Search results for: advanced cardiac life support

Authors: Alan N. A. Heberle, Salatiel W. Da Silva, Valentin Perez-Herranz, Andrea M. Bernardes

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Contaminants of emerging concern are substances widely used, such as pharmaceutical products. These compounds represent risk for both wild and human life since they are not completely removed from wastewater by conventional wastewater treatment plants. In the environment, they can be harm even in low concentration (µ or ng/L), causing bacterial resistance, endocrine disruption, cancer, among other harmful effects. One of the most common taken medicine to treat cardiocirculatory diseases is the Atenolol (ATL), a β-Blocker, which is toxic to aquatic life. In this way, it is necessary to implement a methodology, which is capable to promote the degradation of the ATL, to avoid the environmental detriment. A very promising technology is the advanced electrochemical oxidation (AEO), which mechanisms are based on the electrogeneration of reactive radicals (mediated oxidation) and/or on the direct substance discharge by electron transfer from contaminant to electrode surface (direct oxidation). The hydroxyl (HO•) and sulfate (SO₄•⁻) radicals can be generated, depending on the reactional medium. Besides that, at some condition, the peroxydisulfate (S₂O₈²⁻) ion is also generated from the SO₄• reaction in pairs. Both radicals, ion, and the direct contaminant discharge can break down the molecule, resulting in the degradation and/or mineralization. However, ATL molecule and byproducts can still remain in the treated solution. On this wise, some efforts can be done to implement the AEO process, being one of them the use of a cationic membrane to separate the cathodic (reduction) from the anodic (oxidation) reactor compartment. The aim of this study is investigate the influence of the implementation of a cationic membrane (Nafion®-117) to separate both cathodic and anodic, AEO reactor compartments. The studied reactor was a filter-press, with bath recirculation mode, flow 60 L/h. The anode was an Nb/BDD2500 and the cathode a stainless steel, both bidimensional, geometric surface area 100 cm². The solution feeding the anodic compartment was prepared with ATL 100 mg/L using Na₂SO₄ 4 g/L as support electrolyte. In the cathodic compartment, it was used a solution containing Na₂SO₄ 71 g/L. Between both solutions was placed the membrane. The applied currents densities (iₐₚₚ) of 5, 20 and 40 mA/cm² were studied over 240 minutes treatment time. Besides that, the ATL decay was analyzed by ultraviolet spectroscopy (UV/Vis). The mineralization was determined performing total organic carbon (TOC) in TOC-L CPH Shimadzu. In the cases without membrane, the iₐₚₚ 5, 20 and 40 mA/cm² resulted in 55, 87 and 98 % ATL degradation at the end of treatment time, respectively. However, with membrane, the degradation, for the same iₐₚₚ, was 90, 100 and 100 %, spending 240, 120, 40 min for the maximum degradation, respectively. The mineralization, without membrane, for the same studied iₐₚₚ, was 40, 55 and 72 %, respectively at 240 min, but with membrane, all tested iₐₚₚ reached 80 % of mineralization, differing only in the time spent, 240, 150 and 120 min, for the maximum mineralization, respectively. The membrane increased the ATL oxidation, probably due to avoid oxidant ions (S₂O₈²⁻) reduction on the cathode surface.

Keywords: contaminants of emerging concern, advanced electrochemical oxidation, atenolol, cationic membrane, double compartment reactor

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Authors: V. Kuzhandai Velu, R. Ramesh

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Background and objectives: Acute myocardial infarction (AMI) is the most common cause of mortality and morbidity. Over the last decade, microRNAs (miRs) have emerged as a potential marker for detecting AMI. The current study evaluates the kinetics and importance of miRs in the differential diagnosis of ST-segment elevated MI (STEMI) and non-STEMI (NSTEMI) and its correlation to conventional biomarkers and to predict the immediate outcome of AMI for arrhythmias and left ventricular (LV) dysfunction. Materials and Method: A total of 100 AMI patients were recruited for the study. Routine cardiac biomarker and miRNA levels were measured during diagnosis and serially at admission, 6, 12, 24, and 72hrs. The baseline biochemical parameters were analyzed. The expression of miRs was compared between STEMI and NSTEMI at different time intervals. Diagnostic utility of miR-1, miR-133, miR-208, and miR-499 levels were analyzed by using RT-PCR and with various diagnostics statistical tools like ROC, odds ratio, and likelihood ratio. Results: The miR-1, miR-133, and miR-499 showed peak concentration at 6 hours, whereas miR-208 showed high significant differences at all time intervals. miR-133 demonstrated the maximum area under the curve at different time intervals in the differential diagnosis of STEMI and NSTEMI which was followed by miR-499 and miR-208. Evaluation of miRs for predicting arrhythmia and LV dysfunction using admission sample demonstrated that miR-1 (OR = 8.64; LR = 1.76) and miR-208 (OR = 26.25; LR = 5.96) showed maximum odds ratio and likelihood respectively. Conclusion: Circulating miRNA showed a highly significant difference between STEMI and NSTEMI in AMI patients. The peak was much earlier than the conventional biomarkers. miR-133, miR-208, and miR-499 can be used in the differential diagnosis of STEMI and NSTEMI, whereas miR-1 and miR-208 could be used in the prediction of arrhythmia and LV dysfunction, respectively.

