Search results for: routine
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 570

Search results for: routine

330 Modelling the Tensile Behavior of Plasma Sprayed Freestanding Yttria Stabilized Zirconia Coatings

Authors: Supriya Patibanda, Xiaopeng Gong, Krishna N. Jonnalagadda, Ralph Abrahams

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Yttria stabilized zirconia (YSZ) is used as a top coat in thermal barrier coatings in high-temperature turbine/jet engine applications. The mechanical behaviour of YSZ depends on the microstructural features like crack density and porosity, which are a result of coating method. However, experimentally ascertaining their individual effect is difficult due to the inherent challenges involved like material synthesis and handling. The current work deals with the development of a phenomenological model to replicate the tensile behavior of air plasma sprayed YSZ obtained from experiments. Initially, uniaxial tensile experiments were performed on freestanding YSZ coatings of ~300 µm thick for different crack densities and porosities. The coatings exhibited a nonlinear behavior and also a huge variation in strength values. With the obtained experimental tensile curve as a base and crack density and porosity as prime variables, a phenomenological model was developed using ABAQUS interface with new user material defined employing VUMAT sub routine. The relation between the tensile stress and the crack density was empirically established. Further, a parametric study was carried out to investigate the effect of the individual features on the non-linearity in these coatings. This work enables to generate new coating designs by varying the key parameters and predicting the mechanical properties with the help of a simulation, thereby minimizing experiments.

Keywords: crack density, finite element method, plasma sprayed coatings, VUMAT

Procedia PDF Downloads 115
329 Evaluating the Radiation Dose Involved in Interventional Radiology Procedures

Authors: Kholood Baron

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Radiologic interventional studies use fluoroscopy imaging guidance to perform both diagnostic and therapeutic procedures. These could result in high radiation doses being delivered to the patients and also to the radiology team. This is due to the prolonged fluoroscopy time and the large number of images taken, even when dose-minimizing techniques and modern fluoroscopic tools are applied. Hence, these procedures are part of the everyday routine of interventional radiology doctors, assistant nurses, and radiographers. Thus, it is important to estimate the radiation exposure dose they received in order to give objective advice and reduce both patient and radiology team radiation exposure dose. The aim of this study was to find out the total radiation dose reaching the radiologist and the patient during an interventional procedure and to determine the impact of certain parameters on the patient dose. Method: The radiation dose was measured by TLD devices (thermoluminescent dosimeter; radiation dosimeter device). Physicians, patients, nurses, and radiographers wore TLDs during 12 interventional radiology procedures performed in two hospitals, Mubarak and Chest Hospital. This study highlights the need for interventional radiologists to be mindful of the radiation doses received by both patients and medical staff during interventional radiology procedures. The findings emphasize the impact of factors such as fluoroscopy duration and the number of images taken on the patient dose. By raising awareness and providing insights into optimizing techniques and protective measures, this research contributes to the overall goal of reducing radiation doses and ensuring the safety of patients and medical staff.

Keywords: dosimetry, radiation dose, interventional radiology procedures, patient radiation dose

Procedia PDF Downloads 75
328 Study of Cathodic Protection for Trunk Pipeline of Al-Garraf Oil Field

Authors: Maysoon Khalil Askar

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The delineation of possible areas of corrosion along the external face of an underground oil pipeline in Trunk line of Al- Garraf oil field was investigated using the horizontal electrical resistivity profiling technique and study the contribution of pH, Moisture Content in Soil and Presence chlorides, sulfates and total dissolve salts in soil and water. The test sites represent a physical and chemical properties of soils. The hydrogen-ion concentration of soil and groundwater range from 7.2 to 9.6, and the resistivity values of the soil along the pipeline were obtained using the YH302B model resistivity meter having values between 1588 and 720 Ohm-cm. the chloride concentration in soil and groundwater is high (more than 1000 ppm), total soulable salt is more than 5000 ppm, and sulphate range from 0.17% and 0.98% in soil and more than 600 ppm in groundwater. The soil is poor aeration, the soil texture is fine (clay and silt soil), the water content is high (the groundwater is close to surface), the chloride and sulphate is high in the soil and groundwater, the total soulable salt is high in ground water and finally the soil electric resistivity is low that the soil is very corrosive and there is the possibility of the pipeline failure. These methods applied in the study are quick, economic and efficient for detecting along buried pipelines which need to be protected. Routine electrical geophysical investigations along buried oil pipelines should be undertaken for the early detection and prevention of pipeline failure with its attendant environmental, human and economic consequences.

Keywords: soil resistivity, corrosion, cathodic protection, chloride concentration, water content

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327 Penetrating Neck Injury: No Zone Approach

Authors: Abhishek Sharma, Amit Gupta, Manish Singhal

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Background: The management of patients with penetrating neck injuries in the prehospital setting and in the emergency department has evolved with regard to the use of multidetector computed tomographic (MDCT) imaging. Hence, there is a shift in the management of neck injuries from mandatory exploration in certain anatomic areas to more conservative approach using imaging and so-called “no zone approach”. Objective: To study the no zone approach in the management of penetrating neck injury using routine imaging in all stable patients. Methods: 137 patients with penetrating neck injury attending emergency department of level 1 trauma centre at AIIMS between 2008–2014 were retrospectively analysed. All hemodynamically stable patients were evaluated using CT scanning. Results: Stab injury is most common (55.91%) mode of pni in civilian population followed by gunshot(18.33%). The majority of patients could be managed with imaging and close observation. 39 patients (28.46%) required operative intervention. The most common indication for operative intervention was vascular followed by airway injury manifesting as hemodynamic destabilisation.There was no statistical difference between the zonal distribution of injuries in patients managed conservatively and those taken to OR. Conclusions: Study shows that patients with penetrating neck trauma who are haemodynamically stable and exhibit no “hard signs” of vascular injury or airway injury may be evaluated initially by MDCT imaging even when platysma violation is present. “No Zone” policy may be superior to traditional zone wise management.

