Search results for: Pediatric intensive care unit

Authors: Merve Aygün Esastürk, Deren Ataç Yılmaz, Görkem Oğur, Emre Özgen Kuzu, Sadık Ödemiş

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Hydrocracker plants are one of the most complicated and most profitable units in the refinery process. It takes long chain paraffinic hydrocarbons as feed and turns them into smaller and more valuable products, mainly kerosene and diesel under high pressure with the excess amount of hydrogen. Controlling the product qualities well directly contributes to the unit profit. Control of a plant is mainly based on PID and MPC controllers. Controlling the reaction section is important in terms of reaction severity. However, controlling the fractionation section is more crucial since the end products are separated in fractionation section. In this paper, the importance of well-configured base layer control mechanism, composed of PID controllers, is highlighted. For this purpose, two different base layer control scheme is applied in a hydrocracker fractionator column performances of schemes, which is a direct contribution to better product quality, are compared.

Keywords: controller, distillation, configuration selection, hydrocracker, model predictive controller, proportional-integral-derivative controller

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Authors: Moizza Tahir, Uzma Bashir, Aisha Akhtar, Zainab Ansari, Sameen Ansari, Muhammad Ali Tahir

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Cancer burden has globally increased. Among cutaneous cancers basal cell carcinoma constitute vast majority of skin cancer. There is need for appropriate diagnostic, therapeutic and prognostic significance evaluation for skin cancers Present study report intraoperative frozen section (FS) histopathological clearance for excision of BCC in a tertiary care center and find the frequency of involvement of surgical margin with reference to anatomical site, with size and surgical technique. It was prospective open label interventional study conducted at Dermatology department of tertiary care hospital Rawalpindi Pakistan in lais on with histopathology department from January 2023 to April 2024. Total of thirty-six (n = 36) patients between age 45-80 years with basal cell carcinoma of 10-20mm on face were included following inclusion exclusion criteria by purposive sampling technique. Informed consent was taken. Surgical excision was performed and intraoperative frozen section histopathology clearance of tumor margin was taken from histopathologist on telephone. Surgical reconstruction was done. Final Histopathology report was reexamined on day 10th for margin and depth clearance. Descriptive statistics were calculated for age, gender, sun exposure, reconstructive technique, anatomical site, and tumor free margin report on frozen section analysis. Chi square test was employed for statistical significance of involvement of surgical margin with reference to anatomical site, size and decision on reconstructive surgical technique, p value of <0.05 was considered significant. Total of 36 patients of BCC were enrolled, males 12 (33.3%) and females were 24 (66.6%). Age ranged from 45 year to 80 year mean of 58.36 ±SD7.8. Size of BCC ranged from 10mm to 35mm mean of 25mm ±SD 0.63. Morphology was nodular 18 (50%), superficial spreading 11(30.6%), morphoeic 1 (2.8%) and ulcerative in 6(16.7%) cases. Intraoperative frozen section for histopathological margin clearance with 2-3 mm safety margin and surgical technique has p-value0.51, for anatomical site p value 0.24 and size p-0.84. Intraoperative frozen section (FS) histopathological clearance for BCC face with 2-3mm safety margin with reference to reconstructive technique, anatomical site and size of BCC were insignificant.

Keywords: basal cell carcinoma, tumor free amrgin, basal cell carcinoma and frozen section, safety margin

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Authors: Pippa Sipanoun, Jo Wray, Kate Oulton, Faith Gibson

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Background: With rapidly evolving digital health innovation, there is a need for digital health transformation that is accessible and sustainable, that demonstrates utility for all stakeholders while maintaining data safety. Great Ormond Street Hospital for Children aimed to future-proof the hospital by transitioning to an electronic patient record (EPR) system with a tethered patient portal (MyGOSH) in April 2019. MyGOSH patient portal enables patients 12 years or older (with their parent's consent) to access their digital health data. This includes access to results, documentation, and appointments that facilitate communication with their care team. As part of the Going Digital Study conducted between 2018-2021, data were collected from a sample of all relevant stakeholders before and after EPR and MyGOSH implementation. Data collection reach was wide and included the hospital legal and ethics teams. Aims: This study aims to understand the ethical and legal implications of young people and their parents accessing their digital health data. Methods: A focus group was conducted. Recruited participants were members of the Great Ormond Street Hospital Paediatric Bioethics Centre. Participants included expert and lay members from the Committee from a variety of professional or academic disciplines. Written informed consent was provided by all participants (n=7). The focus group was recorded, transcribed verbatim, and analyzed using thematic analysis. Results: Six themes were identified: access, competence and capacity - granting access to the system; inequalities in access resulting in inequities; burden, uncertainty and responding to change - managing expectations; documenting, risks and data safety; engagement, empowerment and understanding – how to use and manage personal information; legal considerations and obligations. Discussion: If healthcare professionals are to empower young people to be more engaged in their care, the importance of including them in decisions about their health is paramount, especially when they are approaching the age of becoming the consenter for treatment. Complexities exist in assessing competence or capacity when granting system access, when disclosing sensitive information, and maintaining confidentiality. Difficulties are also present in managing clinician burden, managing user expectations whilst providing an equitable service, and data management that meets professional and legal requirements. Conclusion: EPR and tethered-portal implementation at Great Ormond Street Hospital for Children was not only timely, due to the need for a rapid transition to remote consultations during the COVID-19 pandemic, which would not have been possible had EPR/MyGOSH not been implemented, but also integral to the digital health revolution required in healthcare today. This study is highly relevant in understanding the complexities around young people and their parents accessing their digital health data and, although the focus of this research related to portal use and access, the findings translate to young people in the wider digital health context. Ongoing support is required for all relevant stakeholders following MyGOSH patient portal implementation to navigate the ethical and legal complexities. Continued commitment is needed to balance the benefits and burdens, promote inclusion and equity, and ensure portal utility for patient benefit, whilst maintaining an individualized approach to care.

