Search results for: quality assessment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14440

Search results for: quality assessment

10360 Impact of SES and Culture on Well-Being of Adolescent

Authors: Shraddha B. Rai, Mahipatsinh D. Chavda, Bharat S. Trivedi

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The aim of the present research is to study the effect of education and social belonging on well-being of youth. Well-being is one of the most important aspects of human being and the state of well-being can be attained in terms of healthy body with healthy mind. Well-being has been defined as encompassing people’s cognitive and affective evaluations of their lives. Well-being has been interchangeably used with health and quality of life. According to the WHO, the main determinants of health include the social, economic, and the physical environment and the persons individual characteristics and behaviors. WHO lists other factors that can influence the well-being of a person such as the gender, education, social support networks and health services. The main objective of the present investigation is to know the effect of education and social belonging on well-being of youth. The sample of 180 students belonging to Gujarati and English (convent) culture were selected randomly from Guajarati and English (convent) schools of Ahmedabad City of Gujarat (India). General well-being Scale by Dr. Ashok Kalia and Ms. Anita Deswal was administered to measure the Physical, Emotional, and Social and school well-being. The result shows that there is significant different found between Gujarati and English (convent) culture on Well-being in school students. SES is also affect significantly to wellbeing of students.

Keywords: culture, SES, well-being, health, quality of life

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10359 The Impact of Insomnia on the Academic Performance of Mexican Medical Students: Gender Perspective

Authors: Paulina Ojeda, Damaris Estrella, Hector Rubio

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Insomnia is a disorder characterized by difficulty falling asleep, staying asleep or both. It negatively affects the life quality of people, it hinders the concentration, attention, memory, motor skills, among other abilities that complicate work or learning. Some studies show that women are more susceptible to insomnia. Medicine curricula usually involve a great deal of theoretical and memory content, especially in the early years of the course. The way to accredit a university course is to demonstrate the level of competence or acquired knowledge. In Mexico the most widely used form of measurement is written exams, with numerical scales results. The prevalence of sleep disorders in university students is usually high, so it is important to know if insomnia has an effect on school performance in men and women. A cross-sectional study was designed that included a probabilistic sample of 118 regular students from the School of Medicine of the Autonomous University of Yucatan, Mexico. All on legally age. The project was authorized by the School of Medicine and all the ethical implications of the case were monitored. Participants completed anonymously the following questionnaires: Pittsburgh Sleep Quality Index, Insomnia Severity Index, AUDIT test, epidemiological and clinical data. Academic performance was assessed by the average number of official grades earned on written exams, as well as the number of approved or non-approved courses. These data were obtained officially through the corresponding school authorities. Students with at least one unapproved course or average less than 70 were considered to be poor performers. With all courses approved and average between 70-79 as regular performance and with an average of 80 or higher as a good performance. Statistical analysis: t-Student, difference of proportions and ANOVA. 65 men with a mean age of 19.15 ± 1.60 years and 53 women of 18.98 ± 1.23 years, were included. 96% of the women and 78.46% of the men sleep in the family home. 16.98% of women and 18.46% of men consume tobacco. Most students consume caffeinated beverages. 3.7% of the women and 10.76% of the men complete criteria of harmful consumption of alcohol. 98.11% of the women and 90.76% of the men are perceived with poor sleep quality. Insomnia was present in 73% of women and 66% of men. Women had higher levels of moderate insomnia (p=0.02) compared to men and only one woman had severe insomnia. 50.94% of the women and 44.61% of the men had poor academic performance. 18.86% of women and 27% of men performed well. Only in the group of women we found a significant association between poor performance with mild (p= 0.0035) and moderate (p=0.031) insomnia. The medical students reported poor sleep quality and insomnia. In women, levels of insomnia were associated with poor academic performance.

Keywords: scholar-average, sex, sleep, university

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10358 Effects of Microbiological and Physicochemical Processes on the Quality of Complementary Foods Based on Maize (Zea mays) Fortification with Bambara Groundnut (Vigna subterranea)

Authors: T. I. Mbata, M. J. Ikenebomeh

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Background: The study was aim at formulating a complementary foods based on maize and bambara groundnut with a view of reducing malnutrition in low income families. Protein-energy malnutrition is a major health challenge attributed to the inappropriate complementary feeding practices, low nutritional quality of traditional complementary foods and high cost of quality protein-based complementary foods. Methods: The blends 70% maize, 30% bambara groundnut were evaluated for proximate analyses, minerals, amino acids profile, and antinutritional factors, using proprietary formula (‘Nutrend’) as standard. Antinutritional factors, amino acids, microbiological properties and sensory attributes were determined using standard methods. Results; For Protein, the results were 15.0% for roasted bambara groundnut maize germinated flour (RBMGF), 13.80% for cooked bambara groundnut maize germinated flour (CBMGF), 15.18% for soaked bambara groundnut maize germinated flour (SBMGF); values for maize flour and nutrend had 10.4% and 23.21% respectively. With respect to energy value, RBMGF, CBMGF, SBMGF, maize flour and nutrend had 494.9, 327.58, 356.49, 366.8 and 467.2 kcal respectively. The percentages of total essential amino acids in the composition of the blends were 36.9%, 40.7% and 38.9% for CBMGF, SBMGF and RBMGF, respectively, non-essential amino acids contents were 63.1%, 59.3% and 61.1% for CBMGF, SBMGF and RBMGF respectively. The mineral content, that is, calcium, potassium, magnesium and sodium, of formulated samples were higher than those obtained for maize flour and Nutrend. The antinutrient composition of RBMGF and CBMGF were lower than of SBMGF. The rats fed with the control diet exhibited better growth performance such as feed intake (1527 g) and body weight gain (93.8 g). For the microbial status, microflora gradually changed from gram negative enteric bacteria, molds, lactic acid bacteria and yeast to be dominated by gram positive lactic acid bacteria (LAB) and yeasts. Yeasts and LAB growth counts in the complementary food varied between 4.44 and 7.36 log cfu/ml. LAB number increased from 5.40 to 7.36 log cfu/ml during fermentation. Yeasts increased from 4.44 to 5.60 log cfu/ml. Organoleptic evaluation revealed that the foods were well accepted. Conclusion: Based on the findings the application of bambara groundnut fortification to traditional foods can promote the nutritional quality of African maize - based traditional foods with acceptable rheological and cooking qualities.