Keywords: penetrating neck injury, zone approach, CT scanning, multidetector computed tomographic (MDCT)

Procedia PDF Downloads 377
326 Early Education Assessment Methods

Authors: Anantdeep Kaur, Sharanjeet Singh

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Early childhood education and assessment of children is a very essential tool that helps them in their growth and development. Techniques should be developed, and tools should be created in this field as it is a very important learning phase of life. Some information and sources are included for student assessment to provide a record of growth in all developmental areas cognitive, physical, Language, social-emotional, and approaches to learning. As an early childhood educator, it is very important to identify children who need special support and counseling to improve them because they are not mentally mature to discuss with the teacher their problems and needs. It is the duty and responsibility of the educator to assess children from their body language, behavior, and their routine actions about their skills that can be improved and which can take them forward in their future life. And also, children should be assessed with their weaker points because this is the right time to correct them, and they be improved with certain methods and tools by working on them constantly. Observing children regularly with all their facets of development, including intellectual, linguistic, social-emotional, and physical development. Every day, a physical education class should be regulated to check their physical growth activities, which can help to assess their physical activeness and motor abilities. When they are outside on the playgrounds, it is very important to instill environmental understanding among them so that they should know that they are very part of this nature, and it will help them to be one with the universe rather than feeling themselves individually. This technique assists them in living their childhood full of energy all the time. All types of assessments have unique purposes. It is important first to determine what should be measured, then find the program that best assesses those.

Keywords: special needs, motor ability, environmental understanding, physical development

Procedia PDF Downloads 69
325 Prevalence of Anaemia Amongst Antenatal Clinic Attendees at Booking: A Nigerian Study

Authors: S Eli, DGB Kalio, BOA Altraide, P Kua, DA MacPepple, FE Okonofua

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Background: Anaemia in pregnancy is worrisome morbidity encountered by obstetricians and gynaecologist in the developing countries of the world. It is an indirect cause of maternal mortality and also a cause of perinatal mortality. Aim: The study aimed to ascertain the prevalence of anaemia amongst antenatal clinic (ANC) attendees at booking at The Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Rivers State, Nigeria. Method: The method was a cross-sectional study of ANC attendees at booking at RSUTH. The cut-off for anaemia by the WHO used for this study was packed cell volume (PCV) less than 33%. Simple randomized sampling method was used. Information was analyzed using SPSS version 25. Result: A total of 500 questionnaires were distributed, and 488 questionnaires retrieved. The mean age was of the ANC attendees was 31.44 years, and the modal parity was 0. Three hundred and fifty-seven (73.2%) of the respondents had a tertiary level of education, 126(25.8%) had a secondary level of education while 5 (1%) of the respondents had a primary level of education. Five (1%) of the respondents did not volunteer their educational status. The modal packed cell volume was 32%. Three hundred and eighty-two (78.3%) of the ANC attendees had PCV level less than 33% compared to 106 (21.7%) who had PCV equal or greater than 33%. Conclusion: The study revealed that the prevalence of anaemia in pregnancy amongst ANC attendees at the RSUTH was high, representing 73.3% of the subjects. Anaemia was common amongst multiparas (38.5%). Malaria prophylaxis, as well as encouraging pregnant women to be compliant with their routine antenatal drugs as well as counseling on the right diet, cannot be overemphasized during pregnancy. In addition, women should use family planning for child spacing for them to recover from previous pregnancies.

Keywords: anaemia, ANC attendees, Nigeria, prevalence

Procedia PDF Downloads 94
324 Hydraulic Conductivity Prediction of Cement Stabilized Pavement Base Incorporating Recycled Plastics and Recycled Aggregates

Authors: Md. Shams Razi Shopnil, Tanvir Imtiaz, Sabrina Mahjabin, Md. Sahadat Hossain

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Saturated hydraulic conductivity is one of the most significant attributes of pavement base course. Determination of hydraulic conductivity is a routine procedure for regular aggregate base courses. However, in many cases, a cement-stabilized base course is used with compromised drainage ability. Traditional hydraulic conductivity testing procedure is a readily available option which leads to two consequential drawbacks, i.e., the time required for the specimen to be saturated and extruding the sample after completion of the laboratory test. To overcome these complications, this study aims at formulating an empirical approach to predicting hydraulic conductivity based on Unconfined Compressive Strength test results. To do so, this study comprises two separate experiments (Constant Head Permeability test and Unconfined Compressive Strength test) conducted concurrently on a specimen having the same physical credentials. Data obtained from the two experiments were then used to devise a correlation between hydraulic conductivity and unconfined compressive strength. This correlation in the form of a polynomial equation helps to predict the hydraulic conductivity of cement-treated pavement base course, bypassing the cumbrous process of traditional permeability and less commonly used horizontal permeability tests. The correlation was further corroborated by a different set of data, and it has been found that the derived polynomial equation is deemed to be a viable tool to predict hydraulic conductivity.

