Search results for: practice of ADR reporting

Authors: Sajee A. Gamage, Champa J. Wijesinghe, Patricia Burtner, Ananda R. Wickremasinghe

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Background: Teachers working in the context of special education have an enormous responsibility of enhancing performance skills of children in their classroom settings. Fine Motor Skills (FMS) are essential functional skills for children to gain independence in Activities of Daily Living. Children with Down Syndrome (DS) are predisposed to specific challenges due to deficits in FMS. This study is aimed to determine the teachers’ experience on improving FMS of children with DS in the context of special education of Southern Province, Sri Lanka. Methodology: A cross-sectional study was conducted among all consenting eligible teachers (n=147) working in the context of special education in government schools of Southern Province of Sri Lanka. A self-administered questionnaire was developed based on literature and expert opinion to assess teachers’ experience regarding deficits of FMS, limitations of classroom activity performance and barriers to improve FMS of children with DS. Results: Approximately 93% of the teachers were females with a mean age ( ± SD) of 43.1 ( ± 10.1) years. Thirty percent of the teachers had training in special educationand 83% had children with DS in their classrooms. Major deficits of FMS reported were deficits in grasping (n=116; 79%), in-hand manipulation (n=103; 70%) and bilateral hand use (n=99; 67.3%). Paperwork (n=70; 47.6%), painting (n=58; 39.5%), scissor work (n=50; 34.0%), pencil use for writing (n=45; 30.6%) and use of tools in the classroom (n=41; 27.9%) were identified as major classroom performance limitations of children with DS. Parental factors (n=67; 45.6%), disease specific characteristics (n=58; 39.5%) and classroom factors (n=36; 24.5%), were identified as major barriers to improve FMS in the classroom setting. Lack of resources and standard tools, social stigma and late school admission were also identified as barriers to FMS training. Eighty nine percent of the teachers informed that training fine motor activities in a special education classroom was more successful than work with normal classroom setting. Conclusion: Major areas of FMS deficits were grasping, in-hand manipulation and bilateral hand use; classroom performance limitations included paperwork, painting and scissor work of children with DS. Teachers recommended regular practice of fine motor activities according to individual need. Further research is required to design a culturally specific FMS assessment tool and intervention methods to improve FMS of children with DS in Sri Lanka.

Keywords: classroom activities, Down syndrome, experience, fine motor skills, special education, teachers

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Authors: Eva de Mingo-Fernández, Lourdes Rubio Rico, Carmen Ortega-Segura, Montserrat Querol-García, Raúl González-Jauregui

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Today, one of the great challenges that the university faces is to get closer to society and transfer knowledge. The competency-based training approach favours a continuous interaction between practice and theory, which is why it is essential to establish real experiences with reflection and debate and to contrast them with personal and professional knowledge. Service-learning (SL) consists of an integration of academic learning with service in the community, which enables teachers to transfer knowledge with social value and students to be trained on the basis of experience of real needs and problems with the aim of solving them. SLE combines research, teaching, and social value knowledge transfer with the real social needs and problems of a community. Goal: The objective of this study was to design, implement, and evaluate a service-learning program in the subject of adult nursing for second-year nursing students. Methodology: After establishing collaboration with eight associations of people with different pathologies, the students were divided into eight groups, and each group was assigned an association. The groups were made up of 10-12 students. The associations willing to participate were for the following conditions: diabetes, multiple sclerosis, cancer, inflammatory bowel disease, fibromyalgia, heart, lung, and kidney diseases. The methodological design consisting of 5 activities was then applied. Three activities address personal and individual reflections, where the student initially describes what they think it is like to live with a certain disease. They then express their reflections resulting from an interview conducted by peers, in person or online, with a person living with this particular condition, and after sharing the results of their reflections with the rest of the group, they make an oral presentation in which they present their findings to the other students. This is followed by a service task in which the students collaborate in different activities of the association, and finally, a third individual reflection is carried out in which the students express their experience of collaboration. The evaluation of this activity is carried out by means of a rubric for both the reflections and the presentation. It should be noted that the oral presentation is evaluated both by the rest of the classmates and by the teachers. Results: The evaluation of the activity, given by the students, is 7.80/10, commenting that the experience is positive and brings them closer to the reality of the people and the area.

Keywords: academic learning integration, knowledge transfer, service-learning, teaching methodology

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Authors: É. Vincze

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Demand on plant oils has increased to an enormous extent that is due to the change of human nutrition habits on the one hand, while on the other hand to the increase of raw material demand of some industrial sectors, just as to the increase of biofuel production. Besides the determining importance of sunflower in Hungary the production area, just as in part the average yield amount of rapeseed has increased among the produced oil crops. The variety/hybrid palette has changed significantly during the past decade. The available varieties’/hybrids’ palette has been extended to a significant extent. It is agreed that rapeseed production demands professionalism and local experience. Technological elements are successive; high yield amounts cannot be produced without system-based approach. The aim of the present work was to execute the complex study of one of the most critical production technology element of rapeseed production, that was sowing technology. Several sowing technology elements are studied in this research project that are the following: biological basis (the hybrid Arkaso is studied in this regard), sowing time (sowing time treatments were set so that they represent the wide period used in industrial practice: early, optimal and late sowing time) plant density (in this regard reaction of rare, optimal and too dense populations) were modelled. The multifactorial experimental system enables the single and complex evaluation of rapeseed sowing technology elements, just as their modelling using experimental result data. Yield quality and quantity have been determined as well in the present experiment, just as the interactions between these factors. The experiment was set up in four replications at the Látókép Plant Production Research Site of the University of Debrecen. Two different sowing times were sown in the first experimental year (2014), while three in the second (2015). Three different plant densities were set in both years: 200, 350 and 500 thousand plants ha-1. Uniform nutrient supply and a row spacing of 45 cm were applied. Winter wheat was used as pre-crop. Plant physiological measurements were executed in the populations of the Arkaso rapeseed hybrid that were: relative chlorophyll content analysis (SPAD) and leaf area index (LAI) measurement. Relative chlorophyll content (SPAD) and leaf area index (LAI) were monitored in 7 different measurement times.

Keywords: inner quality, plant density, rapeseed, sowing time

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Authors: Jinming Du

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With the COVID-19 pandemic beginning in 2020, many higher education institutions and education systems are turning to hybrid or fully distance online courses to maintain social distance and provide a safe virtual space for learning and teaching. However, the majority of faculty members were not well prepared for the shift to blended or distance learning. Communication frustrations are prevalent in both hybrid and full-distance courses. A systematic literature review was conducted by a comprehensive analysis of 1688 publications that focused on the application of the adoption of chatbots in education. This study aimed to explore instructors' experiences with chatbots in online and blended undergraduate English courses. Language learners are overwhelmed by the variety of information offered by many online sites. The recently emerged chatbots (e.g.: ChatGPT) are slightly superior in performance as compared to those traditional through previous technologies such as tapes, video recorders, and websites. The field of chatbots has been intensively researched, and new methods have been developed to demonstrate how students can best learn and practice a new language in the target language. However, it is believed that among the many areas where chatbots are applied, while chatbots have been used as effective tools for communicating with business customers, in consulting and targeting areas, and in the medical field, chatbots have not yet been fully explored and implemented in the field of language education. This issue is challenging enough for language teachers; they need to study and conduct research carefully to clarify it. Pedagogical chatbots may alleviate the perception of a lack of communication and feedback from instructors by interacting naturally with students through scaffolding the understanding of those learners, much like educators do. However, educators and instructors lack the proficiency to effectively operate this emerging AI chatbot technology and require comprehensive study or structured training to attain competence. There is a gap between language teachers’ perceptions and recent advances in the application of AI chatbots to language learning. The results of the study found that although the teachers felt that the chatbots did the best job of giving feedback, the teachers needed additional training to be able to give better instructions and to help them assist in teaching. Teachers generally perceive the utilization of chatbots to offer substantial assistance to English language instruction.