Keywords: bambara groundnut, maize, fortification, complementary food

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10357 Effect of Selenium Source on Meat Quality of Bonsmara Bull Calves

Authors: J. van Soest, B. Bruneel, J. Smit, N. Williams, P. Swiegers

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Selenium (Se) is an essential trace mineral involved in reducing oxidative stress, enhancing immune status, improving reproduction, and regulating growth. During finishing period, selenium supplementation can be applied to improve meat quality. Dietary selenium can be provided in inorganic or organic forms. Specifically, L-selenomethionine (organic selenium) allows for selenium storage in animal protein which supports the animal during periods of high oxidative stress. The objective of this study was to investigate the effects of synthetically produced, single amino acid, L-selenomethionine (Excential Selenium 4000, Orffa Additives BV) on production parameters, health status, and meat quality of Bonsmara bull calves. 24 calves, 7 months of age, completed a 60-day initial growing period at a commercial feedlot, after which they were transported to research station Rumen-8 (Bethlehem, South-Africa). After a ten-day adaptation period, the bulls were allocated to a control (n=12) or treatment (n=12) group. Each group was divided over 3 pens based on weight. Both groups received Total Mixed Ration supplemented with 5.25 mg Se/head per day. The control group was supplemented with sodium selenite as Se source, whilst the treatment group was supplemented with L-selenomethionine (Excential Selenium 4000, Orffa Additives BV). Animals were limited to 10 kg feed intake per head per day to ensure similar Se intake. Treatment period lasted 1.5 months. A beta-adrenergic agonist was included in the feed for the last 30 days. During the treatment period, average daily gain, average daily feed intake, and feed conversion ratio were recorded. Blood parameters were measured at day 1, day 25, and before slaughter (day 47). After slaughter, carcass weight, dressing percentage, grading, and meat quality (pH, tenderness, colour, odour, purge, proximate analyses, acid detergent fibre, and neutral detergent fibre) were determined. No differences between groups were found in performance. A higher number of animals with cortisol levels below detection limit (27.6 nmol/l) was recorded for the treatment group. Other blood parameters showed no differences. No differences were found regarding carcass weight and dressing percentage. Important parameters of meat quality were significantly improved in the treatment group: instrumental tenderness at 14 days ageing was 2.8 and 3.4 for treatment and control respectively (P=0.010), and a 0.5% decrease in purge (of fresh samples) was shown, 1.5% and 2.0% for treatment group and control respectively (p=0.029). Besides, pH was shown to be numerically reduced in the treatment group. In summary, supplementation with L-selenomethionine as selenium source improved meat quality compared to sodium selenite. Lower instrumental tenderness (Warner Bratzler Shear Force, WBSF) was recorded for the treatment group. This indicates less tough meat and highest consumer satisfaction. Regarding purge, control was just below 2.0%, an important threshold for consumer acceptation. Treatment group scored 0.5% lower for purge than control, indicating higher consumer satisfaction. The lower pH in the treatment group could be an indication of higher glycogen reserves in muscle which could contribute to a reduced risk of Dark Firm Dry carcasses. More animals showed cortisol levels below detection limit in the treatment group, indicating lower levels of stress when animals receive L-selenomethionine.

Keywords: calves, meat quality, nutrition, selenium

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10356 Evaluation of Labelling Conditions, Quality Control, and Biodistribution Study of 99mTc- D-Aminolevulinic Acid (5-ALA)

Authors: Kalimullah Khan, Samina Roohi, Mohammad Rafi, Rizwana Zahoor

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Labeling of 5-Aminolevulinic acid (5-ALA) with 99 mTc was achieved by using tin chloride dihydrate (Sncl2.2H2O) as reducing agent. Radiochemical purity and labeling efficiency was determined by Whattman paper No.3 and instant thin layer chromatographic strips impregnated with silica gel (ITLC/SG). Labeling efficiency was dependent on many parameters such as amount of ligand, reducing agent, pH, and incubation time. Therefore, optimum conditions for maximum labeling were selected. Stability of 99 mTc- 5-ALA was also checked in fresh human serum. Tissue bio-distribution of 99 mTc-5-ALA was evaluated in Spargue Dawley rats. 5-ALA was 98% labeled with 99 mTc under optimum conditions, i.e. 100µg of 5-ALA, pH: 4, 10µg of Sncl2.2H2O and 30 minutes incubation at room temperature. 99 mTc labelled 5- ALA remained stable for 24 hours in human serum. Bio-distribution study (%ID/gm) in rats revealed that maximum accumulation of 99 mTc-5-ALA was in liver, spleen, stomach and intestine after half hour, 4 hours, and 24 hours. Significant activity in bladder and urine indicated urinary mode of excretion.

Keywords: 99mTc-ALA, aminolevulinic acid, quality control, radiopharmaceuticals

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10355 Life Cycle Assessment of a Parabolic Solar Cooker

Authors: Bastien Sanglard, Lou Magnat, Ligia Barna, Julian Carrey, Sébastien Lachaize

