Search results for: Thomas Cochrane

Authors: Shohreh Ghasemi

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Introduction: Managing oral and maxillofacial trauma is a multifaceted challenge, as it can have life-threatening consequences and significant functional and aesthetic impact. Navigation techniques have been introduced to improve surgical precision to meet this challenge. A machine learning algorithm was also developed to support clinical decision-making regarding treating oral and maxillofacial trauma. Given these advances, this systematic meta-analysis aims to assess the efficacy of navigational techniques in treating oral and maxillofacial trauma and explore the impact of machine learning on their management. Methods: A detailed and comprehensive analysis of studies published between January 2010 and September 2021 was conducted through a systematic meta-analysis. This included performing a thorough search of Web of Science, Embase, and PubMed databases to identify studies evaluating the efficacy of navigational techniques and the impact of machine learning in managing oral and maxillofacial trauma. Studies that did not meet established entry criteria were excluded. In addition, the overall quality of studies included was evaluated using Cochrane risk of bias tool and the Newcastle-Ottawa scale. Results: Total of 12 studies, including 869 patients with oral and maxillofacial trauma, met the inclusion criteria. An analysis of studies revealed that navigation techniques effectively improve surgical accuracy and minimize the risk of complications. Additionally, machine learning algorithms have proven effective in predicting treatment outcomes and identifying patients at high risk for complications. Conclusion: The introduction of navigational technology has great potential to improve surgical precision in oral and maxillofacial trauma treatment. Furthermore, developing machine learning algorithms offers opportunities to improve clinical decision-making and patient outcomes. Still, further studies are necessary to corroborate these results and establish the optimal use of these technologies in managing oral and maxillofacial trauma

Keywords: trauma, machine learning, navigation, maxillofacial, management

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Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian Murray

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The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: interoperabilty, medical data exchange, health data standards, case study, Saudi Arabia

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Authors: Satyam Raikwar, Thomas Herlitzius, Jens Fehrmann

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In recent years, the autonomous navigation of orchard and field robots is an emerging technology of the mobile robotics in agriculture. One of the core aspects of autonomous navigation builds upon path planning, which is still a crucial issue. Generally, for simple representation, the path planning for a mobile robot is performed in a two-dimensional space, which creates a path between the start and goal point. This paper presents the automatic path planning approach for robots used in orchards and vineyards using occupancy grid maps with field consideration. The orchards and vineyards are usually structured environment and their topology is assumed to be constant over time; therefore, in this approach, an RGB image of a field is used as a working environment. These images undergone different image processing operations and then discretized into two-dimensional grid matrices. The individual grid or cell of these grid matrices represents the occupancy of the space, whether it is free or occupied. The grid matrix represents the robot workspace for motion and path planning. After the grid matrix is described, a probabilistic roadmap (PRM) path algorithm is used to create the obstacle-free path over these occupancy grids. The path created by this method was successfully verified in the test area. Furthermore, this approach is used in the navigation of the orchard robot.

Keywords: orchard robots, automatic path planning, occupancy grid, probabilistic roadmap

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Authors: M. Solairaju, Nithin J. Thomas, S. Ganesan

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Each and every rotating part of a machine element consists of bearings within its structure. In particular, the rolling element bearings such as cylindrical roller bearing and deep groove ball bearings are frequently used. Improper handling, excessive loading, improper lubrication and sealing cause bearing damage. Hence health monitoring of bearings is an important aspect for radiation pattern of bearing vibration is computed using the dipole model. Sound pressure level for defect-free and race defect the prolonged life of machinery and auto motives. This paper presents modeling and analysis of Acoustic response of deep groove ball bearing with localized race defects. Most of the ball bearings, especially in machine tool spindles and high-speed applications are pre-loaded along an axial direction. The present study is carried out with axial preload. Based on the vibration response, the orbit motion of the inner race is studied, and it was found that the oscillation takes place predominantly in the axial direction. Simplified acoustic is estimated. Acoustic response shows a better indication in identifying the defective bearing. The computed sound signal is visualized in diagrammatic representation using Symmetrised Dot Pattern (SDP). SDP gives better visual distinction between the defective and defect-free bearing

Keywords: bearing, dipole, noise, sound

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Authors: Lizmol Mathew, Divya Thomas, Shiney Rajan

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Educational paradigm all over the globe is undergoing significant reform today. Because of this, so-called flipped classroom model is becoming increasingly popular in higher education. Flipped classroom has proved to be more effective than traditional lecture based model as flipped classroom model promotes active learning by encouraging students to work on in collaborative tasks and peer-led learning during the class-time. However, success of flipped classrooms relies on students’ ability and their attitudes towards collaboration and group work. This paper examines: 1) Students’ attitudes towards collaborative learning; 2) Main challenges to successful collaboration from students’ experience and 3) Students’ perception of criteria for successful team work. 4) Recommendations for enhancing collaborative learning. This study’s methodology involves quantitative analysis of surveys collected from students enrolled in undergraduate Architecture program at Qatar University. Analysis indicates that in general students enrolled in the program do not have positive perceptions or experiences associated with group work. Positive and negative factors that influence collaborative learning in higher education have been identified. Recommendations for improving collaborative work experience have been proposed.

