Search results for: improvement in function of involved joint movements

Authors: H. Soltani, Kevin Laugero

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Obesity is becoming an increasingly critical issue in the United States due to the steady and substantial increase in prevalence over the last 30 years. Existing interventions have been able to help participants achieve short-term weight loss, but have failed to show long-term results. The complex nature of behavioral change remains one of the most difficult barriers in promoting sustainable weight-loss in overweight individuals. Research suggests that the 'intention-behavior gap' can be explained by a person’s ability to regulate higher-order thinking, or Executive Function (EF). A review of 63 research articles was completed in fall of 2017 to identify the role of EF in regulating eating behavior and to identify whether there is a potential for improving dietary quality by enhancing EF. Results showed that poor EF is positively associated with obesogenic behavior, namely increased consumption of highly palatable foods, eating in the absence of hunger, high saturated fat intake and low fruit and vegetable consumption. Recent research has indicated that interventions targeting an improvement in EF can be successful in helping promote healthy behaviors. Furthermore, interventions of longer duration have a more lasting and versatile effect on weight loss and maintenance. This may present an opportunity for the increasingly ubiquitous use of mobile application technology.

Keywords: eating behavior, executive function, nutrition, obesity, weight-loss

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Authors: Geum Yeon Sim, Jasal Patel, Anand Kumthekar, Stanley Wainapel

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A 65-year-old right-hand dominant African-American man, formerly employed as a security guard, was referred to Rehabilitation Medicine with bilateral hand stiffness and weakness. His past medical history was only significant for myelofibrosis, diagnosed 4 years earlier, for which he was receiving scheduled blood transfusions. Approximately 2 years ago, he began to notice stiffness and swelling in his non-dominant hand that progressed to pain and decreased strength, limiting his hand function. Similar but milder symptoms developed in his right hand several months later. There was no history of prior injury or exposure to cold. Physical examination showed enlargement of metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints with finger flexion contractures, Swan-neck and Boutonniere deformities, and associated joint tenderness. Changes were more prominent in the left hand. X-rays showed mild osteoarthritis of several bilateral PIP joints. Anti-nuclear antibodies, rheumatoid factor, and cyclic citrullinated peptide antibodies were negative. MRI of the hand showed no erosions or synovitis. A rheumatology consultation was obtained, and the cause of his symptoms was attributed to myelofibrosis-related arthropathy with secondary osteoarthritis. The patient was tried on diclofenac cream and received a few courses of Occupational Therapy with limited functional improvement. Primary myelofibrosis (PMF) is a rare myeloproliferative neoplasm characterized by clonal proliferation of myeloid cells with variable morphologic maturity and hematopoietic efficiency. Rheumatic manifestations of malignancies include direct invasion, paraneoplastic presentations, secondary gout, or hypertrophic osteoarthropathy. PMF causes gradual bone marrow fibrosis with extramedullary metaplastic hematopoiesis in the liver, spleen, or lymph nodes. Musculoskeletal symptoms are not common and are not well described in the literature. The first reported case of myelofibrosis related arthritis was seronegative arthritis due to synovial invasion of myeloproliferative elements. Myelofibrosis has been associated with autoimmune diseases such as systemic lupus erythematosus, progressive systemic sclerosis, and rheumatoid arthritis. Gout has been reported in patients with myelofibrosis, and the underlying mechanism is thought to be related to the high turnover of nucleic acids that is greatly augmented in this disease. X-ray findings in these patients usually include erosive arthritis with synovitis. Treatment of underlying PMF is the treatment of choice, along with anti-inflammatory medications. Physicians should be cognizant of recognizing this rare entity in patients with PMF while maintaining clinical suspicion for more common causes of joint deformities, such as rheumatic diseases.

Keywords: myelofibrosis, arthritis, arthralgia, malignancy

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Authors: B. Tirpude, V. Surwade, P. Murkey, P. Wankhade, S. Meena

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There is no statistical data to establish variation in epiphyseal fusion in girls in central India population. This significant oversight can lead to exclusion of persons of interest in a forensic investigation. Epiphyseal fusion of proximal end of humerus in eighty females were analyzed on radiological basis to assess the range of variation of epiphyseal fusion at each age. In the study, the X ray films of the subjects were divided into three groups on the basis of degree of fusion. Firstly, those which were showing No Epiphyseal Fusion (N), secondly those showing Partial Union (PC), and thirdly those showing Complete Fusion (C). Observations made were compared with the previous studies.

