Search results for: Pediatric intensive care unit

Authors: Adam J. Bowen

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Abstract— Should robots have rights or legal protections. Often debates concerning whether robots and AI should be afforded rights focus on conditions of personhood and the possibility of future advanced forms of AI satisfying particular intrinsic cognitive and moral attributes of rights-holding persons. Such discussions raise compelling questions about machine consciousness, autonomy, and value alignment with human interests. Although these are important theoretical concerns, especially from a future design perspective, they provide limited guidance for addressing the moral and legal standing of current and near-term AI that operate well below the cognitive and moral agency of human persons. Robots and AI are already being pressed into service in a wide range of roles, especially in healthcare and biomedical contexts. The design and large-scale implementation of robots in the context of core societal institutions like healthcare systems continues to rapidly develop. For example, we bring them into our homes, hospitals, and other care facilities to assist in care for the sick, disabled, elderly, children, or otherwise vulnerable persons. We enlist surgical robotic systems in precision tasks, albeit still human-in-the-loop technology controlled by surgeons. We also entrust them with social roles involving companionship and even assisting in intimate caregiving tasks (e.g., bathing, feeding, turning, medicine administration, monitoring, transporting). There have been advances to enable severely disabled persons to use robots to feed themselves or pilot robot avatars to work in service industries. As the applications for near-term AI increase and the roles of robots in restructuring our biomedical practices expand, we face pressing questions about the normative implications of human-robot interactions and collaborations in our collective worldmaking, as well as the moral and legal status of robots. This paper argues that robots operating in public and private spaces be afforded some protections as either moral patients or legal agents to establish prohibitions on robot abuse, misuse, and mistreatment. We already implement robots and embed them in our practices and institutions, which generates a host of human-to-machine and machine-to-machine relationships. As we interact with machines, whether in service contexts, medical assistance, or home health companions, these robots are first encountered in relationship to us and our respective roles in the encounter (e.g., surgeon, physical or occupational therapist, recipient of care, patient’s family, healthcare professional, stakeholder). This proposal aims to outline a framework for establishing limiting factors and determining the extent of moral or legal protections for robots. In doing so, it advocates for a relational approach that emphasizes the priority of mapping the complex contextually sensitive roles played and the relations in which humans and robots stand to guide policy determinations by relevant institutions and authorities. The relational approach must also be technically informed by the intended uses of the biomedical technologies in question, Design History Files, extensive risk assessments and hazard analyses, as well as use case social impact assessments.

Keywords: biomedical robots, robot ethics, robot laws, human-robot interaction

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Authors: Nibedita Priyadarsini

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It is said that Ethics has a wide range of application which mainly deals with human life and human behavior. All ethical decisions are ultimately concerned with life and death. Both life and death must be considered dignified. Medical ethics with its different topics mostly deals with life and death concepts among which euthanasia is one. Various types of debates continue over Euthanasia long since. The question of putting an end to someone’s life has aroused controversial in legal sphere as well as in moral sphere. To permit or not to permit has remained an enigma the world over. Modern medicine is in the stage of transcending limits that cannot be set aside. The morality of allowing people to die without treatment has become more important as methods of treatment have become more sophisticated. Allowing someone to die states an essential recognition that there is some point in any terminal illness when further curative treatment has no purpose and the patient in such situation should allow dying a natural death in comfort, peace, and dignity, without any interference from medical science and technology. But taking a human life is in general sense is illogical in itself. It can be said that when we kill someone, we cause the death; whereas if we merely let someone die, then we will not be responsible for anyone’s death. This point is often made in connection with the euthanasia cases and which is often debatable. Euthanasia in the pediatric age group involves some important issues that are different from those of adult issues. The main distinction that occurs is that the infants and newborns and young children are not able to decide about their future as the adult does. In certain cases, where the child born with some serious deformities with no hope of recovery, in that cases doctor decide not to perform surgery in order to remove the blockage, and let the baby die. Our aim in this paper is to examine, whether it is ethically justified to withhold or to apply euthanasia on the part of the defective infant. What to do with severely defective infants from earliest time if got to know that they are not going to survive at all? Here, it will deal mostly with the ethics in deciding the relevant ethical concerns in the practice of euthanasia with the defective newborns issues. Some cases in relation to disabled infants and newborn baby will be taken in order to show what to do in a critical condition, that the patient and family members undergoes and under which condition those could be eradicated, if not all but some. The final choice must be with the benefit of the patient.

Keywords: ethics, medical ethics, euthanasia, defective newborns

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Authors: C. Elavarasi, T. Shanmuganantham

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A coplanar waveguide (CPW) feed is presented, and comprising a split ring resonator (SRR) loaded fractal with water lily shape is used for multi band applications. The impedance matching of the antenna is determined by the number of Koch curve fractal unit cells. The antenna is designed on a FR4 substrate with a permittivity of ε_{r =} 4.4 and size of 14 x 16 x 1.6 mm³ to generate multi resonant mode at 3.8 GHz covering S band, 8.68 GHz at X band, 13.96 GHz at Ku band, and 19.74 GHz at K band with reflection coefficient better than -10 dB. Simulation results show that the antenna exhibits the desired voltage standing wave ratio (VSWR) level and radiation patterns across the wide frequency range. The fundamental parameters of the antenna such as return loss, VSWR, good radiation pattern with reasonable gain across the operating bands are obtained.