Keywords: architecture, collaborative learning, female, group work, higher education, Middle East, Qatar, student experience

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Authors: Ebtisam A. Al-Mslemani, Khalid A. Enan, Asmaa Abdelgadier, Nada Assaad, Zaynab Elhussein, Khalid Eltom

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Background: Toxoplasma gondii (T. gondii) is a zoonotic parasite that can be transmitted from animals to humans, with felids acting as its definitive host. Thus, understanding the epidemiology of this parasite in animal populations is vital to controlling its transmission to humans as well as to other animal groups. Objectives: This systematic review and meta-analysis aim to summarise and analyse reports of T. gondii infection in animal species residing in the Arabian Peninsula. Methods: It was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), with relevant studies being retrieved from MEDLINE/PubMed, Scopus, Cochrane Library, Google Scholar and ScienceDirect. All articles published in Arabic or English languages between January 2000 and December 2020 were screened for eligibility. The random effects model was used to calculate the pooled prevalence of T. gondii infection in different animal populations which were found to harbour this infection. The critical appraisal tool for prevalence studies designed by the Joanna Briggs Institute (JBI) was used to assess the risk of bias in all included studies. Results: A total of 15 studies were retrieved, reporting prevalence estimates from 4 countries in this region and in 13 animal species. A quantitative meta-analysis estimated a pooled prevalence of 43% in felids [95% confidence interval (CI) = 23-64%, I2 index = 100%], 48% in sheep (95% CI = 27-70%, I2 = 99%) and 21% in camels (95% CI = 7-35%, I2 = 99%). Evidence of possible publication bias was found in both felids and sheep. Conclusions: This meta-analysis estimates a high prevalence of T. gondii infection in animal species that are of high economic and cultural importance to countries of this region. Hence, these findings provide valuable insight to public health authorities as well as economic and animal resources advisors in countries of the Arabian Peninsula.

Keywords: Arabian Peninsula, toxoplasma gondii, animals; meta-analysis, toxoplasmosis

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Authors: Anders Schou Simonsen, Thomas Condra, Kim Sørensen

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Various processes are modelled using a discrete phase, where particles are seeded from a source. Such particles can represent liquid water droplets, which are affecting the continuous phase by exchanging thermal energy, momentum, species etc. Discrete phases are typically modelled using parcel, which represents a collection of particles, which share properties such as temperature, velocity etc. When coupling the phases, the exchange rates are integrated over the cell, in which the parcel is located. This can cause spikes and fluctuating exchange rates. This paper presents an alternative method of coupling a discrete and a continuous plug flow phase. This is done using triangular parcels, which span between nodes following the dynamics of single droplets. Thus, the triangular parcels are propagated using the corner nodes. At each time step, the exchange rates are spatially integrated over the surface of the triangular parcels, which yields a smooth continuous exchange rate to the continuous phase. The results shows that the method is more stable, converges slightly faster and yields smooth exchange rates compared with the steam tube approach. However, the computational requirements are about five times greater, so the applicability of the alternative method should be limited to processes, where the exchange rates are important. The overall balances of the exchanged properties did not change significantly using the new approach.

Keywords: CFD, coupling, discrete phase, parcel

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Authors: Likewin Thomas, M. V. Manoj Kumar, B. Annappa

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Traditional execution process follows the path of execution drawn by the process analyst without observing the behaviour of resource and other real-time constraints. Identifying process model, predicting the behaviour of resource and recommending the optimal path of execution for a real time process is challenging. The proposed AlfyMiner: αyM iner gives a new dimension in process execution with the novel techniques Process Model Analyser: PMAMiner and Resource behaviour Analyser: RBAMiner for recommending the probable path of execution. PMAMiner discovers next probable activity for currently executing activity in an online process using variant matching technique to identify the set of next probable activity, among which the next probable activity is discovered using decision tree model. RBAMiner identifies the resource suitable for performing the discovered next probable activity and observe the behaviour based on; load and performance using polynomial regression model, and waiting time using queueing theory. Based on the observed behaviour αyM iner recommend the probable path of execution with; next probable activity and the best suitable resource for performing it. Experiments were conducted on process logs of CoSeLoG Project1 and 72% of accuracy is obtained in identifying and recommending next probable activity and the efficiency of resource performance was optimised by 59% by decreasing their load.