Keywords: myocardial infarction, cardiac biomarkers, microRNA, arrhythmia, left ventricular dysfunction

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Authors: My Ha, Suwei Lin, Huiying Zou

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This study aimed at investigating the association between teacher support and academic resilience in a developing country. Using the data from PISA 2018 Student Questionnaire and Cognitive Tests, the study provided evidence of the significant impact teacher support had on reading literacy among 15-year-old students from low socio-economic status (SES) homes in Vietnam. From a total of 5773 Vietnamese participants from all backgrounds, a sample of 1765 disadvantaged students was drawn for analysis. As a result, 32 percent of the low SES sample was identified as resilient. Through their response to the PISA items regarding the frequency of support they received from teachers, the result of Latent Class Analysis (LCA) divides children into three subgroups: High Support (74.6%), Fair Support (21.6%), and Low Support (3.8%). The high support group reported the highest proportion of resilient students. Meanwhile, the low support group scored the lowest mean on reading test and had the lowest rate of resilience. Also, as the level of support increases, reading achievement becomes less dependent on socioeconomic status, reflected by the decrease in both the slope and magnitude of their correlation. Logistic regression revealed that 1 unit increase in standardized teacher support would lead to an increase of 29.1 percent in the odds of a student becoming resilient. The study emphasizes the role of supportive teachers in promoting resilience, as well as lowering educational inequity in general.

Keywords: academic resilience, disadvantaged students, teacher support, inequity, PISA

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Authors: Arezoo Fallahi‎

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Background: Exercise behavior (EB) has a significant impact on infertility, but the magnitude of the effect is not easily determined. The aim of the present study was to assess the effect of social support and self-regulation, as external and internal factors, on changes in exercise behavior among infertile women. Methods: For a cross-sectional study conducted in Sanandaj (Iran) in 2020, we recruited infertile women (n=483) from 35 comprehensive healthcare centers by means of convenience sampling. Standardized face-to-face interviews were conducted using established and reliable instruments for the assessment of EB, social support, and self-regulation. Logistic regression models were applied to assess the association between EB, social support and self-regulation. Results: The majority of the participants (56.7%) had secondary infertility, while 70.8% of them did not perform any exercise. Self-regulation and social support were significantly higher in women with secondary infertility than in those with primary infertility (p < 0.01). Self-regulation was significantly lower in women whose height was below 160 centimeters (cm) (p<0.05). Social support was significantly higher among participants aged ≥ 35 years and weighing ≥ 60 kilograms (kg) (p < 0.01). The odds of EB adoption increased with self-regulation and social support (OR=1.05, 95% CI=1.02-1.09, p <0.01), (OR=1.06, 95% CI=1.02-1.11, p <0.01). Conclusion: Social support and self-regulation almost equally influenced EB in infertile women. Designing support and consultation programs can be considered in encouraging infertile women to do exercise in future research.

Keywords: social support, regulation, infertility, women, exercise

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Authors: Mario Calabrese, Francesca Iandolo, Pietro Vito, Raffaele D'Amore, Francesco Caputo

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This article presents a synopsis of Nature-Based Solutions (NBS), a fresh and emerging concept in mitigating and adapting to climate change. It outlines a classification of NBS, from the least intrusive to the most advanced engineering, and provides illustrations of each. Moreover, it gives an overview of the 'Life Metro Adapt' initiative, which dealt with the climatic challenges faced by the Milan Metropolitan City and encouraged the development of climate change adaptation methods using alternative, nature-focused solutions. Lastly, the article emphasizes the necessity of raising awareness about environmental issues to ensure that NBS becomes a regular practice today and can be refined in the future.

Keywords: nature-based solutions, urban resilience, climate change adaptation, life metro adapt initiative

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Authors: Nadine Sangster, Akil James, Rondell Duke, Aaron Ameerali, Terrence Lalla

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The market place of the 21st century is evolving into one of merging national markets, fragmented consumer markets, and rapidly changing product technologies. The use of new technologies has become vital to the manufacturing industry for their survival and sustainability. This work focused on the assembly type industry in a small developing country and aimed at identifying the use of advanced manufacturing technologies and their impact on this sector of the manufacturing industry. It was found that some technologies were being used and that they had improved the effectiveness of those companies but there was still quite a bit of room for improvements. Some of the recommendations included benchmarking against international standards, the adoption of a “made in TT” campaign and the effective utilisation of the technologies to improve manufacturing effectiveness and thus improve competitive advantages and strategies.

Keywords: advanced manufacturing technology, Trinidad and Tobago, manufacturing, industrial engineering

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Authors: Youn-Sung Kim, Jin-Ho Jo, Mi-Sung Kim, Jae-Kun Lee

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Accelerated life cycle test is applied to various products or components in order to reduce the time of life cycle test in industry. It must be considered for many test conditions according to the product characteristics for the test and the selection of acceleration parameter is especially very important. We have carried out the general life cycle test and the accelerated life cycle test by applying the acceleration factor (AF) considering the characteristics of brushless DC (BLDC) motor for washing machine. The final purpose of this study is to verify the validity by analyzing the results of the general life cycle test and the accelerated life cycle test. It will make it possible to reduce the life test time through the reasonable accelerated life cycle test.