Keywords: artificial intelligence in education, chatbots, education and technology, education system, pedagogical chatbot, chatbots and language education

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Authors: Alberto Abello Moreno-Cid

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Mummification was the process through which immortality was granted to the deceased, so it was of extreme importance to the Egyptians. The techniques of embalming had evolved over the centuries, and specialists created increasingly sophisticated tools. However, due to its eminently religious nature, knowledge about everything related to this practice was jealously preserved, and the testimonies that have survived to our time are scarce. For this reason, embalming instruments found in archaeological excavations are uncommon. The tomb of the Vizier Amenhotep Huy (AT No. -28-), located in the el-Assasif necropolis that is being excavated since 2009 by the team of the Institute of Ancient Egyptian Studies, has been the scene of some discoveries of this type that evidences the existence of mummification practices in this place after the New Kingdom. The clysters or enemas are the fundamental tools in the second type of mummification described by the historian Herodotus to introduce caustic solutions inside the body of the deceased. Nevertheless, such objects only have been found in three locations: the tomb of Ankh-Hor in Luxor, where a copper enema belonged to the prophet of Ammon Uah-ib-Ra came to light; the excavation of the tomb of Menekh-ib-Nekau in Abusir, where was also found one made of copper; and the excavations in the Bucheum, where two more artifacts were discovered, also made of copper but in different shapes and sizes. Both of them were used for the mummification of sacred animals and this is the reason they vary significantly. Therefore, the object found in the tomb No. -28-, is the first known made of faience of all these peculiar tools and the oldest known until now, dated in the Third Intermediate Period (circa 1070-650 B.C.). This paper bases its investigation on the study of those parallelisms, the material, the current archaeological context and the full analysis and reconstruction of the object in question. The key point is the use of faience in the production of this item: creating a device intended to be in constant use seems to be a first illogical compared to other samples made of copper. Faience around the area of Deir el-Bahari had a strong religious component, associated with solar myths and principles of the resurrection, connected to the Osirian that characterises the mummification procedure. The study allows to refute some of the premises which are held unalterable in Egyptology, verifying the utilization of these sort of pieces, understanding its way of use and showing that this type of mummification was also applied to the highest social stratum, in which case the tools were thought out of an exceptional quality and religious symbolism.

Keywords: clyster, el-Assasif, embalming, faience enema mummification, Theban necropolis

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Authors: Julia Wimmers-Klick

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In the contemporary study of anatomy, medical students utilize a diverse array of resources, including lab handouts, lectures, and, increasingly, digital media such as interactive anatomy apps and digital images. Notably, a significant shift has occurred, with fewer students possessing traditional anatomy atlases or books, reflecting a broader trend towards digital approaches like Virtual Reality, Augmented Reality, and web-based programs. This paper seeks to explore the evolution of anatomy education by contrasting current digital tools with historical resources, such as classical anatomical illustrations and atlases, to assess their relevance and potential benefits in modern medical education. Through a comprehensive literature review, the development of anatomical illustrations is traced from the textual descriptions of Galen to the detailed and artistic representations of Da Vinci, Vesalius, and later anatomists. The examination includes how the printing press facilitated the dissemination of anatomical knowledge, transforming covert dissections into public spectacles and formalized teaching practices. Historical illustrations, often influenced by societal, religious, and aesthetic contexts, not only served educational purposes but also reflected the prevailing medical knowledge and ethical standards of their times. Critical questions are raised about the place of historical illustrations in today's anatomy curriculum. Specifically, their potential to teach critical thinking, highlight the history of medicine, and offer unique insights into past societal conditions are explored. These resources are viewed in their context, including the lack of diversity and the presence of ethical concerns, such as the use of illustrations from unethical sources like Pernkopf’s atlas. In conclusion, while digital tools offer innovative ways to visualize and interact with anatomical structures, historical illustrations provide irreplaceable value in understanding the evolution of medical knowledge and practice. The study advocates for a balanced approach that integrates traditional and modern resources to enrich medical education, promote critical thinking, and provide a comprehensive understanding of anatomy. Future research should investigate the optimal combination of these resources to meet the evolving needs of medical learners and the implications of the digital shift in anatomy education.

Keywords: human anatomy, historical illustrations, historical context, medical education

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Authors: Jean De Dieu Ayabagabo, Paul A.Onjoro, Karubiu P. Migwi, Marie C. Dusingize

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This study investigated the effects of feed on milk yield and quality through feed monitoring and quality assessment, and the consequent enteric methane gas emissions from smallholder dairy farms in drier areas of Rwanda, using the Tier II approach for four seasons in three zones, namely; Mayaga and peripheral Bugesera (MPB), Eastern Savanna and Central Bugesera (ESCB), and Eastern plateau (EP). The study was carried out using 186 dairy cows with a mean live weight of 292 Kg in three communal cowsheds. The milk quality analysis was carried out on 418 samples. Methane emission was estimated using prediction equations. Data collected were subjected to ANOVA. The dry matter intake was lower (p<0.05) in the long dry season (7.24 Kg), with the ESCB zone having the highest value of 9.10 Kg, explained by the practice of crop-livestock integration agriculture in that zone. The Dry matter digestibility varied between seasons and zones, ranging from 52.5 to 56.4% for seasons and from 51.9 to 57.5% for zones. The daily protein supply was higher (p<0.05) in the long rain season with 969 g. The mean daily milk production of lactating cows was 5.6 L with a lower value (p<0.05) during the long dry season (4.76 L), and the MPB zone having the lowest value of 4.65 L. The yearly milk production per cow was 1179 L. The milk fat varied from 3.79 to 5.49% with a seasonal and zone variation. No variation was observed with milk protein. The seasonal daily methane emission varied from 150 g for the long dry season to 174 g for the long rain season (p<0.05). The rain season had the highest methane emission as it is associated with high forage intake. The mean emission factor was 59.4 Kg of methane/year. The present EFs were higher than the default IPPC value of 41 Kg from developing countries in African, the Middle East, and other tropical regions livestock EFs using Tier I approach due to the higher live weight in the current study. The methane emission per unit of milk production was lower in the EP zone (46.8 g/L) due to the feed efficiency observed in that zone. Farmers should use high-quality feeds to increase the milk yield and reduce the methane gas produced per unit of milk. For an accurate assessment of the methane produced from dairy farms, there is a need for the use of the Life Cycle Assessment approach that considers all the sources of emissions.

Keywords: footprint, forage, girinka, tier

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Authors: Lu-Chiu Huang, Pei-Pei Chen, Li-Chin Yu, Chiao-Wen Kuo, Tsui-Tao Liu, Rung-Chuang Feng

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Purpose: People put increasing emphasis on demands of medical quality and protecting their interests. Patients' or family's dissatisfaction with medical care may easily lead to medical dispute. Physician-family communication plays an essential role in medical care. A sound communication cannot only strengthen patients' belief in the medical team but make patient have definite insight into treatment course of the disease. A family meeting provides an effective platform for communication between clinical staff, patients and family. Decisions and consensuses formed in family meetings can promote patients' or family's satisfaction with medical care. Clinical staff's attitudes toward family meeting may determine behavioral intentions to hold family meeting. This study aims to explore clinical staff's difficulties in holding family meeting and evaluate how their attitudes and behavior influence the effect of family meetings. Methods: This was a cross-sectional study. It was conducted at a regional teaching hospital in Taipei city. The research team developed its own structural questionnaires, whose expert validity was checked by the nursing experts. Participants filled in the questionnaires online. Data were collected by convenience sampling. A total of 568 participants were invited. They included doctors, nurses, social workers, and so on. Results: 1) The average score of ‘clinical staff’s attitudes to family meetings’ was 5.15 (SD=0.898). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It indicated that clinical staff had positive attitudes toward family meetings, 2) The average score of ‘clinical staff’s behavior to family meetings’ was 5.61 (SD=0.937). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. It meant clinical staff tended to have positive behavior at the family meeting, and 3) The average score of ‘Difficulty in conducting family meetings’ was 5.15 (SD=0.897). It fell between ‘somewhat agree’ and ‘mostly agree’ on the 7-point likert scale. The higher the score was, the less difficulty the clinical staff felt. It demonstrated clinical staff felt less difficulty in conducting family meetings. Clinical staff's identification with family meetings brought favored effects. Persistent and active promotion for family meetings can bring patients and family more benefits. Implications for practice: Understanding clinical staff's difficulty in participating family meeting and exploring their attitudes or behavior toward physician-family communication are helpful to develop modes of interaction. Consequently, quality and satisfaction of physician-family communication can be increased.