Keywords: patient portal, young people and their parents, ethical, legal

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Authors: Oveis Abedinia, Noradin Ghadimi, Nasser Mikaeilvand, Roza Poursoleiman, Asghar Poorfaraj

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In this paper a robust Fuzzy Proportional Integral Differential (PID) controller is applied to multi-machine power system based on Modified Shuffled Frog Leaping (MSFL) algorithm. This newly proposed controller is more efficient because it copes with oscillations and different operating points. In this strategy the gains of the PID controller is optimized using the proposed technique. The nonlinear problem is formulated as an optimization problem for wide ranges of operating conditions using the MSFL algorithm. The simulation results demonstrate the effectiveness, good robustness and validity of the proposed method through some performance indices such as ITAE and FD under wide ranges operating conditions in comparison with TS and GSA techniques. The single-machine infinite bus system and New England 10-unit 39-bus standard power system are employed to illustrate the performance of the proposed method.

Keywords: fuzzy PID, MSFL, multi-machine, low frequency oscillation

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Authors: Qiming Wang

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Dynamic polymer networks (DPNs) crosslinked by dynamic bonds have received intensive attention because of their special crack-healing capability. Diverse DPNs have been synthesized using a number of dynamic bonds, including dynamic covalent bond, hydrogen bond, ionic bond, metal-ligand coordination, hydrophobic interaction, and others. Despite the promising success in the polymer synthesis, the fundamental understanding of their self-healing mechanics is still at the very beginning. Especially, a general analytical model to understand the interfacial self-healing behaviors of DPNs has not been established. Here, we develop polymer-network based analytical theories that can mechanistically model the constitutive behaviors and interfacial self-healing behaviors of DPNs. We consider that the DPN is composed of interpenetrating networks crosslinked by dynamic bonds. bonds obey a force-dependent chemical kinetics. During the self-healing process, we consider the The network chains follow inhomogeneous chain-length distributions and the dynamic polymer chains diffuse across the interface to reform the dynamic bonds, being modeled by a diffusion-reaction theory. The theories can predict the stress-stretch behaviors of original and self-healed DPNs, as well as the healing strength in a function of healing time. We show that the theoretically predicted healing behaviors can consistently match the documented experimental results of DPNs with various dynamic bonds, including dynamic covalent bonds (diarylbibenzofuranone and olefin metathesis), hydrogen bonds, and ionic bonds. We expect our model to be a powerful tool for the self-healing community to invent, design, understand, and optimize self-healing DPNs with various dynamic bonds.

Keywords: self-healing polymers, dynamic covalent bonds, hydrogen bonds, ionic bonds

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Authors: J. Stejskal, P. Hajek

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The goal of this article is the analysis of knowledge transfer at the regional level of the Czech Republic. We show how goals of enterprises´ innovative activities are related to the rate of cooperation with different actors within regional innovative systems as well as in other world regions. The results show that the most important partners of enterprises are their suppliers and clients in most Czech regions. The cooperation rate of enterprises correlates significantly mainly with enterprises´ efforts to enter new markets and reduce labour costs per unit output. The meaning of this cooperation decreases with the increase of partner’s distance. Regarding the type of a cooperating partner, cooperation within an enterprise had to do with the increase of market share and decrease of labour costs. On the other hand, cooperation with clients had to do with efforts to replace outdated products or processes or enter new markets. We can pay less attention to the cooperation with government authorities and organizations. The reasons for marginalization of this cooperation should be submitted to further detailed investigation.