Keywords: accelerated life cycle test, reliability test, motor for washing machine, brushless dc motor test

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Authors: Farzad Jalilian, Mehdi Mirzaei Alavijeh, Fazel Zinat Motlagh

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Social support is an important benchmark of health for people in avoidance conditions. The main goal of this study was to determine the three kinds of social support (family, friend and other significant) to drug cessation among male addicts, in Kermanshah, the west of Iran. This cross-sectional study was conducted among 132 addicts, randomly selected to participate voluntarily in the study. Data were collected from conduct interviews based on standard questionnaire and analyzed by using SPSS-18 at 95% significance level. The majority of addicts were young (Mean: 30.4 years), and with little education. Opium (36.4%), Crack (21.2%), and Methamphetamine (12.9%) were the predominant drugs. Inabilities to reject the offer and having addict friends are the most often reasons for drug usage. Almost, 18.9% reported history of drug injection. 43.2% of the participants already did drug cessation at least once. Logistic regression showed the family support (OR = 1.110), age (OR = 1.106) and drug use initiation age (OR = 0.918) was predicting drug cessation. Our result showed; family support is a more important effect among types of social support in drug cessation. It seems that providing educational program to addict’s families for more support of patients at drug cessation can be beneficial.

Keywords: drug cessation, family support, drug use, initiation age

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Authors: George Nyori Makari

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Data on 92 industrial organizations point to the existence of relationships between advanced manufacturing technology (AMT) adoption and some aspects of organizational structure, including the number of specialized sub-units, the number of levels of authority, span of control, degree of role programming specification, degree of communication programming specification and the degree of output programming. Primary finding is that as the investments and integration of AMTs increases, the more likely the foregoing aspects of structure increase. The findings hold with size and a number of other organizational variables controlled. The results indicate that a company’s capacity to assimilate technology depends on its organizational capabilities. The study encapsulates the need for companies to increase their organizational capabilities during investment and integration of AMTs.

Keywords: advanced manufacturing technology, adoption, organizational structure, Kenya

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Authors: Cansu Arslan Turan, Tuba Cimilli Ozturk, Ebru Unal Akoglu, Kemal Aygun, Ecem Deniz Kırkpantur, Ozge Ecmel Onur

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Although the mechanism of action is not well known, Intravenous Lipid Emulsion (ILE) has been shown to be effective in the treatment of lipophilic drug intoxications. It is thought that ILE probably separate the lipophilic drugs from target tissue by creating a lipid-rich compartment in the plasma. The second theory is that ILE provides energy to myocardium with high dose free fatty acids activating the voltage gated calcium channels in the myocytes. In this study, the effects of ILE treatment on digoxin overdose which are frequently observed in emergency departments was searched in an animal model in terms of cardiac side effects and survival. The study was carried out at Yeditepe University, Faculty of Medicine-Experimental Animals Research Center Labs in December 2015. 40 Sprague-Dawley rats weighing 300-400 g were divided into 5 groups randomly. As the pre-treatment, the first group received saline, the second group received lipid, the third group received DigiFab, and the fourth group received DigiFab and lipid. Following that, digoxin was infused to all groups until death except the control group. First arrhythmia and cardiac arrest occurrence times were recorded. As no medication causing arrhythmia was infused, Group 5 was excluded from the statistical analysis performed for the comparisons of first arrhythmia and death time. According to the results although there was no significant difference in the statistical analysis comparing the four groups, as the rats, only exposed to digoxin intoxication were compared with the rats pre-treated with ILE in terms of first arrhythmia time and cardiac arrest occurrence times, significant difference was observed between the groups. According to our results, using DigiFab treatment, intralipid treatment, intralipid and DigiFab treatment for the rats exposed to digoxin intoxication makes no significant difference in terms of the first arrhythmia and death occurrence time. However, it is not possible to say that at the doses we use in the study, ILE treatment might be successful at least as a known antidote. The fact that the statistical significance between the two groups is not observed in the inter-comparisons of all the groups, the study should be repeated in the larger groups.

Keywords: arrhytmia, cardiac arrest, DigiFab, digoxin intoxication

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Authors: B. Chandra

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In Association Rule Mining, much attention has been paid for developing algorithms for large (frequent/closed/maximal) itemsets but very little attention has been paid to improve the performance of rule generation algorithms. Rule generation is an important part of Association Rule Mining. In this paper, a novel approach named NARG (Association Rule using Antecedent Support) has been proposed for rule generation that uses memory resident data structure named FCET (Frequent Closed Enumeration Tree) to find frequent/closed itemsets. In addition, the computational speed of NARG is enhanced by giving importance to the rules that have lower antecedent support. Comparative performance evaluation of NARG with fast association rule mining algorithm for rule generation has been done on synthetic datasets and real life datasets (taken from UCI Machine Learning Repository). Performance analysis shows that NARG is computationally faster in comparison to the existing algorithms for rule generation.

