Search results for: time history dynamic analysis
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 42134

Search results for: time history dynamic analysis

2294 Embedded Hybrid Intuition: A Deep Learning and Fuzzy Logic Approach to Collective Creation and Computational Assisted Narratives

Authors: Roberto Cabezas H

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The current work shows the methodology developed to create narrative lighting spaces for the multimedia performance piece 'cluster: the vanished paradise.' This empirical research is focused on exploring unconventional roles for machines in subjective creative processes, by delving into the semantics of data and machine intelligence algorithms in hybrid technological, creative contexts to expand epistemic domains trough human-machine cooperation. The creative process in scenic and performing arts is guided mostly by intuition; from that idea, we developed an approach to embed collective intuition in computational creative systems, by joining the properties of Generative Adversarial Networks (GAN’s) and Fuzzy Clustering based on a semi-supervised data creation and analysis pipeline. The model makes use of GAN’s to learn from phenomenological data (data generated from experience with lighting scenography) and algorithmic design data (augmented data by procedural design methods), fuzzy logic clustering is then applied to artificially created data from GAN’s to define narrative transitions built on membership index; this process allowed for the creation of simple and complex spaces with expressive capabilities based on position and light intensity as the parameters to guide the narrative. Hybridization comes not only from the human-machine symbiosis but also on the integration of different techniques for the implementation of the aided design system. Machine intelligence tools as proposed in this work are well suited to redefine collaborative creation by learning to express and expand a conglomerate of ideas and a wide range of opinions for the creation of sensory experiences. We found in GAN’s and Fuzzy Logic an ideal tool to develop new computational models based on interaction, learning, emotion and imagination to expand the traditional algorithmic model of computation.

Keywords: fuzzy clustering, generative adversarial networks, human-machine cooperation, hybrid collective data, multimedia performance

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2293 Cardiac Protective Effect of Olive Oil against Ischemia Reperfusion- Induced Cardiac Arrhythmias in Isolated Diabetic Rat Hearts

Authors: Ishfaq A. Bukhari, Bassem Yousef Sheikh, Abdulrahman Almotrefi, Osama Yousaf, Amer Mahmood

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Olive oil is the primary source of fat in the Mediterranean diet which is associated with a low mortality for cardiovascular disease. Olive oil is rich in monounsaturated fatty acids, and has been reported for variety of beneficial cardiovascular effects including blood pressure lowering, anti-platelet, anti-diabetic and anti-inflammatory effects. Growing number evidences from preclinical and clinical studies have shown that olive oil improves insulin resistance, decrease vessels stiffness and prevent thromboembolism. We evaluated the effects of olive against streptozotocin-induced physiological disorders in the animal models of diabetes and ischemia and reperfusion (I/R)- induced cardiac arrhythmias. Diabetes was induced in male rats with a single intraperitoneal injection of streptozotocin (60 mg/kg), rats were treated for two months with olive oil (1 ml/kg p.o). Control animals received saline. Blood glucose, body weight were monitored every 14 days. At the end of the treatment rats were sacrificed hearts were isolated for mounting on langedorff’s apparatus. The blood glucose and body weight was not significantly different in the control and olive treated animals. The control diabetic animals exhibited 100% incidence of I/R –induced ventricular fibrillation which was reduced to 0% with olive oil, treatment. The duration of ventricular fibrillation reduced from 98.8± 2.3 (control) to 0 seconds in the olive oil treated group. Diltiazem, a calcium channel blocker (1 µm/L) showed similar results and protected the I/R-induced cardiac disorders. The biochemical analysis of the cardiac tissues showed that diabetes and I/R produce marked pathological changes in the cardiomyocytes including decreased glutathione (GSH) and increased oxidative stress (Malondialdehyde; MDA). Pretreatment of animals with olive oil (1 ml/kg p.o) increased GSH and MDA levels. Olive oil also improved the diabetic-induced histopathological changes in the cardiomyocytes. These finding indicates that olive possesses cardiac protective properties. Further studies are under way in our lab to explore the mechanism of the cardio-protective effect of olive oil.

Keywords: diabeties, ischemia-reperfusion, olive oil, rats heart

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2292 The Strategic Engine Model: Redefined Strategy Structure, as per Market-and Resource-Based Theory Application, Tested in the Automotive Industry

Authors: Krassimir Todorov

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The purpose of the paper is to redefine the levels of structure of corporate, business and functional strategies that were established over the past several decades, to a conceptual model, consisting of corporate, business and operations strategies, that are reinforced by functional strategies. We will propose a conceptual framework of different perspectives in the role of strategic operations as a separate strategic place and reposition the remaining functional strategies as supporting tools, existing at all three levels. The proposed model is called ‘the strategic engine’, since the mutual relationships of its ingredients are identical with main elements and working principle of the internal combustion engine. Based on theoretical essence, related to every strategic level, we will prove that the strategic engine model is useful for managers seeking to safeguard the competitive advantage of their companies. Each strategy level is researched through its basic elements. At the corporate level we examine the scope of firm’s product, the vertical and geographical coverage. At the business level, the point of interest is limited to the SWOT analysis’ basic elements. While at operations level, the key research issue relates to the scope of the following performance indicators: cost, quality, speed, flexibility and dependability. In this relationship, the paper provides a different view for the role of operations strategy within the overall strategy concept. We will prove that the theoretical essence of operations goes far beyond the scope of traditionally accepted business functions. Exploring the applications of Resource-based theory and Market-based theory within the strategic levels framework, we will prove that there is a logical consequence of the theoretical impact in corporate, business and operations strategy – at every strategic level, the validity of one theory is substituted to the level of the other. Practical application of the conceptual model is tested in automotive industry. Actually, the proposed theoretical concept is inspired by a leading global automotive group – Inchcape PLC, listed on the London Stock Exchange, and constituent of the FTSE 250 Index.

Keywords: business strategy, corporate strategy, functional strategies, operations strategy

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2291 The Grade Six Pupils' Learning Styles and Their Achievements and Difficulties on Fractions Based on Kolb's Model

Authors: Faiza Abdul Latip

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One of the ultimate goals of any nation is to produce competitive manpower and this includes Philippines. Inclination in the field of Mathematics has a significant role in achieving this goal. However, Mathematics, as considered by most people, is the most difficult subject matter along with its topics to learn. This could be manifested from the low performance of students in national and international assessments. Educators have been widely using learning style models in identifying the way students learn. Moreover, it could be the frontline in knowing the difficulties held by each learner in a particular topic specifically concepts pertaining to fractions. However, as what many educators observed, students show difficulties in doing mathematical tasks and in great degree in dealing with fractions most specifically in the district of Datu Odin Sinsuat, Maguindanao. This study focused on the Datu Odin Sinsuat district grade six pupils’ learning styles along with their achievements and difficulties in learning concepts on fractions. Five hundred thirty-two pupils from ten different public elementary schools of the Datu Odin Sinsuat districts were purposively used as the respondents of the study. A descriptive research using the survey method was employed in this study. Quantitative analysis on the pupils’ learning styles on the Kolb’s Learning Style Inventory (KLSI) and scores on the mathematics diagnostic test on fraction concepts were made using this method. The simple frequency and percentage counts were used to analyze the pupils’ learning styles and their achievements on fractions. To determine the pupils’ difficulties in fractions, the index of difficulty on every item was determined. Lastly, the Kruskal-Wallis Test was used in determining the significant difference in the pupils’ achievements on fractions classified by their learning styles. This test was set at 0.05 level of significance. The minimum H-Value of 7.82 was used to determine the significance of the test. The results revealed that the pupils of Datu Odin Sinsuat districts learn fractions in varied ways as they are of different learning styles. However, their achievements in fractions are low regardless of their learning styles. Difficulties in learning fractions were found most in the area of Estimation, Comparing/Ordering, and Division Interpretation of Fractions. Most of the pupils find it very difficult to use fraction as a measure, compare or arrange series of fractions and use the concept of fraction as a quotient.