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Cooking is a primary need for humans, several techniques being used around the globe based on different sources of energy: electricity, solid fuel (wood, coal...), fuel or liquefied petroleum gas. However, all of them leads to direct or indirect greenhouse gas emissions and sometimes health damage in household. Therefore, the solar concentrated power represent a great option to lower the damages because of a cleaner using phase. Nevertheless, the construction phase of the solar cooker still requires primary energy and materials, which leads to environmental impacts. The aims of this work is to analyse the ecological impacts of a commercialaluminium parabola and to compare it with other means of cooking, taking the boiling of 2 litres of water three times a day during 40 years as the functional unit. Life cycle assessment was performed using the software Umberto and the EcoInvent database. Calculations were realized over more than 13 criteria using two methods: the international panel on climate change method and the ReCiPe method. For the reflector itself, different aluminium provenances were compared, as well as the use of recycled aluminium. For the structure, aluminium was compared to iron (primary and recycled) and wood. Results show that climate impacts of the studied parabola was 0.0353 kgCO2eq/kWh when built with Chinese aluminium and can be reduced by 4 using aluminium from Canada. Assessment also showed that using 32% of recycled aluminium would reduce the impact by 1.33 and 1.43 compared to the use of primary Canadian aluminium and primary Chinese aluminium, respectively. The exclusive use of recycled aluminium lower the impact by 17. Besides, the use of iron (recycled or primary) or wood for the structure supporting the reflector significantly lowers the impact. The impact categories of the ReCiPe method show that the parabola made from Chinese aluminium has the heaviest impact - except for metal resource depletion - compared to aluminium from Canada, recycled aluminium or iron. Impact of solar cooking was then compared to gas stove and induction. The gas stove model was a cast iron tripod that supports the cooking pot, and the induction plate was as well a single spot plate. Results show the parabolic solar cooker has the lowest ecological impact over the 13 criteria of the ReCiPe method and over the global warming potential compared to the two other technologies. The climate impact of gas cooking is 0.628kgCO2/kWh when used with natural gas and 0.723 kgCO2/kWh when used with a bottle of gas. In each case, the main part of emissions came from gas burning. Induction cooking has a global warming potential of 0.12 kgCO2eq/kWh with the electricity mix of France, 96.3% of the impact being due to electricity production. Therefore, the electricity mix is a key factor for this impact: for instance, with the electricity mix of Germany and Poland, impacts are 0.81kgCO2eq/kWh and 1.39 kgCO2eq/kWh, respectively. Therefore, the parabolic solar cooker has a real ecological advantages compared to both gas stove and induction plate.

Keywords: life cycle assessement, solar concentration, cooking, sustainability

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10354 Disadvantages and Drawbacks of Concrete Blocks and Fix Their Defects

Authors: Ehsan Sadie

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Today, the cost of repair and maintenance of structures is very important and by studying the behavior of reinforced concrete structures Will become specified several factors such as : Design and calculation errors, lack of proper implementation of structural changes, the damage caused by the introduction of random loads, concrete corrosion and environmental conditions reduce durability of the structures . Meanwhile building codes alteration also cause changes in the assessment and review of the design and structure rather if necessary will be improved and strengthened in the future.

Keywords: concrete building , expandable cement, honeycombed surface , reinforcement corrosion

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10353 Growth of SWNTs from Alloy Catalyst Nanoparticles

Authors: S. Forel, F. Bouanis, L. Catala, I. Florea, V. Huc, F. Fossard, A. Loiseau, C. Cojocaru

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Single wall carbon nanotubes are seen as excellent candidate for application on nanoelectronic devices because of their remarkable electronic and mechanical properties. These unique properties are highly dependent on their chiral structures and the diameter. Therefore, structure controlled growth of SWNTs, especially directly on final device’s substrate surface, are highly desired for the fabrication of SWNT-based electronics. In this work, we present a new approach to control the diameter of SWNTs and eventually their chirality. Because of their potential to control the SWNT’s chirality, bi-metalics nanoparticles are used to prepare alloy nanoclusters with specific structure. The catalyst nanoparticles are pre-formed following a previously described process. Briefly, the oxide surface is first covered with a SAM (self-assembled monolayer) of a pyridine-functionalized silane. Then, bi-metallic (Fe-Ru, Co-Ru and Ni-Ru) complexes are assembled by coordination bonds on the pre-formed organic SAM. The resultant alloy nanoclusters were then used to catalyze SWNTs growth on SiO2/Si substrates via CH4/H2 double hot-filament chemical vapor deposition (d-HFCVD). The microscopy and spectroscopy analysis demonstrate the high quality of SWNTs that were furthermore integrated into high-quality SWNT-FET.

Keywords: nanotube, CVD, device, transistor

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10352 Longevity of Soybean Seeds Submitted to Different Mechanized Harvesting Conditions

Authors: Rute Faria, Digo Moraes, Amanda Santos, Dione Morais, Maria Sartori

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Seed vigor is a fundamental component for the good performance of the entire soybean production process. Seeds with mechanical damage at harvest time will be more susceptible to fungal and insect attack during storage, which will invariably reduce their vigor to the field, compromising uniformity and final stand performance. Harvesters, even the most modern ones, when not properly regulated or operated, can cause irreversible damages to the seeds, compromising even their commercialization. Therefore, the control of an efficient harvest is necessary in order to guarantee a good quality final product. In this work, the damage caused by two different harvesters (one rented, and another one) was evaluated, traveling in two speeds (4 and 8 km / h). The design was completely randomized in 2 x 2 factorial, with four replications. To evaluate the physiological quality seed germination and vigor tests were carried out over a period of six months. A multivariate analysis of Principal Components (PCA) and clustering allowed us to verify that the leased machine had better performance in the incidence of immediate damages in the seeds, but after a storage period of 6 months the vigor of these seeds reduced more than own machine evidencing that such a machine would bring more damages to the seeds.

Keywords: Glycine max (L.), cluster analysis, PCA, vigor

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10351 Psychological Distress and Quality of Life in Inflammatory Bowel Disease Patients: The Role of Dispositional Mindfulness

Authors: Kelly E. Tow, Peter Caputi, Claudia Rogge, Thomas Lee, Simon R. Knowles

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Inflammatory Bowel Disease (IBD) is a serious chronic health condition, characterised by inflammation of the gastrointestinal tract. Individuals with active IBD experience severe abdominal symptoms, which can adversely impact their physical and mental health, as well as their quality of life (QoL). Given that stress may exacerbate IBD symptoms and is frequently highlighted as a contributing factor for the development of psychological difficulties and poorer QoL, it is vital to investigate stress-management strategies aimed at improving the lives of those with IBD. The present study extends on the limited research in IBD cohorts by exploring the role of dispositional mindfulness and its impact on psychological well-being and QoL. The study examined how disease activity and dispositional mindfulness were related to psychological distress and QoL in a cohort of IBD patients. The potential role of dispositional mindfulness as a moderator between stress and anxiety, depression and QoL in these individuals was also examined. Participants included 47 patients with a clinical diagnosis of IBD. Each patient completed a series of psychological questionnaires and was assessed by a gastroenterologist to determine their disease activity levels. Correlation analyses indicated that disease activity was not significantly related to psychological distress or QoL in the sample of IBD patients. However, dispositional mindfulness was inversely related to psychological distress and positively related to QoL. Furthermore, moderation analyses demonstrated a significant interaction between stress and dispositional mindfulness on anxiety. These findings demonstrate that increased levels of dispositional mindfulness may be beneficial for individuals with IBD. Specifically, the results indicate positive links between dispositional mindfulness, general psychological well-being and QoL, and suggest that dispositional mindfulness may attenuate the negative impacts of stress on levels of anxiety in IBD patients. While further research is required to validate and expand on these findings, the current study highlights the importance of addressing psychological factors in IBD and indicates support for the use of mindfulness-based interventions for patients with the disease.

