. The purpose of this research is to demonstrate how the Neo4j program code alone can be applied for the analysis of e-commerce website customer visits. As the neo4j database engine is optimized for handling and managing data relationships with the capability of building high performance and scalable systems to handle connected data nodes, it will ensure that business owners who advertise their products at websites using neo4j as a database are able to determine the number of visitors so as to know which products are visited at routine intervals for the necessary decision making. It will also help in knowing the best customer segments in relation to specific goods so as to place more emphasis on their advertisement on the said websites.

Keywords: data, engine, intelligence, customer, neo4j, database

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Authors: Won-Gon Kim

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Introduction: The clinical value of arterial line filters is still a controversial issue. Proponents of arterial line filtration argue that filters remove particulate matter and undissolved gas from circulation, while opponents argue the absence of conclusive clinical data. We conducted scanning electron microscope (SEM) studies of arterial line filters used clinically in the CPB circuits during adult cardiac surgery and analyzed the types and characteristics of materials entrapped in the arterial line filters. Material and Methods: Twelve arterial line filters were obtained during routine hypothermic cardiopulmonary bypass in 12 adult cardiac patients. The arterial line filter was a screen type with a pore size of 40 ㎛ (Baxter Health care corporation Bentley division, Irvine, CA, U.S.A.). After opening the housing, the woven polyester strands were examined with SEM. Results and Conclusion: All segments examined(120 segments, each 2.5 X 2.5 cm in size) contained no embolic particles larger in their cross-sectional area than the pore size of the filter(40 ㎛). The origins of embolic particulates were mostly from environmental foreign bodies. This may suggest a possible need for more aggressive filtration of smaller particulates than is generally carried out at the present time.

Keywords: arterial line filter, tubing wear, scanning electron microscopy, SEM

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Authors: Laxman H. Surwase, Lalit V. Sonawane, Bhagwat N. Poul

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A simple stability indicating high performance liquid chromatographic method has been developed for the simultaneous determination of Levosalbutamol Sulphate and Ipratropium Bromide in bulk and pharmaceutical dosage form using reverse phase Zorbax Eclipse Plus C8 column (250mm×4.6mm), with mobile phase phosphate buffer (0.05M KH2PO4): acetonitrile (55:45v/v) pH 3.5 adjusted with ortho-phosphoric acid, the flow rate was 1.0 mL/min and the detection was carried at 212 nm. The retention times of Levosalbutamol Sulphate and Ipratropium Bromide were 2.2007 and 2.6611 min respectively. The correlation coefficient of Levosalbutamol Sulphate and Ipratropium Bromide was found to be 0.997 and 0.998.Calibration plots were linear over the concentration ranges 10-100µg/mL for both Levosalbutamol Sulphate and Ipratropium Bromide. The LOD and LOQ of Levosalbutamol Sulphate were 2.520µg/mL and 7.638µg/mL while for Ipratropium Bromide was 1.201µg/mL and 3.640 µg/mL. The accuracy of the proposed method was determined by recovery studies and found to be 100.15% for Levosalbutamol Sulphate and 100.19% for Ipratropium Bromide respectively. The method was validated for accuracy, linearity, sensitivity, precision, robustness, system suitability. The proposed method could be utilized for routine analysis of Levosalbutamol Sulphate and Ipratropium Bromide in bulk and pharmaceutical capsule dosage form.

Keywords: levosalbutamol sulphate, ipratropium bromide, RP-HPLC, phosphate buffer, acetonitrile