Keywords: cross-organization process mining, process behaviour, path of execution, polynomial regression model

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Authors: V. Khosravi, F. D. Ardejani, A. Aryafar, M. Sedighi

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Heavy metals have a damaging impact for the environment, animals and humans due to their extreme toxicity and removing them from wastewaters is a very important and interesting task in the field of water pollution control. Biosorption is a relatively new method for treatment of wastewaters and recovery of heavy metals. In this study, a continuous fixed bed study was carried out by using Bacillus thuringiensis as a biosorbent for the removal of Cu and Mn ions from Sarcheshmeh Acid Mine Drainage (AMD). The effect of operating parameters such as flow rate and bed height on the sorption characteristics of B. thuringiensis was investigated at pH 6.0 for each metal ion. The experimental results showed that the breakthrough time decreased with increasing flow rate and decreasing bed height. The data also indicated that the equilibrium uptake of both metals increased with decreasing flow rate and increasing bed height. BDST, Thomas, and Yoon–Nelson models were applied to experimental data to predict the breakthrough curves. All models were found suitable for describing the whole dynamic behavior of the column with respect to flow rate and bed height. In order to regenerate the adsorbent, an elution step was carried out with 1 M HCl and five adsorption-desorption cycles were carried out in continuous manner.

Keywords: acid mine drainage, bacillus thuringiensis, biosorption, cu and mn ions, fixed bed

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Authors: Benga Ebouele, Thomas Tengen

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Implementing either periodic or continuous inventory review model within most manufacturing-companies-supply chains as a management tool may incur higher costs. These high costs affect the system flexibility which in turn affects the level of service required to satisfy customers. However, these effects are not clearly understood because the parameters of both inventory review policies (protection demand interval, order quantity, etc.) are not designed to be fully utilized under different and uncertain conditions such as poor manufacturing, supplies and delivery performance. Coming up with a hybrid model which may combine in some sense the feature of both continuous and a periodic inventory review models should be useful. Therefore, there is a need to build and evaluate such hybrid model on the annual total cost, stock out probability and system’s flexibility in order to search for the most cost effective inventory review model. This work also seeks to find the optimal sets of parameters of inventory management under stochastic condition so as to optimise each policy independently. The results reveal that a continuous inventory system always incurs lesser cost than a periodic (R, S) inventory system, but this difference tends to decrease as time goes by. Although the hybrid inventory is the only one that can yield lesser cost over time, it is not always desirable but also natural to use it in order to help the system to meet high performance specification.

Keywords: demand and lead time randomness, hybrid Inventory model, optimization, supply chain

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Authors: Reem Muaid, Thomas Chesney

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Background: Attitude towards organ donation is predominantly positive in the UK; however, the donation rate remains low. To develop more effective interventions, this research aims to examine the behavioural barriers in organ donations using Q methodology to elicit patterns of overlap among different barriers and motivators. Method: A Q methodology study was conducted with 40 participants aged 19-64 who were asked to rank 47 statements on issues that are associated with organ donation. By-person factor analysis using Centroid method and Varimax rotation was conducted to bring out patterns in the way statements were ranked to obtain groupings of participants who had arranged the statements in similar fashion. Results: Four viewpoints were extracted: The Realist, the Optimist Hesitant, the Pessimist Determinant, and the Empathetic. Salient barriers to organ donation presented in each viewpoint suggest that perceived lack of knowledge, anxiety, mistrust in the healthcare system, and lack of cue to action are the main barriers to organ donation. Consensus statements suggest that religion and family agreement are inconsequential if the attitude to organ donation is well-formed. Conclusion: There are different attitudes around deceased organ donation that were uncovered using Q methodology. These results suggest that people respond to behavioural change campaigns differently depending on their own perceptions of organ donation. We argue that a paradigm shift in behavioural interventions is underpinned by understanding the overlapping yet distinctive nature of perceived perspectives.

Keywords: organ donation, Q methodology, behavioural interventions, post Q Survey

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Authors: Seyran Naghdi

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Background: Orphan drug development is limited by very high costs attributed to the research and development and small size market. How health policymakers address this challenge to consider both supply and demand sides need to be explored for directing the policies and plans in the right way. The price is an important signal for pharmaceutical companies’ profitability and the patients’ accessibility as well. Objective: This study aims to find out the orphan drugs' price-setting patterns and approaches in health systems through a systematic review of the available evidence. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach was used. MedLine, Embase, and Web of Sciences were searched via appropriate search strategies. Through Medical Subject Headings (MeSH), the appropriate terms for pricing were 'cost and cost analysis', and it was 'orphan drug production', and 'orphan drug', for orphan drugs. The critical appraisal was performed by the Joanna-Briggs tool. A Cochrane data extraction form was used to obtain the data about the studies' characteristics, results, and conclusions. Results: Totally, 1,197 records were found. It included 640 hits from Embase, 327 from Web of Sciences, and 230 MedLine. After removing the duplicates, 1,056 studies remained. Of them, 924 studies were removed in the primary screening phase. Of them, 26 studies were included for data extraction. The majority of the studies (>75%) are from developed countries, among them, approximately 80% of the studies are from European countries. Approximately 85% of evidence has been produced in the recent decade. Conclusions: There is a huge variation of price-setting among countries, and this is related to the specific pharmacological market structure and the thresholds that governments want to intervene in the process of pricing. On the other hand, there is some evidence on the availability of spaces to reduce the very high costs of orphan drugs development through an early agreement between pharmacological firms and governments. Further studies need to focus on how the governments could incentivize the companies to agree on providing the drugs at lower prices.