Keywords: epiphyseal union, shoulder joint, proximal end of humerus

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Authors: Saima Yaqoob

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Due to advancement in technologies and cutting cost competition, especially in manufacturing business, organizations are now becoming more focused toward achieving exceptional quality standards with low manufacturing cost. In this concern, many process improvement strategies are becoming popular in the way of increasing productivity and output. Lean manufacturing principles are among one of them, increasingly used for improving productivity by reducing wastages. Many success factors are involved in lean implementation. But, the role of senior management is most important in developing the lean culture in an organization. Purpose of this study is to investigate the perception of executive level management related to the successful implementation of lean practices and its comparison with the existing practices in the organization. In order to collect data, survey questionnaire comprised of eight statements rendering the critical success factors were sent to the top management of fifty (50) automotive manufacturing companies of Karachi. After analyzing their feedbacks, the trend of lean manufacturing principles and the commitment of senior management toward its implementation was identified in the manufacturing industries of Karachi, Pakistan.

Keywords: lean manufacturing, process improvement, senior management, perception, involvement, waste reduction

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Authors: Pawinee Sorawech

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The purpose of this study was to investigate the quality improvement of painting assignments for grade 4-6 students by using PDCA cycle. This study employed a qualitative technique. Suan Sunandha Rajabhat University and its demonstration school were selected as the area of study. An in-depth interview was utilized. The findings revealed that model of PDCA cycle was a proper model to increase the quality of painting assignments for grade 4-6 students. The six steps of improvement included: studying the PDCA model, setting up a plan, determining the scope of work, creating a strategy, developing a quality for painting assignment, and coming up with a handbook for a quality improvement of painting assignment.

Keywords: quality, painting assignments, PDCA cycle, grade 4-6 students

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Authors: L. Nahimana

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The eastern edge of the East African Rift in Burundi shows many mass movement phenomena corresponding to landslides, mudflow, debris flow, spectacular erosion (mega-gully), flash floods and alluvial deposits. These phenomena usually occur during the rainy season. Their extent and consecutive damages vary widely. To manage these phenomena, it is necessary to adopt a methodological approach of their mapping with a structured database. The elements for this database are: three-dimensional extent of the phenomenon, natural causes and conditions (geological lithology, slope, weathering depth and products, rainfall patterns, natural environment) and the anthropogenic factors corresponding to the various human activities. The extent of the area provides information about the possibilities and opportunities for mitigation technique. The lithological nature allows understanding the influence of the nature of the rock and its structure on the intensity of the weathering of rocks, as well as the geotechnical properties of the weathering products. The slope influences the land stability. The intensity of annual, monthly and daily rainfall helps to understand the conditions of water saturation of the terrains. Certain natural circumstances such as the presence of streams and rivers promote foot slope erosion and thus the occurrence and activity of mass movements. The construction of some infrastructures such as new roads and agglomerations deeply modify the flow of surface and underground water followed by mass movements. Using geospatial data selected on the East African Rift in Burundi, it is presented case of mass movements illustrating the nature, importance, various factors and the extent of the damages. An analysis of these elements for each hazard can guide the options for mitigation of the phenomenon and its consequences.

Keywords: mass movement, landslide, mudflow, debris flow, spectacular erosion, mega-gully, flash flood, alluvial deposit, East African rift, Burundi

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Authors: Jacquelyn Burkell, Jane Bailey

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Artificial intelligence (AI) solutions deployed within the justice system face the critical task of providing acceptable explanations for decisions or actions. These explanations must satisfy the joint criteria of public and professional accountability, taking into account the perspectives and requirements of multiple stakeholders, including judges, lawyers, parties, witnesses, and the general public. This research project analyzes and integrates two existing literature on explanations in order to propose guidelines for explainable AI in the justice system. Specifically, we review three bodies of literature: (i) explanations of the purpose and function of 'explainable AI'; (ii) the relevant case law, judicial commentary and legal literature focused on the form and function of reasons for judicial decisions; and (iii) the literature focused on the psychological and sociological functions of these reasons for judicial decisions from the perspective of the public. Our research suggests that while judicial ‘reasons’ (arguably accurate descriptions of the decision-making process and factors) do serve similar explanatory functions as those identified in the literature on 'explainable AI', they also serve an important ‘justification’ function (post hoc constructions that justify the decision that was reached). Further, members of the public are also looking for both justification and explanation in reasons for judicial decisions, and that the absence of either feature is likely to contribute to diminished public confidence in the legal system. Therefore, artificially automated judicial decision-making systems that simply attempt to document the process of decision-making are unlikely in many cases to be useful to and accepted within the justice system. Instead, these systems should focus on the post-hoc articulation of principles and precedents that support the decision or action, especially in cases where legal subjects’ fundamental rights and liberties are at stake.