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Authors: Soorya Vennila

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A comprehensive study of malaria in 165 villages (hamlets) in Harur block, Dharmapuri district, has revealed the fact that there are distinct episodes of malaria due to An. culicifacies, the vector, causes persistent transmission in the revenue village called Vedakatamaduvu. A total of 300 household adult samples are randomly selected to study both quantitatively and qualitatively the vulnerability of malaria. On the basis of the response, the problem uncommon with groups was identified as the outdoor routine, particularly open defecation, with which the samples needed to be stratified into two major groups; users of toilets 21 and those who practice open defecation 279. Open defecation, as the habit-based vulnerability, is measured with the Pearson correlation coefficient to estimate the relationship between malaria and open defecation. It is also verified from the literature that plant fluids provide mosquitoes not only with energy but also with nutrition, to the extent that they can develop fertile eggs. In the endemic areas, the bushy Presopis Juliflora, which naturally serves as a feeding and resting spot for mosquitoes, serves as a cover to practice open defecation as well. Eventually, those who get resort to Presopis for open defecation have a higher chance of getting exposed to mosquito bites and being infected with malaria. The study concludes that the combination of bushy Prosopis Juliflora and open defecation leaves the place perpetually vulnerable to malaria.

Keywords: Malaria, open defecation, endemic, presopis juliflora

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Authors: Chryssa Thermolia, Ekaterini S. Bei, Stelios Sotiriadis, Kostas Stravoskoufos, Euripides G. M. Petrakis

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Moving into a new era of healthcare, new tools and devices are developed to extend and improve health services, such as remote patient monitoring and risk prevention. In this concept, Internet of Things (IoT) and Cloud Computing present great advantages by providing remote and efficient services, as well as cooperation between patients, clinicians, researchers and other health professionals. This paper focuses on patients suffering from bipolar disorder, a brain disorder that belongs to a group of conditions called effective disorders, which is characterized by great mood swings.We exploit the advantages of Semantic Web and Cloud Technologies to develop a patient monitoring system to support clinicians. Based on intelligently filtering of evidence-knowledge and individual-specific information we aim to provide treatment notifications and recommended function tests at appropriate times or concluding into alerts for serious mood changes and patient’s non-response to treatment. We propose an architecture, as the back-end part of a cloud platform for IoT, intertwining intelligence devices with patients’ daily routine and clinicians’ support.

Keywords: bipolar disorder, intelligent systems patient monitoring, semantic web technologies, healthcare

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Authors: Alisher Agzamov, Hanan Al Harbi

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BACKGROUND: The timely assessment and treatment of ICU Surgical and Medical Oncology patients is important for Oncology surgeons and Medical Oncologists and Intensivists. We hypothesized that the use of Robot Physician’s (RP - 7) ICU management and care in ICU can improve ICU physician rapid response to unstable ICU Oncology patients. METHODS: This is a prospective study using a before-after, cohort-control design to test the effectiveness of RP. We have used RP to make multidisciplinary ICU rounds in the ICU and for Emergency cases. Data concerning several aspects of the RP interaction including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RP were documented. The effect of RP on ICU length of stay and cost was assessed. RESULTS: The use of RP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RP: 10.2 +/- 3.3 minutes vs conventional: 220 +/- 80 minutes). The response latencies to Oncology Emergency (8.0 +/- 2.8 vs 150 +/- 55 minutes) and for Respiratory Failure (12 +/- 04 vs 110 +/- 45 minutes) were reduced (P < .001), as was the LOS for patients with AML (5 days) and ARDS (10 day). There was an increase in ICU occupancy by 20 % compared with the prerobot era, and there was an ICU cost savings of KD2.5 million attributable to the use of RP. CONCLUSION: The use of RP enabled rapid face-to-face ICU Intensivist - physician response to unstable ICU Oncology patients and resulted in decreased ICU cost and LOS.

Keywords: robot physician, oncology patients, rp - 7 in icu management, cost and icu occupancy

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Authors: David Armany, Matthew Allaway, Preet Gosal, Senarath Edirimanne

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A potentially devastating complication of routine laparoscopic cholecystectomy includes iatrogenic bile duct injuries, which represent a stable incidence rate of 0.3% over the past three decades. Whilst related to several relative risks such as surgeon experience and patient factors (older age, male sex), misinterpretation of biliary tree anatomy remains the most common cause, accounting for 80% of iatrogenic Common Bile Duct injuries. Whilst extremely rare, a duplicate common bile duct anomaly remains a potential variation to encounter during biliary surgery, with 30 recognised cases in the worldwide literature, of which type Vb accounts for 4. We report the case of a rare type Vb variation encountered during intra-operative laparoscopic cholecystectomy and confirmed on cholangiogram. To our knowledge, this is the first documented Type Vb case encountered in an Australian population. Given these anomalies are asymptomatic and can perpetuate iatrogenic common bile duct injuries, awareness of all subtypes is crucial. Irrevocably, preoperative Magnetic Resonance Cholangiopancreatography can help recognise these anomalies before the operating theatre; however, their widespread adoption is limited by expensive and availability.