Keywords: orphan drugs, orphan drug production, pricing, costs, cost analysis

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Authors: Thomas P. Jones

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Overview: Drowning is an important cause of accidental death, particularly in children and young people. Although many survive drowning incidents, it is a relatively rare presenting complaint in Emergency Departments. When cases do present, they can be complex and unpredictable. For patients to receive the best care, it is important that their management is standardized and evidence based, however this can be difficult in a topic area with limited studies and inconsistencies in case reporting. Objectives: To review recent cases to assess the performance of Manchester Royal Infirmary Emergency Department in the management of near drowning. To produce evidence based guideline on the management of drowning victims in the ED. Methods: Emergency department records were searched for patients with the diagnosis of ‘fatal drowning’ or ‘nearly drowning’ and two relevant case notes reviewed. To produce the guideline a literature review was conducted and a series of structured short cut systematic reviews known as Best BETs carried out. This information was used to produce a clear treatment pathway. Results: The case studies emphasized the variety in presentation of drowning victims whilst highlighting inconsistencies in management and documentation. An evidence-based guideline is presented as a flowchart, which illustrates the relevant investigations and treatment that victims of a drowning incident should receive, based on the best available evidence. Conclusion: It is hoped that when put into practice, the guideline will improve and standardize patient care in cases of near drowning. An audit is recommended to assess its effectiveness.

Keywords: drowning, near drowning, non fatal drowning, fatal drowning

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Authors: Federico Pittino, Thomas Arnold

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The shredding of waste materials is a key step in the recycling process towards the circular economy. Industrial shredders for waste processing operate in very harsh operating conditions, leading to the need for frequent maintenance of critical components. Maintenance optimization is particularly important also to increase the machine’s efficiency, thereby reducing the operational costs. In this work, a monitoring system has been developed and deployed on an industrial shredder located at a waste recycling plant in Austria. The machine has been monitored for one year, and methods for predictive maintenance have been developed for two key components: the cutting knives and the drive belt. The large amount of collected data is leveraged by statistical machine learning techniques, thereby not requiring very detailed knowledge of the machine or its live operating conditions. The results show that, despite the wide range of operating conditions, a reliable estimate of the optimal time for maintenance can be derived. Moreover, the trade-off between the cost of maintenance and the increase in power consumption due to the wear state of the monitored components of the machine is investigated. This work proves the benefits of real-time monitoring system for the efficient operation of industrial shredders.

Keywords: predictive maintenance, circular economy, industrial shredder, cost optimization, statistical machine learning

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Authors: Priya Pawar, Rithika Susan Thomas, Emmanuel Blonkowski

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Due to the solar geometry of Singapore, which lay within the geographical classification of equatorial tropics, there is a great deal of thermal energy transfer to the inside of the buildings. With changing face of economic development of cities like Singapore, more and more buildings are designed to be lightweight using transparent construction materials such as glass. Increased demand for energy efficiency and reduced cooling load demands make it important for building designer and operators to adopt new and non-invasive technologies to achieve building energy efficiency targets. A real time performance evaluation study was undertaken at School of Art Design and Media (SADM), Singapore, to determine the efficiency potential of a new generation solar insulation film. The building has a window to wall ratio (WWR) of 100% and is fitted with high performance (low emissivity) double glazed units. The empirical data collected was then used to calibrate a computerized simulation model to understand the annual energy consumption based on existing conditions (baseline performance). It was found that the correlations of various parameters such as solar irradiance, solar heat flux, and outdoor air-temperatures quantification are significantly important to determine the cooling load during a particular period of testing.

Keywords: solar insulation film, building energy efficiency, tropics, cooling load

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Authors: Shaun G. Abbott, Rebecca C. Reynolds, James B. Etter, John B. F. de Wit

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The benefits of physical activity (PA) on health are well documented. Low socioeconomic status (SES) is associated with poor health, with PA a suggested mediator. Pedometers and accelerometers offer an effective behavior change tool to increase PA levels. While the role of pedometer and accelerometer use in increasing PA is recognized in many populations, little is known in low-SES groups. We are aiming to assess the effectiveness of pedometer- and accelerometer-based interventions for increasing PA step count and improving subsequent health outcomes among low-SES groups of high-income countries. Medline, Embase, PsycINFO, CENTRAL and SportDiscus databases were searched to identify articles published before 10th July, 2015; using search terms developed from previous systematic reviews. Inclusion criteria are: low-SES participants classified by income, geography, education, occupation or ethnicity; study duration minimum 4 weeks; an intervention and control group; wearing of an unsealed pedometer or accelerometer to objectively measure PA as step counts per day for the duration of the study. We retrieved 2,142 articles from our database searches, after removal of duplicates. Two investigators independently reviewed titles and abstracts of these articles (50% each) and a combined 20% sample were reviewed to account for inter-assessor variation. We are currently verifying the full texts of 430 articles. Included studies will be critically appraised for risk of bias using guidelines suggested by the Cochrane Public Health Group. Two investigators will extract data concerning the intervention; study design; comparators; steps per day; participants; context and presence or absence of obesity and/or chronic disease. Heterogeneity amongst studies is anticipated, thus a narrative synthesis of data will be conducted with the simplification of selected results into percentage increases from baseline to allow for between-study comparison. Results will be presented at the conference in December if selected.