Keywords: difficulties in fraction, fraction, Kolb's model, learning styles

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2290 Assessment of Utilization of Provider Initiated HIV Testing and Counseling and Associated Factors among Adult out Patient Department Patients in Wonchi Woreda, South West Shoa Zone, Central Ethiopia

Authors: Dinka Fikadu, Mulugeta Shegaze

Abstract:

Background: Currently in health facility, provider-initiated human immunodeficiency virus testing is the key entry point to prevention, care, treatment and support services, but most people remains unaware of their HIV status due to various reasons. In many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome, "has become one of the world’s most serious health and development challenges. Reaching individuals with HIV who do not know their serostatus is a global public health priority. Objective: To assess utilization of provider initiated HIV testing and counseling and associated factors among adult outpatient department patients. Methods: Health facility based cross sectional study was conducted among 392 adult outpatient department patients in Wonchi woreda from February 24 to March 24 /2013. The study participant was recruited patients from all adult outpatient department patients of all four public health facilities of wonchi woreda using systematic sampling. A structured interviewer administered questionnaire was used to elicit all important variables from the study participants and multiple logistic regression analysis was used. Result: A total of 371 adult outpatient department patients aged between 15 to 64 years were actively participated in the study and 291(78.4%) of them utilized provider initiated HIV testing and counseling and 80(21.6%) of them refused. Knowledge on HIV is low in the study population; majority of the participants didn’t have comprehensive knowledge (64.7%) and (35.3%) fail to reject misconception about means of HIV transmission and prevention. Utilization of provider-initiated HIV testing and counseling were associated with divorced/widowed marital status[AOR (95%CI) = 0.32(0.15, 0.69)], being male sex [AOR (95%CI) =1.81(1.01, 3.24)], having comprehensive knowledge on HIV [AOR (95%CI) =0.408(0.220,0.759)],having awareness about provider initiated HIV testing and counseling [AOR(95%CI) =2.89(1.48,5.66)] and receiving test on HIV before[AOR (95%CI)=4.15(2.30, 7.47)]. Conclusion: Utilization of provider initiated HIV testing and counseling among adult outpatient departments in wonchi woreda public health facility was [(78.4%)].Strengthening health information through mass media and peer education on HIV to address barrier to testing in the community such as low awareness on PITC, to increase up take of PITC among adult OPD patients.

Keywords: utilization, human immune deficiency, testing, provider, initiate

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2289 Community Health Workers’ Performance and Their Influence in the Adoption of Strategies to Address Malaria Burden at a Subnational Level Health System in Cameroon

Authors: Tacho Rubby Kong

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Community health workers’ performances are known to influence members’ behaviours and practices while translating policies into service delivery. However, little remains known about the extent to which this remains true within interventions aimed at addressing malaria burden in low-resource settings like Cameroon. The objective of this study was to examine the health workers’ performance and their influence on the adoption of strategies to address the malaria burden at a subnational level health system in Cameroon. A qualitative exploratory design was adopted on a purposively selected sample of 18 key informants. The study was conducted in Konye health district among sub-national health systems, managers, health facility in-charges, and frontline community health workers. Data was collected using semi-structured interview guides in a face-to-face interview with respondents. The analysis adopted a thematic approach utilising journals, credible authors, and peer review articles for data management. Participants acknowledged that workplace networks were influential during the implementation of policies to address malaria. The influence exerted was in form of linkage with other services, caution, and advice regarding strict adherence to policy recommendations, perhaps reflective of the level of trust in providers’ ability to adhere to policy provisions. At the district health management level and among non-state actors, support in perceived areas of weak performance in policy implementation was observed. In addition, timely initiation of contact and subsequent referral was another aspect where community health workers exerted influence while translating policies to address the malaria burden. While the level of support from among network peers was observed to influence community health workers’ adoption and implementation of strategies to address the malaria burden, different mechanisms triggered subsequent response and level of adherence to recommended policy aspects. Drawing from the elicited responses, it was infer that community health workers’ performance influence the direction and extent of success in policy implementation to address the malaria burden at the subnational level.

Keywords: subnational, community, malaria, strategy

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2288 Asylum Seekers' Legal Limbo under the Migrant Protection Protocols: Implications from a US-Mexico Border Project

Authors: Tania M. Guerrero, Ileana Cortes Santiago

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Estamos Unidos Asylum Project has served more than 2,000 asylum seekers and migrants who are under the Migrant Protection Protocols (MPP) policy in Ciudad Juarez, Mexico. The U.S. policy, implemented in January 2019, has stripped asylum seekers of their rights—forcing people fleeing violence and discrimination to wait in similar or worse conditions from which they fled and navigate their entire asylum process in a different country. Several civil rights groups, including the American Civil Liberties Union (ACLU), challenged MPP in U.S. federal courts in February 2019, arguing a violation of international U.S. obligations towards refugees and asylum-seekers under the 1951 Refugee Convention and the Refugee Act of 1980 in regards to the non-refoulement principle. MPP has influenced Mexico's policies, enforcement, and prioritization of the presence of asylum seekers and migrants; it has also altered the way international non-governmental organizations work at the Mexican Northern border. Estamos Unidos is a project situated in a logistical conundrum, as it provides needed legal services to a population in a legal and humanitarian void, i.e., a liminal space. The liminal space occupied by asylum seekers living under MPP is one that, in today's world, should not be overlooked; it dilutes asylum law and U.S. commitments to international protections. This paper provides analysis of and broader implications from a project whose main goal is to uphold the protections of asylum seekers and international refugee law. The authors identified and analyzed four critical points based on field work conducted since August 2019: (1) strategic coalition building with international, local, and national organizations; (2) brokering between domestic and international contexts and critical legal constraints; (3) flexibility to sudden policy changes and the diverse needs of the multiethnic groups of migrants and asylum seekers served by the project; and (4) the complexity of providing legal assistance to asylum seekers who are survivors of trauma. The authors concur with scholarship when highlighting the erosion of protections of asylum seekers and migrants as a dangerous and unjust global phenomenon.

Keywords: asylum, human rights, migrant protection protocols, refugees law

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2287 Household Earthquake Absorptive Capacity Impact on Food Security: A Case Study in Rural Costa Rica

Authors: Laura Rodríguez Amaya

Abstract:

The impact of natural disasters on food security can be devastating, especially in rural settings where livelihoods are closely tied to their productive assets. In hazards studies, absorptive capacity is seen as a threshold that impacts the degree of people’s recovery after a natural disaster. Increasing our understanding of households’ capacity to absorb natural disaster shocks can provide the international community with viable measurements for assessing at-risk communities’ resilience to food insecurities. The purpose of this study is to identify the most important factors in determining a household’s capacity to absorb the impact of a natural disaster. This is an empirical study conducted in six communities in Costa Rica affected by earthquakes. The Earthquake Impact Index was developed for the selection of the communities in this study. The households coded as total loss in the selected communities constituted the sampling frame from which the sample population was drawn. Because of the study area geographically dispersion over a large surface, the stratified clustered sampling hybrid technique was selected. Of the 302 households identified as total loss in the six communities, a total of 126 households were surveyed, constituting 42 percent of the sampling frame. A list of indicators compiled based on theoretical and exploratory grounds for the absorptive capacity construct served to guide the survey development. These indicators were included in the following variables: (1) use of informal safety nets, (2) Coping Strategy, (3) Physical Connectivity, and (4) Infrastructure Damage. A multivariate data analysis was conducted using Statistical Package for Social Sciences (SPSS). The results show that informal safety nets such as family and friends assistance exerted the greatest influence on the ability of households to absorb the impact of earthquakes. In conclusion, communities that experienced the highest environmental impact and human loss got disconnected from the social networks needed to absorb the shock’s impact. This resulted in higher levels of household food insecurity.