Keywords: fractal, metamaterial, split ring resonator, waterlily shape

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Authors: Sanja O. Podunavac-Kuzmanović, Lidija R. Jevrić, Strahinja Z. Kovačević

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In last decade, metal-organic complexes have captured intensive attention because of their wide range of biological activities such as antibacterial, antifungal, anticancerous, antimicrobial and antiHIV. Therefore, it is of great importance for the development of coordination chemistry to explore the assembly of functional organic ligands with metal ion and to investigate the relationship between the structure and property. In view of our studies, we reasoned that benzimidazoles complexed to metal ions could act as a potent antibacterial agents. Thus, we have bioassayed the inhibitory potency of benzimidazoles and their metal salts (Co or Ni) against Gram negative bacteria Escherichia coli. In order to validate our in vitro study, we performed in silico studies using molecular docking software’s. The investigated compounds and their metal complexes (Co, Ni) showed good antibacterial activity against Escherichia coli. In silico docking studies of the synthesized compounds suggested that complexed benzimidazoles have a greater binding affinity and enhanced antibacterial activity in comparison with noncomplexed ligands. In view of their enhanced inhibitory properties we propose that the studied complexes can be used as potential pharmaceuticals. This study is financially supported by COST action CM1306 and the project No. 114-451-347/2015-02, financially supported by the Provincial Secretariat for Science and Technological Development of Vojvodina.

Keywords: benzimidazoles, complexes, antibacterial, Escherichia coli, metal

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Authors: Ali A. Alshahrani

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This study aims to identify Saudi English as a Foreign Language (EFL) students' perspectives towards using the English language in their studies. The study explores students' self-confident and its association with students' actual performance in English courses in their different academic programs. A multimodal methodology was used to fulfill the research purpose and answer the research questions. A 25-item survey questionnaire and final examination grades were used to collect data. Two hundred forty-one students agreed to participate in the study. They completed the questionnaire and agreed to release their final grades to be a part of the collected data. The data were coded and analyzed by SPSS software. The findings indicated a significant difference in students' performance in English courses between participants' academic programs on the one hand. Students' self-confidence in their English language skills, on the other hand, was not significantly different between participants' academic programs. Data analysis also revealed no correlational relationship between students' self-confidence level and their language skills and their performance. The study raises more questions about other vital factors such as course instructors' views of the materials, faculty members of the target department, family belief in the usefulness of the program, potential employers. These views and beliefs shape the student's preparation process and, therefore, should be explored further.

Keywords: English language intensive program, language proficiency, performance, self-confidence

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Authors: N. Mansouri, A. Asadi

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Data Grid is a geographically distributed environment that deals with data intensive application in scientific and enterprise computing. Data replication is a common method used to achieve efficient and fault-tolerant data access in Grids. In this paper, a dynamic data replication strategy, called Enhanced Latest Access Largest Weight (ELALW) is proposed. This strategy is an enhanced version of Latest Access Largest Weight strategy. However, replication should be used wisely because the storage capacity of each Grid site is limited. Thus, it is important to design an effective strategy for the replication replacement task. ELALW replaces replicas based on the number of requests in future, the size of the replica, and the number of copies of the file. It also improves access latency by selecting the best replica when various sites hold replicas. The proposed replica selection selects the best replica location from among the many replicas based on response time that can be determined by considering the data transfer time, the storage access latency, the replica requests that waiting in the storage queue and the distance between nodes. Simulation results utilizing the OptorSim show our replication strategy achieve better performance overall than other strategies in terms of job execution time, effective network usage and storage resource usage.

Keywords: data grid, data replication, simulation, replica selection, replica placement

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Authors: A. Qasmaoui, F. Ohmani, Z. Zaine, I. El Akrad, J. Hamamouchi, K. Halout, B. Belkadi, R. Charof

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The evolution of antibiotic resistance is a crucial aspect of the problem related to the intensive use of these substances in medicine for humans and animals. The production of ESBL extended spectrum β-lactamase enzymes is the main mechanism of resistance to β-lactam antibiotics in Escherichia coli. The objective of our work is to determine the resistance genes in E. coli strains.ESBL coli stored at the epidemic diseases laboratory of the National Institute of Hygiene. The strains were identified according to the classic bacteriological criteria. An antibiogram was performed on the strains isolated by the Mueller Hinton agar disc diffusion method. The production of ESBL in the strains was detected by the synergy assay technique and confirmed for the presence of the blaCTX-M1, blaCTX-M2, blaTEM, blaSHV, blaOXA-48 genes by gene amplification . Of the 27 observed strains of E.coli, 17 isolated strains present the phenotype of extended-spectrum Beta-lactamase with a percentage of 63%.. All 18 cefotaxime-resistant strains were analyzed for an ESBL phenotype. All strains were positive in the double-disc synergy assay. The fight against the emergence and spread of these multi-resistant antibiotic-resistant strains requires the reasonable use of antibiotics.

