Search results for: sample hospital
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7835

Search results for: sample hospital

4145 Waste Water Treatment and Emerging Waste Water Contaminants in Developing Countries

Authors: Opata Obinna Johnpaul

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Wastewater is one of the day-to–day concerns of humans and the environment, in general, due to its importance to the environment. This is because of the presence of various contaminants that are involved in waste water. Wastewater treatment can be defined as the proportion of wastewater that is treated, in order to reduce pollutants before being discharged to the environment, by the level of treatment. This work discusses wastewater treatment, its contaminants, as well as the technologies, involved.The major focus is to analyze Okomu Oil Palm Company Plc, their effluent treatment facility. Okomu Oil Palm Company is based in Nigeria, which is one of the developing countries of the world. Okomu Oil Palm Company uses aquatic treatment technology for their effluent treatment and applies the physio-chemical level of advanced chemical treatment of wastewater treatment process. This work will discuss the outcome of the laboratory sample taken on the 30th January, 2015 and analyzed between 30th January- 4th February 2015.

Keywords: wastewater treatment, contaminants, physio-chemical process, Okomu oil palm

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4144 The Research of Culture Heritage Tourism Loyalty in Taiwan

Authors: Chih-Wen Wu

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This study examines the antecedents of heritage tourism loyalty and its relation to destination image, consumer travel experience, and destination satisfaction in the tourism context. In this respect, a number of important questions concerning how destination image, consumer travel experience, and destination satisfaction impact destination loyalty are raised. This study attempts to identify three key antecedents of loyalty in the heritage context. The author empirically tests predicted relationships by using personal interview data from 475 foreign tourists. The conceptual model investigated the relevant relationships among the constructs by using confirmatory factor analysis(CFA) and structural equation modeling (SEM) approach. Findings from the research sample support the argument that destination image, consumer travel experience, destination satisfaction are the key determinants of destination loyalty. Destination image and consumer travel experience influence destination satisfaction. The author also discusses theoretical and managerial implications of research findings for marketing the heritage globally.

Keywords: heritage, destination loyalty, destination image, consumer travel experience, destination satisfaction, tourism

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4143 The Influence of Covariance Hankel Matrix Dimension on Algorithms for VARMA Models

Authors: Celina Pestano-Gabino, Concepcion Gonzalez-Concepcion, M. Candelaria Gil-Fariña

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Some estimation methods for VARMA models, and Multivariate Time Series Models in general, rely on the use of a Hankel matrix. It is known that if the data sample is populous enough and the dimension of the Hankel matrix is unnecessarily large, this may result in an unnecessary number of computations as well as in numerical problems. In this sense, the aim of this paper is two-fold. First, we provide some theoretical results for these matrices which translate into a lower dimension for the matrices normally used in the algorithms. This contribution thus serves to improve those methods from a numerical and, presumably, statistical point of view. Second, we have chosen an estimation algorithm to illustrate in practice our improvements. The results we obtained in a simulation of VARMA models show that an increase in the size of the Hankel matrix beyond the theoretical bound proposed as valid does not necessarily lead to improved practical results. Therefore, for future research, we propose conducting similar studies using any of the linear system estimation methods that depend on Hankel matrices.

Keywords: covariances Hankel matrices, Kronecker indices, system identification, VARMA models

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4142 Green Supply Chain Management and Corporate Performance: The Mediation Mechanism of Information Sharing among Firms

Authors: Seigo Matsuno, Yasuo Uchida, Shozo Tokinaga

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This paper proposes and empirically tests a model of the relationships between green supply chain management (GSCM) activities and corporate performance. From the literature review, we identified five constructs, namely, environmental commitment, supplier collaboration, supplier assessment, information sharing among suppliers, and business process improvement. These explanatory variables are used to form a structural model explaining the environmental and economic performance. The model was analyzed using the data from a survey of a sample of manufacturing firms in Japan. The results suggest that the degree of supplier collaboration has an influence on the environmental performance directly. While, the impact of supplier assessment on the environmental performance is mediated by the information sharing and/or business process improvement. And the environmental performance has a positive relationship on the economic performance. Academic and managerial implications of our findings are discussed.

Keywords: corporate performance, empirical study, green supply chain management, path modeling

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4141 A Step-by-Step Analytical Protocol For Detecting and Identifying Minor Differences In Like Materials and Polymers Using Pyrolysis -Gas Chromatography/Mass Spectrometry Technique

Authors: Athena Nguyen, Rojin Belganeh

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Detecting and identifying differences in like polymer materials are key factors in failure and deformulation analysis, and reverse engineering. Pyrolysis-GC/MS is an easy solid sample introduction technique which expands the application areas of gas chromatography and mass spectrometry. The Micro furnace pyrolyzer is directly interfaced with the GC injector preventing any potential of cold spot, carryover, and cross contamination. In this presentation, the analysis of the differences in three polystyrene samples is demonstrated. Although the three samples look very similar by Evolve gas analysis (EGA) and Flash pyrolysis, there are indications of small levels of other materials. By performing Thermal desorption-GC/MS, the additive compounds between samples show the differences. EGA, flash pyrolysis, and thermal desorption analysis are the different modes of operations of the micro-furnace pyrolyzer enabling users to perform multiple analytical techniques.