Keywords: absorptive capacity, earthquake, food security, rural

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2286 Posttraumatic Stress and Comorbid Emotional and Behavioral Problems in Sri Lankan Adolescents

Authors: Thyagi Ponnamperuma

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Background: Comorbidity between posttraumatic stress disorder (PTSD) and other psychological problems is common. Recent studies focused to investigate the underlying relationship between PTSD and comorbid psychopathologies. Among adolescents, higher rates of emotional and behavioral problems (EBP) have been reported following trauma, often coexisted with PTSD. The current study, thus, examined the relationship of posttraumatic stress symptoms to EBP in adolescents exposed to a variety of traumatic events. Further, the study investigated the relationship of trauma and comorbid PTSS to the self-perceived negative impact of EBP on daily functioning. Methods: Participants were 729 Sri Lankan adolescents (age 12 to 16 years; 54.9% female) living in areas impacted in varying degrees by the 2004 tsunami. In 2008, school-based screening was conducted and completed measures of, trauma exposure, PTSS, EBP, and related functional impairment. Results: Participants reported a high prevalence of trauma exposure (n = 438), including interpersonal violence (n = 155). DSM-IV criteria for full or partial PTSD were met by 23.7% of the trauma-exposed sample. Across all participants, 13.4% and 16.7% displayed clinically relevant levels of EBP and functional impairment, respectively. Among the trauma-exposed, 7% met criteria for both EBP and PTSD. EBP total scores and caseness were significantly higher in trauma-exposed adolescents with PTSD than in either those without PTSD or the non-traumatized control group. In subscale analysis, higher prevalence of serious emotional, conduct, and hyperactivity problems were reported in the PTSD positive group; the PTSD negative group did not differ significantly from the control group on any of the problem scales. In regression analyses, PTSS (β = .28, p < .001) and interpersonal violence (β = .13, p = .033) were significant predictors of EBP, cumulative trauma (β = .11, p = .076) showed no significant effect. Further, PTSS exacerbated the impact of EBP on daily functioning (β = 0.29, p = .023). Conclusion: PTSS were closely linked to EBP in adolescents, even years after the traumatic experience. PTSD and emotional and behavioral problems together pose a heightened risk for impaired daily functioning. Longitudinal studies are needed to clarify the causal pathway.

Keywords: adolescents, comorbidity, emotional and behavioral problems, functional impairment, posttraumatic stress, traumatic events

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2285 Outcome of Emergency Response Team System in In-Hospital Cardiac Arrest

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

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Introduction: To improve early detection and mortality rate of In- Hospital Cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditions and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90mmHg, respiratory rate <8 or > 28 breaths per minute, O2 saturation < 90%, acute change in conscious state, acute chest pain or worried about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in In-Hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in In-Hospital cardiac arrest and overall hospital mortality rate. We conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed Chi -square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010 ,139 calls in 2011 and 245 calls in 2012.The number of ERT calls per 1000 admissions in year 2009-10 was 7.69, 5.61 in 2011 and 9.38 in 2013. The number of Code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, But we have not found difference in overall hospital mortality rate.

Keywords: emergency response team, ERT, cardiac arrest, emergency medicine

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2284 Down Regulation of Smad-2 Transcription and TGF-B1 Signaling in Nano Sized Titanium Dioxide-Induced Liver Injury in Mice by Potent Antioxidants

Authors: Maha Z. Rizk, Sami A. Fattah, Heba M. Darwish, Sanaa A. Ali, Mai O. Kadry

Abstract:

Although it is known that nano-TiO2 and other nanoparticles can induce liver toxicity, the mechanisms and the molecular pathogenesis are still unclear. The present study investigated some biochemical indices of nano-sized Titanium dioxide (TiO2 NPS) toxicity in mice liver and the ameliorative efficacy of individual and combined doses of idebenone, carnosine and vitamin E. Nano-anatase TiO2 (21 nm) was administered as a total oral dose of 2.2 gm/Kg daily for 2 weeks followed by the afore-mentioned antioxidants daily either individually or in combination for 1month. TiO2-NPS induced a significant elevation in serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and hepatic oxidative stress biomarkers [lipid peroxides (LP), and nitric oxide levels (NOX), while it significantly reduced glutathione reductase (GR), reduced glutathione (GSH) and glutathione peroxidase(GPX) levels. Moreover the quantitative RT-PCR analysis showed that nano-anatase TiO2 can significantly alter the mRNA and protein expressions of the fibrotic factors TGF-B1, VEGFand Smad-2. Histopathological examination of hepatic tissue reinforced the previous biochemical results. Our results also implied that inflammatory responses and liver injury may be involved in nano-anatase TiO2-induced liver toxicity Tumor necrosis factor-α (TNF-α) and Interleukin -6 (IL-6) and increased the percent of DNA damage which was assessed by COMET assay in addition to the apoptotic marker Caspase-3. Moreover mRNA gene expression observed by RT-PCR showed a significant overexpression in nuclear factor relation -2 (Nrf2), nuclear factor kappa beta (NF-Kβ) and the apoptotic factor (bax), and a significant down regulation in the antiapoptotic factor (bcl2) level. In conclusion idebenone, carnosine and vitamin E ameliorated the deviated previously mentioned parameters with variable degrees with the most pronounced role in alleviating the hazardous effect of TiO2 NPS toxicity following the combination regimen.

Keywords: Nano-anatase TiO2, TGF-B1, SMAD-2

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2283 Effectiveness of Self-Learning Module on the Academic Performance of Students in Statistics and Probability

Authors: Aneia Rajiel Busmente, Renato Gunio Jr., Jazin Mautante, Denise Joy Mendoza, Raymond Benedict Tagorio, Gabriel Uy, Natalie Quinn Valenzuela, Ma. Elayza Villa, Francine Yezha Vizcarra, Sofia Madelle Yapan, Eugene Kurt Yboa

Abstract:

COVID-19’s rapid spread caused a dramatic change in the nation, especially the educational system. The Department of Education was forced to adopt a practical learning platform without neglecting health, a printed modular distance learning. The Philippines' K–12 curriculum includes Statistics and Probability as one of the key courses as it offers students the knowledge to evaluate and comprehend data. Due to student’s difficulty and lack of understanding of the concepts of Statistics and Probability in Normal Distribution. The Self-Learning Module in Statistics and Probability about the Normal Distribution created by the Department of Education has several problems, including many activities, unclear illustrations, and insufficient examples of concepts which enables learners to have a difficulty accomplishing the module. The purpose of this study is to determine the effectiveness of self-learning module on the academic performance of students in the subject Statistics and Probability, it will also explore students’ perception towards the quality of created Self-Learning Module in Statistics and Probability. Despite the availability of Self-Learning Modules in Statistics and Probability in the Philippines, there are still few literatures that discuss its effectiveness in improving the performance of Senior High School students in Statistics and Probability. In this study, a Self-Learning Module on Normal Distribution is evaluated using a quasi-experimental design. STEM students in Grade 11 from National University's Nazareth School will be the study's participants, chosen by purposive sampling. Google Forms will be utilized to find at least 100 STEM students in Grade 11. The research instrument consists of 20-item pre- and post-test to assess participants' knowledge and performance regarding Normal Distribution, and a Likert scale survey to evaluate how the students perceived the self-learning module. Pre-test, post-test, and Likert scale surveys will be utilized to gather data, with Jeffreys' Amazing Statistics Program (JASP) software being used for analysis.