Keywords: E coli, BLSE, CTX, TEM, SHV, OXA, résistance aux antibiotique

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Authors: Maryam Enteshari, Kooshan Nayebzadeh, Abdorreza Mohammadi

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In this study, the oxidative stability of soybean oil under different storage temperatures (4 and 25˚C) and during 6-month shelf-life was investigated by various analytical methods and headspace-liquid phase microextraction (HS-LPME) coupled to gas chromatography-mass spectrometry (GC-MS). Oxidation changes were monitored by analytical parameters consisted of acid value (AV), peroxide value (PV), p-Anisidine value (p-AV), thiobarbituric acid value (TBA), fatty acids profile, iodine value (IV), and oxidative stability index (OSI). In addition, concentrations of hexanal and heptanal as secondary volatile oxidation compounds were determined by HS-LPME/GC-MS technique. Rate of oxidation in soybean oil which stored at 25˚C was so higher. The AV, p-AV, and TBA were gradually increased during 6 months while the amount of unsaturated fatty acids, IV, and OSI decreased. Other parameters included concentrations of both hexanal and heptanal, and PV exhibited increasing trend during primitive months of storage; then, at the end of third and fourth months a sudden decrement was understood for the concentrations of hexanal and heptanal and the amount of PV, simultaneously. The latter parameters increased again until the end of shelf-time. As a result, the temperature and time were effective factors in oxidative stability of soybean oil. Also intensive correlations were found for soybean oil at 4 ˚C between AV and TBA (r2=0.96), PV and p-AV (r2=0.9), IV and TBA (-r2=0.9), and for soybean oil stored at 4˚C between p-AV and TBA (r2=0.99).

Keywords: headspace-liquid phase microextraction, oxidation, shelf-life, soybean oil

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Authors: Farjina Malek, Julie King, Niki Edwards

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Across the globe more than a billion people live with a disability and a further billion people, mostly carers, are indirectly impacted. While prevalence data is problematic, it is estimated that more than 15% of the population in Bangladesh live with a disability. Disability service infrastructure in Bangladesh is under-developed; and consequently, the onus of care falls on family, especially on mothers. Within the caring role, mothers encounter many challenging experiences which are not only due to the lack of support delivered through the Bangladeshi health care system but also related to the existence of stigma and perception around disability in the Bangladeshi society. Within this perception, the causes of disability are mostly associated with 'God’s will'; 'possession of ghosts on the disabled person'; and 'karma or the result of past sins of the family members especially the mothers'. These beliefs are likely to have a significant impact on the well-being of mothers and their caring experience of children with disability. This is an ongoing qualitative study which is conducting in-depth interviews with 30 mothers from five districts (Dhaka, Mymensingh, Manikganj, Tangail, and Gazipur) of Bangladesh with the aim to explore the impact of social perception and stigma around physical disability on the caring role of the mothers of children with physical disability. The major findings of this study show that the social perception around disability and the social expectation from a mother regarding her caring role have a huge impact on the well-being of mothers. Mothers are mostly expected to take their child on their lap to prove that they are ‘good mother’. These practices of lifting their children with physical disability and keeping them on the lap for a long time often cause chronic back pain of the mothers. Existing social beliefs consider disability as a ‘curse’ and punishment for the ‘sins’ of the family members, most often by the mother. Mothers are blamed if they give birth to ‘abnormal’ children. This social construction creates stigma, and thus, the caring responsibility of mothers become more challenging. It also encourages the family and mothers to hide their children from the society and to avoid seeking accessible disability services. The mothers also compromise their careers and social interaction as they have to stay with their children at home, and that has a significant impact on personal wellbeing, income, and empowerment of the mothers. The research is informed by intersectional theory and employed an interpretive phenomenological methodology to explore mothers’ experience of caring their children with physical disability, and the contribution and impact of key relationships within the family and the intersection with community and services.

Keywords: mother, family carer, physical disability, children, social stigma, key relationship

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Authors: Sabrina Yulianti

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This study aims to explain the identity struggles of local religious communities in Indonesia. Local religion in Indonesia is not recognized by the government and is not incorporated into the official religion in Indonesia. This makes the local religions in Indonesia experienced the challenges and obstacles in fulfilling their rights as citizens of Indonesia. Challenges and barriers they experience such as: difficulty in making of the birth certificate and marriage. It is as experienced by one of the local religions namely Parmalim which located in North Sumatra. Not only difficulty in taking care of the bureaucracy as a citizen, but the local religion is seen as a minority and sometimes regarded as follower of deviate religion.

Keywords: local religion, faith, struggles, civilization, discrimination

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Authors: Rajesh Mehra

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In this paper an IIR filter has been designed and simulated on an FPGA. The implementation is based on MAC algorithm which uses multiply-and-accumulate operations IIR filter design implementation. Parallel Pipelined structure is used to implement the proposed IIR Filter taking optimal advantage of the look up table of the FPGA device. The designed filter has been synthesized on DSP slice based FPGA to perform multiplier function of MAC unit. The DSP slices are useful to enhance the speed performance. The developed IIR filter is designed and simulated with MATLAB and synthesized with Xilinx Synthesis Tool (XST), and implemented on Virtex 5 and Spartan 3 ADSP FPGA devices. The IIR filter implemented on Virtex 5 FPGA can operate at an estimated frequency of 81.5 MHz as compared to 40.5 MHz in case of Spartan 3 ADSP FPGA. The Virtex 5 based implementation also consumes less slices and slice flip flops of target FPGA in comparison to Spartan 3 ADSP based implementation to provide cost effective solution for signal processing applications.