Keywords: clinical staff, communication, family meeting, physician-family

Procedia PDF Downloads 327

Authors: Valery Gulyayev, Sergey Glazunov, Elena Andrusenko, Nataliya Shlyun

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Enhancement of technology and techniques for drilling deep directed oil and gas bore-wells are of essential industrial significance because these wells make it possible to increase their productivity and output. Generally, they are used for drilling in hard and shale formations, that is why their drivage processes are followed by the emergency and failure effects. As is corroborated by practice, the principal drilling drawback occurring in drivage of long curvilinear bore-wells is conditioned by the need to obviate essential force hindrances caused by simultaneous action of the gravity, contact and friction forces. Primarily, these forces depend on the type of the technological regime, drill string stiffness, bore-hole tortuosity and its length. They can lead to the Eulerian buckling of the drill string and its sticking. To predict and exclude these states, special mathematic models and methods of computer simulation should play a dominant role. At the same time, one might note that these mechanical phenomena are very complex and only simplified approaches (‘soft string drag and torque models’) are used for their analysis. Taking into consideration that now the cost of directed wells increases essentially with complication of their geometry and enlargement of their lengths, it can be concluded that the price of mistakes of the drill string behavior simulation through the use of simplified approaches can be very high and so the problem of correct software elaboration is very urgent. This paper deals with the problem of simulating the regimes of drilling deep curvilinear bore-wells with prescribed imperfect geometrical trajectories of their axial lines. On the basis of the theory of curvilinear flexible elastic rods, methods of differential geometry, and numerical analysis methods, the 3D ‘stiff-string drag and torque model’ of the drill string bending and the appropriate software are elaborated for the simulation of the tripping in and out regimes and drilling operations. It is shown by the computer calculations that the contact and friction forces can be calculated and regulated, providing predesigned trouble-free modes of operation. The elaborated mathematic models and software can be used for the emergency situations prognostication and their exclusion at the stages of the drilling process design and realization.

Keywords: curvilinear drilling, drill string tripping in and out, contact forces, resistance forces

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Authors: Yangzhi Li

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Network transfer of information and performance customization is now a viable method of digital industrial production in the era of Industry 4.0. Robot platforms and network platforms have grown more important in digital design and construction. The pressing need for novel building techniques is driven by the growing labor scarcity problem and increased awareness of construction safety. Robotic approaches in construction research are regarded as an extension of operational and production tools. Several technological theories related to robot autonomous recognition, which include high-performance computing, physical system modeling, extensive sensor coordination, and dataset deep learning, have not been explored using intelligent construction. Relevant transdisciplinary theory and practice research still has specific gaps. Optimizing high-performance computing and autonomous recognition visual guidance technologies improves the robot's grasp of the scene and capacity for autonomous operation. Intelligent vision guidance technology for industrial robots has a serious issue with camera calibration, and the use of intelligent visual guiding and identification technologies for industrial robots in industrial production has strict accuracy requirements. It can be considered that visual recognition systems have challenges with precision issues. In such a situation, it will directly impact the effectiveness and standard of industrial production, necessitating a strengthening of the visual guiding study on positioning precision in recognition technology. To best facilitate the handling of complicated components, an approach for the visual recognition of parts utilizing machine learning algorithms is proposed. This study will identify the position of target components by detecting the information at the boundary and corner of a dense point cloud and determining the aspect ratio in accordance with the guidelines for the modularization of building components. To collect and use components, operational processing systems assign them to the same coordinate system based on their locations and postures. The RGB image's inclination detection and the depth image's verification will be used to determine the component's present posture. Finally, a virtual environment model for the robot's obstacle-avoidance route will be constructed using the point cloud information.

Keywords: robotic construction, robotic assembly, visual guidance, machine learning

Procedia PDF Downloads 86

Authors: Y. H. Chen, P. Y. Chiang, T. Sugiarto, I. Karsuna, Y. J. Lin, C. C. Chang, W. C. Hsu

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Task-specific training with intense practice of functional tasks has been emphasized for the approaches in motor rehabilitation in patients with hemiplegic strokes. Although reciprocal actions which may increase demands on motor control during seated stepping exercise, motor control is not explicitly trained with emphasis and instruction focused on traditional strengthening. Apart from cycling and treadmill, various forms of seated exerciser are becoming available for the lower extremity exercise. The benefit of seated exerciser has been focused on the effect on the cardiopulmonary system. Thus, the aim of current study is to investigate the effect of seated distance on muscle activation during seated strengthening in patients with stroke with extensor synergy pattern in the lower extremities. Electrodes were placed on the surface of lower limbs muscles, including rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF) and gastrocnemius (GT) of both sides. Maximal voluntary contraction (MVC) of the muscles were obtained to normalize the EMG amplitude obtained during dynamic trials with analog raw data digitized with a sampling frequency of 2000 Hz, fully rectified and the linear enveloped. Movement cycle was separated into two phases by pushing (PP) and Return (RP). Integral EMG (iEMG) is then used to quantify level of activation during each of the phases. Subjects performed strengthening with moderate resistance with speed of 60 rpm in two different distances (D1, short) and (D2, long). The results showed greater iEMG in RF and smaller iEMG in VL and BF with obvious increase range of motion of hip flexion in D1 condition. On the contrary, no significant involvement of RF while greater level of muscular activation in VL and BF during RP was found during PP in D2 condition. In addition, greater hip internal rotation was observed in D2 condition. In patients with stroke with abnormal tone revealed by extensor synergy in the lower extremities, shorter seated distance is suggested to facilitate hip flexor muscle activation while avoid inducing hyper extensor tone which may prevent a smooth repetitive motion. Repetitive muscular contraction exercise of hip flexor may be helpful for further gait training as it may assist hip flexion during swing phase of the walking.

Keywords: seated strengthening, patients with stroke, electromyography, synergy pattern

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Authors: Han-Mei Chen, Rongxin Zhou, Taige Wang

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Glass is widely used in everyday life, from glass bottles for beverages to architectural glass for various forms of glazing. Although the mainstream of used glass is recycled in the UK, the single-use and then recycling procedure results in a lot of waste as it incorporates intact glass with smashing, re-melting, and remanufacturing. These processes bring massive energy consumption with a huge loss of high embodied energy and economic value, compared to re-use, which’s towards a ‘zero carbon’ target. As a tourism city, Liverpool has more glass bottle consumption than most less leisure-focused cities. It’s therefore vital for Liverpool to find an upgrading approach for the single-use glass bottles with low carbon output. This project aims to assess the feasibility of industrial symbiosis and upgrading the framework of glass and to investigate the ways of achieving them. It is significant to Liverpool’s future industrial strategy since it provides an opportunity to target economic recovery for post-COVID by industry symbiosis and up-grading waste management in Liverpool to respond to the climate emergency. In addition, it will influence the local government policy for glass bottle reuse and recycling in North West England and as a good practice to be further recommended to other areas of the UK. First, a critical literature review of glass waste strategies has been conducted in the UK and worldwide industrial symbiosis practices. Second, mapping, data collection, and analysis have shown the current life cycle chain and the strong links of glass reuse and upgrading potentials via site visits to 16 local waste recycling centres. The results of this research have demonstrated the understanding of the influence of key factors on the development of a circular industrial symbiosis business model for beverage glass bottles. The current waste management procedures of the glass bottle industry, its business model, supply chain, and material flow have been reviewed. The various potential opportunities for glass bottle up-valuing have been investigated towards an industrial symbiosis in Liverpool. Finally, an up-valuing business model has been developed for an industrial symbiosis framework of glass in Liverpool. For glass bottles, there are two possibilities 1) focus on upgrading processes towards re-use rather than single-use and recycling and 2) focus on ‘smart’ re-use and recycling, leading to optimised values in other sectors to create a wider industry symbiosis for a multi-level and circular economy.