Keywords: self-learning module, academic performance, statistics and probability, normal distribution

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2282 A Single-Use Endoscopy System for Identification of Abnormalities in the Distal Oesophagus of Individuals with Chronic Reflux

Authors: Nafiseh Mirabdolhosseini, Jerry Zhou, Vincent Ho

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The dramatic global rise in acid reflux has also led to oesophageal adenocarcinoma (OAC) becoming the fastest-growing cancer in developed countries. While gastroscopy with biopsy is used to diagnose OAC patients, this labour-intensive and expensive process is not suitable for population screening. This study aims to design, develop, and implement a minimally invasive system to capture optical data of the distal oesophagus for rapid screening of potential abnormalities. To develop the system and understand user requirements, a user-centric approach was employed by utilising co-design strategies. Target users’ segments were identified, and 38 patients and 14 health providers were interviewed. Next, the technical requirements were developed based on consultations with the industry. A minimally invasive optical system was designed and developed considering patient comfort. This system consists of the sensing catheter, controller unit, and analysis program. Its procedure only takes 10 minutes to perform and does not require cleaning afterward since it has a single-use catheter. A prototype system was evaluated for safety and efficacy for both laboratory and clinical performance. This prototype performed successfully when submerged in simulated gastric fluid without showing evidence of erosion after 24 hours. The system effectively recorded a video of the mid-distal oesophagus of a healthy volunteer (34-year-old male). The recorded images were used to develop an automated program to identify abnormalities in the distal oesophagus. Further data from a larger clinical study will be used to train the automated program. This system allows for quick visual assessment of the lower oesophagus in primary care settings and can serve as a screening tool for oesophageal adenocarcinoma. In addition, this system is able to be coupled with 24hr ambulatory pH monitoring to better correlate oesophageal physiological changes with reflux symptoms. It also can provide additional information on lower oesophageal sphincter functions such as opening times and bolus retention.

Keywords: endoscopy, MedTech, oesophageal adenocarcinoma, optical system, screening tool

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2281 DNA Nano Wires: A Charge Transfer Approach

Authors: S. Behnia, S. Fathizadeh, A. Akhshani

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In the recent decades, DNA has increasingly interested in the potential technological applications that not directly related to the coding for functional proteins that is the expressed in form of genetic information. One of the most interesting applications of DNA is related to the construction of nanostructures of high complexity, design of functional nanostructures in nanoelectronical devices, nanosensors and nanocercuits. In this field, DNA is of fundamental interest to the development of DNA-based molecular technologies, as it possesses ideal structural and molecular recognition properties for use in self-assembling nanodevices with a definite molecular architecture. Also, the robust, one-dimensional flexible structure of DNA can be used to design electronic devices, serving as a wire, transistor switch, or rectifier depending on its electronic properties. In order to understand the mechanism of the charge transport along DNA sequences, numerous studies have been carried out. In this regard, conductivity properties of DNA molecule could be investigated in a simple, but chemically specific approach that is intimately related to the Su-Schrieffer-Heeger (SSH) model. In SSH model, the non-diagonal matrix element dependence on intersite displacements is considered. In this approach, the coupling between the charge and lattice deformation is along the helix. This model is a tight-binding linear nanoscale chain established to describe conductivity phenomena in doped polyethylene. It is based on the assumption of a classical harmonic interaction between sites, which is linearly coupled to a tight-binding Hamiltonian. In this work, the Hamiltonian and corresponding motion equations are nonlinear and have high sensitivity to initial conditions. Then, we have tried to move toward the nonlinear dynamics and phase space analysis. Nonlinear dynamics and chaos theory, regardless of any approximation, could open new horizons to understand the conductivity mechanism in DNA. For a detailed study, we have tried to study the current flowing in DNA and investigated the characteristic I-V diagram. As a result, It is shown that there are the (quasi-) ohmic areas in I-V diagram. On the other hand, the regions with a negative differential resistance (NDR) are detectable in diagram.

Keywords: DNA conductivity, Landauer resistance, negative di erential resistance, Chaos theory, mean Lyapunov exponent

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2280 Multimedia Design in Tactical Play Learning and Acquisition for Elite Gaelic Football Practitioners

Authors: Michael McMahon

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The use of media (video/animation/graphics) has long been used by athletes, coaches, and sports scientists to analyse and improve performance in technical skills and team tactics. Sports educators are increasingly open to the use of technology to support coach and learner development. However, an overreliance is a concern., This paper is part of a larger Ph.D. study looking into these new challenges for Sports Educators. Most notably, how to exploit the deep-learning potential of Digital Media among expert learners, how to instruct sports educators to create effective media content that fosters deep learning, and finally, how to make the process manageable and cost-effective. Central to the study is Richard Mayers Cognitive Theory of Multimedia Learning. Mayers Multimedia Learning Theory proposes twelve principles that shape the design and organization of multimedia presentations to improve learning and reduce cognitive load. For example, the Prior Knowledge principle suggests and highlights different learning outcomes for Novice and Non-Novice learners, respectively. Little research, however, is available to support this principle in modified domains (e.g., sports tactics and strategy). As a foundation for further research, this paper compares and contrasts a range of contemporary multimedia sports coaching content and assesses how they perform as learning tools for Strategic and Tactical Play Acquisition among elite sports practitioners. The stress tests applied are guided by Mayers's twelve Multimedia Learning Principles. The focus is on the elite athletes and whether current coaching digital media content does foster improved sports learning among this cohort. The sport of Gaelic Football was selected as it has high strategic and tactical play content, a wide range of Practitioner skill levels (Novice to Elite), and also a significant volume of Multimedia Coaching Content available for analysis. It is hoped the resulting data will help identify and inform the future instructional content design and delivery for Sports Practitioners and help promote best design practices optimal for different levels of expertise.

Keywords: multimedia learning, e-learning, design for learning, ICT

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2279 Societal Resilience Assessment in the Context of Critical Infrastructure Protection

Authors: Hannah Rosenqvist, Fanny Guay

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Critical infrastructure protection has been an important topic for several years. Programmes such as the European Programme for Critical Infrastructure Protection (EPCIP), Critical Infrastructure Warning Information Network (CIWIN) and the European Reference Network for Critical Infrastructure Protection (ENR-CIP) have been the pillars to the work done since 2006. However, measuring critical infrastructure resilience has not been an easy task. This has to do with the fact that the concept of resilience has several definitions and is applied in different domains such as engineering and social sciences. Since June 2015, the EU project IMPROVER has been focusing on developing a methodology for implementing a combination of societal, organizational and technological resilience concepts, in the hope to increase critical infrastructure resilience. For this paper, we performed research on how to include societal resilience as a form of measurement of the context of critical infrastructure resilience. Because one of the main purposes of critical infrastructure (CI) is to deliver services to the society, we believe that societal resilience is an important factor that should be considered when assessing the overall CI resilience. We found that existing methods for CI resilience assessment focus mainly on technical aspects and therefore that is was necessary to develop a resilience model that take social factors into account. The model developed within the project IMPROVER aims to include the community’s expectations of infrastructure operators as well as information sharing with the public and planning processes. By considering such aspects, the IMPROVER framework not only helps operators to increase the resilience of their infrastructures on the technical or organizational side, but aims to strengthen community resilience as a whole. This will further be achieved by taking interdependencies between critical infrastructures into consideration. The knowledge gained during this project will enrich current European policies and practices for improved disaster risk management. The framework for societal resilience analysis is based on three dimensions for societal resilience; coping capacity, adaptive capacity and transformative capacity which are capacities that have been recognized throughout a widespread literature review in the field. A set of indicators have been defined that describe a community’s maturity within these resilience dimensions. Further, the indicators are categorized into six community assets that need to be accessible and utilized in such a way that they allow responding to changes and unforeseen circumstances. We conclude that the societal resilience model developed within the project IMPROVER can give a good indication of the level of societal resilience to critical infrastructure operators.

