Search results for: heart failure recommendations
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5309

Search results for: heart failure recommendations

2099 Drug-Drug Plasma Protein Binding Interactions of Ivacaftor

Authors: Elena K. Schneider, Johnny X. Huang, Vincenzo Carbone, Mark Baker, Mohammad A. K. Azad, Matthew A. Cooper, Jian Li, Tony Velkov

Abstract:

Ivacaftor is a novel CF trans-membrane conductance regulator (CFTR) potentiator that improves the pulmonary function for cystic fibrosis patients bearing a G551D CFTR-protein mutation. Because ivacaftor is highly bound (>97%) to plasma proteins, there is the strong possibility that co-administered CF drugs that compete for the same plasma protein binding sites and impact the free drug concentration. This in turn could lead to drastic changes in the in vivo efficacy of ivacaftor and therapeutic outcomes. This study compares the binding affinity of ivacaftor and co-administered CF drugs for human serum albumin (HSA) and α1-acid glycoprotein (AGP) using surface plasmon resonance and fluorimetric binding assays that measure the displacement of site selective probes. Due to their high plasma protein binding affinities, drug-drug interactions between ivacaftor are to be expected with ducosate, montelukast, ibuprofen, dicloxacillin, omeprazole and loratadine. The significance of these drug-drug interactions is interpreted in terms of the pharmacodynamic/pharmacokinetic parameters and molecular docking simulations. The translational outcomes of the data are presented as recommendations for a staggered treatment regimen for future clinical trials which aims to maximize the effective free drug concentration and clinical efficacy of ivacaftor.

Keywords: human α-1-acid glycoprotein, binding affinity, human serum albumin, ivacaftor, cystic fibrosis

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2098 Evaluation of the Efficacy of Basic Life Support Teaching in Second and Third Year Medical Students

Authors: Bianca W. O. Silva, Adriana C. M. Andrade, Gustavo C. M. Lucena, Virna M. S. Lima

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Introduction: Basic life support (BLS) involves the immediate recognition of cardiopulmonary arrest. Each year, 359.400 and 275.000 individuals with cardiac arrest are attended in emergency departments in USA and Europe. Brazilian data shows that 200.000 cardiac arrests occur every year, and half of them out of the hospital. Medical schools around the world teach BLS in the first years of the course, but studies show that there is a decline of the knowledge as the years go by, affecting the chain of survival. The objective was to analyze the knowledge of medical students about BLS and the retention of this learning throughout the course. Methods: This study included 150 students who were at the second and third year of a medical school in Salvador, Bahia, Brazil. The instrument of data collection was a structured questionnaire composed of 20 questions based on the 2015 American Heart Association guideline. The Pearson Chi-square test was used in order to study the association between previous training, sex and semester with the degree of knowledge of the students. The Kruskal-Wallis test was used to evaluate the different yields obtained between the various semesters. The number of correct answers was described by average and quartiles. Results: Regarding the degree of knowledge, 19.6% of the female students reached the optimal classification, a better outcome than the achieved by the male participants. Of those with previous training, 33.33% were classified as good and optimal, none of the students reached the optimal classification and only 2.2% of them were classified as bad (those who did not have 52.6% of correct answers). The analysis of the degree of knowledge related to each semester revealed that the 5th semester had the highest outcome: 30.5%. However, the acquaintance presented by the semesters was generally unsatisfactory, since 50% of the students, or more, demonstrated knowledge levels classified as bad or regular. When confronting the different semesters and the achieved scores, the value of p was 0.831. Conclusion: It is important to focus on the training of medical professionals that are capable of facing emergency situations, improving the systematization of care, and thereby increasing the victims' possibility of survival.

Keywords: basic life support, cardiopulmonary ressucitacion, education, medical students

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2097 Hybrid Lateral-Directional Robust Flight Control with Propulsive Systems

Authors: Alexandra Monteiro, K. Bousson, Fernando J. O. Moreira, Ricardo Reis

Abstract:

Fixed-wing flying vehicles are usually controlled by means of control surfaces such as elevators, ailerons, and rudders. The failure of these systems may lead to severe or even fatal crashes. These failures resulted in increased popularity for research activities on propulsion control in the last decades. The present work deals with a hybrid control architecture in which the propulsion-controlled vehicle maintains its traditional control surfaces, addressing the issue of robust lateral-directional dynamics control. The challenges stem from the parameter uncertainties in the stability and control derivatives and some unknown terms in the flight dynamics model. Two approaches are implemented and tested: linear quadratic regulation with robustness characteristics and H∞ control. The problem is centered on roll-yaw controller design with full state-feedback, which is able to deal with a standalone propulsion control mode as well as a hybrid mode combining both propulsion control and conventional control surface concepts while maintaining the original flight maneuverability characteristics. The results for both controllers emphasized very good control performances; however, the H∞ controller showed higher stabilization rates and robustness albeit with a slightly higher control magnitude than using the linear quadratic regulator.

Keywords: robust propulsion control, h-infinity control, lateral-directional flight dynamics, parameter uncertainties

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2096 Senior Leadership Team Coaching in Action: Creating High-Performance Teams

Authors: Siqi Fang, Jingxi Hou

Abstract:

Positive psychology and coaching psychology share a number of fundamental assumptions and common themes. Blending positive psychology, mindfulness, and coaching psychology, our work in team coaching with leaders enhances both leadership and team effectiveness. Although individual coaching has proven to be effective, this article advocates the benefits of leadership coaching in team settings, because durable changes in leadership behaviors are more likely to occur. Does leadership team coaching really work? Does it help improve senior leadership team effectiveness and productivity? This action research study answers these questions by tracking the progress of three typical senior leadership teams consisting of 31 executives participating in a six-month team coaching program. Assessments (pre- and post), workshops, and feedback based on ego development theories and mindfulness were applied to upgrade the senior leadership teams’ transformational stages and reframe their organizational leadership cultures. Results suggest that the team effectiveness of the three leadership teams increased up to 43 percent according to post-survey feedback from superior, direct report, and peers. Discussion is offered to show that senior leadership team coaching help teams to achieve a consensus on common purposes, establish a foundation of trust, improve collective skills, and promote efficient operation. All factors translate into better team performance. Implications of the results for future executive development programs are discussed and specific recommendations are provided.