Keywords: explainable AI, judicial reasons, public accountability, explanation, justification

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Authors: Nadiya Didyk

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This thesis deals with the unique history of the emergence of the Ukrainian feminist movement. Ukrainian feminism is still in its making, so the field is under-investigated in general. Nevertheless, the perspective of political economy and the enabling and constraining effects of capitalist dynamics are almost absent from the research on the emergence and the development of the feminist movement in Ukraine. This research was inspired by Hetland and Goodwin’s approach and an attempt to test their approach on the case of the Ukrainian feminist movement. Hetland and Goodwin claim that many scholars tend to neglect political economy from analysis of feminism as a new social movements, namely because such movement are not about class or materialist concerns, and thus have no discernible connection to capitalism. Both scholars, however, point out that there at least four ways in which capitalism has been of high importance for any social movement. Accordingly, the following issues are analysed in this paper: capitalism as the facilitator of the emergence and development of Ukrainian feminism; the influence of class balance in society on the formation of the Ukrainian feminist movement, and the ways in which class divisions within the movement shape its goals and strategies. This paper also focuses on the role of capitalist institutions and free wage labour expansion in shaping collective feminist identities and solidarities. Specific attention is paid to the representativeness of women in the highest echelons in business and politics under the capitalist systems. This study shows that there is a significant hole in the literature regarding the feminist movement in Ukraine and aims to motivate further detailed research.

Keywords: feminism, hetland, goodwin, new soical movements, political economy

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Authors: Zohreh Rostami, Arezoo Khosravi, Mohammad Nikpoor Aghdam, Mahmood Salesi

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Background: Cardiovascular mortality in chronic kidney disease (CKD) and end stage renal disease (ESRD) patients have a strong relationship with baseline or progressive left ventricular hypertrophy (LVH) meanwhile in hemodialysis patients 10% decrement in left ventricular mass was associated with 28% reduction in cardiovascular mortality risk. In consonance with these arguments, we designed a study to measure morphological and functional echocardiographic variations early after transplantation. Method: The patients with normal renal function underwent two advanced echocardiographic studies to examine the structural and functional changes in left ventricular mass before and 3-month after transplantation. Results: From a total of 23 participants 21(91.3%) presented with left ventricular hypertrophy, 60.9% in eccentric and 30.4% in concentric group. Diastolic dysfunction improved in concentric group after transplantation. Both in pre and post transplantation global longitudinal strain (GLS)- average in eccentric group was more than concentric (-17.45 ± 2.75 vs -14.3 ± 3.38 p=0.03) and (-18.08 ± 2.6 vs -16.1 ± 2.7 p= 0.04) respectively. Conclusion: Improvement and recovery of left ventricular function in concentric group was better and sooner than eccentric after kidney transplantation. Although fractional shortening and diastolic function and GLS-4C in pre-transplantation in concentric group was worse than eccentric, but therapeutic response to kidney transplantation in concentric was more and earlier than eccentric group.

Keywords: chronic kidney disease, end stage renal disease, left ventricular hypertrophy, global longitudinal strain

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Authors: Mohammedi Ferhate

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This paper deals with the generalized the notion of the function of wave a micro particle moving free, the concept of the linear operator in the representation function delta of Dirac which is a generalization of the symbol of Kronecker to the case of a continuous variation of the sizes concerned with the condition of orthonormation of the Eigen functions the use of linear operators and their Eigen functions in connection with the solution of given differential equations, it is of interest to study the properties of the operators themselves and determine which of them follow purely from the nature of the operators, without reference to specific forms of Eigen functions. The models simulation examples are also presented.

Keywords: function, operator, simulation, wave

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Authors: Tolga Yazıcı

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As a matter of the fact that online social networks like Twitter, Facebook and MySpace have experienced an extensive growth in recent years. Social media offers individuals with a tool for communicating and interacting with one another. These social networks enable people to stay in touch with other people and express themselves. This process makes the users of online social networks active creators of content rather than being only consumers of traditional media. That’s why millions of people show strong desire to learn the methods and tools of digital content production and necessary communication skills. However, the booming interest in communication and interaction through online social networks and high level of eagerness to invent and implement the ways to participate in content production raise some privacy and security concerns. This presentation aims to open the assumed revolutionary, democratic and liberating nature of the online social media up for discussion by reviewing some recent political developments in Turkey. Firstly, the role of Internet and online social networks in mobilizing collective movements through social interactions and communications will be questioned. Secondly, some cases from Gezi and Okmeydanı Protests and also December 17-25 period will be presented in order to illustrate misinformation and manipulation in social media and violation of individual privacy through online social networks in order to damage social unity and stability contradictory to democratic nature of online social networking.

Keywords: online social media networks, democratic participation, social movements, social polarization, privacy of individuals, Turkey

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Authors: Y. Bhatt, N. Ghosh, N. Tiwari

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Acreage response function are modeled taking account of expected harvest prices, weather related variables and other non-price variables allowing for partial adjustment possibility. At the outset, based on the literature on price expectation formation, we explored suitable formulations for estimating the farmer’s expected prices. Assuming that farmers form expectations rationally, the prices of food and biofuel crops are modeled using time-series methods for possible ARCH/GARCH effects to account for volatility. The prices projected on the basis of the models are then inserted to proxy for the expected prices in the acreage response functions. Food crop acreages in different growing states are found sensitive to their prices relative to those of one or more of the biofuel crops considered. The required percentage improvement in food crop yields is worked to offset the acreage loss.