Keywords: community resilience, critical infrastructure protection, critical infrastructure resilience, societal resilience

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2278 Application of Strategic Management Tools

Authors: Abenezer Nigussie

Abstract:

Strategic control practice is a critical exercise, as it provides a sturdy influence towards firms or production partners to achieve the full implementation of effective predetermined plans. The importance of strategic control in a company is often measured by observing the relationship between strategic management and organizational performance. The conventional philosophy of strategic control in academia and the industry places significant emphasis on the ability to plan and execute initiatives. In contrast, the same emphasis on strategic management has received less attention in the housing industry. Although the pressures of project performance can often obscure the wider social, economic, and professional context in which strategic management is undertaken, it is these broad contextual areas that make strategic control a vital issue for construction businesses. Rapidly changing social and technological issues are creating an informed environment that will appear very different in the coming decades from what is experienced in today’s companies. Construction project activity is not adequately led by strategic management tools; projects are mostly executed through simple plans and schedules. The issues that this thesis addresses and solves involve the successful accompaniment of the construction project process through these strategic management tools. The second important aspect is an evaluation of project activity, which is mostly done through simple economic and technical valuation. However, during this research, effective strategic management tools are evaluated and suggested for the assessment of project activities. The research introduces a study of the current strategic management practices of construction companies and also presents the concept of strategic management and the areas that companies need to address to compete in the global market. A summary of an industry survey is documented along with the historical research that prompted the investigation of these topics with a focus on the implementation of tools. Strategic management is a concept that concerns making decisions and taking corrective actions to achieve the future goals and objectives of a company. The objective of this paper is to review the practice of strategic management in construction companies. Questionnaires were distributed to major construction companies listed under categories of each project capable of specifying the complete expression of strategic management tools. Findings of the research showed that the majority of development companies practice strategic management tools in the process and implementation of each tool.

Keywords: strategic management, management, analysis, project management

Procedia PDF Downloads 48
2277 Effects of Mindfulness Practice on Clinician Burnout: A Scoping Review

Authors: Hani Malik

Abstract:

Background: Clinician burnout is a growing phenomenon in current health systems worldwide. Increasing emotional exhaustion, depersonalisation, and reduced personal accomplishment threaten the effective delivery of healthcare. This can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in clinicians. Objectives: To conduct a scoping review and identify high-quality studies on mindfulness practice in clinician burnout, synthesize themes that emerge from these studies, and discuss the implications of the results to healthcare leadership and innovation. Methodology: A focused scoping review was carried out to investigate the effects of mindfulness practice on clinician burnout. High-ranking journals were targeted to analyse high-quality studies and synthesize common themes in the literature. Studies conducted on current, practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Grey literature and studies conducted only on allied health personnel were excluded from this review. Analysis:31 studies were included in this scoping review. Mindfulness practice was found to decrease emotional exhaustion and depersonalisation while improving mood, responses to stress, and vigour. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged which include: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to clinician mindfulness practice. Conclusion: Mindfulness had widely been reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate clinician leader will play a crucial role in addressing gaps in current practice, prioritise staff mental health, and provide a supportive platform for innovation.

Keywords: mindfulness practice, clinician burnout, healthcare leadership, COVID-19

Procedia PDF Downloads 134
2276 Beta-Cyclodextrin Inclusion Complexes for Antifungal Food Packaging Applications

Authors: Cristina Munoz-Shuguli, Francisco Rodriguez, Julio Bruna, M. Jose Galotto, Abel Guarda

Abstract:

The microbial contamination in fruits due to the presence of fungal is the most important cause of their deterioration and loss. The development of active food packaging materials with antifungal properties has been proposed as an innovative strategy in order to prevent this problem. In this way, natural compounds as the essential oils or their derivatives, also called volatile compounds (VC), can be incorporated in the food packaging materials to control the fungal growth during fruit packaging. However, if the VC is incorporated directly in the packaging material, it is released very fast due to VC high volatility. For this reason, the formation of inclusion complexes through the encapsulation of VC into beta-cyclodextrin (β-CD) and their incorporation in package materials is an alternative to maintain an antifungal atmosphere around the packaged fruits for longer times. In this context, the aim of this work was to develop inclusion complexes based in β-CD and VC (β-CD:VC) for further application in the antifungal food packaging materials development. β-CD:VC inclusion complexes were obtained with two different molar ratios 2:1 and 1:1, through co-precipitation method. The entrapment efficiency of β-CD:VC as well the release of antifungal compound from inclusion complexes exposed to different relative humidity (25, 50, and 97 %) to headspace were determined by gaseous chromatography (GC). Also, thermal and antimicrobial properties of β-CD:VC were determined through thermogravimetric analysis (TGA) and antifungal assays against Botrytis cinerea, respectively. GC results showed that β-CD:VC 2:1 had a higher entrapment efficiency than β-CD:VC 1:1, with values of 75.5 ± 3.71 % and 59.6 ± 1.51 %, respectively. It was probably because during the synthesis of β-CD:VC 1:1, there was less molecular space to the movement of VC molecules. Furthermore, the release of VC from β-CD:VC was directly related with the relative humidity. High amount of VC was released when the inclusion complexes were exposed to high humidity, possibly due to the interactions between the water molecules and the β-CD hydrophilic wall. On the other hand, a better thermal stability of VC in inclusion complexes allowed to verify its effective encapsulation into β-CD. Finally, antimicrobial assays showed that the inclusion complexes had a high antifungal activity at very low concentrations. Therefore, the results obtained in this work allow suggesting the β-CD:VC inclusion complexes as potential candidates to the development of fruit antifungal packaging materials, which activity is relative humidity dependent.

Keywords: Botrytis cinerea, fruit packaging, headspace release, volatile compounds

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2275 Developing a Methodology to Examine Psychophysiological Responses during Stress Exposure and Relaxation: An Experimental Paradigm

Authors: M. Velana, G. Rinkenauer

Abstract:

Nowadays, nurses are facing unprecedented amounts of pressure due to the ongoing global health demands. Work-related stress can cause a high physical and psychological workload, which can lead, in turn, to burnout. On the physiological level, stress triggers an initial activation of the sympathetic nervous and adrenomedullary systems resulting in increases in cardiac activity. Furthermore, activation of the hypothalamus-pituitary-adrenal axis provokes endocrine and immune changes leading to the release of cortisol and cytokines in an effort to re-establish body balance. Based on the current state of the literature, it has been identified that resilience and mindfulness exercises among nurses can effectively decrease stress and improve mood. However, it is still unknown what relaxation techniques would be suitable for and to what extent would be effective to decrease psychophysiological arousal deriving from either a physiological or a psychological stressor. Moreover, although cardiac activity and cortisol are promising candidates to examine the effectiveness of relaxation to reduce stress, it still remains to shed light on the role of cytokines in this process so as to thoroughly understand the body’s response to stress and to relaxation. Therefore, the main aim of the present study is to develop a comprehensive experimental paradigm and assess different relaxation techniques, namely progressive muscle relaxation and a mindfulness exercise originating from cognitive therapy by means of biofeedback, under highly controlled laboratory conditions. An experimental between-subject design will be employed, where 120 participants will be randomized either to a physiological or a psychological stress-related experiment. Particularly, the cold pressor test refers to a procedure in which the participants have to immerse their non-dominant hands into ice water (2-3 °C) for 3 min. The participants are requested to keep their hands in the water throughout the whole duration. However, they can immediately terminate the test in case it would be barely tolerable. A pre-test anticipation phase and a post-stress period of 3 min, respectively, are planned. The Trier Social Stress Test will be employed to induce psychological stress. During this laboratory stressor, the participants are instructed to give a 5-min speech in front of a committee of communication specialists. Before the main task, there is a 10-min anticipation period. Subsequently, participants are requested to perform an unexpected arithmetic task. After stress exposure, the participants will perform one of the relaxation exercises (treatment condition) or watch a neutral video (control condition). Electrocardiography, salivary samples, and self-report will be collected at different time points. The preliminary results deriving from the pilot study showed that the aforementioned paradigm could effectively induce stress reactions and that relaxation might decrease the impact of stress exposure. It is of utmost importance to assess how the human body responds under different stressors and relaxation exercises so that an evidence-based intervention could be transferred in a clinical setting to improve nurses’ general health. Based on suggestive future laboratory findings, the research group plans to conduct a pilot-level randomized study to decrease stress and promote well-being among nurses who work in the stress-riddled environment of a hospital located in Northern Germany.