Keywords: action research, ego development, mindfulness, senior leadership team coaching, team effectiveness, transformational stages

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2095 Inspiring Woman: The Emotional Intelligence Leadership of Khadijah Bint Khuwaylid

Authors: Eman S. Soliman, Sana Hawamdeh, Najmus S. Mahfooz

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Purpose: The purpose of this paper was to examine various components of applied emotional intelligence as demonstrated in the leadership style of Khadijah Bint Khuwaylid in pre and post-Islamic society. Methodology: The research used a qualitative research method, specifically historical and ethnographic techniques. Data collection included both primary and secondary sources. Data from sources were analyzed to document the use of emotional intelligent leadership behaviors throughout Khadijah Bint Khuwaylid leadership experience from 596 A.D. to 621 A.D. Findings: Demonstration of four cornerstones of emotional intelligence which are self-awareness, self-management, social awareness and relationship management. Apply them on khadejah Bint Khuwaylid leadership style reveal that she possess main behavioral competences in the form of emotionally self-aware, self-.confidence, adaptability, empathy and influence. Conclusions: Khadijah Bint Khuwaylid serves as a historical model of effective leadership that included the use of emotional intelligence in her leadership behavior. The inclusion of the effective portion of the brain created a successful leadership style that can be learned by present day and future leadership. The recommendations for future leaders are to include the use of emotionally self-aware and self-confidence, adaptability, empathy and influence as components of leadership. This will then demonstrate in a leadership a basic knowledge and understanding of feelings, the keenness to be emotionally open with others, the ability to prototype beliefs and values, and the use of emotions in future communications, vision and progress.

Keywords: emotional intelligence, leadership, Khadijah Bint Khuwaylid, women

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2094 Designing Creative Events with Deconstructivism Approach

Authors: Maryam Memarian, Mahmood Naghizadeh

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Deconstruction is an approach that is entirely incompatible with the traditional prevalent architecture. Considering the fact that this approach attempts to put architecture in sharp contrast with its opposite events and transpires with attending to the neglected and missing aspects of architecture and deconstructing its stable structures. It also recklessly proceeds beyond the existing frameworks and intends to create a different and more efficient prospect for space. The aim of deconstruction architecture is to satisfy both the prospective and retrospective visions as well as takes into account all tastes of the present in order to transcend time. Likewise, it ventures to fragment the facts and symbols of the past and extract new concepts from within their heart, which coincide with today’s circumstances. Since this approach is an attempt to surpass the limits of the prevalent architecture, it can be employed to design places in which creative events occur and imagination and ambition flourish. Thought-provoking artistic events can grow and mature in such places and be represented in the best way possible to all people. The concept of event proposed in the plan grows out of the interaction between space and creation. In addition to triggering surprise and high impressions, it is also considered as a bold journey into the suspended realms of the traditional conflicts in architecture such as architecture-landscape, interior-exterior, center-margin, product-process, and stability-instability. In this project, at first, through interpretive-historical research method and examining the inputs and data collection, recognition and organizing takes place. After evaluating the obtained data using deductive reasoning, the data is eventually interpreted. Given the fact that the research topic is in its infancy and there is not a similar case in Iran with limited number of corresponding instances across the world, the selected topic helps to shed lights on the unrevealed and neglected parts in architecture. Similarly, criticizing, investigating and comparing specific and highly prized cases in other countries with the project under study can serve as an introduction into this architecture style.

Keywords: anti-architecture, creativity, deconstruction, event

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2093 Development of an Experimental Model of Diabetes Co-Existing with Metabolic Syndrome in Rats

Authors: Rajesh Kumar Suman, Ipseeta Ray Mohanty, Manjusha K. Borde, Ujjawala maheswari, Y. A. Deshmukh

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Background: Metabolic syndrome encompasses cluster of risk factors for cardiovascular disease which includes abdominal obesity, dyslipidemia, hypertension, and hyperglycemia. The incidence of metabolic syndrome is on the rise globally. Objective: The present study was designed to develop a unique animal model that will mimic the pathological features seen in a large pool of individuals with diabetes and metabolic syndrome; suitable for pharmacological screening of drugs beneficial in this condition. Material and Methods: A combination of high fat diet (HFD) and low dose of streptozotocin (STZ) at 30, 35 and 40 mg/kg was used to induce metabolic syndrome co-existing with diabetes mellitus in Wistar rats. Results: The 40 mg/kg STZ produced sustained hyperglycemia and the dose was thus selected for our study to induce diabetes mellitus. Rat fed HFD (HF-DC) group showed significant (p < 0.001) increase in body weight on 4th and 7th week as compared with NC (Normal Control) group rats. However, the increase in body weight of HF-DC group rats was not sustained at the end of 10th weeks. Various components of metabolic syndrome such as dyslipidemia {(Increased Triglyceride, total Cholesterol, LDL Cholesterol and decreased HDL Cholesterol)}, diabetes mellitus (Blood Glucose, HbA1c, Serum Insulin, C-peptide), hypertension {Systolic Blood pressure (p < 0.001)} were mimicked in the developed model of metabolic syndrome co existing with diabetes mellitus. In addition significant cardiac injury as indicated by CPK-MB levels, artherogenic index, hs-CRP. The decline in hepatic function {(p < 0.01) increase in the level of SGPT (U/L)} and renal function {(increase in creatinine levels (p < 0.01)} when compared to NC group rats. The histopathological assessment confirmed presence of edema, necrosis and inflammation in Heart, Pancreas, Liver and Kidney of HFD-DC group as compared to NC. Conclusion: The present study has developed a unique rodent model of metabolic syndrome; with diabetes as an essential component.