Keywords: knowledge, transfer, innovative process, Czech republic, region

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Authors: Sadeq Al Yaari, Fayza Al Hammadi, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari, Salah Al Yami

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Background: When we further take Arabic grammatical issues into account in accordance with applied linguistic investigations on Arabic as Second Language (ASL) learners, a fundamental issue arises at this point as to the production of speech in Arabic: Oral grammatical errors committed by ASL learners. Aims: Using manual rating as well as computational analytic methodology to test a corpus of recorded speech by Second Language (ASL) learners of Arabic, this study aims to find the areas of difficulties in learning Arabic grammar. More specifically, it examines how and why ASL learners make grammatical errors in their oral speech. Methods: Tape recordings of four (4) Arabic as Second Language (ASL) learners who ranged in age from 23 to 30 were naturally collected. All participants have completed an intensive Arabic program (two years) and 20 minute-speech was recorded for each participant. Having the collected corpus, the next procedure was to rate them against Arabic standard grammar. The rating includes four processes: Description, analysis and assessment. Conclusions: Outcomes made from the issues addressed in this paper can be summarized in the fact that ASL learners face many grammatical difficulties when studying Arabic word order, tenses and aspects, function words, subject-verb agreement, verb form, active-passive voice, global and local errors, processes-based errors including addition, omission, substitution or a combination of any of them.

Keywords: grammar, error, oral, Arabic, second language, learner, applied linguistics.

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Authors: Sandeep K. Shukla, Roli Jain, Soumitra S. Pande, Archna Pandey

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Sulfur nanoparticles were prepared by different methods with different sizes and shapes. When the sulfur is present as nanoparticles they have many practical applications in our life. This research discusses sulfur nanoparticles synthesis, characterizations and applications. With dandruff being a common everyday problem and the market is loaded with antidandruff shampoos and such skin care products, it is obvious to assume resourceful research into this area would be both objective to present scenario and potentially lucrative. Nanoparticles are frequently in use in some very powerful antimicrobial, antifungal cosmetics nowadays, especially silver. To check its antidandruff activity, experiments have been conducted on Malassezia furfur the causal organism for seborrheaic dermatitis or dandruff, which have been cultured for such study in our lab.

Keywords: CTAB surfactant SEM, sulfur nanoparticles (S-NPs), XRD, polymeric surfactant

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Authors: Casey Kane

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Burnout is a pervasive challenge among board-certified behavior analysts (BCBAs) working with individuals with developmental disabilities. Addressing burnout is essential for maintaining the well-being of practitioners and the quality of care provided to clients. Developing effective strategies and interventions to mitigate burnout is imperative. This paper offers a comprehensive review of the history of burnout, examines current research within applied behavior analysis (ABA), and explores existing theories and factors contributing to burnout among BCBAs. The necessity of addressing burnout through targeted interventions, including self-advocacy strategies, will be highlighted to emphasize the importance of supporting BCBAs in their professional roles.

Keywords: burnout, applied behavior analysis, board-certified behavior analysts, self-advocacy

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Authors: Soumitr Sanjay Dubey, Shubhajit Roy Chowdhury, Rahul Shrestha

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In this paper, we have presented a novel approach of calculating eigenvalues of any matrix for the first time on Field Programmable Gate Array (FPGA) using Triangular Systolic Arra (TSA) architecture. Conventionally, additional computation unit is required in the architecture which is compliant to the algorithm for determining the eigenvalues and this in return enhances the delay and power consumption. However, recently reported works are only dedicated for symmetric matrices or some specific case of matrix. This works presents an architecture to calculate eigenvalues of any matrix based on QR algorithm which is fully implementable on FPGA. For the implementation of QR algorithm we have used TSA architecture, which is further utilising CORDIC (CO-ordinate Rotation DIgital Computer) algorithm, to calculate various trigonometric and arithmetic functions involved in the procedure. The proposed architecture gives an error in the range of 10−4. Power consumption by the design is 0.598W. It can work at the frequency of 900 MHz.

Keywords: coordinate rotation digital computer, three angle complex rotation, triangular systolic array, QR algorithm

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Authors: Lori Lioce, Gary Maddux, Norven Goddard, Ishella Fogle, Bernard Schroer

