Search results for: multiple nonpharmacological interventions

Authors: Andrej Kocjan

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Introduction: Mobility has been shown to play an important role of health and quality of life among older adults. Falls, which are often related to decreased mobility, as well as to neuromuscular deficits, represent the most common injury among older adults. Fall risk has been shown to increase with reduced lower extremity flexibility. The aim of the paper is to assess the importance of flexibility training on joint range of motion and functional performance among elderly population. Methods: We performed literature research on PubMed and evaluated articles published until 2000. The articles found in the search strategy were also added. The population of interest included older adults (≥ 65 years of age). Results: Flexibility training programs still represent an important part of several rehabilitation programs. Static stretching and proprioceptive neuromuscular facilitation are the most frequently used techniques to improve the length of the muscle-tendon complex. Although the effectiveness of type of stretching seems to be related to age and gender, static stretching is a more appropriate technique to enhance shoulder, hip, and ankle range of motion in older adults. Stretching should be performed in multiple sets with holds of more than 60 seconds for a single muscle group. Conclusion: The literature suggests that flexibility training is an effective method to increase joint range of motion in older adults. In the light of increased functional outcome, activities such as strengthening, balance, and aerobic exercises should be incorporated into a training program for older people. Due to relatively little published literature, it is still not possible to prescribe detailed recommendations regarding flexibility training for older adults.

Keywords: elderly, exercise, flexibility, falls

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Authors: Hussaini Bala

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There are different opinions in the literature on the relationship between Audit Committee characteristics and earnings management. The mix of opinions makes the direction of their relationship ambiguous. This study investigated the relationship between Audit Committee characteristics and earnings management of listed food and beverages Firms in Nigeria. The study covered the period of six years from 2007 to 2012. Data for the study were extracted from the Firms’ annual reports and accounts. After running the OLS regression, a robustness test was conducted for the validity of statistical inferences. The dependent variable was generated using two steps regression in order to determine the discretionary accrual of the sample Firms. Multiple regression was employed to run the data of the study using Random Model. The results from the analysis revealed a significant association between audit committee characteristics and earnings management of the Firms. While audit committee size and committees’ financial expertise showed an inverse relationship with earnings management, committee’s independence, and frequency of meetings are positively and significantly related to earnings management. In line with the findings, the study recommended among others that listed food and beverages Firms in Nigeria should strictly comply with the provision of Companies and Allied Matters Act (CAMA) and SEC Code of Corporate Governance on the issues regarding Audit Committees. Regulators such as SEC should increase the minimum number of Audit Committee members with financial expertise and also have a statutory position on the maximum number of Audit Committees meetings, which should not be greater than four meetings in a year as SEC code of corporate governance is silent on this.

Keywords: audit committee, earnings management, listed Food and beverages size, leverage, Nigeria

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Authors: Mary Rose Everan, Michael McCann, Gary Cullen

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International travel journeys, by their nature, incorporate elements provided by multiple service providers such as airlines, rail carriers, airports, and ground handlers. Data needs to be stored by and exchanged between these parties in the process of managing the journey. The fragmented nature of this shared management of mutual clients is a limiting factor in the development of a seamless, hassle-free, end-to-end travel experience. Traditional interlining agreements attempt to facilitate many separate aspects of co-operation between service providers, typically between airlines and, to some extent, intermodal travel operators, including schedules, fares, ticketing, through check-in, and baggage handling. These arrangements rely on pre-agreement. The development of Virtual Interlining - that is, interlining facilitated by a third party (often but not always an airport) without formal pre-agreement by the airlines or rail carriers - demonstrates an underlying demand for a better quality end-to-end travel experience. Blockchain solutions are being explored in a number of industries and offer, at first sight, an immutable, single source of truth for this data, avoiding data conflicts and misinterpretation. Combined with Smart Contracts, they seemingly offer a more robust and dynamic platform for multi-stakeholder ventures, and even perhaps the ability to join and leave consortia dynamically. Applying blockchain to the intermodal interlining space – termed Blocklining in this paper - is complex and multi-faceted because of the many aspects of cooperation outlined above. To explore its potential, this paper concentrates on one particular dimension, that of through baggage interlining.

Keywords: aviation, baggage, blocklining, intermodal, interlining

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Authors: Ram Mohan, Richard Haney, Ajit Kelkar

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Current developments in computing have shown the advantage of using one or more Graphic Processing Units (GPU) to boost the performance of many computationally intensive applications but there are still limits to these GPU-enhanced systems. The major factors that contribute to the limitations of GPU(s) for High Performance Computing (HPC) can be categorized as hardware and software oriented in nature. Understanding how these factors affect performance is essential to develop efficient and robust applications codes that employ one or more GPU devices as powerful co-processors for HPC computational modeling. This research and technical presentation will focus on the analysis and understanding of the intrinsic interrelationship of both hardware and software categories on computational performance for single and multiple GPU-enhanced systems using a computationally intensive application that is representative of a large portion of challenges confronting modern HPC. The representative application uses unstructured finite element computations for transient composite resin infusion process flow modeling as the computational core, characteristics and results of which reflect many other HPC applications via the sparse matrix system used for the solution of linear system of equations. This work describes these various software and hardware factors and how they interact to affect performance of computationally intensive applications enabling more efficient development and porting of High Performance Computing applications that includes current, legacy, and future large scale computational modeling applications in various engineering and scientific disciplines.

