Search results for: Ling Chai Ying
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 460

Search results for: Ling Chai Ying

70 The Effect of Early Skin-To-Skin Contact with Fathers on Their Supporting Breastfeeding

Authors: Shu-Ling Wang

Abstract:

Background: Multiple studies showed early skin-to-skin contact (SSC) with mothers was beneficial to newborns such as breastfeeding and maternal childcare. In cases of newborns unable to have early SSC with mothers, fathers’ involvement could let early SSC continue without interruption. However, few studies had explored the effects of early SSC by fathers in comparison to early SSC with mothers. Paternal involvement of early SSC should be equally important in term of childcare and breastfeeding. The purpose of this study was to evaluate the efficacy of early SSC by fathers in particular in their support of breastfeeding. Methods: A quasi-experimental design was employed by the study. One hundred and forty-four father-infant pairs had participated the study, in which infants were assigned either to SSC with their fathers (n = 72) or to routine care (n = 72) as the control group. The study was conducted at a regional hospital in northern Taiwan. Participants included parents of both vaginal delivery (VD) and caesarean section birth (CS) infants. To be eligible for inclusion, infants must be over 37-week gestational ages. Data were collected twice: as pretest upon admission and as posttest with online questionnaire during first, second, and third postpartum months. The questionnaire included items for Breastfeeding Social Support, methods of feeding, and the mother-infant 24-hour rooming-in rate. The efficacy of early SSC with fathers was evaluated using the generalized estimating equation (GEE) modeling. Research Result: The primary finding was that SSC with fathers had positive impact on fathers’ support of breastfeeding. Analysis of the online questionnaire indicated that early SSC with fathers improved the support of breastfeeding than the control group (VD: t = -4.98, p < .001; CS: t = -2.37, p = .02). Analysis of mother-infant 24-hour rooming-in rate showed that SSC with fathers after CS had a positive impact on the rooming-in rate (χ² = 5.79, p = .02); however, with VD the difference between early SSC with fathers and the control group was insignificant (χ² = .23, p = .63). Analysis of the rate of exclusive breastfeeding indicated that early SSC with fathers had a higher rate than the control group during first three postpartum months for both delivery methods (VD: χ² = 12.51, p < .001 on 1st postpartum month, χ² = 8.13, p < .05 on 2nd postpartum month, χ² = 4.43, p < .05 on 3rd postpartum month; CS: χ² = 6.92, p < .05 on 1st postpartum month, χ² = 7.41, p < .05 on 2nd postpartum month, χ² = 6.24, p < .05 on 3rd postpartum month). No significant difference was found on the rate of exclusive breastfeeding with both methods of delivery between two groups during hospitalization. (VD: χ² =2 .00, p = .16; CS: χ² = .73, p = .39). Conclusion: Implementing early SSC with fathers has many benefits to both parents. The result of this study showed increasing fathers’ support of breastfeeding. This encourages our nursing personnel to focus the needs of father during breastfeeding, therefore further enhancing the quality of parental care, the rate and duration of breastfeeding.

Keywords: breastfeeding, skin-to-skin contact, support of breastfeeding, rooming-in

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69 A Post-Occupancy Evaluation of Urban Landscape Greenway– A Case Study of the Taiyuan Greenway in Taichung City

Authors: A. Yu-Chen Chien, B. Ying-Ju Su

Abstract:

Greenway is a type of linear park which links the planar parklands and connects the open spaces. In the urban environment, except for providing open spaces with recreational function as well as effectively improve the appearance of the surrounding environment, greenway and parkland also creates benefits to the social and psychological aspects of human. In 2014, the statistics of The Ministry of Home Affairs show that citizens in Taichung enjoy the green area at an average of 4.27 square kilometers per person. How to use the existing green space system effectively and enhance the quality of leisure life thus become the major issues today. The study here points out that greenway and parkland and other open spaces are closely related to the daily life of urban residents. Whether the operation could be executed in accordance with the design is our major concern. To explore the issue, we implemented the Post-Occupancy Evaluation of Taiyuan Greenway in Taichung City. In 1956, Taichung city carried out the urban plan according to Howard’s concept about “Garden City” and built the Taiyuan greenway to restrain the urban expansion. 50-year past, due to the population growth and new demands, the government started to reconstruct the program. It is a three stage modification project of “The Townspace Renaissance project in Taiwan” since 2009, of which the greenway construction is the main point. In this research, we mainly focus on the third stage of this program to investigate the user’s preference and degree of satisfaction based on the Post-Occupancy Evaluation about the finished, unfinished, and undergoing construction sectors as well as facilities. We collected and analyzed the data based on the questionnaires and explored the possible facts that might have affected the degree of satisfaction about the greenway modification project based on the chi-square test. We hope to inspect the purpose of the demonstration projects and provide reference to the Taichung government for the modification planning and the greenway design in the future.

Keywords: greenway, landscape greenway, post-occupancy evaluation, Taichung city

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68 Exploring Coexisting Opportunity of Earthquake Risk and Urban Growth

Authors: Chang Hsueh-Sheng, Chen Tzu-Ling

Abstract:

Earthquake is an unpredictable natural disaster and intensive earthquakes have caused serious impacts on social-economic system, environmental and social resilience, and further increase vulnerability. Due to earthquakes do not kill people, buildings do. When buildings located nearby earthquake-prone areas and constructed upon poorer soil areas might result in earthquake-induced ground damage. In addition, many existing buildings built before any improved seismic provisions began to be required in building codes and inappropriate land usage with highly dense population might result in much serious earthquake disaster. Indeed, not only do earthquake disaster impact seriously on urban environment, but urban growth might increase the vulnerability. Since 1980s, ‘Cutting down risks and vulnerability’ has been brought up in both urban planning and architecture and such concept has way beyond retrofitting of seismic damages, seismic resistance, and better anti-seismic structures, and become the key action on disaster mitigation. Land use planning and zoning are two critical non-structural measures on controlling physical development while it is difficult for zoning boards and governing bodies restrict development of questionable lands to uses compatible with the hazard without credible earthquake loss projection. Therefore, identifying potential earthquake exposure, vulnerability people and places, and urban development areas might become strongly supported information for decision makers. Taiwan locates on the Pacific Ring of Fire where a seismically active zone is. Some of the active faults have been found close by densely populated and highly developed built environment in the cities. Therefore, this study attempts to base on the perspective of carrying capacity and draft out micro-zonation according to both vulnerability index and urban growth index while considering spatial variances of multi factors via geographical weighted principle components (GWPCA). The purpose in this study is to construct supported information for decision makers on revising existing zoning in high-risk areas for a more compatible use and the public on managing risks.

Keywords: earthquake disaster, vulnerability, urban growth, carrying capacity, /geographical weighted principle components (GWPCA), bivariate spatial association statistic

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67 In Vitro and in Vivo Evaluation of Nano Collagen Molecules to Enhance Mesenchymal Stem Cells Differentiate into Insulin Producing Cells

Authors: Chin-Tsu Ma, Yi-Jhen Wu, Hsia Ying Cheng, Han Hsiang Huang, Shyh Ming Kuo

Abstract:

The use of specific molecules including nutrients and pharmacological agents has been tried in modulation of stem cells differentiation (MSCs) to insulin producing cells. The aim of this study is to investigate the ability of nano collagen molecules (nutrient or scaffold) to enhance the MSCs differentiation into insulin-producing cells in combination with nicotinamide and exendin-4 (pharmacological agents) in vitro and in vivo. The results demonstrated that the cells exhibit morphologically islet-like clusters after treatment with nano collagen molecules, nicotinamide and exendin-4. MSCs extra treated with nano collagen molecules showed significant increases in Nkx6.1 and insulin mRNA expression at 14-d and 21-d culture compared with those merely treated with nicotinamide and exendin-4. Early 7-day elevation in PDX-1 mRNA expression was observed. Furthermore, the MSCs exposed to nano collagen molecules produced the highest secretion of insulin (p < 0.05). Type-2 diabetes induced by high-fat diet and low dose of streptozotocin in rat model was built in this study. This rat exhibited higher food intake, water intake, lower glucose tolerance, lower-insulin tolerance, and higher HbA1C (significant increases, p < 0.01) as compared with the normal rat that demonstrated the model of type-2 diabetes was successfully built. Biopsy examinations also showed that obvious destruction of islet. After injection of differentiated MSCs into the destructed pancreas of diabetes rat, more regenerated islet were observed at the rats that treated with nano collagen molecules and exhibited much lower HbA1C as compared with the normal rat and diabetes rat after 4 weeks (significant deceases, p < 0.001). These results indicate that the culturing MSCs with nano collagen molecules, nicotinamide, and exendin-4 are beneficial for MSCs differentiation into islet-like cells. These nano collagen molecules may lead to alternations or up-regulation of gene expression and influence the differentiated outcomes induced by nicotinamide and exendin-4.