Keywords: diabetes, metabolic syndrome, high fat diet, streptozotocin, rats

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2092 Europium Chelates as a Platform for Biosensing

Authors: Eiman A. Al-Enezi, Gin Jose, Sikha Saha, Paul Millner

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Rare earth nanotechnology has gained a considerable amount of interest in the field of biosensing due to the unique luminescence properties of lanthanides. Chelating rare earth ions plays a significant role in biological labelling applications including medical diagnostics, due to their different excitation and emission wavelengths, variety of their spectral properties, sharp emission peaks and long fluorescence lifetimes. We aimed to develop a platform for biosensors based on Europium (Eu³⁺) chelates against biomarkers of cardiac injury (heart-type fatty acid binding protein; H-FABP3) and stroke (glial fibrillary acidic protein; GFAP). Additional novelty in this project is the use of synthetic binding proteins (Affimers), which could offer an excellent alternative targeting strategy to the existing antibodies. Anti-GFAP and anti-HFABP3 Affimer binders were modified to increase the number of carboxy functionalities. Europium nitrate then incubated with the modified Affimer. The luminescence characteristics of the Eu³⁺ complex with modified Affimers and antibodies against anti-GFAP and anti-HFABP3 were measured against different concentrations of the respective analytes on excitation wavelength of 395nm. Bovine serum albumin (BSA) was used as a control against the IgG/Affimer Eu³⁺ complexes. The emission spectrum of Eu³⁺ complex resulted in 5 emission peaks ranging between 550-750 nm with the highest intensity peaks were at 592 and 698 nm. The fluorescence intensity of Eu³⁺ chelates with the modified Affimer or antibodies increased significantly by 4-7 folder compared to the emission spectrum of Eu³⁺ complex. The fluorescence intensity of the Affimer complex was quenched proportionally with increased analyte concentration, but this did not occur with antibody complex. In contrast, the fluorescence intensity for Eu³⁺ complex increased slightly against increased concentration of BSA. These data demonstrate that modified Affimers Eu³⁺ complexes can function as nanobiosensors with potential diagnostic and analytical applications.

Keywords: lanthanides, europium, chelates, biosensors

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2091 Crack Opening Investigation in Fiberconcrete

Authors: Arturs Macanovskis, Vitalijs Lusis, Andrejs Krasnikovs

Abstract:

Work has three stages. In the first stage was examined pull-out process for steel fiber was embedded into a concrete by one end and was pulled out of concrete under the angle to pulling out force direction. Angle was varied. Length of steel fiber was 26 mm, diameter 0.5 mm. On the obtained force- displacement diagrams were observed jumps. For such mechanical behavior explanation, fiber channel in concrete surface microscopical experimental investigation, using microscope KEYENCE VHX2000, was performed. Surface of fiber channel in concrete matrix after pull-out test (fiber angle to pulling out force direction 70°). At the second stage were obtained diagrams for load- crack opening displacement for breaking homogeneously reinforced and layered fiber concrete prisms (with dimensions 10x10x40 cm) subjected to 4-point bending. After testing was analyzed main crack. On the main crack’s both surfaces were recognized all pulled out fibers their locations, angles to crack surface and lengths of pull-out fibers parts. At the third stage elaborated prediction model for the fiber-concrete beam, failure under bending, using the following data: a) diagrams for fibers pulling out at different angles; b) experimental data about steel-straight fibers locations in the main crack.

Keywords: fiberconcrete, pull-out, fiber channel, layered fiberconcrete

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2090 Modeling and Minimizing the Effects of Ferroresonance for Medium Voltage Transformers

Authors: Mohammad Hossein Mohammadi Sanjani, Ashknaz Oraee, Arian Amirnia, Atena Taheri, Mohammadreza Arabi, Mahmud Fotuhi-Firuzabad

Abstract:

Ferroresonance effects cause overvoltage in medium voltage transformers and isolators used in electrical networks. Ferroresonance effects are nonlinear and occur between the network capacitor and the nonlinear inductance of the voltage transformer during saturation. This phenomenon is unwanted for transformers since it causes overheating, introduction of high dynamic forces in primary coils, and rise of voltage in primary coils for the voltage transformer. Furthermore, it results in electrical and thermal failure of the transformer. Expansion of distribution lines, design of the transformer in smaller sizes, and the increase of harmonics in distribution networks result in an increase of ferroresonance. There is limited literature available to improve the effects of ferroresonance; therefore, optimizing its effects for voltage transformers is of great importance. In this study, comprehensive modeling of a medium voltage block-type voltage transformer is performed. In addition, a recent model is proposed to improve the performance of voltage transformers during the occurrence of ferroresonance using damping oscillations. Also, transformer design optimization is presented in this study to show further improvements in the performance of the voltage transformer. The recently proposed model is experimentally tested and verified on a medium voltage transformer in the laboratory, and simulation results show a large reduction of the effects of ferroresonance.

Keywords: optimization, voltage transformer, ferroresonance, modeling, damper

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2089 Corporate Governance and Disclosure Quality: Taxonomy of Tunisian Listed Firms Using the Decision Tree Method Based Approach

Authors: Wided Khiari, Adel Karaa

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This study aims to establish a typology of Tunisian listed firms according to their corporate governance characteristics and disclosure quality. The paper uses disclosed scores to examine corporate governance practices of Tunisian listed firms. A content analysis of 46 Tunisian listed firms from 2001 to 2010 has been carried out and a disclosure index developed to determine the level of disclosure of the companies. The disclosure quality is appreciated through the quantity and also through the nature (type) of information disclosed. Applying the decision tree method, the obtained tree diagrams provide ways to know the characteristics of a particular firm regardless of its level of disclosure. Obtained results show that the characteristics of corporate governance to achieve good quality of disclosure are not unique for all firms. These structures are not necessarily all of the recommendations of best practices, but converge towards the best combination. Indeed, in practice, there are companies which have a good quality of disclosure, but are not well-governed. However, we hope that by improving their governance system their level of disclosure may be better. These findings show, in a general way, a convergence towards the standards of corporate governance with a few exceptions related to the specificity of Tunisian listed firms and show the need for the adoption of a code for each context. These findings shed the light on corporate governance features that enhance incentives for good disclosure. It allows identifying, for each firm and in any date, corporate governance determinants of disclosure quality. More specifically, and all being equal, obtained tree makes a rule of decision for the company to know the level of disclosure based on certain characteristics of the governance strategy adopted by the latter.

