Search results for: functional outcome

Authors: Bsma Adel Bany Mohammad

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The University campuses are a small city containing basic city functions such as educational spaces, accommodations, services and transportation. They are spaces of functional and social life with different activities, different occupants. The campus designed and transformed like cities so both experienced and memorized in same way. Campus memory is the ability of individuals to maintain and reveal the spatial components of designed physical spaces, which form the understandings, experiences, sensations of the environment in all. ‘Cognitive mapping’ is used to decode the physical interaction and emotional relationship between individuals and the city; Cognitive maps are created graphically using geometric and verbal elements on paper by remembering the images of the Urban Environment. In this study, to determine the emotional urban identity belonging to Jordan University of science and technology Campus, architecture students Asked to identify the areas they interact with in the campus by drawing a cognitive map. ‘Campus memory items’ are identified by analyzing the cognitive maps of the campus, then the spatial identity result of such data. The analysis based on the five basic elements of Lynch: paths, districts, edges, nodes, and landmarks. As a result of this analysis, it found that Spatial Identity constructed by the shared elements of the maps. The memory of most students listed the gates structure- which is a large desirable structure, located at the main entrances within the campus defined as major landmarks, then the square spaces defined as nodes, in addition to both stairs and corridors defined as paths. Finally, the districts, edges of educational buildings and service spaces are listed correspondingly in cognitive maps. Findings suggest that the spatial identity of the campus design is related mainly to the gates structures, squares and stairs.

Keywords: cognitive maps, university campus, urban memory, identity

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Authors: Alessandro Balbo, Gianvito Colucci, Matteo Nicoli, Laura Savoldi

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Hydrogen is expected to become a game changer in the energy transition, especially enabling sector coupling possibilities and the decarbonization of hard-to-abate end-uses. The Italian National Recovery and Resilience Plan identifies hydrogen as one of the key elements of the ecologic transition to meet international decarbonization objectives, also including it in several pilot projects for the early development in Italy. This matches the European energy strategy, which aims to make hydrogen a leading energy carrier of the future, setting ambitious goals to be accomplished by 2030. The huge efforts needed to achieve the announced targets require to carefully investigate of their feasibility in terms of economic expenditures and technical aspects. In order to quantitatively assess the hydrogen potential within the Italian context and the feasibility of the planned investments and projects, this work uses the TEMOA-Italy energy system model to study pathways to meet the strict objectives above cited. The possible hydrogen development has been studied both in the supply-side and demand-side of the energy system, also including storage options and distribution chains. The assessment comprehends alternative hydrogen production technologies involved in a competition market, reflecting the several possible investments declined by the Italian National Recovery and Resilience Plan to boost the development and spread of this infrastructure, including the sector coupling potential with natural gas through the currently existing infrastructure and CO2 capture for the production of synfuels. On the other hand, the hydrogen end-uses phase covers a wide range of consumption alternatives, from fuel-cell vehicles, for which both road and non-road transport categories are considered, to steel, and chemical industries uses and cogeneration for residential and commercial buildings. The model includes both high and low TRL technologies in order to provide a consistent outcome for the future decades as it does for the present day, and since it is developed through the use of an open-source code instance and database, transparency and accessibility are fully granted.

Keywords: decarbonization, energy system optimization models, hydrogen, open-source modeling, TEMOA

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Authors: Klea Ramaj

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Objectives: There have recently been increasing calls to better understand the intergenerational transmission of adverse childhood experiences (ACEs). In particular, little is known about the links between maternal (ACEs), maternal stress, maternal depression, and child abuse against toddlers in countries in South-East Europe. This paper, therefore, aims to present new descriptive data on the epidemiology of maternal mental well-being and maternal ACEs in the capital of Albania, Tirana. It also aims to advance our understanding of the overlap between maternal stress, maternal depression, maternal exposure to ACEs, and child abuse toward two-to-three-year-old. Methods: This is a cross-sectional study conducted with a representative sample of 328 mothers of two-to-three-year-olds, recruited through public nurseries located in 8 diverse socio-economic and geographical areas in Tirana, Albania. Maternal stress was measured through the perceived stress scale (α = 0.78); maternal depression was measured via the patient health questionnaire (α = 0.77); maternal exposure to ACEs was captured via the ACEs international questionnaire (α = 0.77); and child maltreatment was captured via ISPCAN ICAST-P (α = 0.66). The main outcome examined here will be child maltreatment. The paper will first present estimates of maternal stress, depression, and child maltreatment by demographic groups. It will then use multiple regression to examine associations between child maltreatment and risk factors in the domains of maternal stress, maternal depression, and maternal ACEs. Results: Mothers' mean age was 32.3 (SD = 4.24), 87.5% were married, 51% had one child, and 83.5% had completed higher education. Analyses show high levels of stress and exposure to childhood adversity among mothers in Tirana. 97.5% of mothers perceived stress during the last month, and 89% had experienced at least one childhood adversity as measured by the ACE questionnaire, with 20.2% having experienced 4+ ACEs. Analyses show significant positive associations between maternal ACEs and maternal stress r(325) = 0.25, p = 0.00. Mothers with a high number of ACEs were more likely to abuse their children r(327) = .43, p = 0.00. 32% of mothers have used physical discipline with their 2–3-year-old, 84% have used psychological discipline, and 35% have neglected their toddler at least once or twice. The mothers’ depression levels were also positively and significantly associated with child maltreatment r(327) = .34, p = 0.00. Conclusions: This study provides cross-sectional data on the link between maternal exposure to early adversity, maternal mental well-being, and child maltreatment within the context of Tirana, Albania. The results highlight the importance of establishing policies that encourage maternal support, positive parenting, and family well-being in order to help break the cycle of transgenerational violence.

Keywords: child maltreatment, maternal mental well-being, intergenerational abuse, Tirana, Albania

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Authors: Angela Maria Sarmiento

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Since the end of the 19th century, the Bora people struggled to survive two stages of colonial domination, which resulted in situations of forced contact with the Western world. Their inclusion in global designs altered the configuration of their local spaces and social practices; thus the Bora language was affected and prone to transformation. This descriptive, interpretive study, within the indigenous and minoritized groups’ research field, aimed at analysing the linguistic attitudes as well as the contextual situation of the Bora language in Providencia, an ancestral territory and a speech community contained in the midst of the Colombian Amazon rainforest. Through the inquiry of their sociolinguistic practices, this study also considered the effects of the course of events derived from the rubber exploitation in the late 19th century, and the arrival of the Capuchin’s mission in the early 20th century. The methodology used in this study had an ethnographic approach, which allowed the researcher to study the social phenomena from the perspective of the participants. Fieldwork, diary, field notes, and semi-structured interviews were conducted and then triangulated with participant observations. The findings of this study suggest that there is a transition from current individual bilingualism towards Spanish monolingualism; this is enhanced by the absence of a functional distribution of the three varieties (Bora, Huitoto, and Spanish). Also, the positive attitudes towards the Spanish language are based on its functionality while positive attitudes towards the Bora language mostly refer to pride and identity. Negative attitudes are only directed towards the Bora language. In the search for the roots of these negative attitudes, appeared the traumatic experiences of the rubber exploitation and the indigenous experiences at the capuchin’s boarding school. Finally, the situation of the Bora language can be configured as a social fact strongly connected to previous years of colonial dominations and to the current and continuous incursion of new global-colonial designs.