Keywords: butterworth, DSP, IIR, MAC, FPGA

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Authors: J. Castaño, S. Rodriguez, C. M. L. Franco

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Starch isolated from non-edible A. hippocastanum seeds was characterized and used for preparing starch-based materials. The apparent amylose content of the isolated starch was 33.1%. The size of starch granules ranged from 0.7 to 35µm, and correlated with the shape of granules (spherical, oval and irregular). The chain length distribution profile of amylopectin showed two peaks, at polymerization degree (DP) of 12 and 41-43. Around 53% of branch unit chains had DP in the range of 11-20. A. hippocastanum starch displayed a typical C-type pattern and the maximum decomposition temperature was 317°C. Thermoplastic starch (TPS) prepared from A. hippocastanum with glycerol and processed by melt blending exhibited adequate mechanical and thermal properties. In contrast, plasticized TPS with glycerol:malic acid (1:1) showed lower thermal stability and a pasty and sticky behavior, indicating that malic acid accelerates degradation of starch during processing.

Keywords: Aesculus hippocastanum L., amylopectin structure, thermoplastic starch, non-edible source

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Authors: Ali Baker, Russel Krawitz

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This paper describes a rare occurrence where a potentially fatal complication of COVID-19 infection (MIS-A) was misdiagnosed as an acute abdomen. As most patients with this syndrome present with fever and gastrointestinal symptoms, they may inadvertently fall under the care of the surgical unit. However, unusual imaging findings and a poor response to anti-microbial therapy should prompt clinicians to suspect a non-surgical etiology. More than half of MIS-A patients require ICU admission and vasopressor support. Prompt referral to a physician is key, as the cornerstone of treatment is IVIG and corticosteroid therapy. A 32 year old woman presented with right sided abdominal pain and fevers. She had also contracted COVID-19 two months earlier. Abdominal examination revealed generalised right sided tenderness. The patient had raised inflammatory markers, but other blood tests were unremarkable. CT scan revealed extensive lymphadenopathy along the ileocolic chain. The patient proved to be a diagnostic dilemma. She was reviewed by several surgical consultants and discussed with several inpatient teams. Although IV antibiotics were commenced, the right sided abdominal pain, and fevers persisted. Pan-culture returned negative. A mild cholestatic derangement developed. On day 5, the patient underwent preparation for colonoscopy to assess for a potential intraluminal etiology. The following day, the patient developed sinus tachycardia and hypotension that was refractory to fluid resuscitation. That patient was transferred to ICU and required vasopressor support. Repeat CT showed peri-portal edema and a thickened gallbladder wall. On re-examination, the patient was Murphy’s sign positive. Biliary ultrasound was equivocal for cholecystitis. The patient was planned for diagnostic laparoscopy. The following morning, a marked rise in cardiac troponin was discovered, and a follow-up echocardiogram revealed moderate to severe global systolic dysfunction. The impression was post-COVID MIS with myocardial involvement. IVIG and Methylprednisolone infusions were commenced. The patient had a great response. Vasopressor support was weaned, and the patient was discharged from ICU. The patient continued to improve clinically with oral prednisolone, and was discharged on day 17. Although MIS following COVID-19 infection is well-described syndrome in children, only recently has it come to light that it can occur in adults. The exact incidence is unknown, but it is thought to be rare. A recent systematic review found only 221 cases of MIS-A, which could be included for analysis. Symptoms vary, but the most frequent include fever, gastrointestinal, and mucocutaneous. Many patients progress to multi-organ failure and require vasopressor support. 7% succumb to the illness. The pathophysiology of MIS is only partly understood. It shares similarities with Kawasaki disease, macrophage activation syndrome, and cytokine release syndrome. Importantly, by definition, the patient must have an absence of severe respiratory symptoms. It is thought to be due to a dysregulated immune response to the virus. Potential mechanisms include reduced levels of neutralising antibodies and autoreactive antibodies that promote inflammation. Further research into MIS-A is needed. Although rare, this potentially fatal syndrome should be considered in the unwell surgical patient who has recently contracted COVID-19 and poses a diagnostic dilemma.

Keywords: acute-abdomen, MIS, COVID-19, ICU

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Authors: S. Kumar, Rajesh Kumar, S. Mandal

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Fiber Reinforced Polymer (FRP) is gaining popularity in many branch of engineering and various applications due to their light weight, specific strength per unit weight and high stiffness in particular direction. As the strength of material is high it can be used in thin walled structure as industrial roof sheds satisfying the strength constraint with comparatively lesser thickness. Analysis of bending behavior of FRP panel has been done here with variation in oriented angle of stiffener panels, fiber orientation, aspect ratio and boundary conditions subjected to transverse loading by using Finite Element Method. The effect of fiber orientation and thickness of ply has also been studied to determine the minimum thickness of ply for optimized section of stiffened FRP panel.