Keywords: hydraulic conductivity, unconfined compressive strength, recycled plastics, recycled concrete aggregates

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323 A Twelve-Week Intervention Programme to Improve the Gross Motor Skills of Selected Children Diagnosed with Autism Spectrum Disorder

Authors: Eileen K. Africa, Karel J. van Deventer

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Neuro-typical children develop the motor skills necessary to play, do schoolwork and interact with others. However, this is not observed in children who have learning or behavioural problems. Children with Autism Spectrum Disorder (ASD) are often referred to as clumsy because their body parts do not work well together in a sequence. Physical Activity (PA) has shown to be beneficial to the general population, therefore, providing children with ASD opportunities to take part in PA programmes, could prove to be beneficial in many ways and should be investigated. The purpose of this study was to design a specialised group intervention programme, to attempt to improve gross motor skills of selected children diagnosed with ASD between the ages of eight and 13 years. A government school for ASD learners was recruited to take part in this study, and a sample of convenience (N=7) was selected. Children in the experimental group (n=4) participated in a 12-week group intervention programme twice per week, while the control group continued with their normal daily routine. The Movement Assessment Battery for Children-Second Edition (MABC-2), was administered pre- and post-test to determine the children’s gross motor proficiency and to determine if the group intervention programme had an effect on the gross motor skills of the experimental group. Statistically significant improvements were observed in total motor skill proficiency (p < 0.05), of the experimental group. These results demonstrate the importance of gross motor skills interventions for children diagnosed with ASD. Future research should include more participants to ensure that the results can be generalised.

Keywords: autism spectrum disorder, children, gross motor skills, group intervention programme

Procedia PDF Downloads 270
322 Effect of 10 Weeks of Aerobic Exercise Training on Serum Concentrations of Surfactant Protein D and Insulin Resistance in Women with Type 2 Diabetes

Authors: Sajjad Rezaei, Mahdieh Molanouri Shamsi, Azadeh Jamali

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Background and purpose: Surfactant protein D (SP-D) is a lung-specific protein that is detectable in human plasma. Effect of exercise training on SP-D levels as well as its relation to metabolic indices is not known. The present study then aimed to investigate the effects of 10 weeks of aerobic training on serum levels of SP-D and insulin resistance in women with type 2 diabetes. Materials and methods: Twenty-two overweight women with type 2 diabetes mellitus were recruited through deliberate sampling and randomly assigned to intervention and control groups (11 in each group). The intervention group underwent a progressive aerobic training program for 10 weeks, 3 days per week, 30-55 min/day at 50-75% heart rate reserve (HRR). Control group continued with its everyday routine. Blood samples were obtained before and after training for biochemical analysis. Within-group and between-group differences were analyzed with paired and independent t-tests in spss software, respectively, and the relation between variables was analyzed with Pearson’s correlation coefficient (all at P = 0.05). Results: Significant differences were observed between groups in leptin, glucose, waist circumference and VO2 max after training. SP-D was decreased and VO2 max was increased significantly in intervention group. However, no significant correlation was observed between SP-D and other variables. Conclusion: Since there was no corresponding decrease in insulin resistance with decreased levels of SP-D, it seems unlikely for SP-D to mediate the association between obesity and insulin resistance in type 2 diabetics.

Keywords: exercise training, SP-D, insulin resistance, type 2 diabetes

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321 Effect of Inspiratory Muscle Training on Diaphragmatic Strength Following Coronary Revascularization

Authors: Abeer Ahmed Abdelhamed

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Introduction: Postoperative pulmonary complications (PPCs) are the most common complications observed and managed after abdominal or cardiothoracic surgery. Hypoxemia, atelectasis, pleural effusion, or diaphragmatic dysfunction, are often a source of morbidity in cardiac surgery patients, and are more common in patients receiving unilateral or bilateral internal mammary artery (IMT) grafts than patients receiving saphenous vein (SV) grafts alone. Purpose: The aim of this work was to investigate the effect of Threshold load inspiratory muscle training on pulmonary gas exchange and maximum inspiratory pressure (MIP) in patient undergoing coronary revascularization. Subject: Thirty three male patients eligible for coronary revascularization were selected to participate in the study. Method: They were divided into two groups(17 patients in the intervention group and 16 patients in the control group), the interventional group received inspiratory muscle training at 30% of their maximum inspiratory pressure throughout the hospitalization period in addition to routine post operative care. Result: The results of this study showed a significant improvement on maximum inspiratory pressure(MIP), Arterial-alveolar pressure gradient (A-a gradient) and oxygen saturation in the intervention group. Conclusion: Inspiratory muscle training using threshold mode significantly improves maximum inspiratory pressure, pulmonary gas exchange tested by alveolar-arterial gradient and oxygen saturation in Patients undergoing coronary revascularization.

Keywords: coronary revascularization, inspiratory muscle training, maximum inspiratory pressure, pulmonary gas exchange

Procedia PDF Downloads 274
320 Pull String to Stop: Public Utility Vehicle Modernization Program

Authors: Frederick Kobe O. Obar, Preity B. Quinzon, Trisha B. Tumbokon, Mario Joshua D. Marron, Kenichi Katsuo Kichiro A. Rimorin

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The Public Utility Vehicle Modernization Program (PUVMP) is a program meant to reform the current state of the Philippines’ public transportation sector. This study determined the impact of the Public Utility Vehicle Modernization Program on San Fernando City, La Union's jeepney drivers, interviewing six individuals, three with traditional vehicles and three with modernized units. This study used a descriptive qualitative research design and employed purposive sampling to select the six participants suited for the study, who were then subjected to a semi-structured face-to-face interview. The gathered data was then analyzed through thematic analysis. The findings highlighted evidence that the jeepney drivers experienced abrupt and prevailing changes in their routine and in their everyday work. This study concludes that while the sentiment of the program was appreciated, it has changed the environment for jeepney drivers drastically, provoking many reactions. These changes have, of course, shifted the daily lives of the jeepney drivers significantly, but through adaptability, they found ways. Recommendations include flexible compliance policies, educational initiatives, and support for drivers, providing valuable insights for informed decision-making in the ongoing transportation modernization discussion. This study concluded that while the drivers are not opposed to reform, they are not entirely in approval of the current effects of the program as it is being implemented in their local area.

