Search results for: hospital selection

Authors: Alexandra Shipley

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Background: Undergraduate paediatric teaching must overcome two major challenges: 1) balancing patient safety with active student engagement and 2) exposing students to a comprehensive range of pathologies within a relatively short clinical placement. Whilst lectures and shadowing on paediatric wards constitute the mainstay of learning, Simulation and Virtual Reality (VR) are emerging as effective teaching tools, which - immune to the unpredictability and seasonal variation of hospital presentations - could expose students to the entire syllabus more reliably, efficiently, and independently. We aim to evaluate the potential utility of Simulation and VR in addressing gaps within the traditional paediatric curriculum from the perspective of medical students. Summary of Work: Exposure to and perceived utility of various learning opportunities within the Paediatric and Emergency Medicine courses were assessed through a questionnaire completed by 5th year medical students (n=23). Summary of Results: Students reported limited exposure to several common acute paediatric presentations, such as bronchiolitis (41%), croup (32%) or pneumonia (14%), and to clinical emergencies, including cardiac/respiratory arrests or trauma calls (27%). Across all conditions, average self-reported confidence in assessment and management to the level expected of an FY1 is greater amongst those who observed at least one case (e.g. 7.6/10 compared with 3.6/10 for croup). Students rated exposure through Simulation or VR to be of similar utility to witnessing a clinical scenario on the ward. In free text responses, students unanimously favoured being ‘challenged’ through ‘hands-on’ patient interaction over passive shadowing, where it is ‘easy to zone out.’ In recognition of the fact that such independence is only appropriate in certain clinical situations, many students reported wanting more Simulation and VR teaching. Importantly, students raised the necessity of ‘proper debriefs’ after these sessions to maximise educational value. Discussion and Conclusion: Our questionnaire elicited several student-perceived challenges in paediatric education, including incomplete exposure to common pathologies and limited opportunities for active involvement in patient care. Indeed, these experiences seem to be important predictors of confidence. Quantitative and qualitative feedback suggests that VR and Simulation satisfy students’ self-reported appetite for independent engagement with authentic clinical scenarios. Take-aways: Our findings endorse further development of VR and Simulation as high-yield adjuncts to paediatric education.

Keywords: paediatric emergency education, simulation, virtual reality, medical education

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Authors: Coriolano Salvini, Ambra Giovannelli

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The use of renewable energy sources for electric power production leads to reduced CO2 emissions and contributes to improving the domestic energy security. On the other hand, the intermittency and unpredictability of their availability poses relevant problems in fulfilling safely and in a cost efficient way the load demand along the time. Significant benefits in terms of “grid system applications”, “end-use applications” and “renewable applications” can be achieved by introducing energy storage systems. Among the currently available solutions, CAES (Compressed Air Energy Storage) shows favorable features. Small-medium size plants equipped with artificial air reservoirs can constitute an interesting option to get efficient and cost-effective distributed energy storage systems. The present paper is addressed to the design and off-design analysis of the compression system of small size CAES plants suited to absorb electric power in the range of hundreds of kilowatt. The system of interest is constituted by an intercooled (in case aftercooled) multi-stage reciprocating compressor and a man-made reservoir obtained by connecting large diameter steel pipe sections. A specific methodology for the system preliminary sizing and off-design modeling has been developed. Since during the charging phase the electric power absorbed along the time has to change according to the peculiar CAES requirements and the pressure ratio increases continuously during the filling of the reservoir, the compressor has to work at variable mass flow rate. In order to ensure an appropriately wide range of operations, particular attention has been paid to the selection of the most suitable compressor capacity control device. Given the capacity regulation margin of the compressor and the actual level of charge of the reservoir, the proposed approach allows the instant-by-instant evaluation of minimum and maximum electric power absorbable from the grid. The developed tool gives useful information to appropriately size the compression system and to manage it in the most effective way. Various cases characterized by different system requirements are analysed. Results are given and widely discussed.

Keywords: artificial air storage reservoir, compressed air energy storage (CAES), compressor design, compression system management.

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Authors: Tunde Szecsi, Janka Szilagyi

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Students majoring in education are underrepresented in undergraduate scholarship. To enable and encourage teacher candidates to engage in scholarly activities, it is essential to infuse skills such as problem-solving, critical thinking, oral and written communication, collaboration and the utilization of information literacy, into courses in teacher preparation programs. In this empirical study, we examined two teacher education programs – one in New York State and one in Florida – in terms of the approaches of the course-based infusion of skills for undergraduate research, and the effectiveness of this infusion. First, course-related documents such as syllabi, assignment descriptions, and course activities were reviewed and analyzed. The goal of the document analysis was to identify and describe the targeted skills, and the pedagogical approaches and strategies for promoting research skills in teacher candidates. Next, a selection of teacher candidates’ scholarly products from the institution in Florida was used as a data set to examine teacher candidates’ skill development in the context of the identified assignments. This dataset was analyzed both quantitatively and qualitatively to describe the changes that occurred in teacher candidates’ critical thinking, communication, and information literacy skills, and to uncover patterns in the skill development at the two institutions. Descriptive statistics were calculated to explore the changes in these skills of teacher candidates over a period of three years. The findings based on data from the teacher education program in Florida indicated a steady gain in written communication and critical thinking and a modest increase in informational literacy. At the institution in New York, candidates’ submission and success rates on the edTPA, a New York State Teacher Certification exam, was used as a measure of scholarly skills. Overall, although different approaches were used for infusing the development of scholarly skills in the courses, the results suggest that a holistic and well-orchestrated infusion of the skills into most courses in the teacher education program might result in steadily developing scholarly skills. These results offered essential implications for teacher education programs in terms of further improvements in teacher candidates’ skills for engaging in undergraduate research and scholarship. In this presentation, our purpose is to showcase two approaches developed by two teacher education programs to demonstrate how diverse approaches toward the promotion of undergraduate scholarship activities are responsive to the context of the teacher preparation programs.

Keywords: critical thinking, pedagogical strategies, teacher education, undergraduate student research

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Authors: Joachim F. Sartor

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According to German guidelines, external natural catchments are greater sub-catchments without significant portions of impervious areas, which possess a surface drainage system and empty in a sewer network. Basically, such catchments should be disconnected from sewer networks, particularly from combined systems. If this is not possible due to local conditions, their flow hydrographs have to be considered at the design of sewer systems, because the impact may be significant. Since there is a lack of sufficient measurements of storm-runoff events for such catchments and hence verified simulation methods to analyze their design flows, German standards give only general advices and demands special considerations in such cases. Compared to urban sub-catchments, external natural catchments exhibit greatly different flow characteristics. With increasing area size their hydrological behavior approximates that of rural catchments, e.g. sub-surface flow may prevail and lag times are comparable long. There are few observed peak flow values and simple (mostly empirical) approaches that are offered by literature for Central Europe. Most of them are at least helpful to crosscheck results that are achieved by simulation lacking calibration. Using storm-runoff data from five monitored rural watersheds in the west of Germany with catchment areas between 0.33 and 1.07 km2 , the author investigated by multiple event simulation three different approaches to determine the rainfall excess. These are the modified SCS variable run-off coefficient methods by Lutz and Zaiß as well as the soil moisture model by Ostrowski. Selection criteria for storm events from continuous precipitation data were taken from recommendations of M 165 and the runoff concentration method (parallel cascades of linear reservoirs) from a DWA working report to which the author had contributed. In general, the two run-off coefficient methods showed results that are of sufficient accuracy for most practical purposes. The soil moisture model showed no significant better results, at least not to such a degree that it would justify the additional data collection that its parameter determination requires. Particularly typical convective summer events after long dry periods, that are often decisive for sewer networks (not so much for rivers), showed discrepancies between simulated and measured flow hydrographs.