Keywords: anxiety, depression, dispositional mindfulness, inflammatory bowel disease, quality of life, stress

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10350 To Include or Not to Include: Resolving Ethical Concerns over the 20% High Quality Cassava Flour Inclusion in Wheat Flour Policy in Nigeria

Authors: Popoola I. Olayinka, Alamu E. Oladeji, B. Maziya-Dixon

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Cassava, an indigenous crop grown locally by subsistence farmers in Nigeria has potential to bring economic benefits to the country. Consumption of bread and other confectionaries has been on the rise due to lifestyle changes of Nigerian consumers. However, wheat, being the major ingredient for bread and confectionery production does not thrive well under Nigerian climate hence the huge spending on wheat importation. To reduce spending on wheat importation, the Federal Government of Nigeria intends passing into law mandatory inclusion of 20% high-quality cassava flour (HQCF) in wheat flour. While the proposed policy may reduce post harvest loss of cassava, and also increase food security and domestic agricultural productivity, there are downsides to the policy which include reduction in nutritional quality and low sensory appeal of cassava-wheat bread, reluctance of flour millers to use HQCF, technology and processing challenges among others. The policy thus presents an ethical dilemma which must be resolved for its successful implementation. While inclusion of HQCF to wheat flour in bread and confectionery is a topic that may have been well addressed, resolving the ethical dilemma resulting from the act has not received much attention. This paper attempts to resolve this dilemma using various approaches in food ethics (cost benefits, utilitarianism, deontological and deliberative). The Cost-benefit approach did not provide adequate resolution of the dilemma as all the costs and benefits of the policy could not be stated in the quantitative term. The utilitarianism approach suggests that the policy delivers greatest good to the greatest number while the deontological approach suggests that the act (inclusion of HQCF to wheat flour) is right hence the policy is not utterly wrong. The deliberative approach suggests a win-win situation through deliberation with the parties involved.

Keywords: HQCF, ethical dilemma, food security, composite flour, cassava bread

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10349 Assessment of Agricultural Damage under Different Simulated Flood Conditions

Authors: M. N. Kadir, M. M. H. Oliver, T. Naher

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The study assesses the areal extent of riverine flood in the flood-prone area of Faridpur District of Bangladesh using hydrological model and Geographic Information System (GIS). In the context of preparing the inundation map, flood frequency analysis was carried out to assess flooding for different flood magnitudes. Flood inundation maps were prepared based on DEM, and discharge at the river using Delft-3D model. LANDSAT satellite images have been used to develop a land cover map in the study area. The land cover map was used for mapping of cropland area. By incorporating the inundation maps on the land cover map, agricultural damage was assessed. Present monetary values of crop damage were collected through field survey from actual flood of the study area. Two different inundation maps were produced from the model for the year 2000 and 2016. In the year 2000, the floods began in the month of July, whereas in the case of the year 2016 is started in August. Under both cases, most of the areas were found to have been flooded in the month of September followed by flood recession. In order to prepare the land cover maps, four categories of LCs were considered viz., cropland, water body, trees, and rivers. Among the 755791 acres area of Faridpur District, the croplands were categorized to be 334,589 acres, followed by water bodies (279900 acres), trees (101930 acres) and rivers 39372 (acres). Damage assessment data revealed that 40% of the total cropland area had been affected by the flood in the year 2000, whereas only 19% area was affected by the 2016 flood. The study concluded that September is the critical month for cropland protection since the highest flood is expected at this time of the year in Faridpur. The northwestern and the southwestern part of the district was categorized as most vulnerable to flooding.

Keywords: agricultural damage, Delft-3d, flood management, land cover map

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10348 Effect of Perioperative Protocol of Care on Clinical Outcomes among Patients Undergoing Coronary Artery Bypass Graft

Authors: Manal Ahmed, Amal Shehata, Shereen Deeb

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The study's purpose was to determine the effect of the perioperative protocol of care on clinical outcomes among patients undergoing coronary artery bypass graft. Subjects: A sample of 100 adult patients who were planned for coronary artery bypass graft, were selected and divided alternatively and randomly into two equal groups (50 study -50 control).The study was carried out at National heart Institute in Cairo and open heart surgical intensive care unit in Shebin El-Kom Teaching Hospital. Instruments: Four instruments were used for data collection: Interviewing questionnaire, dyspnea analogue scale, Biophysiological measurement instrument, and Compliance assessment sheet. Results: There were statistically significant differences between both groups regarding most respiratory system assessment findings at discharge. More than two-thirds of the study group of the current study had a continuous and regular commitment to diet regimen, which ranked first followed by the compliance of daily living activities then quitting smoking. Conclusions: The perioperative protocol of care has a significant improving effect on respiratory findings, dyspnea degree, duration of mechanical ventilation, length of hospital stay, compliance to diet, therapeutic regimen, daily living activities, and quit smoking among study group undergoing CABG. Recommendations: Perioperative protocol of care should be carried out for CABG patients at open-heart surgical units as well as an illustrative colored booklet about CAD, CABG and perioperative care should be available and distributed to all CABG patients.