Keywords: corporate governance, disclosure, decision tree, economics

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2088 Chongqing's Urban Regeneration for Maintaining the Historic Urban Landscape: Success and Failure of Achieving Sustainable Development

Authors: Hanyu Wei

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The last two decades have witnessed a significant number of regeneration practices in historical Chinese cities with the context of rapid urbanisation and economic development. As a response to the possible loss of place identity in the redevelopment process, city makers recognise the potentials of places with cultural significance for maintaining the original landscape. In Chongqing, the prosperities of human settlement history together with the anti-war and post-industrial culture bring this riverside city with its unique urban landscape. Great amounts of historical sites are identified and subjected to conservation planning approaches for urban revitalisation while also maintaining the historic urban landscape. This paper reviews three practices of cultural-led regeneration projects (Hongyadong, Ciqikou, Danzishi) in Chongqing, detailing the urban design and planning principals for the case sites. The paper also presents the conflicting opinions from groups with different interests. By carrying a systematical sustainability evaluation assessment on those projects, the paper critically analyzes the influence of these projects on the broad socio-economic aspects. Although these regeneration cases are thought to achieve the general success in abstaining economic benefits, they are criticised for the over-tourism issues and damages on the authenticity, which further fails to achieve sustainable development.

Keywords: Chongqing, historic urban landscape, sustainable development, urban regeneration

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2087 Productive Performance of Lactating Sows Feed with Cull Chickpea

Authors: J. M. Uriarte, H. R. Guemez, J. A. Romo, R. Barajas, J. M. Romo

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This research was carried out with the objective of knowing the productive performance of sows in lactation when fed with diets containing cull chickpea instead of corn and soybean meal. Thirty-six (Landrace x Yorkshire) lactating sows were divided into three treatments with 12 sows per treatment. On day 107 of gestation, sows were moved into farrowing crates in an environmentally regulated (2.2 × 0.6 m) contained an area (2.2 × 0.5 m) for newborn pigs on each side, all diets were provided as a dry powder, and the sows received free access to water throughout the experimental period. After farrowing, daily feed allowance increased gradually, and sows had ad libitum access to feed by day four. They were fed diets containing 0 (CONT), cull chickpeas 15 % (CHP15), or cull chickpeas 30% (CHP30) for 28 days. The diets contained the same calculated levels of crude protein and metabolizable energy, and contained vitamins and minerals that exceeded the National Research Council (1998) recommendations; sows were fed three times daily. On day 28, piglets were weaned and performances of lactating sows and nursery piglets were recorded. All data in this experiment were analyzed in accordance with a completely randomized design. Results indicated that average daily feed intake (5.61, 5.59 and 5.46 kg for CONT, CHP15, and CHP30 respectively) of sows were not affected (P > 0.05) by different dietary. There was no difference (P > 0.05) in average body weight of piglets on the day of birth (1.35 vs. 1.30, and 1.32 kg) and day 28 (7.10, 6.80 and 6.92 kg) between treatments. The numbers of weaned piglets (10.65 on average) were not affected by treatments. It is concluded that the use of cull chickpea at 30% of the diet does not affect the productive performance of lactating sows.

Keywords: cull chickpea, lactating sow, performance, pigs

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2086 Evolutions of Structural Properties of Native Phospho Casein (NPC) Powder during Storage

Authors: Sarah Nasser, Anne Moreau, Alain Hedoux, Romain Jeantet, Guillaume Delaplace

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Background: Spray dryed powders containing some caseins are commonly produced in dairy industry. It is widely admitted that the structure of casein evolves during powder storage, inducing a loss of solubility. However few studies evaluate accurately the destabilization mechanisms at molecular and mesoscopic level, in particular for Native Phospho Casein powder (NPC). Consequently, at the state of the art, it is very difficult to assess which secondary structure change or crosslinks initiate insolubility during storage. To address this issue, controlled ageing conditions have been applied to a NPC powder (which was obtained by spray drying a concentrate containing a higher content of casein (90%), whey protein (8%) and lactose (few %)). Evolution of structure and loss of solubility, with the effects of temperature and time of storage were systematically reported. Methods: FTIR spectroscopy, Raman and Circular Dichroism were used to monitor changes of secondary structure in dry powder and in solution after rehydration. Besides, proteomic tools and electrophoresis have been performed after varying storage conditions for evaluating aggregation and post translational modifications, like lactosylation or phosphorylation. Finally, Tof Sims and MEB were used to follow in parallel evolution of structure in surface and skin formation due to storage. Results + conclusion: These results highlight the important role of storage temperature in the stability of NPC. It is shown that this is not lactosylation at the heart of formation of aggregates, as advanced in others publications This is almost the rise of multitude post translational modifications (chemical cross link), added to disulphide bridges (physical cross link) wich contribute to the destabilisation of structure and aggregation of casein. A relative quantification of each kind of cross link, source of aggregates, is proposed. In addition, it has been proved that migration of lipids and formation of skin in surface during the ageing also explains the evolution of structure casein and thus the alterations of functional properties of NPC powder.

Keywords: casein, cross link, powder, storage

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2085 Physiological Assessment for Straightforward Symptom Identification (PASSify): An Oral Diagnostic Device for Infants

Authors: Kathryn Rooney, Kaitlyn Eddy, Evan Landers, Weihui Li

Abstract:

The international mortality rate for neonates and infants has been declining at a disproportionally low rate when compared to the overall decline in child mortality in recent decades. A significant portion of infant deaths could be prevented with the implementation of low-cost and easy to use physiological monitoring devices, by enabling early identification of symptoms before they progress into life-threatening illnesses. The oral diagnostic device discussed in this paper serves to continuously monitor the key vital signs of body temperature, respiratory rate, heart rate, and oxygen saturation. The device mimics an infant pacifier, designed to be easily tolerated by infants as well as orthodontically inert. The fundamental measurements are gathered via thermistors and a pulse oximeter, each encapsulated in medical-grade silicone and wired internally to a microcontroller chip. The chip then translates the raw measurements into physiological values via an internal algorithm, before outputting the data to a liquid crystal display screen and an Android application. Additionally, a biological sample collection chamber is incorporated into the internal portion of the device. The movement within the oral chamber created by sucking on the pacifier-like device pushes saliva through a small check valve in the distal end, where it is accumulated and stored. The collection chamber can be easily removed, making the sample readily available to be tested for various diseases and analytes. With the vital sign monitoring and sample collection offered by this device, abnormal fluctuations in physiological parameters can be identified and appropriate medical care can be sought. This device enables preventative diagnosis for infants who may otherwise have gone undiagnosed, due to the inaccessibility of healthcare that plagues vast numbers of underprivileged populations.