Keywords: Gas chromatography/Mass spectrometry, pyrolysis, pyrolyzer, thermal desorption-GC/MS

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4140 Investigating Effective Factors on the Customer Switching Behaviour in the Saipa Emdad Khodro Company of Iran

Authors: Rohollah Asadian Kohestani, Mustafa Hashemzadeh

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The present paper is the outcome of a field research that was conducted with the study objective of influencing factor's effect on the behavior of customers switching in the Saipa Emdad Khodro Company. To achieve this goal, six factors of service quality, service cost, waiting time to receive services, reputation of organization, costs of switching and the way to respond the needs of customers as the independent variables of research and their effect on the customer switching was studied as the variable related to the research. The statistical society of this research included all customers of the Saipa Emdad Khodro company that possess the vehicles of automobile manufacturing group of Saipa throughout the country and the statistical sample included 150 persons of such customers. The results of this research indicated that all under study factors excluding the reputation factor effect on the behavior of customer switching.

Keywords: customer services, switching cost, service price, customer switching behavior

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4139 Gender Diversity on the Board and Asymmetry Information: An Empirical Analysis for Spanish Listed Firms

Authors: David Abad, M. Encarnación Lucas-Pérez, Antonio Minguez-Vera, José Yagüe

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We examine explicitly the relation between the gender diversity on corporate boards and the levels of information asymmetry in the stock market. Based on prior evidence that suggests that the presence of women on director boards increases the quantity and quality of public disclosure by firms, we expect firms with higher gender diversity on their boards to show lower levels of information asymmetry in the market. Using a Spanish sample for the period 2004-2009, proxies for information asymmetry estimated from high-frequency data, and a system GMM methodology, we find that the gender diversity on boards is negative associated with the level of information asymmetry in the stock market. Our findings support legislative changes implemented to increase the presence of women on boards in several European countries by providing evidence that gender diverse boards have beneficial effects on stock markets.

Keywords: corporate board, female directors, gender diversity, information asymmetry, market microstructure

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4138 Personality Traits of Students Effecting Entrepreneurial Intention

Authors: Muhammad Ali, Aamir Sohail, Umair Malik

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Research in entrepreneurship has gained much attention in current academic environment. Youngsters are taking interest to start their own business in spite of risk matter. The objective of the study is to explain how various personality traits (personal attitude, locus of control, instrumental readiness and perceived behavioral control) are affecting entrepreneurial intention of students. The theory of planned behavior supports out study which explains that personal attractiveness, social norms and feasibility are the main factors that affect intentions of an individual. The sample data of 120 is collected from graduating batch of three reputed universities of Islamabad through questionnaires. Our results support the hypothesis that personality traits positively influence the entrepreneurial intention. We conclude from the study that many graduating students are willing to start a new venture, but most of them are likely to do a job in their respective fields. Risk factor also exists in their minds because in our country most people are risk-averse and they do not want to lose their money in case of loss.

Keywords: entrepreneurship, instrumental readiness, locus of control, personal attitude

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4137 Simulation Study of the Microwave Heating of the Hematite and Coal Mixture

Authors: Prasenjit Singha, Sunil Yadav, Soumya Ranjan Mohantry, Ajay Kumar Shukla

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Temperature distribution in the hematite ore mixed with 7.5% coal was predicted by solving a 1-D heat conduction equation using an implicit finite difference approach. In this work, it was considered a square slab of 20 cm x 20 cm, which assumed the coal to be uniformly mixed with hematite ore. It was solved the equations with the use of MATLAB 2018a software. Heat transfer effects in this 1D dimensional slab convective and the radiative boundary conditions are also considered. Temperature distribution obtained inside hematite slab by considering microwave heating time, thermal conductivity, heat capacity, carbon percentage, sample dimensions, and many other factors such as penetration depth, permittivity, and permeability of coal and hematite ore mixtures. The resulting temperature profile can be used as a guiding tool for optimizing the microwave-assisted carbothermal reduction process of hematite slab was extended to other dimensions as well, viz., 1 cm x 1 cm, 5 cm x 5 cm, 10 cm x 10 cm, 20 cm x 20 cm. The model predictions are in good agreement with experimental results.