Keywords: perioperative, effect, clinical outcomes, coronary artery, bypass graft, protocol of care

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10347 Urban Block Design's Impact on the Indoor Daylight Quality, Heating and Cooling Loads of Buildings in the Semi-Arid Regions: Duhok City in Kurdistan Region-Iraq as a Case Study

Authors: Kawar Salih

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It has been proven that designing sustainable buildings starts from early stages of urban design. The design of urban blocks specifically, is considered as one of the pragmatic strategies of sustainable urbanism. There have been previous studies that focused on the impact of urban block design and regulation on the outdoor thermal comfort in the semi-arid regions. However, no studies have been found that concentrated on that impact on the internal behavior of buildings of those regions specifically the daylight quality and energy performance. Further, most studies on semi-arid regions are focusing only on the cooling load reduction, neglecting the heating load. The study has focused on two parameters of urban block distribution which are the block orientation and the surface-to-volume ratio with the consideration of both heating and cooling loads of buildings. In Duhok (a semi-arid city in Kurdistan region of Iraq), energy consumption and daylight quality of different types of residential blocks have been examined using dynamic simulation. The findings suggest that there is a considerable higher energy load for heating than cooling, contradicting many previous studies about these regions. The results also highlight that the orientation of urban blocks can vary the energy consumption to 8%. Regarding the surface-to-volume ratio (S/V), it was observed that after the twice enlargement of the S/V, the energy consumption increased 15%. Though, the study demonstrates as well that there are opportunities for reducing energy consumption with the increase of the S/V which contradicts many previous research on S/V impacts on energy consumption. These results can help to design urban blocks with the bigger S/V than existing blocks in the city which it can provide better indoor daylight and relatively similar energy consumption.

Keywords: blocke orienation, building energy consumption, urban block design, semi-arid regions, surfacet-to-volume ratio

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10346 Reinforcement Learning for Quality-Oriented Production Process Parameter Optimization Based on Predictive Models

Authors: Akshay Paranjape, Nils Plettenberg, Robert Schmitt

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Producing faulty products can be costly for manufacturing companies and wastes resources. To reduce scrap rates in manufacturing, process parameters can be optimized using machine learning. Thus far, research mainly focused on optimizing specific processes using traditional algorithms. To develop a framework that enables real-time optimization based on a predictive model for an arbitrary production process, this study explores the application of reinforcement learning (RL) in this field. Based on a thorough review of literature about RL and process parameter optimization, a model based on maximum a posteriori policy optimization that can handle both numerical and categorical parameters is proposed. A case study compares the model to state–of–the–art traditional algorithms and shows that RL can find optima of similar quality while requiring significantly less time. These results are confirmed in a large-scale validation study on data sets from both production and other fields. Finally, multiple ways to improve the model are discussed.

Keywords: reinforcement learning, production process optimization, evolutionary algorithms, policy optimization, actor critic approach

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10345 Study on Influencing Factors of Walkability of Rail Transit Station Area

Authors: Yang Wenjuan, Xu Yilun

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Based on the comparative analysis of the relevant evaluation methods of walking environment, this paper selects the combined evaluation method of macro urban morphology analysis and micro urban design quality survey, then investigates and analyzes the walking environment of three rail transit station area in Nanjing to explore the influence factor and internal relation of walkability of rail transit station area. Analysis shows that micro urban design factors have greater impact on the walkability of rail transit station area compared with macro urban morphology factors, the convenience is the key factor in the four aspects of convenience, security, identity and comfortability of the urban design factors, the convenience is not only affected by the block network form, but also related to the quality of the street space. The overall evaluation of walkability comes from the overlapping and regrouping of the walking environment at different levels, but some environmental factors play a leading role. The social attributes of pedestrians also partly influence their walking perception and evaluation.

Keywords: rail transit station area, walkability, evaluation, influence factors

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10344 Insulin Resistance in Patients with Chronic Hepatitis C Virus Infection: Upper Egypt Experience

Authors: Ali Kassem

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Background: In the last few years, factors such as insulin resistance (IR) and hepatic steatosis have been linked to progression of hepatic fibrosis.Patients with chronic liver disease, and cirrhosis in particular, are known to be prone to IR. However, chronic HCV (hepatitis C) infection may induce IR, regardless of the presence of liver cirrhosis. Our aims are to study insulin resistance (IR) assessed by HOMA-IR (Homeostatic Model Assessment Insulin Resistance) as a possible risk factor in disease progression in cirrhotic patients and to evaluate the role of IR in hepatic fibrosis progression. The correlations of HOMA-IR values to laboratory, virological and histopathological parameters of chronic HCV are also examined. Methods: The study included 50 people divided into 30 adult chronic hepatitis C patients diagnosed by PCR (polymerase chain reaction) within previous 6 months and 20 healthy controls. The functional and morphological status of the liver were evaluated by ultrasonography and laboratory investigations including liver function tests and by liver biopsy. Fasting blood glucose and fasting insulin levels were measured and body mass index and insulin resistance were calculated. Patients having HOMA-IR >2.5 were labeled as insulin resistant. Results: Chronic hepatitis C patients with IR showed significantly higher mean values of BMI (body mass index) and fasting insulin than those without IR (P < 0.000). Patients with IR were more likely to have steatosis (p = 0.006), higher necroinflammatory activity (p = 0.05). No significant differences were found between the two groups regarding hepatic fibrosis. Conclusion: HOMA-IR measurement could represent a novel marker to identify the cirrhotic patients at greater risk for the progression of liver disease. As IR is a potentially modifiable risk factor, these findings may have important prognostic and therapeutic implications. Assessment of IR by HOMA-IR and improving insulin sensitivity are recommended in patients with HCV and related chronic liver disease.