Keywords: acreage response function, biofuel, food security, sustainable development

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Authors: Adriana Piatti-Crocker

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Drawing on archival documentation, digital platforms, academic journals, and reports, this research will explore the diffusion of a protest movement in Latin America. Starting in Argentina in 2015, this paper will explain how the hashtag #NiUnaMenos (“Not One Woman Less”), created to combat violence against women and girls, led to the spread of a regionwide movement. A year after its introduction, hundreds of thousands of activists mobilized on the streets of major cities in Latin America. Movements arose to protest against specific circumstances and contexts under the hashtag #NiUnaMenos, but the main goal of all of these protests was to fight against misogynist violence. Moreover, unlike previous social movements, the use of social media, such as Facebook, Instagram, Whatsapp, and Twitter, changed the depth and scope of these protests and led to an unprecedented speed in helping transmit their messages, strategies, identities, and goals.

Keywords: social protests, #NiUnaMenos ( Not one woman less), diffusion of social protests, protests and mysoginist violence

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Authors: Chang He, Hiroshi Tamura, Hiroshi Katsuchi, Jiaqi Wang

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In this study, the aim is to infer the slip limit (static friction limit) of contact interfaces in bolt friction joints by analyzing other bolt friction joints with the same contact surface but in a different shape. By using the Weibull distribution to deal with microelements on the contact surface statistically, the slip limit of a certain type of bolt joint was predicted from other types of bolt joint with the same contact surface. As a result, this research succeeded in predicting the slip limit of bolt joins with different numbers of contact surfaces and with different numbers of bolt rows.

Keywords: bolt joints, slip coefficient, finite element method, Weibull distribution

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Authors: Md. Rashidul Hasan, Atikur Rahman Baizid

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The Bayesian estimation approach is a non-classical estimation technique in statistical inference and is very useful in real world situation. The aim of this paper is to study the Bayes estimators of the parameter of exponential distribution under different loss functions and then compared among them as well as with the classical estimator named maximum likelihood estimator (MLE). In our real life, we always try to minimize the loss and we also want to gather some prior information (distribution) about the problem to solve it accurately. Here the gamma prior is used as the prior distribution of exponential distribution for finding the Bayes estimator. In our study, we also used different symmetric and asymmetric loss functions such as squared error loss function, quadratic loss function, modified linear exponential (MLINEX) loss function and non-linear exponential (NLINEX) loss function. Finally, mean square error (MSE) of the estimators are obtained and then presented graphically.

Keywords: Bayes estimator, maximum likelihood estimator (MLE), modified linear exponential (MLINEX) loss function, Squared Error (SE) loss function, non-linear exponential (NLINEX) loss function

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Authors: Dana Kristalova

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This article deals with geographical conditions in terrain and their effect on the movement of vehicles, their effect on speed and safety of movement of people and vehicles. Finding of the optimal routes outside the communication is studied in the army environment, but it occur in civilian as well, primarily in crisis situation, or by the provision of assistance when natural disasters such as floods, fires, storms, etc. have happened. These movements require the optimization of routes when effects of geographical factors should be included. The most important factor is surface of the terrain. It is based on several geographical factors as are slopes, soil conditions, micro-relief, a type of surface and meteorological conditions. Their mutual impact has been given by coefficient of deceleration. This coefficient can be used for commander´s decision. New approaches and methods of terrain testing, mathematical computing, mathematical statistics or cartometric investigation are necessary parts of this evaluation.

Keywords: surface of a terrain, movement of vehicles, geographical factor, optimization of routes

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Authors: Ahmed Gaber Abdel Raheem, Nashwa Ahmed Mohamed

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Introduction: Sensorineural hearing loss (SNHL) is largely caused by the degeneration of the cochlea. Therapeutic options for SNHL are limited to hearing aids and cochlear implants. The cell transplantation approach to the regeneration of hair cells has gained considerable attention because stem cells are believed to accumulate in the damaged sites and have the potential for the repair of damaged tissues. The aim of the work: was to assess the use of bone marrow transplantation in repair of damaged inner ear hair cells in rats after the damage had been inflicted by Amikacin injection. Material and Methods: Thirty albino rats were used in this study. They were divided into three groups. Each group ten rats. Group I: used as control. Group II: Were given Amikacin- intratympanic injection till complete loss of hearing function. This could be assessed by Distortion product Otoacoustic Emission (DPOAEs) and / or auditory brain stem evoked potential (ABR). GroupIII: were given intra-peritoneal injection of bone marrow stem cell after complete loss of hearing caused by Amikacin. Clinical assessment was done using DPOAEs and / or auditory brain stem evoked potential (ABR), before and after bone marrow injection. Histological assessment of the inner ear was done by light and electron microscope. Also, Detection of stem cells in the inner ear by immunohistochemistry. Results: Histological examination of the specimens showed promising improvement in the structure of cochlea that may be responsible for the improvement of hearing function in rats detected by DPOAEs and / or ABR. Conclusion: Bone marrow stem cells transplantation might be useful for the treatment of SNHL.