Keywords: hematite ore, coal, microwave processing, heat transfer, implicit method, temperature distribution

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4136 The Spiritual Distress of Women Coping with the End of Life and Death of Their Spouses

Authors: Szu-Mei Hsiao

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Many nurses have concerns about the difficulties of providing spiritual care for ethnic-Chinese patients and family members within their cultural context. This is due to a lack of knowledge and training. Most family caregivers are female. There has been little research exploring the potential impact of Chinese cultural values on the spiritual distress of couple dyadic participants in Taiwan. This study explores the spiritual issues of Taiwanese women coping with their husband’s advanced cancer during palliative care to death. Qualitative multiple case studies were used. Data was collected through participant observation and in-depth face-to-face interviews. Transcribed interview data was analyzed by using qualitative content analysis. Three couples were recruited from a community-based rural hospital in Taiwan where the husbands were hospitalized in a medical ward. Four spiritual distress themes emerged from the analysis: (1) A personal conflict in trying to come to terms with love and forgiveness; the inability to forgive their husband’s mistakes; and, lack of their family’s love and support. (2) A feeling of hopelessness due to advanced cancer, such as a feeling of disappointment in their destiny and karma, including expressing doubt on survival. (3) A feeling of uncertainty in facing death peacefully, such as fear of facing the unknown world; and, (4) A feeling of doubt causing them to question the meaning and values in their lives. This research has shown that caregivers needed family support, friends, social welfare, and the help of their religion to meet their spiritual needs in coping within the final stages of life and death. The findings of this study could assist health professionals to detect the spiritual distress of ethnic-Chinese patients and caregivers in the context of their cultural or religious background as early as possible.

Keywords: advanced cancer, Buddhism, Confucianism, Taoism, qualitative research, spiritual distress

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4135 Characteristics and Challenges of Post-Burn Contractures in Adults and Children: A Descriptive Study

Authors: Hardisiswo Soedjana, Inne Caroline

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Deep dermal or full thickness burns are inevitably lead to post-burn contractures. These contractures remain to be one of the most concerning late complications of burn injuries. Surgical management includes releasing the contracture followed by resurfacing the defect accompanied by post-operative rehabilitation. Optimal treatment of post-burn contractures depends on the characteristics of the contractures. This study is aimed to describe clinical characteristics, problems, and management of post-burn contractures in adults and children. A retrospective analysis was conducted from medical records of patients suffered from contractures after burn injuries admitted to Hasan Sadikin general hospital between January 2016 and January 2018. A total of 50 patients with post burn contractures were included in the study. There were 17 adults and 33 children. Most patients were male, whose age range within 15-59 years old and 5-9 years old. Educational background was mostly senior high school among adults, while there was only one third of children who have entered school. Etiology of burns was predominantly flame in adults (82.3%); whereas flame and scald were the leading cause of burn injury in children (11%). Based on anatomical regions, hands were the most common affected both in adults (35.2%) and children (48.5%). Contractures were identified in 6-12 months since the initial burns. Most post-burn hand contractures were resurfaced with full-thickness skin graft (FTSG) both in adults and children. There were 11 patients who presented with recurrent contracture after previous history of contracture release. Post-operative rehabilitation was conducted for all patients; however, it is important to highlight that it is still challenging to control splinting and exercise when patients are discharged and especially the compliance in children. In order to improve quality of life in patients with history of deep burn injuries, prevention of contractures should begin right after acute care has been established. Education for the importance of splinting and exercise should be administered as comprehensible as possible for adult patients and parents of pediatric patients.

Keywords: burn, contracture, education, exercise, splinting

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4134 Bearing Capacity Improvement in a Silty Clay Soil with Crushed Polyethylene Terephthalate

Authors: Renzo Palomino, Alessandra Trujillo, Lidia Pacheco

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The document presents a study based on the incremental bearing capacity of silty clay soil with the incorporation of crushed PET fibers. For a better understanding of the behavior of soil, it is necessary to know its origin. The analyzed samples came from the subgrade layer of a highway that connects the cities of Muniches and Yurimaguas in Loreto, Peru. The material in this area usually has properties such as low support index, medium to high plasticity, and other characteristics that make it considered a ‘problematic’ soil due to factors such as climate, humidity, and geographical location. In addition, PET fibers are obtained from the decomposition of plastic bottles that are polluting agents with a high production rate in our country; in that sense, their use in a construction process represents a considerable reduction in environmental impact. Moreover, to perform a precise analysis of the behavior of this soil mixed with PET, tests such as the hydrometer test, Proctor and CBR with 15%, 10%, 5%, 4%, 3%, and 1% of PET with respect to the mass of the sample of natural soil were carried out. The results show that when a low percentage of PET is used, the support index increases.