Keywords: bending behavior, fiber reinforced polymer, finite element method, orientation of stiffeners

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Authors: A. V. Trukhanov, S. V. Trukhanov, L. V. Panina, V. G. Kostishin, V. A. Turchenko

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It has been shown that BaFe₁₂O₁₉ is a perspective room-temperature multiferroic material. A large spontaneous polarization was observed for the BaFe₁₂O₁₉ ceramics revealing a clear ferroelectric hysteresis loop. The maximum polarization was estimated to be approximately 11.8 μC/cm². The FeO₆ octahedron in its perovskite-like hexagonal unit cell and the shift of Fe³⁺ off the center of octahedron are suggested to be the origin of the polarization in BaFe₁₂O₁₉. The magnetic field induced electric polarization has been also observed in the doped BaFe_12-x-δSc_xM_δO₁₉ (δ=0.05) at 10 K and in the BaSc_xFe_12−xO₁₉ and SrSc_xFe_12−xO₁₉ (x = 1.3–1.7) M-type hexaferrites. The investigated BaFe_12-xD_xO₁₉ (x=0.1, D-Al³⁺, In³⁺) samples have been obtained by two-step “topotactic” reactions. The powder neutron investigations of the samples were performed by neutron time of flight method at High Resolution Fourier Diffractometer.

Keywords: substituted hexaferrites, ferrimagnetics, ferroelectrics, neutron powder diffraction, crystal and magnetic structures

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Authors: A. A. Agbor, Jean Joel R. Bigna, Serges Clotaire Billong, Mathurin Cyrille Tejiokem, Gabriel L. Ekali, Claudia S. Plottel, Jean Jacques N. Noubiap, Hortence Abessolo, Roselyne Toby, Sinata Koulla-Shiro

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Background: Contributors to fatal outcomes in patients undergoing tuberculosis (TB) treatment in the setting of HIV co-infection are poorly characterized, especially in sub-Saharan Africa. Our study’s aim was to assess factors associated with death in TB/HIV co-infected patients during the first 6 months their TB treatment. Methods: We conducted a tertiary-care hospital-based retrospective cohort study from January 2006 to December 2013 at the Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify hospitalized co-infected TB/HIV patients aged 15 years and older. Death was defined as any death occurring during TB treatment, as per the World Health Organization’s recommendations. Logistic regression analysis identified factors associated with death. Magnitudes of associations were expressed by adjusted odds ratio (aOR) with 95% confidence interval. A p value < 0.05 was considered statistically significant. Results: The 337 patients enrolled had a mean age of 39.3 (+/- 10.3) years and more (54.3%) were women. TB treatment outcomes included: treatment success in 60.8% (n=205), death in 29.4% (n=99), not evaluated in 5.3% (n=18), loss to follow-up in 5.3% (n=14), and failure in 0.3% (n=1) . After exclusion of patients lost to follow-up and not evaluated, death in TB/HIV co-infected patients during TB treatment was associated with: a TB diagnosis made before national implementation of guidelines regarding initiation of antiretroviral therapy (aOR = 2.50 [1.31-4.78]; p = 0.006), the presence of other AIDS-defining infections (aOR = 2.73 [1.27-5.86]; p = 0.010), non-AIDS comorbidities (aOR = 3.35 [1.37-8.21]; p = 0.008), not receiving co-trimoxazole prophylaxis (aOR = 3.61 [1.71-7.63]; p = 0.001), not receiving antiretroviral therapy (aOR = 2.45 [1.18-5.08]; p = 0.016), and CD4 cell counts < 50 cells/mm3 (aOR = 16.43 [1.05-258.04]; p = 0.047). Conclusions: The success rate of anti-tuberculosis treatment among hospitalized TB/HIV co-infected patients in our setting is low. Mortality in the first 6 months of treatment was high and strongly associated with specific clinical factors including states of greater immunosuppression, highlighting the urgent need for targeted interventions, including provision of anti-retroviral therapy and co-trimoxazole prophylaxis in order to enhance patient outcomes.

Keywords: TB/HIV co-infection, death, treatment outcomes, factors

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Authors: Nuttapimon Bhirommuang, Kulapong Jayanama

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

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

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Authors: Soumaya Mrabet, Taieb Ach, Imen Akkari, Amira Atig, Neirouz Ghannouchi, Koussay Ach, Elhem Ben Jazia