Keywords: amikacin, hair cells, sensorineural hearing loss, stem cells

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Authors: Luis Fernando Pinedo-Lomeli, Rosa Martha Lopez-Gutierrez, Jose Antonio Michel-Macarty, Cesar Cruz-Hernandez, Liliana Cardoza-Avendaño, Humberto Cruz-Hernandez

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Robots are working in industry and services performing repetitive or dangerous tasks, however, when flexible movement capabilities and complex tasks are required, the use of many robots is needed. Also, productivity can be improved by reducing times to perform tasks. In the last years, a lot of effort has been invested in research and development of collective control of mobile robots. This interest is justified as there are many advantages when two or more robots are collaborating in a particular task. Some examples are: cleaning toxic waste, transportation and manipulation of objects, exploration, and surveillance, search and rescue. In this work a study of collective movements of mobile robots is presented. A solution of collisions avoidance is developed. This solution is levered on a communication implementation that allows coordinate movements in different paths were avoiding obstacles.

Keywords: synchronization, communication, robots, legos

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Authors: Hachmia Faqihi, Maarouf Saad, Khalid Benjelloun, Mohammed Benbrahim, M. Nabil Kabbaj

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This paper investigates and presents a cable-driven robot to lower limb rehabilitation use in sagittal plane. The presented rehabilitation robot is used for a trajectory tracking in joint space. The paper covers kinematic and dynamic analysis, which reveals the tensionability of the used cables as being the actuating source to provide a rehabilitation exercises of the human leg. The desired trajectory is generated to be used in the control system design in joint space. The obtained simulation results is showed to be efficient in this kind of application.

Keywords: cable-driven multi-body system, computed-torque controller, lower limb rehabilitation, tracking trajectory

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Authors: Lya Porto, Giulia Giacchè, Mario Aquino Alves

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The paper aims to describe the linkage between government and civil society proposing a study on agro-ecological agriculture policy and urban action in São Paulo city underling the main achievements obtained. The negotiation processes between social movements and the government (inputs) and its results on political regulation and public action for Urban Agriculture (UA) in São Paulo city (outputs) have been investigated. The method adopted is qualitative, with techniques of semi-structured interviews, participant observation, and documental analysis. The authors conducted 30 semi-structured interviews with organic farmers, activists, governmental and non-governmental managers. Participant observation was conducted in public gardens, urban farms, public audiences, democratic councils, and social movements meetings. Finally, public plans and laws were also analyzed. São Paulo city with around 12 million inhabitants spread out in a 1522 km2 is the economic capital of Brazil, marked by spatial and socioeconomic segregation, currently aggravated by environmental crisis, characterized by water scarcity, pollution, and climate changes. In recent years, Urban Agriculture (UA) social movements gained strength and struggle for a different city with more green areas, organic food production, and public occupation. As the dynamics of UA occurs by the action of multiple actresses and institutions that struggle to build multiple senses on UA, the analysis will be based on literature about solidarity economy, governance, public action and networks. Those theories will mark out the analysis that will emphasize the approach of inter-subjectivity built between subjects, as well as the hybrid dynamics of multiple actors and spaces in the construction of policies for UA. Concerning UA we identified four main typologies based on land ownership, main function (economic or activist), form of organization of the space, and type of production (organic or not). The City Hall registers 500 productive unities of agriculture, with around 1500 producers, but researcher estimated a larger number of unities. Concerning the social movements we identified three categories that differ in goals and types of organization, but all of them work by networks of activists and/or organizations. The first category does not consider themselves as a movement, but a network. They occupy public spaces to grow organic food and to propose another type of social relations in the city. This action is similar to what became known as the green guerrillas. The second is configured as a movement that is structured to raise awareness about agro-ecological activities. The third one is a network of social movements, farmers, organizations and politicians that work focused on pressure and negotiation with executive and legislative government to approve regulations and policies on organic and agro-ecological Urban Agriculture. We conclude by highlighting how the interaction among institutions and civil society produced important achievements for recognition and implementation of UA within the city. Some results of this process are awareness for local production, legal and institutional recognition of the rural zone around the city into the planning tool, the investment on organic school public procurements, the establishment of participatory management of public squares, the inclusion of UA on Municipal Strategic Plan and Master Plan.