Keywords: nano collagen molecules, nicotinamide, MSCs, diabetes

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66 Structural Equation Modeling Exploration for the Multiple College Admission Criteria in Taiwan

Authors: Tzu-Ling Hsieh

Abstract:

When the Taiwan Ministry of Education implemented a new university multiple entrance policy in 2002, most colleges and universities still use testing scores as mainly admission criteria. With forthcoming 12 basic-year education curriculum, the Ministry of Education provides a new college admission policy, which will be implemented in 2021. The new college admission policy will highlight the importance of holistic education by more emphases on the learning process of senior high school, except only on the outcome of academic testing. However, the development of college admission criteria doesn’t have a thoughtful process. Universities and colleges don’t have an idea about how to make suitable multi-admission criteria. Although there are lots of studies in other countries which have implemented multi-college admission criteria for years, these studies still cannot represent Taiwanese students. Also, these studies are limited without the comparison of two different academic fields. Therefore, this study investigated multiple admission criteria and its relationship with college success. This study analyzed the Taiwan Higher Education Database with 12,747 samples from 156 universities and tested a conceptual framework that examines factors by structural equation model (SEM). The conceptual framework of this study was adapted from Pascarella's general causal model and focused on how different admission criteria predict students’ college success. It discussed the relationship between admission criteria and college success, also the relationship how motivation (one of admission standard) influence college success through engagement behaviors of student effort and interactions with agents of socialization. After processing missing value, reliability and validity analysis, the study found three indicators can significantly predict students’ college success which was defined as average grade of last semester. These three indicators are the Chinese language scores at college entrance exam, high school class rank, and quality of student academic engagement. In addition, motivation can significantly predict quality of student academic engagement and interactions with agents of socialization. However, the multi-group SEM analysis showed that there is no difference to predict college success between the students from liberal arts and science. Finally, this study provided some suggestions for universities and colleges to develop multi-admission criteria through the empirical research of Taiwanese higher education students.

Keywords: college admission, admission criteria, structural equation modeling, higher education, education policy

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65 Supercritical Hydrothermal and Subcritical Glycolysis Conversion of Biomass Waste to Produce Biofuel and High-Value Products

Authors: Chiu-Hsuan Lee, Min-Hao Yuan, Kun-Cheng Lin, Qiao-Yin Tsai, Yun-Jie Lu, Yi-Jhen Wang, Hsin-Yi Lin, Chih-Hua Hsu, Jia-Rong Jhou, Si-Ying Li, Yi-Hung Chen, Je-Lueng Shie

Abstract:

Raw food waste has a high-water content. If it is incinerated, it will increase the cost of treatment. Therefore, composting or energy is usually used. There are mature technologies for composting food waste. Odor, wastewater, and other problems are serious, but the output of compost products is limited. And bakelite is mainly used in the manufacturing of integrated circuit boards. It is hard to directly recycle and reuse due to its hard structure and also difficult to incinerate and produce air pollutants due to incomplete incineration. In this study, supercritical hydrothermal and subcritical glycolysis thermal conversion technology is used to convert biomass wastes of bakelite and raw kitchen wastes to carbon materials and biofuels. Batch carbonization tests are performed under high temperature and pressure conditions of solvents and different operating conditions, including wet and dry base mixed biomass. This study can be divided into two parts. In the first part, bakelite waste is performed as dry-based industrial waste. And in the second part, raw kitchen wastes (lemon, banana, watermelon, and pineapple peel) are used as wet-based biomass ones. The parameters include reaction temperature, reaction time, mass-to-solvent ratio, and volume filling rates. The yield, conversion, and recovery rates of products (solid, gas, and liquid) are evaluated and discussed. The results explore the benefits of synergistic effects in thermal glycolysis dehydration and carbonization on the yield and recovery rate of solid products. The purpose is to obtain the optimum operating conditions. This technology is a biomass-negative carbon technology (BNCT); if it is combined with carbon capture and storage (BECCS), it can provide a new direction for 2050 net zero carbon dioxide emissions (NZCDE).

Keywords: biochar, raw food waste, bakelite, supercritical hydrothermal, subcritical glycolysis, biofuels

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64 Metadiscourse in Chinese and Thai Request Emails: Analysis and Pedagogical Application

Authors: Chia-Ling Hsieh, Kankanit Potikit

Abstract:

Metadiscourse refers to linguistic resources employed by writers to organize text and interact with readers. While metadiscourse has received considerable attention within the field of discourse analysis, few studies have explored the use of metadiscourse in email, one of the most popular forms of computer-mediated communication. Furthermore, the diversity of cross-linguistic research required to uncover the influence of cultural factors on metadiscourse use is lacking. The present study compares metadiscourse markers employed in Chinese and Thai-language request emails with the purpose of discovering cross-cultural similarities and differences that are meaningful and applicable to foreign language teaching. The analysis is based on a corpus of 200 request emails: 100 composed in Chinese and 100 in Thai, with half of the emails from each language data set addressed to professors and the other half addressed to classmates. Adopting Hyland’s model as an analytical framework, two primary categories of metadiscourse are identified. Textual metadiscourse helps to create text coherence, while interpersonal metadiscourse functions to convey authorial stance. Results of the study make clear that both Chinese and Thai-language emails use significantly more interpersonal markers than textual markers, indicating that email, as a unique communicative medium, is characterized by high degrees of concision and interactivity. Users of both languages further deploy similar patterns in writing emails to recipients of different social statuses. Compared with emails addressed to classmates, emails addressed to professors are notably longer and include more transition and engagement markers. Nevertheless, cultural factors do play a role. Emails composed in Thai, for example, include more textual markers than those in Chinese, as Thai favors formal expressions and detailed explanations, while in contrast, emails composed in Chinese employ more interpersonal markers than those in Thai, since Chinese tends to emphasize recipient involvement and attitudinal warmth. These findings thereby demonstrate the combined effects of email as a communicative medium, social status, and cultural values on metadiscourse usage. The study concludes by applying these findings to pedagogical suggestions for teaching email writing to Chinese and Thai language learners based on similarities and differences in metadiscourse strategy between the two languages.

Keywords: discourse analysis, email, metadiscourse, writing instruction

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63 The Study of Self-Management of Stress (SMS) of Yoga Program for Pregnant Women in Early Pregnancy in Taiwan

Authors: Shau-Ping Shiu, Shu-Ling Lin

Abstract:

Pregnancy lead a process of changing in the endocrine system. Either pregnancy itself or the surrounding affect such as the attitude of family to the pregnant lady can bring lots of stress. Sever stress may lead pregnant women display serious mental problem such as mood swings, impulsivity, and abnormal behavior. A method of self management of stress(SMS) has been proved that help patient of cancer in release their stress. This study were going to use SMS to help pregnant women. Methods: In this study, 42 ladies in the first to third months of pregnancy process applied to join SMS of program have divided into 21 participants in both control and experimental group by draw. 24 sessions of Yoga program were conducted once a week for 6 months for experimental group. Verbatim used to gather more feedbacks from the interview followed by each Yoga sessions. Brief symptom Rating scale also conducted pre and post experiment for 42 participations. Results: Overall score of Brief Symptom Rating Scale reduced 17.82 points and suicide drop 9 points in experimental group, compared to the control group increasing 10.24 point of overall score and suicide add 7 points. Feedback from interviews showed participations improved in emotion, physical health and stress management. They indicated having more positive emotion daily, having better gastrointestinal peristalsis movement, releasing back tention, well weight control, reducing stress and changing the quality of interpersonal relationships. Conclusion: SMS of Yoga program in this study included four key training directions which were stimulation, relaxation, awareness and pranayama lead a great improvment of stress management for pregnant lady. Throughout this Yoga program, women learned to ignite eustress, remove distress, create calmness and breath slows down. As the result, Yoga program has helped women in experiment group lower their tension, and bring the extra benifits in emotion and relationships. It support women to overcome their pregnancy. Suggestion: An unexpected result of this study showed all participants had no morning sickness since they engaged in SMS program, and no one absent from course due to the benefits of it. We strongly suggest that SMS of Yoga program can be a add of medication for women in pregnancy, however, the position of Forward in the SMS sequence has been point out pressing participant’s stomach, which can be replace to Bridge position to comfort participants.