Keywords: hepatic fibrosis, hepatitis C virus infection, hepatic steatosis, insulin resistance

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10343 Efficacy of CAM Methods for Pain Reduction in Acute Non-specific Lower Back Pain

Authors: John Gaber

Abstract:

Objectives: Complementary and alternative medicine (CAM) is a medicine or health practice that is used alongside conventional practice. Nowadays, CAM is commonly used in North America and other countries, and there is a need for more scientific study to understand its efficacy in different clinical cases. This retrospective study explores the effectiveness and recovery time of CAMs such as cupping, acupuncture, and sotai to treat cases of non-specific low back pain (ANLBP). Methods: We assessed the effectiveness of acupuncture, cupping, and sotai methods on pain and for the treatment of ANLBP. We have compared the magnitude of pain relief using a pain scale assessment method to compare the efficacy of each treatment. The Face Pain Scale assessment was conducted before and 24 hours post-treatment. This retrospective study analyzed 40 patients and categorized them according to the treatment they received. The study included the control group, and the three intervention groups, each with ten patients. Each of the three intervention groups received one of the intervention methods. The first group received the cupping treatment, where cups were placed on the lower back of both sides on points: BL23, BL25, BL26, BL54, BL37, BL40, and BL57. After vacuuming, the cups will stay for 10-15 minutes under infrared light (IR) heating. IR heating is applied by an infrared heat lamp. The second group received the acupuncture treatment, placing needles on points: BL23, BL25, BL26, BL52BL54, GB30, BL37, BL40, BL57, BL59, BL60, and KI3. The needles will be simulated with IR light. The final group received the sotai treatment, a Japanese form of structural realignment that relieves pain, balance, and mobility -moving the body naturally and spontaneously towards a comfortable direction by focusing on the inner feeling and synchronizing with the patient’s breathing. The SPSS statistical software was used to analyze the data using repeated-measures ANOVA. The data collected demonstrates the change in the FPS assessment method value over the course of treatment. p<0.05 was considered statistically significant. Results: In the cupping, acupuncture, and sotai therapy groups, the mean of the FPS value reduced from 8.7±1.2, 8.8±1.2, 9.0±0.8 before the intervention to 3.5±1.4, 4.3±1.4, 3.3±1.3, 24 hours after the intervention, respectively. The data collected shows that the CAM methods included in this study all show improvements in pain relief 24 hours after treatment. Conclusion: Complementary and alternative medicine were developed to treat injuries and illnesses with the whole body in mind, designed to be used in addition to standard treatments. The data above shows that the use of these treatments can have a pain-relieving effect, but more research should be done on the matter, as finding CAM methods that are efficacious is crucial in the landscape of health sciences.

Keywords: acupuncture, cupping, alternative medicine, rehabilitation, acute injury

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10342 Uterine Cervical Cancer; Early Treatment Assessment with T2- And Diffusion-Weighted MRI

Authors: Susanne Fridsten, Kristina Hellman, Anders Sundin, Lennart Blomqvist

Abstract:

Background: Patients diagnosed with locally advanced cervical carcinoma are treated with definitive concomitant chemo-radiotherapy. Treatment failure occurs in 30-50% of patients with very poor prognoses. The treatment is standardized with risk for both over-and undertreatment. Consequently, there is a great need for biomarkers able to predict therapy outcomes to allow for individualized treatment. Aim: To explore the role of T2- and diffusion-weighted magnetic resonance imaging (MRI) for early prediction of therapy outcome and the optimal time point for assessment. Methods: A pilot study including 15 patients with cervical carcinoma stage IIB-IIIB (FIGO 2009) undergoing definitive chemoradiotherapy. All patients underwent MRI four times, at baseline, 3 weeks, 5 weeks, and 12 weeks after treatment started. Tumour size, size change (∆size), visibility on diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and change of ADC (∆ADC) at the different time points were recorded. Results: 7/15 patients relapsed during the study period, referred to as "poor prognosis", PP, and the remaining eight patients are referred to "good prognosis", GP. The tumor size was larger at all time points for PP than for GP. The ∆size between any of the four-time points was the same for PP and GP patients. The sensitivity and specificity to predict prognostic group depending on a remaining tumor on DWI were highest at 5 weeks and 83% (5/6) and 63% (5/8), respectively. The combination of tumor size at baseline and remaining tumor on DWI at 5 weeks in ROC analysis reached an area under the curve (AUC) of 0.83. After 12 weeks, no remaining tumor was seen on DWI among patients with GP, as opposed to 2/7 PP patients. Adding ADC to the tumor size measurements did not improve the predictive value at any time point. Conclusion: A large tumor at baseline MRI combined with a remaining tumor on DWI at 5 weeks predicted a poor prognosis.

Keywords: chemoradiotherapy, diffusion-weighted imaging, magnetic resonance imaging, uterine cervical carcinoma

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10341 Brain-Computer Interface System for Lower Extremity Rehabilitation of Chronic Stroke Patients

Authors: Marc Sebastián-Romagosa, Woosang Cho, Rupert Ortner, Christy Li, Christoph Guger

Abstract:

Neurorehabilitation based on Brain-Computer Interfaces (BCIs) shows important rehabilitation effects for patients after stroke. Previous studies have shown improvements for patients that are in a chronic stage and/or have severe hemiparesis and are particularly challenging for conventional rehabilitation techniques. For this publication, seven stroke patients in the chronic phase with hemiparesis in the lower extremity were recruited. All of them participated in 25 BCI sessions about 3 times a week. The BCI system was based on the Motor Imagery (MI) of the paretic ankle dorsiflexion and healthy wrist dorsiflexion with Functional Electrical Stimulation (FES) and avatar feedback. Assessments were conducted to assess the changes in motor improvement before, after and during the rehabilitation training. Our primary measures used for the assessment were the 10-meters walking test (10MWT), Range of Motion (ROM) of the ankle dorsiflexion and Timed Up and Go (TUG). Results show a significant increase in the gait speed in the primary measure 10MWT fast velocity of 0.18 m/s IQR = [0.12 to 0.2], P = 0.016. The speed in the TUG was also significantly increased by 0.1 m/s IQR = [0.09 to 0.11], P = 0.031. The active ROM assessment increased 4.65º, and IQR = [ 1.67 - 7.4], after rehabilitation training, P = 0.029. These functional improvements persisted at least one month after the end of the therapy. These outcomes show the feasibility of this BCI approach for chronic stroke patients and further support the growing consensus that these types of tools might develop into a new paradigm for rehabilitation tools for stroke patients. However, the results are from only seven chronic stroke patients, so the authors believe that this approach should be further validated in broader randomized controlled studies involving more patients. MI and FES-based non-invasive BCIs are showing improvement in the gait rehabilitation of patients in the chronic stage after stroke. This could have an impact on the rehabilitation techniques used for these patients, especially when they are severely impaired and their mobility is limited.