Keywords: accelerometer, pedometer, physical activity, socioeconomic, step count

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Authors: Erwin Geroleo, Higinio Mappala

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Introduction Overt Hepatic Encephalopathy (OHE) is the most dreaded outcome of liver cirrhosis. Aside from the triggering factors which are already known to precipitate OHE, there is growing evidence that an altered gut microbiota profile (dysbiosis) can also trigger OHE. MHE is the mildest form of hepatic encephalopathy(HE), affecting about one-third of patients with cirrhosis, and close 80% of patients with cirrhosis and manifests as abnormalities in central nervous system function. Since these symptoms are subclinical most patients are not being treated to prevent OHE. The gut microbiota have been evaluated by several studies as a therapeutic option for MHE, especially in decreasing the levels of ammonia, thus preventing progression to OHE Objectives This study aims to evaluate the efficacy of probiotics in terms of reduction of ammonia levels in patient with minimal hepatic encephalopathies and to determine if Probiotics has role in the prevention of progression to overt hepatic encephalopathy in adult patients with minimal hepatic encephalopathy (MHE) Methods and Analysis The literature search strategy was restricted to human studies in adults subjects from 2004 to 2022. The Jadad Score Calculation was utilized in the assessment of the final studies included in this study. Eight (8) studies were included. Cochrane’s Revman Web, the Fixed Effects model and the Ztest were all used in the overall analysis of the outcomes. A p value of less than 0.0005 was statistically significant. Results. These results show that Probiotics significantly lowers the level of Ammonia in Cirrhotic patients with OHE. It also shows that the use of Probiotics significantly prevents the progression of MHE to OHE. The overall risk of bias graph indicates low risk of publication bias among the studies included in the meta-analysis. Main findings This research found that plasma ammonia concentration was lower among participants treated with probiotics (p<0.00001).) Ammonia level of the probiotics group is lower by 13.96 μmol/ on the average. Overall risk of developing overt hepatic encephalopathy in the probiotics group is shown to be decreased by 15% as compared to the placebo group Conclusion The analysis showed that compared with placebo, probiotics can decrease serum ammonia, may improve MHE and may prevent OHE.

Keywords: minimal hepatic encephalopathy, probiotics, liver cirrhosis, overt hepatic encephalopathy

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Authors: Maliha Ahmed Suleman, Sidra Ahmed Suleman

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Introduction: The use of pacifiers is common amongst infants and young children as a comforting behavior. These non-nutritive sucking habits can be detrimental to the developing occlusion should they persist while the permanent dentition is established. Orthodontic pacifiers have been recommended as an alternative to conventional pacifiers as they are considered to have less interference with orofacial development. However, there is a lack of consensus on whether this is true. Aim and objectives: To review the prevalence of malocclusion associated with the use of orthodontic pacifiers. Methodology: Literature was identified through a rigorous search of the Embase, Pubmed, CINAHL, and Cochrane Library databases. Articles published from 2000 onwards were included. In total, 5 suitable papers were identified. Results: One study showed that the use of orthodontic pacifiers increased the risk of malocclusion, as seen through a greater prevalence of accentuated overjet, posterior crossbites, and anterior open bites in comparison to individuals who did not use pacifiers. However, this study found that there was a clinically significant reduction in the prevalence of anterior open bites amongst orthodontic pacifier users in comparison to conventional pacifier users. Another study found that both types of pacifiers lead to malocclusion; however, they found no difference in the mean overjet and prevalence of anterior open bites amongst conventional and orthodontic pacifier users. In contrast, one study suggested that orthodontic pacifiers do not seem to be related to the development of malocclusions in the primary dentitions, and using them between the ages of 0-3 months was actually beneficial as it prevents thumb-sucking habits. One of the systemic reviews concluded that orthodontic pacifiers do not seem to reduce the occurrence of posterior crossbites; however, they could reduce the development of open bites by virtue of their thin neck design. Whereas another systematic review concluded that there were no differences as to the effects on the stomatognathic system when comparing conventional and orthodontic pacifiers. Conclusion: There is limited and conflicting evidence to support the notion that orthodontic pacifiers can reduce the prevalence of malocclusion when compared to conventional pacifiers. Well-designed randomized controlled trials are required in the future in order to thoroughly assess the effects of orthodontic pacifiers on the developing occlusion and orofacial structures.