Keywords: knowledge discovery, association rule mining, antecedent support, rule generation

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Authors: Benghenia Hadj Abd El Kader

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Sleep apnea events as obstructive, central, mixed or hypopnea are characterized by frequent breathing cessations or reduction in upper airflow during sleep. An advanced method for analyzing the patterning of biomedical signals to recognize obstructive sleep apnea and hypopnea is presented. In the aim to extract characteristic parameters, which will be used for classifying the above stated (obstructive, central, mixed) sleep apnea and hypopnea, the proposed method is based first on the analysis of polysomnography signals such as electrocardiogram signal (ECG) and electromyogram (EMG), then classification of the (obstructive, central, mixed) sleep apnea and hypopnea. The analysis is carried out using the wavelet transform technique in order to extract characteristic parameters whereas classification is carried out by applying the SVM (support vector machine) technique. The obtained results show good recognition rates using characteristic parameters.

Keywords: obstructive, central, mixed, sleep apnea, hypopnea, ECG, EMG, wavelet transform, SVM classifier

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Authors: Israa Sh. Tawfic, Sema Koc Kayhan

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Given a large sparse signal, great wishes are to reconstruct the signal precisely and accurately from lease number of measurements as possible as it could. Although this seems possible by theory, the difficulty is in built an algorithm to perform the accuracy and efficiency of reconstructing. This paper proposes a new proved method to reconstruct sparse signal depend on using new method called Least Support Matching Pursuit (LS-OMP) merge it with the theory of Partial Knowing Support (PSK) given new method called Partially Knowing of Least Support Orthogonal Matching Pursuit (PKLS-OMP). The new methods depend on the greedy algorithm to compute the support which depends on the number of iterations. So to make it faster, the PKLS-OMP adds the idea of partial knowing support of its algorithm. It shows the efficiency, simplicity, and accuracy to get back the original signal if the sampling matrix satisfies the Restricted Isometry Property (RIP). Simulation results also show that it outperforms many algorithms especially for compressible signals.

Keywords: compressed sensing, lest support orthogonal matching pursuit, partial knowing support, restricted isometry property, signal reconstruction

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Authors: Ali H. Muhammad

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This paper investigates both instrumental and emotional family support on employee job satisfaction and perception of work-family conflict. Instrumental family support is manifested in family behavior that contributes to the reduction of employee’s family responsibilities and keeping the physical home environment in a proper shape. Emotional family support includes the encouragement and praise that the employee receives from his family and families for the employee’s work problem and their role in assisting the employees in dealing with these problems. The paper suggests that instrumental and emotional family support increases employee’s job satisfaction. Furthermore, the study proposes that family support decreases employee’s perception of work-family conflict. In addition, this study examines the reliability and validity of the family support index developed by Lynda King and her colleagues in 1995. Confirmatory factor analysis is used to test the validity of the instrument in an Arab business setting. A paper-pencil questionnaire was used to collect data from a random sample of 70 Kuwaiti employees working in the oil sector. Data were analyzed using factor analysis, reliability tests, and regression analysis. Results confirmed the research hypothesis. Family support had a positive effect on job satisfaction. Furthermore, family support significantly contributed to the reduction of employee perception of work-family conflict.

Keywords: family support, job satisfaction, work-family conflict, Kuwait oil sector

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Authors: Rafiqul Hasan, A. S. M. Tanim Anwar, Mohammad Azizul Hakim

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Background: Chronic kidney disease (CKD) is a major public health problem that continues to increase in prevalence globally. The prevalence of chronic kidney disease is increasing day by day in low to middle income countries (LMICs). People living in LMICs have the highest need for renal replacement therapy (RRT) despite they have lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, very much infrastructure, dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. To authors knowledge there was scarcity of data regarding CAPD performance in remote area of Bangladesh. This study was aimed to report the characteristics and outcomes of CAPD in ESRD patients lived in least developed area of Bangladesh. Methods: This prospective study was conducted in Cox’sbazar Medical College Hospital, Cox’sbazar and Parkview hospital Ltd, Chattogram, Bangladesh. Data were collected by questionnaire from the patients of any age with end-stage renal disease (ESRD) who underwent CAPD in 2018–2021. The baseline characteristics, PD-related complication as well as patient and technique survivals were analyzed. Results: Out of 31 patients who underwent CAPD, 18 (58%) were male on the age range of 15–79 years. The mean follow-up duration was 18 months. Mortality was inversely related with the EF of echocardiography. The peritonitis rate was 0.48 episodes per patient per year. The 1, 3 and 4-year patient survival rates were 64.34% (95% CI = 52.5–81.5), 23.79% (95% CI = 17.9 – 57.4) and 3.22% (95% CI = 31.2–77.5) respectively. Conclusions: In this study, CAPD performance was poorer than usual reference. Cardiac compromised patient and inappropriate dwell might be the main contributing factors behind this scenario. The peritonitis rate was nearly similar to that of developed countries. CAPD was cost effective than HD in remote area. Some accessible measures may be taken to make CAPD a more acceptable RRT modality with improved outcomes in poor socioeconomic backgrounds.