Keywords: glass bottles, industry symbiosis, smart re-use, waste upgrading

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Authors: Fatema Akram, Mohammad G. Rasul, M. Masud K. Khan, M. Sharif I. I. Amir

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Australia is a country of some 7,700 million square kilometres with a population of about 22.6 million. At present water security is a major challenge for Australia. In some areas the use of water resources is approaching and in some parts it is exceeding the limits of sustainability. A focal point of proposed national water conservation programs is the recycling of both urban storm-water and treated wastewater. But till now it is not widely practiced in Australia, and particularly storm-water is neglected. In Australia, only 4% of storm-water and rainwater is recycled, whereas less than 1% of reclaimed wastewater is reused within urban areas. Therefore, accurately monitoring, assessing and predicting the availability, quality and use of this precious resource are required for better management. As storm-water is usually of better quality than untreated sewage or industrial discharge, it has better public acceptance for recycling and reuse, particularly for non-potable use such as irrigation, watering lawns, gardens, etc. Existing storm-water recycling practice is far behind of research and no robust technologies developed for this purpose. Therefore, there is a clear need for using modern technologies for assessing feasibility of storm-water harvesting and reuse. Numerical modelling has, in recent times, become a popular tool for doing this job. It includes complex hydrological and hydraulic processes of the study area. The hydrologic model computes storm-water quantity to design the system components, and the hydraulic model helps to route the flow through storm-water infrastructures. Nowadays water quality module is incorporated with these models. Integration of Geographic Information System (GIS) with these models provides extra advantage of managing spatial information. However for the overall management of a storm-water harvesting project, Decision Support System (DSS) plays an important role incorporating database with model and GIS for the proper management of temporal information. Additionally DSS includes evaluation tools and Graphical user interface. This research aims to critically review and discuss all the aspects of storm-water harvesting and reuse such as available guidelines of storm-water harvesting and reuse, public acceptance of water reuse, the scopes and recommendation for future studies. In addition to these, this paper identifies, understand and address the importance of modern technologies capable of proper management of storm-water harvesting and reuse.

Keywords: storm-water management, storm-water harvesting and reuse, numerical modelling, geographic information system, decision support system, database

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Authors: Doris Lacej, Eni Bushi

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Cleaning and disinfection procedures are essential for maintaining the cleanliness status of the pharmaceutical manufacturing environment particularly of the cleanrooms and sterile unit area. The Good Manufacturing Practice (GMP) Annex 1 recommendation highly requires the implementation of the standard and validated cleaning and disinfection protocols. However, environmental monitoring has shown that even a validated cleaning method with certified agents may result in the presence of atypical microorganisms’ colony that exceeds GMP limits for a specific cleanroom area. In response to this issue, this case study aims to arrive at the root cause of the microbial contamination observed in the sterile production environment in Profarma pharmaceutical industry in Albania through applying a problem-solving practical approach that ensures the appropriate sterility grade. The guidelines and literature emphasize the importance of several factors in the prevention of possible microbial contamination occurring in cleanrooms, grade A and C. These factors are integrated into a practical framework, to identify the root cause of the presence of Aspergillus Niger colony in the sterile production environment in Profarma pharmaceutical industry in Albania. In addition, the application of a semi-automatic disinfecting system such as H2O2 FOG into sterile grade A and grade C cleanrooms has been an effective solution in eliminating the atypical colony of Aspergillus Niger. Selecting the appropriate detergents and disinfectants at the right concentration, frequency, and combination; the presence of updated and standardized guidelines for cleaning and disinfection as well as continuous training of operators on these practices in accordance with the updated GMP guidelines are some of the identified factors that influence the success of achieving sterility grade. However, to ensure environmental sustainability it is important to be prepared for identifying the source of contamination and making the appropriate decision. The proposed case-based practical approach may help pharmaceutical companies to achieve sterile production and cleanliness environmental sustainability in challenging situations. Apart from the integration of valid agents and standardized cleaning and disinfection protocols according to GMP Annex 1, pharmaceutical companies must be careful and investigate the source and all the steps that can influence the results of an abnormal situation. Subsequently apart from identifying the root cause it is important to solve the problem with a successful alternative approach.

Keywords: cleanrooms, disinfectants, environmental monitoring, GMP Annex 1

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Authors: Xiaoyuan Chen

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Background: This study aimed to characterize the epidemiological and clinical features of five rare subtypes of hepatocellular carcinoma (HCC) and to create a competing risk nomogram for predicting cancer-specific survival. Methods: This study used the Surveillance, Epidemiology, and End Results database to analyze the clinicopathological data of 50,218 patients with classic HCC and five rare subtypes (ICD-O-3 Histology Code=8170/3-8175/3) between 2004 and 2018. The annual percent change (APC) was calculated using Joinpoint regression, and a nomogram was developed based on multivariable competing risk survival analyses. The prognostic performance of the nomogram was evaluated using the Akaike information criterion, Bayesian information criterion, C-index, calibration curve, and area under the receiver operating characteristic curve. Decision curve analysis was used to assess the clinical value of the models. Results: The incidence of scirrhous carcinoma showed a decreasing trend (APC=-6.8%, P=0.025), while the morbidity of other rare subtypes remained stable from 2004 to 2018. The incidence-based mortality plateau in all subtypes during the period. Clear cell carcinoma was the most common subtype (n=551, 1.1%), followed by fibrolamellar (n=241, 0.5%), scirrhous (n=82, 0.2%), spindle cell (n=61, 0.1%), and pleomorphic (n=17, ~0%) carcinomas. Patients with fibrolamellar carcinoma were younger and more likely to have non-cirrhotic liver and better prognoses. Scirrhous carcinoma shared almost the same macro clinical characteristics and outcomes as classic HCC. Clear cell carcinoma tended to occur in the Asia-Pacific elderly male population, and more than half of them were large HCC (Size>5cm). Sarcomatoid (including spindle cell and pleomorphic) carcinoma was associated with larger tumor size, poorer differentiation, and more dismal prognoses. The pathological subtype, T stage, M stage, surgery, alpha-fetoprotein, and cancer history were identified as independent predictors in patients with rare subtypes. The nomogram showed good calibration, discrimination, and net benefits in clinical practice. Conclusion: The rare subtypes of HCC had distinct clinicopathological features and biological behaviors compared with classic HCC. Our findings could provide a valuable reference for clinicians. The constructed nomogram could accurately predict prognoses, which is beneficial for individualized management.