Keywords: self-management of stress(SMS), yoga program, pregnant women, early pregnancy

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62 Properties of Magnesium-Based Hydrogen Storage Alloy Added with Palladium and Titanium Hydride

Authors: Jun Ying Lin, Tzu Hsiang Yen, Cha'o Kuang Chen

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Nowadays, the great majority believe that there is great potentiality in hydrogen storage alloy storing hydrogen by physical and chemical absorption. However, the hydrogen storage alloy is limited by high operation temperature. Scientists find that adding transition elements can improve the properties of hydrogen storage alloy. In this research, outstanding improvements of kinetic and thermal properties are given by the addition of Palladium and Titanium hydride to Magnesium-based hydrogen storage alloy. Magnesium-based alloy is the main material, into which TiH2 / Pd are added separately. Following that, materials are milled by a Planetary Ball Miller at 650 rpm. TGA/DSC and PCT measure the capacity, spending time and temperature of abs/des-orption. Additionally, SEM and XRD analyze the structures and components of material. It is clearly shown that Pd is beneficial to kinetic properties. 2MgH2-0.1Pd has the highest capacity of all the alloys listed, approximately 5.5 wt%. Secondly, there are not any new Ti-related compounds found from XRD analysis. Thus, TiH2, considered as the catalyst, leads to the condition of 2MgH2-TiH2 and 2MgH2-TiH2-0.1Pd efficiently absorbing hydrogen in low temperature. 2MgH2-TiH2 can reach roughly 3.0 wt% in 82.4 minutes at 50°C and 8 minutes at 100°C, while2MgH2-TiH2-0.1Pd can reach 2.0 wt% in 400 minutes at 50°C and in 48 minutes at 100°C. The lowest temperature of 2MgH2-0.1Pd and 2MgH2-TiH2 is similar (320°C), otherwise the lowest temperature of 2MgH2-TiH2-0.1Pd decrease by 20°C. From XRD, it can be observed that PdTi2 and Pd3Ti are produced by mechanical alloying when adding Pd as well as TiH2 into MgH2. Due to the synergistic effects between Pd and TiH2, 2MgH2-TiH2-0.1Pd owns the lowest dehydrogenation temperature. Furthermore, the Pressure-Composition-Temperature (PCT) curve of 2MgH2-TiH2-0.1Pd is measured at different temperature, 370°C, 350°C, 320°C and 300°C separately. The plateau pressure is given form the PCT curves above. In accordance to different plateau pressures, enthalpy and entropy in the Van’t Hoff equation can be solved. In 2MgH2-TiH2-0.1Pd, the enthalpy is 74.9 KJ/mol and the entropy is 122.9 J/mol. Activation means that hydrogen storage alloy undergoes repeat abs/des-orpting processes. It plays an important role in the abs/des-orption. Activation shortens the abs/des-orption time because of the increase in surface area. From SEM, it is clear that the grain size and surface become smaller and rougher

Keywords: hydrogen storage materials, magnesium hydride, abs-/des-orption performance, Plateau pressure

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61 Anti-Arthritic Effect of a Herbal Diet Formula Comprising Fruits of Rosa Multiflora and Flowers of Lonicera Japonica

Authors: Brian Chi Yan Cheng, Hui Guo, Tao Su, Xiu‐qiong Fu, Ting Li, Zhi‐ling Yu

Abstract:

Rheumatoid arthritis (RA) affects around 1% of the globe population. Yet, there is still no cure for RA. Toll-like receptor 4 (TLR4) signalling has been found to be involved in the pathogenesis of RA, making it a potential therapeutic target for RA treatment. A herbal formula (RL) consisting of fruits of Rosa Multiflora (Eijitsu rose) and flowers of Lonicera Japonica (Japanese honeysuckle) has been used in treating various inflammatory disorders for more than a thousand year. Both of them are rich sources of nutrients and bioactive phytochemicals, which can be used in producing different food products and supplements. In this study, we would evaluate the anti-arthritic effect of RL on collagen-induced arthritis (CIA) in rats and investigate the involvement of TLR4 signaling in the mode of action of RL. Anti-arthritic efficacy was evaluated using CIA rats induced by bovine type II collagen. The treatment groups were treated with RL (82.5, 165, and 330 mg/kg bw per day, p.o.) or positive control indomethacin (0.25 mg/kg bw per day, p.o.) for 35 days. Clinical signs (hind paw volume and arthritis severity scores), changes in serum inflammatory mediators, pro-/antioxidant status, histological and radiographic changes of joints were investigated. Spleens and peritoneal macrophages were used to determine the effects of RL on innate and adaptive immune responses in CIA rats. The involvement of TLR4 signalling pathways in the anti-arthritic effect of RL was examined in cartilage tissue of CIA rats, murine RAW264.7 macrophages and human THP-1 monocytic cells. The severity of arthritis in the CIA rats was significantly attenuated by RL. Antioxidant status, histological score and radiographic score were efficiently improved by RL. RL could also dose-dependently inhibit pro-inflammatory cytokines in serum of CIA rats. RL significantly inhibited the production of various pro-inflammatory mediators, the expression and/or activity of the components of TLR4 signalling pathways in animal tissue and cell lines. RL possesses anti-arthritic effect on collagen-induced arthritis in rats. The therapeutic effect of RL may be related to its inhibition on pro-inflammatory cytokines in serum. The inhibition of the TAK1/NF-κB and TAK1/MAPK pathways participate in the anti-arthritic effects of RL. This provides a pharmacological justification for the dietary use of RL in the control of various arthritic diseases. Further investigation should be done to develop RL into a anti-arthritic food products and/or supplements.

Keywords: japanese honeysuckle, rheumatoid arthritis, rosa multiflora, rosehip

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60 Understanding the Qualitative Nature of Product Reviews by Integrating Text Processing Algorithm and Usability Feature Extraction

Authors: Cherry Yieng Siang Ling, Joong Hee Lee, Myung Hwan Yun

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The quality of a product to be usable has become the basic requirement in consumer’s perspective while failing the requirement ends up the customer from not using the product. Identifying usability issues from analyzing quantitative and qualitative data collected from usability testing and evaluation activities aids in the process of product design, yet the lack of studies and researches regarding analysis methodologies in qualitative text data of usability field inhibits the potential of these data for more useful applications. While the possibility of analyzing qualitative text data found with the rapid development of data analysis studies such as natural language processing field in understanding human language in computer, and machine learning field in providing predictive model and clustering tool. Therefore, this research aims to study the application capability of text processing algorithm in analysis of qualitative text data collected from usability activities. This research utilized datasets collected from LG neckband headset usability experiment in which the datasets consist of headset survey text data, subject’s data and product physical data. In the analysis procedure, which integrated with the text-processing algorithm, the process includes training of comments onto vector space, labeling them with the subject and product physical feature data, and clustering to validate the result of comment vector clustering. The result shows 'volume and music control button' as the usability feature that matches best with the cluster of comment vectors where centroid comments of a cluster emphasized more on button positions, while centroid comments of the other cluster emphasized more on button interface issues. When volume and music control buttons are designed separately, the participant experienced less confusion, and thus, the comments mentioned only about the buttons' positions. While in the situation where the volume and music control buttons are designed as a single button, the participants experienced interface issues regarding the buttons such as operating methods of functions and confusion of functions' buttons. The relevance of the cluster centroid comments with the extracted feature explained the capability of text processing algorithms in analyzing qualitative text data from usability testing and evaluations.