Keywords: graphical processing unit, software development and engineering, performance analysis, system architecture and software performance

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Authors: Emma S. Bowers

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Perturbations in global environments and temperatures have heightened the urgency of creating cost-efficient, energy-neutral building techniques. Structural responses to this thermal crisis have included designs (including those of the building standard PassivHaus) with airtightness, window placement, insulation, solar orientation, shading, and heat-exchange ventilators as potential solutions or interventions. Limitations in the predictability of the circulation of cooled air through the ambient temperature gradients throughout a structure are one of the major obstacles facing these enhanced building methods. A diverse range of air-cooling devices utilizing varying technologies is implemented around the world. Many of them worsen the problem of climate change by consuming energy. Using natural ventilation principles of air buoyancy and density to circulate fresh air throughout a building with no energy input can combat these obstacles. A unique prototype of an energy-neutral air-circulation system was constructed in order to investigate potential temperature and pressure gradients related to the stack effect (updraft of air through a building due to changes in air pressure). The stack effect principle maintains that since warmer air rises, it will leave an area of low pressure that cooler air will rush in to fill. The result is that warmer air will be expelled from the top of the building as cooler air is directed through the bottom, creating an updraft. Stack effect can be amplified by cooling the air near the bottom of a building and heating the air near the top. Using readily available, mostly recyclable or biodegradable materials, an insulated building module was constructed. A tri-part construction model was utilized: a subterranean earth-tube heat exchanger constructed of PVC pipe and placed in a horizontally oriented trench, an insulated, airtight cube aboveground to represent a building, and a solar chimney (painted black to increase heat in the out-going air). Pressure and temperature sensors were placed at four different heights within the module as well as outside, and data was collected for a period of 21 days. The air pressures and temperatures over the course of the experiment were compared and averaged. The promise of this design is that it represents a novel approach which directly addresses the obstacles of air flow and expense, using the physical principle of stack effect to draw a continuous supply of fresh air through the structure, using low-cost and readily available materials (and zero manufactured energy). This design serves as a model for novel approaches to creating temperature controlled buildings using zero energy and opens the door for future research into the effects of increasing module scale, increasing length and depth of the earth tube, and shading the building. (Model can be provided).

Keywords: air circulation, PassivHaus, stack effect, thermal gradient

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Authors: Fahimeh Marefat, Marzieh Marefat

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The present research is inspired by the comment that “A substantive, thorough, sophisticated literature review is a precondition for doing substantive, thorough, sophisticated research”. This study is a report on an action research to solve my problem of preparing students to write a Literature Review (LR) that is more than mere cut and paste. More specifically, this study was initiated to discover whether there is an impact of equipping students with tools to write LR on the quality of research and on their view on LR significance. The participants were twenty-four Iranian TEFLers at Allameh Tabataba’i University. they were taking their advanced writing course with the lead researcher. We met once a week for 90 minutes for five weeks followed by individual consultations. Working through a process approach, and implementing tasks, the lead researcher ran workshops implementing different controlled assignments and subsequent activities to lead students to practice appropriate source use on multiple drafts: From choosing the topic, finding sources, forming questions, preparing quotation, paraphrase, and summary note cards, to outlining and most importantly introducing them the tools to evaluate prior research and offer their own take of it and finally synthesizing and incorporating the notes into the body of the LR section of their papers. The LR scoring rubric was implemented and a note was emailed to the students asking about their views. It was indicated that awareness raising and detailed explicit instruction improved the LR quality compared to their previous projects. Interestingly enough, they acknowledged how LR shaped all stages of their research, a further support for the notion of “being scholars before researchers”. The key to success is mastery over the literature which translates into extensive reading and critically appraising it.

Keywords: controlled tasks, critical evaluation, review of literature, writing synthesis

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Authors: Alessandra Turini Bolsoni Silva, Nilson Rogério Da Silva

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The hospitalization process for long periods and the experience of invasive and painful clinical procedures can trigger a set of stressors in children, family members and professionals, leading to stress. Mothers are, in general, the main caregivers and, therefore, have a high degree of sadness and stress with an impact on mental health. However, the father, in the face of the mother's absence, needs to assume other responsibilities such as domestic activities and healthy children in addition to work activities. In addition, he has to deal with changes in family and work relationships during the child's hospitalization, with disagreements and changes in the relationship with the partner, changes in the relationship with the children, and finding it difficult to reconcile the new tasks as a caregiver and work. A consequence of the hospitalization process is the interruption of the routine activities of both the child and the family members responsible for the care, who can go through stressful moments due to the consequences of family breakdown, attention focused only on the child and sleepless nights. In this sense, both the mother and the father can have their health affected by their child's hospitalization. The present study aims to compare the prevalence of stress and overload in mothers and fathers of hospitalized children, as well as possible associations with activities related to care. The participants were 10 fathers and 10 mothers of children hospitalized in a hospital located in a medium-sized city in the interior of São Paulo. Three instruments were used for data collection: 1) Script to characterize the participants; 2) The Lipp Stress Symptom Inventory (ISSL, 2000) 3) Zarit Burden Interview Protocol – ZBT. Contact was made with the management of the hospital in order to present the objectives of the project, then authorization was requested for the participation of the parents; after an agreement, the time and place were convenient for the participant to carry out the interview. Thus, they signed the Free and Informed Consent Term. Data were analyzed according to the instrument application manuals and organized in Figures and Tables. The results revealed that fathers and mothers have their family and professional routine affected by the hospitalization of their children, with the consequent presence of stress and overload indicators. However, the study points to a greater presence of stress and overload in mothers due to their role as the main caregiver, often interrupting their professional life to exercise care. In the case of the father, the routine is changed due to taking on household chores and taking care of the other children, with the professional life being less affected. It is hoped that the data can guide future interventions that promote and develop strategies that favor care and, at the same time, preserve the health of caregivers and that include mothers and fathers, considering that both are affected, albeit in a different way.