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This paper presents the integration of technologies into nursing education. The collaborative effort includes the College of Nursing (CoN) at the University of Alabama in Huntsville (UAH) and the UAH Systems Management and Production Center (SMAP). The faculty at the CoN conducts needs assessments to identify education and training requirements. A team of CoN faculty and SMAP engineers then prioritize these requirements and establish improvement/development teams. The development teams consist of nurses to evaluate the models and to provide feedback and of undergraduate engineering students and their senior staff mentors from SMAP. The SMAP engineering staff develops and creates the physical models using 3D printing, silicone molds and specialized molding mixtures and techniques. The collaboration has focused on developing teaching and training, or clinical, simulators. In addition, the onset of the Covid-19 pandemic has intensified this relationship, as 3D modeling shifted to supplied personal protection equipment (PPE) to local health care providers. A secondary collaboration has been introducing students to clinical benchmarking through the UAH Center for Management and Economic Research. As a result of these successful collaborations the Model Exchange & Development of Nursing & Engineering Technology (MEDNET) has been established. MEDNET seeks to extend and expand the linkage between engineering and nursing to K-12 schools, technical schools and medical facilities in the region to the resources available from the CoN and SMAP. As an example, stereolithography (STL) files of the 3D printed models, along with the specifications to fabricate models, are available on the MEDNET website. Ten 3D printed models have been developed and are currently in use by the CoN. The following additional training simulators are currently under development:1) suture pads, 2) gelatin wound models and 3) printed wound tattoos. Specification sheets have been written for these simulations that describe the use, fabrication procedures and parts list. These specifications are available for viewing and download on MEDNET. Included in this paper are 1) descriptions of CoN, SMAP and MEDNET, 2) collaborative process used in product improvement/development, 3) 3D printed models of training and teaching simulators, 4) training simulators under development with specification sheets, 5) family care practice benchmarking, 6) integrating the simulators into the nursing curriculum, 7) utilizing MEDNET as a pandemic response, and 8) conclusions and lessons learned.

Keywords: 3D printing, nursing education, simulation, trainers

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Authors: Hakan Akin

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The aim of this study was to examine the policy making process in Turkish Health System. This policy making process will be examined through public policy change theories. Since political actors played in the formulation of public policies also explains the type of policy change, this actors will be inspected in the supranational and national basis. Also the transformation of public policy in the Turkish health care system will be analysed under the concepts of New right ideology, neo-liberalism, neo-conservatism and governance. And after this analyse, the outputs and outcomes of this transformation will be discussed in the context of developing countries.

Keywords: policy transfer, policy diffusion, policy convergence, new right, governance

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Authors: Yemane Tadesse Gebreslassie, Henok Gidey Gebretnsae

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Nanotechnology has emerged as a highly promising field of research with wide-ranging applications across various scientific disciplines. In recent years, tin oxide has garnered significant attention due to its intriguing properties, particularly when synthesized in the nanoscale range. While numerous physical and chemical methods exist for producing tin oxide nanoparticles, these approaches tend to be costly, energy-intensive, and involve the use of toxic chemicals. Given the growing concerns regarding human health and environmental impact, there has been a shift towards developing cost-effective and environmentally friendly processes for tin oxide nanoparticle synthesis. Green synthesis methods utilizing biological entities such as plant extracts, bacteria, and natural biomolecules have shown promise in successfully producing tin oxide nanoparticles. However, scaling up the production to an industrial level using green synthesis approaches remains challenging due to the complexity of biological substrates, which hinders the elucidation of reaction mechanisms and formation processes. Thus, this review aims to provide an overview of the various sources of biological entities and methodologies employed in the green synthesis of tin oxide nanoparticles, as well as their impact on nanoparticle properties. Furthermore, this research delves into the strides made in comprehending the mechanisms behind the formation of nanoparticles as documented in existing literature. It also sheds light on the array of analytical techniques employed to investigate and elucidate the characteristics of these minuscule particles.

Keywords: nanotechnology, tin oxide, green synthesis, formation mechanisms

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Authors: Danila Merino, Leandro N. Ludueña, Vera A. Alvarez

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Clays are commonly used to reinforce polymeric materials. In order to modify them, long-chain quaternary-alkylammonium salts have been widely employed. However, the application of these clays in biological fields is limited by the toxicity and poor biocompatibility presented by these modifiers. Meanwhile, soy lecithin, acts as a natural biosurfactant and environment-friendly biomodifier. In this report, we analyse the effect of content of soy lecithin-modified bentonite on the properties of polycaprolactone (PCL) nanocomposites. Commercial grade PCL (CAPA FB 100) was supplied by Perstorp, with Mw = 100000 g/mol. Minarmco S.A. and Melar S.A supplied bentonite and soy lecithin, respectively. Clays with 18, 30 and 45 wt% of organic content were prepared by exchanging 4 g of Na-Bent with 1, 2 and 4 g of soy lecithin aqueous and acid solution (pH=1, with HCl) at 75ºC for 2 h. Then, they were washed and lyophilized for 72 h. Samples were labeled A, B and C. Nanocomposites with 1 and 2 wt.% of each clay were prepared by melt-intercalation followed by compression-moulding. An intensive Brabender type mixer with two counter-rotating roller rotors was used. Mixing temperature was 100 ºC; speed of rotation was 100 rpm. and mixing time was 10 min. Compression moulding was carried out in a hydraulic press under 75 Kg/mm2 for 10 minutes at 100 ºC. The thickness of the samples was about 1 mm. Thermal and mechanical properties were analysed. PCL nanocomposites with 1 and 2% of B presented the best mechanical properties. It was observed that an excessive organic content produced an increment on the rigidity of PCL, but caused a detrimental effect on the tensile strength and elongation at break of the nanocomposites. Thermogravimetrical analyses suggest that all reinforced samples have higher resistance to degradation than neat PCL.