Keywords: hepatocellular carcinoma, pathological subtype, fibrolamellar carcinoma, scirrhous carcinoma, clear cell carcinoma, spindle cell carcinoma, pleomorphic carcinoma

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Authors: Recep Keşli, Gülşah Aşık, Cengiz Demir, Onur Türkyılmaz

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Objective: Serratia species are identified as aerobic, motile Gram negative rods. The species Serratia marcescens (S. marcescens) causes both opportunistic and nosocomial infections. The genus Providencia is Gram-negative bacilli and includes urease-producing that is responsible for a wide range of human infections. Although most Providencia infections involve the urinary tract, they are also associated with gastroenteritis, wound infections, and bacteremia. The aim of this study was evaluate the antimicrobial resistance rates of S. marcescens and Providencia spp. strains which had been isolated from various clinical materials obtained from different patients who belongs to intensive care units (ICU) and inpatient clinics. Methods: A total of 35 S. marcescens and Providencia spp. strains isolated from various clinical samples admitted to Medical Microbiology Laboratory, ANS Research and Practice Hospital, Afyon Kocatepe University between October 2013 and September 2015 were included in the study. Identification of the bacteria was determined by conventional methods and VITEK 2 system (bio-Merieux, Marcy l’etoile, France) was used additionally. Antibacterial resistance tests were performed by using Kirby Bauer disc (Oxoid, Hampshire, England) diffusion method following the recommendations of CLSI. Results: The distribution of clinical samples were as follows: upper and lower respiratory tract samples 26, 74.2 % wound specimen 6, 17.1 % blood cultures 3, 8.5%. Of the 35 S. marcescens and Providencia spp. strains; 28, 80% were isolated from clinical samples sent from ICU. The resistance rates of S. marcescens strains against trimethoprim-sulfamethoxazole, piperacillin-tazobactam, imipenem, gentamicin, ciprofloxacin, ceftazidime, cefepime and amikacin were found to be 8.5 %, 22.8 %, 11.4 %, 2.8 %, 17.1 %, 40 %, 28.5 % and 5.7 % respectively. Resistance rates of Providencia spp. strains against trimethoprim-sulfamethoxazole, piperacillin-tazobactam, imipenem, gentamicin, ciprofloxacin, ceftazidime, cefepime and amikacin were found to be 10.2 %, 33,3 %, 18.7 %, 8.7 %, 13.2 %, 38.6 %, 26.7%, and 11.8 % respectively. Conclusion: S. marcescens is usually resistant to ampicillin, amoxicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefuroxime, cephamycins, nitrofurantoin, and colistin. The most effective antibiotic on the total of S. marcescens strains was found to be gentamicin 2.8 %, of the totally tested strains the highest resistance rate found against to ceftazidime 40 %. The lowest and highest resistance rates were found against gentamiycin and ceftazidime with the rates of 8.7 % and 38.6 % for Providencia spp.

Keywords: Serratia marcescens, Providencia spp., antibiotic resistance, intensive care unit

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Authors: Anilkumar L. Rathod

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This paper examines event tourism as a field of study and area of professional practice updating the previous review article published in 2015. In this substantially extended review, a deeper analysis of the field's evolution and development is presented, charting the growth of the literature, focusing both chronologically and thematically. A framework for understanding and creating knowledge about events and tourism is presented, forming the basis which signposts established research themes and concepts and outlines future directions for research. In addition, the review article focuses on constraining and propelling forces, ontological advances, contributions from key journals, and emerging themes and issues. It also presents a roadmap for research activity in event tourism. Published scholarly studies within this period are examined through content analysis, using such keywords as knowledge management, organizational learning, hospitality, tourism, tourist destinations, travel industry, hotels, lodging, motels, hotel industry, gaming, casino hotel and convention to search scholarly research journals. All contributions found are then screened for a hospitality and tourism theme. Researchers mostly discuss knowledge management approach in improving information technology, marketing and strategic planning in order to gain competitive advantage. Overall, knowledge management research is still limited. Planned events in tourism are created for a purpose, and what was once the realm of individual and community initiatives has largely become the realm of professionals and entrepreneurs provides a typology of the four main categories of planned events within an event-tourism context, including the main venues associated with each. It also assesses whether differences exist between socio-demographic groupings. An analysis using primarily descriptive statistics indicated both sub-samples had similar viewpoints although Maharashtra residents tended to have higher scores pertaining to the consequences of gambling. It is suggested that the differences arise due to the greater exposure of Maharashtra residents to the influences of casino development.

Keywords: organizational learning, hospitality, tourism, tourist destinations, travel industry, hotels, lodging, motels, hotel industry, gaming, casino hotel and convention to search scholarly research journals

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Authors: Rima Mammadova

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Azerbaijan is a developing country that tries to keep its own culture and traditions. At the same time tries to get benefit from the experience and knowledge of the developed countries. After the collapse of the Soviet Union, Azerbaijan got its independence and currently, implements various programs and policy initiatives to the development of different fields, such as an education, human rights, etc. Disability related issues are also in the main priority list of the country. During the Soviet Union, children with disabilities studied in the special schools, which called boarding schools. They were isolated from the society and most of them were not able to get their higher education. As the result of this kind of tendency, they were in dependence on their parents, relatives and especially the government, as there were several kind of pensions provided by the government depending on the level of disability. Although Azerbaijan maintain different programs, the remnants of the Soviet period still exists. This paper investigates the current situation in Azerbaijan concerning the higher education of people with disabilities. Qualitative and quantitative research methods used in this paper. As a qualitative method a literature review was done on what the term “disability” is and what kind of education rights possess people with disabilities in Azerbaijan. A detailed research also was done on legislation of the Republic of Azerbaijan concerning the education rights of people with disabilities in Azerbaijan. As a quantitative method, questionnaire was used. The questionnaires were sent to the 8 Azerbaijani Higher Education Institutions (HEIs) which are located in different regions of Azerbaijan in order to assess and evaluate the situation concerning the students with disabilities. The main aims of these questionnaires were to find out how many students with disabilities study in Higher Education Institutions in 8 HEIs and what kind of obstacles and challenges Institutions face concerning the education of students with disabilities. The researches provided for the project brought up the results that people with disabilities possess all rights concerning the education rights legally. However in the practice they face various types of obstacles and challenges. The number of students with disabilities in HEIs in Azerbaijan is significantly low. There are several kind of reasons that affect the number of students with disabilities in HEIs. As was mentioned before the remnants of the Soviet period exists in Azerbaijan and children with disabilities get their education in boarding schools and in most cases, these boarding schools give education till the 9th class, but to enter the University, pupils have to finish 11 classes in Azerbaijan. As a result, pupils with disabilities automatically disqualify to enter the university. The paper comes into conclusion that to eliminate the isolation of pupils with disabilities from HEIs, the government should pay more attention to the special schools for the pupils with disabilities, the boarding schools should be cancelled and etc. By the applying these kind of changes the rights of people with disabilities will be provided not only theoretically but also practically.

Keywords: Azerbaijan, disability, students with disabilities, boarding schools

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Authors: Housein Deli, Loui Al-Shrouf, Hammoud Al Joumaa, Mohieddine Jelali

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When forming metallic materials, fluctuations in material properties, process conditions, and wear lead to deviations in the component geometry. Several hundred features sometimes need to be measured, especially in the case of functional and safety-relevant components. These can only be measured offline due to the large number of features and the accuracy requirements. The risk of producing components outside the tolerances is minimized but not eliminated by the statistical evaluation of process capability and control measurements. The inspection intervals are based on the acceptable risk and are at the expense of productivity but remain reactive and, in some cases, considerably delayed. Due to the considerable progress made in the field of condition monitoring and measurement technology, permanently installed sensor systems in combination with machine learning and artificial intelligence, in particular, offer the potential to independently derive forecasts for component geometry and thus eliminate the risk of defective products - actively and preventively. The reliability of forecasts depends on the quality, completeness, and timeliness of the data. Measuring all geometric characteristics is neither sensible nor technically possible. This paper, therefore, uses the example of car seat rail production to discuss the necessary first step of feature selection and reduction by correlation analysis, as otherwise, it would not be possible to forecast components in real-time and inline. Four different car seat rails with an average of 130 features were selected and measured using a coordinate measuring machine (CMM). The run of such measuring programs alone takes up to 20 minutes. In practice, this results in the risk of faulty production of at least 2000 components that have to be sorted or scrapped if the measurement results are negative. Over a period of 2 months, all measurement data (> 200 measurements/ variant) was collected and evaluated using correlation analysis. As part of this study, the number of characteristics to be measured for all 6 car seat rail variants was reduced by over 80%. Specifically, direct correlations for almost 100 characteristics were proven for an average of 125 characteristics for 4 different products. A further 10 features correlate via indirect relationships so that the number of features required for a prediction could be reduced to less than 20. A correlation factor >0.8 was assumed for all correlations.