Keywords: neonate mortality, infant mortality, low-cost diagnostics, vital signs, saliva testing, preventative care

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2084 Organizational Climate of Silence and Job Performance: Examining the Mediatory and Moderating Role of Work Engagement and Supervisor Support among Frontline Nurses

Authors: Sabina Ampon-Wireko

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Purpose: The study explores the influence of the organizational climate of silence on job performance through the mediating effects of work engagement (WE). Further, the degree to which supervisor support (SS) and work engagement moderate job performance are examined. Method: Using a questionnaire, the study collected 565 valid responses from frontline nurses in Ghana. The hierarchical regression technique was employed in estimating the relationship between the variables. Findings: The results showed a significant negative influence of top managers' and supervisors' attitudes to silence on both contextual and task performance. Communication opportunities, however, revealed positive and significant effects on contextual and task performance. Work engagement had no role in mediating top managers' and supervisors’ attitudes toward silence, communication opportunities, and task performance. Supervisor support acted as a moderating factor in the relationship between job engagement and task performance. In contrast, despite the direct positive relationship between supervisor support and contextual performance, it failed to moderate the relationship between work engagement and contextual performance. Practical implications: The study's findings demonstrate the need for health managers and supervisors to become more conscious of silence. The findings offer diverse recommendations for encouraging the sharing of relevant ideas, facts, and opinions within the health sector.

Keywords: organizational climate of silence, job performance, work engagement, supervisor support, frontline nurses

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2083 Effect of Rural Entrepreneurship in Rural Development in Nigeria: A Study of Selected Entrepreneurs in Ikwuano Local Government Area, Abia State, Nigeria

Authors: Ifeanyi Charles Otuokere, Victoria Nneoma Nnochiri

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Entrepreneurship generally and specifically within the rural communities in Nigeria is a fast means of bringing development within the communities. This is made possible by utmost maximization and management of available local resources to develop rural areas through good management of these local resources. This study anchors on the rural development paradigm and the integrated rural development theories to understudy the knowledge of rural entrepreneurs on rural economic development. The research study made use of surveys and descriptive analysis. The assessable population for the study, which was randomly selected, is 100 rural entrepreneurs from ten rural communities within the Ikwuano Local Government Area of Abia State. The study made use of both primary and secondary as a source of data collection with much emphasis on a primary source, although secondary data such as journals, textbooks electronic sources were also utilised. A carefully structured questionnaire drafted to extract raw data was administered to selected entrepreneurs. The findings of the study showed that developments within rural communities can only be achieved through rural entrepreneurship. This is evidenced in increased output, job creation, and most importantly, reduction of rural to urban migration, among other things. Recommendations were also made based on these findings; the researchers recommended that infrastructural developments should be made available in the rural communities and government policies should create enabling environments along with other assistance to help these rural entrepreneurs achieve their sole aim.

Keywords: economic developments, rural communities, rural development, rural entrepreneurship

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2082 Corporate Fund Mobilization for Listed Companies and Economic Development: Case of Mongolian Stock Exchange

Authors: Ernest Nweke, Enkhtuya Bavuudorj

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The Mongolia Stock Exchange (MSE) serves as a vehicle for executing the privatization policy of Mongolian Government as it transitioned from socialist to free market economy. It was also the intention of the Government to develop the investment and securities market through its establishment and to further boost the ailing Mongolian economy. This paper focuses on the contributions of the Mongolian Stock Exchange (MSE) to the industrial and economic development of Mongolia via Corporate fund mobilization for listed companies in Mongolia. A study of this nature is imperative as economic development in Mongolia has been accelerated by corporate investments. The key purpose of the research was to critically analyze the operations of the MSE to ascertain the extent to which the objectives for which it was established have been accomplished and to assess its contributions to industrial and economic development of Mongolia. In achieving this, secondary data on the activities of the MSE; its market capitalization over the years were collected and analyzed vis-à-vis the figures for Mongolia’s macro-economic data for the same time period to determine whether the progressive increase in market capitalization of the MSE has positively impacted on Mongolia’s economic growth. Regression analysis package was utilized in dissecting the data. It was proven that the Mongolian Stock Exchange has contributed positively and significantly to Mongolia’s economic development though not yet to the desired level. Against the findings of this research, recommendations were made to address, the problems facing the MSE and to enhance its performance and ultimately its contributions to industrial and economic development of the Mongolian nation.

Keywords: Corporate Fund Mobilization, Gross Domestic Product (GDP), market capitalization, purchasing power, stock exchange

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2081 Numerical Simulations on the Torsional Behavior of Multistory Concrete Masonry Buildings

Authors: Alvaro Jose Cordova, Hsuan Teh Hu

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The use of concrete masonry constructions in developing countries has become very frequent, especially for domestic purpose. Most of them with asymmetric wall configurations in plan resulting in significant torsional actions when subjected to seismic loads. The study consisted on the finding of a material model for hollow unreinforced concrete masonry and a validation with experimental data found in literature. Numerical simulations were performed to 20 buildings with variations in wall distributions and heights. Results were analyzed by inspection and with a non-linear static method. The findings revealed that eccentricities as well as structure rigidities have a strong influence on the overall response of concrete masonry buildings. In addition, slab rotations depicted more accurate information about the torsional behavior than maximum versus average displacement ratios. The failure modes in low buildings were characterized by high tensile strains in the first floor. Whereas in tall buildings these strains were lowered significantly by higher compression stresses due to a higher self-weight. These tall buildings developed multiple plastic hinges along the height. Finally, the non-linear static analysis exposed a brittle response for all masonry assemblies. This type of behavior is undesired in any construction and the need for a material model for reinforced masonry is pointed out.