Keywords: stress, overload, caregivers, parents

Procedia PDF Downloads 52

Authors: Cheyenne Johnson, Samantha Robinson, Christina Chant, Ann M. Mitchell, Carol Price, Carmel Clancy, Adam Searby, Deborah S. Finnell

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Introduction: Substance use along the continuum from at-risk use to a substance use disorder (SUD) contributes substantially to the burden of disease and related harms worldwide. There is a growing body of literature that highlights the lack of substance use related content in nursing curricula. Furthermore, there is also a lack of consensus on key competencies necessary for entry-level nurses. Globally, there is a lack of established nursing competencies related to prevention, health promotion, harm reduction and treatment of at-risk substance use and SUDs. At a critical time in public health, this gap in nursing curricula contributes to a lack of preparation for entry-level nurses to support people along the continuum of substance use. Thus, in practice, early opportunities for screening, support, and interventions may be missed. To address this gap, an international committee was convened to develop international entry-level nursing competencies specifying the knowledge, skills, and abilities that all nurses should possess in order to address the continuum of substance use. Methodology: An international steering committee, including representation from Canada, United States, United Kingdom, and Australia was established to lead this work over a one-year time period. The steering committee conducted a scoping review, undertaken to examine nursing competency frameworks, and to inform a competency structure that would guide this work. The next steps were to outline key competency areas and establish leaders for working groups to develop the competencies. In addition, a larger international committee was gathered to contribute to competency working groups, review the collective work and concur on the final document. Findings: A comprehensive framework was developed with competencies covering a wide spectrum of substance use across the lifespan and in the context of prevention, health promotion, harm reduction and treatment, including special populations. The development of this competency-based framework meets an identified need to provide guidance for universities, health authorities, policy makers, nursing regulators and other organizations that provide and support nursing education which focuses on care for patients and families with at-risk substance use and SUDs. Conclusion: Utilizing these global competencies as expected outcomes of an educational and skill building curricula for entry-level nurses holds great promise for incorporating evidence-informed training in the care and management of people across the continuum of substance use.

Keywords: addiction nursing, addiction nursing curriculum, competencies, substance use

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Authors: Harish Rajak, Kamlesh Raghuwanshi

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Histone deacetylase (HDAC) are promising target for cancer treatment. The panobinostat (Farydak; Novartis; approved by USFDA in 2015) and chidamide (Epidaza; Chipscreen Biosciences; approved by China FDA in 2014) are the novel HDAC inhibitors ratified for the treatment of patients with multiple myeloma and peripheral T cell lymphoma, respectively. On the other hand, two other HDAC inhibitors, Vorinostat (SAHA; approved by USFDA in 2006) and Romidepsin (FK228; approved by USFDA in 2009) are already in market for the treatment of cutaneous T-cell lymphoma. Several hydroxamic acid based HDAC inhibitors i.e., belinostat, givinostat, PCI24781 and JNJ26481585 are in clinical trials. HDAC inhibitors consist of three pharmacophoric features - an aromatic cap group, zinc binding group (ZBG) and a linker chain connecting cap group to ZBG. Herein, we report synthesis, characterization and biological evaluation of HDAC inhibitors possessing substituted isatin moiety as cap group which recognize the surface of active enzyme pocket and thiosemicarbazide moiety incorporated as linker group responsible for connecting cap group to ZBG (hydroxamic acid). Several analogues were found to inhibit HDAC and cellular proliferation of Hela cervical cancer cells with GI50 values in the micro molar range. Some of the compounds exhibited promising results in vitro antiproliferative studies. Attempts were also made to establish the structure activity relationship among synthesized HDAC inhibitors.

Keywords: HDAC inhibitors, hydroxamic acid derivatives, isatin derivatives, antiproliferative activity, docking

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Authors: Gerard Bray, Derek Mao, Arya Bahadori, Sachinka Ranasinghe

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The EAU currently recommends partial nephrectomy as the preferred management for localised cT1 renal tumours, irrespective of surgical approach. With the advent of robotic assisted partial nephrectomy, there is growing evidence that warm ischaemia time may be reduced compared to the traditional laparoscopic approach. There is still no clear differences between the two approaches with regards to other peri-operative and oncological outcomes. Current limitations in the field denote the lack of single surgeon series to compare the two approaches as other studies often include multiple operators of different experience levels. To the best of our knowledge, this study is the first single surgeon series comparing peri-operative outcomes of robotic assisted and laparoscopic PN. The current study aims to reduce intra-operator bias while maintaining an adequate sample size to assess the differences in outcomes between the two approaches. We retrospectively compared patient demographics, peri-operative outcomes, and renal function derangements of all partial nephrectomies undertaken by a single surgeon with experience in both laparoscopic and robotic surgery. Warm ischaemia time, length of stay, and acute renal function deterioration were all significantly reduced with robotic partial nephrectomy, compared to laparoscopic nephrectomy. This study highlights the benefits of robotic partial nephrectomy. Further prospective studies with larger sample sizes would be valuable additions to the current literature.

Keywords: partial nephrectomy, robotic assisted partial nephrectomy, warm ischaemia time, peri-operative outcomes

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Authors: Alireza Barari, Ahmad Abdi

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Regular body trainings cause adaption in various system in body. One of the important effect of body training is its effect on immune system. It seems that cytokines usually release after long period exercises or some exercises which cause skeletal muscular damages. If some of the cytokines which cause responses such as inflammation of cells in skeletal muscles, with manipulating of training program, it can be avoided or limited from those exercises which induct cytokines release. Ginger plant is a kind of medicinal plants which is known as a anti inflammation plant. This plant is as most precedence medicinal plants in medicine science especially in inflammation cure. The aim of the present study was the effect of selected resistance training and consumption of ginger extract on IL-1α and TNFα untrained young women. The population includes young women interested in participating in the study with the average of 30±2 years old from Abbas Abad city among which 32 participants were chosen randomly and divided into 4 four groups, resistance training (R), resistance training and ginger consumption(RG), Ginger consumption(G)and Control group(C). The training groups performed circuit resistance training at the intensity of 65-75% one repeat maximum, 3 days a week for 6 weeks. Besides resistance training, subjects were given either ginseng (5 mg/kg per day) or placebo. Prior to and 48 hours after interventions body composition was measured and blood samples were taken in order to assess serum levels of IL-1α and TNFα. Plasma levels of cytokines were measured with commercially available ELISA Kits.IL-1α kit and TNFα kit were used in this research. To demonstrate the effectiveness of the independent variable and the comparison between groups, t-test and ANOVA were used. To determine differences between the groups, the Scheffe test was used that showed significant changes in any of the variables. we observed that circuit resistance training in R and RG groups can significant decreased in weight and body mass index in untrained females (p<0.05). The results showed a significant decreased in the mean level of IL-1α levels before and after the training period in G group (p=0.046) and RG group (p=0.022). Comparison between groups also showed there was significant difference between groups R-RG and RG-C. Intergroup comparison results showed that the mean levels of TNFα before and after the training in group G (p=0.044) and RG (p=0.037), significantly decreased. Comparison between groups also showed there was significant difference between groups R–RG , R-G ,RG-C and G-C. The research shows that circuit resistance training with reducing overload method results in systemic inflammation had significant effect on IL-1α levels and TNFα. Of course, Ginger can counteract the negative effects of resistance training exercise on immune function and stability of the mast cell membrane. Considerable evidence supported the anti-inflammatory properties of ginger for several constituents, especially gingerols, shogaols, paradols, and zingerones, through decreased cytokine gene TNF α and IL-1Α expression and inhibition of cyclooxygenase 1 and 2. These established biological actions suggest that ingested ginger could block the increase in IL-1α.