Keywords: dialysis cost, peritoneal dialysis, peritonitis, CAPD, least developed area, remote area, Bangladesh

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Authors: V. Reyes, P. Ferreira

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In response to high levels of competitiveness, industrial systems have evolved to improve productivity. As a consequence, a rapid increase in volume production and simultaneously, a customization process require lower costs, more variety, and accurate quality of products. Reducing time-cycle production, enabling customizability, and ensure continuous quality improvement are key features in advance intelligent industry. In this scenario, customers and producers will be able to participate in the ongoing production life cycle through real-time interaction. To achieve this vision, transparency, predictability, and adaptability are key features that provide the industrial systems the capability to adapt to customer demands modifying the manufacturing process through an autonomous response and acting preventively to avoid errors. The industrial system incorporates a diversified number of components that in advanced industry are expected to be decentralized, end to end communicating, and with the capability to make own decisions through feedback. The evolving process towards advanced intelligent industry defines a set of stages to empower components of intelligence and enhancing efficiency to achieve the decision-making stage. The integrated system follows an industrial cyber-physical system (CPS) architecture whose real-time integration, based on a set of enabler technologies, links the physical and virtual world generating the digital twin (DT). This instance allows incorporating sensor data from real to virtual world and the required transparency for real-time monitoring and control, contributing to address important features of the advanced intelligent industry and simultaneously improve sustainability. Assuming the industrial CPS as the core technology toward the latest advanced intelligent industry stage, this paper reviews and highlights the correlation and contributions of the enabler technologies for the operationalization of each stage in the path toward advanced intelligent industry. From this research, a real-time integration architecture for a cyber-physical system with applications to collaborative robotics is proposed. The required functionalities and issues to endow the industrial system of adaptability are identified.

Keywords: cyber-physical systems, digital twin, sensor data, system integration, virtual model

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Authors: Rodrigo Zepeda

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Transaction cost analysis (TCA) is a way of analyzing the relative performance of different intermediaries and different trading strategies for trades undertaken in financial instruments. It is a way for an investor to determine the overall quality of execution of a particular trade, and there are many different approaches to undertaking TCA. Under the updated Markets in Financial Instruments Directive (2014/65/EU) (MiFID II), investment firms are required when executing orders, to take all sufficient steps to obtain the best possible result for their clients. This requirement for 'Best Execution' must take into account price, costs, speed, likelihood of execution and settlement, size, nature or any other consideration relevant to the execution of the order. The new regulatory compliance framework under MiFID II will now also apply across a very broad range of financial instruments. This article will provide a comprehensive technical analysis of how TCA and Best Execution will significantly change under MiFID II. It will also explain why harmonization of post-trade reporting requirements under MiFID II could potentially support the development of peer group analysis, which in turn could provide a new and highly advanced framework for TCA that could more effectively support Best Execution requirements under MiFID II. The study is significant because there are no studies that have dealt with TCA and Best Execution under MiFID II in the literature.

Keywords: transaction cost analysis, execution quality, best execution, MiFID II, financial instruments

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Authors: Rahat Zaman

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The present study was conducted to investigate psychological well-being and positive and negative affect among adults. The sample comprised 221 adults; the sample was collected from all over Pakistan. Psychological well-being was measured with the help of the psychological well-being scale developed by Ryff and Keyes (1995). Lifestyle was measured with the help of the Health Promoting Lifestyle Profile Scale developed by Walker et al. (1995). Positive and negative effects were measured by PANAS, developed by Watson, Clark, and Tellegen (1998). To check the properties of scale, the alpha reliability coefficient was calculated. To test the hypotheses of the research, correlation, independent sample t-rest, and ANOVA were computed. It was hypothesized that there would be a positive relationship between psychological well-being and lifestyles and positive affect. The results show that psychological well-being, lifestyle, and positive affect are positively related. This also supports our hypothesis. The research also searched for relationships in the study variables according to the demographics of the sample. The respondents varied according to their dominant affect levels with respect to their psychological well-being and lifestyles. The research found significant differences for the genders in life appreciation, nutrition, and negative affect. Single and married individuals differed significantly on autonomy, environmental mastery, life appreciation, nutrition, and stress management. Individuals showed significant differences with respect to their living situation, joint and nuclear family members showed significant differences in personal growth, autonomy, health responsibilities, social support, physical activities, and stress management. The sample showed significant differences in environmental mastery, personal growth, purpose in life, life appreciation, health responsibilities, physical activities, stress management, and negative affect when divided in socioeconomic status. Age-wise analysis showed significant differences in autonomy, personal growth, purpose in life, life appreciation, nutrition, and stress management. Provincially significant differences were found in life appreciation, nutrition, social support, physical activities, and stress management, and both positive and negative effects were experienced. Implications of the results are discussed.

Keywords: wellbeing, healthy lifestyle, self acceptance, positive

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Authors: Olga Muries-Cantan, Alice Schippers, Climent Gine, Noelle van den Heuvel

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A systematic review of the literature about the quality of life perceptions of siblings of people with intellectual and developmental disabilities (ID/DD) has shown differences and similarities among siblings’ perceptions around the world. Some of these differences might be explained by the influence of cultural and religious backgrounds on siblings’ quality of life through values, beliefs, and perceptions of ‘normalcy’ and stigma. The main goal of the multiple case study that we present, is to explore the quality of life perceptions of two adolescent siblings of individuals with ID/DD in order to identify the role cultural influence has played in their perceptions of quality of life. Two siblings from different European regions will participate in the study: one from a Southern European country (Spain) and the other one from a Western European country (The Netherlands). Taking a cross-cultural perspective, concepts such as values, cultural beliefs regarding disability, expectations, identity, supports, desires, and sibling relationships, will be discussed in a semi-structured interview with each sibling. Data will be analysed following an interpretative phenomenological analysis (IPA). It is expected that findings will show the particularities of the experience of having a brother or a sister with ID/DD and the singular influence of the culture on siblings’ perceptions of quality of life. The results of this study will help to spread awareness around the necessity that researchers, practitioners, and policymakers take into account the cultural background of the individuals in order to provide them with better services and support. In this line, more culturally situated research is required to enlarge the knowledge in this field.