Keywords: transport reform, transport modernization, public transport, jeepney drivers, PUVMP, urban planning, public utility vehicles

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319 Localization of Frontal and Temporal Speech Areas in Brain Tumor Patients by Their Structural Connections with Probabilistic Tractography

Authors: B.Shukir, H.Woo, P.Barzo, D.Kis

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Preoperative brain mapping in tumors involving the speech areas has an important role to reduce surgical risks. Functional magnetic resonance imaging (fMRI) is the gold standard method to localize cortical speech areas preoperatively, but its availability in clinical routine is difficult. Diffusion MRI based probabilistic tractography is available in head MRI. It’s used to segment cortical subregions by their structural connectivity. In our study, we used probabilistic tractography to localize the frontal and temporal cortical speech areas. 15 patients with left frontal tumor were enrolled to our study. Speech fMRI and diffusion MRI acquired preoperatively. The standard automated anatomical labelling atlas 3 (AAL3) cortical atlas used to define 76 left frontal and 118 left temporal potential speech areas. 4 types of tractography were run according to the structural connection of these regions to the left arcuate fascicle (FA) to localize those cortical areas which have speech functions: 1, frontal through FA; 2, frontal with FA; 3, temporal to FA; 4, temporal with FA connections were determined. Thresholds of 1%, 5%, 10% and 15% applied. At each level, the number of affected frontal and temporal regions by fMRI and tractography were defined, the sensitivity and specificity were calculated. At the level of 1% threshold showed the best results. Sensitivity was 61,631,4% and 67,1523,12%, specificity was 87,210,4% and 75,611,37% for frontal and temporal regions, respectively. From our study, we conclude that probabilistic tractography is a reliable preoperative technique to localize cortical speech areas. However, its results are not feasible that the neurosurgeon rely on during the operation.

Keywords: brain mapping, brain tumor, fMRI, probabilistic tractography

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318 Mobile Augmented Reality for Collaboration in Operation

Authors: Chong-Yang Qiao

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Mobile augmented reality (MAR) tracking targets from the surroundings and aids operators for interactive data and procedures visualization, potential equipment and system understandably. Operators remotely communicate and coordinate with each other for the continuous tasks, information and data exchange between control room and work-site. In the routine work, distributed control system (DCS) monitoring and work-site manipulation require operators interact in real-time manners. The critical question is the improvement of user experience in cooperative works through applying Augmented Reality in the traditional industrial field. The purpose of this exploratory study is to find the cognitive model for the multiple task performance by MAR. In particular, the focus will be on the comparison between different tasks and environment factors which influence information processing. Three experiments use interface and interaction design, the content of start-up, maintenance and stop embedded in the mobile application. With the evaluation criteria of time demands and human errors, and analysis of the mental process and the behavior action during the multiple tasks, heuristic evaluation was used to find the operators performance with different situation factors, and record the information processing in recognition, interpretation, judgment and reasoning. The research will find the functional properties of MAR and constrain the development of the cognitive model. Conclusions can be drawn that suggest MAR is easy to use and useful for operators in the remote collaborative works.

Keywords: mobile augmented reality, remote collaboration, user experience, cognition model

Procedia PDF Downloads 172
317 Changes in Knowledge and Awareness for a Community-Based Cancer Screening Educational Program

Authors: Shenghui Wu, Patricia Chalela, Amelie G. Ramirez

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Background: Cervical cancer (CC), colorectal cancer (CRC), and breast cancer (BC) are diseases that can be prevented/detected through early test. Through educational programs, individuals can become better informed about these cancers and understand the importance of screening and early detection. A community-based educational program was developed to improve knowledge and awareness toward the screening of the three cancer types in a South Texas underserved population. Methods: Residents living in Laredo, Texas were invited to participate in the present study. From January 2020 to April 2021, participants were recruited using social media and flyer distributions in general community. Participants received a free live web cancer education presentation delivered by bilingual community health educators, and online pre- and post-education surveys for CC, CRC, and BC separately. Pre-post changes in knowledge for individual items were compared using McNemar’s chi-squared tests. Results: Overall, participants demonstrated increases in CC (n=237), CRC (n=59), and BC (n=56) screening knowledge and awareness after receiving the cancer screening education (Ps<0.05). After receiving the cancer screening education, 85-97% of participants had an intent to talk to a healthcare provider about CC/CRC/BC screening, 88-97% had an intent to get a CC/CRC/BC screening test in the next 12 months or at the next routine appointment, and 90-97% had an intent to talk about CC/CRC/BC with their family members or friends. Conclusion: A community-based educational program can help increase knowledge and awareness about cervical, colorectal, and breast cancer screening, promote positive changes in population's knowledge and awareness about the benefits of cancer screening.

Keywords: cervical cancer, colorectal cancer, breast cancer, educational program, health knowledge, awareness, Hispanics, screening, health education

Procedia PDF Downloads 76
316 Fast Return Path Planning for Agricultural Autonomous Terrestrial Robot in a Known Field

Authors: Carlo Cernicchiaro, Pedro D. Gaspar, Martim L. Aguiar

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The agricultural sector is becoming more critical than ever in view of the expected overpopulation of the Earth. The introduction of robotic solutions in this field is an increasingly researched topic to make the most of the Earth's resources, thus going to avoid the problems of wear and tear of the human body due to the harsh agricultural work, and open the possibility of a constant careful processing 24 hours a day. This project is realized for a terrestrial autonomous robot aimed to navigate in an orchard collecting fallen peaches below the trees. When it receives the signal indicating the low battery, it has to return to the docking station where it will replace its battery and then return to the last work point and resume its routine. Considering a preset path in orchards with tree rows with variable length by which the robot goes iteratively using the algorithm D*. In case of low battery, the D* algorithm is still used to determine the fastest return path to the docking station as well as to come back from the docking station to the last work point. MATLAB simulations were performed to analyze the flexibility and adaptability of the developed algorithm. The simulation results show an enormous potential for adaptability, particularly in view of the irregularity of orchard field, since it is not flat and undergoes modifications over time from fallen branch as well as from other obstacles and constraints. The D* algorithm determines the best route in spite of the irregularity of the terrain. Moreover, in this work, it will be shown a possible solution to improve the initial points tracking and reduce time between movements.