Keywords: usability, qualitative data, text-processing algorithm, natural language processing

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59 Efficacy of Ergonomics Ankle Support on Squatting Pushing Skills during the Second Stage of Labor

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

Abstract:

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

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

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58 Risk and Reliability Based Probabilistic Structural Analysis of Railroad Subgrade Using Finite Element Analysis

Authors: Asif Arshid, Ying Huang, Denver Tolliver

Abstract:

Finite Element (FE) method coupled with ever-increasing computational powers has substantially advanced the reliability of deterministic three dimensional structural analyses of a structure with uniform material properties. However, railways trackbed is made up of diverse group of materials including steel, wood, rock and soil, while each material has its own varying levels of heterogeneity and imperfections. It is observed that the application of probabilistic methods for trackbed structural analysis while incorporating the material and geometric variabilities is deeply underworked. The authors developed and validated a 3-dimensional FE based numerical trackbed model and in this study, they investigated the influence of variability in Young modulus and thicknesses of granular layers (Ballast and Subgrade) on the reliability index (-index) of the subgrade layer. The influence of these factors is accounted for by changing their Coefficients of Variance (COV) while keeping their means constant. These variations are formulated using Gaussian Normal distribution. Two failure mechanisms in subgrade namely Progressive Shear Failure and Excessive Plastic Deformation are examined. Preliminary results of risk-based probabilistic analysis for Progressive Shear Failure revealed that the variations in Ballast depth are the most influential factor for vertical stress at the top of subgrade surface. Whereas, in case of Excessive Plastic Deformations in subgrade layer, the variations in its own depth and Young modulus proved to be most important while ballast properties remained almost indifferent. For both these failure moods, it is also observed that the reliability index for subgrade failure increases with the increase in COV of ballast depth and subgrade Young modulus. The findings of this work is of particular significance in studying the combined effect of construction imperfections and variations in ground conditions on the structural performance of railroad trackbed and evaluating the associated risk involved. In addition, it also provides an additional tool to supplement the deterministic analysis procedures and decision making for railroad maintenance.

Keywords: finite element analysis, numerical modeling, probabilistic methods, risk and reliability analysis, subgrade

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57 Influencing Factors for Job Satisfaction and Turnover Intention of Surgical Team in the Operating Rooms

Authors: Shu Jiuan Chen, Shu Fen Wu, I. Ling Tsai, Chia Yu Chen, Yen Lin Liu, Chen-Fuh Lam

Abstract:

Background: Increased emotional stress in workplace and depressed job satisfaction may significantly affect the turnover intention and career life of personnel. However, very limited studies have reported the factors influencing the turnover intention of the surgical team members in the operating rooms, where extraordinary stress is normally exit in this isolated medical care unit. Therefore, this study aimed to determine the environmental and personal characteristic factors that might be associated with job satisfaction and turnover intention in the non-physician staff who work in the operating rooms. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses, nurse anesthetists, surgeon assistants, orderly and other non-physician staff. Numerical and categorical data were analyzed using unpaired t-test and Chi-square test, as appropriate (SPSS, version 20.0). Results: A total of 167 effective questionnaires were collected from 200 eligible, non-physician personnel who worked in the operating room (response rate 83.5%). The overall satisfaction of all responders was 45.64 ± 7.17. In comparison to those who had more than 4-year working experience in the operating rooms, the junior staff ( ≤ 4-year experience) reported to have significantly higher satisfaction in workplace environment and job contentment, as well as lower intention to quit (t = 6.325, P =0.000). Among the different specialties of surgical team members, nurse anesthetists were associated with significantly lower levels of job satisfaction (P=0.043) and intention to stay (x² = 8.127, P < 0.05). Multivariate regression analysis demonstrates job title, seniority, working shifts and job satisfaction are the significant independent predicting factors for quit jobs. Conclusion: The results of this study highlight that increased work seniorities ( > 4-year working experience) are associated with significantly lower job satisfaction, and they are also more likely to leave their current job. Increased workload in supervising the juniors without appropriate job compensation (such as promotions in job title and work shifts) may precipitate their intention to quit. Since the senior staffs are usually the leaders and core members in the operating rooms, the retention of this fundamental manpower is essential to ensure the safety and efficacy of surgical interventions in the operating rooms.

Keywords: surgical team, job satisfaction, resignation intention, operating room

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56 Using Smartphone Instant Messaging (IM) App for Academic Discussion in an Undergraduate Chemistry Course

Authors: Mei Xuan Tan, Eng Ying Bong

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Academic discussion during and after instructional teaching is an integral part of learning. Such discussion between the instructor and student or peer-to-peer discussion can be in several different forms. It could be face-to-face discussion, via email and use of online discussion forum. In this study, the effectiveness of using WhatsApp for academic discussion for a first year half-credit Chemistry course was examined. This study was run over two years with two different batches of students. Participation in the study was voluntary and student volunteers were recruited within the first week of the term. The activity in the WhatsApp group was monitored by two instructors teaching the course. At the end of the course, the students participated in an online survey to evaluate their experience of using WhatsApp for academic discussion. There were a total of 26 questions. The survey had a total of 4 sections with regards to the use of WhatsApp for academic discussion: 1) Familiarity with WhatsApp, 2) Effectiveness of using WhatsApp for discussion, 3) Challenges and 4) Overall experience. The main purpose of using an IM platform for academic discussion was to encourage after-class discussion amongst the students. 32% of the participants had used other online platform, such as Piazza and forums in Learning Management System (LMS), for after-class academic discussion with their instructors and peers. This was a low percentage considering that some courses use such online platform as their main forum amongst instructors and students. At the end of our study, over 83% of the participants felt that WhatsApp was a more effective platform compared to other online forum. One interesting finding was the effect of WhatsApp discussion on face-to-face interaction with instructors. 28% of the students agreed that the use of WhatsApp as a discussion forum had encouraged them to approach their instructors during or after class. 51% of students answered neutral. This could be interpreted that the use of WhatsApp had not affected the frequent (or lack of) face-to-face interaction with their instructors. A second survey question, similar but phrased differently from the first, was also asked to evaluate the aspect of face-to-face interaction with instructors. 34% disagreed that the use of WhatsApp had reduced the frequency of face-to-face interaction. This could imply that the frequency remained the same or might have increased. The 38% who agreed to a decrease in face-to-face interaction have either asked the questions in WhatsApp or had their questions answered by a query from another student in the group chat. These outcomes suggested that the use of technology aided and complemented face-to-face interaction between instructors and students. The study also looked at the challenges of using WhatsApp for academic discussion. Some challenges included difficulty in referring back to previous discussion and students finding some discussions irrelevant to them. In conclusion, the use of IM platform for academic discussion was desirable for the students, but it should not be the only channel as face-to-face consultation and online forum for lengthy discussion are still important for after-class learning of students.

Keywords: chemistry, pedogogy, technological tools, undergraduate

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55 Spatial Distribution and Cluster Analysis of Sexual Risk Behaviors and STIs Reported by Chinese Adults in Guangzhou, China: A Representative Population-Based Study

Authors: Fangjing Zhou, Wen Chen, Brian J. Hall, Yu Wang, Carl Latkin, Li Ling, Joseph D. Tucker

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Background: Economic and social reforms designed to open China to the world has been successful, but also appear to have rapidly laid the foundation for the reemergence of STIs since 1980s. Changes in sexual behaviors, relationships, and norms among Chinese contributed to the STIs epidemic. As the massive population moved during the last 30 years, early coital debut, multiple sexual partnerships, and unprotected sex have increased within the general population. Our objectives were to assess associations between residences location, sexual risk behaviors and sexually transmitted infections (STIs) among adults living in Guangzhou, China. Methods: Stratified cluster sampling followed a two-step process was used to select populations aged 18-59 years in Guangzhou, China. Spatial methods including Geographic Information Systems (GIS) were utilized to identify 1400 coordinates with latitude and longitude. Face-to-face household interviews were conducted to collect self-report data on sexual risk behaviors and diagnosed STIs. Kulldorff’s spatial scan statistic was implemented to identify and detect spatial distribution and clusters of sexual risk behaviors and STIs. The presence and location of statistically significant clusters were mapped in the study areas using ArcGIS software. Results: In this study, 1215 of 1400 households attempted surveys, with 368 refusals, resulting in a sample of 751 completed surveys. The prevalence of self-reported sexual risk behaviors was between 5.1% and 50.0%. The self-reported lifetime prevalence of diagnosed STIs was 7.06%. Anal intercourse clustered in an area located along the border within the rural-urban continuum (p=0.001). High rate clusters for alcohol or other drugs using before sex (p=0.008) and migrants who lived in Guangzhou less than one year (p=0.007) overlapped this cluster. Excess cases for sex without a condom (p=0.031) overlapped the cluster for college students (p<0.001). Conclusions: Short-term migrants and college students reported greater sexual risk behaviors. Programs to increase safer sex within these communities to reduce the risk of STIs are warranted in Guangzhou. Spatial analysis identified geographical clusters of sexual risk behaviors, which is critical for optimizing surveillance and targeting control measures for these locations in the future.