Keywords: Bora language, language contact, linguistic attitudes, speech communities

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Authors: Peng Zhang, Lihui Zheng, Xiangchun Wang, Xiaopan Kou

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Quantitative research on the main control factors of lost circulation has few considerations and single data source. Using Unmanned Intervention Algorithm to find the main control factors of lost circulation adopts all measurable parameters. The degree of lost circulation is characterized by the loss rate as the objective function. Geological, engineering and fluid data are used as layers, and 27 factors such as wellhead coordinates and WOB are used as dimensions. Data classification is implemented to determine function independent variables. The mathematical equation of loss rate and 27 influencing factors is established by multiple regression method, and the undetermined coefficient method is used to solve the undetermined coefficient of the equation. Only three factors in t-test are greater than the test value 40, and the F-test value is 96.557%, indicating that the correlation of the model is good. The funnel viscosity, final shear force and drilling time were selected as the main control factors by elimination method, contribution rate method and functional method. The calculated values of the two wells used for verification differ from the actual values by -3.036m3/h and -2.374m3/h, with errors of 7.21% and 6.35%. The influence of engineering factors on the loss rate is greater than that of funnel viscosity and final shear force, and the influence of the three factors is less than that of geological factors. Quantitatively calculate the best combination of funnel viscosity, final shear force and drilling time. The minimum loss rate of lost circulation wells in Shunbei area is 10m3/h. It can be seen that man-made main control factors can only slow down the leakage, but cannot fundamentally eliminate it. This is more in line with the characteristics of karst caves and fractures in Shunbei fault solution oil and gas reservoir.

Keywords: drilling and completion, drilling fluid, lost circulation, loss rate, main controlling factors, unmanned intervention algorithm

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Authors: Yindi Zhao, Yun Zhang, Silu Xia, Lixin Wu

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The contours and areas of water surfaces, especially lakes, often change due to natural disasters and construction activities. It is an effective way to extract and update water contours from satellite images using image processing algorithms. However, to produce optimal water surface contours that are close to true boundaries is still a challenging task. This paper compares the performances of three different level set models, including the Chan-Vese (CV) model, the signed pressure force (SPF) model, and the region-scalable fitting (RSF) energy model for extracting lake contours. After experiment testing, it is indicated that the RSF model, in which a region-scalable fitting (RSF) energy functional is defined and incorporated into a variational level set formulation, is superior to CV and SPF, and it can get desirable contour lines when there are “holes” in the regions of waters, such as the islands in the lake. Therefore, the RSF model is applied to extracting lake contours from Landsat satellite images. Four temporal Landsat satellite images of the years of 2000, 2005, 2010, and 2014 are used in our study. All of them were acquired in May, with the same path/row (121/036) covering Xuzhou City, Jiangsu Province, China. Firstly, the near infrared (NIR) band is selected for water extraction. Image registration is conducted on NIR bands of different temporal images for information update, and linear stretching is also done in order to distinguish water from other land cover types. Then for the first temporal image acquired in 2000, lake contours are extracted via the RSF model with initialization of user-defined rectangles. Afterwards, using the lake contours extracted the previous temporal image as the initialized values, lake contours are updated for the current temporal image by means of the RSF model. Meanwhile, the changed and unchanged lakes are also detected. The results show that great changes have taken place in two lakes, i.e. Dalong Lake and Panan Lake, and RSF can actually extract and effectively update lake contours using multi-temporal satellite image.

Keywords: level set model, multi-temporal image, lake contour extraction, contour update

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Authors: Nargiza Nuralieva

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This meta-analysis investigates the effectiveness of mental health interventions tailored for international students in China, with a specific focus on Uzbek students and Silk Road scholarship recipients. The comprehensive literature review synthesizes existing studies, papers, and reports, evaluating the outcomes, limitations, and cultural considerations of these programs. Data selection targets mental health programs for international students, honing in on a subset analysis related to Uzbek students and Silk Road scholarship recipients. The analysis encompasses diverse outcome measures, such as reported stress levels, utilization rates of mental health services, academic performance, and more. Results reveal a consistent and statistically significant reduction in reported stress levels, emphasizing the positive impact of these interventions. Utilization rates of mental health services witness a significant increase, highlighting the accessibility and effectiveness of support. Retention rates show marked improvement, though academic performance yields mixed findings, prompting nuanced exploration. Psychological well-being, quality of life, and overall well-being exhibit substantial enhancements, aligning with the overarching goal of holistic student development. Positive outcomes are observed in increased help-seeking behavior, positive correlations with social support, and significant reductions in anxiety levels. Cultural adaptation and satisfaction with interventions both indicate positive outcomes, underscoring the effectiveness of culturally sensitive mental health support. The findings emphasize the importance of tailored mental health interventions for international students, providing novel insights into the specific needs of Uzbek students and Silk Road scholarship recipients. This research contributes to a nuanced understanding of the multifaceted impact of mental health programs on diverse student populations, offering valuable implications for the design and refinement of future interventions. As educational institutions continue to globalize, addressing the mental health needs of international students remains pivotal for fostering inclusive and supportive learning environments.

Keywords: international students, mental health interventions, cross-cultural support, silk road scholarship, meta-analysis

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Authors: Zsofia Patyi

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While empirical studies under socialism in Hungary focused on the lawyer society as a whole, current research deals with law students in specific. The change of regime and the mutation of legal education have influenced the motivation, efficiency, social background and self-concept of law students. This shift needs to be acknowledged, and the education system improved for students and together with students. A new law student society requires a different legal education system, different legal studies, or, at the minimum, a different approach to teaching law. This is to ensure that competitive lawyers be trained who understand the constantly changing nature of the law and, as a result, can potentially transform or create legislation themselves. A number of developments can affect law students’ awareness of legal relations in a democratic state. In today’s Hungary, these decisive factors are primarily the new regulation of the financing of law students, and secondly, the new Hungarian constitution (henceforth: Alaptörvény), which has modified the base of the Hungarian legal system. These circumstances necessitate a new, comprehensive, and empirical, investigation of law students. To this end, our research team (comprising a professor, a Ph.D. student, and two law students), is conducting a new type of study in February 2017. The first stage of the research project uses the desktop method to open up the research antecedents. Afterward, a structured questionnaire draft will be designed and sent to the Head of Department of Sociology and the Associate Professor of the Department of Constitutional Law at the University of Szeged to have the draft checked and amended. Next, an open workshop for students and teachers will be organized with the aim to discuss the draft and create the final questionnaire. The research team will then contact each Hungarian university with a Faculty of Law to reach all 1st- and 4th-year law students. 1st-year students have not yet studied the Alaptörvény, while 4th-year students have. All students will be asked to fill in the questionnaire (in February). Results are expected to be in at the end of February. In March, the research team will report the results and present the conclusions. In addition, the results will be compared to previous researches. The outcome will help us answer the following research question: How should legal studies and legal education in Hungary be reformed in accordance with law students and the future lawyer society? The aim of the research is to (1) help create a new student- and career-centered teaching method of legal studies, (2) offer a new perspective on legal education, and (3) create a helpful and useful de lege ferenda proposal for the attorney general as regards legal education as part of higher education.