Keywords: resistance training, ginger, IL-1α , TNFα

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Authors: Liyang Yue, Bing Yan, James N. Monks, Rakesh Dhama, Zengbo Wang, Oleg V. Minin, Igor V. Minin

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A particle can function as a refractive lens to focus a plane wave, generating a narrow, high intensive, weak-diverging beam within a sub-wavelength volume, known as the ‘photonic jet’. Refractive index contrast (particle to background media) and scaling effect of the dielectric particle (relative-to-wavelength size) play key roles in photonic jet formation, rather than the shape of particle-lens. Waist (full width of half maximum, FWHM) of a photonic jet could be beyond the diffraction limit and smaller than the Airy disk, which defines the minimum distance between two objects to be imaged as two instead of one. Many important applications for imaging and sensing have been afforded based upon the super-resolution characteristic of the photonic jet. It is known that apodization method, in the form of an amplitude pupil-mask centrally situated on a particle-lens, can further reduce the waist of a photonic nanojet, however, usually lower its intensity at the focus due to blocking of the incident light. In this paper, the anomalously intensity-enhanced apodization effect was discovered in the near-field via numerical simulation. It was also experimentally verified by a scale model using a copper-masked Teflon cuboid solid immersion lens (SIL) with 22 mm side length under radiation of a plane wave with 8 mm wavelength. Peak intensity enhancement and the lateral resolution of the produced photonic jet increased by about 36.0 % and 36.4 % in this approach, respectively. This phenomenon may possess the scale effect and would be valid in multiple frequency bands.

Keywords: apodization, particle-lens, scattering, near-field optics

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Authors: Manendra Singh Parihar, Sandip Ghosh Chowdhury

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Austenitic stainless steels are widely used and give a good combination of properties. When this steel is plastically deformed, a phase transformation of the metastable Face Centred Cubic Austenite to the stable Body Centred Cubic (α’) or to the Hexagonal close packed (ԑ) martensite may occur, leading to the enhancement in the mechanical properties like strength. The work was based on variant selection and corresponding texture analysis for the strain induced martensitic transformation during deformation of the parent austenite FCC phase to form the product HCP and the BCC martensite phases separately, obeying their respective orientation relationships. The automated method for reconstruction of the parent phase orientation using the EBSD data of the product phase orientation is done using the MATLAB and TSL-OIM software. The method of triplets was used which involves the formation of a triplet of neighboring product grains having a common variant and linking them using a misorientation-based criterion. This led to the proper reconstruction of the pre-transformation phase orientation data and thus to its microstructure and texture. The computational speed of current method is better compared to the previously used methods of reconstruction. The reconstruction of austenite from ԑ and α’ martensite was carried out for multiple samples and their IPF images, pole figures, inverse pole figures and ODFs were compared. Similar type of results was observed for all samples. The comparison gives the idea for estimating the correct sequence of the transformation i.e. γ → ε → α’ or γ → α’, during deformation of AISI 304 austenitic stainless steel.

Keywords: variant selection, reconstruction, EBSD, austenitic stainless steel, martensitic transformation

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Authors: Paulin Mbecke

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Research Issue: Under economic constraints, socio-economic conditions of households worsen discounting child’s wellbeing to the bottom of many governments and households’ priority lists. In such situation, many governments fail to rebalance priorities in providing services such as education, housing and social security which are the prerequisites for the wellbeing of children. Consequently, many households struggle to respond to basic needs especially those of children. Although economic conditions play a crucial role in creating prosperity or poverty in households and therefore the wellbeing or misery for children; they are not the sole cause. Research Insights: The review of the South African Index of Multiple Deprivation and the South African Child Gauge establish the extent to which economic conditions impact on the wellbeing or misery of children. The analysis of social, cultural, environmental and structural theories demonstrates that non-economic factors contribute equally to the wellbeing or misery of children, yet, they are disregarded. In addition, the assessment of a child abuse database proves a weak correlation between economic factors (prosperity or poverty) and child’s wellbeing or misery. Theoretical Implications: Through critical social research theory and modelling, the paper proposes a Theory-Based Model that combines different factors to facilitate the understanding of child’s wellbeing or misery. Policy Implications: The proposed model assists in broad policy and decision making and reviews processes in promoting child’s wellbeing and in preventing, intervening and managing child’s misery with regard to education, housing, and social security.