Keywords: chemical modification, clay, nanocomposite, characterization

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Authors: Min Zhou, Kaixuan Lin, Yaping Huang

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In this paper, the industrial space of metropolitan area in Wuhan is taken as a sample. First of all, it puts forward that the structure of service economy, circle gradient relocation and high degree of regional collaboration are the rules of industrial spatial development in the modern world cities. Secondly, using the economic statistics and land use vector data (1993, 2004, 2010, and 2013) of Wuhan, it analyzes the present situation of industry development and the characteristics of industrial space layout from three aspects of the industrial economic structure, industrial layout, and industrial regional synergy. Then, based on the industrial development regularity of world cities, it puts forward to construct the industrial spatial level of ‘complex industrial concentration area + modular industry unit’ and the industrial spatial structure of ‘13525’. Finally, it comes up with the optimization tactics of the industrial space’s transformation in the future under the background of new economic era.

Keywords: big city of metropolitan area, industrial space, characteristics, layout, strategy

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Authors: Kwangho Lee, Joongmyeon Bae

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Fuel cells are spotlighted in the world for being highly efficient and environmentally friendly. A hydrogen fuel for a fuel cell is obtained from a number of sources. Most of fuel cell for APU(Auxiliary power unit) system using diesel fuel as a hydrogen source. Diesel fuel has many advantages, such as high hydrogen storage density, easy to transport and also well-infra structure. However, conventional diesel reforming system for PEMFC(Proton exchange membrane fuel cell) requires a large volume and complex CO removal system for the lower the CO level to less than 10ppm. In addition, the PROX(Preferential Oxidation) reaction cooling load is needed because of the strong exothermic reaction. However, the hydrogen separation membrane that we propose can be eliminated many disadvantages, because the volume is small and permeates only pure hydrogen. In this study, we were conducted to the pressurized diesel reforming and water-gas shift reaction experiment for the hydrogen permeable membrane application.

Keywords: hydrogen, diesel, reforming, ATR, WGS, PROX, membrane, pressure

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Authors: Rahmat Purwoko, Bambang Riyanto Trilaksono

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This paper gives comparison of INS/GNSS architecture namely Loosely Coupled and Tightly Coupled using Hardware in the Loop Simulation in Guided Missile RKX-200 rocket model. INS/GNSS Tightly Coupled architecture requires pseudo-range, pseudo-range rate, and position and velocity of each satellite in constellation from GPS (Global Positioning System) measurement. The Loosely Coupled architecture use estimated position and velocity from GNSS receiver. INS/GNSS architecture also requires angular rate and specific force measurement from IMU (Inertial Measurement Unit). Loosely Coupled arhitecture designed using 15 states Kalman Filter and Tightly Coupled designed using 17 states Kalman Filter. Integration algorithm calculation using ECEF frame. Navigation System implemented Zedboard All Programmable SoC.

Keywords: kalman filter, loosely coupled, navigation system, tightly coupled

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Authors: Hattie Hope Makumbe, Bhekisisa Dlamini, Frederick Tabit

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Listeria monocytogenes is one of the most important foodborne pathogens associated with ready-to-eat (RTE) food. This study investigated the incidence of Listeria monocytogenes in 80 RTE food sold in the formal (dairy and processed meat) and informal markets (vegetable salads, beef stew, and rice) of Johannesburg, South Africa. High Enterobacteriaceae, S. aureus, and E. coli counts were obtained, which ranged from 1.9-7.5 log CFU/g. Listeria monocytogenes microbial counts in the food samples ranged from 3.5-6.0 log colony forming unit per gram except in cooked rice. The Listeria monocytogenes isolates were identified using biochemical tests and confirmed with the Biolog identification system and PCR analyses. The percentage incidence for Listeria monocytogenes in ready to eat food was 12.5%. When Minimum Inhibitory Concentrations were under consideration, all disinfectants were effective against Listeria monocytogenes strains. For antimicrobial work, rates of resistance amongst the antibiotics ranged from 17-100%. Therefore, more effective preventive control strategies for Listeria monocytogenes are needed to reduce the prevalence of the pathogen in RTE food that is sold in Johannesburg.