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Introduction: Celiac disease (CD) and type 1 diabetes mellitus (T1D) are complex disorders with shared genetic components. The association between CD and T1D has been reported in many pediatric series. The aim of our study is to describe the epidemiological, clinical and evolutive characteristics of adult patients presenting this association. Material and Methods: This is a retrospective study including patients diagnosed with CD and T1D, explored in Internal Medicine, Gastroenterology and Endocrinology and Diabetology Departments of the Farhat Hached University Hospital, between January 2005 and June 2016. Results: Among 57 patients with CD, 15 patients had also T1D (26.3%). There are 11 women and 4 men with a median age of 27 years (16-48). All patients developed T1D prior to the diagnosis of CD with an average duration of 47 months between the two diagnosis (6 months-5 years). CD was revealed by recurrent abdominal pain in 11 cases, diarrhea in 10 cases, bloating in 8 cases, constipation in 6 cases and vomiting in 2 cases. Three patients presented cycle disorders with secondary amenorrhea in 2 patients. Anti-Endomysium, anti-transglutaminase and Anti-gliadin antibodies were positive respectively in 57, 54 and 11 cases. The biological tests revealed anemia in 10 cases, secondary to iron deficiency in 6 cases and folate and vitamin B12 deficiency in 4 cases, hypoalbuminaemia in 4 cases, hypocalcemia in 3 cases and hypocholesterolemia in 1 patient. Upper gastrointestinal endoscopy showed an effacement of the folds of the duodenal mucosa in 6 cases and a congestive duodenal mucosa in 3 cases. The macroscopic appearance was normal in the others cases. Microscopic examination showed an aspect of villous atrophy in 57 cases, which was partial in 10 cases and total in 47 cases. After an average follow-up of 3 years 2 months, the evolution was favorable in all patients under gluten-free diet with the necessity of less important doses of insulin in 10 patients. Conclusion: In our study, the prevalence of T1D in adult patients with CD was 26.3%. This association can be attributed to overlapping genetic HLA risk loci. In recent studies, the role of gluten as an important player in the pathogenesis of CD and T1D has been also suggested.

Keywords: celiac disease, gluten, prevalence, type 1 diabetes

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Authors: Gokhan Kilic, Pelin Celik

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Structural health monitoring (SHM) is widely used in evaluating the state and health of membrane structures. In the past, in order to collect data and send it to a data collection unit on membrane structures, wire sensors had to be put as part of the SHM process. However, this study recommends using wireless sensors instead of traditional wire ones to construct an economical, useful, and easy-to-install membrane structure health monitoring system. Every wireless sensor uses a software translation program that is connected to the monitoring server. Operational neural networks (ONNs) have recently been developed to solve the shortcomings of convolutional neural networks (CNNs), such as the network's resemblance to the linear neuron model. The results of using ONNs for monitoring to evaluate the structural health of a membrane are presented in this work.

Keywords: wireless sensor network, non-destructive testing, operational neural networks, membrane structures, dynamic monitoring

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Authors: Tamara Vagg, Cathy Shortt, Claire Hickey, Joseph A. Eustace, Barry J. Plant, Sabin Tabirca

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Introduction: Paper-based patient passports have been used advantageously for older patients, patients with diabetes, and patients with learning difficulties. However, these passports can experience issues with data security, patients forgetting to bring the passport, patients being over encumbered, and uncertainty with who is responsible for entering and managing data in this passport. These issues could be resolved by transferring the paper-based system to a convenient platform such as a smartphone application (app). Background: Life expectancy for some Cystic Fibrosis (CF) patients are rising and as such new complications and procedures are predicted. Subsequently, there is a need for education and management interventions that can benefit CF adults. This research proposes a CF patient passport to record basic medical information through a smartphone app which will allow CF adults access to their basic medical information. Aim: To provide CF patients with their basic medical information via mobile multimedia so that they can receive care when traveling abroad or between CF centres. Moreover, by recording their basic medical information, CF patients may become more aware of their own condition and more active in their health care. Methods: This app is designed by a CF multidisciplinary team to be a lightweight reflection of a hospital patient file. The passport app is created using PhoneGap so that it can be deployed for both Android and iOS devices. Data entered into the app is encrypted and stored locally only. The app is password protected and includes the ability to set reminders and a graph to visualise weight and lung function over time. The app is introduced to seven participants as part of a stress test. The participants are asked to test the performance and usability of the app and report any issues identified. Results: Feedback and suggestions received via this testing include the ability to reorder the list of clinical appointments via date, an open format of recording dates (in the event specifics are unknown), and a drop down menu for data which is difficult to enter (such as bugs found in mucus). The app is found to be usable and accessible and is now being prepared for a pilot study with adult CF patients. Conclusions: It is anticipated that such an app will be beneficial to CF adult patients when travelling abroad and between CF centres.

Keywords: Cystic Fibrosis, digital patient passport, mHealth, self management

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Authors: Kulwinder Singh Mann

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The innovative features of information system, known as Radiology Information System (RIS), for electronic medical records has shown a good impact in the hospital. The objective is to help and make their work easier; such as for a physician to access the patient’s data and for a patient to check their bill transparently. The interoperability of RIS with the other intra-hospital information systems it interacts with, dealing with the compatibility and open architecture issues, are accomplished by two novel mechanisms. The first one is the particular message handling system that is applied for the exchange of information, according to the Health Level Seven (HL7) protocol’s specifications and serves the transfer of medical and administrative data among the RIS applications and data store unit. The second one implements the translation of information between the formats that HL7 and Digital Imaging and Communication in Medicine (DICOM) protocols specify, providing the communication between RIS and Picture and Archive Communication System (PACS) which is used for the increasing incorporation of modern medical imaging equipment.

Keywords: RIS, PACS, HIS, HL7, DICOM, messaging service, interoperability, digital images

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Authors: Shubham Tandon, Rajni Goel

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The prime objective of our review paper is to study the quantitative psychology impact on our daily life. Quantitative techniques have been studied with the aim of discovering solutions in an advanced way. To get the unbiased and correct results, statistics and other useful mathematical aspects have been reviewed. So, many psychologists use quantitative techniques while working in the area of psychology with the aim of discovering solutions in an advanced way. This ensures their accurate outcomes as those will make use of precise criteria in knowing the minds and conditions of any person. Also, proper experimentation and observational tools are taken care of to avoid some possibilities of invalid data.