Keywords: nurses, psychophysiology, relaxation, stress

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2274 Gender, Climate Change, and Resilience in Kenyan Pastoralist Communities

Authors: Anne Waithira Dormal

Abstract:

Climate change is threatening pastoral livelihoods in Kajiado County, Kenya, through water shortages, livestock deaths, and increasing poverty. This study examines how these impacts differ for men and women within these communities. Limited access to resources, limited land and livestock rights, and limited decision-making power increase women's vulnerability, which is further burdened by traditional gender roles in water procurement. The research recognizes the complexity of climate change and emphasizes that factors such as wealth, family dynamics, and socioeconomic status also influence resilience. Effective adaptation strategies must address all genders. While livestock farming provides a safety net, socioeconomic empowerment through access to credit, healthcare, and education strengthens entire communities. An intersectional perspective that takes ethnicity, social status, and other factors into account is also crucial. This research, therefore, aims to examine how gender-specific adaptation strategies interact with gender and socioeconomic factors to determine the resilience of these Kenyan pastoralist communities. Such strategies, which address the specific needs and vulnerabilities of men and women, are expected to lead to increased resilience to climate change. The aim of the study is to identify effective, gender-specific adaptation strategies that can be integrated into climate change planning and implementation. Additionally, research awaits a deeper understanding of how socioeconomic factors interact with gender to influence vulnerability and resilience within these communities. The study uses a gender-sensitive qualitative approach with focus group discussions in four different pastoral and agropastoral communities. Both qualitative and demographic data are used to capture sources of income, education level, and household size of focus group respondents to increase the power of the analysis. While the research acknowledges the limitations of specific focus sites and potential biases in self-reporting, it offers valuable insights into gender and climate change in pastoral contexts. This study contributes to understanding gender-based vulnerabilities and building resilience in these communities.

Keywords: climate adaptation strategies, climate change, climate resilience, gendered vulnerability, pastoralism

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2273 Additional Method for the Purification of Lanthanide-Labeled Peptide Compounds Pre-Purified by Weak Cation Exchange Cartridge

Authors: K. Eryilmaz, G. Mercanoglu

Abstract:

Aim: Purification of the final product, which is the last step in the synthesis of lanthanide-labeled peptide compounds, can be accomplished by different methods. Among these methods, the two most commonly used methods are C18 solid phase extraction (SPE) and weak cation exchanger cartridge elution. SPE C18 solid phase extraction method yields high purity final product, while elution from the weak cation exchanger cartridge is pH dependent and ineffective in removing colloidal impurities. The aim of this work is to develop an additional purification method for the lanthanide-labeled peptide compound in cases where the desired radionuclidic and radiochemical purity of the final product can not be achieved because of pH problem or colloidal impurity. Material and Methods: For colloidal impurity formation, 3 mL of water for injection (WFI) was added to 30 mCi of 177LuCl3 solution and allowed to stand for 1 day. 177Lu-DOTATATE was synthesized using EZAG ML-EAZY module (10 mCi/mL). After synthesis, the final product was mixed with the colloidal impurity solution (total volume:13 mL, total activity: 40 mCi). The resulting mixture was trapped in SPE-C18 cartridge. The cartridge was washed with 10 ml saline to remove impurities to the waste vial. The product trapped in the cartridge was eluted with 2 ml of 50% ethanol and collected to the final product vial via passing through a 0.22μm filter. The final product was diluted with 10 mL of saline. Radiochemical purity before and after purification was analysed by HPLC method. (column: ACE C18-100A. 3µm. 150 x 3.0mm, mobile phase: Water-Acetonitrile-Trifluoro acetic acid (75:25:1), flow rate: 0.6 mL/min). Results: UV and radioactivity detector results in HPLC analysis showed that colloidal impurities were completely removed from the 177Lu-DOTATATE/ colloidal impurity mixture by purification method. Conclusion: The improved purification method can be used as an additional method to remove impurities that may result from the lanthanide-peptide synthesis in which the weak cation exchange purification technique is used as the last step. The purification of the final product and the GMP compliance (the final aseptic filtration and the sterile disposable system components) are two major advantages.

Keywords: lanthanide, peptide, labeling, purification, radionuclide, radiopharmaceutical, synthesis

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2272 Evaluation of Associated Risk Factors and Determinants of near Miss Obstetric Cases at B.P. Koirala Institute of Health Sciences, Dharan

Authors: Madan Khadka, Dhruba Uprety, Rubina Rai

Abstract:

Background and objective: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of the level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near-miss obstetric cases and maternal death. Material and Methods A Prospective Observational Study was done from August 1, 2014, to June 30, 2015, in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by the 5-factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, and a complication of abortion, ruptured uterus, medical/surgical condition and sepsis. Results: A total of 9,727 delivery were attended during the study period from August 2014 to June 2014. There were 6307 (71.5%) vaginal delivery and 2777(28.5%) caesarean section and 181 perinatal death with a total of 9,546 live birth. A total of 162 near miss was identified, and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions (WLTC) of 172, Severe maternal outcome ratio of 18.64 per 1000 live birth, Maternal near-miss mortality ratio (MNM: 1 MD) 10.1:1, Mortality index (MI) of 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9%. 19.75% were prim gravidae, with mean age 25.66 yrs, and cardiovascular and coagulation dysfunction as a major life threatening condition and sepsis (25%) was the major cause of mortality. Conclusion: Hemorrhage and hypertensive disorders are the leading causes of near miss event and sepsis as a leading cause of mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.

Keywords: abortion, eclampsia, hemorrhage, maternal mortility, near miss

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2271 Sialic Acid Profile and Sialidase Activity in HIV-Infected Individuals

Authors: Hadiza Abdullahi

Abstract:

Sialic Acids and sialidases have been implicated in many disease states particularly bacterial and viral infections which are common opportunist infections of HIV disease. Their role in HIV/AIDS is contemplated. A study was carried out to determine Sialic Acid profile and Sialidase Activity in HIV infected and Apparently Healthy individuals, and also determine the relationship between the sialic acid levels and sialidase activity. Blood samples were collected from 200 subjects (150 HIV infected individuals and 50 apparently healthy individuals divided into four groups- HIV ART Naïve, HIV Stable (on ART but have been stable with no clinical episodes), HIV-OI (on ART with opportunistic infections), and Apparently Healthy). Complete Blood Count, Erythrocyte Surface Sialic Acid (ESSA), Free Serum Sialic Acid (FSSA) concentrations and Sialidase activity were determined for all 200 subjects. Analysis of variance (ANOVA) was used to compare the results of the different groups of HIV infected individuals as well as controls. The mean haemoglobin (HGB), Packed Cell Volume (PCV) and Red Blood Cells (RBC) concentrations were significantly lower (P ≤ 0.05) in the HIV groups compared with the apparently healthy groups. Anaemia and neutropaenia were the most common heamatological abnormalities observed in this study with highest prevalence of anaemia found in the ART naive group. The mean FSSA was 0.4±0.4mg/ml. There was a significant difference (p ≤ 0.05) between some groups. The highest levels of FSSA was observed in the HIV ART naïve (0.65±0.5mg/ml). The mean ESSA value for the study population was 0.54±0.35mg/ml with no significant difference (p ≤ 0.05) between groups. The mean sialidase activity values were 0.52±0.1 µmol/min/µl, 0.40±0.1 µmol/min/µl, 0.45±0.1 µmol/min/µl and 0.41±0.1 µmol/min/µl for the HIV ART naïve, HIV stable, HIV/OIs and apparently healthy groups respectively. No significant difference (p ≤ 0.05) was found between groups and also in gender and age. The finding in this study of higher mean sialidase activity and FSSA levels in the ART naïve HIV group compared with other groups indicate that the virus and other opportunistic pathogens may be sialidase producers in vivo which cleave off sialic acids from erythrocytes surface, leading to high levels of FSSA, anaemia and neutropaenia seen in this group. The higher ESSA concentration found in the HIV stable group along with lowest FSSA concentration in the group suggests the presence of sialyltransferases.