Keywords: Listeria monocytogenes, Listeria species, ready to eat food, sanitiser efficacy

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Authors: Jihene Jlassi, Ahmed Frikha, Wazna Kortli

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The objectives of Nurse-Patient Assignment are the minimization of the overall hospital cost and the maximization of nurses ‘preferences. This paper aims to assess nurses' satisfaction related to the implementation of patient acuity tool-based assignments. So, we used an integer linear program that assigns patients to nurses while balancing nurse workloads. Then, the proposed model is applied to the Paediatrics Department at Kasserine Hospital Tunisia. Where patients need special acuities and high-level nursing skills and care. Hence, numerical results suggested that proposed nurse-patient assignment models can achieve a balanced assignment

Keywords: nurse-patient assignment, mathematical model, logistics, pediatrics department, balanced assignment

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Authors: David Glassmeyer

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Quantitative reasoning is necessary to robustly understand mathematical concepts ranging from elementary to university levels. Quantitative reasoning involves identifying and representing quantities and the relationships between these quantities. Without reasoning quantitatively, students often resort to memorizing formulas and procedures, which have negative impacts when they encounter mathematical topics in the future. This study investigated how high school students’ quantitative reasoning could be fostered within a unit on arc measure and angle relationships. Arc measure, or the measure of a central angle that cuts off a portion of a circle’s circumference, is often confused with arclength. In this study, the researcher redesigned an activity to clearly distinguish arc measure and arc length by using a quantitative reasoning framework. Data were collected from high school students to determine if this approach impacted their understanding of these concepts. Initial data indicates the approach was successful in supporting students’ quantitative reasoning of these topics. Implications for the work are that teachers themselves may also benefit from considering mathematical definitions from a quantitative reasoning framework and can use this activity in their own classrooms.

Keywords: arc length, arc measure, quantitative reasoning, student content knowledge

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Authors: Suzanne L. Stewart, Sarah J. Ponton, Mikaela D. Gabriel, Roy Strebel, Xinyi Lu

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Indigenous Peoples have faced unique barriers to accessing and receiving culturally safe and appropriate mental health care while also facing daunting rates of mental health diagnoses and comorbidities. Indigenous researchers and clinicians have well established the connection of the current mental health issues in Indigenous communities as a direct result of colonization by way of intergenerational trauma throughout Canada’s colonial history. Such mental health barriers and challenges have become exacerbated during the COVID-19 pandemic. Throughout the pandemic, access to mental health, cultural, ceremonial, and community services were severely impacted and restricted; however, it is these same cultural activities and community resources that are key to supporting Indigenous mental health from a traditional and community-based perspective. This research employed a unique combination of a thorough, analytical scoping review of the existent mental health literature of Indigenous mental health in the COVID-19 pandemic, alongside narrative interviews employing an oral storytelling tradition methodology with key community informants that provide comprehensive cultural services to the Indigenous community of Toronto, as well as across Canada. These key informant interviews provided a wealth of insights into virtual transitions of Indigenous care and mental health support; intersections of historical underfunding and current financial navigation in technology infrastructure; accessibility and connection with Indigenous youth in remote locations; as well as maintaining community involvement and traditional practices in a current pandemic. Both the scoping review and narrative interviews were meticulously analyzed for overarching narrative themes to best explore the extent of the literature on Indigenous mental health and services during COVID-19; identify gaps in this literature; identify barriers and supports for the Indigenous community, and explore the intersection of community and cultural impacts to mental health. Themes of the scoping review included: Historical Context; Challenges in Culturally-Based Services; and Strengths in Culturally-Based Services. Meta themes across narrative interviews included: Virtual Transitions; Financial Support for Indigenous Services; Health Service Delivery & Wellbeing; and Culture & Community Connection. The results of this scoping review and narrative interviews provide wide application and contribution to the mental health literature, as well as recommendations for policy, service provision, autonomy in Indigenous health and wellbeing, and crucial insights into the present and enduring mental health needs of Indigenous Peoples throughout the COVID-19 pandemic.

Keywords: indigenous community services, indigenous mental health, indigenous scoping review, indigenous peoples and Covid-19

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Authors: Dae Kyung Choi, Won Man Park, Kyungsoo Kim, Yoon Hyuk Kim

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The interspinous process devices have been recently used due to its advantages such as minimal invasiveness and less subsidence of the implant to the osteoporotic bone. In this paper, we have analyzed the influences of ligature tightening of several interspinous process devices using finite element analysis. Four types of interspinous process implants were inserted to the L3-4 spinal motion segment based on their surgical protocols. Inferior plane of L4 vertebra was fixed and 7.5 Nm of extension moment were applied on superior plane of L3 vertebra with 400N of compressive load along follower load direction and pretension of the ligature. The stability of the spinal unit was high enough than that of intact model. The higher value of pretension in the ligature led the decrease of dynamic stabilization effect in cases of the WallisTM, DiamTM, Viking, and Spear®. The results of present study could be used to evaluate surgical option and validate the biomechanical characteristics of the spinal implants.