Keywords: external natural catchments, sewer network design, storm-runoff modelling, urban drainage

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Authors: Carolina Silva Ansélmo

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Airports are demand-generating poles that affect the flow of traffic around them. The airport access system must be fast, convenient, and adequately planned, considering its potential users. An airport with good ground access conditions can provide the user with a more satisfactory access experience. When several transport options are available, service providers must understand users' preferences and the expected quality of service. The present study focuses on airport access in a comparative scenario between bus, private vehicle, subway, taxi and urban mobility transport applications to São Paulo/Guarulhos International Airport. The objectives are (i) to identify the factors that influence the choice, (ii) to measure Willingness to Pay (WTP), and (iii) to estimate the market share for each modal. The applied method was Adaptive Choice-based Conjoint Analysis (ACBC) technique using Sawtooth Software. Conjoint analysis, rooted in Utility Theory, is a survey technique that quantifies the customer's perceived utility when choosing alternatives. Assessing user preferences provides insights into their priorities for product or service attributes. An additional advantage of conjoint analysis is its requirement for a smaller sample size compared to other methods. Furthermore, ACBC provides valuable insights into consumers' preferences, willingness to pay, and market dynamics, aiding strategic decision-making to provide a better customer experience, pricing, and market segmentation. In the present research, the ACBC questionnaire had the following variables: (i) access time to the boarding point, (ii) comfort in the vehicle, (iii) number of travelers together, (iv) price, (v) supply power, and (vi) type of vehicle. The case study questionnaire reached 213 valid responses considering the scenario of access from the São Paulo city center to São Paulo/Guarulhos International Airport. As a result, the price and the number of travelers are the most relevant attributes for the sample when choosing airport access. The market share of the selection is mainly urban mobility transport applications, followed by buses, private vehicles, taxis and subways.

Keywords: adaptive choice-based conjoint analysis, ground access to airport, market share, willingness to pay

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Authors: Shilpa Avarebeel

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Background: India is one of the seven identified countries in South-East Asia region, regularly reporting dengue infection and may soon transform into a major niche for dengue epidemics. Objective: To study the clinical profile of dengue in our setting with special reference to respiratory complication. Study design: Descriptive and exploratory study, for one year in 2014. All patients confirmed as dengue infection were followed and their clinical profile, along with outcome was determined. Study proforma was designed based on the objective of the study and it was pretested and used after modification. Data was analyzed using statistical software SPSS-Version 16. Data were expressed as mean ±S .D for parametric variables and actual frequencies or percentage for non-parametric data. Comparison between groups was done using students’ t-test for independent groups, Chie square test, one-way ANOVA test, Karl Pearson’s correlation test. Statistical significance is taken at P < 0.05. Results: Study included 134 dengue positive cases. 81% had dengue fever, 18% had dengue hemorrhagic fever, and one had dengue shock syndrome. Most of the cases reported were during the month of June. Maximum number of cases was in the age group of 26-35 years. Average duration of hospital stay was less than seven days. Fever and myalgia was present in all the 134 patients, 16 had bleeding manifestation. 38 had respiratory symptoms, 24 had breathlessness, and 14 had breathlessness and dry cough. On clinical examination of patients with respiratory symptoms, all twenty-eight had hypoxia features, twenty-four had signs of pleural effusion, and four had ARDS features. Chest x-ray confirmed the same. Among the patients with respiratory symptoms, the mean platelet count was 26,537 c/cmm. There was no statistical significant difference in the platelet count in those with ARDS and other dengue complications. Average four units of platelets were transfused to all those who had ARDS in view of bleeding tendency. Mechanical ventilator support was provided for ARDS patients. Those with pleural effusion and pulmonary oedema were given NIV (non-invasive ventilation) support along with supportive care. However, steroids were given to patients with ARDS and 10 patients with signs of respiratory distress. 100%. Mortality was seen in patients with ARDS. Conclusion: Dengue has to be checked for those presenting with fever and breathlessness. Supportive treatments remain the cornerstone of treatment. Platelet transfusion has to be given only by clinical judgment. Steroids have no role except in early ARDS, which is controversial. Early NIV support helps in speedy recovery of dengue patients with respiratory distress.

Keywords: adult respiratory distress syndrome, dengue fever, non-invasive ventilation, pulmonary complication

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Authors: Newton Muhury, Armando A. Apan, Tek Maraseni

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This study modelled the relationships between vegetation response and available water below the soil surface using the Terra’s Moderate Resolution Imaging Spectroradiometer (MODIS) generated Normalised Difference Vegetation Index (NDVI) and soil water content (SWC) data. The Soil & Water Assessment Tool (SWAT) interface known as ArcSWAT was used in ArcGIS for the groundwater analysis. The SWAT model was calibrated and validated in SWAT-CUP software using 10 years (2001-2010) of monthly streamflow data. The average Nash-Sutcliffe Efficiency during the calibration and validation was 0.54 and 0.51, respectively, indicating that the model performances were good. Twenty years (2001-2020) of monthly MODIS NDVI data for three different types of vegetation (forest, shrub, and grass) and soil water content for 43 sub-basins were analysed using the WEKA, machine learning tool with a selection of two supervised machine learning algorithms, i.e., support vector machine (SVM) and random forest (RF). The modelling results show that different types of vegetation response and soil water content vary in the dry and wet season. For example, the model generated high positive relationships (r=0.76, 0.73, and 0.81) between the measured and predicted NDVI values of all vegetation in the study area against the groundwater flow (GW), soil water content (SWC), and the combination of these two variables, respectively, during the dry season. However, these relationships were reduced by 36.8% (r=0.48) and 13.6% (r=0.63) against GW and SWC, respectively, in the wet season. On the other hand, the model predicted a moderate positive relationship (r=0.63) between shrub vegetation type and soil water content during the dry season, which was reduced by 31.7% (r=0.43) during the wet season. Our models also predicted that vegetation in the top location (upper part) of the sub-basin is highly responsive to GW and SWC (r=0.78, and 0.70) during the dry season. The results of this study indicate the study region is suitable for seasonal crop production in dry season. Moreover, the results predicted that the growth of vegetation in the top-point location is highly dependent on groundwater flow in both dry and wet seasons, and any instability or long-term drought can negatively affect these floodplain vegetation communities. This study has enriched our knowledge of vegetation responses to groundwater in each season, which will facilitate better floodplain vegetation management.