Keywords: change, constitution, investigation, law students, lawyer society, legal education, legal studies, motivation, reform

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Authors: A. O. Abulibdeh

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The aim of this study is to investigate and compare the changes in the Land Surface Temperature (LST) as a function of urbanization, particularly land use/land cover changes, in three cities in the UAE, mainly Abu Dhabi, Dubai, and Al Ain. The scale of this assessment will be at the macro- and micro-levels. At the macro-level, a comparative assessment will take place to compare between the four cities in the UAE. At the micro-level, the study will compare between the effects of different land use/land cover on the LST. This will provide a clear and quantitative city-specific information related to the relationship between urbanization and local spatial intra-urban LST variation in three cities in the UAE. The main objectives of this study are 1) to investigate the development of LST on the macro- and micro-level between and in three cities in the UAE over two decades time period, 2) to examine the impact of different types of land use/land cover on the spatial distribution of LST. Because these three cities are facing harsh arid climate, it is hypothesized that (1) urbanization is affecting and connected to the spatial changes in LST; (2) different land use/land cover have different impact on the LST; and (3) changes in spatial configuration of land use and vegetation concentration over time would control urban microclimate on a city scale and control macroclimate on the country scale. This study will be carried out over a 20-year period (1996-2016) and throughout the whole year. The study will compare between two distinct periods with different thermal characteristics which are the cool/cold period from November to March and warm/hot period between April and October. The best practice research method for this topic is to use remote sensing data to target different aspects of natural and anthropogenic systems impacts. The project will follow classical remote sensing and mapping techniques to investigate the impact of urbanization, mainly changes in land use/land cover, on LST. The investigation in this study will be performed in two stages. Stage one remote sensing data will be used to investigate the impact of urbanization on LST on a macroclimate level where the LST and Urban Heat Island (UHI) will be compared in the three cities using data from the past two decades. Stage two will investigate the impact on microclimate scale by investigating the LST and UHI using a particular land use/land cover type. In both stages, an LST and urban land cover maps will be generated over the study area. The outcome of this study should represent an important contribution to recent urban climate studies, particularly in the UAE. Based on the aim and objectives of this study, the expected outcomes are as follow: i) to determine the increase or decrease of LST as a result of urbanization in these four cities, ii) to determine the effect of different land uses/land covers on increasing or decreasing the LST.

Keywords: land use/land cover, global warming, land surface temperature, remote sensing

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Authors: Anshika Kankane, Dongshik Kang

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Marine debris has a significant influence on coastal environments, damaging biodiversity, and causing loss and damage to marine and ocean sector. A functional cost-effective and automatic approach has been used to look up at this problem. Computer vision combined with a deep learning-based model is being proposed to identify and categorize marine debris of seven kinds on different beach locations of Japan. This research compares state-of-the-art deep learning models with a suggested model architecture that is utilized as a feature extractor for debris categorization. The model is being proposed to detect seven categories of litter using a manually constructed debris dataset, with the help of Mask R-CNN for instance segmentation and a shape matching network called HOGShape, which can then be cleaned on time by clean-up organizations using warning notifications of the system. The manually constructed dataset for this system is created by annotating the images taken by fixed KaKaXi camera using CVAT annotation tool with seven kinds of category labels. A pre-trained HOG feature extractor on LIBSVM is being used along with multiple templates matching on HOG maps of images and HOG maps of templates to improve the predicted masked images obtained via Mask R-CNN training. This system intends to timely alert the cleanup organizations with the warning notifications using live recorded beach debris data. The suggested network results in the improvement of misclassified debris masks of debris objects with different illuminations, shapes, viewpoints and litter with occlusions which have vague visibility.

Keywords: computer vision, debris, deep learning, fixed live camera images, histogram of gradients feature extractor, instance segmentation, manually annotated dataset, multiple template matching

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Authors: S. Albert, R. Cossu, A. Grinham, C. Heatherington, C. Wilson

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Shipping trends suggest increasing vessel size and draught visiting Australian ports highlighting potential challenges to port infrastructure and requiring optimization of shipping channels to ensure safe passage for vessels. The Port of Brisbane in Queensland, Australia has an 80 km long access shipping channel which vessels must transit 15 km of relatively shallow coffee rock (generic class of indurated sands where sand grains are bound within an organic clay matrix) outcrops towards the northern passage in Moreton Bay. This represents a risk to shipping channel deepening and maintenance programs as the dredgeability of this material is more challenging due to its high cohesive strength compared with the surrounding marine sands and potential higher acid sulfate risk. In situ assessment of acid sulfate sediment for dredge spoil control is an important tool in mitigating ecological harm. The coffee rock in an anoxic undisturbed state does not pose any acid sulfate risk, however when disturbed via dredging it’s vital to ensure that any present iron sulfides are either insignificant or neutralized. To better understand the potential risk we examined the reduction potential of coffee rock across the entire dredge cycle in order to accurately portray the true outcome of disturbed acid sulfate sediment in dredging operations in Moreton Bay. In December 2014 a dredge trial was undertaken with a trailing suction hopper dredger. In situ samples were collected prior to dredging revealed acid sulfate potential above threshold guidelines which could lead to expensive dredge spoil management. However, potential acid sulfate risk was then monitored in the hopper and subsequent discharge, both showing a significant reduction in acid sulfate potential had occurred. Additionally, the acid neutralizing capacity significantly increased due to the inclusion of shell fragments (calcium carbonate) from the dredge target areas. This clearly demonstrates the importance of assessing potential acid sulfate risk across the entire dredging cycle and highlights the need to carefully evaluate sources of acidity.

Keywords: acid sulfate, coffee rock, indurated sand, dredging, maintenance dredging

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Authors: Xiaoqing Liu, Kurt Friese, Karsten Rinke

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Lacustrine sediment archives rich paleoenvironmental information in lake and surrounding environment. Additionally, modern sediment is used as an effective medium for the monitoring of lake. Organic carbon in sediment is a heterogeneous mixture with varying turnover times and qualities which result from the different biogeochemical processes in the deposition of organic material. Therefore, the isolation of different carbon pools is important for the research of lacustrine condition in the lake. However, the numeric available fractionation procedures can hardly yield homogeneous carbon pools on terms of stability and age. In this work, a multi-step fractionation protocol that treated sediment with hot water, HCl, H2O2 and Na2S2O8 in sequence was adopted, the treated sediment from each step were analyzed for the isotopic and structural compositions with Isotope Ratio Mass Spectrometer coupled with element analyzer (IRMS-EA) and Solid-state 13C Nuclear Magnetic Resonance (NMR), respectively. The sequential extractions with hot-water, HCl, and H2O2 yielded a more homogeneous and C3 plant-originating OC fraction, which was characterized with an atomic C/N ratio shift from 12.0 to 20.8, and 13C and 15N isotopic signatures were 0.9‰ and 1.9‰ more depleted than the original bulk sediment, respectively. Additionally, the H2O2- resistant residue was dominated with stable components, such as the lignins, waxes, cutans, tannins, steroids and aliphatic proteins and complex carbohydrates. 6M HCl in the acid hydrolysis step was much more effective than 1M HCl to isolate a sedimentary OC fraction with higher degree of homogeneity. Owing to the extremely high removal rate of organic matter, the step of a Na2S2O8 oxidation is only suggested if the isolation of the most refractory OC pool is mandatory. We conclude that this multi-step chemical fractionation procedure is effective to isolate more homogeneous OC pools in terms of stability and functional structure, and it can be used as a promising method for OC pools fractionation of sediment or soil in future lake research.