Keywords: concrete damaged plasticity, concrete masonry, macro-modeling, nonlinear static analysis, torsional capacity

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2080 Diagnostic Clinical Skills in Cardiology: Improving Learning and Performance with Hybrid Simulation, Scripted Histories, Wearable Technology, and Quantitative Grading – The Assimilate Excellence Study

Authors: Daly M. J, Condron C, Mulhall C, Eppich W, O'Neill J.

Abstract:

Introduction: In contemporary clinical cardiology, comprehensive and holistic bedside evaluation including accurate cardiac auscultation is in decline despite having positive effects on patients and their outcomes. Methods: Scripted histories and scoring checklists for three clinical scenarios in cardiology were co-created and refined through iterative consensus by a panel of clinical experts; these were then paired with recordings of auscultatory findings from three actual patients with known valvular heart disease. A wearable vest with embedded pressure-sensitive panel speakers was developed to transmit these recordings when examined at the standard auscultation points. RCSI medical students volunteered for a series of three formative long case examinations in cardiology (LC1 – LC3) using this hybrid simulation. Participants were randomised into two groups: Group 1 received individual teaching from an expert trainer between LC1 and LC2; Group 2 received the same intervention between LC2 and LC3. Each participant’s long case examination performance was recorded and blindly scored by two peer participants and two RCSI examiners. Results: Sixty-eight participants were included in the study (age 27.6 ± 0.1 years; 74% female) and randomised into two groups; there were no significant differences in baseline characteristics between groups. Overall, the median total faculty examiner score was 39.8% (35.8 – 44.6%) in LC1 and increased to 63.3% (56.9 – 66.4%) in LC3, with those in Group 1 showing a greater improvement in LC2 total score than that observed in Group 2 (p < .001). Using the novel checklist, intraclass correlation coefficients (ICC) were excellent between examiners in all cases: ICC .994 – .997 (p < .001); correlation between peers and examiners improved in LC2 following peer grading of LC1 performances: ICC .857 – .867 (p < .001). Conclusion: Hybrid simulation and quantitative grading improve learning, standardisation of assessment, and direct comparisons of both performance and acumen in clinical cardiology.

Keywords: cardiology, clinical skills, long case examination, hybrid simulation, checklist

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2079 Knowledge Transformation Flow (KTF) of Visually Impaired Students: The Virtual Knowledge System as a New Service Innovation

Authors: Chatcai Tangsri, Onjaree Na-Takuatoong

Abstract:

This paper aims to present the key factors that support the decision to use the technology and to present the knowledge transformation flow of visually impaired students after the use of virtual knowledge system as proposed as a new service innovation to universities in Thailand. Correspondents of 27 visually impaired students are involved in this research. Total of 25 students are selected from the University that mainly conducts non-classroom teaching environment; while another 2 visually impaired students are selected from classroom teaching environment. All of them are fully involved in the study along 8 weeks duration. All correspondents are classified into 5 small groups in various conditions. The research results revealed that the involvement from knowledge facilitator can push out for the behavioral actual use of the virtual knowledge system although there is no any developed intention to use behaviors. Secondly, the situations that the visually impaired students inadequate of the knowledge sources that usually provided by assistants i.e. peers, audio files etc. In this case, they will use the virtual knowledge system for both knowledge access and knowledge transfer request. With this evidence, the need of knowledge would play a stronger role than all technology acceptance factors. Finally, this paper revealed that the knowledge transfer in the normal method that students have a chance to physically meet up is still confirmed as their preference method. In term of other aspects of technology acceptance, it will be discussed together with challenges and recommendations at the end of this paper.

Keywords: knowledge system, visually impaired students, higher education, knowledge management enable technology, synchronous/asynchronous knowledge access, synchronous/asynchronous knowledge transfer

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2078 Solid Waste Pollution and the Importance of Environmental Planning in Managing and Preserving the Public Environment in Benghazi City and Its Surrounding Areas

Authors: Abdelsalam Omran Gebril

Abstract:

Pollution and solid waste are the most important environmental problems plaguing the city of Benghazi as well as other cities and towns in Libya. These problems are caused by the lack of environmental planning and sound environmental management. Environmental planning is very important at present for the development of projects that preserve the environment, therefore, the planning process should be prioritized over the management process. Pollution caused by poor planning and environmental management exists not only in Benghazi but also in all other Libyan cities. This study was conducted through various field visits to several neighborhoods and areas within Benghazi as well as its neighboring regions. Follow-ups in these areas were conducted from March 2013 to October 2013 and documented by photographs. The existing methods of waste collection and means of transportation were investigated. Interviews were conducted with relevant authorities, including the Environment Public Authority in Benghazi and the Public Service Company of Benghazi. The objective of this study is to determine the causes of solid waste pollution in Benghazi City and its surrounding areas. Results show that solid waste pollution in Benghazi and its surrounding areas is the result of poor planning and environmental management, population growth, and the lack of hardware and equipment for the collection and transport of waste from the city to the landfill site. One of the most important recommendations in this study is the development of a complete and comprehensive plan that includes environmental planning and environmental management to reduce solid waste pollution.