Keywords: duplicated common bile duct, type Vb, cholecystitis, MRCP, cholangiogram, iatrogenic CBD

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Authors: Godwin A. Otogo, Sansanee Wangvoralak, Graham J. Pierce, Lee C. Hastie, Beth Scott

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The squid Loligo forbesii is suspected to be an important species in marine food webs, as it can strongly impact its prey and be impacted upon by predation, competition, fishing and/or climate variability. To quantify these impacts in the food web, the measurement of its trophic position and ecological role within well-studied ecosystems is essential. An Ecopath model was balanced and run for the Moray Firth ecosystem and was used to investigate the significance of this squid’s trophic roles. The network analysis routine included in Ecopath with Ecosim (EwE) was used to estimate trophic interaction, system indicators (health condition and developmental stage) and food web features. Results indicated that within the Moray Firth squid occupy a top trophic position in the food web and also a major prey item for many other species. Results from Omnivory Index (OI) showed that squid is a generalized feeder transferring energy across wide trophic levels and is more important as a predator than that as a prey in the Moray Firth ecosystem. The results highlight the importance of taking squid into account in the management of Europe’s living marine resources.

Keywords: Squid, Loligo forbesii, Ecopath, Moray Firth, Trophic level

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Authors: Jaqueline Nichi, Leila Da Costa Ferreira, Fabiana Barbi Seleguim, Gabriela Marques Di Giulio, Mariana Barbieri

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The transport sector is responsible for approximately 55% of global greenhouse gas (GHG) emissions, in addition to pollution and other negative externalities, such as road accidents and congestion, that impact the routine of those who live in large cities. The objective of this article is to discuss the application and use of distinct mobility technologies such as climate adaptation and mitigation measures in the context of smart cities in the Global South. The documentary analysis is associated with 22 semi structured interviews with managers who work with mobility technologies in the public and private sectors and in civil society organizations to explore solutions in multilevel governance for smart and low-carbon mobility based on the case study from the city of São Paulo, Brazil. The hypothesis that innovation and technology to mitigate and adapt to climate impacts are not yet sufficient to make mobility more sustainable has been confirmed. The results indicate four relevant aspects for advancing a climate agenda in smart cities: integrated planning, coproduction of knowledge, experiments in governance, and new means of financing to guarantee the sustainable sociotechnical transition of the sector.

Keywords: urban mobility, climate change, smart cities, multilevel governance

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Authors: Xiangmei Li

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Domestic violence (DV) victims are at a greater risk of suffering mental health problems; however, not all victims experience the same degree of depression. Women respond differently to gender inequalities based on their gender ideologies. This study explored the moderating role of gender ideology in the relation between exposure to DV and depression. Data were drawn from a sub-sample of women aged 18-60 from the Third WaveSurvey on the Social Status of Women in China (N = 10,701). The survey adopted astratified three-stage sampling design to select a representative sample of respondents from the country. Regression models were used to examine the moderating effects of gender ideology on the relation between DV and depression. Women who reported DV experience had more severe depressive symptoms after controlling for confounding social–demographic factors (β = 0.592, 95% CI: 0.489 – 0.695). Women's gender ideology moderated the association between DV severity and depression (β = -0.049, 95% CI: -0.085 – -0.013), despite being subjected to the same levels of victimization. The experience of domestic violence is a useful indicator for routine screening for depression in clinic and community settings. Interventions that aim to decrease depression caused by DV are more likely to be effective if they promote more egalitarian gender ideology to counter the mindset that a woman's role is confined to the home and a family suffers if the wife participates in the labor force.