Keywords: interspinous process device, bone fracture risk, lumbar spine, finite element analysis

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Authors: Reza Mehrafarin, Nafiseh Mirshekari

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The Sistan plain has always been a site for the settlement of various human societies, thanks to its favorable environmental conditions, such as abundant water from the Hirmand River and fertile sedimentary soil. Consequently, there was a need for a systematic archaeological investigation in the area. The survey had multiple objectives, with the most significant ones being the creation of an archaeological map and the identification and documentation of all ancient sites to establish their records and chronology. The survey was carried out in two phases, with each phase covering half of the area. The research method involved fieldwork, with two teams of professional archaeologists conducting a comprehensive survey of each of the 22 areas in Sistan. Once an area was identified, various recording, scientific, and field operations were executed to study the site. In the first phase (2007), an intensive field survey focused on the residential area of Sistan, including its northern and eastern regions. This phase resulted in the identification of 808 sites in eleven selected areas. In the second phase (2009), the desert area of Sistan, or its southern half, was surveyed, leading to the identification of approximately 853 sites. Overall, these surveys resulted in the identification of 1661 sites in Sistan. Among these sites, approximately 899 belong to the Bronze Age (late 4th millennium BCE to early 2nd millennium BCE). Of these sites, around 501 date back to the historical period, while nearly 590 sites pertain to the Islamic period. The archaeological investigations of both phases revealed that Sistan has consistently possessed fertile soil, abundant water, and a skilled workforce, making it capable of becoming Iran's granary and the center of the East once again if these conditions are restored.

Keywords: sistan, field surveys, archaeology, archaeological map

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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Authors: Michelle Themalil, Celia Bueno, Rulla Al- Araji

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Objective and Study: There are no established guidelines for antibiotic prophylaxis in children with central venous catheters (CVCs) on home parenteral nutrition (HPN), leading to varying practices across UK Centres. We hypothesize that children with intestinal failure are at increased risk for bacteraemia due to altered anatomy, dysmotility, inflammation, biofilm formation in long-term CVCs, and the use of central lines during procedures. Given the bacteraemia rates of up to 8% in upper and 25% in lower endoscopy for adults without central lines, we argue that prophylactic antibiotics are reasonable, given the increased risks faced by this high-risk group of children. Methods: We conducted a five-year review of patients with central venous access receiving home parenteral nutrition (HPN) who underwent endoscopies with antibiotic prophylaxis at our center (tertiary). We documented and analyzed post-procedure infections and their associated risk factors. Results: A total of 15 patients on HPN underwent 29 endoscopic procedures, including 4 upper, 9 combined upper and lower, and 16 combined upper, lower, and ileoscopy. Confirmed infection rates remained at 0% up to 28 days post-procedure. The agreed-upon prophylaxis regimen was implemented, with ciprofloxacin and metronidazole administered as the primary antibiotics. Notably, only 51.7% of patients received a peripheral cannula despite recommendations to avoid central line use during anesthesia, and 20.6% had small intestinal bacterial overgrowth. Conclusions: This study is the first to investigate post-endoscopy infection rates in pediatric patients on HPN. Despite a small sample size, we observed a 0% infection rate, significantly lower than reported rates in adults. These findings suggest that further research is warranted to explore the implications of antibiotic prophylaxis in this unique patient cohort and to establish guidelines that may enhance patient safety during endoscopic procedures.

Keywords: post endosopy infections, central venous access, home parenteral nutrition, intestinal failure

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Authors: Shantol McIntosh

Abstract:

Due to environmental and underlying health disparities, the COVID-19 pandemic has caused an added set of economic implications worldwide. Black and Hispanic individuals are more susceptible to contract COVID-19, and if they do, they are more likely to have a severe case that necessitates hospitalization or results in death (Altarum et al., 2020). The literature shows that disparities in health and health treatment are nothing new as they have been recorded for decades and indicate systemic and structural imbalances rooted in racism and discrimination. The purpose of this study is to determine the frequency with which these populations have access to healthcare and treatment. The study will also highlight the key drivers of health disparities. Findings and implications for research and policy will be discussed.

Keywords: COVID-19, racial and ethnic disparities, discrimination, policy

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Authors: Erwin, Cheng-Cheng Chen, Charles J. Salim

Abstract:

One of the method to solve the lateral torsional buckling (LTB) problem is by using side plates to increased the buckling resistance of the beam. Some modifications in designing the side plates are made in this study to simplify the construction in the field and reduce the cost. At certain region, side plates are not added: (1) At the beam end to preserve some spaces for bolt installation, but the beam is strengthened by adding cover plate at both flanges and (2) at the middle span of the beam where the moment is smaller. Three small scale full span beam specimens are tested under cyclic loading to investigate the LTB resistant and the ductility of the proposed design method. Test results show that the LTB deformation can be effectively suppressed and very high ductility level can be achieved. Following the test, a finite element analysis (FEA) model is established and is verified using the test results. An intensive parametric study is conducted using the established FEA model. The analysis reveals that the length of side plates is the most important parameter determining the performance of the beam and the required side plates length is determined by some parameters which are (1) beam depth to flange width ratio, (2) beam slenderness ratio (3) strength and thickness of the side plates, (4) compactness of beam web and flange, and (5) beam yield strength. At the end of the paper, a design formula to calculate the required side plate length is suggested.