Keywords: neuroscience, brain computer interfaces, rehabilitat, stroke

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10340 Assessing the Vulnerability Level in Coastal Communities in the Caribbean: A Case Study of San Pedro, Belize

Authors: Sherry Ann Ganase, Sandra Sookram

Abstract:

In this paper, the vulnerability level to climate change is analysed using a comprehensive index, consisting of five pillars: human, social, natural, physical, and financial. A structural equation model is also applied to determine the indicators and relationships that exist between the observed environmental changes and the quality of life. Using survey data to model the results, a value of 0.382 is derived as the vulnerability level for San Pedro, where values closer to zero indicates lower vulnerability and values closer to one indicates higher vulnerability. The results showed the social pillar to be most vulnerable, with the indicator ‘participation’ ranked the highest in its cohort. Although, the environmental pillar is ranked as least vulnerable, the indicators ‘hazard’ and ‘biodiversity’ obtained scores closer to 0.4, suggesting that changes in the environment are occurring from natural and anthropogenic activities. These changes can negatively influence the quality of life as illustrated in the structural equation modelling. The study concludes by reporting on the need for collective action and participation by households in lowering vulnerability to ensure sustainable development and livelihood.

Keywords: climate change, participation, San Pedro, structural equation model, vulnerability index

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10339 Wastewater Treatment by Floating Macrophytes (Salvinia natans) under Algerian Semi-Arid Climate

Authors: Laabassi Ayache, Boudehane Asma

Abstract:

Macrophyte pond has developed strongly in the field of wastewater treatment for irrigation in rural areas and small communities. Their association allows, in some cases, to increase the hydraulic capacity while maintaining the highest level of quality. The present work is devoted to the treatment of domestic wastewater under climatic conditions of Algeria (semi-arid) through a system using two tanks planted with Salvinia natans. The performance study and treatment efficiency of the system overall shows that the latter provides a significant removal of nitrogen pollution: total Kjeldahl nitrogen NTK (85.2%), Ammonium NH₄⁺-N (79%), Nitrite NO₂⁻-N (40%) also, a major meaningful reduction of biochemical oxygen demand BOD₅ was observed at the output of the system (96.9 %). As BOD₅, the chemical oxygen demand (COD) removal was higher than 95% at the exit of the two tanks. A moderately low yield of phosphate-phosphorus (PO₄³-P) was achieved with values not exceeding 37%. In general, the quality of treated effluent meets the Algerian standard of discharge and which allows us to select a suitable species in constructed wetland treatment systems under semi-arid climate.

Keywords: nutrient removal, Salvinia natans, semi-arid climate, wastewater treatment

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10338 Proposed Organizational Development Interventions in Managing Occupational Stressors for Business Schools in Batangas City

Authors: Marlon P. Perez

Abstract:

The study intended to determine the level of occupational stress that was experienced by faculty members of private and public business schools in Batangas City with the end in view of proposing organizational development interventions in managing occupational stressors. Stressors such as factors intrinsic to the job, role in the organization, relationships at work, career development and organizational structure and climate were used as determinants of occupational stress level. Descriptive method of research was used as its research design. There were only 64 full-time faculty members coming from private and public business schools in Batangas City – University of Batangas, Lyceum of the Philippines University-Batangas, Golden Gate Colleges, Batangas State University and Colegio ng Lungsod ng Batangas. Survey questionnaire was used as data gathering instrument. It was found out that all occupational stressors were assessed stressful when grouped according to its classification of tertiary schools while response of subject respondents differs on their assessment of occupational stressors. Age variable has become significantly related to respondents’ assessments on factors intrinsic to the job and career development; however, it was not significantly related to role in the organization, relationships at work and organizational structure and climate. On the other hand, gender, marital status, highest educational attainment, employment status, length of service, area of specialization and classification of tertiary school were revealed to be not significantly related to all occupational stressors. Various organizational development interventions have been proposed to manage the occupational stressors that are experienced by business faculty members in the institution.

Keywords: occupational stress, business school, organizational development, intervention, stressors, faculty members, assessment, manage

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10337 Management Challenges and Product Quality of Fish Farms in Greece

Authors: S. Anastasiou, C. Nathanailides, S. Logothetis, G. Kanlis

Abstract:

The Greek aquaculture industry is second most important economic sector for the growth of the Greek Economy. The purpose of the present work is to present some data for the management challenges that the Aquaculture industry in Greece is currently facing. Currently the Greek aquaculture industry is going through a series of mergers and restructure. The financial status of the different aquaculture companies, the working conditions and management practices may vary according to lending exposure, market mix, company size, and technological parameters of the different fish farm units and rearing systems. Frequently, the aquaculture personnel are exposed to harsh environmental conditions and to occupational risk. Furthermore, there is pressure on the personnel of fish farms to constantly improve their production efficiency and to enhance their work skills to the new methods and practices which are adopted by the aquaculture industry. There is some data to suggest the existence of gender inequality in the workforce of Greek fish farms. Women are paid less, frequently absent higher managerial positions and most of the male workmates consider the job to harsh for women. Nevertheless, high level of job satisfaction was observed in both men and women. This high level of job satisfaction of the aquaculture personnel can be attributed, at least partially, to the nature of the work which has a very distinct working environment but most of the staff has very positive experiences with the interaction with their workmates and the satisfaction of being in a business which always exceeds its production target. Indeed, there is some evidence to suggest that the Greek aquaculture industry is always exceeding its production targets, while it is rapidly adopting and improving new technology, constantly improving of human resources management practices, which include constant training of the staff, very good communication channels between management and the personnel and reducing the risk of occupational hazard to the aquaculture personnel. All these parameters of management may have a determining role for the volume and quality of the production and future of this sector in Greece.