Keywords: domestic violence against wives, depression, gender ideology, moderation

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Authors: Kevser Cakmak, Adrián Montesano, Lourdes Artigas, Marta Salla, Clara Mateu

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The main objective of this research is to explore the relational letter writing technique as an intervention in couple therapy for reconnecting couples with their values and ethical preferences. This is a recently developed therapeutic tool within the framework of Narrative Therapy that consists of two interviews and a letter writing task, in which a meta-conversation between the relationship itself, the couple members, and the therapists is fostered. Although this specific therapeutic technique can be used within the therapy process, in this case study, it is used as a brief stand-alone narrative intervention for a middle age heterosexual couple breast cancer survivor. Couple’s relational and personal wellbeing was monitored before, during, and after the intervention by means of the dyadic adjustment and the clinical outcomes in routine evaluation-outcome measure, respectively. The couple showed a significant improvement after the intervention in both levels. The content of the letter writing exercises was qualitatively analysed to explore the reconstruction of their ethical values. Results from both methods are integrated in order to get an in-depth perspective of the newly developed tool. The potential of the letter writing technique as stand-alone and as adjunct brief intervention is discussed.

Keywords: couple therapy, narrative therapy, psychotherapy tool, relational letter writing

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Authors: Fatema Ali Lanewala, Akhtar Jamal Khan

Abstract:

The ocular complications in renal transplant recipients at the biggest transplant center in Pakistan were seen to be diverse, multiple, and sight-threatening. These complications could mainly be due to the primary disease causing renal failure, the process of transplantation, and/or the medications used pre and post-transplantation. A retrospective case series recently published in the Journal of Pakistan Medical Association highlights the common ocular pathologies encountered in renal transplant population. Majority of the patients suffered from cataract, which is a known side-effect of long-term steroids routinely used for graft survival. There was a unique finding in Pakistani population, never reported before from any other transplant centre world over; a large number of recipients was reported to be suffering from night blindness, which significantly improved on vitamin A supplementation. There were a variety of other ocular complications seen which emphasizes the necessity of ocular care and routine examination of transplant recipient’s eyes by an ophthalmologist in order to avoid visual compromise and improve the quality of life of the transplant recipient.

Keywords: cataract, night blindness, ocular complications, renal transplantation

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Authors: Delsy Salinas, Andreia Garcês, Augusto Silva, Paula Brilhante Simões

Abstract:

Urinary tract infection (UTI) is a common disease affecting dogs and cats in both community and hospital environment. Bacteria is the most frequent agent isolated, fewer than 1% of infections are due to parasitic, fungal, or viral agents. Common symptoms and laboratory abnormalities includeabdominal pain, pyrexia, renomegaly, and neutrophilia with left shift. A rapid and precise identification of the bacterial agent is still a challenge in veterinarian laboratories. Therefore, this cross-sectional study aims to describe bacterial colony patterns of urine samples by using chromID™ CPS® EliteAgar (BioMérieux, France) from canine and feline specimens submitted to a veterinary laboratory in Portugal (INNO Veterinary Laboratory, Braga)from January to March2022. All urine samples were cultivated in CPS Elite Agar with calibrated 1 µL inoculating loop and incubated at 37ºC for 18-24h. Color,size, and shape (regular or irregular outline)were recorded for all samples. All colonies were classified as Gram-negative or Gram-positive bacteriausing Gram stain (PREVI® Color BioMérieux, France) and determined if they were pure colonies. Identification of bacteria species was performed using GP and GN cards inVitek 2® Compact(BioMérieux, France). A total of 256/1003 submitted urine samples presented bacterial growth, from which 172 isolates were included in this study. The sample’s population included 111 dogs (n=45 males and n=66 females) and 61 cats (n=35 males and n=26 females). The most frequent isolated bacteria wasEscherichia coli (44,7%), followed by Proteus mirabilis (13,4%). All Escherichia coli isolates presented red to burgundy colonies, a colony diameter between 2 to 6 mm, and regular or irregular outlines. Similarly, 100% of Proteus mirabilis isolates were dark yellow colonies with a diffuse pigment and the same size and shape as Escherichia coli. White and pink pale colonies where Staphylococcus species exclusively and S. pseudintermedius was the most frequent (8,2 %). Cian to blue colonies were mostly Enterococcusspp. (8,2%) and Streptococcus spp. (4,6%). Beige to brown colonies were Pseudomonas aeruginosa (2,9%) and Citrobacter spp. (1,2%).Klebsiella spp.,Serratia spp. and Enterobacter spp were green colonies. All Gram-positive isolates were 1 to 2 mm diameter long and had a regular outline, meanwhile, Gram-negative rods presented variable patterns. This results showed that theprevalence of E coli and P. mirabilis as uropathogenic agents follows the same trends in Europe as previously described in other studies. Both agents presented a particular color pattern in CPS Elite Agar to identify them without needing complementary tests. No other bacteria genus could be correlated strongly to a specific color pattern, and similar results have been observed instudies using human’s samples. Chromogenic media shows a great advantage for common urine bacteria isolation than traditional COS, McConkey, and CLEDAgar mediums in a routine context, especially when mixed fermentative Gram-negative agents grow simultaneously. In addition, CPS Elite Agar is versatile for Artificial Intelligent Reading Plates Systems. Routine veterinarian laboratories could use CPS Elite Agar for a rapid screening for bacteria identification,mainlyE coli and P.mirabilis, saving 6h to 10h of automatized identification.