Keywords: erythrocyte surface sialic acid, free serum sialic acid, HIV, sialidase

Procedia PDF Downloads 186
2270 Efficacy and Safety of Electrical Vestibular Stimulation on Adults with Symptoms of Insomnia: A Double-Blind, Randomized, Sham-Controlled Trial

Authors: Teris Cheung, Joyce Yuen Ting Lam, Kwan Hin Fong, Calvin Pak-Wing Cheng, Julie Sittlington, Yu-Tao Xiang, Tim Man Ho Li

Abstract:

Insomnia is one of the most common health problems in the general population. Insomnia can be acute, intermittent, and become chronic, often due to comorbidity with other physical and mental health conditions. Although there are conventional pharmaceutical and psychotherapeutic treatments to treat symptoms of insomnia, however; there is no robust and novel randomized controlled trial (RCT) using transdermal neurostimulation on individuals with insomnia symptoms. This gives us the impetus to execute the first nationwide RCT. Aim: To evaluate the efficacy of Electrical Vestibular Stimulation (VeNS) on individuals with insomnia in Hong Kong. Design: This study was a two-armed, double blinded, randomized, sham-controlled trial. Sampling: 60 community-dwelling adults aged 18 and 60 years with moderate insomnia symptoms or above (Insomnia Severity Index > 14) were recruited. All subjects were computerized randomized into either the active VeNS group or the sham VeNS group on a 1:1 ratio. Intervention: All participants received a home-use VeNS device and used 30-min VeNS sessions during five consecutive days across a 4-week period (total treatment hours: 10). Baseline measurements and post-VeNS evaluation of the psychological outcomes, including 1) insomnia severity, 2) sleep quality, and 3) quality of life were investigated. The short-and long-term sustainability of the VeNS intervention was assessed immediately after poststim and at a 1-month and 3-month follow-up period. Data analysis: A mixed GEE model was used to analyze the repeated measures data. Missing data were managed by multiple imputations. The level of significance was set to p < 0.05. Significance of the study: This is the first trial to examine the efficacy and safety of VeNS among adults with insomnia symptoms in Hong Kong. Findings that emerged were used to determine whether this VeNS device can be considered a self-help technological device to reduce the severity of insomnia in the community setting and to reduce the global disease burden. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT04452981.

Keywords: adults, insomnia, neuromodulation, rct, vestibular stimulation

Procedia PDF Downloads 63
2269 An Unusual Cause of Electrocardiographic Artefact: Patient's Warming Blanket

Authors: Sanjay Dhiraaj, Puneet Goyal, Aditya Kapoor, Gaurav Misra

Abstract:

In electrocardiography, an ECG artefact is used to indicate something that is not heart-made. Although technological advancements have produced monitors with the potential of providing accurate information and reliable heart rate alarms, despite this, interference of the displayed electrocardiogram still occurs. These interferences can be from the various electrical gadgets present in the operating room or electrical signals from other parts of the body. Artefacts may also occur due to poor electrode contact with the body or due to machine malfunction. Knowing these artefacts is of utmost importance so as to avoid unnecessary and unwarranted diagnostic as well as interventional procedures. We report a case of ECG artefacts occurring due to patient warming blanket and its consequences. A 20-year-old male with a preoperative diagnosis of exstrophy epispadias complex was posted for surgery under epidural and general anaesthesia. Just after endotracheal intubation, we observed nonspecific ECG changes on the monitor. At a first glance, the monitor strip revealed broad QRs complexes suggesting a ventricular bigeminal rhythm. Closer analysis revealed these to be artefacts because although the complexes were looking broad on the first glance there was clear presence of normal sinus complexes which were immediately followed by 'broad complexes' or artefacts produced by some device or connection. These broad complexes were labeled as artefacts as they were originating in the absolute refractory period of the previous normal sinus beat. It would be physiologically impossible for the myocardium to depolarize so rapidly as to produce a second QRS complex. A search for the possible reason for the artefacts was made and after deepening the plane of anaesthesia, ruling out any possible electrolyte abnormalities, checking of ECG leads and its connections, changing monitors, checking all other monitoring connections, checking for proper grounding of anaesthesia machine and OT table, we found that after switching off the patient’s warming apparatus the rhythm returned to a normal sinus one and the 'broad complexes' or artefacts disappeared. As misdiagnosis of ECG artefacts may subject patients to unnecessary diagnostic and therapeutic interventions so a thorough knowledge of the patient and monitors allow for a quick interpretation and resolution of the problem.

Keywords: ECG artefacts, patient warming blanket, peri-operative arrhythmias, mobile messaging services

Procedia PDF Downloads 256
2268 Numerical Investigation of the Operating Parameters of the Vertical Axis Wind Turbine

Authors: Zdzislaw Kaminski, Zbigniew Czyz, Tytus Tulwin

Abstract:

This paper describes the geometrical model, algorithm and CFD simulation of an airflow around a Vertical Axis Wind Turbine rotor. A solver, ANSYS Fluent, was applied for the numerical simulation. Numerical simulation, unlike experiments, enables us to validate project assumptions when it is designed to avoid a costly preparation of a model or a prototype for a bench test. This research focuses on the rotor designed according to patent no PL 219985 with its blades capable of modifying their working surfaces, i.e. absorbing wind kinetic energy. The operation of this rotor is based on a regulation of blade angle α between the top and bottom parts of blades mounted on an axis. If angle α increases, the working surface which absorbs wind kinetic energy also increases. CFD calculations enable us to compare aerodynamic characteristics of forces acting on rotor working surfaces and specify rotor operation parameters like torque or turbine assembly power output. This paper is part of the research to improve an efficiency of a rotor assembly and it contains investigation of the impact of a blade angle of wind turbine working blades on the power output as a function of rotor torque, specific rotational speed and wind speed. The simulation was made for wind speeds ranging from 3.4 m/s to 6.2 m/s and blade angles of 30°, 60°, 90°. The simulation enables us to create a mathematical model to describe how aerodynamic forces acting each of the blade of the studied rotor are generated. Also, the simulation results are compared with the wind tunnel ones. This investigation enables us to estimate the growth in turbine power output if a blade angle changes. The regulation of blade angle α enables a smooth change in turbine rotor power, which is a kind of safety measures if the wind is strong. Decreasing blade angle α reduces the risk of damaging or destroying a turbine that is still in operation and there is no complete rotor braking as it is in other Horizontal Axis Wind Turbines. This work has been financed by the Polish Ministry of Science and Higher Education.