Keywords: environmental impact, geotechnics, PET, silty clay soil

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4133 Attitudes of Faculty Members Towards Inclusion of Students with Disability at Prince Sattam Bin Abdulaziz University

Authors: Khalid Alasim

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This study investigates the attitudes of faculty members at Prince Sattam bin Abdulaziz University toward integrating students with disabilities. Additionally, this research examines the possible factors that might affect faculty members’ attitudes about the inclusion of students with disability; the factors include occupation, gender, college, the country in which the certificate was obtained, years of experience, previous experience in teaching students with disabilities, the presence of a family member with a disability, attending a program on teaching students with disabilities. The researcher used a survey to collect data and the study sample consisted of 102 faculty members at the university. The findings indicated an increase in the attitudes of faculty members at Prince Sattam bin Abdulaziz University towards the inclusion of students with disabilities in the university, while there is no effect for all study independents variables on the attitudes of faculty members, and there is no interaction between the variables as well. The study concluded with the importance of training and preparing faculty members to teach and deal with students with disabilities at the university level.

Keywords: attitutes, inclusion, disability, faculty members

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4132 The Anti-Allergic Activity of Prasaprohyai Preparation Extract after Accelerated Stability Testing

Authors: Sunita Makchuchit, Arunporn Itharat

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Prasaprohyai, a Thai traditional medicine preparation listed in the Thai National List of Essential Medicines, is commonly used for treatment of fever and colds. Prasaprohyai preparation consists of 21 different plants, with Kaempferia galanga (50% w/w) as the main ingredient. The objective of this study was to investigate the anti-allergic activity of the crude extract from Prasaprohyai after accelerated stability test procedure. The method of extract used maceration in 95% ethanol and the crude extract was kept under accelerated condition at 40 ± 2 oC and 75 ± 5% relative humidity (RH) for six months. After six months of storage at 40 oC, the crude sample in various storage times (0, 15, 30, 45, 60, 90, 120, 150 and 180 days) were investigated for anti-allergic activity using IgE-sensitized RBL-2H3 cell lines. The results showed that the stability of crude ethanolic extract from Prasaprohyai under accelerated testing had no significant effect of anti-allergic activity when compared with day 0. The results showed that the ethanolic extract could be stored for two years at room temperature without loss of activity.

Keywords: accelerated stability, anti-allergy, prasaprohyai, RBL-2H3 cell lines

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4131 Violence and Unintentional Injuries among Secondary School Students in Jordan

Authors: Malakeh Zuhdi Malak, Mahmoud Taher Kalaldeh

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In Jordan, no available data exists regarding violence and unintentional injuries among secondary school students aged 15-19 years. The purpose of this study was to assess the violence and unintentional injuries among those students, and to compare these two behaviors between male and female students. A descriptive cross-sectional design was carried out on randomly selected eight comprehensive secondary schools (four schools for females and four schools for males) from the public school educational directorate located in Amman. A modified Arabic version of the General School Health Survey questionnaire was used to measure violence and unintentional injuries. A sample of 750 secondary school students was studied. The findings showed that 26.8 % of students had been physically attacked. Overall, 43.3 % of students had been involved in a physical fight and 20.1% of them had been bullied. Overall, 45.3% of students were seriously injured. There was a difference between male and female students regarding to physical attack, physical fight, and serious injuries. In conclusion, it is necessary to develop effective training program in life skills for students that functions to reduce risk-taking behaviors that often leading to violence and unintentional injuries.

Keywords: secondary school students, violence, unintentional injuries, bullying

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4130 Alumni Experiences of How Their Undergraduate Medical Education Instilled and Fostered a Commitment to Community-Based Work in Later Life: A Sequential Exploratory Mixed-Methods Study

Authors: Harini Aiyer, Kalyani Premkumar

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Health professionals are the key players who can help achieve the goals of population health equity. Social accountability (SA) of health professionals emphasizes their role in addressing issues of equity in the population they serve. Therefore, health professional education must focus on instilling SA in health professionals. There is limited literature offering a longitudinal perspective of how students sustain the practice of SA in later life. This project aims to identify the drivers of social accountability among physicians. This study employed an exploratory mixed methods design (QUAL-> Quant) to explore alumni perceptions and experiences. The qualitative data, collected via 20 in-depth, semi-structured interviews, provided an understanding of the perceptions of the alumni regarding the influence of their undergraduate learning environment on their SA. This was followed by a quantitative portion -a questionnaire designed from the themes identified from the qualitative data. Emerging themes from the study highlighted community-centered education and a focus on social and preventative medicine in both curricular and non-curricular facilitators of SA among physicians. Curricular components included opportunities to engage with the community, such as roadside clinics, community-orientation programs, and postings at a secondary hospital. Other facilitators that emerged were the faculty leading by example, a subsidized fee structure, and a system that prepared students for practice in rural and remote areas. The study offers a fresh perspective and dimension on how SA is addressed by medical schools. The findings may be adapted by medical schools to understand how their own SA initiatives have been sustained among physicians over the long run.