Keywords: children, child’s misery, child’s wellbeing, household’s despair, household’s prosperity

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Authors: Amit Kumar Sinha

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A coal preparation plant typically operates with multiple beneficiation circuits to process individual size fractions of coal obtained from mine so that the targeted overall plant efficiency in terms of yield and ash is achieved. Conventional coal beneficiation plant in India or overseas operates generally in two methods of processing; coarse beneficiation with treatment in dense medium cyclones or in baths and fines beneficiation with treatment in flotation cell. This paper seeks to address the proven application of intermediate circuit along with coarse and fines circuit in Jamadoba New Coal Preparation Plant of capacity 2 Mt/y to treat -0.5 mm+0.25 mm size particles in reflux classifier. Previously this size of particles was treated directly in Flotation cell which had operational and metallurgical limitations which will be discussed in brief in this paper. The paper also details test work results performed on the representative samples of TSL coal washeries to determine the top size of intermediate and fines circuit and discusses about the overlapping process of intermediate circuit and how it is process wise suitable to beneficiate misplaced particles from coarse circuit and fines circuit. This paper also compares the separation efficiency (Ep) of various intermediate circuit process equipment and tries to validate the use of reflux classifier over fine coal DMC or spirals. An overview of Modern coal preparation plant treating Indian coal especially Washery Grade IV coal with reference to Jamadoba New Coal Preparation Plant which was commissioned in 2018 with basis of selection of equipment and plant profile, application of reflux classifier in intermediate circuit and process design criteria is also outlined in this paper.

Keywords: intermediate circuit, overlapping process, reflux classifier

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Authors: Chanchai Wimon, Polin Muangngam, Thannapat Nimsumram, Chanin Prombutra, Prasert Aengchuan, Perawat Boonpuek

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Cleaning water containers is essential for drinking water production to prevent contamination and residual chemicals from washing liquid. Water distribution divisions in Thailand are facing a critical problem with residual contamination in 15-liter drinking water containers due to dust and residual chemicals (TDS value > 200) after normal washing. A thorough washing process is required before filling the purified water into each container. Unfortunately, the washing procedure and frequency do not align with the work instructions provided by the health department. The measured Total Dissolved Solids (TDS) value of the remaining water was found to range between 195–202, exceeding the standard TDS for excellent drinking water (50-190 ppm). This research uses the design of experiment technique in statistics to improve the washing process and reduce such contamination. Statistical data from our survey of the cleaning process is collected to identify affecting factors. Washing time and water volume are varied to test the efficiency of the washing process in reducing residual sediment in the water. The result indicates that cleaning the 15-liter container with 2 liters of tap water mixed with 15 milliliters of dishwashing liquid for 3.12 minutes per container is optimal, as the resulting TDS reduces to 189.75, falling within the standard value for good drinking water. This study result would benefit the drinking water industry in implementing a statistically evaluated cleaning procedure without conducting multiple trials, thus saving takt time and production costs.

Keywords: design of experiment, drinking water purification, quality management, production process reliability

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Authors: Qianyu Zhang

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The spread of digital technology in China has worsened the generation gap and intergenerational competition for cultural and aesthetic discourse. Meanwhile, the increased accessibility of cultural works has encouraged the sharing and inheritance of collective cultural memories between generations. However, not each cultural work can engage positively with efforts to bridge intergenerational aesthetic differences. This study argues that in contemporary China, where new media and the Internet are widely available, featured cultural works have more potential to help enhance the cultural aesthetic consensus among different generations, thus becoming an effective countermeasure to narrow the intergenerational aesthetic rift and cultural discontinuity. Specifically, the generational aesthetic gap is expected to be bridged or improved through the shared appreciation or consumption of cultural works that meet certain conditions by several generations. In-depth interviews of Gen X and Gen Z (N=15, respectively) in China uncovered their preferences and commonalities for cultural works and shared experiences in appreciating them. Results demonstrate that both generations’ shared appreciation of cultural work is a necessary but insufficient condition for its effective response to the generational aesthetic gap. Coding analysis rendered six dimensions that cultural works with the potential to bridge the intergenerational aesthetic divide should satisfy simultaneously: genre, theme, content, elements, quality, and accessibility. Cultural works that engage multiple senses/ compound realistic, domestic and contemporary cultural memories/ contain the narrative of family life and nationalism/ include more elements familiar to the previous generation/ are superb-produced and unaffected/ are more accessible better promote intergenerational aesthetic exchange and value recognition. Moreover, compared to the dilemma of the previous generation facing the aesthetic gap, the later generation plays a crucial role in bridging the generational aesthetic divide.

Keywords: cultural works, generation gap, generation X, generation Z, cultural memory

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Authors: Ran An, Dang Wang

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Background: Mechanical ventilation has been confirmed to increase the incidence of postoperative pulmonary complications (PPCs), and several studies have shown that low tidal volumes combined with positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RM) reduce the incidence of PPCs. However, the optimal lung-protective ventilatory strategy remains unclear. Methods: Multiple databases were searched for randomized controlled trials (RCTs) published prior to October 2023. The association between individual PEEP (iPEEP) or other forms of lung-protective ventilation and the incidence of PPCs was evaluated by Bayesian network meta-analysis. Results: We included 58 studies (11610 patients) in this meta-analysis. The network meta-analysis showed that low ventilation (LVt) combined with iPEEP and RM was associated with significantly lower incidences of PPCs [HVt: OR=0.38 95CrI (0.19, 0.75), LVt: OR=0.33, 95% CrI (0.12, 0.82)], postoperative atelectasis, and pneumonia than was HVt or LVt. In abdominal surgery, LVT combined with iPEEP or medium-to-high PEEP and RM were associated with significantly lower incidences of PPCs, postoperative atelectasis, and pneumonia. LVt combined with iPEEP and RM was ranked the highest, which was based on SUCRA scores. Conclusion: LVt combined with iPEEP and RM decreased the incidences of PPCs, postoperative atelectasis, and pneumonia in noncardiac surgery patients. iPEEP-guided ventilation was the optimal lung protection ventilation strategy. The quality of evidence was moderate.