Keywords: aquaculture, fish quality, management, production targets

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10336 To Investigate a Discharge Planning Connect with Long Term Care 2.0 Program in a Medical Center in Taiwan

Authors: Chan Hui-Ya, Ding Shin-Tan

Abstract:

Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

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10335 Practice of Social Innovation in School Education: A Study of Third Sector Organisations in India

Authors: Prakash Chittoor

Abstract:

In the recent past, it is realised especially in third sector that employing social innovation is crucial for achieving viable and long lasting social transformation. In this context, education is one among many sectors that have opened up itself for such move where employing social innovation emerges as key for reaching out to the excluded sections who are often failed to get support from either policy or market interventions. In fact, education is being as a crucial factor for social development is well understood at both academic and policy level. In order to move forward to achieve better results, interventions from multiple sectors may be required as its reach cultivates capabilities and skill of the deprived in order to ensure both market and social participation in the long run. Despite state’s intervention, it is found that still millions of children are out of school due to lack of political will, lapses in policy implementation and neoliberal intervention of marketization. As a result, universalisation of elementary education became as an elusive goal to poor and marginalised sections where state obtain constant pressure by corporate sector to withdraw from education sector that led convince in providing quality education. At this juncture, the role of third sector organizations plays is quite remarkable. Especially, it has evolved as a key player in education sector to reach out to the poor and marginalised in the far-flung areas. These organisations work in resources constrain environment, yet, in order to achieve larger social impact they adopt various social innovations from time to time to reach out to the unreached. Their attempts not only limited to just approaching the unreached children but to retain them for long-time in the schooling system in order to ripe the results for their families and communities. There is a need to highlight various innovative ways adopted and practiced by the third sector organisations in India to achieve the elusive goal of universal access of primary education with quality. With this background, the paper primarily attempts to present an in-depth understanding about innovative practices employed by third sectors organisations like Isha Vidya through government schools adoption programme in India where it engages itself with government and build capabilities among the government teachers to promote state run schooling with quality and better infrastructure. Further, this paper assess whether such innovative attempts succeeded in to achieving universal quality education in the areas where it operates and draws implications for State policy.

Keywords: school education, third sector organisations, social innovation, market domination

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10334 Reverse Logistics End of Life Products Acquisition and Sorting

Authors: Badli Shah Mohd Yusoff, Khairur Rijal Jamaludin, Rozetta Dollah

Abstract:

The emerging of reverse logistics and product recovery management is an important concept in reconciling economic and environmental objectives through recapturing values of the end of life product returns. End of life products contains valuable modules, parts, residues and materials that can create value if recovered efficiently. The main objective of this study is to explore and develop a model to recover as much of the economic value as reasonably possible to find the optimality of return acquisition and sorting to meet demand and maximize profits over time. In this study, the benefits that can be obtained for remanufacturer is to develop demand forecasting of used products in the future with uncertainty of returns and quality of products. Formulated based on a generic disassembly tree, the proposed model focused on three reverse logistics activity, namely refurbish, remanufacture and disposal incorporating all plausible means quality levels of the returns. While stricter sorting policy, constitute to the decrease amount of products to be refurbished or remanufactured and increases the level of discarded products. Numerical experiments carried out to investigate the characteristics and behaviour of the proposed model with mathematical programming model using Lingo 16.0 for medium-term planning of return acquisition, disassembly (refurbish or remanufacture) and disposal activities. Moreover, the model seeks an analysis a number of decisions relating to trade off management system to maximize revenue from the collection of use products reverse logistics services through refurbish and remanufacture recovery options. The results showed that full utilization in the sorting process leads the system to obtain less quantity from acquisition with minimal overall cost. Further, sensitivity analysis provides a range of possible scenarios to consider in optimizing the overall cost of refurbished and remanufactured products.

Keywords: core acquisition, end of life, reverse logistics, quality uncertainty

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10333 Ground Track Assessment Using Electrical Resistivity Tomography Application

Authors: Noryani Natasha Yahaya, Anas Ibrahim, Juraidah Ahmad, Azura Ahmad, Mohd Ikmal Fazlan Rosli, Zailan Ramli, Muhd Sidek Muhd Norhasri

Abstract:

The subgrade formation is an important element of the railway structure which holds overall track stability. Conventional track maintenance involves many substructure component replacements, as well as track re-ballasting on a regular basis is partially contributed to the embankment's long-term settlement problem. For subgrade long-term stability analysis, the geophysical method is commonly being used to diagnose those hidden sources/mechanisms of track deterioration problems that the normal visual method is unable to detect. Electrical resistivity tomography (ERT) is one of the applicable geophysical tools that are helpful in railway subgrade inspection/track monitoring due to its flexibility and reliability of the analysis. The ERT was conducted at KM 23.0 of Pinang Tunggal track to investigate the subgrade of railway track through the characterization/mapping on track formation profiling which was directly generated using 2D analysis of Res2dinv software. The profiles will allow examination of the presence and spatial extent of a significant subgrade layer and screening of any poor contact of soil boundary. Based on the finding, there is a mix/interpretation/intermixing of an interlayer between the sub-ballast and the sand. Although the embankment track considered here is at no immediate risk of settlement effect or any failure, the regular monitoring of track’s location will allow early correction maintenance if necessary. The developed data of track formation clearly shows the similarity of the side view with the assessed track. The data visualization in the 2D section of the track embankment agreed well with the initial assumption based on the main element structure general side view.

Keywords: ground track, assessment, resistivity, geophysical railway, method

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10332 Effects of Milling Process Parameters on Cutting Forces and Surface Roughness When Finishing Ti6al4v Produced by Electron Beam Melting

Authors: Abdulmajeed Dabwan, Saqib Anwar, Ali Al-Samhan

Abstract:

Electron Beam Melting (EBM) is a metal powder bed-based Additive Manufacturing (AM) technology, which uses computer-controlled electron beams to create fully dense three-dimensional near-net-shaped parts from metal powder. It gives the ability to produce any complex parts directly from a computer-aided design (CAD) model without tools and dies, and with a variety of materials. However, the quality of the surface finish in EBM process has limitations to meeting the performance requirements of additively manufactured components. The aim of this study is to investigate the cutting forces induced during milling Ti6Al4V produced by EBM as well as the surface quality of the milled surfaces. The effects of cutting speed and radial depth of cut on the cutting forces, surface roughness, and surface morphology were investigated. The results indicated that the cutting speed was found to be proportional to the resultant cutting force at any cutting conditions while the surface roughness improved significantly with the increase in cutting speed and radial depth of cut.

Keywords: electron beam melting, additive manufacturing, Ti6Al4V, surface morphology

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10331 Trauma Scores and Outcome Prediction After Chest Trauma

Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

Abstract:

Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

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