Keywords: ArcSWAT, machine learning, floodplain vegetation, MODIS NDVI, groundwater

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Authors: Yu-Ching Lin, Meei-Ling Gau, Ghi-Hwei Kao, Hung-Chang Lee

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Objective: To compare the pushing experiences and birth outcomes of three different pushing positions during the second stage of labor. The three positions were: semi-recumbent, squatting, and squatting with the aid of ergonomically designed ankle supports. Methods: A randomized controlled trial was conducted at a regional teaching hospital in northern Taiwan. Data were collected from 168 primiparous women in their 38th to 42nd gestational week. None of the participants received epidural analgesia during labor and all were free of pregnancy and labor-related complications. Intervention: During labor, after full cervical dilation and when the fetal head had descended to at least the +1 station and had turned to the occiput anterior position, the experimental group was asked to push in the squatting position while wearing the ergonomically designed ankle supports; comparison group A was asked to push in the squatting position without the use of these supports; and comparison group B was asked to push in a standard semi-recumbent position. Measures: The participants completed a demographic and obstetrics datasheet, the Short Form McGill Pain Questionnaire (MPQ-SF), and the Labor Pushing Experience scale within 4-hours postpartum. Conclusion: In terms of delivery time, the duration between the start of pushing to crowning for the experimental group (squatting with ankle supports) averaged 25.52 minutes less (F =6.02, p< .05) than the time for comparison group B (semi-recumbent). Furthermore, the duration between the start of pushing to infant birth averaged 25.21 minutes less for the experimental group than for comparison group B (F =6.14, p< .05). Moreover, the experimental group had a lower average VAS pain score (5.05±3.22) than comparison group B and the average McGill pain score for the experimental group was lower than both comparison groups (F=18.12, p< .001). In summary, the participants in the group that delivered from a squatting position with ankle supports had better labor pushing experiences than their peers in the comparison groups. Results: In comparison to both unsupported squatting and semi-recumbent pushing, squatting with the aid of ergonomically designed ankle supports reduced pushing times, ameliorated labor pain, and improved the pushing experience. Clinical application and suggestion: The squatting with ankle-support intervention introduced in the present study may significantly reduce tiredness and difficulties in maintaining balance as well as increase pushing efficiency. Thus, this intervention may reduce the caring needs of women during the second stage of labor. This intervention may be introduced in midwifery education programs and in clinical practice as a method to improve the care of women during the second stage of labor.

Keywords: second stage of labor, pushing, squatting with ankle supports, squatting

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Authors: Ahmed Auda, Manjree Agarwala, Giles Hardya, Yonglin Rena

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Botrytis cinerea is a major pest for many plants. It can attack a wide range of plant parts. It can attack buds, flowers, and leaves, stems, and fruit. However, B. cinerea can be mixed with other diseases that cause the same damage. There are many species of botrytis and more than one different strains of each. Botrytis might infect the foliage of nursery stock stored through winter in damp conditions. There are no known resistant plants. Botrytis must have nutrients or food source before it infests the plant. Nutrients leaking from wounded plant parts or dying tissue like old flower petals give the required nutrients. From this food, the fungus becomes more attackers and invades healthy tissue. Dark to light brown rot forms in the ill tissue. High humidity conditions support the growth of this fungus. However, we suppose that selection pressure can act on the morphological and neurophysiologic filter properties of the receiver and on both the biochemical and the physiological regulation of the signal. Communication is implied when signal and receiver evolves toward more and more specific matching, culminating. In other hand, receivers respond to portions of a body odor bouquet which is released to the environment not as an (intentional) signal but as an unavoidable consequence of metabolic activity or tissue damage. Each year Botrytis species can cause considerable economic losses to plant crops. Even with the application of strict quarantine and control measures, these fungi can still find their way into crops and cause the imposition of onerous restrictions on exports. Blueberry fruit mould caused by a fungal infection usually results in major losses during post-harvest storage. Therefore, the management of infection in early stages of disease development is necessary to minimize losses. The overall purpose of this study will develop sensitive, cheap, quick and robust diagnostic techniques for the detection of B. cinerea in blueberry. The specific aim was designed to investigate the performance of volatile organic compounds (VOCs) in the detection and discrimination of blueberry fruits infected by fungal pathogens with an emphasis on Botrytis in the early storage stage of post-harvest.

Keywords: botrytis cinerea, blueberry, GC/MS, VOCs

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

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

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

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Authors: Iman Jabbar

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Within the scope of professionalism and in order to compete with the modern world, teachers, are expected to develop their teaching skills and activities in addition to their professional knowledge. At the college level, the teacher should be able to face classroom challenges through his engagement with the learning situation to understand the students and their needs. In our field of TESOL, the role of the English teacher is no longer restricted to teaching English texts, but rather he should endeavor to enhance the students’ skills such as communication and critical analysis. Within the literature of professionalism, there are certain strategies and tools that an English teacher should adopt to develop his competence and performance. Reflective practice, which is an exploratory process, is one of these strategies. Another strategy contributing to classroom development is motivation. It is crucial in students’ learning as it affects the quality of learning English in the classroom in addition to determining success or failure as well as language achievement. This is a qualitative study grounded on interpretive perspectives of teachers and students regarding the process of professional development. This study aims at (a) understanding how teachers at the college level conceptualize reflective practice and motivation inside EFL classroom, and (b) exploring the methods and strategies that they implement to practice reflection and motivation. This study and is based on two questions: 1. How do EFL teachers perceive and view reflection and motivation in relation to their teaching and professional development? 2. How can reflective practice and motivation be developed into practical strategies and actions in EFL teachers’ professional context? The study is organized into two parts, theoretical and practical. The theoretical part reviews the literature on the concept of reflective practice and motivation in relation to professional development through providing certain definitions, theoretical models, and strategies. The practical part draws on the theoretical one, however; it is the core of the study since it deals with two issues. It involves the research design, methodology, and methods of data collection, sampling, and data analysis. It ends up with an overall discussion of findings and the researcher's reflections on the investigated topic. In terms of significance, the study is intended to contribute to the field of TESOL at the academic level through the selection of the topic and investigating it from theoretical and practical perspectives. Professional development is the path that leads to enhancing the quality of teaching English as a foreign or second language in a way that suits the modern trends of globalization and advanced technology.

Keywords: professional development, motivation, reflection, learning

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Authors: E. Isaac, I. Jalo, Y. Alkali, A. Ajani, A. Rasaki, Y. Jibrin, K. Mustapha, A. Ayuba, S. Charanchi, H. Danlami