Keywords: community-based work, global health, health education, medical education, providing health in remote areas, social accountability

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4129 The Relationship between Class Attendance and Performance of Industrial Engineering Students Enrolled for a Statistics Subject at the University of Technology

Authors: Tshaudi Motsima

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Class attendance is key at all levels of education. At tertiary level many students develop a tendency of not attending all classes without being aware of the repercussions of not attending all classes. It is important for all students to attend all classes as they can receive first-hand information and they can benefit more. The student who attends classes is likely to perform better academically than the student who does not. The aim of this paper is to assess the relationship between class attendance and academic performance of industrial engineering students. The data for this study were collected through the attendance register of students and the other data were accessed from the Integrated Tertiary Software and the Higher Education Data Analyzer Portal. Data analysis was conducted on a sample of 93 students. The results revealed that students with medium predicate scores (OR = 3.8; p = 0.027) and students with low predicate scores (OR = 21.4, p < 0.001) were significantly likely to attend less than 80% of the classes as compared to students with high predicate scores. Students with examination performance of less than 50% were likely to attend less than 80% of classes than students with examination performance of 50% and above, but the differences were not statistically significant (OR = 1.3; p = 0.750).

Keywords: class attendance, examination performance, final outcome, logistic regression

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4128 Utilization, Barriers and Determinants of Emergency Medical Services in Mekelle City, Tigray, Ethiopia: A Community-Based Cross-Sectional Study

Authors: Goitom Molalign Takele, Tsegalem Hailemariam Ballo, Kiros Belay Gebrekidan, Birhan Gebresilassie Gebregiorgis

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Background: Emergency medical services (EMS) are services that provide out-of-hospital emergency medical care to injured or ill peoples, and transporting to definitive care. EMS is an integral part of the emergency medical system and has been associated with decreased morbidity and mortality related to emergency cases. The aim of this study was to assess the utilization, barriers, and determinants of EMS in Mekelle, Ethiopia. Methods: A community-based cross-sectional study was conducted in selected sub-cities of Mekelle. A multistage sampling method was employed to recruit study participants, and data were collected by trained data collectors using an interviewer-administered questionnaire. Multivariate logistic regression analysis was used to examine the statistical association of the determinants of EMS utilization. Results: Half (50.5%) of the respondents had experienced or witnessed an emergency incident in the past year. The common means of transportations used were Bajaj’s (39.2%) and ambulances (22.7%). Majority (88.1%) of the respondents did not knew the EMS access phone number of an ambulance. As their preferred mode of transportation in case of emergency conditions, 42.2% of the participants reported an ambulance, followed by Bajaj 33.7%. Where participants who had gynecologic emergencies were 9.4 times (AOR=9.4, 95% CI: 1.04, 85, p=0.046), and those who knew any ambulance numbers were 3.6 times (AOR=3.6, 95% CI: 1.22, 10.8, p=0.02) more likely to use ambulance services in case of emergencies. Conclusion: The ambulance utilization level in Mekelle city was low and victims of emergency conditions were being transported mainly using public transports such as Bajaj’s and taxis. Even though the perception of the public towards EMS services is favorable, lack of awareness of EMS access, and lack of integrated EMS system in the city are the barriers that may have contributed to the low utilization. Actions to improve EMS access and integrating the system are warranted to promote the services utilization.

Keywords: emergency medical services, utilization, Mekelle, barriers

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4127 Higher Order Thinking Skills Workshop: Faculty Professional Development and Its Effect on Their Teaching Strategies

Authors: Amani Hamdan

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A post-workshop of higher-order thinking skills (HOTS), for faculty from diverse academic disciplines, was conducted and the researcher surveyed the participants’ intentions and plans to include HOTS as a goal, as learning and teaching task in their practices. Follow-up interviews with a random sample of participants were used to determine if they fulfilled their intentions three 3 months after the workshop. The degree of planned and enacted HOTS then was analyzed against the post-workshop HOT ability and knowledge. This is one topic that has not been adequately explored in faculty professional development literature where measuring the effect of learning on their ability to use what they learned. This qualitative method study explored a group of male and female faculty members (n=85) enrolled in HOTS 2 day workshop. The results showed that 89% of faculty members although were mostly enthused to apply what they learned after a 3 months period they were caught up with routine presentations and lecturing.