Keywords: protection ventilation strategies, postoperative pulmonary complications, network meta-analysis, noncardiac surgery

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Authors: Masih Nikgou

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ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

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Authors: Jasmeet Kaur, Anup Singh, Shashikant Iyengar, Arun Kumar, Ira Sahay

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Latent autoimmune diabetes in adults (LADA) is an irreversible autoimmune disease that affects insulin production. LADA is characterized by the production of Glutamic acid decarboxylase (GAD) antibodies, which is similar to type 1 diabetes. Individuals with LADA may eventually develop overt diabetes and require insulin. In this condition, the pancreas produces little or no insulin, which is a hormone used by the body to allow glucose to enter cells and produce energy. While type 1 diabetes was traditionally associated with children and teenagers, its prevalence has increased in adults as well. LADA is frequently misdiagnosed as type 2 diabetes, especially in adulthood when type 2 diabetes is more common. LADA develops in adulthood, usually after age 30. Managing LADA involves metabolic control with exogenous insulin and prolonging the life of surviving beta cells, thereby slowing the disease's progression. This case study examines the impact of approximately 3 months of low-carbohydrate dietary intervention in a 42-year-old woman with LADA who was initially misdiagnosed as having type 2 diabetes. Her c-peptide was 0.13 and her HbA1c was 9.3% when this trial began. Low-carbohydrate interventions have been shown to improve blood sugar levels, including fasting, post-meal, and random blood sugar levels, as well as haemoglobin levels, blood pressure, energy levels, sleep quality, and satiety levels. The use of low-carbohydrate dietary intervention significantly reduces both hypo- and hyperglycaemia events. During the 3 months of the study, there were 2 to 3 hyperglycaemic events owing to physical stress and a single hypoglycaemic event. Low-carbohydrate dietary therapies lessen insulin dose inaccuracy, which explains why there were fewer hyperglycaemic and hypoglycaemic events. In three months, the glycated haemoglobin (HbA1c) level was reduced from 9.3% to 6.3%. These improvements occur without the need for caloric restriction or physical activity. Stress management was crucial aspect of the treatment plan as stress-induced neuroendocrine hormones can cause immunological dysregulation. Additionally, supplements that support immune system and reduce inflammation were used as part of the treatment during the trial. Long-term studies are needed to track disease development and corroborate the claim that such dietary treatments can prolong the honeymoon phase in LADA. Various factors can contribute to additional autoimmune attacks, so measuring c-peptide is crucial on a regular basis to determine whether insulin levels need to be adjusted.

Keywords: autoimmune, diabetes, LADA, low_carb, nutrition

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Authors: Vaishali Chaurasia

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Ageing is the universal phenomenon that is associated with deteriorating health status. As the human becomes old, certain changes take place in an organism leading to morbidities, disabilities, and event death. Furthermore, older people are more vulnerable for the various kinds of diseases and health problem. Due to the some unhealthy conventions like smoking, drinking and unhealthy foods is the genesis of the lifestyle diseases. These diseases associated with the way a person or group of people lives. The main purpose of the study is to determine the prevalence of lifestyle diseases and its association with physical activity as well as the risk factors associated with it among the adult population in India. Longitudinal Aging Study in India and Study on Global Aging and Adult Health in India were used in the study. We will take population aged 50 and older, began in 1935, and regularly refreshed at younger ages with new birth cohorts. Life style diseases are more prominent in 65+ age group. The study finds an association between prevalence of life style diseases and life style risk factors. The lifestyle disease prevalence is more among higher age group people, female, richest quintile, and doing lesser physical activity. A higher prevalence of lifestyle diseases associated with the multiple risk factors. The occurrence of three and four risk factors was more prevalent in India. The frequency of different type of life style disease is higher among those who hardly or never do any physical activity as compare to those who do physical activity every day. The pattern remains the same in Moderate as well as vigorous physical activity. Those who are regularly doing physical activities have lesser percentage of having any disease and those who hardly ever or never do any physical activities and equally involve with some risk factors have higher percentage of having all type of diseases.

Keywords: lifestyle disease, morbidity, disability, physical activity

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Authors: Selam Mulugeta, Barkot Milkias, Mesfin Araya, Abel Worku, Eyasu Mulugeta

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In Ethiopia, there is inadequate information on non-adherence to antidepressant treatment in patients with depressive disorders. Having awareness of the pattern of adherence is important in future prognosis, quality of life, and functionality in these patients. This hospital-based cross-sectional quantitative study was done on a sample of 216 consecutive outpatients with depressive disorders. Data were collected using questionnaires through in-person and phone call interviews. The 8-item Morisky scale was used to assess the pattern of medication adherence. Other specially developed tools were used to obtain sociodemographic and clinical information from electronic medical records and patient interviews. Data were analyzed using the Statistical Package for the Social Sciences Version - 25. Univariate and multivariable analyses were carried out to assess factors associated with non-adherence. 90% of the participants had a primary diagnosis of major depressive disorder. Based on the 8-item Morisky Medication Adherence Scale, the prevalence of non-adherence was found to be 84.7%. Living distance between 11 to 50 km from the hospital (AOR= 11, 95% CI (29,46.6)), post-secondary level of education (AOR= 8.3, 95% CI (1, 64.4)) and taking multiple medications (AOR= 6.1, 95% CI (1, 34.9)) were found to have significantly increased odds of non-adherence. Non-adherence was significantly associated with factors such as increased living distance from the hospital, relatively higher educational level, and polypharmacy. Proper and patient-centered psychoeducation, addressing the communication gap between patients and doctors, adherence to prescribing guidelines, avoiding polypharmacy unless indicated & working on accessibility of treatment is essential to decrease non-adherence.

Keywords: depressive disorders, Ethiopia, medication adherence, Addis Ababa

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Authors: Revoti Prasad Bora, Saurabh Yadav, Nikita Katyal

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In the context of educational data mining, the use case of extracting information from images containing both text and diagrams is of high importance. Hence, document analysis requires the extraction of diagrams from such images and processes the text and diagrams separately. To the author’s best knowledge, none among plenty of approaches for extracting tables, figures, etc., suffice the need for real-time processing with high accuracy as needed in multiple applications. In the education domain, diagrams can be of varied characteristics viz. line-based i.e. geometric diagrams, chemical bonds, mathematical formulas, etc. There are two broad categories of approaches that try to solve similar problems viz. traditional computer vision based approaches and deep learning approaches. The traditional computer vision based approaches mainly leverage connected components and distance transform based processing and hence perform well in very limited scenarios. The existing deep learning approaches either leverage YOLO or faster-RCNN architectures. These approaches suffer from a performance-accuracy tradeoff. This paper proposes a U-Net based architecture that formulates the diagram extraction as a segmentation problem. The proposed method provides similar accuracy with a much faster extraction time as compared to the mentioned state-of-the-art approaches. Further, the segmentation mask in this approach allows the extraction of diagrams of irregular shapes.