Keywords: cats, CPS elite agar, dogs, urine pathogens

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Authors: Khaled M. Alhawiti

Abstract:

This research study aims to present a retrospective study about speech recognition systems and artificial intelligence. Speech recognition has become one of the widely used technologies, as it offers great opportunity to interact and communicate with automated machines. Precisely, it can be affirmed that speech recognition facilitates its users and helps them to perform their daily routine tasks, in a more convenient and effective manner. This research intends to present the illustration of recent technological advancements, which are associated with artificial intelligence. Recent researches have revealed the fact that speech recognition is found to be the utmost issue, which affects the decoding of speech. In order to overcome these issues, different statistical models were developed by the researchers. Some of the most prominent statistical models include acoustic model (AM), language model (LM), lexicon model, and hidden Markov models (HMM). The research will help in understanding all of these statistical models of speech recognition. Researchers have also formulated different decoding methods, which are being utilized for realistic decoding tasks and constrained artificial languages. These decoding methods include pattern recognition, acoustic phonetic, and artificial intelligence. It has been recognized that artificial intelligence is the most efficient and reliable methods, which are being used in speech recognition.

Keywords: speech recognition, acoustic phonetic, artificial intelligence, hidden markov models (HMM), statistical models of speech recognition, human machine performance

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Authors: Alisher Agzamov, Hanan Al Harbi

Abstract:

BACKGROUND: The timely assessment and treatment of ICU Surgical and Medical Oncology patients is important for Oncology surgeons and Medical Oncologists and Intensivists (1). We hypothesized that the use of Robot Physician’s (RP - 7) ICU management and care in ICU can improve ICU physician rapid response to unstable ICU Oncology patients. METHODS: This is a prospective study of 1501 oncology patients using a before-after, cohort-control design to test the effectiveness of RP. We have used RP to make multidisciplinary ICU rounds in the ICU and for Emergency cases. Data concerning several aspects of the RP interaction, including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RP, were documented. The effect of RP on ICU length of stay and cost was assessed. RESULTS: The use of RP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RP: 10.2 +/- 3.3 minutes vs conventional: 210 +/- 40 minutes). The response latencies to Oncology Emergency (8.0 +/- 2.8 vs 140 +/- 35 minutes) and for Respiratory Failure (12 +/- 04 vs 110 +/- 45 minutes) were reduced (P < .001), as was the LOS for oncology patients (5 days) and ARDS (10 day). There was an increase in ICU occupancy by 29 % compared with the prerobot era, and there was an ICU cost savings of KD2.2 million attributable to the use of RP. CONCLUSION: The use of RP enabled rapid face-to-face ICU Intensivist - physician response to unstable ICU Oncology patients and resulted in decreased ICU cost and LOS.

Keywords: robot physician, oncology patients, icu management and care, cost and icu occupancy

Procedia PDF Downloads 42