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Introduction: Hepatitis B infection continues to be a serious global health problem with about 2 billion people infected worldwide, many of these in sub-Saharan Africa. Nigeria is one of the countries with the highest incidence, with a prevalence of 10-15%. Methods: Records of Hepatitis B surface and envelope antigen test results in adults in Federal Teaching Hospital, Gombe between May 2000 and May 2015 were retrieved and analyzed. Findings: Adult out-patient consultations and in-patient admissions were 343,083 and 67,761 respectively, accounting for 87% of total. Hepatitis B surface antigenaemia was tested for in 23,888 adults and children. 88.9% (21240) were adults. Males constituted 56% (11902/21240) and females 44% (9211/21240). 5104 (24.0%) of tested individuals were 19-25years; 12,039 (56.7%) 26-45years; 21119 (9.0%) 46-55years; 2.8% (590/21240) and 766 (3.6%) >65years. Among adult males, 17% (2133/11902) was contributed by ages 19-25. 58% (7017/11902), 11.9% (1421/11902), 6.4% (765/11902) and 4.7% (563/11902) of males were 26-45 years old, 46-55 years old and 56-65 years and >65year old respectively. Adults aged 19-25years, 26-45 years, 46-55years, 56-65 and > 65years each constituted 32% (2966/9211); 54.4% (5009/9211); 7.4% (684/9211), 3.8% (350/9211) and 2.2% (201/9211) of females respectively. 16.2% (3431/21,240) demonstrated Hepatitis B surface antigenaemia. The sero-positivity rate was 16.9% (865//5104) between 19-25years, 21.2% (2559/12,039) among 26-45year old individuals. 17.9% (377/2111); 14.1% (83/590) and 7.3% (56/766) of 46-55year old, 56-65year old and >65year old individuals screened were seropositive. The highest sero-positivity rate was found in male young adults aged 19-25years 27.9% (398/1426) and lowest in elderly males 7.4% (28/377). HBe antigen testing rate among HbSAg seropositive individuals was 97.3% (3338/3431). Males constituted 59.7% (1992/3338) and females 40.3% (1345/3338). 25.3% (844/3338) were aged 19-25years; 61.1% (2039/3338) 26-45years; 10.2% (340/3338) 46-55years; 2.7% (90/3338) 56-65years and 0.7% >65years old. HB e antigenaemia was positive in 8.2% (275/3338) of those tested. 41% (113/275); 50.2% (138/275); 5.4% (15/275); 1.8% (5/275) and 1.1 (3/275) of HB e sero-positivity was among age groups 19-25, 26-45, 46-55, 56-65 and > 65year old individuals. Dual sero-positivity rate was highest 13% (113/844) in young adults 19-25years and lowest between 46-55years; 15/340 (4.4%). 4.2% (15/360); 13.5% (69/512); 6.7% (90/1348); 4.6% (10/214); 5% (2/40) and 6.7% (1/15) of males aged 19-25; 26-45; 46-55; 56-65; and >65years had HB e antigenaemia respectively. Among females - 27/293 (9.2%) aged 19-25; 26/500 (5.2%) 26-45; 2/84 (2.4%) 46-55; 1/12 (8.3%) 56-65 and 1/9(11.1%) >65years had dual antigenaemia. In women of childbearing age, 6.9% (53/793) had a dual carriage. Conclusion: Dual hepatitis B surface and envelope antigenaemia are highest in young adult males. This will have significant implications for the development of chronic liver disease and hepatocellular carcinoma.

Keywords: adult, Hepatitis B, Nigeria, dual carriage

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Authors: Ya-Chu May Tsai, Ibrahim Yacoub, Eoin Casey

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The Australian and New Zealand College of Anaesthetists (ANZCA) advises that smoking should not be permitted within 12 hours of surgery. There is little information in the medical literature regarding patients awareness of perioperative smoking cessation recommendations nor their appreciation of how smoking might negatively impact their perioperative course. The aim of the study is to assess the prevalence of current smokers presenting to Werribee Mercy Hospital (WMH) and to evaluate if pre-operative provision of both written and verbal pre-operative advice was, 1: Effective in improving patient awareness of the benefits of pre-operative smoking cessation, 2: Associated with an increase in the number of elective surgical patients who stop smoking at least 12 hours pre-operatively. Methods: The initial survey included all patients who presented to WMH for elective surgical procedures from 19 – 30 September 2016 using a standardized questionnaire focused on patients’ smoking history and their awareness of smoking cessation preoperatively. The intervention consisted of a standard pre-operative phone call to all patients advising them of the increased perioperative risks associated with smoking, and advised patients to cease 12 hours prior. In addition, written information on smoking cessation strategies were sent out in mail at least 1 week prior to planned procedure date to all patients. Questionnaire-based study after the intervention was conducted on day of elective procedure from 10 – 21 October 2016 inclusive. Primary outcomes measured were patient’s awareness of smoking cessation and proportion of smokers who quit >12 hours, considered a clinically meaning duration to reduce anaesthetics complications. Comparison of pre and post intervention results were made using SPSS 21.0. Results: In the pre-intervention group (n=156), 36 (22.4%) patients were current smokers, 46 were ex-smokers (29.5%) and 74 were non-smokers (48.1%). Of the smokers, 12 (33%) reported having been informed of smoking cessation prior to operation and 8 (22%) were aware of increased intra- and perioperative adverse events associated with smoking. In the post-intervention group n= 177, 38 (21.5%) patients were current smokers, 39 were ex-smokers (22.0%) and 100 were non-smokers (56.5%). Of the smokers, 32 (88.9%) reported having been informed of smoking cessation prior to operation and 35 (97.2%) reported being aware of increased intra- and perioperative adverse events associated with smoking. The median time since last smoke in the pre-intervention group was 5.5 hours (Q1-Q3 = 2-14) compared with 13 hours (Q1-Q3 = 5-24) in post intervention group. Amongst the smokers, smoking cessation at least 12 hours prior to surgery significantly increased from 27.8% pre-intervention to 52.6% post intervention (P=0.03). Conclusion: A standard preoperative phone call and written instruction on smoking cessation guidelines at time of waitlist placement increase preoperative smoking cessation rates by almost 2-fold.

Keywords: anaesthesia, audit, perioperative medicine, smoking cessation

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Authors: Huda Arshadlamphon

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Advancing frontiers of technology and industry is moving rapidly fast influenced by the economic and political phenomena. One vital phenomenon,which has had consolidated the world to a one single village, is Globalization. In response, architecture and the built-environment have faced numerous changes, adjustments, and developments. Tall-buildings, as a product of globalization, represent prestigious icons, symbols, and landmarks for highly economics and advanced countries. Despite the fact, this trend has been encountering several design challenges incorporating architectural identity, traditions, and characteristics that enhance the built-environments' sociocultural values and traditions. The necessity of these values and traditionsform self-solitarily, leading to visual and spatial creativity, independency, and individuality. In other words, they maintain the inherited identity and avoid replications in all means and aspects. This paper, firstly, defines globalization phenomenon, architectural identity, and the concerns of sociocultural values in relation to the traditional characteristics of the built-environment. Secondly, through three case-studies of tall-buildings located in Jeddah city, Saudi Arabia, the Queen's Building, the National Commercial Bank Building (NCB), and the Islamic Development Bank Building; design strategies and methodologies in acclimating architectural identity and characteristics in tall-buildings are discussed. The case-studies highlight buildings' sites and surroundings, concepts and inspirations, design elements, architectural forms and compositions, characteristics, issues, barriers, and trammels facing the designs' decisions, representation of facades, and selection of materials and colors. Furthermore, the research will elucidate briefs of the dominant factors that shape the architectural identity of Jeddah city. In conclusion, the study manifests four tall-buildings' design standards guideline in preserving and developing architectural identity in Jeddah city; the scale of urban and natural environment, the scale of architectural design elements, the integration of visual images, and the creation of spatial scenes and scenarios. The prosed guideline will encourage the development of architectural identity aligned with zeitgeist demands and requirements, supports the contemporary architectural movement toward tall-buildings, and shoresself-solitarily in representing sociocultural values and traditions of the built-environment.