Keywords: higher education, faculty development, Saudi Arabia, higher order thinking skills

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4126 Biochemical Characterization of CTX-M-15 from Enterobacter cloacae and Designing a Novel Non-β-Lactam-β-Lactamase Inhibitor

Authors: Mohammad Faheem, M. Tabish Rehman, Mohd Danishuddin, Asad U. Khan

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The worldwide dissemination of CTX-M type β-lactamases is a threat to human health. Previously, we have reported the spread of blaCTX-M-15 gene in different clinical strains of Enterobacteriaceae from the hospital settings of Aligarh in north India. In view of the varying resistance pattern against cephalosporins and other β-lactam antibiotics, we intended to understand the correlation between MICs and catalytic activity of CTX-M-15. In this study, steady-state kinetic parameters and MICs were determined on E. coli DH5α transformed with blaCTX-M-15 gene that was cloned from Enterobacter cloacae (EC-15) strain of clinical background. The effect of conventional β-lactamase inhibitors (clavulanic acid, sulbactam and tazobactam) on CTX-M-15 was also studied. We have found that tazobactam is the best among these inhibitors against CTX-M-15. The inhibition characteristic of tazobactam is defined by its very low IC50 value (6 nM), high affinity (Ki = 0.017 µM) and better acylation efficiency (k+2/K9 = 0.44 µM-1s-1). It forms an acyl-enzyme covalent complex, which is quite stable (k+3 = 0.0057 s-1). Since increasing resistance has been reported against conventional b-lactam antibiotic-inhibitor combinations, we aspire to design a non-b-lactam core containing b-lactamase inhibitor. For this, we screened ZINC database and performed molecular docking to identify a potential non-β-lactam based inhibitor (ZINC03787097). The MICs of cephalosporin antibiotics in combination with this inhibitor gave promising results. Steady-state kinetics and molecular docking studies showed that ZINC03787097 is a reversible inhibitor which binds non-covalently to the active site of the enzyme through hydrogen bonds and hydrophobic interactions. Though, it’s IC50 (180 nM) is much higher than tazobactam, it has good affinity for CTX-M-15 (Ki = 0.388 µM). This study concludes that ZINC03787097 compound can be used as seed molecule to design more efficient non-b-lactam containing b-lactamase inhibitor that could evade pre-existing bacterial resistance mechanisms.

Keywords: ESBL, non-b-lactam-b-lactamase inhibitor, bioinformatics, biomedicine

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4125 Imaginal and in Vivo Exposure Blended with Emdr: Becoming Unstuck, an Integrated Inpatient Treatment for Post-Traumatic Stress Disorder

Authors: Merrylord Harb-Azar

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Traditionally, PTSD treatment has involved trauma-focused cognitive behaviour therapy (TF CBT) to consolidate traumatic memories. A piloted integrated treatment of TF CBT and eye movement desensitisation reprocessing therapy (EMDR) of eight phases will fasten the rate memory is being consolidated and enhance cognitive functioning in patients with PTSD. Patients spend a considerable amount of time in treatment managing their traumas experienced firsthand, or from aversive details ranging from war, assaults, accidents, abuse, hostage related, riots, or natural disasters. The time spent in treatment or as inpatient affects overall quality of life, relationships, cognitive functioning, and overall sense of identity. EMDR is being offered twice a week in conjunction with the standard prolonged exposure as an inpatient in a private hospital. Prolonged exposure for up to 5 hours per day elicits the affect response required for EMDR sessions in the afternoon to unlock unprocessed memories and facilitate consolidation in the amygdala and hippocampus. Results are indicating faster consolidation of memories, reduction in symptoms in a shorter period of time, reduction in admission time, which is enhancing the quality of life and relationships, and improved cognition. The impact of events scale (IES) results demonstrate a significant reduction in symptoms, trauma symptoms inventory (TSI), and posttraumatic stressor disorder check list (PCL) that demonstrates large effect sizes to date. An integrated treatment approach for PTSD achieves a faster resolution of memories, improves cognition, and reduces the amount of time spent in therapy.

Keywords: EMDR enhances cognitive functioning, faster consolidation of trauma memory, integrated treatment of TF CBT and EMDR, reduction in inpatient admission time

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4124 Characterization and Antimicrobial Properties of Functional Polypropylene Films Incorporated with AgSiO2, AgZn, and AgZ Useful as Returnable Packaging in Seafood Distribution

Authors: Suman Singh, Myungho Lee, Insik Park, Yangjai Shin, Youn Suk Lee

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Active antimicrobial films prepared by incorporating AgSiO2, AgZn, and AgZ at 1%, 3%, 5%, 10% (w/w) into polypropylene (PP) matrix. Complete thermal, structural, mechanical and functional characterization were carried out of all formulations and determined the antimicrobial efficiency and returnable antimicrobial efficiency according to the Japanese Industrial Standard method. The morphology of the films showed agglomerates of particles in the composites. The active formulation had decreased elongation compared to the pure PP sample. Thermal analyses indicated that the active formulation compositions had increased thermal stability. The films showed 50% antimicrobial properties after the fifth wash against the tested microorganisms, presenting better activity against Gram negative organisms than Gram positive ones. These findings suggest that PP films with AgSiO2, AgZn, and AgZ particles could provide a significant contribution to the quality and safety of seafood in the distribution chain.