Keywords: 13C-CPMAS-NMR, 13C signature, lake sediment, OC fractionation

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Authors: Bikram K. Das, Kalyan K. Chattopadhyay

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The advent of 2-D materials in the last decade has induced a fresh spur of growth in fuel cell technology as these materials have some highly promising traits that can be exploited to felicitate Oxygen Reduction Reaction (ORR) in an efficient way. Among the various 2-D carbon materials, graphyne (Gy) and graphdiyne (Gdy)1 with their intrinsic non-uniform charge distribution holds promises in this purpose and it is expected2 that substitutional Nitrogen (N) doping could further enhance their efficiency. In this regard, dispersive force corrected density functional theory is used to map the oxygen reduction reaction (ORR) kinetics of five different kinds of N doped graphyne and graphdiyne systems (namely αGy, βGy, γGy, RGy and 6,6,12Gy and Gdy) in alkaline medium. The best doping site for each of the Gy/ Gdy system is determined comparing the formation energies of the possible doping configurations. Similarly, the best di-oxygen (O₂) adsorption sites for the doped systems are identified by comparing the adsorption energies. O₂ adsorption on all N doped Gy/ Gdy systems is found to be energetically favorable. ORR on a catalyst surface may occur either via the Eley-Rideal (ER) or the Langmuir–Hinschelwood (LH) pathway. Systematic studies performed on the considered systems reveal that all of them favor the ER pathway. Further, depending on the nature of di-oxygen adsorption ORR can follow either associative or dissociative mechanism; the possibility of occurrence of both the mechanisms is tested thoroughly for each N doped Gy/ Gdy. For the ORR process, all the Gy/Gdy systems are observed to prefer the efficient four-electron pathway but the expected monotonically exothermic reaction pathway is found only for N doped 6,6,12Gy and RGy following the associative pathway and for N doped βGy, γGy and Gdy following the dissociative pathway. Further computation performed for these systems reveals that for N doped 6,6,12Gy, RGy, βGy, γGy and Gdy the overpotentials are 1.08 V, 0.94 V, 1.17 V, 1.21 V and 1.04 V respectively depicting N doped RGy is the most promising material, to carry out ORR in alkaline medium, among the considered ones. The stability of the ORR intermediate states with the variation of pH and electrode potentials is further explored with Pourbiax diagrams and the activities of these systems in the alkaline medium are compared with the prior reported B/N doped identical systems for ORR in an acidic medium in terms of a common descriptor.

Keywords: graphdiyne, graphyne, nitrogen-doped, ORR

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Authors: T. Mcgraw, F. N. Morin, N. Desai

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Background: Antimicrobial resistance is a critical issue in global health care and a significant contributor to increased patient morbidity and mortality. Suspected urinary tract infection (UTI) is a key area of inappropriate antibiotic prescription in pediatrics. Management patterns of infectious diseases have been shown to vary by provider type within a single setting. The aim of this study was to assess compliance with national UTI management guidelines by nurse practitioners in a pediatric emergency department (ED). Methods: This was a post-hoc analysis of a retrospective cohort study to review and evaluate visits to a tertiary care freestanding pediatric emergency department. Patients were included if they were 60 days to 36 months old and discharged with a diagnosis of UTI or ‘rule-out UTI’ between July 2015 and July 2020. Primary outcome measure was proportion of visits seen by Nurse Practitioners (NP) which were associated with national guideline compliance in the diagnosis and treatment of suspected UTI. We performed descriptive statistics and comparative analyses to determine differences in practice patterns between NPs, and physicians. Results: A total of 636 charts were reviewed, of which 402 patients met inclusion criteria. 17 patients were treated by NPs, 385 were treated by either Pediatric Emergency Medicine physicians (PEM) or non-PEM physicians. Overall, the proportion of infants receiving guideline-compliant care was 25.9% (21.8-30.4%). Of those who were prescribed antibiotics, 79.6% (74.7-83.8%) received first line guideline recommended therapy and 58.9% (53.8-63.8%) received fully compliant therapy with respect to age, dose, duration, and frequency. In patients treated by NPs, 16/17 (94%(95% CI:73.0-99.0)) required antibiotics, 15/16 (93%(95% CI: 71.7-98.9)) were treated with first line agent (cephalexin), 8/16 (50%(95% CI:28-72)) were guideline compliant of dose and duration. 5/8 (63%(95% CI:30.6-86.3)) were noncompliant for dose being too high. There was no difference in receiving guideline compliant empiric antibiotic therapy between physicians and nurse practitioners (OR: 0.837 CI: 0.302-2.69). Conclusion: In this post-hoc analysis, guideline noncompliance by nurse practitioners is common in children tested and treated for UTIs in a pediatric emergency department. Care by a Nurse Practitioner was not associated with greater rate of noncompliance than care by a Pediatric Emergency Medicine physician. Future appropriately powered studies may focus on confirming these results.

Keywords: antibiotic stewardship, infectious disease, nurse practitioner, urinary tract infection

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Authors: P. Bauer, K. Mougin, V. Vignal, A. Buch, P. Ponthiaux, D. Faye

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Nowadays, noble metallic nanostructures with unique morphology are widely used as new sensors due to their fascinating optical, electronic and catalytic properties. Among various shapes, dendritic nanostructures have attracted much attention because of their large surface-to-volume ratio, high sensitivity and special texture with sharp tips and nanoscale junctions. Several methods have been developed to fabricate those specific structures such as electrodeposition, photochemical way, seed-mediated growth or wet chemical method. The present study deals with a novel approach for a controlled growth pattern-directed organisation of Au flower-like crystals (NFs) deposited onto stainless steel plates to achieve large-scale functional surfaces. This technique consists in the deposition of a soft nanoporous template on which Au NFs are grown by electroplating and seed-mediated method. Size, morphology, and interstructure distance have been controlled by a site selective nucleation process. Dendritic Au nanostructures have appeared as excellent Raman-active candidates due to the presence of very sharp tips of multi-branched Au nanoparticles that leads to a large local field enhancement and a good SERS sensitivity. In addition, these structures have also been used as electrochemical sensors to detect traces of molecules present in a solution. A correlation of the number of active sites on the surface and the current charge by both colorimetric method and cyclic voltammetry of gold structures have allowed a calibration of the system. This device represents a first step for the fabrication of MEMs platform that could ultimately be integrated into a lab-on-chip system. It also opens pathways to several technologically large-scale nanomaterials fabrication such as hierarchically ordered crystal architectures for sensor applications.