Keywords: architectural identity, built-environment, globalization, sociocultural values and traditions, tall-buildings

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Authors: Sohyoung Won, Heebal Kim, Dajeong Lim

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Genomic prediction is an effective way to measure the abilities of livestock for breeding based on genomic estimated breeding values, statistically predicted values from genotype data using best linear unbiased prediction (BLUP). Using haplotypes, clusters of linked single nucleotide polymorphisms (SNPs), as markers instead of individual SNPs can improve the reliability of genomic prediction since the probability of a quantitative trait loci to be in strong linkage disequilibrium (LD) with markers is higher. To efficiently use haplotypes in genomic prediction, finding optimal ways to define haplotypes is needed. In this study, 770K SNP chip data was collected from Hanwoo (Korean cattle) population consisted of 2506 cattle. Haplotypes were first defined in three different ways using 770K SNP chip data: haplotypes were defined based on 1) length of haplotypes (bp), 2) the number of SNPs, and 3) k-medoids clustering by LD. To compare the methods in parallel, haplotypes defined by all methods were set to have comparable sizes; in each method, haplotypes defined to have an average number of 5, 10, 20 or 50 SNPs were tested respectively. A modified GBLUP method using haplotype alleles as predictor variables was implemented for testing the prediction reliability of each haplotype set. Also, conventional genomic BLUP (GBLUP) method, which uses individual SNPs were tested to evaluate the performance of the haplotype sets on genomic prediction. Carcass weight was used as the phenotype for testing. As a result, using haplotypes defined by all three methods showed increased reliability compared to conventional GBLUP. There were not many differences in the reliability between different haplotype defining methods. The reliability of genomic prediction was highest when the average number of SNPs per haplotype was 20 in all three methods, implying that haplotypes including around 20 SNPs can be optimal to use as markers for genomic prediction. When the number of alleles generated by each haplotype defining methods was compared, clustering by LD generated the least number of alleles. Using haplotype alleles for genomic prediction showed better performance, suggesting improved accuracy in genomic selection. The number of predictor variables was decreased when the LD-based method was used while all three haplotype defining methods showed similar performances. This suggests that defining haplotypes based on LD can reduce computational costs and allows efficient prediction. Finding optimal ways to define haplotypes and using the haplotype alleles as markers can provide improved performance and efficiency in genomic prediction.

Keywords: best linear unbiased predictor, genomic prediction, haplotype, linkage disequilibrium

Procedia PDF Downloads 128

Authors: Merilin Ivanova Ivanova, Kalin Dimitrov Atanasov, Stefan Petrov Enchev

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Backgroud: Neuromyelitis optica spectrum disorder, also known as Devic’s disease, is a relapsing demyelinating autoimmune inflammatory disorder of the central nervous system associated with anti-aquaporin 4 (AQP4) antibodies that can manifest with devastating secondary neurological deficits. Most commonly affected are the optic nerves and the spinal cord-clinically this is often presented with optic neuritis (loss of vision), transverse myelitis(weakness or paralysis of extremities),lack of bladder and bowel control, numbness. APS is a core clinical entity of NMOSD and adds to the clinical representation the following symptoms: intractable nausea, vomiting and hiccup, it usually occurs isolated at onset, and can lead to a significant delay in the diagnosis. The condition may have features similar to multiple sclerosis (MS) but the episodes are worse in NMO and it is treated differently. It could be relapsing or monophasic. Possible complications are visual field defects and motor impairment, with potential blindness and irreversible motor deficits. In severe cases, myogenic respiratory failure ensues. The incidence of reported cases is approximately 0.3–4.4 per 100,000. Paediatric cases of NMOSD are rare but have been reported occasionally, comprising less than 5% of the reported cases. Objective: The case serves to show the difficulty when it comes to the diagnostic processes regarding a rare autoimmune disease with non- specific symptoms, taking large interval of rimes to reveal as complete clinical manifestation of the aforementioned syndrome, as well as the necessity of multidisciplinary approach in the setting of а general paediatric department in аn emergency hospital. Methods: itpatient's history, clinical presentation, and information from the used diagnostic tools(MRI with contrast of the central nervous system) lead us to the conclusion .This was later on confirmed by the positive results from the anti-aquaporin 4 (AQP4) antibody serology test. Conclusion: APS is a common symptom of NMOSD and is considered a challenge in a differential-diagnostic plan. Gaining an increased awareness of this disease/syndrome, obtaining a detailed patient history, and performing thorough physical examinations are essential if we are to reduce and avoid misdiagnosis.

Keywords: neuromyelitis, devic's disease, hiccup, autoimmune, MRI

Procedia PDF Downloads 27

Authors: Jillian M. Hagel, Joseph E. Tucker, Peter J. Facchini

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With the aim of establishing a holistic approach for the treatment of central nervous system (CNS) disorders, we are pursuing a drug development program rapidly progressing through discovery and characterization phases. The drug candidates identified in this program are referred to as neuroplastogens owing to their ability to mediate neuroplasticity, which can be beneficial to patients suffering from anxiety, depression, or posttraumatic stress disorder. These and other related neuropsychiatric conditions are associated with the onset of neuronal atrophy, which is defined as a reduction in the number and/or productivity of neurons. The stimulation of neuroplasticity results in an increase in the connectivity between neurons and promotes the restoration of healthy brain function. We have synthesized a substantial catalogue of proprietary indolethylamine derivatives based on the general structures of serotonin (5-hydroxytryptamine) and psychedelic molecules such as N,N-dimethyltryptamine (DMT) and psilocin (4-hydroxy-DMT) that function as neuroplastogens. A primary objective in our screening protocol is the identification of derivatives associated with a significant reduction in hallucination, which will allow administration of the drug at a dose that induces neuroplasticity and triggers other efficacious outcomes in the treatment of targeted CNS disorders but which does not cause a psychedelic response in the patient. Both neuroplasticity and hallucination are associated with engagement of the 5HT2A receptor, requiring drug candidates differentially coupled to these two outcomes at a molecular level. We use novel and proprietary artificial intelligence algorithms to predict the mode of binding to the 5HT2A receptor, which has been shown to correlate with the hallucinogenic response. Hallucination is tested using the mouse head-twitch response model, whereas mouse marble-burying and sucrose preference assays are used to evaluate anxiolytic and anti-depressive potential. Neuroplasticity is assays using dendritic outgrowth assays and cell-based ELISA analysis. Pharmacokinetics and additional receptor-binding analyses also contribute the selection of lead candidates. A summary of the program is presented.

Keywords: neuroplastogen, non-hallucinogenic, drug development, anxiety, depression, PTSD, indolethylamine derivatives, psychedelic-inspired, 5-HT2A receptor, computational chemistry, head-twitch response behavioural model, neurite outgrowth assay

Procedia PDF Downloads 109

Authors: Mohamad Ammar Ayass, Natalya Griko, Victor Pashkov, Wanying Cao, Kevin Zhu, Jin Zhang, Lina Abi Mosleh

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Respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus disease 2019 (COVID-19). Early evidence pointed at the angiotensin-converting enzyme 2 (ACE-2) expressed on the epithelial cells of the lung as the main entry point of SARS-CoV-2 into the cells. The viral entry is mediated by the binding of the Receptor Binding Domain (RBD) of the spike protein that is expressed on the surface of the virus to the ACE-2 receptor. As the number of SARS-CoV-2 variants continues to increase, mutations arising in the RBD of SARS-CoV-2 may lead to the ineffectiveness of RBD targeted neutralizing antibodies. To address this limitation, the objective of this study is to develop a combination of aptamers that target different regions of the RBD, preventing the binding of the spike protein to ACE-2 receptor and subsequent viral entry and replication. A safe and innovative biomedical tool was developed to inhibit viral infection and reduce the harms of COVID-19. In the present study, DNA aptamers were developed against a recombinant trimer S protein using the Systematic Evolution of Ligands by Exponential enrichment (SELEX). Negative selection was introduced at round number 7 to select for aptamers that bind specifically to the RBD domain. A series of 9 aptamers (ADI2010, ADI2011, ADI201L, ADI203L, ADI205L, ADIR68, ADIR74, ADIR80, ADIR83) were selected and characterized with high binding affinity and specificity to the RBD of the spike protein. Aptamers (ADI25, ADI2009, ADI203L) were able to bind and pull down endogenous spike protein expressed on the surface of SARS-CoV-2 virus in COVID-19 positive patient samples and determined by liquid chromatography- tandem mass spectrometry analysis (LC-MS/MS). LC-MS/MS data confirmed that aptamers can bind to the RBD of the spike protein. Furthermore, results indicated that the combination of the 9 best aptamers inhibited the binding of the purified trimer spike protein to the ACE-2 receptor found on the surface of Vero E6 cells. In the same experiment, the combined aptamers displayed a better neutralizing effect than antibodies. The data suggests that the selected aptamers could be used in therapy to neutralize the effect of the SARS-CoV-2 virus by inhibiting the interaction between the RBD and ACE-2 receptor, preventing viral entry into target cells and therefore blocking viral replication.