Keywords: culture, intellectual disability, quality of life, siblings

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Authors: Sawsan J. Al-husseini, Talib A. Dosa

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Educational institutions are today facing increasing pressures due to economic, political and social upheaval. This is only exacerbated by the nature of education as an intangible good which relies upon the intellectual assets of the organisation, its staff. Top management support has been acknowledged as having a positive general influence on knowledge management and creativity. However, there is a lack of models linking top management support, knowledge sharing, and innovation within higher education institutions, in general within developing countries, and particularly in Iraq. This research sought to investigate the impact of top management support on innovation through the mediating role of knowledge sharing in Iraqi private HEIs. A quantitative approach was taken and 262 valid responses were collected to test the causal relationships between top management support, knowledge sharing, and innovation. Employing structural equation modelling with AMOS v.25, the research demonstrated that knowledge sharing plays a pivotal role in the relationship between top management support and innovation. The research has produced some guidelines for researchers as well as leaders, and provided evidence to support the use of knowledge sharing to increase innovation within the higher education environment in developing countries, particularly Iraq.

Keywords: top management support, knowledge sharing, innovation, structural equation modelling

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Authors: Reetika Sharma, Lalit Tejwani, Himanshu Shekhar, Arun Singhvi

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Purpose: Advanced Glaucoma with Failed trab is not an uncommon sight in glaucoma clinic, and such cases usually tend to present with high intraocular pressure (IOP) and advanced cupping, or even glaucomatous atrophy stage. Re-surgery is needed for such cases, and wound modulation poses a major challenge in these cases. We share our experience in this case series with the use of Ologen (collagen matrix implant) along with MMC 0.04% used in surgery. The purpose of the study was to evaluate the efficacy and outcome of collagen matrix implant in re-trabeculectomy in advanced glaucoma cases. Methodology: Eleven eyes of 11 patients (one eye of one patient) underwent re-trabeculectomy surgery with MMC and Ologen. Ologen implant was used in sub scleral and subconjunctival space, as a spacer and wound modulator. In five cases, triple modulation with implant soaked in anti-VEGF was used. Results: All patients had cupping more than 0.9, and one case was GOA. All cases were on maximal medication at presentation and majority were on systemic anti-glaucoma therapy also. Post-surgery, follow-up ranged from 13 – 34 months, and all cases had a follow longer than the gap between previous surgery (which was failed) and re-trab. One case needed AC reformation and one needling was done. Phaco was done at same sitting in four cases. All cases had their IOP lowered post surgery, and vision was maintained in all, however one case was considered as failed re-surgery case. Topical medication was needed in seven cases post-surgery also. Conclusion: Ologen as adjuvant should be considered in all re-trab cases and all high risk and advanced cases, and triple modulation can be next step in these cases. Aggressive IOP control and non- reluctance to continue topical medications post second surgery should be considered in such cases, to give them best possible vision.

Keywords: failed trabeculectomy, ologen, trabeculectomy, advanced glaucoma

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Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

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Background: The prevalence of cardiovascular diseases (CVD) in different triathlon sports disciplines has not been determined. Purpose: The present study aimed to determine the prevalence of CVD in world-class triathletes according to their sex, sports disciplines (aquathlon, duathlon, triathlon…), and formats (short/medium, long, and ultra-long distance). Methods: Male and female elite athletes from eleven triathlon sport disciplines, ranked in the internationally yearly top 10 between 2006 and 2019, were included. The athlete’s name was associated in a Google search with selected key terms related to heart disease and/or cardiac abnormalities. The prevalence and the hazard function of the variation were calculated, and the differences were then compared. Results: From 1329 athletes (male 639, female 690), 13 cases of CVD (0.98%, 95% CI: [0.45-1.51]) were identified, and the mean age of their occurrence was 29±6 years. Although no sex differences were found in each sport discipline/format (p > 0.05), severe outcomes (sudden cardiac arrest/death and those who had to stop their sports practice) were only observed in males. Short-distance triathlon (5.08%, 95% CI: [1.12-9.05]) was more affected than other disciplines in short/medium, long, and ultra-long formats. The prevalence of CVD in athletes who participated in multi-type of sports disciplines (4.14%, 95% CI: [1.14-7.15]) was higher than in those who participated in one type (0.52%, 95% CI: [0.10-0.93]) (p = 0.0004). Conclusion: Athletes in short-distance triathlon were more affected than other disciplines in short/medium, long and ultra-long formats. Athletes who participate in short/medium distances and those who participate in multi-type of sports disciplines should be closely monitored regardless of sex.