Keywords: quantitative psychology, psychologists, statistics, person, results, minds

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Authors: Yusuf Ali Abdulle, Azhar Uddin Keerio

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Background: Protein elicitors play a key role in signaling or displaying plant defense mechanisms and emerging as vital tools for bio-control of insects. This study was aimed at the characterization of the novel protein elicitor isolated from entomopathogenic fungi Lecanicillium lecanii (V3) strain and its activity against Whitefly, Bemisia tabaci in cotton. The sequence of purified elicitor protein showed 100% similarity with hypothetical protein LEL_00878 [Cordyceps confragosa RCEF 1005], GenBank no (OAA81333.1). This novel protein elicitor has 253 amino acid residues and 762bp with a molecular mass of 29 kDa. The protein recombinant was expressed in Escherichia coli using pET‐28a (+) plasmid. Effects of purified novel protein elicitor on Bemisia tabaci were determined at three concentrations of protein (i.e., 58.32, 41.22, 35.41 μg mL⁻¹) on cotton plants and were exposed to newly molted adult B.tabaci. Bioassay results showed a significant effect of the exogenous application of novel protein elicitor on B. tabaci in cotton. In addition, the gene expression analysis found a significant up-regulation of the major genes associated with salicylic acid (SA) and jasmonic acid (JA) linked plant defense pathways in elicitor protein-treated plants. Our results suggested the potential application of a novel protein elicitor derived from Lecanicillium lecanii as a future bio-intensive controlling approach against the whitefly, Bemisia tabaci.

Keywords: resistance, Lecanicillium lecanii, secondary metabolites, whitefly

Procedia PDF Downloads 191

Authors: Anamika Devi

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Based on Vygotsky’s cultural, historical theory and Hedegaard’s concept of transition, this study aims to investigate to propose strategies to maintain digital wellbeing of children and parents during and post COVID pandemic. Due COVID 19 pandemic, children and families have been facing new challenges and sudden changes in their everyday life. While children are juggling to adjust themselves in new circumstance of onsite and online learning settings, parents are juggling with their work-life balance. A number of papers have identified that the COVID-19 pandemic has affected the lives of many families around the world in many ways, for example, the stress level of many parents increased, families faced financial difficulties, uncertainty impacted on long term effects on their emotional and social wellbeing. After searching and doing an intensive literature review from 2020 and 2021, this study has found some scholarly articles provided solution or strategies of reducing stress levels of parents and children in this unprecedented time. However, most of them are not underpinned by proper theoretical lens to ensure they validity and success. Therefore, this study has proposed strategies that are underpinned by theoretical lens to ensure their impact on children’s and parents' emotional wellbeing during and post COVID-19 era. The strategies will highlight on activities for positive coping strategies to the best use of family values and digital technologies.

Keywords: onsite and online learning, strategies, emotional wellbeing, tips, and strategies, COVID19

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Authors: Tijing Cai, Qimeng Xu, Daijin Zhou

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This paper puts forward a short-baseline dual-antenna BDS/MEMS-IMU integrated navigation, constructs the carrier phase double difference model of BDS (BeiDou Navigation Satellite System), and presents a 2-position initial orientation method on BDS. The Extended Kalman-filter has been introduced for the integrated navigation system. The differences between MEMS-IMU and BDS position, velocity and carrier phase indications are used as measurements. To show the performance of the short-baseline dual-antenna BDS/MEMS-IMU integrated navigation system, the experiment results show that the position error is less than 1m, the pitch angle error and roll angle error are less than 0.1°, and the heading angle error is about 1°.

Keywords: MEMS-IMU (Micro-Electro-Mechanical System Inertial Measurement Unit), BDS (BeiDou Navigation Satellite System), dual-antenna, integrated navigation

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Authors: Ricardo Andrés Márquez Ortiz

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Objective: The objective of this literature review is to compile updated information from studies that have addressed the association between dental pathologies and agriculture. Materials and method: The research carried out corresponds to a documentary study of ex post facto retrospective, historiographic, and bibliometric design. An exhaustive bibliographic review search was carried out in databases and the Internet, books and articles on dental anthropology, archeology, and dentistry, on the relationship between dental pathologies and agriculture in prehistoric and current populations from different parts of the world. Subsequently, data collection was carried out through the ATLAS.ti computer program. Conclusions: In an influential article by Turner, which addresses the correlation between caries and the way of subsistence of both prehistoric and modern populations (hunting and gathering, mixed and agricultural economies), an average of 1.3% was found in hunter-gatherer societies, and 10.4% in agricultural societies. Sreebny compared global grain supply data (rice, wheat and corn) with DMF (spoiled, lost and blocked) rates. He concluded that rice has no association with dental caries, corn has a negative correlation, and wheat has a positive correlation. Additionally, intensive monoculture agricultural production systems cause an increase in dental pathologies. Meanwhile, polyculture agriculture, which leads to a more varied diet, generates a better state of dental health.