Keywords: solid waste, pollution, environmental planning, management, Benghazi, Libya

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2077 Comparing Performance of Neural Network and Decision Tree in Prediction of Myocardial Infarction

Authors: Reza Safdari, Goli Arji, Robab Abdolkhani Maryam zahmatkeshan

Abstract:

Background and purpose: Cardiovascular diseases are among the most common diseases in all societies. The most important step in minimizing myocardial infarction and its complications is to minimize its risk factors. The amount of medical data is increasingly growing. Medical data mining has a great potential for transforming these data into information. Using data mining techniques to generate predictive models for identifying those at risk for reducing the effects of the disease is very helpful. The present study aimed to collect data related to risk factors of heart infarction from patients’ medical record and developed predicting models using data mining algorithm. Methods: The present work was an analytical study conducted on a database containing 350 records. Data were related to patients admitted to Shahid Rajaei specialized cardiovascular hospital, Iran, in 2011. Data were collected using a four-sectioned data collection form. Data analysis was performed using SPSS and Clementine version 12. Seven predictive algorithms and one algorithm-based model for predicting association rules were applied to the data. Accuracy, precision, sensitivity, specificity, as well as positive and negative predictive values were determined and the final model was obtained. Results: five parameters, including hypertension, DLP, tobacco smoking, diabetes, and A+ blood group, were the most critical risk factors of myocardial infarction. Among the models, the neural network model was found to have the highest sensitivity, indicating its ability to successfully diagnose the disease. Conclusion: Risk prediction models have great potentials in facilitating the management of a patient with a specific disease. Therefore, health interventions or change in their life style can be conducted based on these models for improving the health conditions of the individuals at risk.

Keywords: decision trees, neural network, myocardial infarction, Data Mining

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2076 Guarding the Fortress: Intellectual Property Rights and the European Union’s Cross-Border Jurisdiction

Authors: Sara Vora (Hoxha)

Abstract:

The present article delves into the intricate matters concerning Intellectual Property Rights (IPR) and cross-border jurisdiction within the confines of the European Union (EU). The prevalence of cross-border intellectual property rights (IPR) disputes has increased in tandem with the globalization of commerce and the widespread adoption of technology. The European Union (EU) is not immune to this trend. The manuscript presents a comprehensive analysis of various forms of intellectual property rights (IPR), such as patents, trademarks, and copyrights, and the regulatory framework established by the European Union (EU) to oversee these rights. The present article examines the diverse approaches employed for ascertaining the appropriate jurisdiction within the European Union (EU), and their potential application in the sphere of cross-border intellectual property rights (IPR) conflicts. The article sheds light on jurisdictional issues and outcomes of significant cross-border intellectual property rights (IPR) disputes in the European Union (EU). Additionally, the document provides suggestions for effectively managing intellectual property rights conflicts across borders within the European Union, which encompasses the utilization of alternative methods for resolving disputes. The article highlights the significance of comprehending the relevant jurisdiction in the European Union for Intellectual Property Rights (IPR). It also offers optimal approaches for enterprises and individuals who aim to safeguard their intellectual property beyond national boundaries. The primary objective of this article is to furnish a thorough comprehension of Intellectual Property Rights (IPR) and the relevant jurisdiction in the European Union (EU). Additionally, it endeavors to provide pragmatic recommendations for managing cross-border IPR conflicts in this intricate and ever-changing legal milieu.

Keywords: intellectual property rights (IPR), cross-border jurisdiction, applicable laws and regulations, dispute resolution, best practices

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2075 New Employee on-Boarding Program: Effective Tool for Reducing the Prevalence of Workplace Injuries/Accidents

Authors: U. Ugochukwu, J. Lee, P. Conley

Abstract:

According to a recent survey by the UT Southwestern Workplace Safety Committee, the three most common on-the-job injuries reported by workers at the medical center are musculoskeletal injuries, slip-and-fall injuries and repetitive motion injuries. Last year alone, of the 650 documented workplace injuries and accidents, 45% were seen in employees in their first-two years of employment. UT Southwestern New Employee On-Boarding program was created and modeled to follows OSHA’s model that consist of: determining if training is needed, identifying training needs, identifying goals and objectives, developing learning activities, conducting the training, evaluating program effectiveness, and improving the program. The hospital’s management best practices were recreated to limit and control workplace injuries and accidents. Regular trainings and workshops on workplace safety and compliance were initiated for new employees. Various computer workstations were evaluated and recommendations were made to reduce musculoskeletal disorders. Post exposure protocols and workers protection programs were remodeled for infectious agents and chemicals used in the hospital, and medical surveillance programs were updated, for every emerging threat, to ensure they are in compliance with the US policy, regulatory and standard setting organizations. If ignorance of specific job hazards and of proper work practices is to blame for this higher injury rate, then training will help to provide a solution. Use of this program in training activities is just one of many ways UT Southwestern complied with the OSHA standards that relate to training while enhancing the safety and health of their employees.

Keywords: ergonomics, hazard, on-boarding, surveillance, workplace

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2074 Embodied Spirituality in Gestalt Therapy

Authors: Silvia Alaimo

Abstract:

This lecture brings to our attention the theme of spirituality within Gestalt therapy’s theoretical and clinical perspectives and which is closely connected to the fertile emptiness and creative indifference’ experiences. First of all, the premise that must be done is the overcoming traditional western culture’s philosophical and religious misunderstandings, such as the dicotomy between spirituality and pratical/material daily life, as well as the widespread secular perspective of classic psychology. Even fullness and emptiness have traditionally been associated with the concepts of being and not being. "There is only one way through which we can contact the deepest layers of our existence, rejuvenate our thinking and reach intuition (the harmony of thought and being): inner silence" (Perls) *. Therefore, "fertile void" doesn't mean empty in itself, but rather an useful condition of every creative and responsible act, making room for a deeper dimension close to spirituality. Spirituality concerns questions about the meaning of existence, which lays beyond the concrete and literal dimension, looking for the essence of things, and looking at the value of personal experience. Looking at fundamentals of Gestalt epistemology, phenomenology, aesthetics, and the relationship, we can reach the heart of a therapeutic work that takes spiritual contours and which are based on an embodied (incarnate size), through the relational aesthetic knowledge (Spagnuolo Lobb ), the deep contact with each other, the role of compassion and responsibility, as the patient's recognition criteria (Orange, 2013) rooted in the body. The aesthetic dimension, like the spiritual dimension to which it is often associated, is a subtle dimension: it is the dimension of the essence of things, of their "soul." In clinical practice, it implies that the relationship between therapist and patient is "in the absence of judgment," also called "zero point of creative indifference," expressed by ‘therapeutic mentality’. It consists in following with interest and authentic curiosity where the patient wants to go and support him in his intentionality of contact. It’s a condition of pure and simple awareness, of the full acceptance of "what is," a moment of detachment from one's own life in which one does not take oneself too seriously, a starting point for finding a center of balance and integration that brings to the creative act, to growth, and, as Perls would say, to the excitement and adventure of living.