Keywords: cover plate, earthquake resistant design, lateral torsional buckling, side plate, steel structure

Procedia PDF Downloads 177

Authors: Anne Hovgaard Jorgensen

Abstract:

This study investigates how Muslim fathers in Denmark are struggling to overcome notions of mistrust from teachers and educators. Starting from school-home-cooperation (parent conferences, school-home communication, etc.), the study finds that many Muslim fathers do not feel acknowledged as a resource in the upbringing of their children. To explain these experiences further, the study suggest the notion of ‘mistrusted masculinity’ to grasp the controlling image these fathers meet in various schools and child-care-institutions in the Danish Welfare state. The paper is based on 9 months of fieldwork in a Danish school, a social housing area and in various ‘father groups’ in Denmark. Additional, 50 interviews were conducted with fathers, children, mothers, schoolteachers, and educators. By using Connell's concepts 'hegemonic' and 'marginalized' masculinity as steppingstones, the paper argues that these concepts might entail a too static and dualistic picture of gender. By applying the concepts of 'emergent masculinity' and 'emergent fatherhood' the paper brings along a long needed discussion of how Muslim men in Denmark are struggling to overcome and change the controlling images of them as patriarchal and/or ignorant fathers regarding the upbringing of their children. As such, the paper shows how Muslim fathers are taking action to change this controlling image, e.g. through various ‘father groups’. The paper is inspired by the phenomenological notions of ‘experience´ and in the light of this notion, the paper tells the fathers’ stories about their upbringing of their children and aspirations for fatherhood. These stories share light on how these fathers take care of their children in everyday life. The study also shows that the controlling image of these fathers have affected how some Muslim fathers are actually being fathers. The study shows that fear of family-interventions from teachers or social workers e.g. have left some Muslim fathers in a limbo, being afraid of scolding their children, and being confused of ‘what good parenting in Denmark is’. This seems to have led to a more lassie fair upbringing than these fathers actually wanted. This study is important since anthropologists generally have underexposed the notion of fatherhood, and how fathers engage in the upbringing of their children. Over more, the vast majority of qualitative studies of fatherhood have been on white middleclass fathers, living in nuclear families. In addition, this study is crucial at this very moment due to the major refugee crisis in Denmark and in the Western world in general. A crisis, which has resulted in a vast number of scare campaigns against Islam from different nationalistic political parties, which enforces the negative controlling image of Muslim fathers.

Keywords: fatherhood, Muslim fathers, mistrust, education

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Authors: Sudhakar Kadiyala, Sripad R. Naik

Abstract:

Large cavern in Bhutan Himalayas is being monitored since the construction period. The behavior of the cavern is being monitored for last 16 years. Instrumentation includes measurement of convergence of high walls by geodetic monitoring, load on the support systems with load cells and instrumented bolts. Analysis of the results of instrumentation showed that during the construction period of the cavern, the convergence of the cavern varied from 181 - 233 mm in the unit bay area with maximum convergence rate of 2.80mm/day. Whereas during the operational period the total convergence observed was in the range of 21 to 45 mm during a period of 11.30 years with convergence rate of 0.005 to 0.011 mm/day. During the last five years, there were no instances of high tensile stress recorded by the instrumented bolts. Load on the rock bolts have shown stabilization trend at most of the locations. This paper discusses in detail the results of long-term monitoring using the geotechnical instruments and how the data is being used in 3D numerical model to confirm the stability of the cavern.

Keywords: convergence, displacements, geodetic monitoring, long-term stability

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Authors: Jessica Gladden

Abstract:

This study explored the perceived benefits of trauma-sensitive yoga programs. Participants attended one of two six-week trauma-sensitive yoga programs utilizing the G.R.A.C.E model, a format developed based on Emerson’s trauma-sensitive yoga guidelines and modified by the instructors. Participants in this study completed surveys on their experiences. The results of the surveys indicated that participants perceived improvements in self-care, embodiment, and mood. These results show that trauma-sensitive yoga may have benefits beyond the treatment of specific diagnoses that could be applied to a variety of populations. Reflections from one of the researchers who teaches in this program, as well as qualitative statements from the participants, will be shared to support the continued use of this method.

Keywords: yoga, trauma-sensitive, yoga therapy, trauma

Procedia PDF Downloads 167