Keywords: cluster analysis, migrant, sexual risk behaviors, spatial distribution

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54 Identification of Lipo-Alkaloids and Fatty Acids in Aconitum carmichaelii Using Liquid Chromatography–Mass Spectrometry and Gas Chromatography–Mass Spectrometry

Authors: Ying Liang, Na Li

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Lipo-alkaloid is a kind of C19-norditerpenoid alkaloids existed in Aconitum species, which usually contains an aconitane skeleton and one or two fatty acid residues. The structures are very similar to that of diester-type alkaloids, which are considered as the main bioactive components in Aconitum carmichaelii. They have anti-inflammatory, anti-nociceptive, and anti-proliferative activities. So far, more than 200 lipo-alkaloids were reported from plants, semisynthesis, and biotransformations. In our research, by the combination of ultra-high performance liquid chromatography-quadruple-time of flight mass spectrometry (UHPLC-Q-TOF-MS) and an in-house database, 148 lipo-alkaloids were identified from A. carmichaelii, including 93 potential new compounds and 38 compounds with oxygenated fatty acid moieties. To our knowledge, this is the first time of the reporting of the oxygenated fatty acids as the side chains in naturally-occurring lipo-alkaloids. Considering the fatty acid residues in lipo-alkaloids should come from the free acids in the plant, the fatty acids and their relationship with lipo-alkaloids were further investigated by GC-MS and LC-MS. Among 17 fatty acids identified by GC-MS, 12 were detected as the side chains of lipo-alkaloids, which accounted for about 1/3 of total lipo-alkaloids, while these fatty acid residues were less than 1/4 of total fatty acid residues. And, total of 37 fatty acids were determined by UHPCL-Q-TOF-MS, including 18 oxidized fatty acids firstly identified from A. carmichaelii. These fatty acids were observed as the side chains of lipo-alkaloids. In addition, although over 140 lipo-alkaloids were identified, six lipo-alkaloids, 8-O-linoleoyl-14-benzoylmesaconine (1), 8-O-linoleoyl-14-benzoylaconine (2), 8-O-palmitoyl-14-benzoylmesaconine (3), 8-O-oleoyl-14-benzoylmesaconine (4), 8-O-pal-benzoylaconine (5), and 8-O-ole-Benzoylaconine (6), were found to be the main components, which accounted for over 90% content of total lipo-alkaloids. Therefore, using these six components as standards, a UHPLC-Triple Quadrupole-MS (UHPLC-QQQ-MS) approach was established to investigate the influence of processing on the contents of lipo-alkaloids. Although it was commonly supposed that the contents of lipo-alkaloids increased after processing, our research showed that no significant change was observed before and after processing. Using the same methods, the lipo-alkaloids in the lateral roots of A. carmichaelii and the roots of A. kusnezoffii were determined and quantified. The contents of lipo-alkaloids in A. kusnezoffii were close to that of the parent roots of A. carmichaelii, while the lateral roots had less lipo-alkaloids than the parent roots. This work was supported by Macao Science and Technology Development Fund (086/2013/A3 and 003/2016/A1).

Keywords: Aconitum carmichaelii, fatty acids, GC-MS, LC-MS, lipo-alkaloids

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53 Molecular Alterations Shed Light on Alteration of Methionine Metabolism in Gastric Intestinal Metaplesia; Insight for Treatment Approach

Authors: Nigatu Tadesse, Ying Liu, Juan Li, Hong Ming Liu

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Gastric carcinogenesis is a lengthy process of histopathological transition from normal to atrophic gastritis (AG) to intestinal metaplasia (GIM), dysplasia toward gastric cancer (GC). The stage of GIM identified as precancerous lesions with resistance to H-pylori eradication and recurrence after endoscopic surgical resection therapies. GIM divided in to two morphologically distinct phenotypes such as complete GIM bearing intestinal type morphology whereas the incomplete type has colonic type morphology. The incomplete type GIM considered to be the greatest risk factor for the development of GC. Studies indicated the expression of the caudal type homeobox 2 (CDX2) gene is responsible for the development of complete GIM but its progressive downregulation from incomplete metaplasia toward advanced GC identified as the risk for IM progression and neoplastic transformation. The downregulation of CDX2 gene have promoted cell growth and proliferation in gastric and colon cancers and ascribed in chemo-treatment inefficacies. CDX2 downregulated through promoter region hypermethylation in which the methylation frequency positively correlated with the dietary history of the patients, suggesting the role of diet as methyl carbon donor sources such as methionine. However, the metabolism of exogenous methionine is yet unclear. Targeting exogenous methionine metabolism has become a promising approach to limits tumor cell growth, proliferation and progression and increase treatment outcome. This review article discusses molecular alterations that could shed light on the potential of exogenous methionine metabolisms, such as gut microbiota alteration as sources of methionine to host cells, metabolic pathway signaling via PI3K/AKt/mTORC1-c-MYC to rewire exogenous methionine and signature of increased gene methylation index, cell growth and proliferation in GIM, with insights to new treatment avenue via targeting methionine metabolism, and the need for future integrated studies on molecular alterations and metabolomics to uncover altered methionine metabolism and characterization of CDX2 methylation in gastric intestinal metaplasia for potential therapeutic exploitation.

Keywords: altered methionine metabolism, Intestinal metaplesia, CDX2 gene, gastric cancer

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52 The Association of Work Stress with Job Satisfaction and Occupational Burnout in Nurse Anesthetists

Authors: I. Ling Tsai, Shu Fen Wu, Chen-Fuh Lam, Chia Yu Chen, Shu Jiuan Chen, Yen Lin Liu

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Purpose: Following the conduction of the National Health Insurance (NHI) system in Taiwan since 1995, the demand for anesthesia services continues to increase in the operating rooms and other medical units. It has been well recognized that increased work stress not only affects the clinical performance of the medical staff, long-term work load may also result in occupational burnout. Our study aimed to determine the influence of working environment, work stress and job satisfaction on the occupational burnout in nurse anesthetists. The ultimate goal of this research project is to develop a strategy in establishing a friendly, less stressful workplace for the nurse anesthetists to enhance their job satisfaction, thereby reducing occupational burnout and increasing the career life for nurse anesthetists. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator 2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the nurse anesthetists. The relationships between two numeric datasets were analyzed by the Pearson correlation test (SPSS 20.0). Results: A total of 66 completed questionnaires were collected from 75 nurses (response rate 88%). The average scores for the working environment, job satisfaction, and work stress were 69.6%, 61.5%, and 63.9%, respectively. The three perspectives used to assess the occupational burnout, namely emotional exhaustion, depersonalization and sense of personal accomplishment were 26.3, 13.0 and 24.5, suggesting the presence of moderate to high degrees of burnout in our nurse anesthetists. The presence of occupational burnout was closely correlated with the unsatisfactory working environment (r=-0.385, P=0.001) and reduced job satisfaction (r=-0.430, P=0.000). Junior nurse anesthetists (<1-year clinical experience) reported having higher satisfaction in working environment than the seniors (5 to 10-year clinical experience) (P=0.02). Although the average scores for work stress, job satisfaction, and occupational burnout were lower in junior nurses, the differences were not statistically different. The linear regression model, the working environment was the independent factor that predicted occupational burnout in nurse anesthetists up to 19.8%. Conclusions: High occupational burnout is more likely to develop in senior nurse anesthetists who experienced the dissatisfied working environment, work stress and lower job satisfaction. In addition to the regulation of clinical duties, the increased workload in the supervision of the junior nurse anesthetists may result in emotional stress and burnout in senior nurse anesthetists. Therefore, appropriate adjustment of clinical and teaching loading in the senior nurse anesthetists could be helpful to improve the occupational burnout and enhance the retention rate.