Keywords: cardiovascular diseases, sudden cardiac death, triathlon sport disciplines, world-class athletes

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Authors: Tadaaki Tomiie, Hiroki Shinkawa

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The present study was aimed to examine the structure of children’s adaptation during school transition and to identify a commonality and dissimilarity at the elementary and junior high school. 1,983 students in the 6th grade and 2,051 students in the 7th grade were extracted by stratified two-stage random sampling and completed the ASSESS that evaluated the school adaptation from the view point of ‘general satisfaction’, ‘teachers’ support’, ‘friends’ support’, ‘anti-bullying relationship’, ‘prosocial skills’, and ‘academic adaptation’. The 7th graders tend to be worse adaptation than the 6th graders. A structural equation modeling showed the goodness of fit for each grades. Both models were very similar but the 7th graders’ model showed a lower coefficient at the pass from ‘teachers’ support’ to ‘friends’ support’. The role of ‘teachers’ support’ was decreased to keep a good relation in junior high school. We also discussed how we provide a continuous assistance for prevention of the 7th graders’ gap.

Keywords: school transition, social support, psychological adaptation, K-12

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Authors: Amna Khan, Zareena Kausar, Saad Malik

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Bio Mechatronics has extended applications in the field of rehabilitation. It has been contributing since World War II in improving the applicability of prosthesis and assistive devices in real life scenarios. In this paper, classification accuracies have been compared for two classifiers against five positions of elbow. Electromyography (EMG) signals analysis have been acquired directly from skeletal muscles of human forearm for each of the three defined positions and at modified extreme positions of elbow flexion and extension using 8 electrode Myo armband sensor. Features were extracted from filtered EMG signals for each position. Performance of two classifiers, support vector machine (SVM) and linear discriminant analysis (LDA) has been compared by analyzing the classification accuracies. SVM illustrated classification accuracies between 90-96%, in contrast to 84-87% depicted by LDA for five defined positions of elbow keeping the number of samples and selected feature the same for both SVM and LDA.

Keywords: classification accuracies, electromyography, linear discriminant analysis (LDA), Myo armband sensor, support vector machine (SVM)

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Authors: Rolla Monib, Chris Ian Goodier, Alistair Gibb

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This paper aims to investigate decision support strategies in the EC sector to determine the most appropriate degree of modularization. This is achieved through three oil and gas (O&G) and two power plant case studies via semi-structured interviews (n=59 and n=27, respectively), analysis of project documents, and case study-specific semi-structured validation interviews (n=12 and n=8). New terminology to distinguish degrees of modularization is proposed, along with a decision-making support checklist and a diagrammatic decision-making support figure. Results indicate that the EC sub-sectors were substantially more satisfied with the application of component, structural, or traditional modularization compared with system modularization for some types of modules. Key drivers for decisions on the degree of modularization vary across module types. This paper can help the EC sector determine the most suitable degree of modularization via a decision-making support strategy.

Keywords: modularization, engineering construction, case study, decision support

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Authors: Adel Smeda, Badr Najep

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Software architecture is a method of describing the architecture of a software system at a high level of abstraction. It represents a common abstraction of a system that stakeholders can use as a basis for mutual understanding, negotiation, consensus, and communication. It also manifests the earliest design decisions about a system, and these early bindings carry weight far out of proportion to their individual gravity with respect to the system's remaining development, its deployment, and its maintenance life, therefore it is the earliest point at which design decisions governing the system to be built can be analyzed. In this paper, we present a tool to model the architecture of software systems. It represents the first method by which system defects can be detected, and provide a clear representation of a system’s components and interactions at a high level of abstraction. It can be distinguished from other tools by its support to all software architecture elements. The tool is built using VB.net 2010. We used this tool to describe two well know systems, i.e. Capitalize and Client/Server, and the descriptions we obtained support all architectural elements of the two systems.

Keywords: software architecture, architecture description languages, modeling

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Authors: Priestly Malambo, Sonja Van Putten, Hanlie Botha, Gerrit Stols

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The relevance of what is content is taught in tertiary teacher training has long been in question. This study attempts to understand how advanced mathematics courses equip student teachers to teach functions at secondary school level. This paper reports on an investigation that was conducted in an African university, where preservice teachers were purposefully selected for participation in individual semi-structured interviews after completing a test on functions as taught at secondary school. They were asked to justify their reasoning in the test and to explain functions in a way that might bring about understanding of the topic in someone who did not know how functions work. These were final year preservice mathematics teachers who had studied advanced mathematics courses for three years. More than 50% of the students were not able to explain concepts or to justify their reasoning about secondary school functions in a coherent way. The results of this study suggest that the study of advanced mathematics does not automatically enable students to teach secondary school functions, and that, although these students were able to do advanced mathematics, they were unable to explain the working of functions in a way that would allow them to teach this topic successfully.