Keywords: dendritic, electroplating, gold, template

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Authors: Anna Zimoch-Korzycka, Dominika Kulig, Andrzej Jarmoluk

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The aim of this study was to obtain chitooligosaccharides from chitosan with better functional properties using three different enzyme preparations and compare the products of enzymatic hydrolysis. Commercially available cellulase (CL), xylanase (X) and chitosanase (CS) preparations were used to investigate hydrolytic activity on chitosan (CH) with low molecular weight and DD of 75-85%. It has been reported that CL and X have side activities of other enzymes, such as β-glucanase or β-glucosidase. CS enzyme has a foreign activity of chitinase. Each preparation was used in 1000 U of activity and in the same reaction conditions. The degree of deacetylation and molecular weight of chitosan were specified using titration and viscometric methods, respectively. The hydrolytic activity of enzymes preparations on chitosan was monitored by dynamic viscosity measurement. After 4 h reaction with stirring, solutions were filtered and chitosan oligomers were isolated by methanol solution into two fractions: precipitate (A) and supernatant (B). A Fourier-transform infrared spectroscopy was used to characterize the structural changes of chitosan oligomers fractions and initial chitosan. Furthermore, the solubility of lyophilized hydrolytic mixture (C) and two chitooligomers fractions (A, B) of each enzyme hydrolysis was assayed. The antioxidant activity of chitosan oligomers was evaluated as DPPH free radical scavenging activity. The dynamic viscosity measured after addition of enzymes preparation to the chitosan solution decreased dramatically over time in the sample with X in comparison to solution without the enzyme. For mixtures with CL and CS, lower viscosities were also recorded but not as low as the ones with X. A and B fractions were characterized by the most similar viscosity obtained by the xylanase hydrolysis and were 15 mPas and 9 mPas, respectively. Structural changes of chitosan oligomers A, B, C and their differences related with various enzyme preparations used were confirmed. Water solubility of A fractions was not possible to filter and the result was not recorded. Solubility of supernatants was approximately 95% and was higher than hydrolytic mixture. It was observed that the DPPH radical scavenging effect of A, B, C samples is the highest for X products and was approximately 13, 17, 19% respectively. In summary, a mixture of chitooligomers may be useful for the design of edible protective coatings due to the improved biophysical properties.

Keywords: cellulase, xylanase, chitosanase, chitosan, chitooligosaccharides

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Authors: Shivani Dolas, A. Richa Mishra

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The existence of Courtyards in India can be traced back to ‘Indus valley civilization’ and various layers of history bearing implications like socio-cultural, traditional, religious, climatic, etc., moreover serving as a breathing space in case of historical core areas. Over time, with the overlay of various historic layers within the historic urban cores and the present high density populace, the cores are getting congested day by day. In this case, courtyards may emerge out as an efficient medium to provide quality of life through livable spaces. Presently, with the growing population of the historic town of Gwalior, town in Madhya Pradesh holds remarkable essence of courtyards with its multiple concepts over time. Its scale and function varies from an imposing grand appearance in palatial form, up to functional practices as residential. Its privilege can also be drawn in urban forms, in sharing single space by multiple dwellings and in temples which can be sketched specifically in the region. Moreover, the effectiveness of courtyards has proven balance and control of micro-climate in such composite climate region. The research paper aims to underline the concept of courtyards in case of a mixed use neighborhood, Naya bazar, in Lashkar area of Gwalior, which developed during 19th century, highlighting the need of its preservation. The paper also elaborates its various implications on user-space relationship as in the present context, and growing congestion in the area, user and space relationship is seen lost. The noticeable change in the behavioral context in buildings and users can be noticed with the downfall of courtyards, isolating users with land. Also, a concern has been expressed on negligence of courtyard planning in future development, suggesting recommendations on preserving the courtyard typology as heritage.

Keywords: courtyards, Gwalior, historic settlement, heritage

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Authors: Henry Pariaman, Iwa Garniwa, Isti Surjandari, Bambang Sugiarto

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Availability of a complex system of thermal power plant is strongly influenced by the reliability of spare parts and maintenance management policies. A reliability-centered maintenance (RCM) technique is an established method of analysis and is the main reference for maintenance planning. This method considers the consequences of failure in its implementation, but does not deal with further risk of down time that associated with failures, loss of production or high maintenance costs. Risk-based maintenance (RBM) technique provides support strategies to minimize the risks posed by the failure to obtain maintenance task considering cost effectiveness. Meanwhile, condition-based maintenance (CBM) focuses on monitoring the application of the conditions that allow the planning and scheduling of maintenance or other action should be taken to avoid the risk of failure prior to the time-based maintenance. Implementation of RCM, RBM, CBM alone or combined RCM and RBM or RCM and CBM is a maintenance technique used in thermal power plants. Implementation of these three techniques in an integrated maintenance will increase the availability of thermal power plants compared to the use of maintenance techniques individually or in combination of two techniques. This study uses the reliability, risks and conditions-based maintenance in an integrated manner to increase the availability of thermal power plants. The method generates MPI (Priority Maintenance Index) is RPN (Risk Priority Number) are multiplied by RI (Risk Index) and FDT (Failure Defense Task) which can generate the task of monitoring and assessment of conditions other than maintenance tasks. Both MPI and FDT obtained from development of functional tree, failure mode effects analysis, fault-tree analysis, and risk analysis (risk assessment and risk evaluation) were then used to develop and implement a plan and schedule maintenance, monitoring and assessment of the condition and ultimately perform availability analysis. The results of this study indicate that the reliability, risks and conditions-based maintenance methods, in an integrated manner can increase the availability of thermal power plants.

Keywords: integrated maintenance techniques, availability, thermal power plant, MPI, FDT

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Authors: Ballari Bagchi

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The dynamism ingrained in the process of urban-rural integration is manifested in the emergence of rurban settlements, referring to areas that combine the characteristics of agricultural activities found in rural zones with those of suburban living areas and industrialised zones. The concept of rurbanisation refers to the idea of introducing urban conveniences and opportunities, to rural areas in an attempt to stem rural urban migration. In the backdrop of the worldwide problem of disharmonised urban-rural dependence and the associated problems in urban and rural areas, the present study seeks to explore the potentialities of few settlements having a blend of rural and urban characteristics in the urban field of Koch Bihar. The prime concern of the present paper is three-fold: (i) to identify the rurban centres, (ii) to analyse the spatial integration of these identified centres with the rural areas situated in the urban periphery, and (iii) to suggest the necessities to be introduced in these settlements. The methodology applied here includes rurban index, gravity model, and functional classification of rurban centres, correlation and regression analysis and cartographic representation of data collected through primary and secondary sources. The investigation has identified a number of settlements potentially viable to be termed as rurban centres which may render services to the other less equipped rural areas in all aspects of life and thereby would lessen the burden on Koch Bihar urban centre. The levels of infrastructure of these settlements should be such that it might even attract the urban population in a reverse direction. The villages belonging to the lower rung of these service settlements would require metalled road connection with these intermediate settlements in addition to their connection with the core town. That is to say, a proper policy needs to be adopted in this regard to furnish these settlements with required infrastructures for serving their own population as well as the population of other villages. As a consequence of that, the idea of a well-coordinated settlement hierarchy may emerge in future.