Keywords: long-term SHM, condition monitoring, machine learning, correlation analysis, component prediction, wear prediction, regressions analysis

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Authors: A. Tamimi, S. Greatrex-White, A. Narayanasamy

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Background: Spirituality has been increasingly acknowledged in the nursing literature as an important element of holistic patient care. To date there have been numerous studies investigating the meaning of spirituality in Western cultures. Spirituality in Middle Eastern countries however remains under-researched. We will present a study which aimed to address this gap. Aim: The study aimed to explore how spirituality manifests in the lives of Jordanian End Stage Renal Failure (ESRF) patients. Methodology and Method: A hermeneutic phenomenological approach was adopted informed by the philosophy of Martin Heidegger. Participants (n=27) were recruited from four different dialysis units: in a public hospital, a private hospital, an educational hospital and a refugee’s hospital in Jordan. Data was collected through in-depth unstructured interviews. Data Analysis: Analysis was guided by the tenets of hermeneutic phenomenology namely: gaining immediate sense of what was said both during and after each interview, transcribing data verbatim, translating interviews into the English language, intensive reading and re-reading, seeking meaning units by line to line coding, developing situated structures (how spirituality was manifest in each text), developing a general structure from the individual situated structures (how the phenomenon ‘spirituality’ comes into being). Findings: Three major themes emerged from analysis: Religion, Relationships and Desperation. We will argue that a ‘secular’ concept of spirituality had no meaning for the participants in the study. Spirituality is fundamentally part of religion and vice versa. Discussion: The findings may have consequences for the use of spirituality in multi-cultural settings in Western countries. Additionally, findings highlighted an important emphasis on the practice of spirituality, often underestimated in previous literature for Arab-Muslim Jordanian patients. Conclusion: The study findings contribute to the existing gap in knowledge regarding how Arab-Muslim Jordanian ESRF patients experience spirituality during their illness. It provides valuable insights into the importance of spirituality for this patient group and suggests how nurses, educators and policy makers might help address ESRF patients’ spiritual needs and provide appropriate spiritual care. We suggest the findings may have relevance beyond the Jordanian context in educating nurses’ on the importance of appreciating the religious dimension of spirituality.

Keywords: spirituality, nursing, muslim, Jordan

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Authors: Gabrielle Brand, Christopher Etherton-Beer

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The learning landscape of higher education environment is changing, with an increased focus over the past decade on how educators might begin to cultivate reflective skills in health professions students. In addition, changing professional requirements demand that health professionals are adequately prepared to practice in today’s complex Australian health care systems, including responding to changing demographics of population ageing. To counteract a widespread perception of health professions students’ disinterest in caring for older persons, the authors will report on an exploratory, mixed method research study that used photographs, narrative and small group work to enhance medical and nursing students’ reflective learning experience. An innovative photo-elicitation technique and reflective questioning prompts were used to increase engagement, and challenge students to consider new perspectives (around ageing) by constructing shared storylines in small groups. The qualitative themes revealed how photographs, narratives and small group work created learning spaces for reflection whereby students could safely explore their own personal and professional values, beliefs and perspectives around ageing. By providing the space for reflection, the students reported how they found connection and meaning in their own learning through a process of self-exploration that often challenged their assumptions of both older people and themselves as future health professionals. By integrating cognitive and affective elements into the learning process, this research demonstrates the importance of embedding visual methodologies that enhance reflection and transformative learning. The findings highlight the importance of integrating the arts into predominantly empirically driven health professional curricula and can be used as a catalyst for individual and/or collective reflection which can potentially enhance empathy, insight and understanding of the lived experiences of older patients. Based on these findings, the authors have developed ‘Depth of Field: Exploring Ageing’ an innovative, interprofessional, digital reflective learning resource that uses Prezi Inc. software (storytelling tool that presents ideas on a virtual canvas) to enhance students’ reflective capacity in the higher education environment.

Keywords: narrative, photo-elicitation, reflective learning, qualitative research

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Authors: Mei Lin, Chang Liu

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Argumentative writing is the most prevalent genre in diverse writing tests. How to construct academic arguments is often regarded as a difficult task by most English as a foreign language (EFL) learners. A failure to generate enough ideas and organise them coherently and logically as well as a lack of competence in supporting their arguments with relevant evidence are frequent problems faced by EFL learners when approaching an English argumentative writing task. Overall, these problems are closely related to planning, and planning an argumentative writing at pre-writing stage plays a vital role in a good academic essay. However, how teachers can effectively guide students to generate ideas is rarely discussed in planning English argumentative writing, apart from brainstorming. Brainstorming has been a common practice used by teachers to help students generate ideas. However, some limitations of brainstorming suggest that it can help students generate many ideas, but ideas might not necessarily be coherent and logic, and could sometimes impede production. It calls for a need to explore effective instructional strategies at pre-writing stage of English argumentative writing. This paper will first examine how a Six Thinking Hats approach can be used to provide a dialogic space for EFL learners to experience and collaboratively generate ideas from multiple perspectives at pre-writing stage. Part of the findings of the impact of a twelve-week intervention (from March to July 2021) on students learning to generate ideas through engaging in group discussions of using Six Thinking Hats will then be reported. The research design is based on the sociocultural theory. The findings present evidence from a mixed-methods approach and fifty-nine participants from two first-year undergraduate natural classes in a Chinese university. Analysis of pre- and post- questionnaires suggests that participants had a positive attitude toward the Six Thinking Hats approach. It fosters their understanding of prewriting and argumentative writing, helps them to generate more ideas not only from multiple perspectives but also in a systematic way. A comparison of participants writing plans confirms an improvement in generating counterarguments and rebuttals to support their arguments. Above all, visual and transcripts data of group discussion collected from different weeks throughout the intervention enable teachers and researchers to ‘see’ the hidden process of learning to generate ideas in action.

Keywords: argumentative writing, innovative pedagogy, six thinking hats, dialogic space, prewriting, higher education

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Authors: Comsun Thongchai, Vorapoj Promasatayaprot

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Background: Child development center is a day care center that gathers large numbers of children in the same areas. As a result, it provides high opportunity for infection, especially gastrointestinal and respiratory infections. Ubon Ratchathani has been a province with an increasing number of cases of Hand foot and mouth disease each year reported between 2014 and 2016. Accorded to a recent investigation reported, HFMD occurred in the Child Development Center and kindergartens, this was a place where HFMD spreads. This research was aimed to investigate the knowledge, attitude and behavior about hand foot and mouth disease preventing of child caregivers in child development centers, Ubon Ratchathani Province. Method: Descriptive study was conducted between April and July, 2017. The study instruments used questionnaires and in-depth interviews on their practices of prevention and environment management of HFMD. The samples of survey questionnaires were caregivers who are working in 160 child development centers of the 160 parishes in Ubon Ratchathani province. The data was analyzed by percentages, means and standard deviations and Pearson Product Moment Correlation Coefficient. Result: The results showed that the majority were female (96.3%), average age 41 years (68.3%), marital status were couples (85.7%) and studied in undergraduate (75.2%). with a period of performance as teachers in child development centers range from 10 to 14 years were percentage 58.7 and 71.8 percent of them had been trained by health worker about the control HFMD. The knowledge for preventive in hand foot mouth disease on child caregivers was at high level. The mean score was 2.76 (S.D. = 0.114). The attitude of child caregivers was at a moderate level. Its mean score was 2.28 (S.D. = 0.247). On the other hand, the level of environmental management to prevent HFMD was low. The mean score was 1.34 (S.D. = 0.215). The factor of personal characteristics as gender, age, educational level, duration at work, knowledge and attitude of preventive HFMD was associated with Preventive of Behaviors to a statistically significant level (p<0.05 respectively). Conclusion: These results should be concerned to develop knowledge and improving practice for preventive hand foot mouth disease of child caregivers in child development centers by training. Preparation of media education, Surveillance of hand foot mouth disease and health behaviors promotion with community participation need to be supported continuously.