Keywords: path planning, fastest return path, agricultural autonomous terrestrial robot, docking station

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315 Nature-based Solutions for Mitigating the Impact of Climate Change on Plants: Utilizing Encapsulated Plant Growth Regulators and Associative Microorganisms

Authors: Raana Babadi Fathipour

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Over the past decades, the climatic CO2 concentration and worldwide normal temperature have been expanding, and this drift is anticipated to before long gotten to be more extreme. This situation of climate alter escalate abiotic stretch components (such as dry spell, flooding, saltiness, and bright radiation) that debilitate timberland and related environments as well as trim generation. These variables can contrarily influence plant development and advancement with a ensuing lessening in plant biomass aggregation and surrender, in expansion to expanding plant defenselessness to biotic stresses. As of late, biostimulants have ended up a hotspot as an viable and economical elective to reduce the negative impacts of stresses on plants. In any case, the larger part of biostimulants has destitute solidness beneath natural conditions, which leads to untimely debasement, shortening their organic movement. To unravel these bottlenecks, small scale- and nano-based definitions containing biostimulant atoms and/or microorganisms are picking up consideration as they illustrate a few points of interest over their routine details. In this survey, we center on the embodiment of plant development controllers and plant acquainted microorganisms as a technique to boost their application for plant assurance against abiotic stresses. We moreover address the potential restrictions and challenges confronted for the execution of this innovation, as well as conceivable outcomes with respect to future inquire about.

Keywords: bio stimulants, Seed priming, nano biotechnology, plant growth-promoting, rhizobacteria, plant growth regulators, microencapsulation

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314 Jelly and Beans: Appropriate Use of Ultrasound in Acute Kidney Injury

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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313 Genetic Diversity and Molecular Basis of Carbapenem Resistance in Acinetobacter Baumannii Isolates from Cattle

Authors: Minhas Alam, Muhammad Hidayat Rasool, Mohsin Khurshid, Bilal Aslam

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Acinetobacter baumannii is a notorious bacterial pathogen that is an emerging nightmare in clinical settings and is mainly involved in severe nosocomial infections. However, the data related to carbapenem-resistant A. baumannii (CRAB) from veterinary settings is limited, especially in developing countries like Pakistan. To investigate the genetic diversity and molecular basis of carbapenem resistance in Acinetobacter baumannii isolates from Cattle, a total of 1960 samples were collected from cattle from Punjab, Pakistan. The isolates were analyzed by routine microbiological procedures and confirmed by polymerase chain reaction (PCR). The isolates were further screened for antimicrobial susceptibility and the presence of multiple antimicrobial-resistant determinants by PCR. Multilocus sequence typing (MLST) was performed. The results of the current study revealed that the overall prevalence of A. baumannii in cattle was 3.28% (65/1980). Among cattle 27.7% (18/65) were found CRAB strains. The CRAB isolates harbor class D β- lactamases genes, e-g, blaOXA-23 and blaOXA-51, 94.4% (17/18). CRAB isolates carry class B β- lactamases gene blaIMP, and only one isolate carries the blaNDM-1 gene. The MLST results of CRAB isolates from cattle demonstrated 5 STs and one new ST. The commonly found sequence types in CRAB isolates were ST2 (n=10, 55.5%), followed by ST642 (n=5, 27.8%) and ST600 & ST889 (n=1, 5.55%). The presence of CRAB isolates in cattle indicates an alarming situation in Punjab, Pakistan. Immediate control measures should be taken to stop the transmission of CRAB isolates within cattle, to the environment, and to clinical settings.

Keywords: acinetobacter baumannii, carbapenemases, veterinary, drug resistance

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312 Big Data and Cardiovascular Healthcare Management: Recent Advances, Future Potential and Pitfalls

Authors: Maariyah Irfan

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Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

Procedia PDF Downloads 102
311 Surveillance for African Swine Fever and Classical Swine Fever in Benue State, Nigeria

Authors: A. Asambe, A. K. B. Sackey, L. B. Tekdek

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A serosurveillance study was conducted to detect the presence of antibodies to African swine fever virus (ASFV) and Classical swine fever virus in pigs sampled from piggeries and Makurdi central slaughter slab in Benue State, Nigeria. 416 pigs from 74 piggeries across 12 LGAs and 44 pigs at the Makurdi central slaughter slab were sampled for serum. The sera collected were analysed using Indirect Enzyme Linked Immunosorbent Assay (ELISA) test kit to test for antibodies to ASFV, while competitive ELISA test kit was used to test for antibodies to CSFV. Of the 416 pigs from piggeries and 44 pigs sampled from the slaughter slab, seven (1.7%) and six (13.6%), respectively, tested positive to ASFV antibodies and was significantly associated (p < 0.0001). Out of the 12 LGAs sampled, Obi LGA had the highest ASFV antibody detection rate of (4.8%) and was significantly associated (p < 0.0001). None of the samples tested positive to CSFV antibodies. The study concluded that antibodies to CSFV were absent in the sampled pigs in piggeries and at the Makurdi central slaughter slab in Benue State, while antibodies to ASFV were present in both locations; hence, the need to keep an eye open for CSF too since both diseases may pose great risk in the study area. Further studies to characterise the ASFV circulating in Benue State and investigate the possible sources is recommended. Routine surveillance to provide a comprehensive and readily accessible data base to plan for the prevention of any fulminating outbreak is also recommended.