Keywords: public action, policies, agroecology, urban and peri-urban agriculture, Sao Paulo

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Authors: Evelyn Marie Richmond, Andrew McBride, Chris Johnston, John Marley

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Background: Good quality patient information resources for orthognathic treatment help to reinforce information delivered during the initial consultation and help patients make informed decisions about their care. The Consultant Orthodontists and a Dental Core Trainee noted limited patient engagement with the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources and that the existing BOS patient information leaflet (PIL) could be customised and developed to meet local requirements. Aim: The quality improvement project (QIP) aimed to improve patients' understanding of orthognathic treatment by ensuring at least 90% of patients had read the new in-house patient information leaflet (PIL) and a minimum of 50% of patients had accessed the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources before attending the joint orthognathic multidisciplinary clinic by June 2023. Methods: The QIP was undertaken in the orthodontic department of the School of Dentistry, Belfast. Data was collected prospectively during a 6-month period from January 2023 to June 2023 over 3 Plan, Do, Study, Act (PDSA) cycles. Suitable patients were identified at consultant orthodontic new patient clinics. Following initial consultation for orthognathic treatment, patients were contacted to complete a patient questionnaire. Design: The change ideas were a poster with a QR code directing patients to the BOS 'Your Jaw Surgery' website in consultation areas and a new in-house PIL with a QR code directing patients to the BOS 'Your Jaw Surgery' website. Results: In PDSA cycle 1, 86.7% of patients were verbally directed to the BOS 'Your Jaw Surgery' website, and 53.3% accessed the online resources after their initial consultation. Although 100% of patients reported reading the existing PIL, only 64.3% felt it discussed the risks of orthognathic treatment in sufficient detail. By PDSA cycle 3, 100% of patients reported being directed to the BOS 'Your Jaw Surgery' website, however, only 58.3% engaged with the website. 100% of patients who read the new PIL felt that it discussed the risks of orthognathic treatment in sufficient detail. Conclusion: The slight improvement in access to the BOS 'Your Jaw Surgery' website shows that patients do not necessarily choose to access information online despite its availability. The uptake of the new PIL was greater than reported patient engagement with the BOS 'Your Jaw Surgery' website, which indicates patients still value written information despite the availability of online resources.

Keywords: orthognathic surgery, patient information resources, quality improvement project, risks

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Authors: Nirali Sanghavi, Julia Ash, Amy Wasserman

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Introduction: To the best of our knowledge, there is only one case report that found an association between leuprolide and scleroderma renal crisis (SRC). Leuprolide has been noted to cause acute renal failure in some patients. Given the close timing of the leuprolide injection and the worsening renal function in our patient, leuprolide likely caused exacerbation of lupus nephritis and SRC. Interestingly, our patient on long-term hydroxychloroquine (HCQ) with normal baseline cardiac function was found to have HCQ cardiomyopathy highlighting the need for close monitoring of HCQ toxicity. We know that some of the risk factors that are involved in HCQ induced cardiomyopathy are older age, females, increased dose and >10 years of HCQ use, and pre-existing cardiac and renal insufficiency. Case presentation: A 34-year-old African American woman with a history of overlap of systemic lupus erythematosus (SLE) and scleroderma features and class III lupus nephritis presented with severe headaches, elevated blood pressure (180/120 mmHg) and worsening creatinine levels (2.07 mg/dL). The headaches started 1 month ago after she started leuprolide injections for fibroids. She was being treated with mycophenolate mofetil 1 gm twice a day, belimumab weekly, HCQ 200mg, and prednisone 5 mg daily. She has been on HCQ since her teenage years. The examination was unremarkable except for proximal interphalangeal joint contractures in the right hand and sclerodactyly of bilateral hands, unchanged from baseline. Laboratory findings include urinalysis, which showed 3+ protein, 1+ blood, 6 red blood cells, and 14 white blood cells ruling out thrombotic microangiopathy. C3 was 32 mg/dL, C4 <5 mg/dL, and +dsDNA increased >1000. She was started on captopril and discharged once creatinine and blood pressure was controlled. She was readmitted with hypertension, hyperkalemia, worsening creatinine, nephrotic range proteinuria, complaints of chest pressure, and shortness of breath with pleuritic chest pain. Physical examination and lab findings were unchanged. She was treated with pulse dose methyl prednisone followed by taper and multiple anti-hypertensive agents, including captopril, for presumed lupus nephritis flare versus SRC. Renal biopsy was consistent with SRC and class IV lupus nephritis and was started on cyclophosphamide. While cardiac biopsy showed borderline myocarditis without necrosis and cytoplasmic vacuolization consistent with HCQ cardiomyopathy, hence HCQ was discontinued. Summary: It highlights a rare association of leuprolide causing exacerbation of lupus nephritis or SRC. Although rare, the current case reinforces the importance of close monitoring for HCQ toxicity in patients with renal insufficiency.