Keywords: spirituality, bodily, embodied aesthetics, phenomenology, relationship

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2073 Machine Learning Algorithms for Rocket Propulsion

Authors: Rômulo Eustáquio Martins de Souza, Paulo Alexandre Rodrigues de Vasconcelos Figueiredo

Abstract:

In recent years, there has been a surge in interest in applying artificial intelligence techniques, particularly machine learning algorithms. Machine learning is a data-analysis technique that automates the creation of analytical models, making it especially useful for designing complex situations. As a result, this technology aids in reducing human intervention while producing accurate results. This methodology is also extensively used in aerospace engineering since this is a field that encompasses several high-complexity operations, such as rocket propulsion. Rocket propulsion is a high-risk operation in which engine failure could result in the loss of life. As a result, it is critical to use computational methods capable of precisely representing the spacecraft's analytical model to guarantee its security and operation. Thus, this paper describes the use of machine learning algorithms for rocket propulsion to aid the realization that this technique is an efficient way to deal with challenging and restrictive aerospace engineering activities. The paper focuses on three machine-learning-aided rocket propulsion applications: set-point control of an expander-bleed rocket engine, supersonic retro-propulsion of a small-scale rocket, and leak detection and isolation on rocket engine data. This paper describes the data-driven methods used for each implementation in depth and presents the obtained results.

Keywords: data analysis, modeling, machine learning, aerospace, rocket propulsion

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2072 The Effectiveness of Treating Anxiety with Reiki

Authors: Erika Humphreys

Abstract:

The effectiveness of treating anxiety with Reiki is explored within ten quantitative studies. The methodology utilized for a critical appraisal and systematic review of the literature is explained with inclusion and exclusion criteria. The theoretical framework for the project is grounded in the work of Hildegard Peplau, whose nursing theory based on the therapeutic use of self is foundational for Reiki implementation. A thorough critique of the literature is conducted for key components of robustness and believability. This critique is conducted using a structured guide addressing synthesized strengths and weaknesses of the body of literature. A synthesis of the literature explores the findings of the studies. This synthesis reports on Reiki’s effectiveness in treating anxiety within a variety of patient settings and populations, its effect on subscales of anxiety, physiological manifestations of anxiety, and pain associated with anxiety. Cultural considerations affecting Reiki’s potential effectiveness are discussed. Gaps in the literature are examined, including the studies’ narrow sample population, lack of participant exclusionary factors for controlled outcome data, and the lack of studies across time. Implications for future research are discussed with recommendations for expanded research that includes a broader variety of settings, age groups, and patient diagnoses, including anxiety disorders, for research data that is transferable. Implications for further practice for the advanced practice registered nurse (APRN) are explored, with the potential benefits for both providers and patients, including improved patient satisfaction and expansion of provider treatment modalities.

Keywords: Reiki, anxiety, complementary alternative medicine, pandemic

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2071 Nursing Experience of Providing Nursing Care to a Lung Transplantation Patient by Applying the Self-Efficacy Theory

Authors: Hsin-Yi Huang

Abstract:

This study mainly discussed the disease-induced and surgery-induced physical, psychological, and spiritual issues faced by a patient who suffered from emphysema and respiratory failure and had underwent a right-lung transplantation surgery. Nursing care was provided from May 21 to May 29. Based on the observations, interviews, physical examinations, and evaluations that were carried out using Roy’s adaptation model, the following nursing issues were identified: risk of infection, lack of knowledge, and anxiety. Active care was provided and a good nursing relationship with the patient and the patient’s family was established. The four strategies of Bandura’s self-efficacy theory (self-transcendence, vicarious experience, verbal persuasion, and biofeedback) were employed. Instructions for the appropriate rehabilitation exercises were given, immunosuppressant concentration was monitored, and special measures were taken to prevent infection. The patient was encouraged to express feelings and was provided with sufficient information to alleviate anxiety. With assistance from nursing personnel and the medical team, the patient was successfully discharged from the hospital and thereafter embarked on the path of postoperative recovery. The patient learned about the importance of home self-care and regular follow-up outpatient visits, and patient management was implemented for discharge preparation services. This nursing case study may serve as a reference to nurses managing similar cases in future.

Keywords: anxiety, lung transplantation, Roy's adaptation model, self-efficacy theory

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2070 A Constructivist and Strategic Approach to School Learning: A Study in a Tunisian Primary School

Authors: Slah Eddine Ben Fadhel

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Despite the development of new pedagogic methods, current teaching practices put more emphasis on the learning products than on the processes learners deploy. In school syllabi, for instance, very little time is devoted to both the explanation and analysis of strategies aimed at resolving problems by means of targeting students’ metacognitive procedures. Within a cognitive framework, teaching/learning contexts are conceived of in terms of cognitive, metacognitive and affective activities intended for the treatment of information. During these activities, learners come to develop an array of knowledge and strategies which can be subsumed within an active and constructive process. Through the investigation of strategies and metacognition concepts, the purpose is to reflect upon the modalities at the heart of the learning process and to demonstrate, similarly, the inherent significance of a cognitive approach to learning. The scope of this paper is predicated on a study where the population is a group of 76 primary school pupils who experienced difficulty with learning French. The population was divided into two groups: the first group was submitted during three months to a strategy-based training to learn French. All through this phase, the teachers centred class activities round making learners aware of the strategies the latter deployed and geared them towards appraising the steps these learners had themselves taken by means of a variety of tools, most prominent among which is the logbook. The second group was submitted to the usual learning context with no recourse whatsoever to any strategy-oriented tasks. The results of both groups point out the improvement of linguistic competences in the French language in the case of those pupils who were trained by means of strategic procedures. Furthermore, this improvement was noted in relation with the native language (Arabic), a fact that tends to highlight the importance of the interdisciplinary investigation of (meta-)cognitive strategies. These results show that strategic learning promotes in pupils the development of a better awareness of their own processes, which contributes to improving their general linguistic competences.

Keywords: constructive approach, cognitive strategies, metacognition, learning

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