Keywords: orthodontics, pacifier, malocclusion, review

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Authors: David Glew, Felix Thomas, Matthew Brooke-Peat

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Improving the thermal performance of homes is seen as an essential step in achieving climate change, fuel security, fuel poverty targets. One of the most effective thermal retrofits is to insulate solid walls. However, it has been observed that applying insulation to the internal face of solid walls reduces the surface temperature of the inner wall leaf, which may introduce condensation risk and may interrupt seasonal moisture accumulation and dissipation. This research quantifies the extent to which the risk of condensation and moisture accumulation in the wall increases (which can increase the risk of timber rot) following the installation of six different types of internal wall insulation. In so doing, it compares how risk is affected by both the thermal resistance, thickness, and breathability of the insulation. Thermal bridging, surface temperatures, condensation risk, and moisture accumulation are evaluated using hygrothermal simulation software before and after the thermal upgrades. The research finds that installing internal wall insulation will always introduce some risk of condensation and moisture. However, it identifies that risks were present prior to insulation and that breathable materials and insulation with lower resistance have lower risks than alternative insulation options. The implications of this may be that building standards that encourage the enhanced thermal performance of solid walls may be introducing moisture risks into homes.

Keywords: condensation risk, hygrothermal simulation, internal wall insulation, thermal bridging

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Authors: Elvin Lim

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This article integrates the debate about presidential powers with the debate about federalism, arguing that there are two ways of exercising presidential powers, one working in tandem with expanding federal powers, and the other working against it. Alexander Hamilton and Thomas Jefferson—the former a Federalist and the latter echoing the views of many Anti-Federalists—disagreed not only on the constitutional basis of prerogative, but also on the ends for which it should be deployed. This tension has always existed in American politics, and is reproduced today. Modern Democrats and Republicans both want a strong executive, but the Democrats who want a strong executive to pass legislation to expand the reach of the federal government; naturally, they must rely on an equally empowered Congress to do so. Republicans generally do not want an intrusive federal government, which is why their defense of a strong presidency does not come alongside a call for a strong Congress. This distinction cannot be explained without recourse to foundational yet opposing views about the appropriate role of federal power. When we bring federalism back in, we see that there are indeed two presidencies; one neo-Federalist, in favor of moderate presidential prerogative alongside a robust Congress directed collectively to a national state-building agenda and expanding the federal prerogative; another, neo-Anti-Federalist, in favor of expansive presidential prerogative and an ideologically sympathetic Congress equally suspicious of federal power to retard or roll back national state-building in favour of states rights.

Keywords: US presidency, federalism, prerogative, anti-federalism

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Authors: Ian M. Grey, Bryan Roche, Anna Dillon, Justin Thomas, Sarah Cassidy, Dylan Colbert, Ian Stewart

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This paper presents findings from a study conducted in two schools in Abu Dhabi. The hypothesis is that teaching young children to derive various relations between stimuli leads to increases in full-scale IQ scores of typically developing children. In the experimental group, sixteen 6-7-year-old children were exposed over six weeks to an intensive training intervention designed specifically for their age group. This training intervention, presented on a tablet, aimed to improve their understanding of the relations Same, Opposite, Different, contextual control over the concept of Sameness and Difference, and purely arbitrary derived relational responding for Sameness and Difference. In the control group, sixteen 6-7-year-old children interacted with KIBO robotics over six weeks. KIBO purports to improve cognitive skills through engagement with STEAM activities. Increases in full-scale IQ were recorded for most children in the experimental group, while no increases in full-scale IQ were recorded for the control group. These findings support the hypothesis that relational skills underlie many aspects of general cognitive ability.

Keywords: early childhood, derived relational responding, intelligence, relational frame theory, relational skills

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Authors: Ken Hampshire, Thomas Mazzuchi, Shahram Sarkani

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As a subset of metaheuristics, nature-inspired optimization algorithms such as particle swarm optimization (PSO) have shown promise both in solving intractable problems and in their extensibility to novel problem formulations due to their general approach requiring few assumptions. Unfortunately, single instantiations of algorithms require detailed tuning of parameters and cannot be proven to be best suited to a particular illustrative problem on account of the “no free lunch” (NFL) theorem. Using these algorithms in real-world problems requires exquisite knowledge of the many techniques and is not conducive to reconciling the various approaches to given classes of problems. This research aims to present a unified view of PSO-based approaches from the perspective of relevant systems engineering problems, with the express purpose of then eliciting the best solution for any problem formulation in an ensemble learning bucket of models approach. The central hypothesis of the research is that extending the PSO algorithms found in the literature to real-world optimization problems requires a general ensemble-based method for all problem formulations but a specific implementation and solution for any instance. The main results are a problem-based literature survey and a general method to find more globally optimal solutions for any systems engineering optimization problem.