Keywords: nurse anesthetists, working environment, work stress, job satisfaction, occupational burnout

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51 Disability Management and Occupational Health Enhancement Program in Hong Kong Hospital Settings

Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

Abstract:

Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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50 Evaluation of Medicinal Plants, Catunaregam spinosa, Houttuynia cordata, and Rhapis excelsa from Malaysia for Antibacterial, Antifungal and Antiviral Properties

Authors: Yik Sin Chan, Bee Ling Chuah, Wei Quan Chan, Ri Jin Cheng, Yan Hang Oon, Kong Soo Khoo, Nam Weng Sit

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Traditionally, medicinal plants have been used to treat different kinds of ailments including infectious diseases. They serve as a good source of lead compounds for the development of new and safer anti-infective agents. This study aimed to investigate the antimicrobial potential of the leaves of three medicinal plants, namely Catunaregam spinosa (Rubiaceae; Mountain pomegranate), Houttuynia cordata (Saururaceae; "fishy-smell herb") and Rhapis excelsa (Arecaceae; “broadleaf lady palm”). The leaves extracts were obtained by sequential extraction using hexane, chloroform, ethyl acetate, ethanol, methanol and water. The antibacterial and antifungal activities were assessed using a colorimetric broth microdilution method against a panel of human pathogenic bacteria (Gram-positive: Bacillus cereus and Staphylococcus aureus; Gram-negative: Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa) and fungi (yeasts: Candida albicans, Candida parapsilosis and Cryptococcus neoformans; Moulds: Aspergillus fumigatus and Trichophyton mentagrophytes) respectively; while antiviral activity was evaluated against the Chikungunya virus on monkey kidney epithelial (Vero) cells by neutral red uptake assay. All the plant extracts showed bacteriostatic activity, however, only 72% of the extracts (13/18) were found to have bactericidal activity. The lowest minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were given by the hexane extract of C. spinosa against S. aureus with the values of 0.16 and 0.31 mg/mL respectively. All the extracts also possessed fungistatic activity. Only the hexane, chloroform and ethyl acetate extracts of H. cordata exerted inhibitory activity against A. fumigatus, giving the lowest fungal susceptibility index of 16.7%. In contrast, only 61% of the extracts (11/18) showed fungicidal activity. The ethanol extract of R. excelsa exhibited the strongest fungicidal activity against C. albicans, C. parapsilosis and T. mentagrophytes with minimum fungicidal concentration (MFC) values of 0.04–0.08 mg/mL, in addition to its methanol extract against T. mentagrophytes (MFC=0.02 mg/mL). For anti-Chikungunya virus activity, only chloroform and ethyl acetate extracts of R. excelsa showed significant antiviral activity with 50% effective concentrations (EC50) of 29.9 and 78.1 g/mL respectively. Extracts of R. excelsa warrant further investigations into their active principles responsible for antifungal and antiviral properties.

Keywords: bactericidal, Chikungunya virus, extraction, fungicidal

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49 Prediction of Coronary Artery Stenosis Severity Based on Machine Learning Algorithms

Authors: Yu-Jia Jian, Emily Chia-Yu Su, Hui-Ling Hsu, Jian-Jhih Chen

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Coronary artery is the major supplier of myocardial blood flow. When fat and cholesterol are deposit in the coronary arterial wall, narrowing and stenosis of the artery occurs, which may lead to myocardial ischemia and eventually infarction. According to the World Health Organization (WHO), estimated 740 million people have died of coronary heart disease in 2015. According to Statistics from Ministry of Health and Welfare in Taiwan, heart disease (except for hypertensive diseases) ranked the second among the top 10 causes of death from 2013 to 2016, and it still shows a growing trend. According to American Heart Association (AHA), the risk factors for coronary heart disease including: age (> 65 years), sex (men to women with 2:1 ratio), obesity, diabetes, hypertension, hyperlipidemia, smoking, family history, lack of exercise and more. We have collected a dataset of 421 patients from a hospital located in northern Taiwan who received coronary computed tomography (CT) angiography. There were 300 males (71.26%) and 121 females (28.74%), with age ranging from 24 to 92 years, and a mean age of 56.3 years. Prior to coronary CT angiography, basic data of the patients, including age, gender, obesity index (BMI), diastolic blood pressure, systolic blood pressure, diabetes, hypertension, hyperlipidemia, smoking, family history of coronary heart disease and exercise habits, were collected and used as input variables. The output variable of the prediction module is the degree of coronary artery stenosis. The output variable of the prediction module is the narrow constriction of the coronary artery. In this study, the dataset was randomly divided into 80% as training set and 20% as test set. Four machine learning algorithms, including logistic regression, stepwise regression, neural network and decision tree, were incorporated to generate prediction results. We used area under curve (AUC) / accuracy (Acc.) to compare the four models, the best model is neural network, followed by stepwise logistic regression, decision tree, and logistic regression, with 0.68 / 79 %, 0.68 / 74%, 0.65 / 78%, and 0.65 / 74%, respectively. Sensitivity of neural network was 27.3%, specificity was 90.8%, stepwise Logistic regression sensitivity was 18.2%, specificity was 92.3%, decision tree sensitivity was 13.6%, specificity was 100%, logistic regression sensitivity was 27.3%, specificity 89.2%. From the result of this study, we hope to improve the accuracy by improving the module parameters or other methods in the future and we hope to solve the problem of low sensitivity by adjusting the imbalanced proportion of positive and negative data.

Keywords: decision support, computed tomography, coronary artery, machine learning

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48 Investigation and Monitoring Method of Vector Density in Kaohsiung City

Authors: Chiu-Wen Chang, I-Yun Chang, Wei-Ting Chen, Hui-Ping Ho, Chao-Ying Pan, Joh-Jong Huang

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Dengue is a ‘community disease’ or ‘environmental disease’, as long as the environment exist suitable container (including natural and artificial) for mosquito breeding, once the virus invade will lead to the dengue epidemic. Surveillance of vector density is critical to effective infectious disease control and play an important role in monitoring the dynamics of mosquitoes in community, such as mosquito species, density, distribution area. The objective of this study was to examine the relationship in vector density survey (Breteau index, Adult index, House index, Container index, and Larvae index) form 2014 to 2016 in Kaohsiung City and evaluate the effects of introducing the Breeding Elimination and Appraisal Team (hereinafter referred to as BEAT) as an intervention measure on eliminating dengue vector breeding site started from May 2016. BEAT were performed on people who were suspected of contracting dengue fever, a surrounding area measuring 50 meters by 50 meters was demarcated as the emergency prevention and treatment zone. BEAT would perform weekly vector mosquito inspections and vector mosquito inspections in regions with a high Gravitrap index and assign a risk assessment index to each region. These indices as well as the prevention and treatment results were immediately reported to epidemic prevention-related units every week. The results indicated that, vector indices from 2014 to 2016 showed no statistically significant differences in the Breteau index, adult index, and house index (p > 0.05) but statistically significant differences in the container index and larvae index (p <0.05). After executing the integrated elimination work, container index and larvae index are statistically significant different from 2014 to 2016 in the (p < 0.05). A post hoc test indicated that the container index of 2014 (M = 12.793) was significantly higher than that of 2016 (M = 7.631), and that the larvae index of 2015 (M = 34.065) was significantly lower than that of 2014 (M = 66.867). The results revealed that effective vector density surveillance could highlight the focus breeding site and then implement the immediate control action (BEAT), which successfully decreased the vector density and the risk of dengue epidemic.