Keywords: computer vision, deep-learning, educational data mining, faster-RCNN, figure extraction, image segmentation, real-time document analysis, text extraction, U-Net, YOLO

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Authors: Shazali Abdulahi

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Project planning is the first phase in project life cycle which relates to the use of schedules such as Gantt charts to plan and subsequently report the project progress within the project environment. Likewise, project execution is the third phase in project lifecycle, is the phase where the work of the project must get done correctly and it’s the longest phase in the project lifecycle therefore, they must be effectively communicated, now today Communication has become the crucial element of every organization. During construction project delivery, information needs to be accurately and timely communicating among project stakeholders in order to realize the project objective. Effective communication among stakeholders during construction project delivery is one of the major factors that impact construction project delivery. Therefore, the aim of the research work is to examine the critical factors influencing effective communication among stakeholders on construction project delivery from the perspective of construction professionals (Architects, Builders, Quantity surveyors, and Civil engineers). A quantitative approach was adopted. This entailed the used of structured questionnaire to one (108) construction professionals in public and private organization within dutse metropolis. Frequency, mean, ranking and multiple linear regression using SPSS vision 25 software were used to analyses the data. The results show that Leadership, Trust, Communication tools, Communication skills, Stakeholders involvement, Cultural differences, and Communication technology were the most critical factors influencing effective communication among stakeholders on construction project delivery. The hypothesis revealed that, effective communication among stakeholders has significant effects on construction project delivery. This research work will profit the construction stakeholders in construction industry, by providing adequate knowledge regarding the factors influencing effective communication among stakeholders, so that necessary steps to be taken to improve project performance. Also, it will provide knowledge about the appropriate strategies to employ in order to improve communication among stakeholders.

Keywords: effetive communication, ineffective communication, stakeholders, project delivery

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Authors: Sanam Preet Singh

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Music in comparison to any other art form is more reactive and alive. It has the capacity to directly interact with the listener's mind and generate an emotional response. All the major research conducted in the area majorly relied on the listener’s perspective to draw an understanding of music and its effects. There is a very small number of studies which focused on the source from which music originates, the music composers. This study aims to understand the process of how music composers understand and perceive emotions and how they translate them into music, in simpler terms how music composers encode their compositions to express determining emotions. One-to-one in-depth semi structured interviews were conducted, with 8 individuals both male and female, who were professional to intermediate-level music composers and Thematic analysis was conducted to derive the themes. The analysis showed that there is no single process on which music composers rely, rather there are combinations of multiple micro processes, which constitute the understanding and translation of emotions into music. In terms of perception of emotions, the role of processes such as Rumination, mood influence and escapism was discovered in the analysis. Unique themes about the understanding of their top down and bottom up perceptions were also discovered. Further analysis also revealed the role of imagination and emotional trigger explaining how music composers make sense of emotions. The translation process of emotions revealed the role of articulation and instrumentalization, in encoding or translating emotions to a composition. Further, applications of the trial and error method, nature influences and flow in the translation process are also discussed. In the end themes such as parallels between musical patterns and emotions, comfort zones and relatability also emerged during the analysis.

Keywords: comfort zones, escapism, flow, rumination

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Authors: Neliswa Dyosi

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Purpose - Using an integrated Technology-Organization-Environment (TOE) framework and the model of technology appropriation (MTA) as a theoretical lens, this interpretive qualitative study seeks to understand and explain the factors that influence the appropriation, non-appropriation, and disappropriation of bitcoin as a payment method by South African retailers. Design/methodology/approach –The study adopts the interpretivist philosophical paradigm. Multiple case studies will be adopted as a research strategy. For data collection, the study follows a qualitative approach. Qualitative data will be collected from the six retailers in various industries. Semi-structured interviews and documents will be used as the data collection techniques. Purposive and snowballing sampling techniques will be used to identify participants within the organizations. Data will be analyzed using thematic analysis. Originality/value - Using the deduction approach, the study seeks to provide a descriptive and explanatory contribution to theory. The study contributes to theory development by integrating the MTA and TOE frameworks as a means to understand technology adoption behaviors of organizations, in this case, retailers. This is also the first study that looks at an integrated approach of the Technology-Organization-Environment (TOE) framework and the MTA framework to understand the adoption and use of a payment method. South Africa is ranked amongst the top ten countries in the world on cryptocurrency adoption. There is, however, still a dearth of literature on the current state of adoption and usage of bitcoin as a payment method in South Africa. The study will contribute to the existing literature as bitcoin cryptocurrency is gaining popularity as an alternative payment method across the globe.

Keywords: cryptocurrency, bitcoin, payment methods, blockchain, appropriation, online retailers, TOE framework, disappropriation, non-appropriation

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Authors: Umair Shoukat Ali, Rashna Hoshang Sukhia, Mubassar Fida