Keywords: antimicrobial film, properties and characterization, returnable packaging, sea food

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4123 Caregiver’s Perception Regarding Diagnosis Disclosure to Children Living with Human Immunodeficiency Virus in Resource-Limited Settings: Observational Study from India

Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

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4122 Phytoremediation Rates of Water Hyacinth in an Aquaculture Effluent Hydroponic System

Authors: E. A. Kiridi, A. O. Ogunlela

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Conventional wastewater treatment plants of activated carbon, electrodialysis, ion exchange, reverse osmosis etc. are expensive to install, operate and maintain especially in developing countries; therefore, the use of aquatic macrophytes for wastewater purification is a viable alternative. On the first day of experimentation, approximately 100g of water hyacinth was introduced into the hydroponic units in four replicates. The water quality parameters measured were total suspended solids (TSS), pH and electrical conductivity (EC). Others were concentration of ammonium–nitrogen (NH4+-N), nitrite-nitrogen (NO2--N), nitrate-nitrogen (NO3--N), phosphate–phosphorus (PO43--P), and biomass value. At phytoremediation intervals of 7, 14, 21 and 28 days, the biomass recorded were 438.2 g, 600.7 g, 688.2 g and 725.7 g. Water hyacinth was able to reduce the pollutant concentration of all the selected parameter. The percentage reduction of pH ranged from 1.9% to 14.7%, EC from 49.8% to 97.0%, TDS from 50.4% to 97.6%, TSS from 34.0% to 78.3%, NH4+-N from 38.9% to 85.2%, NO2--N from 0% to 84.6%, NO3--N from 63.2% to 98.8% and PO43--P from 10% to 88.0%. Paired sample t-test shows that at 95% confidence level, it can be concluded statistically that the inequality between the pre-treatment and post-treatment values are significant. This suggests that the use of water hyacinth is valuable in the design and operation of aquaculture effluent treatment and should therefore be adopted by environmental and wastewater managers.

Keywords: aquaculture effluent, phytoremediation, pollutant, water hyacinth

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4121 The Research of Industrial Space Characteristics, Layout, and Strategy in Metropolitan Area in China: In Case of Wuhan

Authors: Min Zhou, Kaixuan Lin, Yaping Huang

Abstract:

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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4120 Anatomically-Based Oropharyngeal Rehabilitation for the Patients with Obstructive Sleep Apnea Using a Multilevel Approach

Authors: Hsin-Yu Lin, Ching-Hsia Hung

Abstract:

Obstructive sleep apnea (OSA) is characterized by a complete or partial obstruction of the upper airway during sleep. The vulnerable sites of upper airway collapses are consequences of sleep state-dependent reductions in tone in specific pharyngeal dilators. Clinical examinations reveal multilevel collapses of the upper airway among the patients with OSA. Therefore, an anatomically-based oropharyngeal rehabilitation should comprise a multilevel approach, including retropalatal, retroglossal, hypopharyngeal, temporomandibular, and facial levels, all of which involve different muscle groups and contribute to multifunctional interaction and coordination, such as swallowing, breathing, and phonation. The purpose of the study was to exam the effects of this rehabilitation program with a multilevel approach. In this study, fifteen subjects with newly diagnosed moderate or severe OSA (Apnea-Hypopnea-Index≥15) were randomized into an intervention group and control group. The intervention group (N=8) underwent a 12-week-intervention of a hospital-based rehabilitation program, while the control group (N=7) was kept on the waiting list. The 12-week-intervention comprised an anatomically based multilevel approach. The primary outcome was Polysomnography (PSG) data, and the secondary outcome was oropharyngeal and respiratory muscle function. In the intervention group, Apnea-Hypopnea-Index significantly improved (46.96±19.45 versus 32.78±10.78 events/h, p=0.017) compared with control group (35.77±17.49 versus 42.96±17.32 events/h, p=0.043). While the control group remained no change, the intervention group demonstrated other PSG outcomes significantly improvement, including arousal index (46.04±18.9 versus 32.98±8.35/h, p=0.035), mean SpO2 (92.88±2.1 versus 94.13±1.46%, p=0.039). Besides, the intervention group demonstrated significant improvement in oropharyngeal and respiratory muscle function compared to the control group. This anatomically-based oropharyngeal rehabilitation with a multilevel approach can be proven as a non-invasive therapy for patients with OSA.