Keywords: Hinterland, rurban, settlement hierarchy, urban-rural integration

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Authors: Abdullah Al-Nassri, Ahmed Al-Alawi

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Seaweeds are classified into three groups: red, green, and brown. Each group of seaweeds consists of several types that have differences in composition. Even at the species level, there are differences in some ingredients, although in general composition, they are the same. Environmental conditions, availability of nutrients, and maturity stage are the main reasons for composition differences. In this study, two red seaweed species, Melanothamnus somalensis & Gelidium omanense, were collected in September 2021 from Sadh (Dhofar governorate, Oman). Five organic solvents were used sequentially to achieve extraction. The solvents were applied in the following order: hexane, dichloromethane, ethyl acetate, acetone, and methanol. Preparative HPLC (PrepLC) was performed to fraction the extracts. The chemical composition was measured; also, total phenols, flavonoids, and tannins were investigated. The structure of the extracts was analyzed by Fourier-transform infrared spectroscopy (FTIR). Seaweeds demonstrated high differences in terms of chemical composition, total phenolic content (TPC), total flavonoid content (TFC), and total tannin content (TTC). Gelidium omanense showed high moisture content, lipid content and carbohydrates (9.8 ± 0.15 %, 2.29 ± 0.09 % and 70.15 ± 0.42 %, respectively) compared to Melanothamnus somalensis (6.85 ± 0.01 %, 2.05 ± 0.12 % and 52.7 ± 0.36 % respectively). However, Melanothamnus somalensis showed high ash content and protein (27.68 ± 0.40 % and 52.7 ± 0.36 % respectively) compared to Gelidium omanense (8.07 ± 0.39 % and 9.70 ± 0.22 % respectively). Melanothamnus somalensis showed higher elements and minerals content, especially sodium and potassium. This is attributed to the jelly-like structure of Melanothamnus somalensis, which allows storage of more solutes compared to the leafy-like structure of Gelidium omanense. Furthermore, Melanothamnus somalensis had higher TPC in all fractions except the hexane fraction than Gelidium omanense. Except with hexane, TFC in the other solvents’ extracts was significantly different between Gelidium omanense and Melanothamnus somalensis. In all fractions, except dichloromethane and ethyl acetate fractions, there were no significant differences in TTC between Gelidium omanense and Melanothamnus somalensis. FTIR spectra showed variation between fractions, which is an indication of different functional groups.

Keywords: chemical composition, organic extract, Omani seaweeds, biological activity, FTIR

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Authors: Nakul V. Naphade, Sandra G. L. Persiani, Yew Wah Wong, Pramod S. Kamath, Avinash H. Anantharam, Hui Ling Aw, Yann Grynberg

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Achieving zero-energy targets in existing buildings is known to be a difficult task requiring important cuts in the building energy consumption, which in many cases clash with the functional necessities of the building wherever the on-site energy generation is unable to match the overall energy consumption. Between the building’s consumption optimization limit and the energy, target stretches a case-specific optimization grey zone, which requires tailored intervention and enhanced user’s commitment. In the view of the future adoption of more stringent energy-efficiency targets in the context of hot-humid tropical climates, this study aims to define the energy optimization grey zone by assessing the energy-efficiency limit in the state-of-the-art typical mid- and high-rise full AC office buildings, through the integration of currently available technologies. Energy models of two code-compliant generic office-building typologies were developed as a baseline, a 20-storey ‘high-rise’ and a 7-storey ‘mid-rise’. Design iterations carried out on the energy models with advanced market ready technologies in lighting, envelope, plug load management and ACMV systems and controls, lead to a representative energy model of the current maximum technical potential. The simulations showed that ZEB targets could be achieved in fully AC buildings under an average of seven floors only by compromising on energy-intense facilities (as full AC, unlimited power-supply, standard user behaviour, etc.). This paper argues that drastic changes must be made in tropical buildings to span the energy optimization grey zone and achieve zero energy. Fully air-conditioned areas must be rethought, while smart technologies must be integrated with an aggressive involvement and motivation of the users to synchronize with the new system’s energy savings goal.

Keywords: energy simulation, office building, tropical climate, zero energy buildings

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Authors: Sónia Ribeiro, Diana Farinha, Elsa Pereira, Hélia Sales, Filipa Figueiredo, Rita Pontes, João Nunes

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Conventional plastic impacts on Planet, natural resources contamination, human health as well as animals are the most attractive environmental and health attention. The lack of treatment in the end-of-life (EOL) phase and uncontrolled discard allows plastic to be found everywhere in the world. Food waste is increasing significantly, with a final destination to landfills. To face these difficulties, new packaging solutions are needed with the objective of prolonging the shelf-life of products as well as equipment solutions for the development of the mentioned packaging. FLUI project thus presents relevance and innovation to reach a new level of knowledge and industrial development focused in Ecodesign. Industrial equipment field for the manufacture of new packaging solutions based on biodegradable plastics films to apply in the food sector. With lesser environmental impacts and new solutions that make it possible to prevent food waste, reduce the production e consequent poor disposal of plastic of fossil origin. It will be a paradigm shift at different levels, from industry to waste treatment stations, passing through commercial agents and consumers. It can be achieved through the life cycle assessment (LCA) and ecodesign of the products, which integrates the environmental concerns in the design of the product as well as through the entire life cycle. The FLUI project aims to build a piece of new bio-PLA extrusion equipment with the incorporation of bioactive extracts through the production of flexible mono- and multi-layer functional films (FLUI systems). The biofunctional and biodegradable films will prompt the extension of packaged products’ shelf-life, reduce food waste and contribute to reducing the consumption of non-degradable fossil plastics, as well as the use of raw material from renewable sources.

Keywords: food packing, bioplastics, ecodesign, circular economy

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Authors: Shady S. Hassan, Brijesh K. Tiwari, Gwilym A. Williams, Amit K. Jaiswal

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Waste materials from a wide range of agro-industrial processes may be used as substrates for microbial growth, and subsequently the production of a range of high value products and bioenergy. In addition, utilization of these agro-residues in bioprocesses has the dual advantage of providing alternative substrates, as well as solving their disposal problems. Spent coffee grounds (SCG) are a by-product (45%) of coffee processing. SCG is a lignocellulosic material, which is composed mainly of cellulose, hemicelluloses, and lignin. Thus, a pretreatment process is required to facilitate an efficient enzymatic hydrolysis of such carbohydrates. In this context, microwave pretreatment of lignocellulosic biomass without the addition of harsh chemicals represents a green technology. Moreover, microwave treatment has a high heating efficiency and is easy to implement. Thus, microwave pretreatment of SCG without adding of harsh chemicals investigated as a green technology to enhance enzyme hydrolysis. In the present work, microwave pretreatment experiments were conducted on SCG at varying power levels (100, 250, 440, 600, and 1000 W) for 60 s. By increasing microwave power to a certain level (which vary by varying biomass), reducing sugar increases, then reducing sugar from biomass start to decrease with microwave power increase beyond this level. Microwave pretreatment of SCG at 60s followed by enzymatic hydrolysis resulted in total reducing sugars of 91.6 ± 7.0 mg/g of biomass (at microwave power of 100 w). Fourier transform Infrared Spectroscopy (FTIR) was employed to investigate changes in functional groups of biomass after pretreatment, while high-performance liquid chromatography (HPLC) was employed for determination of glucose. Pretreatment of lignocellulose using microwave was found to be an effective and energy efficient technology to improve saccharification and glucose yield. Energy performance will be evaluated for the microwave pretreatment, and the enzyme hydrolysate will be used as media component substitute for the production of ethanol and other high value products.