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Introduction: The objective of the study was to compare outcomes in terms of Bleeding index (BI), Gingival Index (GI), and Orthodontic Plaque Index (OPI) with video graphics and plaque disclosing tablets (PDT) versus verbal instructions in adult orthodontic patients undergoing fixed appliance treatment (FAT). Materials and Methods: Adult orthodontic patients have recruited from outpatient orthodontic clinics who fulfilled the inclusion criteria and were randomly allocated to three groups i.e., video, PDT, and verbal groups. We included patients undergoing FAT for six months of both genders with all teeth bonded mesial to first molars having no co-morbid conditions such as rheumatic fever and diabetes mellitus. Subjects who had gingivitis as assessed by Bleeding Index (BI), Gingival Index (GI), and Orthodontic Plaque Index (OPI) were recruited. We excluded subjects having > 2 mm of clinical attachment loss, pregnant and lactating females, any history of periodontal therapy within the last six months, and any consumption of antibiotics or anti-inflammatory drugs within the last one month. Pre- and post-interventional measurements were taken at two intervals only for BI, GI, and OPI. The primary outcome of this trial was to evaluate the mean change in the BI, GI, and OPI in the three study groups. A computer-generated randomization list was used to allocate subjects to one of the three study groups using a random permuted block sampling of 6 and 9 to randomize the samples. No blinding of the investigator or the participants was performed. Results: A total of 99 subjects were assessed for eligibility, out of which 96 participants were randomized as three of the participants declined to be part of this trial. This resulted in an equal number of participants (32) that were analyzed in all three groups. The mean change in the oral hygiene indices score was assessed, and we found no statistically significant difference among the three interventional groups. Pre- and post-interventional results showed statistically significant improvement in the oral hygiene indices for the video and PDT groups. No statistically significant difference for age, gender, and education level on oral hygiene indices were found. Simple linear regression showed that the video group produced significantly higher mean OPI change as compared to other groups. No harm was observed during the trial. Conclusions: Visual aids performed better as compared to the verbal group. Gender, age, and education level had no statistically significant impact on the oral hygiene indices. Longer follow-ups will be required to see the long-term effects of these interventions. Trial Registration: NCT04386421 Funding: Aga Khan University and Hospital (URC 183022)

Keywords: oral hygiene, orthodontic treatment, adults, randomized clinical trial

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Authors: Kiran Nair, Jincy George, Suhaib Anagreh

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Artificial intelligence (AI) in a marketing context is a form of a deterministic tool designed to optimize and enhance marketing tasks, research tools, and techniques. It is on the verge of transforming marketing roles and revolutionize the entire industry. This paper aims to explore the current dissemination of the application of artificial intelligence (AI) in the marketing mix, reviewing the scope and application of AI in various aspects of sales and distribution management. The paper also aims at identifying the areas of the strong impact of AI in factors of sales and distribution management such as distribution channel, purchase automation, customer service, merchandising automation, and shopping experiences. This is a qualitative research paper that aims to examine the impact of AI on sales and distribution management of 30 multinational brands in six different industries, namely: airline; automobile; banking and insurance; education; information technology; retail and telecom. Primary data is collected by means of interviews and questionnaires from a sample of 100 marketing managers that have been selected using convenient sampling method. The data is then analyzed using descriptive statistics, correlation analysis and multiple regression analysis. The study reveals that AI applications are extensively used in sales and distribution management, with a strong impact on various factors such as identifying new distribution channels, automation in merchandising, customer service, and purchase automation as well as sales processes. International brands have already integrated AI extensively in their day-to-day operations for better efficiency and improved market share while others are investing heavily in new AI applications for gaining competitive advantage.

Keywords: artificial intelligence, sales and distribution, marketing mix, distribution channel, customer service

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Authors: Ciro Cursio, Pio Luigi Cursio, Giulia Cursio, Isabella Chiardi, Luigi Cursio

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Introduction: Full-face aesthetic treatments often present a difficult task: since different patients possess different anatomical and tissue characteristics, there is no guarantee that the same treatment will have the same effect on multiple patients; additionally, full-face rejuvenation and beautification treatments require not only a high degree of technical skill but also the ability to choose the right product for each area and a keen artistic eye. Method: We present an artificial intelligence-based algorithm that can generate realistic post-treatment 3D models based on the patient’s requests together with the doctor’s input. These 3-dimensional predictions can be used by the practitioner for two purposes: firstly, they help ensure that the patient and the doctor are completely aligned on the expectations of the treatment; secondly, the doctor can use them as a visual guide, obtaining a natural result that would normally stem from the practitioner's artistic skills. To this end, the algorithm is able to predict injection zones, the type and quantity of hyaluronic acid, the injection depth, and the technique to use. Results: Our innovation consists in providing an objective visual representation of the patient that is helpful in the patient-doctor dialogue. The patient, based on this information, can express her desire to undergo a specific treatment or make changes to the therapeutic plan. In short, the patient becomes an active agent in the choices made before the treatment. Conclusion: We believe that this algorithm will reveal itself as a useful tool in the pre-treatment decision-making process to prevent both the patient and the doctor from making a leap into the dark.

Keywords: hyaluronic acid, fillers, full face, artificial intelligence, 3D

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Authors: Hussain Hameed Mayuuf

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We may find multiple functions that are required to exist in order for meaning, in any certain context, to manifest and act accordingly. Pragmatic function and symbolic function need to be contributing in a combined effort towards that manifestation in order for meaning to be acquired or achieved from within a structure too complex to detect meaning in it by employing any other means. This paper inspects symbolism pragma-stylistically in literary texts. Thus, it principally aims at showing the ways writers utilize symbolism to contribute to the themes of their works and, consequently, pinpointing the most frequently flouted maxim involved in symbolic interpretations in addition to the reason(s) behind the writer's exploitation of that maxim in the literary work. E. E. Cummings' play Him constitutes rich data for the present study. Thus, to achieve its aims, the present study hypothesizes that the descriptions of scenes, the playwright’s remarks, and the characters’ references are all manipulated symbolically to contribute to the themes of the play. It is also hypothesized that the maxim of manner is the most frequently flouted maxim involved in symbolic interpretations in the play, which comes as a result of the intended ambiguity and obscurity manipulated in the descriptions of the scenes, the playwright’s remarks and the characters’ references. In order to achieve the aims of the study and test its hypotheses, a theoretical background about symbolism in general and symbolism from pragma-stylistic points of view is presented. Then, (six) extracts of Him according to Eco’s (1984) model Semiotics and the Philosophy of Language are analyzed. The findings of the analysis verify the above-mentioned hypotheses.

Keywords: pragmatic function, stylistic function, Symbolism, pragma-stylistics, Cummings

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