Keywords: obstructive sleep apnea, upper airway, oropharyngeal rehabilitation, multilevel approach

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4119 Osteoarticular Manifestations and Abnormalities of Bone Metabolism in Celiac Disease

Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia

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Introduction: Celiac disease (CD) is a chronic autoimmune inflammatory enteropathy caused by gluten. The clinical presentation is very variable. Malabsorption in the MC is responsible for an alteration of the bone metabolism. Our purpose is to study the osteoarticular manifestations related to this condition. Material and methods: It is a retrospective study of 41 cases of CD diagnosed on clinical, immunological, endoscopic and histological arguments, in the Internal Medicine and Gastroenterology Department of Farhat Hached Hospital between September 2005 and January 2016. Results: Osteoarticular manifestations were found in 9 patients (22%) among 41 patients presenting CD. These were 7 women and 2 men with an average age of 35.7 years (25 to 67 years). These manifestations were revelatory of CD in 3 cases. Abdominal pain and diarrhea were present in 6 cases. Inflammatory polyarthralgia of wrists and knees has been reported in 7 patients. Mechanical mono arthralgia was noted in 2 patients. Biological tests revealed microcytic anemia by iron deficiency in 7 cases, hypocalcemia in 5 cases, Hypophosphatemia in 3 cases and elevated alkaline phosphatases in 3 cases. Upper gastrointestinal endoscopy with duodenal biopsy found villous atrophy in all cases. In immunology, Anti-transglutaminase antibodies were positive in all patients, Anti-endomysium in 7 cases. Measurement of bone mineral density (BMD) by biphotonic X-ray absorptiometer with evaluation of the T-score and the Z-score was performed in Twenty patients (48.8%). It was normal in 7 cases (33%) and showed osteopenia in 5 patients (25%) and osteoporosis in 2 patients (10%). All patients were treated with a Gluten-free diet associated with vitamin D and calcium substitution in 5 cases. The evolution was favorable in all cases with reduction of bone pain and normalization of the phosphocalcic balance. Conclusion: The bone impact of CD is frequent but often asymptomatic. Patients with CD should be evaluated by the measurement of bone mineral density and monitored for calcium and vitamin D deficiencies.

Keywords: bone mineral density, celiac disease, osteoarticular manifestations, vitamin D and calcium

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4118 Model Averaging in a Multiplicative Heteroscedastic Model

Authors: Alan Wan

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In recent years, the body of literature on frequentist model averaging in statistics has grown significantly. Most of this work focuses on models with different mean structures but leaves out the variance consideration. In this paper, we consider a regression model with multiplicative heteroscedasticity and develop a model averaging method that combines maximum likelihood estimators of unknown parameters in both the mean and variance functions of the model. Our weight choice criterion is based on a minimisation of a plug-in estimator of the model average estimator's squared prediction risk. We prove that the new estimator possesses an asymptotic optimality property. Our investigation of finite-sample performance by simulations demonstrates that the new estimator frequently exhibits very favourable properties compared to some existing heteroscedasticity-robust model average estimators. The model averaging method hedges against the selection of very bad models and serves as a remedy to variance function misspecification, which often discourages practitioners from modeling heteroscedasticity altogether. The proposed model average estimator is applied to the analysis of two real data sets.

Keywords: heteroscedasticity-robust, model averaging, multiplicative heteroscedasticity, plug-in, squared prediction risk

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4117 The Effect of Computer-Based Formative Assessment on Learning Outcome

Authors: Van Thien NGO

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The purpose of the study is to examine the effect of student response systems in computer-based formative assessment on learning outcomes. The backward design course is a tool to be applied for collecting necessary assessment evidence. The quasi-experimental research design involves collecting pre and posttest data on students assigned to the control group and the experimental group. The sample group consists of 150 college students randomly selected from two of the eight classes of electrical and electronics students at Cao Thang Technical College in Ho Chi Minh City, Vietnam. Findings from this research revealed that the experimental group, in which student response systems were applied, got better results than the controlled group, who did not apply them. Results show that using student response systems for technology-based formative assessment is vital and meaningful not only for teachers but also for students in the teaching and learning process.

Keywords: student response system, computer-based formative assessment, learning outcome, backward design course

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4116 Choosing the Right Lignin for Phenolic Adhesive Application

Authors: Somayyeh Kalami, Mojgan Nejad

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Based on the source (softwood, hardwood or annual crop) and isolation method (kraft, organosolv, sulfite or pre-enzymatic treatment), there are significant variations in lignin structure and properties. The first step in using lignin as biobased feedstock is to make sure that specific lignin is suitable for intended application. Complete characterization of lignin and measuring its chemical, physical and thermal properties can help to predict its suitability. To replace 100% phenol portion of phenolic adhesive, lignin should have high reactivity toward formaldehyde. Theoretically, lignins with closer backbone structure to phenol should be better candidate for this application. In this study, a number of different lignins were characterized and used to formulate phenolic adhesive. One of the main findings was that lignin sample with higher percentage of hydroxyl-phenyl units was better candidate than lignin with more syringyl units. This could be explained by the fact that hydroxyl-phenyl lignin units have two available ortho positions for reaction with formaldehyde while in syringyl units all ortho and para positions are occupied, and there is no available site in lignin structure to react with formaldehyde.

Keywords: lignin, phenolic adhesive, biobased, sustainable

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