Keywords: Breteau index, dengue control, monitoring method, vector density

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47 The Evaluation of the Cognitive Training Program for Older Adults with Mild Cognitive Impairment: Protocol of a Randomized Controlled Study

Authors: Hui-Ling Yang, Kuei-Ru Chou

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Background: Studies show that cognitive training can effectively delay cognitive failure. However, there are several gaps in the previous studies of cognitive training in mild cognitive impairment: 1) previous studies enrolled mostly healthy older adults, with few recruiting older adults with cognitive impairment; 2) they also had limited generalizability and lacked long-term follow-up data and measurements of the activities of daily living functional impact. Moreover, only 37% were randomized controlled trials (RCT). 3) Limited cognitive training has been specifically developed for mild cognitive impairment. Objective: This study sought to investigate the changes in cognitive function, activities of daily living and degree of depressive symptoms in older adults with mild cognitive impairment after cognitive training. Methods: This double-blind randomized controlled study has a 2-arm parallel group design. Study subjects are older adults diagnosed with mild cognitive impairment in residential care facilities. 124 subjects will be randomized by the permuted block randomization, into intervention group (Cognitive training, CT), or active control group (Passive information activities, PIA). Therapeutic adherence, sample attrition rate, medication compliance and adverse events will be monitored during the study period, and missing data analyzed using intent-to-treat analysis (ITT). Results: Training sessions of the CT group are 45 minutes/day, 3 days/week, for 12 weeks (36 sessions each). The training of active control group is the same as CT group (45min/day, 3days/week, for 12 weeks, for a total of 36 sessions). The primary outcome is cognitive function, using the Mini-Mental Status Examination (MMSE); the secondary outcome indicators are: 1) activities of daily living, using the Lawton’s Instrumental Activities of Daily Living (IADLs) and 2) degree of depressive symptoms, using the Geriatric Depression Scale-Short form (GDS-SF). Latent growth curve modeling will be used in the repeated measures statistical analysis to estimate the trajectory of improvement by examining the rate and pattern of change in cognitive functions, activities of daily living and degree of depressive symptoms for intervention efficacy over time, and the effects will be evaluated immediate post-test, 3 months, 6 months and one year after the last session. Conclusions: We constructed a rigorous CT program adhering to the Consolidated Standards of Reporting Trials (CONSORT) reporting guidelines. We expect to determine the improvement in cognitive function, activities of daily living and degree of depressive symptoms of older adults with mild cognitive impairment after using the CT.

Keywords: mild cognitive impairment, cognitive training, randomized controlled study

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46 Validation of an Impedance-Based Flow Cytometry Technique for High-Throughput Nanotoxicity Screening

Authors: Melanie Ostermann, Eivind Birkeland, Ying Xue, Alexander Sauter, Mihaela R. Cimpan

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Background: New reliable and robust techniques to assess biological effects of nanomaterials (NMs) in vitro are needed to speed up safety analysis and to identify key physicochemical parameters of NMs, which are responsible for their acute cytotoxicity. The central aim of this study was to validate and evaluate the applicability and reliability of an impedance-based flow cytometry (IFC) technique for the high-throughput screening of NMs. Methods: Eight inorganic NMs from the European Commission Joint Research Centre Repository were used: NM-302 and NM-300k (Ag: 200 nm rods and 16.7 nm spheres, respectively), NM-200 and NM- 203 (SiO₂: 18.3 nm and 24.7 nm amorphous, respectively), NM-100 and NM-101 (TiO₂: 100 nm and 6 nm anatase, respectively), and NM-110 and NM-111 (ZnO: 147 nm and 141 nm, respectively). The aim was to assess the biological effects of these materials on human monoblastoid (U937) cells. Dispersions of NMs were prepared as described in the NANOGENOTOX dispersion protocol and cells were exposed to NMs at relevant concentrations (2, 10, 20, 50, and 100 µg/mL) for 24 hrs. The change in electrical impedance was measured at 0.5, 2, 6, and 12 MHz using the IFC AmphaZ30 (Amphasys AG, Switzerland). A traditional toxicity assay, Trypan Blue Dye Exclusion assay, and dark-field microscopy were used to validate the IFC method. Results: Spherical Ag particles (NM-300K) showed the highest toxic effect on U937 cells followed by ZnO (NM-111 ≥ NM-110) particles. Silica particles were moderate to non-toxic at all used concentrations under these conditions. A higher toxic effect was seen with smaller sized TiO2 particles (NM-101) compared to their larger analogues (NM-100). No interferences between the IFC and the used NMs were seen. Uptake and internalization of NMs were observed after 24 hours exposure, confirming actual NM-cell interactions. Conclusion: Results collected with the IFC demonstrate the applicability of this method for rapid nanotoxicity assessment, which proved to be less prone to nano-related interference issues compared to some traditional toxicity assays. Furthermore, this label-free and novel technique shows good potential for up-scaling in directions of an automated high-throughput screening and for future NM toxicity assessment. This work was supported by the EC FP7 NANoREG (Grant Agreement NMP4-LA-2013-310584), the Research Council of Norway, project NorNANoREG (239199/O70), the EuroNanoMed II 'GEMN' project (246672), and the UH-Nett Vest project.

Keywords: cytotoxicity, high-throughput, impedance, nanomaterials

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45 Exposure Assessment for Worker Exposed to Heavy Metals during Road Marking Operations

Authors: Yin-Hsuan Wu, Perng-Jy Tsai, Ying-Fang Wang, Shun-Hui Chung

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The present study was conducted to characterize exposure concentrations, concentrations deposited on the different respiratory regions, and resultant health risks associated with heavy metal exposures for road marking workers. Road marking workers of three similar exposure groups (SEGs) were selected, including the paint pouring worker, marking worker, and preparing worker. Personal exposure samples were collected using an inhalable dust sampler (IOM), and the involved particle size distribution samples were estimated using an eight-stage Marple personal cascade impactor during five working days. In total, 25 IOM samples and 20 Marple samples were collected. All collected samples were analyzed for their heavy metal contents using the ICP/MS. The resultant heavy metal particle size distributions were also used to estimate the fractions of particle deposited on the head airways (Chead), tracheobronchial (Cthorac) and alveolar regions (Cresp) of the exposed workers. In addition, Pb and Cr were selected to estimate the incremental cancer risk, and Zn, Ti, and Mo were selected to estimate the corresponding non-cancer risk in the present study. Results show that three heavy metals, including Pb, Cr, and Ti, were found with the highest concentrations for the SEG of the paint pouring worker (=0.585±2.98, 0.307±1.71, 0.902±2.99 μg/m³, respectively). For the fraction of heavy metal particle deposited on the respiratory tract, both alveolar and head regions were found with the highest values (=23-43% and 39-61%, respectively). For both SEGs of the paint pouring and marking, 51% of Cr, 59-61% of Zn, and 48-51% of Ti were found to be deposited on the alveolar region, and 41-43% of Pb was deposited on the head region. Finally, the incremental cancer risk for the SEGs of the paint pouring, marking, and preparing were found as 1.08×10⁻⁵, 2.78×10⁻⁶, and 2.20×10⁻⁶, respectively. In addition, the estimated non-cancer risk for the above three SEGs was found to be consistently less than unity. In conclusion, though the estimated non-cancer risk was less than unity, all resultant incremental cancer risk was greater than 10⁻⁶ indicating the abatement of workers’ exposure is necessary. It is suggested that strategies, including placing on the molten kettle, substitution the currently used paints for less heavy metal containing paints, and wearing fume protecting personal protective equipment can be considered in the future from reducing the worker’s exposure aspect.