Keywords: leuprolide, lupus nephritis, scleroderma, SLE

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Authors: N. Attari, S. Amziane, M. Chemrouk

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A large number of old buildings have been identified as having potentially critical detailing to resist earthquakes. The main reinforcement of lap-spliced columns just above the joint region, discontinuous bottom beam reinforcement, and little or no joint transverse reinforcement are the most critical details of interior beam column joints in such buildings. This structural type constitutes a large share of the building stock, both in developed and developing countries, and hence it represents a substantial exposure. Direct observation of damaged structures, following the Algiers 2003 earthquake, has shown that damage occurs usually at the beam-column joints, with failure in bending or shear, depending on geometry and reinforcement distribution and type. While substantial literature exists for the design of concrete frame joints to withstand this type of failure, after the earthquake many structures were classified as slightly damaged and, being uneconomic to replace them, at least in the short term, suitable means of repairs of the beam column joint area are being studied. Furthermore; there exists a large number of buildings that need retrofitting of the joints before the next earthquake. The paper reports the results of the experimental programme, constituted of three beam-column reinforced concrete joints at a scale of one to three (1/3) tested under the effect of a pre-stressing axial load acting over the column. The beams were subjected at their ends to an alternate cyclic loading under displacement control to simulate a seismic action. Strain and cracking fields were monitored with the help a digital recording camera. Following the analysis of the results, a comparison can be made between the performances in terms of ductility, strength and mode of failure of the different strengthening solution considered.

Keywords: fibre reinforced polymers, joints, reinforced concrete, beam columns

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Authors: Jihad H. Asad

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An expression for the Green’s function (GF) of anisotropic face cantered cubic (IFCC) lattice is evaluated analytically and numerically for a single impurity problem. The density of states (DOS), phase shift and scattering cross section are expressed in terms of complete elliptic integrals of the first kind.

Keywords: lattice Green's function, elliptic integral, physics, cubic lattice

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Authors: Gopinath Rathod, Vinod Puranik

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Growing business recognizes environmental consciousness as an important concept for survival in the competitive scenario. Environmental consciousness is a critical intersection between manufacturing and product design processes with environmental issues and concerns. This article presents a project in which quality function deployment (QFD) for environment (ECQFD) has been applied to rotary switches for enabling environmentally conscious design in the early stage of product development. ECQFD is capable of handling simultaneously the environmental and traditional product quality requirements. ECQFD consists of four phases. ECQFD phases I and II are concerned with the identification of parts that are important in enhancing environmental consciousness. ECQFD phases III and IV are concerned with the evaluation of effect of design improvement on environmental quality requirements. The case study has been practically validated which indicated the receptivity of applying ECQFD in industrial scenario.

Keywords: quality function deployment, environment, product design, design for environment, rotary switches

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Authors: Utkan Mutman, Omer Ayhan

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In highway work in a field that is selected in Kocaeli/TURKEY district to the ground improvement and piling is done. In this study, the degree of improvement was observed on the ground after the columns made of stone and bored piles in the field and compared. In this context, improving the ground before and after analysis and solution analysis made with values obtained by the finite element method, which was made Plaxis program. On the improved ground, in order to control of manufactured bored piles, continuity of bored piles and pile load tests were carried out. In addition, the test of load capacity specified in the project is made of stone columns. Test results of the soil improvement were observed to be successful, the results obtained in the field and the results obtained from Plaxis program were compared.

Keywords: bored piling, stone columns, plaxis, soil improvement

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Authors: Hazaila Binti Hassan, Abu Yazid Bin Abu Bakar, Salleh Amat

Abstract:

This study is to get the validity and reliability of the questionnaire for behaviour change on low-performing officers. This study aimed to develop and evaluate the behaviour of low performing officers. There are 75 items in this questionnaire which involves 5 subscales, which are the 5 dimensions intended to be studied: 1st emotional stability, 2nd psycho-spiritual enhancement, 3rd social skills development, 4th cognitive and rationality improvement and 5th behavioural alignment and adjustment. There are 2 processes in this research whereby to check the validity and reliability. Both use quantitative methods. Validity content testing has been conducted to validate the behavioural change questionnaire of the low performing officers. For the face validity, 4 people are involved, two are psychologists who carried out the program and the other two are officers of the same rank, i.e. supporting officers. They are involved in correction of sentences, languages, and grammar as well as the sentence structures so that it tallies with the purpose of studies. The questionnaire underwent content validity by the experts. Five experts are appointed to attend this session, 3 are directly involved in the construction of this questionnaire and 2 others are experts from the university with a background in questionnaire development. The result shows that the content validity obtained a high coefficient of 0.745 with a minimum and maximum value of more than 0.60 which satisfies the characteristic of Content Value Ratio. The Cronbach’s alpha result is 0.867. The highest scores are the behavioural alignment and adjustment sub-scale recorded the highest value, followed by social skills development sub-scale, cognitive and rational improvements sub-scale, psycho-spiritual enhancement sub-scale, and lastly emotional stability. Therefore, both of validity and reliability result were accepted that this questionnaire is valid and reliable can be used in the study of behaviour changes of low performing officers in the civil service.