Keywords: computational fluid dynamics, mathematical model, numerical analysis, power, renewable energy, wind turbine

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2267 In Vitro Intestine Tissue Model to Study the Impact of Plastic Particles

Authors: Ashleigh Williams

Abstract:

Micro- and nanoplastics’ (MNLPs) omnipresence and ecological accumulation is evident when surveying recent environmental impact studies. For example, in 2014 it was estimated that at least 52.3 trillion plastic microparticles are floating at sea, and scientists have even found plastics present remote Arctic ice and snow (5,6). Plastics have even found their way into precipitation, with more than 1000 tons of microplastic rain precipitating onto the Western United States in 2020. Even more recent studies evaluating the chemical safety of reusable plastic bottles found that hundreds of chemicals leached into the control liquid in the bottle (ddH2O, ph = 7) during a 24-hour time period. A consequence of the increased abundance in plastic waste in the air, land, and water every year is the bioaccumulation of MNLPs in ecosystems and trophic niches of the animal food chain, which could potentially cause increased direct and indirect exposure of humans to MNLPs via inhalation, ingestion, and dermal contact. Though the detrimental, toxic effects of MNLPs have been established in marine biota, much less is known about the potentially hazardous health effects of chronic MNLP ingestion in humans. Recent data indicate that long-term exposure to MNLPs could cause possible inflammatory and dysbiotic effects. However, toxicity seems to be largely dose-, as well as size-dependent. In addition, the transcytotic uptake of MNLPs through the intestinal epithelia in humans remain relatively unknown. To this point, the goal of the current study was to investigate the mechanisms of micro- and nanoplastic uptake and transcytosis of Polystyrene (PE) in human stem-cell derived, physiologically relevant in vitro intestinal model systems, and to compare the relative effect of particle size (30 nm, 100 nm, 500 nm and 1 µm), and concentration (0 µg/mL, 250 µg/mL, 500 µg/mL, 1000 µg/mL) on polystyrene MNLP uptake, transcytosis and intestinal epithelial model integrity. Observational and quantitative data obtained from confocal microscopy, immunostaining, transepithelial electrical resistance (TEER) measurements, cryosectioning, and ELISA cytokine assays of the proinflammatory cytokines Interleukin-6 and Interleukin-8 were used to evaluate the localization and transcytosis of polystyrene MNPs and its impact on epithelial integrity in human-derived intestinal in vitro model systems. The effect of Microfold (M) cell induction on polystyrene micro- and nanoparticle (MNP) uptake, transcytosis, and potential inflammation was also assessed and compared to samples grown under standard conditions. Microfold (M) cells, link the human intestinal system to the immune system and are the primary cells in the epithelium responsible for sampling and transporting foreign matter of interest from the lumen of the gut to underlying immune cells. Given the uptake capabilities of Microfold cells to interact both specifically and nonspecific to abiotic and biotic materials, it was expected that M- cell induced in vitro samples would have increased binding, localization, and potentially transcytosis of Polystyrene MNLPs across the epithelial barrier. Experimental results of this study would not only help in the evaluation of the plastic toxicity, but would allow for more detailed modeling of gut inflammation and the intestinal immune system.

Keywords: nanoplastics, enteroids, intestinal barrier, tissue engineering, microfold (M) cells

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2266 Structure-Reactivity Relationship of Some Rhᴵᴵᴵ and Osᴵᴵᴵ Complexes with N-Inert Ligands in Ionic Liquids

Authors: Jovana Bogojeski, Dusan Cocic, Nenad Jankovic, Angelina Petrovic

Abstract:

Kinetically-inert transition metal complexes, such as Rh(III) and Os(III) complexes, attract increasing attention as leading scaffolds for the development of potential pharmacological agents due to their inertness and stability. Therefore, we have designed and fully characterized a few novel rhodium(III) and osmium(III) complexes with a tridentate nitrogen−donor chelate system. For some complexes, the crystal X-ray structure analysis was performed. Reactivity of the newly synthesized complexes towards small biomolecules, such as L-methionine (L-Met), guanosine-5’-monophosphate (5’-GMP), and glutathione (GSH) has been examined. Also, the reactivity of these complexes towards the DNA/RNA (Ribonucleic acid) duplexes was investigated. Obtained results show that the newly synthesized complexes exhibit good affinity towards the studied ligands. Results also show that the complexes react faster with the RNA duplex than with the DNA and that in the DNA duplex reaction is faster with 15mer GG than with the 22mer GG. The UV-Vis (Ultraviolet-visible spectroscopy) is absorption spectroscopy, and the EB (Ethidium bromide) displacement studies were used to examine the interaction of these complexes with CT-DNA and BSA (Bovine serum albumin). All studied complex showed good interaction ability with both the DNA and BSA. Furthermore, the DFT (Density-functional theory) calculation and docking studies were performed. The impact of the metal complex on the cytotoxicity was tested by MTT assay (a colorimetric assay for assessing cell metabolic activity) on HCT-116 lines (human colon cancer cell line). In addition, all these tests were repeated in the presence of several water-soluble biologically active ionic liquids. Attained results indicate that the ionic liquids increase the activity of the investigated complexes. All obtained results in this study imply that the introduction of different spectator ligand can be used to improve the reactivity of rhodium(III) and osmium(III) complexes. Finally, these results indicate that the examined complexes show reactivity characteristics needed for potential anti-tumor agents, with possible targets being both the DNA and proteins. Every new contribution in this field is highly warranted due to the current lack of clinically used Metallo-based alternatives to cisplatin.

Keywords: biomolecules, ionic liquids, osmium(III), rhodium(III)

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2265 Long-Term Outcome of Emergency Response Team System in In-Hospital Cardiac Arrest

Authors: Jirapat Suriyachaisawat, Ekkit Surakarn

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Introduction: To improve early detection and mortality rate of in-hospital cardiac arrest, Emergency Response Team (ERT) system was planned and implemented since June 2009 to detect pre-arrest conditons and for any concerns. The ERT consisted of on duty physicians and nurses from emergency department. ERT calling criteria consisted of acute change of HR < 40 or > 130 beats per minute, systolic blood pressure < 90 mmHg, respiratory rate <8 or >28 breaths per minute, O2 saturation <90%, acute change in conscious state, acute chest pain or worry about the patients. From the data on ERT system implementation in our hospital in early phase (during June 2009-2011), there was no statistic significance in difference in in-hospital cardiac arrest incidence and overall hospital mortality rate. Since the introduction of the ERT service in our hospital, we have conducted continuous educational campaign to improve awareness in an attempt to increase use of the service. Methods: To investigate outcome of ERT system in in-hospital cardiac arrest and overall hospital mortality rate, we conducted a prospective, controlled before-and after examination of the long term effect of a ERT system on the incidence of cardiac arrest. We performed chi-square analysis to find statistic significance. Results: Of a total 623 ERT cases from June 2009 until December 2012, there were 72 calls in 2009, 196 calls in 2010, 139 calls in 2011 and 245 calls in 2012. The number of ERT calls per 1000 admissions in year 2009-10 was 7.69; 5.61 in 2011 and 9.38 in 2013. The number of code blue calls per 1000 admissions decreased significantly from 2.28 to 0.99 per 1000 admissions (P value < 0.001). The incidence of cardiac arrest decreased progressively from 1.19 to 0.34 per 1000 admissions and significant in difference in year 2012 (P value < 0.001 ). The overall hospital mortality rate decreased by 8 % from 15.43 to 14.43 per 1000 admissions (P value 0.095). Conclusions: ERT system implementation was associated with progressive reduction in cardiac arrests over three year period, especially statistic significant in difference in 4th year after implementation. We also found an inverse association between number of ERT use and the risk of occurrence of cardiac arrests, but we have not found difference in overall hospital mortality rate.

Keywords: cardiac arrest, outcome, in-hospital, ERT

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