Keywords: secondary school, mathematical reasoning, student-teachers, functions

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Authors: Johannes Gantner, Michael Held, Matthias Fischer

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The refurbishment of the building stock in terms of energy supply and efficiency is one of the major challenges of the German turnaround in energy policy. As the building sector accounts for 40% of Germany’s total energy demand, additional insulation is key for energy efficient refurbished buildings. Nevertheless the energetic benefits often the environmental and economic performances of insulation materials are questioned. The methods Life Cycle Assessment (LCA) as well as Life Cycle Costing (LCC) can form the standardized basis for answering this doubts and more and more become important for material producers due efforts such as Product Environmental Footprint (PEF) or Environmental Product Declarations (EPD). Due to increasing use of LCA and LCC information for decision support the robustness and resilience of the results become crucial especially for support of decision and policy makers. LCA and LCC results are based on respective models which depend on technical parameters like efficiencies, material and energy demand, product output, etc.. Nevertheless, the influence of parameter uncertainties on lifecycle results are usually not considered or just studied superficially. Anyhow the effect of parameter uncertainties cannot be neglected. Based on the example of an exterior wall the overall lifecycle results are varying by a magnitude of more than three. As a result simple best case worst case analyses used in practice are not sufficient. These analyses allow for a first rude view on the results but are not taking effects into account such as error propagation. Thereby LCA practitioners cannot provide further guidance for decision makers. Probabilistic analyses enable LCA practitioners to gain deeper understanding of the LCA and LCC results and provide a better decision support. Within this study, the environmental and economic impacts of an exterior wall system over its whole lifecycle are illustrated, and the effect of different uncertainty analysis on the interpretation in terms of resilience and robustness are shown. Hereby the approaches of error propagation and Monte Carlo Simulations are applied and combined with statistical methods in order to allow for a deeper understanding and interpretation. All in all this study emphasis the need for a deeper and more detailed probabilistic evaluation based on statistical methods. Just by this, misleading interpretations can be avoided, and the results can be used for resilient and robust decisions.

Keywords: uncertainty, life cycle assessment, life cycle costing, Monte Carlo simulation

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Authors: Jan C. Droste, Justine Burns, Nithin Narayan

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Introduction: Life-threatening detrimental effects of inappropriate adrenaline (epinephrine) administration, e.g., by giving the wrong dose, in the context of anaphylaxis management is well documented in the medical literature. Half of the fatal anaphylactic reactions in the UK are iatrogenic, and the median time to a cardio-respiratory arrest can be as short as 5 minutes. It is therefore imperative that hospital doctors of all grades have active and accurate knowledge of the correct route, site, and dosage of administration of adrenaline. Given this time constraint and the potential fatal outcome with inappropriate management of anaphylaxis, it is alarming that surveys over the last 15 years have repeatedly shown only a minority of doctors to have accurate knowledge of adrenaline administration as recommended by the UK Resuscitation Council guidelines (2008 updated 2012). This comparison of survey results of the medical workforce over several years in a small NHS District General Hospital was conducted in order to establish the effect of the employment of multiple educational methods regarding adrenaline administration in anaphylaxis in adults. Methods: Between 2010 and 2017, several education methods and tools were used to repeatedly inform the medical workforce (doctors and advanced clinical practitioners) in a single district general hospital regarding the treatment of anaphylaxis in adults. Whilst the senior staff remained largely the same cohort, junior staff had changed fully in every survey. Examples included: (i) Formal teaching -in Grand Rounds; during the junior doctors’ induction process; advanced life support courses (ii) In-situ simulation training performed by the clinical skills simulation team –several ad hoc sessions and one 3-day event in 2017 visiting 16 separate clinical areas performing an acute anaphylaxis scenario using actors- around 100 individuals from multi-disciplinary teams were involved (iii) Hospital-wide distribution of the simulation event via the Trust’s Simulation Newsletter (iv) Laminated algorithms were attached to the 'crash trolleys' (v) A short email 'alert' was sent to all medical staff 3 weeks prior to the survey detailing the emergency treatment of anaphylaxis (vi) In addition, the performance of the surveys themselves represented a teaching opportunity when gaps in knowledge could be addressed. Face to face surveys were carried out in 2010 ('pre-intervention), 2015, and 2017, in the latter two occasions including advanced clinical practitioners (ACP). All surveys consisted of convenience samples. If verbal consent to conduct the survey was obtained, the medical practitioners' answers were recorded immediately on a data collection sheet. Results: There was a sustained improvement in the knowledge of the medical workforce from 2010 to 2017: Answers improved regarding correct drug by 11% (84%, 95%, and 95%); the correct route by 20% (76%, 90%, and 96%); correct site by 40% (43%, 83%, and 83%) and the correct dose by 45% (27%, 54%, and 72%). Overall, knowledge of all components -correct drug, route, site, and dose-improved from 13% in 2010 to 62% in 2017. Conclusion: This survey comparison shows knowledge of the medical workforce regarding adrenaline administration for treatment of anaphylaxis in adults can be considerably improved by employing a variety of educational methods.

Keywords: adrenaline, anaphylaxis, epinephrine, medical education, patient safety

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Authors: Mette Kjerholt, Thora Grothe Thomsen, Connie Bøttcher Berthelsen, Bibi Hølge Hazelton

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Academic nursing is a relatively new phenomenon in Denmark. Leadership and management training in nursing does not prepare Danish nurse leaders to become leaders for nurses with academic background, and some leaders may feel estranged with including this kind of nursing staff in clinical settings. Currently there is a debate regarding what academic nurses can contribute with in clinical practice, and some managers express concern regarding whether this will lead to less focus on clinical practice and more focus on theoretical issues that may not seem so relevant in a busy everyday clinical setting. The paper will present the experiences of integrating three advanced nurse practitioners with Ph.D. degrees (ANP) in three different clinical departments at a regional hospital in Denmark with no prior experiences with such profiles among its staff.

Keywords: leadership, advanced nurse practitioners, clinical practice, academic nursing

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