Keywords: aptamer, ACE-2 receptor, binding inhibitor, COVID-19, spike protein, SARS-CoV-2, treatment

Procedia PDF Downloads 174

Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

Procedia PDF Downloads 103

Authors: Michalis Michael, Mauro Overend

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Buildings, in which we spend 87-90% of our time, act as a shelter protecting us from environmental conditions and weather phenomena. The building's overall performance is significantly dependent on the envelope’s glazing part, which is particularly critical as it is the most vulnerable part to heat gain and heat loss. However, conventional glazing technologies have relatively low-performance thermo-optical characteristics. In this regard, during winter, the heat losses due to the glazing part of a building envelope are significantly increased as well as the heat gains during the summer period. In this study, the contribution of an innovative glazing technology, namely Closed Cavity Façade (CCF) in improving energy efficiency and IEQ in office buildings is examined, aiming to optimize various design configurations of CCF. Using Energy Plus and IDA ICE packages, the performance of several CCF configurations and geometries for various climate types were investigated, aiming to identify the optimum solution. The model used for the simulations and optimization process was MATELab, a recently constructed outdoor test facility at the University of Cambridge (UK). The model was previously experimentally calibrated. The study revealed that the use of CCF technology instead of conventional double or triple glazing leads to important benefits. Particularly, the replacement of the traditional glazing units, used as the baseline, with the optimal configuration of CCF led to a decrease in energy consumption in the range of 18-37% (depending on the location). This mainly occurs due to integrating shading devices in the cavity and applying proper glass coatings and control strategies, which lead to improvement of thermal transmittance and g-value of the glazing. Since the solar gain through the façade is the main contributor to energy consumption during cooling periods, it was observed that a higher energy improvement is achieved in cooling-dominated locations. Furthermore, it was shown that a suitable selection of the constituents of a closed cavity façade, such as the colour and type of shading devices and the type of coatings, leads to an additional improvement of its thermal performance, avoiding overheating phenomena and consequently ensuring temperatures in the glass cavity below the critical value, and reducing the radiant discomfort providing extra benefits in terms of Indoor Environmental Quality (IEQ).

Keywords: building energy efficiency, closed cavity façade, optimization, occupants comfort

Procedia PDF Downloads 50

Authors: Louise Ödlund, Danica Djuric Ilic

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From a system perspective, there are several benefits of DH. A possibility to utilize the excess heat from waste incineration and biomass-based combined heat and power (CHP) production (e.g. possibility to utilize the excess heat from electricity production) are two examples. However, in a future sustainable society, the benefits of DH may be less obvious. Due to the climate changes and increased energy efficiency of buildings, the demand for space heating is expected to decrease. Due to the society´s development towards circular economy, a larger amount of the waste will be material recycled, and the possibility for DH production by the energy recovery through waste incineration will be reduced. Furthermore, the benefits of biomass-based CHP production will be less obvious since the marginal electricity production will no longer be linked to high greenhouse gas emissions due to an increased share of renewable electricity capacity in the electricity system. The purpose of the study is (1) to provide an overview of the possible development of other sectors which may influence the DH in the future and (2) to detect new business strategies which would enable for DH to adapt to the future conditions and remain competitive to alternative heat production in the future. A system approach was applied where DH is seen as a part of an integrated system which consists of other sectors as well. The possible future development of other sectors and the possible business strategies for DH producers were searched through a systematic literature review In order to remain competitive to the alternative heat production in the future, DH producers need to develop new business strategies. While the demand for space heating is expected to decrease, the space cooling demand will probably increase due to the climate changes, but also due to the better insulation of buildings in the cases where the home appliances are the heat sources. This opens up a possibility for applying DH-driven absorption cooling, which would increase the annual capacity utilization of the DH plants. The benefits of the DH related to the energy recovery from the waste incineration will exist in the future since there will always be a need to take care of materials and waste that cannot be recycled (e.g. waste containing organic toxins, bacteria, such as diapers and hospital waste). Furthermore, by operating central controlled heat pumps, CHP plants, and heat storage depending on the intermittent electricity production variation, the DH companies may enable an increased share of intermittent electricity production in the national electricity grid. DH producers can also enable development of local biofuel supply chains and reduce biofuel production costs by integrating biofuel and DH production in local DH systems.

Keywords: district heating, sustainable business strategies, sustainable development, system approach

Procedia PDF Downloads 69

Authors: Reuben Mugisha, Stella Bakibinga

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The cervical cancer burden is a global threat, but more so in low income settings where more than 85% of mortality cases occur due to lack of sufficient screening programs. There is consequently a lack of early detection of cancer and precancerous cells among women. Studies show that 3% to 35% of deaths could have been avoided through early screening depending on prognosis, disease progression, environmental and lifestyle factors. In this study, a systematic literature review is undertaken to understand potential barriers and facilitators as documented in previous studies that focus on the application of telehealth in cervical cancer screening programs for early detection of cancer and precancerous cells. The study informs future studies especially those from low income settings about lessons learned from previous studies and how to be best prepared while planning to implement telehealth for cervical cancer screening. It further identifies the knowledge gaps in the research area and makes recommendations. Using a specified selection criterion, 15 different articles are analyzed based on the study’s aim, theory or conceptual framework used, method applied, study findings and conclusion. Results are then tabulated and presented thematically to better inform readers about emerging facts on barriers and facilitators to telehealth implementation as documented in the reviewed articles, and how they consequently lead to evidence informed conclusions that are relevant to telehealth implementation for cervical cancer screening. Preliminary findings of this study underscore that use of low cost mobile colposcope is an appealing option in cervical cancer screening, particularly when coupled with onsite treatment of suspicious lesions. These tools relay cervical images to the online databases for storage and retrieval, they permit integration of connected devices at the point of care to rapidly collect clinical data for further analysis of the prevalence of cervical dysplasia and cervical cancer. Results however reveal the need for population sensitization prior to use of mobile colposcopies among patients, standardization of mobile colposcopy programs across screening partners, sufficient logistics and good connectivity, experienced experts to review image cases at the point-of-care as important facilitators to the implementation of mobile colposcope as a telehealth cervical cancer screening mechanism.