Keywords: health risk assessment, heavy metal, respiratory track deposition, road marking

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44 Computationally Efficient Electrochemical-Thermal Li-Ion Cell Model for Battery Management System

Authors: Sangwoo Han, Saeed Khaleghi Rahimian, Ying Liu

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Vehicle electrification is gaining momentum, and many car manufacturers promise to deliver more electric vehicle (EV) models to consumers in the coming years. In controlling the battery pack, the battery management system (BMS) must maintain optimal battery performance while ensuring the safety of a battery pack. Tasks related to battery performance include determining state-of-charge (SOC), state-of-power (SOP), state-of-health (SOH), cell balancing, and battery charging. Safety related functions include making sure cells operate within specified, static and dynamic voltage window and temperature range, derating power, detecting faulty cells, and warning the user if necessary. The BMS often utilizes an RC circuit model to model a Li-ion cell because of its robustness and low computation cost among other benefits. Because an equivalent circuit model such as the RC model is not a physics-based model, it can never be a prognostic model to predict battery state-of-health and avoid any safety risk even before it occurs. A physics-based Li-ion cell model, on the other hand, is more capable at the expense of computation cost. To avoid the high computation cost associated with a full-order model, many researchers have demonstrated the use of a single particle model (SPM) for BMS applications. One drawback associated with the single particle modeling approach is that it forces to use the average current density in the calculation. The SPM would be appropriate for simulating drive cycles where there is insufficient time to develop a significant current distribution within an electrode. However, under a continuous or high-pulse electrical load, the model may fail to predict cell voltage or Li⁺ plating potential. To overcome this issue, a multi-particle reduced-order model is proposed here. The use of multiple particles combined with either linear or nonlinear charge-transfer reaction kinetics enables to capture current density distribution within an electrode under any type of electrical load. To maintain computational complexity like that of an SPM, governing equations are solved sequentially to minimize iterative solving processes. Furthermore, the model is validated against a full-order model implemented in COMSOL Multiphysics.

Keywords: battery management system, physics-based li-ion cell model, reduced-order model, single-particle and multi-particle model

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43 Middle Ordovician (Llanvirnian) Relative Sea-Level Fluctuations

Authors: Ying Jia Teoh

Abstract:

The Canning Basin is located between the Kimberley and Pilbara Precambrian cratonic blocks. It is a large but relatively poorly explored Paleozoic basin in remote Western Australia. During the early Ordovician period, the Australian continent was located near the equator. Middle Ordovician age Nita and Goldwyer Formations in Canning Basin are therefore warm water carbonates. The Nita Formation carbonates are a regressive sequence which conformably overlies the Goldwyer Formation. It contains numerous progradational cycles of limestone, vuggy dolomitized carbonate beds and shale deposited in subtidal to supratidal environments. The Goldwyer Formation contains transgressive shale sequences and regressive carbonates deposited in shallow subtidal conditions. The shales contain oil-prone Gloeocapsormorpha prisca-bearing source rocks. Llanvirnian relative sea-level fluctuations were reconstructed by using Fischer plots methodology for three key wells (wells McLarty 1, Looma 1 and Robert 1) in Broome Platform and compared with INPEFA data. The Goldwyer lower shale (interval Or1000P) shows increasing relative sea-level and this matches with a transgressive systems tract. Goldwyer middle carbonate (interval Or2000) shows relative sea-level drop and this matches with a regressive systems tract. Goldwyer upper shale (interval Or2000P) shows relative sea-level drop and this matches with a transgressive systems tract. Nita Formation Leo Member (interval Or3000) shows a relative sea level drop and this matches with a regressive systems tract. The Nita Formation Cudalgarra Member (intervals Or3000P and Or4000) with transgressive systems tract then this is followed by a regressive systems tract. This pattern matches with the relative sea-level curves in wells McLarty 1 and Robert 1. The correlation is weak for parts of well Looma 1. This is probably influenced by the fact that the thickness of this section is quite small. As a conclusion, Fischer plots for the Llanvirnian Goldwyer and Nita Formations show good agreement with the third order global sea level cycles of Haq and others. Fischer plots are generally correlated well with trend and cyclicity determined by INPEFA curves and as a method of cross-checking INPEFA data and sea-level change.

Keywords: canning basin, Fischer plots, Llanvirnian, middle Ordovician, sea-level fluctuations, stratigraphy

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42 Uterine Torsion: A Rare Differential Diagnosis for Acute Abdominal Pain in Pregnancy

Authors: Tin Yee Ling, Kavita Maravar, Ruzica Ardalic

Abstract:

Background: Uterine torsion (UT) in pregnancy of more than 45-degree along the longitudinal axis is a rare occurrence, and the aetiology remains unclear. Case: A 34-year-old G2P1 woman with a history of one previous caesarean section presented at 36+2 weeks with sudden onset lower abdominal pain, syncopal episode, and tender abdomen on examination. She was otherwise haemodynamically stable. Cardiotocography showed a pathological trace with initial prolonged bradycardia followed by a subsequent tachycardia with reduced variability. An initial diagnosis of uterine dehiscence was made, given the history and clinical presentation. She underwent an emergency caesarean section which revealed a 180-degree UT along the longitudinal axis, with oedematous left round ligament lying transverse anterior to the uterus and a segment of large bowel inferior to the round ligament. Detorsion of uterus was performed prior to delivery of the foetus, and anterior uterine wall was intact with no signs of rupture. There were no anatomical uterine abnormalities found other than stretched left ovarian and round ligaments, which were repaired. Delivery was otherwise uneventful, and she was discharged on day 2 postpartum. Discussion: UT is rare as the number of reported cases is within the few hundreds worldwide. Generally, the uterus is supported in place by uterine ligaments, which limit the mobility of the structure. The causes of UT are unknown, but risk factors such as uterine abnormalities, increased uterine ligaments’ flexibility in pregnancy, and foetal malposition has been identified. UT causes occlusion of uterine vessels, which can lead to ischaemic injury of the placenta causing premature separation of the placenta, preterm labour, and foetal morbidity and mortality if delivery is delayed. Diagnosing UT clinically is difficult as most women present with symptoms similar to placenta abruption or uterine rupture (abdominal pain, vaginal bleeding, shock), and one-third are asymptomatic. The management of UT involves surgical detorsion of the uterus and delivery of foetus via caesarean section. Extra vigilance should be taken to identify the anatomy of the uterus experiencing torsion prior to hysterotomy. There have been a few cases reported with hysterotomy on posterior uterine wall for delivery of foetus as it may be difficult to identify and reverse a gravid UT when foetal well-being is at stake. Conclusion: UT should be considered a differential diagnosis of acute abdominal pain in pregnancy. It is crucial that the torsion is addressed immediately as it is associated with maternal and foetal morbidity and mortality.

Keywords: uterine torsion, pregnancy complication, abdominal pain, torted uterus

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41 A Tutorial on Model Predictive Control for Spacecraft Maneuvering Problem with Theory, Experimentation and Applications

Authors: O. B. Iskender, K. V. Ling, V. Dubanchet, L. Simonini

Abstract:

This paper discusses the recent advances and future prospects of spacecraft position and attitude control using Model Predictive Control (MPC). First, the challenges of the space missions are summarized, in particular, taking into account the errors, uncertainties, and constraints imposed by the mission, spacecraft and, onboard processing capabilities. The summary of space mission errors and uncertainties provided in categories; initial condition errors, unmodeled disturbances, sensor, and actuator errors. These previous constraints are classified into two categories: physical and geometric constraints. Last, real-time implementation capability is discussed regarding the required computation time and the impact of sensor and actuator errors based on the Hardware-In-The-Loop (HIL) experiments. The rationales behind the scenarios’ are also presented in the scope of space applications as formation flying, attitude control, rendezvous and docking, rover steering, and precision landing. The objectives of these missions are explained, and the generic constrained MPC problem formulations are summarized. Three key design elements used in MPC design: the prediction model, the constraints formulation and the objective cost function are discussed. The prediction models can be linear time invariant or time varying depending on the geometry of the orbit, whether it is circular or elliptic. The constraints can be given as linear inequalities for input or output constraints, which can be written in the same form. Moreover, the recent convexification techniques for the non-convex geometrical constraints (i.e., plume impingement, Field-of-View (FOV)) are presented in detail. Next, different objectives are provided in a mathematical framework and explained accordingly. Thirdly, because MPC implementation relies on finding in real-time the solution to constrained optimization problems, computational aspects are also examined. In particular, high-speed implementation capabilities and HIL challenges are presented towards representative space avionics. This covers an analysis of future space processors as well as the requirements of sensors and actuators on the HIL experiments outputs. The HIL tests are investigated for kinematic and dynamic tests where robotic arms and floating robots are used respectively. Eventually, the proposed algorithms and experimental setups are introduced and compared with the authors' previous work and future plans. The paper concludes with a conjecture that MPC paradigm is a promising framework at the crossroads of space applications while could be further advanced based on the challenges mentioned throughout the paper and the unaddressed gap.

Keywords: convex optimization, model predictive control, rendezvous and docking, spacecraft autonomy

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