Keywords: African swine fever, classical swine fever, piggery, slaughter slab, surveillance

Procedia PDF Downloads 164
310 Evaluation of Gingival Hyperplasia Caused by Medications

Authors: Ilma Robo, Saimir Heta, Greta Plaka, Vera Ostreni

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Purpose: Drug gingival hyperplasia is an uncommon pathology encountered during routine work in dental units. The purpose of this paper is to present the clinical appearance of gingival hyperplasia caused by medications. There are already three classes of medications that cause hyperplasia and based on data from the literature, the clinical cases encountered and included in this study have been compared. Materials and Methods: The study was conducted in a total of 311 patients, out of which 182 patients were included in our study, meeting the inclusion criteria. After each patient's history was recorded and it was found that patients were in their knowledge of chronic illness, undergoing treatment of gingivitis hypertrophic drugs was performed with a clinical examination of oral cavity and assessment by vertical and horizontal evaluation according to the periodontal indexes. Results: Of the data collected during the study, it was observed that 97% of patients with gingival hyperplasia are treated with nifedipine. 84% of patients treated with selected medicines and gingival hyperplasia in the oral cavity has been exposed at time period for more than 1 year and 1 month. According to the GOI, in the first rank of this index are about 21% of patients, in the second rank are 52%, in the third rank are 24% and in the fourth grade are 3%. According to the horizontal growth index of gingival hyperplasia, grade 1 included about 61% of patients and grade 2 included about 39% of patients with gingival hyperplasia. Bacterial index divides patients by degrees: grading 0 - 8.2%, grading 1 - 32.4%, grading 2 - 14% and grading 3 - 45.1%. Conclusions: The highest percentage of gingival hyperplasia caused by drugs is due to dosing of nifedipine for a duration of dosing and application for systemic healing for more than 1 year.

Keywords: drug gingival hyperplasia, horizontal growth index, vertical growth index

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309 Protein Extraction by Enzyme-Assisted Extraction followed by Alkaline Extraction from Red Seaweed Eucheuma denticulatum (Spinosum) Used in Carrageenan Production

Authors: Alireza Naseri, Susan L. Holdt, Charlotte Jacobsen

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In 2014, the global amount of carrageenan production was 60,000 ton with a value of US$ 626 million. From this number, it can be estimated that the total dried seaweed consumption for this production was at least 300,000 ton/year. The protein content of these types of seaweed is 5 – 25%. If just half of this total amount of protein could be extracted, 18,000 ton/year of a high-value protein product would be obtained. The overall aim of this study was to develop a technology that will ensure further utilization of the seaweed that is used only as raw materials for carrageenan production as single extraction at present. More specifically, proteins should be extracted from the seaweed either before or after extraction of carrageenan with focus on maintaining the quality of carrageenan as a main product. Different mechanical, chemical and enzymatic technologies were evaluated. The optimized process was implemented in lab scale and based on its results; the new experiments were done a pilot and larger scale. In order to calculate the efficiency of the new upstream multi-extraction process, protein content was tested before and after extraction. After this step, the extraction of carrageenan was done and carrageenan content and the effect of extraction on yield were evaluated. The functionality and quality of carrageenan were measured based on rheological parameters. The results showed that by using the new multi-extraction process (submitted patent); it is possible to extract almost 50% of total protein without any negative impact on the carrageenan quality. Moreover, compared to the routine carrageenan extraction process, the new multi-extraction process could increase the yield of carrageenan and the rheological properties such as gel strength in the final carrageenan had a promising improvement. The extracted protein has initially been screened as a plant protein source in typical food applications. Further work will be carried out in order to improve properties such as color, solubility, and taste.

Keywords: carrageenan, extraction, protein, seaweed

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308 Qf-Pcr as a Rapid Technique for Routine Prenatal Diagnosis of Fetal Aneuploidies

Authors: S. H. Atef

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Background: The most common chromosomal abnormalities identified at birth are aneuploidies of chromosome 21, 18, 13, X and Y. Prenatal diagnosis of fetal aneuploidies is routinely done by traditional cytogenetic culture, a major drawback of this technique is the long period of time required to reach a diagnosis. In this study, we evaluated the QF-PCR as a rapid technique for prenatal diagnosis of common aneuploidies. Method:This work was carried out on Sixty amniotic fluid samples taken from patients with one or more of the following indications: Advanced maternal age (3 case), abnormal biochemical markers (6 cases), abnormal ultrasound (12 cases) or previous history of abnormal child (39 cases).Each sample was tested by QF-PCR and traditional cytogenetic. Aneuploidy screenings were performed amplifying four STRs on chromosomes 21, 18, 13, two pseudoautosomal,one X linked, as well as the AMXY and SRY; markers were distributed in two multiplex QFPCR assays (S1 and S2) in order to reduce the risk of sample mishandling. Results: All the QF-PCR results were successful, while there was two culture failures, only one of them was repeated. No discrepancy was seen between the results of both techniques. Fifty six samples showed normal patterns, three sample showed trisomy 21, successfully detected by both techniques and one sample showed normal pattern by QF-PCR but could not be compared to the cytogenetics due to culture failure, the pregnancy outcome of this case was a normal baby. Conclusion: Our study concluded that QF-PCR is a reliable technique for prenatal diagnosis of the common chromosomal aneuploidies. It has the advantages over the cytogenetic culture of being faster with the results appearing within 24-48 hours, simpler, doesn't need a highly qualified staff, less prone to failure and more cost effective.