Keywords: cervical cancer screening, digital technology, hand-held colposcopy, knowledge-sharing

Procedia PDF Downloads 206

Authors: Seemabahen Dave, Maria Varua, Basant Maheshwari, Roger Packham

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The declining groundwater levels and quality are acknowledged to be affecting the well-being of farmers especially those located in the semi-arid regions where groundwater is the only source of water for domestic and agricultural use. Further, previous studies have identified the need to examine the quality of life of farmers beyond economic parameters and for a shift in setting rural development policy goals to the perspective of beneficiaries. To address these gaps, this paper attempts to ascertain the subjective wellbeing of farmers from two semi-arid regions of India. The study employs the integrated conceptual framework for the assessment of individual and regional subjective wellbeing developed by Larson in 2009 at Australia. The method integrates three domains i.e. society, natural environment and economic services consisting of 37 wellbeing factors. The original set of 27 revised wellbeing factors identified by John Ward is further revised in current study to make it more region specific. Generally, researchers in past studies select factors of wellbeing based on literature and assign the weights arbitrary. In contrast, the present methodology employs a unique approach by asking respondents to identify the factors most important to their wellbeing and assign weights of importance based on their responses. This method minimises the selection bias and assesses the wellbeing from farmers’ perspectives. The primary objectives of this study are to identify key wellbeing attributes and to assess the influence of groundwater on subjective wellbeing of farmers. Findings from 507 farmers from 11 villages of two watershed areas of Rajasthan and Gujarat, India chosen randomly and were surveyed using a structured face-to-face questionnaire are presented in this paper. The results indicate that significant differences exist in the ranking of wellbeing factors at individual, village and regional levels. The top five most important factors in the study areas include electricity, irrigation infrastructure, housing, land ownership, and income. However, respondents are also most dissatisfied with these factors and correspondingly perceive a high influence of groundwater on them. The results thus indicate that intervention related to improvement of groundwater availability and quality will greatly improve the satisfaction level of well-being factors identified by the farmers.

Keywords: groundwater, farmers, semi-arid regions, subjective wellbeing

Procedia PDF Downloads 238

Authors: Misuk Kim, Seokho Kang, Jehyuk Lee, Hyunchang Cho, Sungzoon Cho

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In semiconductor manufacturing, virtual metrology (VM) refers to methods to predict properties of a wafer based on machine parameters and sensor data of the production equipment, without performing the (costly) physical measurement of the wafer properties (Wikipedia). Additional benefits include avoidance of human bias and identification of important factors affecting the quality of the process which allow improving the process quality in the future. It is however rare to find VM applied to other areas of manufacturing. In this work, we propose to use VM to copper clad laminate (CCL) manufacturing. CCL is a core element of a printed circuit board (PCB) which is used in smartphones, tablets, digital cameras, and laptop computers. The manufacturing of CCL consists of three processes: Treating, lay-up, and pressing. Treating, the most important process among the three, puts resin on glass cloth, heat up in a drying oven, then produces prepreg for lay-up process. In this process, three important quality factors are inspected: Treated weight (T/W), Minimum Viscosity (M/V), and Gel Time (G/T). They are manually inspected, incurring heavy cost in terms of time and money, which makes it a good candidate for VM application. We developed prediction models of the three quality factors T/W, M/V, and G/T, respectively, with process variables, raw material, and environment variables. The actual process data was obtained from a CCL manufacturer. A variety of variable selection methods and learning algorithms were employed to find the best prediction model. We obtained prediction models of M/V and G/T with a high enough accuracy. They also provided us with information on “important” predictor variables, some of which the process engineers had been already aware and the rest of which they had not. They were quite excited to find new insights that the model revealed and set out to do further analysis on them to gain process control implications. T/W did not turn out to be possible to predict with a reasonable accuracy with given factors. The very fact indicates that the factors currently monitored may not affect T/W, thus an effort has to be made to find other factors which are not currently monitored in order to understand the process better and improve the quality of it. In conclusion, VM application to CCL’s treating process was quite successful. The newly built quality prediction model allowed one to reduce the cost associated with actual metrology as well as reveal some insights on the factors affecting the important quality factors and on the level of our less than perfect understanding of the treating process.

Keywords: copper clad laminate, predictive modeling, quality control, virtual metrology

Procedia PDF Downloads 340

Authors: Nilda Tri Putri, Muhammad Taufik

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Tools and agricultural machinery (Alsintan) is a tool used in agribusiness activities. Alsintan used to change the traditional farming systems generally use manual equipment into modern agriculture with mechanization. CV Nugraha Chakti Consultant make an action plan for industrial development Alsintan West Sumatra in 2012 to develop medium industries of Alsintan become a major industry of Alsintan, one of efforts made is increase the production capacity of the industry Alsintan. Production capacity for superior products as hydrotiller and threshers set each for 2.000 units per year. CV Citra Dragon as one of the medium industry alsintan in West Sumatra has a plan to relocate the existing plant to meet growing consumer demand each year. Increased production capacity and plant relocation plan has led to a change in the layout; therefore need to design the layout of the plant facility CV Citra Dragon. First step the to design of plant layout is design the layout of the production floor. The design of the production floor layout is done by applying group technology layout. The initial step is to do a machine grouping and part family using the Average Linkage Clustering (ALC) and Rank Order Clustering (ROC). Furthermore done independent work station design and layout design using the Modified Spanning Tree (MST). Alternative selection layout is done to select the best production floor layout between ALC and ROC cell grouping. Furthermore, to design the layout of warehouses, offices and other production support facilities. Activity Relationship Chart methods used to organize the placement of factory facilities has been designed. After structuring plan facilities, calculated cost manufacturing facility plant establishment. Type of layout is used on the production floor layout technology group. The production floor is composed of four cell machinery, assembly area and painting area. The total distance of the displacement of material in a single production amounted to 1120.16 m which means need 18,7minutes of transportation time for one time production. Alsintan Factory has designed a circular flow pattern with 11 facilities. The facilities were designed consisting of 10 rooms and 1 parking space. The measure of factory building is 84 m x 52 m.

Keywords: Average Linkage Clustering (ALC), Rank Order Clustering (ROC), Modified Spanning Tree (MST), Activity Relationship Chart (ARC)

Procedia PDF Downloads 479

Authors: Ratneev Kaur, Tajinder Kaur, Anupam Kaur

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Introduction: Polycystic Ovary Syndrome (PCOS) is a heterogenous disorder of endocrine system among women of reproductive age. PCOS is characterized by hyperandrogenism, anovulation, polycystic ovaries, hirsutism, obesity, and hyperinsulinemia. Several pathways are implicated in its etiology including the metabolic pathway of steroid hormone synthesis regulatory pathways. PCOS is an androgen excess disorder, genes operating in steroidogenesis may alter pathogenesis of PCOS. The cytochrome P450scc is a cholesterol side chain cleavage enzyme coded by CYP11A1 gene and catalyzes conversion of cholesterol to pregnenolone, the initial and rate-limiting step in steroid hormone synthesis. It is postulated that polymorphisms in this gene may play an important role in the regulation of CYP11A1 expression and leading to increased or decreased androgen production. The present study will be the first study from north India to best of our knowledge, to analyse the association of CYP11A1 (rs11632698) polymorphism in women suffering from PCOS. Methodology: The present study was approved by ethical committee of Guru Nanak Dev University in consistent with declaration of Helsinki. A total of 300 samples (150 PCOS cases and 150 controls) were recruited from Hartej hospital, for the present study. Venous blood sample (3ml) was withdrawn from women diagnosed with PCOS by doctor, according to Rotterdam 2003 criteria and from healthy age matched controls only after informed consent and detailed filled proforma. For molecular genetics analysis, blood was stored in EDTA vials. After DNA isolation by organic method, PCR-RFLP approach was used for genotyping and association analysis of rs11632698 polymorphism. Statistical analysis was done to check for significance of selected polymorphism with PCOS. Results: In 150 PCOS cases, the frequency of AA, AG and GG genotype was found to be 48%, 35%, and 13% compared to 62%, 27% and 8% in 150 controls. The major allele (A) and minor allele (G) frequency was 68% and 32% in cases and 78% and 22% in controls. Minor allele frequency was higher in cases as compared to controls, as well as the distribution of genotype was observed to be statistically significant (ᵡ²=6.525, p=0.038). Odds ratio in dominant, co-dominant and recessive models observed was 1.81 (p=0.013), 1.54 (p=0.012) and 1.77 (p=0.132) respectively. Conclusion: The present study showed statistically significant association of rs11632698 with PCOS (p=0.038) in North Indian women.