Keywords: lignocellulose, microwave, pretreatment, spent coffee grounds

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Authors: Zaida Perez-Bassart, Berta Polanco-Estibalez, Maria Jose Fabra, Amparo Lopez-Rubio, Antonio Martinez-Abad

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Mushroom production has enormously increased in recent years, not only as food products but also for applications in pharmaceuticals, nutraceuticals, and cosmetics. Consequently, interest in its chemical composition, nutritional value, and therapeutic properties has also increased. Fungi are rich in bioactive compounds such as polysaccharides, polyphenols, glycopeptides, and ergosterol, of great medicinal value, but within polysaccharides, β-glucans are the most prominent molecules. They are formed by D-glucose monomers, linked by β-glucosidic bonds β-(1,3) with side chains linked by β-(1,6) bonds. The number and position of the β-(1,6) branches strongly influence the arrangement of the tertiary structure, which, together with the molecular weight, determine the different attributed bioactivities (immunostimulating, anticancer, antimicrobial, prebiotic, etc.) and physico-chemical properties (solubility, bioaccessibility, viscosity or emulsifying). On the other hand, there is a growing interest in the study of fungi as an alternative source of chitin obtained from the by-products of the fungal industry. In this work, a cascade extraction process using aqueous neutral and alkaline treatments was carried out for Grifola frondosa and Lentinula edodes, and the compositional analysis and functional properties of each fraction were characterized. Interestingly, the first fraction obtained by using aqueous treatment at room temperature was the richest in polysaccharides, proteins, and polyphenols, thus obtaining a greater antioxidant capacity than in the other fractions. In contrast, the fractions obtained by alkaline treatments showed a higher degree of β-glucans purification compared to aqueous extractions but a lower extraction yield. Results revealed the different structural recalcitrance of β-glucans, preferentially linked to proteins or chitin depending on the fungus type, which had a direct impact on the functionalities and bioactivities of each fraction.

Keywords: fungi, mushroom, β-glucans, chitin

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Authors: Joanna Skopinska-Wisniewska, Anna Bajek, Marta Ziegler-Borowska, Alina Sionkowska

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Hydrogels are a class of materials widely used in medicine for many years. Proteins, such as collagen, due to the presence of a large number of functional groups are easily wettable by polar solvents and can create hydrogels. The supramolecular network capable to swelling is created by cross-linking of the biopolymers using various reagents. Many cross-linking agents has been tested for last years, however, researchers still are looking for a new, more secure reactants. Squaric acid, 3,4-dihydroxy 3-cyclobutene 1,2- dione, is a very strong acid, which possess flat and rigid structure. Due to the presence of two carboxyl groups the squaric acid willingly reacts with amino groups of collagen. The main purpose of this study was to investigate the influence of addition of squaric acid on the chemical, physical and biological properties of collagen materials. The collagen type I was extracted from rat tail tendons and 1% solution in 0.1M acetic acid was prepared. The samples were cross-linked by the addition of 5%, 10% and 20% of squaric acid. The mixtures of all reagents were incubated 30 min on magnetic stirrer and then dialyzed against deionized water. The FTIR spectra show that the collagen structure is not changed by cross-linking by squaric acid. Although the mechanical properties of the collagen material deteriorate, the temperature of thermal denaturation of collagen increases after cross-linking, what indicates that the protein network was created. The lyophilized collagen gels exhibit porous structure and the pore size decreases with the higher addition of squaric acid. Also the swelling ability is lower after the cross-linking. The in vitro study demonstrates that the materials are attractive for 3T3 cells. The addition of squaric acid causes formation of cross-ling bonds in the collagen materials and the transparent, stiff hydrogels are obtained. The changes of physicochemical properties of the material are typical for cross-linking process, except mechanical properties – it requires further experiments. However, the results let us to conclude that squaric acid is a suitable cross-linker for protein materials for medicine and tissue engineering.

Keywords: collagen, squaric acid, cross-linking, hydrogel

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Authors: Kamila Weissova, Jitka Skrabalova, Katerina Skalova, Jana Koprivova, Zdenka Bendova

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Any Arctic visitor has to deal with extreme conditions, including constant light during the summer season or constant darkness during winter time. Light/dark cycle is the most powerful synchronizing signal for biological clock and the absence of daily dark period during the polar day can significantly alter the functional state of the internal clock. However, the inner clock can be synchronized by other zeitgebers such as physical activity, food intake or social interactions. Here, we investigated the effect of polar day on circadian clock of 10 researchers attending the polar base station in the Svalbard region during July. The data obtained on Svalbard were compared with the data obtained before the researchers left for the expedition (in the Czech Republic). To determine the state of circadian clock we used wrist actigraphy followed by sleep diaries, saliva, and buccal mucosa samples, both collected every 4 hours during 24h-interval to detect melatonin by radioimmunoassay and clock gene (PER1, BMAL1, NR1D1, DBP) mRNA levels by RT-qPCR. The clock gene expression was analyzed using cosinor analysis. From our results, it is apparent that the constant sunlight delayed melatonin onset and postponed the physical activity in the same order. Nevertheless, the clock gene expression displayed higher amplitude on Svalbard compared to the amplitude detected in the Czech Republic. These results have suggested that the common daily schedule at the Svalbard expedition can strengthen circadian rhythm in the environment that is lacking light/dark cycle. In conclusion, the constant sunlight delays melatonin onset, but it still maintains its rhythmic secretion. The effect of constant sunlight on circadian clock can be minimalized by common daily scheduled activity.

Keywords: actighraph, clock genes, human, melatonin, polar day

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Authors: Mukesh K. Dwivedi, Rajeshwar N. Srivastava, Amit K. Bhagat, Saloni Raj

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Introduction: Management of Pressure Ulcer (PU) is an ongoing clinical challenge particularly in traumatic paraplegia patients in developing countries where socio economic conditions often dictate treatment modalities. When negative pressure wound therapy (NPWT) was introduced, there were a series of devices (V.A.C., KCI, San Antonio, TX) manufactured. These devices for NPWT are costly and hard to afford by patients in developing countries like India. Considering this limitation, this study was planned to design an RCT to compare NPWT by an indigenized locally constructed NPD and conventional gauze dressing for the treatment of PU. Material and Methods: This RCT (CTRI/2014/09/0050) was conducted in the Department of Orthopaedic Surgery at King George’s Medical University (KGMU), India. Thirty-four (34) subjects of traumatic paraplegia having PU of stage 3 or 4, were enrolled and randomized in two treatment groups (NPWT Group & Conventional dressing group). The outcome measures of this study were surface area and depth of PU, exudates, microorganisms and matrix metalloproteinase-8 (MMP-8) during 0 to 9 weeks follow-ups. Levels of MMP-8 were analyzed in the tissues of PU at week 0, 3, 6 and week 9 by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Significantly reduced length of PU in NPWT group was observed at week 6 (p=0.04) which further reduced at week 9 (p=0.001) as compared to conventionally treated group. Similarly significant reduction of width and depth of PU was observed in NPWT at week 9 (p<0.05). The exudate became significantly (p=0.001) lower in NPWT group as compared with conventionally treated group from 6th to 9th week. Clearance and conversion of slough into red granulation tissue was significantly higher in NPWT group (p=0.001). At week 9, the wound culture was negative in all the subjects of NPWT group, while it was positive in 10 (41⋅6%) subjects of conventional group. Significantly lower level of MMP-8 was observed in subjects of NPWT group at week 6 (0.006**), and continually more reduction was observed at week 9 (<0.0001**) as compared to the conventional group. Conclusion: NPWT by locally constructed NPD is better wound care procedure for management of PU. Our device gave similar results as commercially available devices. Reduction of level of MMP-8 and increased rate of healing was achieved by negative pressure wound therapy (NPWT) as compared to conventional dressing.