Keywords: particle swarm optimization, nature-inspired optimization, metaheuristics, systems engineering, ensemble learning

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Authors: Marwah Mohsin, Thomas Beach, Alan Kwan, Mahdi Ismail

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This paper describes the differences in views on sustainable development between the general public and experts in a developing country, Iraq. This paper will answer the question: How do the views of the public differ from the generally accepted view of experts in the context of sustainable urban development in Iraq? In order to answer this question, the views of both the public and the experts will be analysed. These results are taken from a public survey and a Delphi questionnaire. These will be analysed using statistical methods in order to identify the significant differences. This will enable investigation of the different perceptions between the public perceptions and the experts’ views towards urban sustainable development factors. This is important due to the fact that different viewpoints between policy-makers and the public will impact on the acceptance by the public of any future sustainable development work that is undertaken. The brief findings of the statistical analysis show that the views of both the public and the experts are considered different in most of the variables except six variables show no differences. Those variables are ‘The importance of establishing sustainable cities in Iraq’, ‘Mitigate traffic congestion’, ‘Waste recycling and separating’, ‘Use wastewater recycling’, ‘Parks and green spaces’, and ‘Promote investment’.

Keywords: urban sustainability, experts views, public views, principle component analysis, PCA

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Authors: Muhammad Irfan Aziz, Thomas Owens, Uzair Khaleeq uz Zaman

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The instantaneous and spatial localization for visually impaired people in dynamically changing environments with unexpected hazards and obstacles, is the most demanding and challenging issue faced by the navigation systems today. Since Bluetooth cannot utilize techniques like Time Difference of Arrival (TDOA) and Time of Arrival (TOA), it uses received signal strength indicator (RSSI) to measure Receive Signal Strength (RSS). The measurements using RSSI can be improved significantly by improving the existing methodologies related to RSSI. Therefore, the current paper focuses on proposing an improved method using trilateration for localization of Bluetooth devices for visually impaired people. To validate the method, class 2 Bluetooth devices were used along with the development of a software. Experiments were then conducted to obtain surface plots that showed the signal interferences and other environmental effects. Finally, the results obtained show the surface plots for all Bluetooth modules used along with the strong and weak points depicted as per the color codes in red, yellow and blue. It was concluded that the suggested improved method of measuring RSS using trilateration helped to not only measure signal strength affectively but also highlighted how the signal strength can be influenced by atmospheric conditions such as noise, reflections, etc.

Keywords: Bluetooth, indoor/outdoor localization, received signal strength indicator, visually impaired

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Authors: Matthew Cameron, Stephen Yang, Latifa Al Kharusi, Adam Gosselin, Anissa Chirico, Pouya Gholipour Baradari

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Background: Iron supplementation has been evaluated in several randomized controlled trials (RCTs) for the potential to increase baseline hemoglobin and decrease the incidence of red blood cell (RBC) transfusion during cardiac surgery. This study's main objective was to evaluate the evidence for iron administration in cardiac surgery patients for its effect on the incidence of perioperative RBC transfusion. Methods: This systematic review protocol was registered with PROSPERO (CRD42020161927) on Dec. 19th, 2019, and was prepared as per the PRISMA guidelines. MEDLINE, EMBASE, CENTRAL, Web of Science databases, and Google Scholar were searched for RCTs evaluating perioperative iron administration in adult patients undergoing cardiac surgery. Each abstract was independently reviewed by two reviewers using predefined eligibility criteria. The primary outcome was perioperative RBC transfusion, with secondary outcomes of the number of RBC units transfused, change in ferritin level, reticulocyte count, hemoglobin, and adverse events, after iron administration. The risk of bias was assessed with the Cochrane Collaboration Risk of Bias Tool, and the primary and secondary outcomes were analyzed with a random-effects model. Results: Out of 1556 citations reviewed, five studies (n = 554 patients) met the inclusion criteria. The use of iron demonstrated no difference in transfusion incidence (RR 0.86; 95% CI 0.65 to 1.13). There was a low heterogeneity between studies (I²=0%). The trial sequential analysis suggested an optimal information size of 1132 participants, which the accrued information size did not reach. Conclusion: The current literature does not support the routine use of iron supplementation before cardiac surgery; however, insufficient data is available to draw a definite conclusion. A critical knowledge gap has been identified, and more robust RCTs are required on this topic.

Keywords: cardiac surgery, iron, iron supplementation, perioperative medicine, meta-analysis, systematic review, randomized controlled trial

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Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

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Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

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Authors: Thomas Geninatti, Bruno Giacomo, Alessandro Grattoni

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Nanofluidic devices have been investigated for over a decade as promising platforms for the controlled release of therapeutics. The nanochannel drug delivery system (nDS), a membrane fabricated with high precision silicon techniques, capable of zero-order release of drugs by exploiting diffusion transport at the nanoscale originated from the interactions between molecules with nanochannel surfaces, showed the flexibility of the sustained release in vitro and in vivo, over periods of time ranging from weeks to months. To improve the implantable bio nanotechnology, in order to create a system that possesses the key features for achieve the suitable release of therapeutics, the next generation of nDS has been created. Platinum electrodes are integrated by e-beam deposition onto both surfaces of the membrane allowing low voltage (<2 V) and active temporal control of drug release through modulation of electrostatic potentials at the inlet and outlet of the membrane’s fluidic channels. Hence, a tunable administration of drugs is ensured from the nanochannel drug delivery system. The membrane will be incorporated into a peek implantable capsule, which will include drug reservoir, control hardware and RF system to allow suitable therapeutic regimens in real-time. Therefore, this new nanotechnology offers tremendous potential solutions to manage chronic disease such as cancer, heart disease, circadian dysfunction, pain and stress.