Keywords: polycystic ovary syndrome, CYP11A1, rs11632698, hyperandrogenism

Procedia PDF Downloads 124

Authors: M. S. Sarkar, J. A. Johnson, S. Sen, G. K. Saha, K. Ramesh

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There is growing recognition of several important roles played by tigers for maintaining sustainable biodiversity at diverse ecosystems in South and South-East Asia. Only <3200 individuals are left in the wild because of poaching and habitat loss. Thus, restoring wild population is an emerging as well as important conservation initiative, but such efforts still remain challenging due to their elusive and solitary behavior. After careful translocation of few individuals, how reintroduced individuals colonize into suitable habitat and achieve stable stage population through reproduction is vital information for forest managers and policy makers of its 13 distribution range countries. Four wild and two captive radio collared tigers were reintroduced at Panna Tiger Reserve, Madhya-pradesh, India during 2009-2014. We critically examined their settlement behavior and population growth over the period. Results from long term telemetry data showed that male explored larger areas rapidly in short time span, while females explored small area in long time period and with significant high rate of movement in both sexes during exploratory period. Significant difference in home range sizes of tigers were observed in exploratory and settlement period. Though all reintroduced tigers preferred densely vegetated undisturbed forest patches within the core area of tiger reserve, a niche based k select analysis showed that individual variation in habitat selection was prominent among reintroduced tigers. Total 18 litter of >42 known cubs were born with low mortality rate, high maternity rate, high observed growth rate and short generation time in both the sexes. The population achieved its carrying capacity in a very short time span, marking success of this current tiger conservation programme. Our study information could provide significant insights on the tiger biology of translocated tigers with implication for future conservation strategies that consider translocation based recovery in their range countries.

Keywords: reintroduction, tiger, home range, demography

Procedia PDF Downloads 206

Authors: Prince Vivek, Vijay K. Bharti, Manishi Mukesh, Ankita Sharma, Om Prakash Chaurasia, Bhuvnesh Kumar

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High performance of endurance in equid requires adaptive changes involving physio-biochemical, and molecular responses in an attempt to regain homeostasis. We hypothesized that the identification of the suitable reference genes might be considered for assessing of endurance related traits in pony at high altitude and may ensure for individuals struggling to potent endurance trait in ponies at high altitude. A total of 12 mares of ponies, Zanskar breed, were divided into three groups, group-A (without load), group-B, (60 Kg) and group-C (80 Kg) on backpack loads were subjected to a load carry protocol, on a steep climb of 4 km uphill, and of gravel, uneven rocky surface track at an altitude of 3292 m to 3500 m (endpoint). Blood was collected before and immediately after the load carry on sodium heparin anticoagulant, and the peripheral blood mononuclear cell was separated for total RNA isolation and thereafter cDNA synthesis. Real time-PCR reactions were carried out to evaluate the mRNAs expression profile of a panel of putative internal control genes (ICGs), related to different functional classes, namely glyceraldehyde 3-phosphate dehydrogenase (GAPDH), β₂ microglobulin (β₂M), β-actin (ACTB), ribosomal protein 18 (RS18), hypoxanthine-guanine phosophoribosyltransferase (HPRT), ubiquitin B (UBB), ribosomal protein L32 (RPL32), transferrin receptor protein (TFRC), succinate dehydrogenase complex subunit A (SDHA) for normalizing the real-time quantitative polymerase chain reaction (qPCR) data of native pony’s. Three different algorithms, geNorm, NormFinder, and BestKeeper software, were used to evaluate the stability of reference genes. The result showed that GAPDH was best stable gene and stability value for the best combination of two genes was observed TFRC and β₂M. In conclusion, the geometric mean of GAPDH, TFRC and β₂M might be used for accurate normalization of transcriptional data for assessing endurance related traits in Zanskar ponies during load carrying.

Keywords: endurance exercise, ubiquitin B (UBB), β₂ microglobulin (β₂M), high altitude, Zanskar ponies, reference gene

Procedia PDF Downloads 119

Authors: Liane J. Ioannou, Jonathan Serpell, Joanne Dean, Cino Bendinelli, Jenny Gough, Dean Lisewski, Julie Miller, Win Meyer-Rochow, Stan Sidhu, Duncan Topliss, David Walters, John Zalcberg, Susannah Ahern

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Background: The occurrence of thyroid cancer is increasing throughout the developed world, including Australia and New Zealand, and since the 1990s has become the fastest increasing malignancy. Following the success of a number of institutional databases that monitor outcomes after thyroid surgery, the Australian and New Zealand Endocrine Surgeons (ANZES) agreed to auspice the development of a bi-national thyroid cancer registry. Objectives: To establish a bi-national population-based clinical quality registry with the aim of monitoring and improving the quality of care provided to patients diagnosed with thyroid cancer in Australia and New Zealand. Patients and Methods: The Australian and New Zealand Thyroid Cancer Registry (ANZTCR) captures clinical data for all patients, over the age of 18 years, diagnosed with thyroid cancer, confirmed by histopathology report, that have been diagnosed, assessed or treated at a contributing hospital. Data is collected by endocrine surgeons using a web-based interface, REDCap, primarily via direct data entry. Results: A multi-disciplinary Steering Committee was formed, and with operational support from Monash University the ANZTCR was established in early 2017. The pilot phase of the registry is currently operating in Victoria, New South Wales, Queensland, Western Australia and South Australia, with over 30 sites expected to come on board across Australia and New Zealand in 2018. A modified-Delphi process was undertaken to determine the key quality indicators to be reported by the registry, and a minimum dataset was developed comprising information regarding thyroid cancer diagnosis, pathology, surgery, and 30-day follow up. Conclusion: There are very few established thyroid cancer registries internationally, yet clinical quality registries have shown valuable outcomes and patient benefits in other cancers. The establishment of the ANZTCR provides the opportunity for Australia and New Zealand to further understand the current practice in the treatment of thyroid cancer and reasons for variation in outcomes. The engagement of endocrine surgeons in supporting this initiative is crucial. While the pilot registry has a focus on early clinical outcomes, it is anticipated that future collection of longer-term outcome data particularly for patients with the poor prognostic disease will add significant further value to the registry.

Keywords: thyroid cancer, clinical registry, population health, quality improvement

Procedia PDF Downloads 176

Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

Abstract:

Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: catchment area of healthcare, chronic disease management, Geographic information system, quality of diabetes care

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