Keywords: content validity, reliability, five dimension, low-performing officers, questionnaire

Procedia PDF Downloads 283

Authors: X. Wang, T. J. Craft, H. Iacovides

Abstract:

When handling the near-wall regions of turbulent flows, it is necessary to account for the viscous effects which are important over the thin near-wall layers. Low-Reynolds- number turbulence models do this by including explicit viscous and also damping terms which become active in the near-wall regions, and using very fine near-wall grids to properly resolve the steep gradients present. In order to overcome the cost associated with the low-Re turbulence models, a more advanced wall function approach has been implemented within OpenFoam and tested together with a standard log-law based wall function in the prediction of flows which involve 2-D shock wave/turbulent boundary layer interactions (SWTBLIs). On the whole, from the calculation of the impinging shock interaction, the three turbulence modelling strategies, the Lauder-Sharma k-ε model with Yap correction (LS), the high-Re k-ε model with standard wall function (SWF) and analytical wall function (AWF), display good predictions of wall-pressure. However, the SWF approach tends to underestimate the tendency of the flow to separate as a result of the SWTBLI. The analytical wall function, on the other hand, is able to reproduce the shock-induced flow separation and returns predictions similar to those of the low-Re model, using a much coarser mesh.

Keywords: SWTBLIs, skin-friction, turbulence modeling, wall function

Procedia PDF Downloads 346

Authors: Ashit Syngle, Inderjit Verma, Pawan Krishan

Abstract:

Therapeutic approaches used previously relied on disease-modifying antirheumatic drugs (DMARDs) that had only partial clinical benefit and were associated with significant toxicity. Spironolactone, an oral aldosterone antagonist, suppresses inflammatory mediators. Clinical efficacy of spironolactone compared with placebo in patients with active psoriatic arthritis despite treatment with prior traditional DMARDs. In the 24-week, placebo-controlled study patients (n=31) were randomized to placebo and spironolactone (2 m/kg/day). Patients on background concurrent DMARDs continued stable doses (methotrexate, leflunomide, and/or sulfasalazine). Primary outcome measures were the assessment of disease activity measures i.e. 28-joint disease activity score (DAS28) and diseases activity in psoriatic arthritis (DAPSA) at week 24. The key secondary endpoint was change from baseline in Health Assessment Questionnaire–Disability Index (HAQ-DI) at week 24. Additional efficacy outcome measures at week 24 included improvements in the markers of inflammation (ESR and CRP) and pro-inflammatory cytokines TNF-α, IL-6 and IL-1. At week 24, spironolactone significantly reduced disease activity measure DAS-28 (p<0.001) and DAPSA (p=0.001) compared with placebo. Significant improvements in key secondary measures HAQ-DI (disability index) were evident with spironolactone (p=0.02) versus placebo. After week 24, there was significant reduction in pro-inflammatory cytokines level TNF-α, IL-6 (p<0.01) as compared with placebo group. However, there was no significant improvement in IL-1 in both treatment and placebo groups. There were minor side effects which did not mandate stopping of spironolactone. No change in any biochemical profile was noted after spironolactone treatment. Spironolactone was effective in the treatment of PsA, improving disease activity, physical function and suppressing the level of pro-inflammatory cytokines. Spironolactone demonstrated an acceptable safety profile and was well tolerated.

Keywords: spironolactone, inflammation, inflammatory cytokine, psoriatic arthritis

Procedia PDF Downloads 337

Authors: Natalie Tyldesley-Marshall, Janette Parr, Anna Brown, Yen-Fu Chen, Amy Grove

Abstract:

It is widely recognised in policy and research that the provision of services for children and young people (CYP) with Special Educational Needs and Disabilities (SEND) is enhanced when health and social care, and education services collaborate and interact effectively. In the UK, there have been significant changes to policy and provisions which support and improve collaboration. However, professionals responsible for implementing these changes face multiple challenges, including a lack of specific implementation guidance or framework to illustrate how effective multi-agency working could or should work. This systematic review will identify the key components of effective multi-agency working in services for CYP with SEND; and the most effective forms of partnership working in this setting. The review highlights interventions that lead to service improvements; and the conditions in the local area that support and encourage success. A protocol was written and registered with PROSPERO registration: CRD42022352194. Searches were conducted on several health, care, education, and applied social science databases from the year 2012 onwards. Citation chaining has been undertaken, as well as broader grey literature searching to enrich the findings. Qualitative, quantitative, mixed methods studies and systematic reviews were included, assessed independently, and critically appraised or assessed for risk of bias using appropriate tools based on study design. Data were extracted in NVivo software and checked by a more experienced researcher. A convergent segregated approach to synthesis and integration was used in which the quantitative and qualitative data were synthesised independently and then integrated using a joint display integration matrix. Findings demonstrate the key ingredients for effective partnership working for services delivering SEND. Interventions deemed effective are described, and lessons learned across interventions are summarised. Results will be of interest to educators and health and social care professionals that provide services to those with SEND. These will also be used to develop policy recommendations for how UK healthcare, social care, and education services for CYP with SEND aged 0-25 can most effectively collaborate and achieve service improvement. The review will also identify any gaps in the literature to recommend areas for future research. Funding for this review was provided by the Department for Education.

Keywords: collaboration, joint commissioning, service delivery, service improvement

Procedia PDF Downloads 107