Keywords: dental pathologies, agricultural production systems, extensive agriculture, dental anthropology

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Authors: S. N. C. M. Dias, Niels Schuetze, Franz Lennartz

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The current focus in irrigated agriculture will move from maximizing crop production per unit area towards maximizing the crop production per unit amount of water (water productivity) used. At the same time, inadequate water supply or deficit irrigation will be the only solution to cope with water scarcity in the near future. Soil matric potential based irrigation plays an important role in such deficit irrigated agriculture to grow any crop including rice. Rice as the staple food for more than half of the world population, grows mainly under flooded conditions. It requires more water compared to other upland cereals. A major amount of this water is used in the land preparation and is lost at field level due to evaporation, deep percolation, and seepage. A field experimental study was conducted in the experimental premises of rice research and development institute of Sri Lanka in Kurunegala district to estimate the water productivity of rice under deficit irrigation. This paper presents the feasibility of improving current irrigation management in rice cultivation under water scarce conditions. The experiment was laid out in a randomized complete block design with four different irrigation treatments with three replicates. Irrigation treatments were based on soil matric potential threshold values. Treatment W0 was maintained between 60-80mbars. W1 was maintained between 80-100mbars. Other two dry treatments W2 and W3 were maintained at 100-120 mbar and 120 -140 mbar respectively. The sprinkler system was used to irrigate each plot individually upon reaching the maximum threshold value in respective treatment. Treatments were imposed two weeks after seed establishment and continued until two weeks before physiological maturity. Fertilizer applications, weed management, and other management practices were carried out per the local recommendations. Weekly plant growth measurements, daily climate parameters, soil parameters, soil tension values, and water content were measured throughout the growing period. Highest plant growth and grain yield (5.61t/ha) were observed in treatment W2 followed by W0, W1, and W3 in comparison to the reference yield (5.23t/ha) of flooded rice grown in the study area. Water productivity was highest in W3. Concerning the irrigation water savings, grain yield, and water productivity together, W2 showed the better performance. Rice grown under unsaturated conditions (W2) shows better performance compared to the continuously saturated conditions(W0). In conclusion, soil matric potential based irrigation is a promising practice in irrigation management in rice. Higher irrigation water savings can be achieved in this method. This strategy can be applied to a wide range of locations under different climates and soils. In future studies, higher soil matric potential values can be applied to evaluate the maximum possible values for rice to get higher water savings at minimum yield losses.

Keywords: irrigation, matric potential, rice, water scarcity

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Authors: M. Eckert, M. Oliveira, A. Bettencourt Ribeiro

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The intensive use of natural aggregate, near the towns, associated to the increase of the global population, leads to its depletion and increases the transport distances. The uncontrolled deposition of construction and demolition waste in landfills and city outskirts, causes pollution and take up space for noblest purposes. The main problem of recycled aggregate lies in its high water absorption, what is due to the porosity of the materials which constitute this type of aggregate. When the aggregates are dry, water flows from the inside to the engaging cement paste matrix, and when they are saturated an inverse process occurs. This water flow breaks the aggregate-cement paste bonds and the greater water concentration, in the inter-facial transition zone, degrades the concrete properties in its fresh and hardened state. Based on the water absorption over time, it was optimized an staged mixing method, to regulate the said flow and manufacture recycled aggregate concrete with levels of work-ability, strength and shrinkage equivalent to those of conventional concrete.The physical, mechanical and geometrical properties of the aggregates where related to the properties of concrete in its fresh and hardened state. Three types of commercial recycled aggregates and two types of natural aggregates where evaluated. Six compositions with different percentages of recycled coarse aggregate where tested.

Keywords: recycled aggregate, water absorption, interfacial transition zone, compressive-strength, shrinkage

Procedia PDF Downloads 456

Authors: Rahma Fitriani, Zerlita Fahdha Pusdiktasari, Herman Cahyo Diartho

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Spatial panel model is commonly used to specify more complicated behavior of economic agent distributed in space at an individual-spatial unit level. There are several spatial panel models which can be adapted based on certain assumptions. A package called splm in R has several functions, ranging from the estimation procedure, specification tests, and model selection tests. In the absence of prior assumptions, a comprehensive procedure which utilizes the available functions in splm must be formed, which is the objective of this study. In this way, the best specification and model can be fitted based on data. The implementation of the procedure works well. It specifies SARAR-FE as the best model for agricultural productivity growth of the 38 East Java’s Regencies/Municipalities.

Keywords: spatial panel, specification, splm, agricultural productivity growth

Procedia PDF Downloads 176

Authors: Satyendra Pratap Singh, S. P. Singh

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This paper presents a methodology using Gravitational Search Algorithm for optimal placement of Phasor Measurement Units (PMUs) in order to achieve complete observability of the power system. The objective of proposed algorithm is to minimize the total number of PMUs at the power system buses, which in turn minimize installation cost of the PMUs. In this algorithm, the searcher agents are collection of masses which interact with each other using Newton’s laws of gravity and motion. This new Gravitational Search Algorithm based method has been applied to the IEEE 14-bus, IEEE 30-bus and IEEE 118-bus test systems. Case studies reveal optimal number of PMUs with better observability by proposed method.

Keywords: gravitational search algorithm (GSA), law of motion, law of gravity, observability, phasor measurement unit

Procedia PDF Downloads 511