Keywords: NPWT, NPD, MMP8, ELISA

Procedia PDF Downloads 253

Authors: Cristóbal Moënne-Loccoz, Rodrigo C. Vergara, Vladimir López, Domingo Mery, Diego Cosmelli

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Our daily interaction with computational interfaces is plagued of situations in which we go from inexperienced users to experts through self-motivated exploration of the same task. In many of these interactions, we must learn to find our way through a sequence of decisions and actions before obtaining the desired result. For instance, when drawing cash from an ATM machine, choices are presented in a step-by-step fashion so that a specific sequence of actions must be performed in order to produce the expected outcome. But, as they become experts in the use of such interfaces, do users adopt specific search and learning strategies? Moreover, if so, can we use this information to follow the process of expertise development and, eventually, predict future actions? This would be a critical step towards building truly adaptive interfaces that can facilitate interaction at different moments of the learning curve. Furthermore, it could provide a window into potential mechanisms underlying decision-making behavior in real world scenarios. Here we tackle this question using a simple game interface that instantiates a 4-level binary decision tree (BDT) sequential decision-making task. Participants have to explore the interface and discover an underlying concept-icon mapping in order to complete the game. We develop a Hidden Markov Model (HMM)-based approach whereby a set of stereotyped, hierarchically related search behaviors act as hidden states. Using this model, we are able to track the decision-making process as participants explore, learn and develop expertise in the use of the interface. Our results show that partitioning the problem space into such stereotyped strategies is sufficient to capture a host of exploratory and learning behaviors. Moreover, using the modular architecture of stereotyped strategies as a Mixture of Experts, we are able to simultaneously ask the experts about the user's most probable future actions. We show that for those participants that learn the task, it becomes possible to predict their next decision, above chance, approximately halfway through the game. Our long-term goal is, on the basis of a better understanding of real-world decision-making processes, to inform the construction of interfaces that can establish dynamic conversations with their users in order to facilitate the development of expertise.

Keywords: behavioral modeling, expertise acquisition, hidden markov models, sequential decision-making

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Authors: K. Genise, S. Murthy

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Introductory Statement: The results of this retrospective chart review suggest the effects of bacterial colonization in critically ill children with viral bronchiolitis, currently unproven, are clinically insignificant. Background: Viral bronchiolitis is one of the most prevalent causes of illness requiring hospitalization among children worldwide and one of the most common reasons for admission to pediatric intensive care. It has been hypothesized that co-infection with bacteria results in more severe clinical outcomes. Conversely, the effects of bacterial colonization in critically ill patients with bronchiolitis are poorly defined. Current clinical management of colonized patients consists primarily of supportive therapies with the role of antibiotics remaining controversial. Methods: A retrospective review of all critically ill children admitted to the BC Children’s Hospital Pediatric Intensive Care Unit (PICU) from 2014-2017 with a diagnosis of bronchiolitis was performed. Routine testing in this time frame consisted of complete pathogen testing, including PCR for Streptococcus pneumoniae. Analyses were performed to determine the impact of bacterial colonization and antibiotic use on a primary outcome of PICU length-of-stay, with secondary outcomes of hospital length-of-stay and duration of ventilation. Results: There were 92 patients with complete pathogen testing performed during the assessed timeframe. A comparison between children with detected Streptococcus pneumoniae (n=22) and those without (n=70) revealed no significant (p=0.20) differences in severity of illness on presentation as per Pediatric Risk of Mortality III scores (mean=3.0). Patients colonized with S. pneumoniae had significantly shorter PICU stays (p=0.002), hospital stays (p=0.0001) and duration of non-invasive ventilation (p=0.002). Multivariate analyses revealed that these effects on length of PICU stay and duration of ventilation do not persist after controlling for antibiotic use, presence of radiographic consolidation, age, and severity of illness (p=0.15, p=0.32). The relationship between colonization and duration of hospital stay persists after controlling for these variables (p=0.008). Conclusions: Children with viral bronchiolitis colonized with S. pneumoniae do not appear to have significantly different PICU length-of-stays or duration of ventilation compared to children who are not colonized. Colonized children appear to have shorter hospital stays. The results of this study suggest bacterial colonization is not associated with increased severity of presenting illness or negative clinical outcomes.

Keywords: bronchiolitis, colonization, critical care, pediatrics, pneumococcal, infection

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Authors: Stoyanka Vladeva, Elena Kirilova, Nikola Kirilov

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Background: The creatinine clearance is a widely used value to estimate the GFR. Increased creatinine clearance is often called hyperfiltration and is usually seen during pregnancy, patients with diabetes mellitus preceding the diabetic nephropathy. It may also occur with large dietary protein intake or with plasma volume expansion. Renal injury in lupus nephritis is known to affect the glomerular, tubulointerstitial, and vascular compartment. However high creatinine clearance has not been found in patients with SLE, Target: Follow-up of creatinine clearance values in patients with systemic lupus erythematosus without history of kidney injury. Material and methods: We observed the creatinine, creatinine clearance, GFR and dipstick protein values of 7 women (with a mean age of 42.71 years) with systemic lupus erythematosus. Patients with active lupus have been monthly tested in the period of 13 months. Creatinine clearance has been estimated by Cockcroft-Gault Equation formula in ml/sec. GFR has been estimated by MDRD formula (The Modification of Diet in renal Disease) in ml/min/1.73 m2. Proteinuria has been defined as present when dipstick protein > 1+.Results: In all patients without history of kidney injury we found elevated creatinine clearance levels, but GFRremained within the reference range. Two of the patients were in remission while the other five patients had clinically and immunologically active Lupus. Three of the patients had a permanent presence of high creatinine clearance levels and proteinuria. Two of the patients had periodically elevated creatinine clearance without proteinuria. These results show that kidney disturbances may be caused by the vascular changes typical for SLE. Glomerular hyperfiltration can be result of focal segmental glomerulosclerosis caused by a reduction in renal mass. Probably lupus nephropathy is preceded not only by glomerular vascular changes, but also by tubular vascular changes. Using only the GFR is not a sufficient method to detect these primary functional disturbances. Conclusion: For early detection of kidney injury in patients with SLE we determined that the follow up of creatinine clearance values could be helpful.

Keywords: systemic Lupus erythematosus, kidney injury, elevated creatinine clearance level, normal glomerular filtration rate

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