Keywords: preventive behavior, child development center, hand foot mouth disease, Thailand

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Authors: Angelis P. Barlampas

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Objective: The confusion of terms is a common practice in many situations of the everyday life. But, in some circumstances, such as in medicine, the precise meaning of a word curries a critical role for the health of the patient. Fahr disease and Fahr syndrome are often falsely used interchangeably, but they are two different conditions with different physical histories of different etiology and different medical management. A case of the seldom Fahr disease is presented, and a comparison with the more common Fahr syndrome follows. Materials and method: A 72 years old patient came to the emergency department, complaining of some kind of non specific medal disturbances, like anxiety, difficulty of concentrating, and tremor. The problems had a long course, but he had the impression of getting worse lately, so he decided to check them. Past history and laboratory tests were unremarkable. Then, a computed tomography examination was ordered. Results: The CT exam showed bilateral, hyperattenuating areas of heavy, dense calcium type deposits in basal ganglia, striatum, pallidum, thalami, the dentate nucleus, and the cerebral white matter of frontal, parietal and iniac lobes, as well as small areas of the pons. Taking into account the absence of any known preexisting illness and the fact that the emergency laboratory tests were without findings, a hypothesis of the rare Fahr disease was supposed. The suspicion was confirmed with further, more specific tests, which showed the lack of any other conditions which could probably share the same radiological image. Differentiating between Fahr disease and Fahr syndrome. Fahr disease: Primarily autosomal dominant Symmetrical and bilateral intracranial calcifications The patient is healthy until the middle age Absence of biochemical abnormalities. Family history consistent with autosomal dominant Fahr syndrome :Earlier between 30 to 40 years old. Symmetrical and bilateral intracranial calcifications Endocrinopathies: Idiopathic hypoparathyroidism, secondary hypoparathyroidism, hyperparathyroidism, pseudohypoparathyroidism ,pseudopseudohypoparathyroidism, e.t.c The disease appears at any age There are abnormal laboratory or imaging findings. Conclusion: Fahr disease and Fahr syndrome are not the same illness, although this is not well known to the inexperienced doctors. As clinical radiologists, we have to inform our colleagues that a radiological image, along with the patient's history, probably implies a rare condition and not something more usual and prompt the investigation to the right route. In our case, a genetic test could be done earlier and reveal the problem, and thus avoiding unnecessary and specific tests which cost in time and are uncomfortable to the patient.

Keywords: fahr disease, fahr syndrome, CT, brain calcifications

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Authors: Catherine Peyrols Wu

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Intercultural interactions are becoming increasingly common in organizations and life. These interactions are often the stage of miscommunication and conflict. In management research, these problems are commonly attributed to cultural differences in values and interactional norms. As a result, the notion that intercultural competence can minimize these challenges is widely accepted. Cultural differences, however, are not the only source of a challenge during intercultural interactions. The need to rely on a lingua franca – or common language between people who have different mother tongues – is another important one. In theory, a lingua franca can improve communication and ease coordination. In practice however, disparities in people’s ability and confidence to communicate in the language can exacerbate tensions and generate inefficiencies. In this study, we draw on power theory to develop a model of disparities in language competence and conflict in a multicultural work context. Specifically, we hypothesized that differences in language competence between interaction partners would be positively related to conflict such that people would report greater conflict with partners who have more dissimilar levels of language competence and lesser conflict with partners with more similar levels of language competence. Furthermore, we proposed that cultural intelligence (CQ) an intercultural competence that denotes an individual’s capability to be effective in intercultural situations, would weaken the relationship between disparities in language competence and conflict such that people would report less conflict with partners who have more dissimilar levels of language competence when the interaction partner has high CQ and more conflict when the partner has low CQ. We tested this model with a sample of 135 undergraduate students working in multicultural teams for 13 weeks. We used a round-robin design to examine conflict in 646 dyads nested within 21 teams. Results of analyses using social relations modeling provided support for our hypotheses. Specifically, we found that in intercultural dyads with large disparities in language competence, partners with the lowest level of language competence would report higher levels of interpersonal conflict. However, this relationship disappeared when the partner with higher language competence was also high in CQ. These findings suggest that communication in a lingua franca can be a source of conflict in intercultural collaboration when partners differ in their level of language competence and that CQ can alleviate these effects during collaboration with partners who have relatively lower levels of language competence. Theoretically, this study underscores the benefits of CQ as a complement to language competence for intercultural effectiveness. Practically, these results further attest to the benefits of investing resources to develop language competence and CQ in employees engaged in multicultural work.

Keywords: cultural intelligence, intercultural interactions, language competence, multicultural teamwork

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Authors: Xiaohong Li, Wenfan Yan

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Background: While it is widely considered that the university library plays a critical role in fulfilling the institution's mission and providing students’ learning experience beyond the classrooms, how the technology-enhanced library reform changed college students’ learning experience hasn’t been thoroughly investigated. The purpose of this study is to explore how technology-enhanced library reform affects students’ learning experience and career readiness and further identify the factors and effective conditions that enable the quality learning outcome of Chinese college students. Methodologies: This study selected the qualitative comparative analysis (QCA) method to explore the effects of technology-enhanced university library reform on college students’ learning experience and career readiness. QCA is unique in explaining the complex relationship between multiple factors from a holistic perspective. Compared with the traditional quantitative and qualitative analysis, QCA not only adds some quantitative logic but also inherits the characteristics of qualitative research focusing on the heterogeneity and complexity of samples. Shenyang Normal University (SNU) selected a sample of the typical comprehensive university in China that focuses on students’ learning and application of professional knowledge and trains professionals to different levels of expertise. A total of 22 current university students and 30 graduates who joined the Library Readers Association of SNU from 2011 to 2019 were selected for semi-structured interviews. Based on the data collected from these participating students, qualitative comparative analysis (QCA), including univariate necessity analysis and the multi-configuration analysis, was conducted. Findings and Discussion: QCA analysis results indicated that the influence of technology-enhanced university library restructures and reorganization on student learning experience and career readiness is the result of multiple factors. Technology-enhanced library equipment and other hardware restructured to meet the college students learning needs and have played an important role in improving the student learning experience and learning persistence. More importantly, the soft characteristics of technology-enhanced library reform, such as library service innovation space and culture space, have a positive impact on student’s career readiness and development. Technology-enhanced university library reform is not only the change in the building's appearance and facilities but also in library service quality and capability. The study also provides suggestions for policy, practice, and future research.

Keywords: career readiness, college student learning experience, qualitative comparative analysis (QCA), technology-enhanced library reform

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Authors: Ali Benali Djouher Leila

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Labiovelarization of velar consonants and labials is a very widespread phenomenon. It is attested in all the major northern Berber dialects. Only the Tuareg is totally unaware of it. But, even within the large Berber-speaking regions of the north, it is very unstable: it may be completely absent in certain dialects (such as the Bougie region in Kabylie), and its extension and frequency can vary appreciably between the dialects which know it. Some dialects of Great Kabylia or the Chleuh domain, for example, "labiovélarize" more than others from the same region. Thus, in Great Kabylia, the adjective "large" will be pronounced: amqqwran with the At Yiraten and amqqran with the At Yanni, a few kilometers away. One of the problems with them is deciding whether it is one or two phonemes. All the criteria used by linguists in this kind of case lead to the conclusion that they are unique phonemes (a phoneme and not a succession of two phonemes, / k + w /, for example). The phonetic and phonological criteria are moreover clearly confirmed by the morphological data since, in the system of verbal alternations, these complex segments are treated as single phonemes: agree, "to draw, to fetch water," akwer, "to fly," have exactly the same morphology as as "jealous," arem" taste," Ames, "dirty" or afeg, "steal" ... verbs with two radical consonants (type aCC). At the level of notation, both scientific and usual, it is, therefore, necessary to represent the labiovélarized by a single letter, possibly accompanied by a diacritic. In fact, actual practices are diverse. - The scientific representation of type does not seem adequate for current use because its realization is easy only on a microcomputer. The Berber Documentation File used a small ° (of n °) above the writing line: k °, g ° ... which has the advantage of being easy to achieve since it is part of general typographical conventions in Latin script and that it is present on a typewriter keyboard. Mouloud Mammeri, then the Berber Study Group of Vincennes (Tisuraf review), and a majority of Kabyle practitioners over the last twenty years have used the succession "consonant +" semi-vowel / w / "(CW) on the same line of writing; for all the reasons explained previously, this practice is not a good solution and should be abandoned, especially as it particularizes Kabyle in the Berber ensemble. In this study, we were interested in two velar consonants, / g / and / k /, labiovellarized: / gw / and the / kw / (we adopted the addition of the "w") for the representation for ease of writing in graphical mode. It is a question of trying to characterize these four consonants in order to see if they have different places of articulation and if they are distinct (if these velars are distinct from their labiovellarized counterpart). This characterization is done using locus equations.