Keywords: QF-PCR, traditional cytogenetic fetal aneuploidies, trisomy 21, prenatal diagnosis

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307 Performance of the Aptima® HIV-1 Quant Dx Assay on the Panther System

Authors: Siobhan O’Shea, Sangeetha Vijaysri Nair, Hee Cheol Kim, Charles Thomas Nugent, Cheuk Yan William Tong, Sam Douthwaite, Andrew Worlock

Abstract:

The Aptima® HIV-1 Quant Dx Assay is a fully automated assay on the Panther system. It is based on Transcription-Mediated Amplification and real time detection technologies. This assay is intended for monitoring HIV-1 viral load in plasma specimens and for the detection of HIV-1 in plasma and serum specimens. Nine-hundred and seventy nine specimens selected at random from routine testing at St Thomas’ Hospital, London were anonymised and used to compare the performance of the Aptima HIV-1 Quant Dx assay and Roche COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 Test, v2.0. Two-hundred and thirty four specimens gave quantitative HIV-1 viral load results in both assays. The quantitative results reported by the Aptima Assay were comparable those reported by the Roche COBAS AmpliPrep/COBAS TaqMan HIV-1 Test, v2.0 with a linear regression slope of 1.04 and an intercept on -0.097. The Aptima assay detected HIV-1 in more samples than the Roche assay. This was not due to lack of specificity of the Aptima assay because this assay gave 99.83% specificity on testing plasma specimens from 600 HIV-1 negative individuals. To understand the reason for this higher detection rate a side-by-side comparison of low level panels made from the HIV-1 3rd international standard (NIBSC10/152) and clinical samples of various subtypes were tested in both assays. The Aptima assay was more sensitive than the Roche assay. The good sensitivity, specificity and agreement with other commercial assays make the HIV-1 Quant Dx Assay appropriate for both viral load monitoring and detection of HIV-1 infections.

Keywords: HIV viral load, Aptima, Roche, Panther system

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306 Understanding the Manifestation of Psychosocial Difficulties in Children with Developmental Language Disorder, with a Focus on Anxiety and Social Frustration

Authors: Annabel Burnley, Michelle St. Clair, Charlotte Dack, Yvonne Wren

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Children with Developmental Language Disorder (DLD) are well documented to experience social and emotional difficulties. Despite this, there is little consensus as to how these difficulties manifest, without which the ability to develop prevention initiatives is limited. An online survey was completed by 107 parents of either child with DLD (‘DLD sample’; n=57), or typically developing children (‘typical sample’; n=50), all aged 6-12 years old. Psychosocial symptom measures were used, alongside 11 psychosocial statements generated from previous qualitative work. Qualitative interviews were then held to understand the manifestation of key difficulties in more depth (n=4). The DLD sample scored significantly higher on all psychosocial statements than the typical sample. Experiencing anxiety (80.7%), requiring routine and sameness (75.4%) and struggling to regulate their emotions (75.4%) were the most common difficulties for a majority of children with DLD. For this DLD sample, family communication and coping styles were found not to contribute to the manifestation of these difficulties. Two separate mediation models were run to understand the role of other psychosocial difficulties in the manifestation of (1) anxiety and (2) social frustration. ‘Intolerance of uncertainty was found to strongly mediate the relationship between DLD diagnosis and symptoms of anxiety. Emotion regulation was found to moderately mediate the relationship between DLD diagnosis and social frustration. Parents appear to cope well with their children’s complex psychosocial needs, but further external intervention is needed. Intervention focussing on intolerance of uncertainty and emotion dysregulation may help the management of anxiety and social frustration. Further research is needed to understand the children’s routined behaviors.

Keywords: psychosocial difficulties, developmental language disorder, specific language impairment, parent, anxiety

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305 The Prevalence of Postpartum Stress among Jordanian Women

Authors: Khitam Ibrahem Shlash Mohammad

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Background: Postnatal depression is a focus of considerable research attention, but little is known about the pattern of stress across this period. Objective: to investigate the prevalence of stress after childbirth for Jordanian women and identify associated risk factors. Method: Design: A descriptive cross-sectional study. Participants were recruited six to eight weeks postpartum, provided personal, social and obstetric information, and completed the stress subscale of Depression Anxiety and Stress Scale (DASS-S), the Maternity Social Support Scale (MSSS), and Perceived Self-Efficacy Scale (PSES). Setting: maternal and child health care clinics in four health care centres in Maan city in Southern Jordan. Participants: Arabic speaking women (n = 324) between the ages of 18 and 45 years, six to eight weeks postpartum, primiparous or multiparous at low risk for obstetric complications. Data collection took place between October 2015 and January 2016. Ethical clearance was obtained prior to data collection. Results: The prevalence of postpartum stress among Jordanian women was 39.8 %. A regression analysis revealed that occupation, low social support, financial problems, difficult marital relationships, difficult relationship with family-in-law, giving birth to a female baby, difficult childbirth, and low self-efficacy were associated with postpartum stress. Conclusions and implications for practice: Jordanian women need support during pregnancy, during and after childbirth. Postpartum emotional support and assessment of symptoms of stress need to be incorporated into routine practice. The opportunity for open discussion along with increased awareness and clarification of common misconceptions about postpartum stress is necessary.

Keywords: prevalence, postpartum, stress, Jordanian women

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304 Frenotomy for Tongue Tie: The Unlikely Benefit of Massage

Authors: Kailas Bhandarkar, Talib Dar, Laura Karia, Manasvi Upadhyaya

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Introduction: Frenotomy for tongue tie is commonly performed in breastfed infants who experience difficulty in latching after failed conservative management for tongue tie. However, there is no consensus for the routine use of massage following frenotomy. Our aim was to assess the efficacy of massage in preventing recurrence following frenotomy. Methods: The tongue tie service in our tertiary referral hospital consists of 5 consultants and a breastfeeding (BF) midwife. 3 consultants routinely advice massage post procedure. Babies are assessed by the midwife after the procedure and a follow-up consultation after a week. After due ethical approval, data were collected by two staff members who were independent of TT service on a standardized questionnaire to avoid bias. Fischer exact test was employed (p < 0.05 considered significant). Results: Six hundred and thirty-two babies attended the clinic from January 2018 to December 2018. Thirty-three of these were excluded as the procedure was not needed. Parents were contacted at a median of six months post-procedure (range 2-10 months). 282/599 were advised massage. 92/282 could be contacted. 40/ 92 adhered to massage regimen. None of these had a recurrence. 52/92 (54%), although advised, did not perform massage. Reasons cited for lack of adherence to massage included difficulty in performing massaging and conflicting advice given by other health care professionals involved in patient care like paediatricians and group practice and lack of information on the internet). Overall, 4/599 (0.66%) had recurrences, and this difference was not statistically significant. Conclusion: In our experience, the rate of recurrence after frenotomy is low enough for us to conclude that there is no significant benefit of massage after frenotomy for tongue tie. We could also conclude that among parents who were advised massage more than half failed to adhere to the advice.