Keywords: nanochannel membrane, drug delivery, tunable release, personalized administration, nanoscale transport, biomems

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Authors: M. Hadi Bordbar, Matthew England, Alex Sen Gupta, Agus Santoso, Andrea Taschetto, Thomas Martin, Wonsun Park, Mojib Latif

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Climate models generally simulate long-term reductions in the Pacific Walker Circulation with increasing atmospheric greenhouse gases. However, over two recent decades (1992-2011) there was a strong intensification of the Pacific Trade Winds that is linked with a slowdown in global surface warming. Using large ensembles of multiple climate models forced by increasing atmospheric greenhouse gas concentrations and starting from different ocean and/or atmospheric initial conditions, we reveal very diverse 20-year trends in the tropical Pacific climate associated with a considerable uncertainty in the globally averaged surface air temperature (SAT) in each model ensemble. This result suggests low confidence in our ability to accurately predict SAT trends over 20-year timescale only from external forcing. We show, however, that the uncertainty can be reduced when the initial oceanic state is adequately known and well represented in the model. Our analyses suggest that internal variability in the Pacific trade winds can mask the anthropogenic signal over a 20-year time frame, and drive transitions between periods of accelerated global warming and temporary slowdown periods.

Keywords: trade winds, walker circulation, hiatus in the global surface warming, internal climate variability

Procedia PDF Downloads 239

Authors: Hendri Purwadi, Christine McCloud

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Triage is a complex decision-making process that aims to categorize a victim’s level of acuity and the need for medical assistance. Two common triage systems have been widely used in Mass Casualty Incidents (MCIs) and disaster situation are START (Simple triage algorithm and rapid treatment) and SALT (sort, asses, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over START triage system. This systematic review aims to investigate and compare the effectiveness between SALT and START triage system in disaster and MCIs setting. Literatures were searched via systematic search strategy from 2009 until 2019 in PubMed, Cochrane Library, CINAHL, Scopus, Science direct, Medlib, ProQuest. This review included simulated-based and medical record -based studies investigating the accuracy and applicability of SALT and START triage systems of adult and children population during MCIs and disaster. All type of studies were included. Joana Briggs institute critical appraisal tools were used to assess the quality of reviewed studies. As a result, 1450 articles identified in the search, 10 articles were included. Four themes were identified by review, they were accuracy, under-triage, over-triage and time to triage per individual victim. The START triage system has a wide range and inconsistent level of accuracy compared to SALT triage system (44% to 94. 2% of START compared to 70% to 83% of SALT). The under-triage error of START triage system ranged from 2.73% to 20%, slightly lower than SALT triage system (7.6 to 23.3%). The over-triage error of START triage system was slightly greater than SALT triage system (START ranged from 2% to 53% compared to 2% to 22% of SALT). The time for applying START triage system was faster than SALT triage system (START was 70-72.18 seconds compared to 78 second of SALT). Consequently; The START triage system has lower level of under-triage error and faster than SALT triage system in classifying victims of MCIs and disaster whereas SALT triage system is known slightly more accurate and lower level of over-triage. However, the magnitude of these differences is relatively small, and therefore the effect on the patient outcomes is not significance. Hence, regardless of the triage error, either START or SALT triage system is equally effective to triage victims of disaster and MCIs.

Keywords: disaster, effectiveness, mass casualty incidents, START triage system, SALT triage system

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Authors: Thomas, Daniel Tajo, Kish

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Sight is primarily associated with the function of gathering and processing near and extended spatial information which is largely used to support self-determined interaction with the environment through self-directed movement and navigation. By contrast, hearing is primarily associated with the function of gathering and processing sequential information which may typically be used to support self-determined communication through the self-directed use of music and language. Blindness or the lack of vision is traditionally characterized by a lack of capacity to access spatial information which, in turn, is presumed to result in a lack of capacity for self-determined interaction with the environment due to limitations in self-directed movement and navigation. However, through a specific protocol of FlashSonar education developed by World Access for the Blind, the function of hearing can be expanded in blind people to carry out some of the functions normally associated with sight, that is to access and process near and extended spatial information to construct three-dimensional acoustic images of the environment. This perceptual education protocol results in a significant restoration in blind people of self-determined environmental interaction, movement, and navigational capacities normally attributed to vision - a new way to see. Thus, by expanding the function of hearing to process spatial information to restore self-determined movement, we are not only changing the meaning of blindness, and what it means to be blind, but we are also recasting the meaning of vision and what it is to see.

Keywords: echolocation, changing, sensory, function

Procedia PDF Downloads 130