Keywords: berber consonants;, labiovelarization, locus equations, acoustical caracterization, kabylian dialect, algerian language

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Authors: Chikang Wang, Jhongjheng Jian, Poming Huang

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Among a wide variety of pharmaceutical compounds, tetracycline antibiotics are one of the largest groups of pharmaceutical compounds extensively used in human and veterinary medicine to treat and prevent bacterial infections. Because it is water soluble, biologically active, stable and bio-refractory, release to the environment threatens aquatic life and increases the risk posed by antibiotic-resistant pathogens. In practice, due to its antibacterial nature, tetracycline cannot be effectively destructed by traditional biological methods. Hence, in this study, two advanced oxidation processes such as ozonation and sono-Fenton processes were conducted individually to degrade the tetracycline for investigating their feasibility on tetracycline degradation. Effect of operational variables on tetracycline degradation, release of nitrogen and change of toxicity were also proposed. Initial tetracycline concentration was 50 mg/L. To evaluate the efficiency of tetracycline degradation by ozonation, the ozone gas was produced by an ozone generator (Model LAB2B, Ozonia) and introduced into the reactor with different flows (25 - 500 mL/min) at varying pH levels (pH 3 - pH 11) and reaction temperatures (15 - 55°C). In sono-Fenton system, an ultrasonic transducer (Microson VCX 750, USA) operated at 20 kHz combined with H₂O₂ (2 mM) and Fe²⁺ (0.2 mM) were carried out at different pH levels (pH 3 - pH 11), aeration gas and flows (air and oxygen; 0.2 - 1.0 L/min), tetracycline concentrations (10 - 200 mg/L), reaction temperatures (15 - 55°C) and ultrasonic powers (25 - 200 Watts), respectively. Sole ultrasound was ineffective on tetracycline degradation, where the degradation efficiencies were lower than 10% with 60 min reaction. Contribution of Fe²⁺ and H₂O₂ on the degradation of tetracycline was significant, where the maximum tetracycline degradation efficiency in sono-Fenton process was as high as 91.3% followed by 45.8% mineralization. Effect of initial pH level on tetracycline degradation was insignificant from pH 3 to pH 6 but significantly decreased as the pH was greater than pH 7. Increase of the ultrasonic power was slightly increased the degradation efficiency of tetracycline, which indicated that the hydroxyl radicals dominated the oxidation of tetracycline. Effects of aeration of air or oxygen with different flows and reaction temperatures were insignificant. Ozonation showed better efficiencies in tetracycline degradation, where the optimum reaction condition was found at pH 3, 100 mL O₃/min and 25°C with 94% degradation and 60% mineralization. The toxicity of tetracycline was significantly decreased due to the mineralization of tetracycline. In addition, less than 10% of nitrogen content was released to solution phase as NH₃-N, and the most degraded tetracycline cannot be full mineralized to CO₂. The results shown in this study indicated that both the sono-Fenton process and ozonation can effectively degrade the tetracycline and reduce its toxicity at profitable condition. The costs of two systems needed to be further investigated to understand the feasibility in tetracycline degradation.

Keywords: degradation, detoxification, mineralization, ozonation, sono-Fenton process, tetracycline

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Authors: Lisa Bennett, Cynthia Walters, Cynthia Argani, Andy Satin, Geeta Sood, Kerri Huber, Lisa Grubb, Woodrow Noble, Melissa Eichelberger, Darlene Zinalabedini, Eric Ausby, Jeffrey Snyder, Kevin Kirchoff

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Background: Surgical site infections (SSIs) within the obstetric population pose a variety of complications, creating clinical and personal challenges for the new mother and her neonate during the postpartum period. Our journey to achieve compliance with the SSI core measure for cesarean sections revealed many opportunities to improve these outcomes. Objective: Achieve and sustain core measure compliance keeping surgical site infection rates below the national benchmark pooled mean of 1.8% in post-operative patients, who delivered via cesarean section at the Johns Hopkins Bayview Medical Center. Methods: A root cause analysis was performed and revealed several environmental, pharmacologic, and clinical practice opportunities for improvement. A multidisciplinary approach led by the OB Safety Nurse, OB Medical Director, and Infectious Disease Department resulted in the implementation of fourteen interventions over a twenty-month period. Interventions included: post-operative dressing changes, standardizing operating room attire, broadening pre-operative antibiotics, initiating vaginal preps, improving operating room terminal cleaning, testing air quality, and re-educating scrub technicians on technique. Results: Prior to the implementation of our interventions, the SSI quarterly rate in Obstetrics peaked at 6.10%. Although no single intervention resulted in dramatic improvement, after implementation of all fourteen interventions, the quarterly SSI rate has subsequently ranged from to 0.0% to 2.70%. Significance: Taking an introspective look at current practices can reveal opportunities for improvement which previously were not considered. Collectively the benefit of these interventions has shown a significant decrease in surgical site infection rates. The impact of this quality improvement project highlights the synergy created when members of the multidisciplinary team work in collaboration to improve patient safety, and achieve a high quality of care.

Keywords: cesarean section, surgical site infection, collaboration and teamwork, patient safety, quality improvement

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Authors: Robson da Cunha Santos, Caio Cezar R. Bonifacio, Diego Mureb Quesada, Gerson Gomes Cunha

Abstract:

The paper is related to the safety of oil wells and environmental preservation on the planet, because they require great attention and commitment from oil companies and people who work with these equipments. This must occur from drilling the well until it is abandoned in order to safeguard the environment and prevent possible damage. The project had as main objective the constitution resulting from comparatives made among books, articles and publications with information gathered in technical visits to operational bases of Petrobras. After the visits, the information from methods of utilization and present managements, which were not available before, became available to the general audience. As a result, it is observed a huge flux of incorrect and out-of-date information that comprehends not only bibliographic archives, but also academic resources and materials. During the gathering of more in-depth information on the manufacturing, assembling, and use aspects of DHSVs, several issues that were previously known as correct, customary issues were discovered to be uncertain and outdated. Information of great importance resulted in affirmations about subjects as the depth of the valve installation that was before installed to 30 meters from the seabed (mud line). Despite this, the installation should vary in conformity to the ideal depth to escape from area with the biggest tendency to hydrates formation according to the temperature and pressure. Regarding to valves with nitrogen chamber, in accordance with books, they have their utilization linked to water line ≥ 700 meters, but in Brazilian exploratory fields, their use occurs from 600 meters of water line. The valves used in Brazilian fields are able to be inserted to the production column and self-equalizing, but the use of screwed valve in the column of production and equalizing is predominant. Although these valves are more expensive to acquire, they are more reliable, efficient, with a bigger shelf life and they do not cause restriction to the fluid flux. It follows that based on researches and theoretical information confronted to usual forms used in fields, the present project is important and relevant. This project will be used as source of actualization and information equalization that connects academic environment and real situations in exploratory situations and also taking into consideration the enrichment of precise and easy to understand information to future researches and academic upgrading.

Keywords: down hole safety valve, security devices, installation, oil-wells

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