Keywords: tongue tie, frenotomy, massage, recurrence

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303 Perception of Healthcare Workers Regarding the Psychological Impact of COVID-19 on Their Children

Authors: Saima Batool, Saima Rafique

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Background and Objective: Pandemics like COVID-19 adversely affect children’s behavior and psychological development by disrupting routine life activities. Children of healthcare workers are exposed additionally due to the fear of parental exposure to the virus. The objective of this study was to assess the perception of frontline healthcare workers (HCWs) regarding the psychological impact of the COVID-19 pandemic on their children. We also sought to identify the difference in the psychological impact on children of male and female healthcare workers. Methods: A survey questionnaire was developed comprising 10 questions about the perception of HCWs regarding the psychological impact of COVID-19 on their children. It was distributed both online and face-to-face among 150 healthcare professionals working in training and non-training posts in 4 public and 5 nongovernment hospitals in Pakistan. The mean and standard deviation were calculated for each survey item using Statistical Package for the Social Sciences 26.0. Results: The response rate was 71.3%, and the majority (64.2%) of the healthcare professionals were ≥30 years of age. Ninety-two HCWs (85.98%) either agreed or strongly agreed that parental separation from their kids for long hours during the pandemic had a negative psychological impact on their children. There was a significant difference in the perceived psychological impact of COVID-19 on the children of male and female HCWs, with a mean survey score of 2.29 ± 1.82 and 1.69 ± 0.79, respectively (t = 2.29, p-value = 0.024). Conclusion: Children of healthcare workers experience more stress and anxiety because of long duty hours and working in high-risk settings. Continuous psychological support and counseling services may be adopted formally to prevent unforeseen adverse events or any long-term negative impact on their physical and mental health.

Keywords: healthcare workers, pandemic, COVID-19, anxiety, psychological

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302 African Swine Fewer Situation and Diagnostic Methods in Lithuania

Authors: Simona Pileviciene

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On 24th January 2014, Lithuania notified two primary cases of African swine fever (ASF) in wild boars. The animals were tested positive for ASF virus (ASFV) genome by real-time PCR at the National Reference Laboratory for ASF in Lithuania (NRL), results were confirmed by the European Union Reference Laboratory for African swine fever (CISA-INIA). Intensive wild and domestic animal monitoring program was started. During the period of 2014-2017 ASF was confirmed in two large commercial pig holding with the highest biosecurity. Pigs were killed and destroyed. Since 2014 ASF outbreak territory from east and south has expanded to the middle of Lithuania. Diagnosis by PCR is one of the highly recommended diagnostic methods by World Organization for Animal Health (OIE) for diagnosis of ASF. The aim of the present study was to compare singleplex real-time PCR assays to a duplex assay allowing the identification of ASF and internal control in a single PCR tube and to compare primers, that target the p72 gene (ASF 250 bp and ASF 75 bp) effectivity. Multiplex real-time PCR assays prove to be less time consuming and cost-efficient and therefore have a high potential to be applied in the routine analysis. It is important to have effective and fast method that allows virus detection at the beginning of disease for wild boar population and in outbreaks for domestic pigs. For experiments, we used reference samples (INIA, Spain), and positive samples from infected animals in Lithuania. Results show 100% sensitivity and specificity.

Keywords: African swine fewer, real-time PCR, wild boar, domestic pig

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301 Prevalence and Genetic Determinant of Drug Resistant Tuberculosis among Patients Completing Intensive Phase of Treatment in a Tertiary Referral Center in Nigeria

Authors: Aminu Bashir Mohammad, Agwu Ezera, Abdulrazaq G. Habib, Garba Iliyasu

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Background: Drug resistance tuberculosis (DR-TB) continues to be a challenge in developing countries with poor resources. Routine screening for primary DR-TB before commencing treatment is not done in public hospitals in Nigeria, even with the large body of evidence that shows a high prevalence of primary DR-TB. Data on drug resistance and its genetic determinant among follow up TB patients is lacking in Nigeria. Hence the aim of this study was to determine the prevalence and genetic determinant of drug resistance among follow up TB patients in a tertiary hospital in Nigeria. Methods: This was a cross-sectional laboratory-based study conducted on 384 sputum samples collected from consented follow-up tuberculosis patients. Standard microbiology methods (Zeil-Nielsen staining and microscopy) and PCR (Line Probe Assay)] were used to analyze the samples collected. Person’s Chi-square was used to analyze the data generated. Results: Out of three hundred and eighty-four (384) sputum samples analyzed for mycobacterium tuberculosis (MTB) and DR-TB twenty-five 25 (6.5%) were found to be AFB positive. These samples were subjected to PCR (Line Probe Assay) out of which 18(72%) tested positive for DR-TB. Mutations conferring resistance to rifampicin (rpo B) and isoniazid (katG, and or inhA) were detected in 12/18(66.7%) and 6/18(33.3%), respectively. Transmission dynamic of DR-TB was not significantly (p>0.05) dependent on demographic characteristics. Conclusion: There is a need to strengthened the laboratory capacity for diagnosis of TB and drug resistance testing and make these services available, affordable, and accessible to the patients who need them.

Keywords: drug resistance tuberculosis, genetic determinant, intensive phase, Nigeria

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